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SHS 300 > laryngeal anatomy > Flashcards

laryngeal anatomy Flashcards

1
Q

larynx is a specialized tube or cavity sitting above trachea that contains a sphincter

A

larynx

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2
Q

supraglottal cavity

A

region above VF

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3
Q

subglottal cavity

A

region below VF

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4
Q

laryngeal inlet

A

aditus
opening to pharynx
-inlet closed by epiglottis

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5
Q

vestibule

A

space between inlet and false vocal folds

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6
Q

ventricle

A

space between false vocal folds and true vocal folds

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7
Q 
structure of larynx:
function
4 primary cartilaginous structures
A

for sound production

-and airway production

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8
Q

structure of larynx:

1 important cartilage structure

A

epiglottis

-for protecting airway

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9
Q

structure of larynx:

1 critical bone

A

hyoid bone

-for anchoring the larynx, protecting airway and moving the larynx up and down

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10
Q

cricoid cartilage

A

lower most cartilage sitting atop trachea

  • specialized tracheal ring fused together
  • resembles a signet ring
  • supports and articulates with the thyroid cartilage and arytenoid cartilages
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11
Q

narrow anterior aspect of cricoid cartilage

A

called the arch

-provides clearance for the vocal folds

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12
Q

posterior lamina of cricoid cartilage

A

provides surface for arytenoid cartilage

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13
Q

on lateral surface of cricoid cartilage

A

articulator facets which is the site of cricothyroid joint (synovial)

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14
Q

thyroid cartilage

A

largest cartilage fused at anterior midline and open posteriorly

  • plates of arch course forward to form a thyroid angle
  • oblique line on side of plates is site of muscle attachments
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15
Q

thyroid is ____ in males and has a greater angle

A

larger

-sexual dimorphism

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16
Q 
lower cornu (horns) 
of thyroid cartilage
A

articulate with cricoid cartilage (joint)

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17
Q

superior cornu

or thyroid cartilage

A

attaches to hyoid bone via thyrohyoid ligament (not joint)

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18
Q

arytenoid cartilage

A

small paired cartilages with critical function

  • rest on top of posterior cricoid
  • apex is peak, topped by small corniculate cartilages
  • base has concave surface for joint
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19
Q

cricoarytenoid joint allows

A

rotation

-rocking and gliding of arytenoid cartilages

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20
Q

vocal process

A
  • anterior projection of arytenoid cartilage

- attachment for vocal folds

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21
Q

muscular processes

A
  • lateral projection of arytenoid cartilage

- attachment for muscles that adduct and abduct vocal folds

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22
Q

epiglottis

A

large fused leaf-like structure

  • arises from inner surface of thyroid cartilage below notch
  • connective tissue from sides of epiglottis join to arytenoid cartilages via aryepiglottic folds
  • has anterior connection to tongue
  • glosso-epiglottic folds
  • attaches to hyoid bone via hyoepiglottic ligament
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23
Q

epiglottis extends ____ beyond ____ and ___ ____

A

upward, larynx, hyoid bone

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24
Q

valleculue

A

formed from juncture of folds and tongue

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25
Q

hyoid bone

A

only bone in body that is not attached to another bone

  • floating bone connected by muscles to other structures
  • U-shaped with arch anterior - body of hyoid
  • has greater horns (cornu) and lesser horns (cornu)
  • greater cornu are posterior
  • less cornu arise at junction of body and greater cornu - point upwards
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26
Q

pull hyoid and larynx downward

A

infra hyoid muscles

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27
Q

pull hyoid and larynx upward and forward

A

suprahyoids

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28
Q

cricothyroid joint

A
  • junction of inferior cornu of thyroid cartilage and lateral arch of cricoid
  • synovial joint allowing thyroid cartilage to rotate and move forwards/backwards
  • this joint has primary importance in changing length of vocal folds
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29
Q

cricoarytenoid joint

A
  • synovial joint with less mobility than cricothyroid
  • concave inferior surface of arytenoid rests on convex surface of cricoid
  • principal motions are gliding, rocking, and rotation
  • rocking actions bring vocal processes together (adduct and abduct)
  • rocking can abduct vocal processes away from each other
  • gliding actions can pull arytenoids close to each other assisting in closure
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30
Q

laryngeal musculature

A
  • each motion described previously allows for closure, opening and length changes of vocal folds
  • motions accomplished by muscle contraction
31
Q

two sets of laryngeal muscles

A
  • intrinsic make connections between laryngeal cartilages

- extrinsic connect laryngeal cartilages to other structures

32
Q

intrinsic muscles

A 
cricothyroid
posterior cricoarytenoid
lateral cricoarytenoid
thyroarytenoid
vocalis
interarytenoids: oblique and transverse
33
Q

