Larynx Flashcards
Rima glottidis
opening bw true vocal folds
shape varies depending on position of focal folds
variation in the tension and length of the vocal folds with width of rimal produces changes in pitch of the voice
glottis
rima glottids +true vocal folds
Cricoid cartilage level
CV6
site where carotid can be compressed against CV6
junction of larynx and trachea
junction of pharynx and esophagus
tracheotomy
obstruction of the airway can be overcome by puncturing the larynx or trachea
incision is made bw the cricoid cartilage and first tracheal cartilages
incision can also be made bw the cricoid and thyroid cartilages thru the cricothyroid ligament
Thyroid cartilages
anterior to CV4 and CV5
2 laminae fuse anteriorly and remain open posterior
superior horn to hyoid (posterior)
inferior horn to cricoid cartilage
laryngeal prominence (adams apple)
cricoid cartilage
only fixed cartilage of the larynx
anterior to CV6
immobile ring attached via tracheal cartilage
anterior arch
posterior arch articulates with arytenoid and thyroid cartilage
arytenoid cartilage
where vocal ligaments attach to via vocal process
muscular processes attach to posterior and lateral to the cricoarythnoid m.
epiglottic
leaf shaped cartilage posterior to root of the tongue
broad, superior end is free, inf end is attached to the thyroid cartilage
mm. of teh pharynx pull thyroid cartilage against epiglottis during swallowing to prevent aspiration
extrinsic ligaments
thyrohyoid membrane
hypoepiglottic lig
cricotracheal lig
glossoepiglottic lig
Intrinsic ligaments
quadragular ligments
cricovocal ligament
quadrangular ligament
attaches anterior to thyroid and epiglottic cartilage and posterior to arytenoid
forms vestibular ligaments and aryepiglottic ligaments
Cricovocal ligament (conus elasticus)
attaches inferior to cricoid and attaches superior to thyroid and arytenoid cartilages
thickened medial and lateral ligaments
**vocal ligament extend from internal surface of thyroid lamina to vocal process of arytenoid covered with mucosa= vocal fold
vocal folds
formed from mucosa overlying vocal ligaments and vocalis m
vocal lig is innermost of cricovocal ligament
vocalis m. is innermost portion of thyrodartenoid m.
open=abduction
closed=adduction (during speech) -close rima glottidis
vestibular folds
from mucosa overlying vestibular ligament
covered with highly vascularized mucosa containing mucus secreting glands
Lower part of quadrangular membrane
cricothyroid jt
articulation bw cricoid and inf horn of thyroid cartilage
synovial-gliding
allows thyroid to glide on cricoid in order to change vocal cord length
cricoarytenoid jt
articulation bw cricoid and arytenoid cartilage
synovial-mainly gliding and rotational movements (condylar joint)
allows arytenoid cartilages to rotate glide, towards one another
stretches the vocal ligament
Cricothyroid m.
tilts thyroid forward to elongate and tighten vocal ligament
from arch 4, innervated by CN X via external br of superior laryngeal n.
transverse and oblique arytenoids
adduct arytenoid cartilage
close laryngeal inlet by approximating arytenoids
posterior cricoarytenoid
abduct vocal folds to open rima glottidis
lateral cricoarytenoid
adduct vocal folds to close rima glottidis
thyroarytenoid
rotates thyroid cartilage back to shorten and loosen vocal ligament
vocalis muscles
innermost portion of thyroaretenoid muscle
lateral to vocal lig
locally controls vocal ligament, produce minute adjustments or vocal ligament tension and length
rotation of arytenoid
abducts (posterior CA) and adducts (latera CA) vocal ligaments
gliding of arytenoids
adduct ligaments and close rima (transverse and oblique aretenoids)
rotating of thyroid cartilage on cricothyroid jt
increase (cricothyroid m.) and decrease (thyroarytenoids) tension on the vocal ligaments
cough reflex
In by X (GVA) and out by X (SVE)
injury to superior laryngeal will ablate this function due to anesthesia of laryngeal mucosa
sup laryngeal n. lesion
loss of cough reflex and paralysis of cricothyroid m. which causes a monotonous voice
superior laryngeal n. block
needed when administering a endotracheal tube
insert needle halfway bw the hyoid and superior border of the thyroid cartilage
needle pierces the thyrohyoid memb and anesthetic agenr will bathe the superior laryngeal n.
inf laryngeal n.
continuation of recurrent laryngeal
enters larynx by passing inferior to the inf constrictor
GVE-P and GVA distal to vocal folds
SVE to mm of larynx, except cricothyroid
unilateral damage= hoarseness, bilateral= aphonia
lymph drainage above true folds
superior deep cervical nodes
lymph drainage belos folds
inferior deep cervical nodes
