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FINALS General Anatomy > Larynx > Flashcards

Larynx Flashcards

1
Q

The ______ is a hollow musculoligamentous structure with a cartilaginous framework that caps the lower respiratory tract.

A

larynx

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2
Q

The ______ is continuous below with the trachea, and above opens into the pharynx immediately posterior and slightly inferior to the tongue and the posterior opening (______) of the oral cavity.

A

cavity of the larynx, oropharyngeal isthmus

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3
Q

The ______ is both a valve (or sphincter) to close the lower respiratory tract, and an instrument to produce sound.

A

larynx

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4
Q

The larynx is composed of:

• three large unpaired cartilages (______, ______, and ______),
• three pairs of smaller cartilages (______, ______, and ______), and
• a ______ membrane and numerous ______ muscles.

A

cricoid, thyroid, epiglottis, arytenoid, corniculate, cuneiform, fibro-elastic, intrinsic

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5
Q

The ______ is suspended from the hyoid bone above and attached to the trachea below by membranes and ligaments.

A

larynx

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6
Q

The ______ is highly mobile in the neck and can be moved up and down and forward and backward by the action of extrinsic muscles that attach either to itself or to the hyoid bone.

A

larynx

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7
Q

During swallowing, the dramatic upward and forward movements of the larynx facilitate closing the ______ and opening the ______.

A

laryngeal inlet, esophagus

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8
Q

Motor and sensory innervation of the larynx is provided by the ______.

A

vagus nerve [X]

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9
Q

What are the laryngeal cartilages?

A

Cricoid cartilage, Thyroid cartilage, Epiglottis, Arytenoid cartilages

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10
Q

The ______ is the most inferior of the laryngeal cartilages and completely encircles the airway.

A

cricoid cartilage

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11
Q

The cricoid cartilage is shaped like a signet ring with a broad ______ of cricoid cartilage posterior to the airway and a much narrower ______ of cricoid cartilage circling anteriorly.

A

lamina, arch

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12
Q

The posterior surface of the lamina of cricoid cartilage is characterized by two shallow oval depressions separated by a ______. The ______ is attached to the ridge and the depressions are for attachment of the ______ muscles.

A

vertical ridge, esophagus, posterior cricoarytenoid

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13
Q

The cricoid cartilage has two articular facets on each side for articulation with other laryngeal cartilages:

• One facet is on the sloping ______ of the lamina and articulates with the base of an ______.
• The other facet is on the ______ of the lamina near its base and is for articulation with the medial surface of the ______ of the ______.

A

superolateral surface, arytenoid cartilage, lateral surface, inferior horn, thyroid cartilage

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14
Q

The ______ is the largest of the laryngeal cartilages.

A

thyroid cartilage

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15
Q

The ______ is formed by a right and a left lamina, which are widely separated posteriorly, but converge and join anteriorly. The most superior point of the site of fusion between the two broad flat laminae projects forward as the ______ (______).
The angle between the two laminae is more acute in men (______) than in women (______) so the ______ is more apparent in men than women.

A

thyroid cartilage, laryngeal prominence, Adam’s apple, 90°, 120°, laryngeal prominence

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16
Q

Just superior to the laryngeal prominence, the ______ separates the two laminae as they diverge laterally. Both the ______ and the ______ are palpable landmarks in the neck. There is a less distinct ______ in the midline along the base of the thyroid cartilage.

A

superior thyroid notch, superior thyroid notch, laryngeal prominence, inferior thyroid notch

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17
Q

The posterior margin of each lamina of the thyroid cartilage is elongated to form a ______ and an ______:

• The medial surface of the ______ has a facet for articulation with the cricoid cartilage.
• The ______ is connected by a ______ ligament to the posterior end of the greater horn of the hyoid bone.

A

superior horn, inferior horn, inferior horn, superior horn, lateral thyrohyoid

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18
Q

The lateral surface of each thyroid lamina is marked by a ridge (the ______), which curves anteriorly from the base of the superior horn to a little short of midway along the inferior margin of the lamina.

A

oblique line

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19
Q

The ends of the oblique line are expanded to form ______ and ______ tubercles. The oblique line is a site of attachment for the extrinsic muscles of the larynx (______, ______, and ______).

