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Anatomy Week 14 BT > Larynx > Flashcards

Larynx Flashcards

1
Q

What suspends the Larynx from the hyoid bone?

A

Thyrohyoid Membrane

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2
Q

T or F: the hyoid is not part of the larynx

A

True

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3
Q

What is the role does the hyoid play in laryngeal function?

A
  • All of the muscles attached to the hyoid elevate or depress the larynx

**Important action during swallowing

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4
Q

What are the 3 large unparied cartilages of the larynx?

A
  1. Thyroid
  2. Cricoid
  3. Epiglottis
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5
Q

What are the 3 smaller cartilages that are PAIRED in the larynx?

A
  1. Arytenoids
  2. Corniculate
  3. Cuneiform
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6
Q

What nerve provides both motor and sensory innervation to the larynx?

A

Vagus Nerve (X)

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7
Q

What direction do the lamina and arch of the cricoid cartilage face?

A

Arch of the Cricoid Cartilage - Anterior (much more narrow)

Lamina of the Cricoid Cartilage - Posterior

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8
Q

What cartilage articulates with the cricoid cartilage on the posteriorlateral surface of the cricoid lamina (wide posterior part)?

A
  • Artenoid Cartilages
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9
Q

What does the lateral side of the cricoid lamina (wide posterior part) articulate with?

A
  • Medial Surface of Inferior Horn of the Thyroid Cartilage
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10
Q

What is formed by the fusion of the TWO laminae that make up the thyroid cartilage?

A
  • Laryngeal Prominence (adam’s apple)

**More acute in men (90º) and less acute in women (120º)

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11
Q

What separates the two laminae in the center of the thyroid cartilage above the laryngeal prominence?

A
  • Superior Thyroid Notch
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12
Q

What is formed as elongations of the thryoid cartilage at the posterior aspect of the laminae?

A
  • Superior and Inferior Horns
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13
Q

What does the inferior horn of the thyroid cartilage articulate with?

A

Cricoid

*medial aspect of horn on lateral aspect of cricoid

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14
Q

What connects the Posterior end of the Greater horn of the thyroid cartilage to the hyoid bone?

A

Lateral Thryohyoid ligament

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15
Q

What is formed at the inferior aspect of the oblique line of the thyroid cartilage?

A
  • Superior and Inferior Thryoid Tubercle
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16
Q

What does the Thryo-epiglottic ligament attach the thryoid to the epiglottis?

A
  • Attaches thin (stem) of the epiglottis to the ANTERIOR part of epiglottis between the Thryoid Prominence and they inferior notch
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17
Q

What do the Apex and Base of the Arytenoid Cartilages articulate with?

A

Apex:
Coriniculate Cartilage

Base: 
Cricoid cartilage (on superiolateral facets)
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18
Q

What is the job of the corniculate and cuneiform cartilages?

A

Corniculate:
- Make the arytenoids taller

Cuneiform:
- Support the wall of the laryngeal vestibule

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19
Q

What is the larynx suspended from?

A

Hyoid Bone

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20
Q

Where do both the pharynx and larynx end?

A

C6 (cricoid is here)

**Also the point where the vertebral artery enters the transverse cervical foramen

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21
Q

What do the inferior horns of the thyroid cartilage articulate with?
- What kind of movement is allowed

A
  • Cricoid

- Allows thyroid cartilage to rock anteriorly and posteriorly over the cricoid

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22
Q

What happens when the thyroid cartilage rocks over the cricoid cartilage?

A
  • The vocal folds are stretched and relaxed

* This allows us to make high and low pitch noise

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23
Q

What 3 muscles attach to the oblique line of the thyroid cartilage?

A
  1. Sternothryoid
  2. Thyrohyoid
  3. Inferior Pharyngeal Constrictor
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24
Q

What direction does the epiglottis fold when you swallow?

A

Posteriorly

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25
Q

What 3 structures is the epiglottis attached to?

A
  1. Base of the Tongue
  2. Hyoid Bone
  3. Thryoid cartilage
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26
Q

What is formed at the attachment of the tongue to the epiglottis?

A

Median and Lateral Glossoepiglottic Folds

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27
Q

What Is formed between the glossoepiglottic folds?

A

Vallecula

**Small intentions where things can get caught

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28
Q

Where does the epiglottic cartilage meet the thyroid cartilage?

A
  • Attaches to the interior surface of the thyroid cartilage in midline (where two Laminae meet)
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29
Q

What forms the medial and lateral borders of the piriform recess?

A

Medial:
Cricoid and Arytenoid Cartilage

Lateral:
Thyroid Cartilage

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30
Q

What separates the Supraglottic space from the piriform recess?

A

Aryepiglottic Folds

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31
Q

What is included in the glottis?

A

Includes the Vocal Folds and the space between them

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32
Q

What is the space between the VOCAL folds called?

A

Rima Glottidis

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33
Q

What is the extent of the infraglottic space?

A
  • Vocal Folds to Inferior aspect of cricoid cartilage
34
Q

T or F: the vestibular folds are often known as Faslse vocal cords

A

True

35
Q

What are the posterior and anterior attachments of the vocal ligament?

