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MBBCh 2- ANAT2020A > Larynx > Flashcards

Larynx Flashcards

1
Q

What is the larynx and where is it connected? (3)

A
  • Composed of 9 cartilages connected by ligaments and membranes and contains vocal folds
  • Located in the anterior neck at the level of the bodies of C3-C6 vertebrae
  • Connects the inferior part of the pharynx with the trachea
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2
Q

What are the functions of the larynx? (3)

A

o Valve routing air and food
- Upward and forward movements facilitate the closing of the laryngeal inlet and opening of the oesophagus
o Voice production
- Vocal ligament and intrinsic muscles
o Airway patency
- Serves as the sphincter of the lower respiratory tract

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3
Q

Laryngeal Skeleton
* Consists of 3 single cartilages:

A

(thyroid, cricoid and epiglottic),
3 paired cartilages (arytenoid, corniculate and cuneiform), extrinsic and intrinsic membranes

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4
Q

What are the 1. Thyroid cartilages? (2)

A

o Largest of the cartilages
o Superior border lies opposite C4 vertebra

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5
Q
  1. Thyroid cartilage:
    o Laminae:
A
  • Two plate-like regions of the inferior 2/3 of the cartilage that fuse anteriorly in the median plane to form the laryngeal prominence (Adam’s apple)
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6
Q
  1. Thyroid cartilage:
    o Superior thyroid notch:
A
  • V-shape superior to the laryngeal prominence where the laminae diverge
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7
Q
  1. Thyroid cartilage:
    o Inferior thyroid notch:
A
  • Shallow indentation in the middle of the inferior border of the cartilage
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8
Q
  1. Thyroid cartilage:
    o Superior and inferior horns:
A
  • Superior and inferior projections of the posterior border of each lamina
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9
Q
  1. Thyroid cartilage:
    o Median thyroid ligament:
A
  • Thick part in the median part of the thyrohyoid membrane
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10
Q
  1. Thyroid cartilage:
    o Lateral thyrohyoid ligaments:
A
  • Thick parts in the lateral parts of the thyrohyoid membrane
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11
Q
  1. Thyroid cartilage:
    o Cricothyroid joints: (2)
A
  • Articulation between the inferior horns of the thyroid cartilage and the lateral surfaces of the cricoid cartilage
  • Movements- rotation and gliding of the thyroid cartilage ® change in length of vocal folds
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12
Q

What is the 2. Cricoid cartilage? (2)

A

o Smaller than thyroid cartilage but thicker and stronger
o Cricoid is the only complete ring of cartilage to encircle any part of the airway

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13
Q
  1. Cricoid cartilage
    Lamina: (3)
A
  • Posterior part of cricoid
  • Depressions for attachment of posterior
    cricoarytenoids
  • Vertical ridge for attachment to oesophagus
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14
Q
  1. Cricoid cartilage
    o Arch:
A
  • Anterior part of cricoid
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15
Q
  1. Cricoid cartilage
    o Median cricothyroid ligament:
A
  • Attachment of the cricoid to the inferior margin of the thyroid cartilage
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16
Q

What is the 3. Epiglottis? (5)

A

o Consists of elastic cartilage for flexibility
o Heart-shaped and covered with mucous membrane
o Located posterior to the root of the tongue and the hyoid and anterior to the laryngeal inlet
o Forms the superior part of the anterior wall and the superior margin of the inlet
o Has a broad, free superior end

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17
Q

o Stalk of the epiglottis:

A
  • Attached to the angle formed by the thyroid laminae
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18
Q

What are the Extrinsic laryngeal membranes? (4)

A
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19
Q

What is the 1. Arytenoid (paired cartilages)? (4)

A

o Paired, 3-sided pyramidal cartilages
o Articulate with the lateral parts of the superior border of the cricoid cartilage lamina
o Apex superiorly, vocal process anteriorly and muscular process laterally
o Apex- bears the corniculate cartilage and attaches to the aryepiglottic fold

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20
Q
  1. Arytenoid
    What is the o Vocal process?
A

o Vocal process- provides the posterior attachment for the vocal ligament

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21
Q
  1. Arytenoid
    What is the muscular process?
A

o Muscular process- lever to which the posterior and lateral cricoarytenoid muscles are attached

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22
Q

What are cricoarytenoid joints?