A

superior, inferior thyroid, sternothyroid, thyrohyoid, inferior constrictor

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20
Q

The ______ is a leaf-shaped cartilage attached by its stem to the posterior aspect of the thyroid cartilage at the angle and projects posterosuperiorly from its attachment to the thyroid cartilage. The attachment is via the ______ ligament in the midline approximately midway between the laryngeal prominence and the inferior thyroid notch.

A

epiglottis, thyro-epiglottic

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21
Q

The upper margin of the epiglottis is behind the ______ part of the tongue.

A

pharyngeal

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22
Q

The inferior half of the posterior surface of the epiglottis is raised slightly to form an ______.

A

epiglottic tubercle

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23
Q

The two _______ are pyramid-shaped cartilages with three surfaces, a ______ and an ______.

A

arytenoid cartilages, base of arytenoid cartilage, apex of arytenoid cartilage

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24
Q

The two arytenoid cartilages are pyramid-shaped cartilages with three surfaces, a base of arytenoid cartilage and an apex of arytenoid cartilage:

• The base is ______ and articulates with the sloping ______ on the superolateral surface of the lamina of cricoid cartilage.
• The apex articulates with a ______.
• The ______ of each cartilage faces the other.
• The anterolateral surface has two depressions, separated by a ridge, for muscle (______) and ligament (______) attachment.
• The posterior surface is covered by the transverse ______ muscle.

The anterior angle of the base is elongated into a ______ to which the vocal ligament is attached. The lateral angle is similarly elongated into a muscular process for attachment of the posterior and lateral crico-arytenoid muscles.

A

concave, articular facet, corniculate cartilage, medial surface, vocalis, vestibular ligament, arytenoid, vocal process

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25
Q

The ______ are two small conical cartilages whose bases articulate with the apices of the arytenoid cartilages. Their apices project posteromedially toward each other.

A

corniculate cartilages

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26
Q

These two small club-shaped cartilages (______) lie anterior to the corniculate cartilages and are suspended in the part of the fibro-elastic membrane of the larynx that attaches the arytenoid cartilages to the lateral margin of the epiglottis.

A

Cuneiform

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27
Q

What are the extrinsic ligaments?

A

Thyrohyoid membrane, Hyo-epiglottic ligament, Cricotracheal ligament

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28
Q

The ______ is a tough fibro-elastic ligament that spans between the superior margin of the thyroid cartilage below and the hyoid bone above. It is attached to the superior margin of the thyroid laminae and adjacent anterior margins of the superior horns, and ascends medial to the greater horns and posterior to the body of the hyoid bone to attach to the superior margins of these structures.

A

thyrohyoid membrane

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29
Q

An aperture in the lateral part of the thyrohyoid membrane on each side is for the ______, the internal branch of the superior laryngeal nerve, and lymphatics.

A

superior laryngeal artery

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30
Q

The posterior borders of the thyrohyoid membrane are thickened to form the ______ ligaments. The membrane is also thickened anteriorly in the midline to form the ______ ligament.

A

lateral thyrohyoid, median thyrohyoid

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31
Q

Occasionally, there is a small cartilage (______) in each lateral thyrohyoid ligament.

A

triticeal cartilage

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32
Q

The ______ ligament extends from the midline of the epiglottis, anterosuperiorly to the body of the hyoid bone.

A

hyo-epiglottic

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33
Q

The ______ ligament runs from the lower border of the cricoid cartilage to the adjacent upper border of the first tracheal cartilage.

A

cricotracheal

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34
Q

What are the intrinsic ligaments?

A

Fibro-elastic membrane of the larynx, Conus elasticus (cricovocal membrane), Quadrangular membrane

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35
Q

The ______ membrane of the larynx links together the laryngeal cartilages and completes the architectural framework of the laryngeal cavity. It is composed of two parts — a ______ and an ______ membrane.

A

fibro-elastic, lower conus elasticus, upper quadrangular

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36
Q

The ______ is attached to the arch of cricoid cartilage and extends superiorly to end in a free upper margin within the space enclosed by the thyroid cartilage. On each side, this upper free margin attaches:

• anteriorly to the ______, and
• posteriorly to the vocal processes of the ______.

A

conus elasticus, thyroid cartilage, arytenoid cartilages

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37
Q

(conus elasticus)

The free margin between these two points of attachment is thickened to form the ______, which is under the ______ (______) of the larynx.

