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RESP. ANATOMY > L6 Anatomy of Larynx > Flashcards

L6 Anatomy of Larynx Flashcards

1
Q

What are the function of larynx ?

A
  1. Guarding the airways during swallowing ( most important )

2. Organ of voice production with the help of lungs and others

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2
Q

What is the structure and position of larynx ?

A

Structure : made of 9 cartilages connected by ligaments and membranes

Position : from C3 to C6 however it is extend to C2 ( axis vertebra ) or C1 ( atlas vertebra ) in children making them able to swallow and breath in the same time

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3
Q

What is the component of laryngeal wall ?

A
  1. Mucosa ( inner )
  2. Submucosa
  3. CT
  4. Muscles
  5. Cartilages ( outer )
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4
Q

What are the cartilages of larynx? Which are important (i) which is not (n) ?

A

3 unpaired (=3)

  1. Thyroid (i)
  2. Cricoid (i)
  3. Epiglottis (i)

3 paired (=6)

  1. Artynoid (i)
  2. Corniculate (n)
  3. Cuniform (n)
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5
Q

What is the thyroid cartilage structure? To what does it attach ?

A

Thyroid cartilage is the largest hyaline cartilage

Structure:-
Anteriorly :
- 2 laminae-fuse anteriorly to form the laryngeal prominence (Adam’s apple)

Posteriorly:
Two lamellar projections —

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6
Q

What is the structure of cricoid cartilage ?

A

It is a hyaline ring that has :

  • arch anteriorly
  • lamella posteriorly ( artynoid cartilage is attached to the upper boarder to of the lamellar )
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7
Q

What is the structure of artynoid cartilage ?

A

It is made by two types of cartilages:

  • lower part … hyaline
  • upper part … elastic ( which articulate with the elastic corniculate )

Its movement ( rotation or gliding ) will occur as the rima glottides is changing its shape

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8
Q

What does the epiglottis made of ?

A

It is made of :

  1. Elastic cartilage
  2. Mucous membrane
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9
Q

What is the position of epiglottis?

A
  1. Upper end is free ( which will be bent during swallowing to protect air passages )
  2. Lower end is attached to the thyroid
  3. Attached to the hyoid bone by hyo-epiglottic membrane
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10
Q

What are the surfaces of epiglottis and their histology ?

A
  1. Anterior ( lingual ) :
    - it is stratified squamous epithelium
  2. Posterior ( pharyngeal ) :
    - it is psudo-stratified columnar epithelium with pores for gland’s secretion
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11
Q

What does the interior of larynx is made of : ( 3 parts)

A
  1. Vestibule
  2. Middle part / laryngeal ventricle ( the narrow space between upper vestibular fold and lower vocal folds )
  3. Infra-glottic part
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12
Q

What is the fibro-elastic membrane ? And what is its structure ?

A

It is sub-mucosal fibro-elastic membrane that divides into two parts :
1. Upper ( in vestibular part ) —

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13
Q

What does the glottis is made of ?

A
  1. Vocal processes of artynoid cartilage
  2. Vocal ligaments
  3. Rima glottides
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14
Q

What does the rima glottides is made of ? And what is its function ?

A

Anteriorly : attached to thyroid cartilage
Posteriorly: attached to vocal processes of artynoid cartilage
And the vocal folds

It is involved in determination of voice pitch

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15
Q

What determines the pitch of the voice ?

A
  1. Tension of vocal folds
  2. Shape of rima glottides
  3. The force of air expiration
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16
Q

What is the histology of the larynx ?

A
  • Generally it psudo-stratified columnar epithelium ( resp. epithelium) similar to the posterior surface of the epiglottis
  • when you reach the vestibular folds it can be stratified squamous
  • in the vestibule it is stratified columnar
  • when you reach the vocal folds it is always stratified squamous ( as cuboidal and columnar will be damaged with the vibrations )
  • as you going down it becomes stratified columnar then psudo-stratified columnar (resp. epithelium )
17
Q

What is the components of lamina propria in larynx ?

A
  • loose CT
  • glands

However, in the vocal folds :
- dense CT ( reinke space )

18
Q

What are the muscles of larynx?

A
  1. Crico-thyroid
  2. Thyro-artynoid
  3. Vocalis
  4. Posterior crico-artynoid
  5. Lateral crico artynoid
  6. Transverse artynoid
  7. Oblique artynoid

All of them are innervated by the recurrent (inferior ) laryngeal nerve of the vagus except the crico-thyroid which is innervated by the external ( superior ) laryngeal nerve of the vagus

19
Q

What is the diffrence between thyro-artynoid and vocalis ?

A

They differ in their attachment to arytenoid cartilage

  • Thyro-arytenoid is more lateral and attaches to the anterior part of arytenoid cartilage
  • vocalis is more medial and attaches to the aryteoid muscle by its vocal muscle

Bothe relaxes the vocal ligament ( vocalis relax posterior part and stretch the anterior part )

20
Q

What is the function of crico-thyroid muscle ?

A

It will stretch the vocal ligament as it will will pull the thyroid cartilage away

21
Q

What is the difference between Posterior and lateral crico-arytenoids ?

A

Posterior crico-arytenoids :
Attachment: from (posterior part of cricoid lamina ) to the ( posterior part of muscular process )
Action : abduction of vocal lig. by moving arytenoid and opening the rima glottides

Lateral crico-arytenoids :
Attachment: from ( cricoid arch ) to the ( anterior part of muscular process )
Action : adduction of vocal lig. Without moving arytenoid process

Their actions

22
Q

What is the difference between lateral crico-arytenoid muscle and oblique/transverse arytenoid muscle ?

A

Both will adduct the vocal ligament, however :
Lateral crico-arytenoid —> by moving inter-ligamentous parts only

oblique/transverse arytenoid —

23
Q

What are the muscles that close (narrow) the larynx inlet ? What will open it ?

A

Muscles that will close it :

  1. Oblique and transverse arytenoid muscle
  2. Thyro-epiglottis
  3. Ary-epiglottis
  4. Lateral crico-arytenoid muscle

Muscles that will open it :
1. Thyro-arytenoid muscle

24
Q

What are the Variations in shape of the rima glottidis during different conditions ?

A

Go to the note

25
Q

What is the Blood supply, (sensory) nerve supply and lymphatic drainage of larynx

A

BLOOD SUPPLY :
- sup. and inf. laryngeal artery and vien which are branches of superior and inferior thyroid artery

SENSORY INNERVATION :

  • above vocal fold : internal laryngeal
  • below vocal fold : inferior laryngeal

LYMPHATIC DRAINAGE:

  • above vocal fold: superior deep cervical lymph nodes
  • below vocal fold : inferior deep cervical lymph nodes
26
Q

Why right laryngeal nerve is more affected than left ? And how ?

A

As the left is more vertical and hidden between the trachea and esophagus

Normally, inferior thyroid artery and inferior laryngeal nerve ( mostly right) are near the thyroid gland,
So during surgery and when there is a need to ligate the inferior thyroid artery it should be ligated away from the thyroid gland to prevent the injury the inferior laryngeal nerve .

27
Q

Which action is damaged and healed first ?

A

Normally, abduction is damaged first and healed lastly

RESP. ANATOMY (6 decks)

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