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Head and Neck > Larynx > Flashcards

Larynx Flashcards

1
Q

What are the three main functions of the larynx?

A

Airway protection,
Ventilation,
Phonation.

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2
Q

What are the borders of the larynx?

A

Laryngeal inlet - lower border of cricoid cartilage (C6).

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3
Q

What are the piriform fossae?

A

Depressions found within the laryngopharynx that help to divert food around the laryngeal inlet, and are a common site for foreign bodies.

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4
Q

What are the arytenoid cartilages?

A

Pyramidal shaped cartilage structures that act as the attachment site of the true vocal cords

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5
Q

What is special about the cricoid cartilage? (Think about structure)

A

It is the only complete ring of cartilage in the upper respiratory tract

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6
Q

Which two synovial joints connect the cartilages of the larynx?

A

Cricoid-arytenoid,

Thyroid-cricothyroid.

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7
Q

What membranes are found in the larynx?

A 
Thyrohyoid membrane (between thyroid cartilage and hyoid).
Cricothyroid membrane (between thyroid and cricoid cartilages).
Crichotracheal membrane (between crichoid cartilage and trachea).
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8
Q

What is a crichothyroidotomy?

A

Procedure puncturing the cricothyroid membrane and providing an emergency airway beneath the vocal cords.

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9
Q

What are the margins of the laryngeal inlet?

A

Aryepiglottic folds and the upper edge of the epiglottis.

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10
Q

What does the upper border of the quadrangular membrane form?
What about the lower border?

A

Aryepiglottic fold.

Vestibular ligament.

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11
Q

Where do the false vocal cords originate from?

Where do the true vocal cords originate from?

A 
Vestibular ligament.
Vocal ligament (free upper border of the cricothyroid membrane).
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12
Q

What three regions is the larynx divided into?

A

Supraglottis - epiglottis to false cords.
Glottis - below false cords until 1cm below true cords.
Infraglottis - below true vocal cords to the inferior boundary of cricoid.

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13
Q

What epithelia lines the larynx?

What is the exception?

A

Pseudostratified ciliates columnar epithelium with goblet cells.
True vocal cords are lined with stratified squamous epithelium.

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14
Q

What is the valecula?

A

Small opening in the larynx near the root of the tongue, often located as a anatomical landmark for use of a laryngoscope.

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15
Q

What are the two broad movements of the intrinsic laryngeal muscles?

A

Alteration of the size and shape of the laryngeal inlet.

Alter tension in and position of the true vocal cords.

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16
Q

What nerve supplies the intrinsic laryngeal muscles?

What is the exception?

A

Recurrent laryngeal nerve (branch of CNX)
Cricothyroid (tilts thyroid cartilage anteriorly to increase tension of vocal cords and innervated by superior laryngeal nerve.)

17
Q

What is the Rima glottis?

A

Patent airway between the vocal cords, can be adducted and closed.

18
Q

Which muscle is the only abductor of the vocal cords?

A

Posterior cricoarytenoid.

19
Q

How are the vocal cords adducted and abducted?

A

Action of intrinsic laryngeal muscles on the arytenoids to adduct or abduct, which attach to the true vocal cords and pull them into place

20
Q

What position are the vocal cords in when speaking or singing?
What must the vocal cords do to cough?

A

Closely but not fully adducted.

Closely adduct to build pressure, then snap open.

21
Q

Which muscle is responsible for creating higher pitched sounds?

A

Cricothyroid

22
Q

How does the larynx help protect against swallowing food?

A

Narrowing of laryngeal inlet by Aryepiglottic muscles.
Horizontal movement of the epiglottis.
Hyoid bone elevated and moved anteriorly by suprahyoid muscles.
Adduction of true vocal cords.

23
Q

Which branch of the superior laryngeal nerve supplies cricothyroid?
What does the other branch supply?

A

External branch.

Internal branch - sensory information to supraglottis and glottis.

24
Q

Which artery does the external branch of the superior laryngeal nerve closely associate with?

A

Superior thyroid artery (first branch of external carotid)

25
Q

What is a common cause of paralysis of vocal cords and intrinsic laryngeal muscles?

A

Thyroid surgery.

Others include aortic arch aneurysm and cancer of apex of lung.

26
Q

What position do the vocal cords assume in a recurrent laryngeal nerve injury?
How does this present?

A

Paramedian - between adducted and abducted.

Hoarse voice and ineffective cough.

27
Q

What is the risk of bilateral recurrent laryngeal nerve injury?

A

Narrowing of the rima glottis and airway obstruction. Would require surgical airway access such as cricothyrotomy or tracheotostomy.

28
Q

How does laryngitis present?

A

Hoarse voice and sore throat,
History of URTI,
Systemic signs eg fever.

29
Q

What are laryngeal nodules?

Why is it important they are visualised?

A

Benign growths on vocal cords resulting from acute trauma or chronic irritation. Often caused singers nodules.
Must exclude laryngeal cancer.

30
Q

What common conditions risk occlusion of the airway?

A

Laryngeal oedema,
Allergic reaction,
Swallowed foreign body.

31
Q

What is epiglottitis?

A

Inflammation of epiglottis causing obstruction of airway. Patients characteristically sit in sniffing position and drool as swallowing is painful. Treated with antibiotics and securing the airway. Do not examine throat as this may exacerbate the obstruction.

32
Q

What is croup?

A

Barking cough often found in children aged 3 months to 6 years. Worsens with agitation. Stridor at rest would indicate admission and corcticosteroid treatment.

33
Q

What symptoms are common alongside a compromised upper airway?

A

Stridor, raised resp rate, distress, hypoxia and cyanosis.

34
Q

What simple manoeuvres help secure the airway?

A

Head tilt,

Chin lift.

35
Q

What two airway adjuncts can be used to hold the airway open if the patient is still breathing spontaneously?

A

Oropharyngeal (Guedel) - patient will gag if not unconscious.
Nasopharyngeal.

36
Q

When are supraglottic airways commonly used?

What are their advantages?

A

First line in cardiac arrest.

Minimal skill required to insert, afford some protection to the airway.

37
Q

What is the main advantage of an endotracheal tube?

A

Secures and protects lower respiratory tract from vomit and secretions.

Head and Neck (12 decks)

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