A

vocal ligament, true vocal cord

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38
Q

The conus elasticus is also thickened anteriorly in the midline to form a distinct ______, which spans the distance between the arch of cricoid cartilage and the inferior thyroid notch and adjacent deep surface of the thyroid cartilage up to the attachment of the vocal ligaments.

A

median cricothyroid ligament

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39
Q

In emergency situations, when the airway is blocked above the level of the vocal folds, the ______ can be perforated to establish an airway. Except for small vessels and the occasional presence of a pyramidal lobe of the thyroid gland, normally there are few structures between the ______ and skin.

A

median cricothyroid ligament, median cricothyroid ligament

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40
Q

The ______ membrane on each side runs between the lateral margin of the epiglottis and the anterolateral surface of the arytenoid cartilage on the same side. It is also attached to the corniculate cartilage, which articulates with the apex of arytenoid cartilage.

A

quadrangular

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41
Q

Each quadrangular membrane has a free upper margin, between the top of the epiglottis and the corniculate carti-lage, and a free lower margin. The free lower margin is thickened to form the ______ under the ______ (______) of the larynx.

A

vestibular ligament, vestibular fold, false vocal cord

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42
Q

The ______ ligament is attached posteriorly to the superior depression on the anterolateral surface of the arytenoid cartilage and anteriorly to the thyroid angle just superior to the attachment of the vocal ligament.

A

vestibular

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43
Q

On each side, the vestibular ligament of the quadrangular membrane is separated from the vocal ligament of the cricothyroid ligament below by a ______.

A

gap

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44
Q

Because the vestibular ligament attaches to the anterolateral surface of the arytenoid cartilage and the vocal ligament attaches to the vocal process of the same cartilage, the vestibular ligament is lateral to the ______ when viewed from above.

A

vocal ligament

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45
Q

What are the laryngeal joints?

A

Cricothyroid joints, Crico-arytenoid joints

46
Q

The joints (______) between the inferior horns of the thyroid cartilage and the cricoid cartilage, and between the cricoid cartilage and arytenoid cartilages are synovial. Each is surrounded by a capsule and is reinforced by associated ligaments.

A

Cricothyroid joints

47
Q

The ______ joints enable the thyroid cartilage to move forward and tilt downward on the cricoid cartilage.

A

cricothyroid

48
Q

Because the vocal ligaments pass between the posterior aspect of the thyroid angle and the arytenoid cartilages that sit on the lamina of cricoid cartilage, forward movement and downward rotation of the thyroid cartilage on the cricoid cartilage effectively ______ and ______ on the vocal ligaments.

A

lengthens, puts tension

49
Q

The ______ joints between articular facets on the superolateral surfaces of the cricoid cartilage and the bases of the arytenoid cartilages enable the arytenoid cartilages to slide away or toward each other and to rotate so that the vocal processes pivot either toward or away from the midline. These movements ______ and ______ the vocal ligaments.

A

crico-arytenoid, abduct, adduct

50
Q

The ______ of the larynx is tubular and lined by mucosa. Its architectural support is provided by the ______ membrane of the larynx and by the ______ to which it is attached.

A

central cavity, fibro-elastic, laryngeal cartilages

51
Q

The superior aperture of the cavity (______)
opens into the anterior aspect of the pharynx just below and posterior to the tongue:

• Its anterior border is formed by ______ covering the superior margin of the epiglottis.
• Its lateral borders are formed by ______ (______), which enclose the superior margins of the quadrangular membranes and adjacent soft tissues, and two tubercles on the more posterolateral margin of the laryngeal inlet on each side mark the positions of the underlying cuneiform and corniculate cartilages.
• Its posterior border in the midline is formed by a mucosal fold that forms a depression (______)
between the two corniculate tubercles.

A

laryngeal inlet, mucosa, mucosal folds, aryepiglottic folds, interarytenoid notch

52
Q

The inferior opening of the laryngeal cavity is continuous with the ______ of the trachea, is completely encircled by the ______, and is ______ in position unlike the laryngeal inlet, which is oblique and points posterosu-periorly into the pharynx. In addition, the inferior opening is continuously ______, whereas the laryngeal inlet can be closed by downward movement of the epiglottis.