A

-Located between the bases of the arytenoid cartilages and the superolateral surfaces of the lamina of the cricoid cartilage

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23
Q

What do the Cricoarytenoid joints permit? (3)

A
  • Permit the arytenoid cartilages
  • to slide toward or away from one another
  • to tilt anteriorly and posteriorly
  • to rotate
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24
Q

What is the 2. Corniculate? (2)

A

o Appears as a small nodule in the posterior part of the aryepiglottic fold
o Attaches to the apex of the arytenoid cartilage

25
Q

What is the 3. Cuneiform? (2)

A

o Appears as a small nodule in the posterior part of the aryepiglottic fold
o Does not directly attach to other cartilages

26
Q

What are Intrinsic laryngeal membranes? (2)

A
  1. Conus elasticus (cricovocal membrane)
  2. Quadrangular membrane
27
Q

Fibroelastic membrane of the larynx
1. Conus elasticus (cricovocal membrane):
* Inferior attachment:

A

o Arch of the cricoid cartilage

28
Q

Fibroelastic membrane of the larynx
1. Conus elasticus (cricovocal membrane):
* Superior attachments: (2)

A

o Anterior- thyroid cartilage
o Posterior- vocal processes of arytenoids

29
Q
  1. Conus elasticus (cricovocal membrane)
    * Vocal ligament-
A
  • Vocal ligament- thickened medial part of membrane under the vocal fold
30
Q
  1. Conus elasticus (cricovocal membrane)
    * Median cricothyroid ligament-
A
  • Median cricothyroid ligament- anterior thickening in the midline of the membrane
31
Q

What is the 2. Quadrangular membrane? (2)

A
  • Runs between the lateral margin of the epiglottis and the anterolateral surface of the arytenoid cartilage
  • Attached to the corniculate cartilage
32
Q
  • Vestibular ligament-
A
  • Vestibular ligament- thickened free lower margin under the vestibular fold
33
Q
  • Vestibular ligament-
    o Attached posteriorly to…
    o Attached anteriorly to…
A

o Attached posteriorly to the anterolateral surface of the arytenoid
o Attached anteriorly to the thyroid angle just superior to the vocal ligament

34
Q

Cavity of the larynx:
* Superior aperture: (2)

A

o Laryngeal inlet
o Opens into the anterior aspect of the pharynx below the posterior tongue

35
Q

Cavity of the larynx:
What are the boundaries of the superior aperture? (3)

A
  • Anteriorly- mucosa covering the superior margin of the epiglottis
  • Laterally- aryepiglottic folds
  • Posteriorly- interarytenoid notch in the midline
36
Q

Cavity of the larynx:
* Inferior aperture: (3)

A

o Continuous with the trachea
o Completely encircled by the cricoid cartilage
o Always open (unlike superior aperture which can be closed by the epiglottis)

37
Q

What are the regions of the cavity? (3)

A
  1. Vestibule
    o Upper chamber
    o Between the laryngeal inlet and the vestibular folds (membrane enclosing vestibular ligaments)
  2. Middle part
    o Between the vestibular folds above and vocal folds (membrane enclosing vocal ligaments) below
  3. Infraglottic space
    o Inferior chamber
    o Between the vocal folds and inferior aperture
38
Q
  • Laryngeal ventricles and saccules:
    o Mucosa of the middle cavity bulges ______
    o Between the vestibular and _____ ligaments
A

laterally
vocal

39
Q

What is the o Laryngeal ventricle?

A

o Laryngeal ventricle- trough shaped space produced by mucosal bulging

40
Q

What is the o Laryngeal saccule?