A

Anterior:
Thyroid Cartilage

Posterior:
Vocal process of Arytenoid cartiages

36
Q

Where are the attachments of the Vestibular ligament relative to the vocal ligament?

A

Thyroid Anteriorly and Arytenoids Posteriorly but more superior and lateral than the true vocal folds.

37
Q

Movement around the verticle axis of the arytenoids brings about what motion in the vocal ligaments?

A
  • Abduction

- Adduction

38
Q

What are the boundaries of the quadrangular membrane?

  • Anteriorly
  • Posteriorly
  • Inferior/Medially
  • Superior/Laterally
A

Anteriorly:
Epiglottic Cartilage

Posteriorly:
Arytenoid Cartilage

Inferior/Medially:
Vestibular Ligament/Fold

Superior/Laterally:
Aryepiglottic Fold (when covered)
39
Q

What is formed between the vestibular and vocal folds?

A

The Ventricle

40
Q

What ligament thickens to form the vocal ligament/fold?

A
  • Conus Elasticus
41
Q

What are the borders of the Conus Elasticus?

  • Anteriorly
  • Posteriorly
  • Laterally
  • Medially
A

Anterior:
Thyroid Cartilage

Posterior:
Vocal Process of Arytenoid Cartilage

Laterally:
Cricoid Cartilage

Medially:
Vocal Ligament

42
Q

What is the job of the Intrisic Muscles of the Larynx?

A
  • Protect against entry of Foreign materials
  • Expel Objects
  • Tune vocal folds
43
Q

What part of the larynx creates speech?

A
  • Larynx Creates a buzzing tone, everthing above creates speech
44
Q

What does Flexion of the Cricothryoid muscles do the vocal folds?
- What joint is moving

A
  • Pulls them down ANTERIORLY by pulling (rotating) down thyroid cartilage
  • INCREASES tension by INCREASING fold length
  • Cricothyroid Joints
45
Q

What is the only 1 of the 7 intrinsic laryngeal muscles that is not innervated by the inferior layngeal n.?
- What is its innervation?

A
  • Cricothyroid

- Superior Layngeal n. (EXTERNAL branch)

46
Q

T or F: the nerve to the cricothyroid passes through a hole in the thyroid membrane.

A

FALSE, Cricothryoid is innervated by the EXTERNAL branch of the Superior Laryngeal n. but the INTERNAL branch passes through the Thyroid membrane (with superior Laryngeal a. => superior thyroid a.)

47
Q

Fibers from what muslce ascend to the aryepiglottic fold and blend with the aryepiglottic muscles along the laryngeal inlet?

A

Thyroarytenoid muscle

48
Q

Fibers of the Thyroarytenoid muscle that attach to the eppigottis are given a different name.

  • Name?
  • What do they do?
A
  • Thyroeppiglottic muscles

- Work WITH the Thyroarytenoid Muscles to pull down the epiglottis to cover the laryngeal inlet

49
Q

What muscle flexes to shorten the vocal folds and oppose the action of the cricothyroid m.?

A
  • Thyoarytenoid
50
Q

What makes up the intercartilagenous and intramembranous glottis?

A

Intermembranous:
-True vocal folds and space between them

Intercartilagenous:
- Vocal Processes of Arytenoid Cartilages and the Space between them

51
Q

What is the space between the vocal cords called?

A

Rima Glottis

52
Q

What muscles are flexed and relaxed during normal breathing?

A

Flexed:
- Posterior Arytenoids

Relaxed:
- Transverse and Oblique Arytenoids

***Since we spend most of our time breathing the POSTERIOR Arytenoids are FLEXED most of the time

53
Q

**What muscles are contracted during normal Speaking?

A
  1. Lateral Arytenoid

2. Transverse and Oblique Arytenoid

54
Q

**What is the status up the intermembranous and intercartilaginous parts of the larynx during speaking?

A
  • CLOSED
55
Q

**What regulates tension on the vocal Cords during normal speaking?

A
  1. Thyroartenoid (loosens, deepens)
  2. Vocalis (controls tone?)
  3. Cricoarytenoid m.
56
Q

What shaped the tone produced by the vocal cords into speech?

A
  1. Pharynx
  2. Oral Cavity
  3. Nasal Cavity
  4. Tongue
  5. Lips
57
Q

What 5 characteristics control the vibration of the vocal folds?

A
  1. Level of ADduction
  2. Thickness of Vocal Folds
  3. Length of Vocal Folds
  4. Tension on Vocal Folds
  5. Breath
58
Q

What controls the level of ADDUCTION of the vocal cords?

- what if these muscles are weak?

A
  • How Strongly the Cricoarytenoids are contracting

- Weak muscles = Breathy sound

59
Q

What controls the THICKNESS of vocal folds?

  • Thin vocal cord sound
  • Thick vocal cord sound
A
  1. Cricothyroid mm.
  2. Vocalis m.

THIN:
High Pitched Voice

THICK:
Deep voice

60
Q

What aspect of the sound of speech is controlled by TENSION on the vocal folds?