A

lumen, cricoid cartilage, horizontal, open

53
Q

Two pairs of mucosal folds, the ______ and ______ folds, which project medially from the lateral walls of the laryngeal cavity, constrict it and divide it into three major regions—the ______, a ______, and the ______.

A

vestibular, vocal, vestibule, middle chamber, infraglottic cavity

54
Q

• The ______ is the upper chamber of the laryngeal cavity between the laryngeal inlet and the vestibular folds, which encloses the vestibular ligaments and associated soft tissues.
• The ______ of the laryngeal cavity is very thin and is between the vestibular folds above and the vocal folds below.
• The ______ is the most inferior chamber of the laryngeal cavity and is between the vocal folds (which encloses the vocal ligaments and related soft tissues) and the inferior opening of the larynx.

A

vestibule, middle part, infraglottic space

55
Q

On each side, the mucosa of the middle cavity bulges laterally through the gap between the vestibular and vocal ligaments to produce an expanded trough-shaped space (a ______).

A

laryngeal ventricle

56
Q

An elongate tubular extension of each ventricle (______) projects anterosuperiorly between the vestibular fold and thyroid cartilage and may reach as high as the top of the thyroid cartilage.

A

laryngeal saccule

57
Q

Within the walls of these ______ are numerous mucous glands. Mucus secreted into the saccules lubricates the ______.

A

laryngeal saccules, vocal folds

58
Q

When viewed from above, there is a triangular opening (the ______) between the two adjacent vestibular folds at the entrance to the middle chamber of the laryngeal cavity. The apex of the opening is anterior and its base is formed by the posterior wall of the laryngeal cavity.

A

rima vestibuli

59
Q

Inferior to the vestibular folds, the vocal folds (true vocal cords) and adjacent mucosa-covered parts of the arytenoid cartilages form the lateral walls of a similar, but narrower, triangular opening (the ______ between the two adjacent vocal folds). This opening separates the ______ above from the ______ below.
The base of this triangular opening is formed by the fold of mucosa (______) at the bottom of the interarytenoid notch.

A

rima glottidis, middle chamber, infraglottic cavity, interarytenoid fold

60
Q

Both the ______ and the ______ can be opened and closed by movement of the arytenoid cartilages and associated fibro-elastic membranes.

A

rima glottidis, rima vestibuli

61
Q

What are the intrinsic muscles of the larynx?

A

Cricothyroid, Posterior crico-arytenoid, Lateral crico-arytenoid, Transverse arytenoid, Oblique arytenoid, Thyro-arytenoid, Vocalis

62
Q

The ______ muscles of the larynx adjust tension in the vocal ligaments, open and close the rima glottidis, control the inner dimensions of the vestibule, close the rima vestibuli, and facilitate closing of the laryngeal inlet. They do this mainly by:

• ______ on the cricothyroid and crico-arytenoid joints,
• ______ the distance between the epiglottis and aryte-noid cartilages,
• ______ directly on the vocal ligaments, and
• ______ soft tissues associated with the quadrangular membranes and vestibular ligaments toward the midline.

A

intrinsic, acting, adjusting, pulling, forcing

63
Q

Origin of the Cricothyroid

A

Anterolateral aspect of arch of cricoid cartilage

64
Q

Origin of the Posterior crico-arytenoid

A

Oval depression on posterior surface of lamina of cricoid cartilage

65
Q

Origin of the Lateral crico-arytenoid

A

Superior surface of arch of
cricoid cartilage

66
Q

Origin of the Transverse arytenoid

A

Lateral border of posterior surface of arytenoid cartilage

67
Q

Origin of the Oblique arytenoid

A

Posterior surface of muscular process of arytenoid cartilage

68
Q

Origin of the Thyro-arytenoid

A

Thyroid angle and adjacent cricothyroid ligament

69
Q

Origin of the Vocalis

A

Lateral surface of vocal process of arytenoid cartilage

70
Q

Insertion of the Cricothyroid

A

Oblique part — inferior horn of the thyroid cartilage; straight part —inferior margin of thyroid cartilage

71
Q

Insertion of Posterior crico-arytenoid

A

Posterior surface of muscular process of arytenoid cartilage

72
Q

Insertion of Lateral crico-arytenoid

A

Anterior surface of muscular process of arytenoid cartilage

73
Q

Insertion of Transverse arytenoid

A

Lateral border of posterior surface of opposite arytenoid cartilage

74
Q

Insertion of Oblique arytenoid

A

Posterior surface of apex of adjacent arytenoid cartilage; extends into ary-epiglottic fold