extrinsic muscles

A

sternothyroid
thyrohyoid
inferior pharyngeal constrictor

34
Q

hyoid muscles

A 
suprahyoid
-digastric (anterior and posterior bellies)
geniohyoid
mylohyoid
stylohyoid
genioglossus
infrahyoid
-sternohyoid (sternothyroid & thyrohyoid)
omohyoid
35
Q

posterior cricoarytenoid

A

PCA

  • intrinsic laryngeal muscle
  • origin: posterior outer surface of cricoid arch
  • insertion: muscular process of arytenoid
  • fibers course upward and backward
  • contraction pulls muscular process posteriorly
  • rocks arytenoids away from each other
36
Q

action of PCA

A

abduct vocal folds
-sole muscle that performs this action
importance during respiration and speech
-stabilizes arytenoid position

37
Q

lateral cricoarytenoid

A

LCA

origin: superior lateral surface of cricoid
insertion: courses upwards and backwards to muscular process
* antagonist of PCA

38
Q

interarytenoid muscles

A

IA

  • connect the arytenoid cartilages across the midline
  • transverse muscle is a single unpaired muscle spanning cartilages
  • oblique interarytenoid muscle overlie transverse in X shape
  • contraction of these muscles pulls arytenoids together
39
Q

action of LCA

A

action: rocks muscular process inwards leading to vocal fold adduction
- can also adjust amount of compression between folds (medial compression)

40
Q

action of IA

A

action: pulls arytenoids together which assists in closing vocal folds

41
Q

vocal fold muscle

A

-inner or deep portion of vocal folds is occupied by a muscle
-main mass of folds
general name: thyroarytenoid
fan shaped muscle
inner surface of thyroid cart near arch to arytenoid vocal process
-bottom contributes to vocal fold while top diverges towards epiglottis
*forms thyroepiglottis

42
Q

thyroarytenoid

A
  • two separate muscles
  • pulls arytenoids and thyroid closer
  • result: shortens and relaxes vocal folds acting unopposed (almost NEVER happens)
  • the muscle divisions appear to have opposing functions
43
Q

two muscles of thyroarytenoid

A

-vocalis can tense VF when other intrinsic laryngeal muscles are increasing vocal fold tension and adduction
-thyromuscularis contraction can shorten and relax VFs
together these contribute to pitch control

44
Q

cricothyroid

A

origin: arch of cricoid
insertion: inferior horn of thyroid - pars oblique
- contraction pulls thyroid towards cricoid
- increase distance between thyroid and arytenoids
- stretches and tenses vocal folds***

45
Q

Vagus Nerve

A

CN X

  • arises from nucleus ambigus in brainstem
  • regulates cardiac rhythm
  • called the wanderer because it wanders throughout body regulating function of many internal organs
46
Q

emerges from medulla of brainstem

A

Vagus

  • exits skull through jugular foramen
  • runs between internal jugular vein and internal carotid giving off branches to pharynx, larynx and constrictors
  • continues descending to reach cardiac, pulmonary and esophageal plexuses
47
Q

superior laryngeal nerve

A

branches off from vagus

  • splits inter external and internal branches
  • external brach provides motor innervation to CT
  • internal branch provides sensory innervation to entire layers excluding inferior surface of vocal folds
48
Q

recurrent laryngeal nerve

A

RLN

  • arises more distally
  • loops back upwards to larynx
  • right side emerges from vagus within neck and loops around subclavian artey
  • left side branches off in chest and loops around aorta
  • provides motor innervation to ALL the intrinsic laryngeal muscles
  • carries sensory info from inferior surface of vocal folds and upper trachea
49
Q

mucosal membranes and ligaments

A

external mucosal membrane refers to surface covering oral cavity, nasal cavity, larynx

  • intrinsic membranes form the tough connective tissue and ligaments
  • includes connective tissue connecting laryngeal cartilages
  • not skin, but covers the internal passageways in the same way as skin
  • essential to keep mucosa hydrated and healthy
  • thickened membranes called ligaments even though they are NOT connecting bones
50
Q

quadrangular membrane

A

paired membrane joined anteriorly
connects lateral margins of epiglottis to thyroid, corniculate and arytenoids
-fibers curve and descend around to posterior cartilages
-joins up with conus elasticus
superior lateral margins form thickened aryepiglottic folds
inferior portion forms ventricular ligaments overlying ventricular fold