A
  • Affects tone PITCH

- Too much causes tightness in the throat and harsh tone

61
Q

Describe how the following change moving from low to high tone?

A
  1. Length INCREASES
  2. Tension on Vocal folds INCREASES
  3. Thickness of Vocal folds DECREASE
62
Q

How can the intermembranous Glottis close Independently of the Intercartilaginous glottis?

A

Contract:
LATERAL cricoarytenoids

Relax:
Transverse and Oblique arytenoids

63
Q

T or F: the vocal cords vibrate during a whisper.

A

FALSE, the air passing through is shaped into recognizable sounds by the structures of Superior Larynx

64
Q

What is the state intermembranous glottis and intercartilaginous glottis during coughing?
- muscles controlling this?

A
  • both are SHUT tight

Flexed:

  • Lateral Arytenoids
  • Transvers and Oblique Arytenoids
65
Q

What are the fiber types and action of the INTERNAL branch of the SUPERIOR LARYNGEAL n.?

A

GSA:
Mucosa and Glands Down Above Vocal Folds (Including Ventricles and sacculus)

GVA:
Mucosa and Glands Down Above Vocal Folds (Including Ventricles and sacculus)

SA:
Taste (base of tongue epiglottis)

66
Q

What nerve descends under the tendinous arch between the thyroid and cricoid cartilages?
- What does it innervate

A
  • EXTERNAL SUPERIOR Laryngeal n.
  • Innervates Cricothyroid

***this happens after it pierces and innervates the inferior constrictor (which creates the arch)

67
Q

What are the fiber types and action of the INFERIOR laryngeal n.?

A
  1. BE to ALL Intrinsic Muscles of larynx (EXCEPT Cricothyroid)
  2. GVE: all glands and mucosa BELOW vocal folds (including conus elasticus ligment)
  3. GSA: Below Vocal folds (including conus elasticus ligment)
68
Q

What are the fiber types and actions of the EXTERNAL branch of the superior laryngeal n.?

A
  1. BE - Cricothryoid Muscle
69
Q

What nerve gives parasympathetic innervation to the epiglottis, tongue, laryngeal inlet, and vestibule?

A
  • GVE fibers of Internal Superior Laryngeal n.
70
Q

What is the terminal branch of the recurrent laryngeal nn.?

A
  • Inferior Laryngeal n.
71
Q

Give the path of blood from the subclavian a. to the laynx.

A
  1. Subclavian a.
  2. Thyrocervical trunk
  3. Inferior Thyroid a.
  4. Interior Laryngeal a.
72
Q

Give the path of blood from the external carotid a. to the larynx.

A
  1. External Carotid a.
  2. Superior thyroid a.
  3. Superior laryngeal a. (actually pierces thyroid membrane w/ the v. and n.)
73
Q

What are some risk factors for laryngeal cancer?

A
  1. Smoking
  2. Drinking
  3. Weak Immune System
  4. GERD
  5. Male
74
Q

What causes a hemmoragic polyp on the vocal cords?

A
  • Broken Capillaries

**Polyp can hit the other side and cause some calluses to form

75
Q

What is the key indicator that something could be wrong with the larynx or its innervation?

A

Hoarseness

76
Q

What nerves are at risk in surgery on the carotid and what effect would this have?

**Note this is a unilateral lesion so loss of function would only occur on the side of the injury

A
  1. Cervical Portion of Vagus
    - Cut this and you would probably die
  2. Superior Laryngeal n.
    Internal portion:
    - Loss of sensation in the and parasympathetic activity of mucosa and glands down to vocal folds (GSA, GVE)
    - Loss of some taste (SA)

External Portion:
- Loss of function of Cricothyroid (no anterior down rotation of thyroid cart.)

77
Q

What nerves are at risk in surgery on the thyroid and what is the effect of hitting these?

**Note this is a unilateral lesion so loss of function would only occur on the side of the injury

A
  1. Inferior Laryngeal
    - Hit only one side you probably would have hoarseness of voice due to loss of function of the intrinsic muscles of the larynx (BE)
  • No parasympathetic activity below vocal folds (GVE)
  • No sensory below folds (GSA)
  1. External Branch of Superior laryngeal n.
    - loss of function of Cricothyroid
78
Q

What would a pancoast tumor affect?

A
  1. RIGHT RECURRENT LAYNGEAL => inferior laryngeal a. on the right
    - Hoarseness of the voice
79
Q

Would a pancoast tumor on the left lung apex have the same effect as the right?

A
  • NO because on the left side the LEFT recurrent laryngeal is around the arch of the aorta and travels more medially
80
Q

When would lung cancer affect the LEFT recurrent laryngeal?

A
  • If they metastasize to the Mediastinum or to the Tracheobrochial lymph nodes
81
Q

What should you think when you hear about a problem with the LEFT vocal cord?

A
  • Cancer in the CHEST near Left Recurrent Laryngeal
82
Q

What shoud you think when you hear about a problem with the RIGHT vocal cord?

A
  • Pancoast tumor (ON RIGHT lung apex)

Anatomy Week 14 BT (6 decks)

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