75
Q

Insertion of Thyro-arytenoid

A

Anterolateral surface of arytenoid cartilage; some fibers continue in ary-epiglottic folds to the lateral margin of the epiglottis

76
Q

Insertion of Vocalis

A

Vocal ligament and thyroid angle

77
Q

Innervation of Cricothyroid

A

External branch of superior laryngeal nerve from the vagus nerve [X]

78
Q

Innervation of Posterior crico-arytenoid, Lateral crico-arytenoid, Transverse arytenoid, Oblique arytenoid, Thyro-arytenoid, Vocalis

A

Recurrent laryngeal branch of the vagus nerve [X]

79
Q

Function of Cricothyroid

A

Forward and downward rotation of the thyroid cartilage at the cricothyroid joint

80
Q

Function of Posterior crico-arytenoid

A

Abduction and external rotation of the arytenoid cartilage. The posterior Che primary aid metes the
vocal folds. In other words, they are the primary openers of the rima glottidis.

81
Q

Function of Lateral crico-arytenoid

A

Internal rotation of the arytenoid cartilage and adduction of vocal folds

82
Q

Function of Transverse arytenoid

A

Adduction of arytenoid cartilages

83
Q

Function of Oblique arytenoid

A

Sphincter of the laryngeal inlet

84
Q

Function of Thyro-arytenoid

A

Sphincter of vestibule and of laryngeal inlet

85
Q

Function of Vocalis

A

Adjusts tension in vocal folds

86
Q

The ______ is an elaborate sphincter for the lower respiratory tract and provides a mechanism for producing sounds.

A

larynx

87
Q

Adjustments of the size of the central cavity of the larynx result from changes in the dimensions of the ______, the ______, the ______, and the ______. These changes result from muscle actions and laryngeal mechanics.

A

rima glottidis, rima vestibuli, vestibule, laryngeal inlet

88
Q

During ______, the laryngeal inlet, vestibule, rima vestibuli, and rima glottidis are open. The arytenoid cartilages are ______ and the rima glottidis is ______.

A

quiet respiration, abducted, triangular shaped

89
Q

During ______, the arytenoid cartilages are rotated laterally, mainly by the action of the posterior crico-arytenoid muscles. As a result, the vocal folds are ______ and the rima glottidis widens into a ______, which effectively increases the diameter of the ______.

A

forced inspiration, abducted, rhomboid shape, laryngeal airway

90
Q

When ______, the arytenoid cartilages and vocal folds are adducted and air is forced through the closed rima glottidis. This action causes the vocal folds to ______ against each other and produce sounds, which can then be modified by the upper parts of the airway and oral cavity.

A

phonating, vibrate

91
Q

Tension in the vocal folds can be adjusted by the ______ and ______ muscles.

A

vocalis, cricothyroid

92
Q

______ of the larynx occurs when air is retained in the thoracic cavity to stabilize the trunk, for example during heavy lifting, or as part of the mechanism for increasing intra-abdominal pressure.

A

Effort closure

93
Q

During effort closure, the rima glottidis is completely ______, as is the rima vestibuli and lower parts of the vestibule. The result is to completely and forcefully shut the ______.

A

closed, airway

94
Q

During swallowing, the rima glottidis, rima vestibuli, and vestibule are ______ and the laryngeal inlet is ______.
In addition, the larynx moves ______ and ______. This action causes the epiglottis to swing ______ toward the ary-tenoid cartilages and to effectively narrow or close the laryngeal inlet. The up and forward movement of the larynx also opens the ______, which is attached to the posterior aspect of the lamina of the cricoid cartilage. All these actions together prevent solids and liquids from entry into the ______ and facilitate their movement through the piriform fossae into the esophagus.

A

closed, narrowed, up, forward, downward, esophagus, airway

95
Q

What procedure?

In emergency situations, when the airway is blocked above the level of the vocal folds, the median cricothyroid ligament can be perforated and a small tube inserted through the incision to establish an airway. Except for small vessels and the occasional presence of a pyramidal lobe of the thyroid gland, normally there are few structures between the median cricothyroid ligament and the skin.