51
Q

conus elasticus

A

inferior portion

  • connects thyroid, arytenoid, and cricoid carts
  • name refers to cone shaped upper trachea ending at VFs
  • forms anterior cricothyroid ligaments and lateral cricothyroid membrane
  • free thickened margins from vocal ligaments*
  • vocal ligament forms medial margin of VF
  • vocal ligament permits highly specific vibration characteristics to VFs
52
Q

extrinsic membrane

A

lining surface of larynx and epiglottis is the wet sticky surface called mucosal membrane

  • most of if loosely covers underlying structures
  • cells forming cover called columner epithelium
53
Q

squamous epithelium & layers

A

5 specialized layers including surface membrane, vocal ligament, and muscle
only present for VFs

54
Q

layer one

A

protective membranous layer that also retains moisture

  • thin layers of cells called squamous epithelium
    0. 1 mm
55
Q

layer two

A

superficial lamina propria (SLP)

  • tough stretchy elastic fibers
  • tolerates extensive stretching
56
Q

layer three

A

intermediate lamina propina of ILP
1-2mm
-tough stretchy tissue intermixed with SLP
-fibers run in AP direction so are cross-layered
-combination of directions increases strength

57
Q

layer four

A

deep lamina propria or DLP
1-2mm
-tough collagen supportive fibers that resist stretching

58
Q

layer five

A

muscular layer composed of thyroarytenoid

-forms bulk of VF

59
Q

extrinsic muscles/hyoid muscles

A

muscles move larynx up or down or stiffen its position
one attachment to laryngeal cartilages and to another structure
-sternohyoid
-thyrohyoid
-thyropharyngeus
-other muscles attach to hyoid bone but effectively move larynx

60
Q

**coordinated synergistic function to stabilize or move larynx

A
  • intrinsic muscles act at same time as extrinsic
  • extrinsic groups broadly affect laryngeal position and provide stability
  • intrinsics are producing fine changes in VF adduction
  • muscle groups do NOT work against each other in normal function
61
Q

thyrohyoid

A

INFRAHYOID

origin: thyroid cartilage
insertion: hyoid bone
innervation: ansa cervicalis
function: brings hyoid and thyroid closer
- elevates larynx when hyoid fixed
- depressed hyoid when larynx fixed

62
Q

inferior pharyngeal constrictor

A

origin: thyroid lamina (external)
insertion: posterior pharyngeal raphe
innervation: Vagus
functon: constricts pharynx and elevates larynx
AKA thyropharyngeus

63
Q

sternothyroid

A

INFRAHYOID

origin: manubrium
- insertion: oblique line of thyroid cartilage
innervation: CN XI and C1 & C2
function: depresses or fixates thyroid cartilage and larynx

64
Q

extrinsic laryngeal muscles

A

thyrohyoid
inferior pharyngeal constrictor (thyropharyngeus)
sternothyroid

65
Q

sternohyoid

A

INFRAHYOID

origin: manubrium
insertion: hyoid
innervation: ansa cervicalis
- together ST and SH can stabilize larynx in medial or depressed position

66
Q

omohyoid

A

infrahyoid

origin:
superior: hyoid
inferior: scapula
insertion:
superior: inferior belly by intermediate tendon
inferior: superior belly
innervation: ansa cervicalis
function: contraction of superior belly pulls hyoid down

67
Q

stylohyoid

A

suprahyoid

origin: styloid process of temporal bone
insertion: hyoid bone
innervation: CN VII facial nerve
function: elevates and retracts hyoid and larynx

68
Q

digastric muscle

A

suprahyoid

origin: temporal bone & mandible
insertion: hyoid bone
innervation: CN VII facial nerve
function: depress mandible but elevate hyoid bone and base of tongue

69
Q

mylohyoid

A

suprahyoid

origin: mandible
insertion: hyoid bone
innervation: CN V trigeminal nerve
function: pulls hyoid up and forward when mouth fixed

70
Q

geniohyoid

A

suprahyoid

origin: mandible
insertion: hyoid
innervation: CN XII hypoglossal nerve
function: pull hyoid forward and up

71
Q

hyoglossus

A

suprahyoid

origin: hyoid bone
insertion: tongue
innervation: CN XII hypoglossal nerve
function: elevates hyoid or pulls tongue back

72
Q

genioglossus

A

suprahyoid

origin: hyoid bone
insertion: tongue
innervation: CN XII hypoglossal nerve
function: elevate and protrude tongue which pulls hyoid and larynx up and forward

73
Q

VF function

A

protect airway during aspiration

  • open during breathing and closed during swallowing
  • coughing out foreign particles
  • distinct and separate reflex actions
  • vibrate to produce sound
74
Q

cells covering medial portion of vocal folds, ventricular folds and parts of the epiglottis

A

stratified squamous epithelium

-these cells are tightly bound to underlying tissue

SHS 300 (14 decks)

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