L11.1 Larynx and Phonation Flashcards
1
Q
Larynx Position
A
- Begins at epiglottis → lower border of cricoid cartilage (at C6)
- Hyoid bone at the top
- Above 1st tracheal ring
2
Q
Thyroid cartilage
A
- Prominent angle ANT (adam’s apple)
- Deficient POS → forms laryngeal inlet (where air gets in and out)
- 2 Laminas, one on each side
- INF horn articulates with cricoid cartilage
3
Q
Cricoid cartilage
A
- Closed
- Short ANT arch
- Tall POS lamina
4
Q
Arytenoid cartilages
A
- P-L aspect above lamina
- Pyramidal, apex at top (pointing up)
- Vocal process INF → projects into space of larynx
- Forms attaches to vocal ligaments
- Muscular process points out
- Muscles pulling on process → allows ADD/AB of vocal processes
- Muscles b/w the arytenoid cartilage → produce Sliding movement pulling processes towards midline
5
Q
Epiglottic cartilage
A
- Has POS attachment to adam’s apple → projects up to behind hyoid bone and POS surface of the tongue
6
Q
Membranes b/w cartilage
A
- Thyrohyoid membrane
- Cricothyroid membrane/ligament → important for management of emergency airway
- Quadrangular membrane → attaches from arytenoid cartilage to LAT surface of epiglottic cartilage
- INF free edge → vestibular ligament
- SUP free edge → aryepiglottic ligament
7
Q
Vocal ligaments
A
- Vocal ligaments projects ANT towards the midline, below the epiglottic cartilage
- Vibrates against each other to produce sound
8
Q
Aryepiglottic fold
A
- Hooks around underneath of vestibular ligament → project LAT → along wall of thyroid cartilage → top of vocal ligaments → continuous down the airway
- Space b/w 2 folds = ventricles
- Ligament underneath
9
Q
True/False vocal cords
A
- True vocal cords → Vocal folds
- Relatively avascular
- False vocal cords → vestibular folds (does not produce sound)
- A protective barrier for the vocal folds beneath
- Produces sound in cats
10
Q
Rima glottis
A
- Space b/w vocal ligaments
11
Q
Function of AB/ADD of vocal ligaments
A
- AB → breathing
- ADD → phonation
- Manipulate movements/geometry of vocal ligaments → affects pitch of sound produced
- High pitch → ligaments stretched and tightened
- Manipulate movements/geometry of vocal ligaments → affects pitch of sound produced
12
Q
POS cricoarytenoid
A
- Cricoid → muscular aspect of aryetenoid
- AB vocal fold
- Only muscle which AB vocal folds (critical for breathing)
13
Q
LAT cricoarytenoid
A
- LAT cricoid → muscular aspect of aryetenoid
- Oppose action of POS C.A
- ADD vocal folds (pulling muscular process away from each other)
14
Q
Vocalis and thyroarytenoid
A
- Vocalis along vocal ligament
- Both work together to pull ANT thryoid cart back to arytenoid cart → Relax vocal ligaments
- Low pitched
15
Q
Cricothyroid
A
- Pull back of thyroid cart fwd → tighten vocal ligaments
- High pitch
- Oppose thyroarytenoid & Vocalis
16
Q
Transverse and oblique arytenoid
A
- Pull aryetenoid tgt twd midline (sliding mechanism)
- Closes Rima glottis → help LAT C.A bringing vocal lig together
17
Q
Nerves of the larynx
A
- Branches of vagus N
- SUP laryngeal
- INF recurrent laryngeal
18
Q
SUP laryngeal
A
- SUP laryngeal N branches into:
- internal laryngeal → through deficiency in thyrohyoid membrane
- Sensory to upper mucosa (above level of vocal ligament)
- ex laryngeal
- Motor → Cricothyroid muscles
- internal laryngeal → through deficiency in thyrohyoid membrane
19
Q
INF recurrent laryngeal
A
- supply mucosa INF to ligament and all other intrinsic muscles
- May be damaged when operating on patent ductus arteriosum
- All AB/ADD muscles damaged on that side (except for cricothyroid)
- Unable to add vocal ligaments on that side → hoarse voice and stridor (sense of effect on talking - ↑energy needed to get folds vibrating tgt)
20
Q
BS of the larynx
A
- S/I thyroid branches → S/I laryngeal branches
- Vessels are directly superficial to trachea
21
Q
Emergency airways
A
- Cricothryoid puncture
- Only do tracheotomy under full surgical conditions (consider the BVs in there)
- Intubation tube for artificial ventilation
- May damage surrounding structures