A

Cricothyrotomy

96
Q

A ______ is a surgical procedure in which a hole is made in the trachea and a tube is inserted to enable ventilation.

A

tracheostomy

97
Q

A ______ is typically performed when there is obstruction to the larynx as a result of inhalation of a foreign body, severe edema secondary to anaphylactic reaction, or severe head and neck trauma.

A

tracheostomy

98
Q

Patients with long-term ______ are unable to vocalize because no air is passing through the vocal cords.

A

tracheostomies

99
Q

______ is a medical procedure that is used to inspect the larynx. The functions of ______ include the evaluation of patients with difficulty swallowing, assessment of the vocal cords, and assessment of the larynx for tumors, masses, and weak voice.

A

Laryngoscopy, laryngoscopy

100
Q

The larynx is typically visualized using two methods.
______ involves passage of a small rod-mounted mirror (not dissimilar to a dental mirror) into the oropharynx permitting indirect visualization of the larynx. ______ can be performed using a device with a curved metal tip that holds the tongue and epiglottis forward, allowing direct inspection of the larynx. This procedure can be performed only in the unconscious patient or in a patient in whom the gag reflex is not intact. Other methods of inspection include the passage of ______ through either the oral cavity or nasal cavity.

A

Indirect laryngoscopy, Direct laryngoscopy, fiberoptic endoscopes

101
Q

The major blood supply to the larynx is by the ______ and ______ arteries.

A

superior, inferior laryngeal

102
Q

The ______ artery originates near the upper margin of the thyroid cartilage from the superior thyroid branch of the external carotid artery, and accompanies the internal branch of the superior laryngeal nerve through the thyrohyoid membrane to reach the larynx.

A

superior laryngeal

103
Q

The ______ artery originates from the inferior thyroid branch of the thyrocervical trunk of the subclavian artery low in the neck and, together with the recurrent laryngeal nerve, ascends in the groove between the esophagus and trachea—it enters the larynx by passing deep to the margin of the inferior constrictor muscle of the pharynx.

A

inferior laryngeal

104
Q

Veins draining the larynx accompany the arteries:

______ veins drain into superior thyroid veins, which in turn drain into the internal jugular veins.

______ veins drain into inferior thyroid veins, which drain into the left brachiocephalic vein.

A

Superior laryngeal, Inferior laryngeal

105
Q

Lymphatics drain regions above and below the vocal folds:

• Those above the vocal folds follow the ______ artery and terminate in ______ nodes associated with the bifurcation of the common carotid artery.
• Those below the vocal folds drain into ______ associated with the ______ artery or with nodes associated with the front of the cricothyroid ligament or upper trachea.

A

superior laryngeal, deep cervical, deep nodes, inferior thyroid

106
Q

Sensory and motor innervation of the larynx is by two branches of the vagus nerves [X] — the ______ nerves and the ______ nerves.

A

superior laryngeal, recurrent laryngeal

107
Q

The _______ nerves originate from the inferior vagal ganglia high in the neck.

A

superior laryngeal

108
Q

On each side, the superior laryngeal nerve descends medial to the internal carotid artery and divides into internal and external branches just above the level of the superior horn of the hyoid bone:

• The external branch (______) descends along the lateral wall of the pharynx to supply and penetrate the inferior constrictor of the pharynx and ends by supplying the cricothyroid muscle.
• The internal branch (______) passes anteroinferiorly to penetrate the thyrohyoid membrane—it is mainly sensory and supplies the laryngeal cavity down to the level of the vocal folds.

A

external laryngeal nerve, internal laryngeal nerve

109
Q

The recurrent laryngeal nerves are:

• ______ to the laryngeal cavity below the level of the vocal folds, and
• ______ to all intrinsic muscles of the larynx except for the cricothyroid.

A

sensory, motor

110
Q

The ______ recurrent laryngeal nerve originates in the thorax, whereas the ______ recurrent laryngeal nerve originates in the root of the neck. Both nerves generally ascend in the neck in the groove between the esophagus and trachea and enter the ______ deep to the margin of the inferior constrictor. They may pass medial to, lateral to, or through the ______ ligament of the thyroid gland, which attaches the thyroid gland to the trachea and lower part of the cricoid cartilage on each side.

A

left, right, larynx, lateral

FINALS General Anatomy (2 decks)

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