A

o Laryngeal saccule- tubular extension of each ventricle
- Projects antero-superiorly between vestibular fold and thyroid cartilage
- Contains numerous mucous glands to lubricate the vocal folds

41
Q

What is the * Rima vestibuli? (2)

A

o Triangular opening between the adjacent vestibular folds
o Apex is anterior and base is formed by posterior wall of laryngeal cavity

42
Q

What is the Rima glottidis? (3)

A

o Inferior to the rima vestibuli and narrower
o Triangular opening between the adjacent vocal folds
o Base of the triangle is formed by interarytenoid fold (mucosa covering interarytenoid notch)

43
Q
  • Both rima glottidis and rima vestibuli can be opened and closed by movement of _______.
A

cartilages

44
Q

What are the Intrinsic Laryngeal Muscles? (3)

A
  • Adjust the tension in the vocal ligaments to open and close the rima glottidis
  • Control the inner dimensions of the vestibule and close the rima vestibuli
  • Facilitate closing of the laryngeal inlet
45
Q

What are the Intrinsic Laryngeal Muscles? (7)

A
46
Q

Intrinsic Laryngeal Muscles:
Cricothyroid
Origin:
Insertion:
Main Action:
Innervation:

A
47
Q

Intrinsic Laryngeal Muscles:
Posterior crico-arytenoid
Origin:
Insertion:
Main Action:
Innervation:

A
  • Posterior surface of lamina of cricoid
  • Vocal process of arytenoid
  • Abduction and external rotation of arytenoid (opens rima glottidis)
  • Recurrent laryngeal br. of vagus n.
48
Q

Intrinsic Laryngeal Muscles:
Lateral crico-arytenoid
Origin:
Insertion:
Main Action:
Innervation:

A
  • Superior surface of arch of cricoid
  • Vocal process of arytenoid
  • Internal rotation of arytenoid (closes rima glottidis)
  • Recurrent laryngeal br. of vagus n.
49
Q

Intrinsic Laryngeal Muscles:
Transverse arytenoid
Origin:
Insertion:
Main Action:
Innervation:

A
  • Posterior surface of arytenoid
  • Posterior surface of opposite arytenoid
  • Adduction of arytenoids
  • Recurrent laryngeal br. of vagus n.
50
Q

Intrinsic Laryngeal Muscles:
Oblique arytenoid
Origin:
Insertion:
Main Action:
Innervation:

A
  • Muscular process of arytenoid
  • Apex of opposite arytenoid
    Aryepiglottic part- extends into aryepiglottic fold
  • Sphincter of laryngeal inlet
  • Recurrent laryngeal br. of vagus n.
51
Q

Intrinsic Laryngeal Muscles:
Thyroarytenoid
Origin:
Insertion:
Main Action:
Innervation:

A
  • Thyroid angle and cricothyroid ligament
  • Anterolateral part of arytenoid
    Lateral margin of epiglottis
  • Sphincter of vestibule and laryngeal inlet
    Relaxes vocal ligament
  • Recurrent laryngeal br. of vagus n.
52
Q

Intrinsic Laryngeal Muscles:
Vocalis
Origin:
Insertion:
Main Action:
Innervation:

A
  • Vocal process of arytenoid
  • Ipsilateral vocal ligament
    Thyroid angle
  • Adjusts tension (minutely) in vocal folds
  • Recurrent laryngeal br. of vagus n.
53
Q

Intrinsic Laryngeal Muscles:
* Abductors-
* Adductors-
* Sphinters-
* Tensors-
* Relaxers-

A
  • Abductors- posterior crico-arytenoids
  • Adductors- lateral crico-arytenoids, transverse and oblique arytenoids
  • Sphinters- adductors and aryepiglottic part of oblique arytenoids
  • Tensors- cricothyroid muscles
  • Relaxers- thyroarytenoid muscles
54
Q

What are the Arteries of the larynx? (2)

A
  • Superior laryngeal artery
  • Inferior laryngeal artery
55
Q

What is the Superior laryngeal artery? (4)

A

o Branch of superior thyroid artery
o Pierces thyrohyoid membrane
o Supplies superior internal surface of larynx
o Accompanied by superior laryngeal nerve

56
Q

What are the veins of the larynx? (2)

A
  • Superior laryngeal vein
    o To superior thyroid v. to IJV
  • Inferior laryngeal vein
    o To inferior thyroid v. to left brachiocephalic v.
57
Q

Lymphatic drainage of the larynx
* Above vocal folds:

A

o Superior deep cervical lymph nodes

58
Q

Lymphatic drainage of the larynx
* Below vocal folds:

A

o Pretracheal or paratracheal lymph nodes to inferior deep cervical lymph nodes

59
Q

Innervation of the larynx:

A

MBBCh 2- ANAT2020A (60 decks)

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