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Anatomy Week 14 BT > Larynx > Flashcards

Larynx Flashcards

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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
What 3 structures is the epiglottis attached to?
1. Base of the Tongue 2. Hyoid Bone 3. Thryoid cartilage
26
What is formed at the attachment of the tongue to the epiglottis?
Median and Lateral Glossoepiglottic Folds
27
What Is formed between the glossoepiglottic folds?
Vallecula **Small intentions where things can get caught
28
Where does the epiglottic cartilage meet the thyroid cartilage?
- Attaches to the interior surface of the thyroid cartilage in midline (where two Laminae meet)
29
What forms the medial and lateral borders of the piriform recess?
Medial: Cricoid and Arytenoid Cartilage Lateral: Thyroid Cartilage
30
What separates the Supraglottic space from the piriform recess?
Aryepiglottic Folds
31
What is included in the glottis?
Includes the Vocal Folds and the space between them
32
What is the space between the VOCAL folds called?
Rima Glottidis
33
What is the extent of the infraglottic space?
- Vocal Folds to Inferior aspect of cricoid cartilage
34
T or F: the vestibular folds are often known as Faslse vocal cords
True
35
What are the posterior and anterior attachments of the vocal ligament?
Anterior: Thyroid Cartilage Posterior: Vocal process of Arytenoid cartiages
36
Where are the attachments of the Vestibular ligament relative to the vocal ligament?
Thyroid Anteriorly and Arytenoids Posteriorly but more superior and lateral than the true vocal folds.
37
Movement around the verticle axis of the arytenoids brings about what motion in the vocal ligaments?
- Abduction | - Adduction
38
What are the boundaries of the quadrangular membrane? - Anteriorly - Posteriorly - Inferior/Medially - Superior/Laterally
Anteriorly: Epiglottic Cartilage Posteriorly: Arytenoid Cartilage Inferior/Medially: Vestibular Ligament/Fold ``` Superior/Laterally: Aryepiglottic Fold (when covered) ```
39
What is formed between the vestibular and vocal folds?
The Ventricle
40
What ligament thickens to form the vocal ligament/fold?
- Conus Elasticus
41
What are the borders of the Conus Elasticus? - Anteriorly - Posteriorly - Laterally - Medially
Anterior: Thyroid Cartilage Posterior: Vocal Process of Arytenoid Cartilage Laterally: Cricoid Cartilage Medially: Vocal Ligament
42
What is the job of the Intrisic Muscles of the Larynx?
- Protect against entry of Foreign materials - Expel Objects - Tune vocal folds
43
What part of the larynx creates speech?
- Larynx Creates a buzzing tone, everthing above creates speech
44
What does Flexion of the Cricothryoid muscles do the vocal folds? - What joint is moving
- Pulls them down ANTERIORLY by pulling (rotating) down thyroid cartilage - INCREASES tension by INCREASING fold length - Cricothyroid Joints
45
What is the only 1 of the 7 intrinsic laryngeal muscles that is not innervated by the inferior layngeal n.? - What is its innervation?
- Cricothyroid | - Superior Layngeal n. (EXTERNAL branch)
46
T or F: the nerve to the cricothyroid passes through a hole in the thyroid membrane.
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
Fibers from what muslce ascend to the aryepiglottic fold and blend with the aryepiglottic muscles along the laryngeal inlet?
Thyroarytenoid muscle
48
Fibers of the Thyroarytenoid muscle that attach to the eppigottis are given a different name. - Name? - What do they do?
- Thyroeppiglottic muscles | - Work WITH the Thyroarytenoid Muscles to pull down the epiglottis to cover the laryngeal inlet
49
What muscle flexes to shorten the vocal folds and oppose the action of the cricothyroid m.?
- Thyoarytenoid
50
What makes up the intercartilagenous and intramembranous glottis?
Intermembranous: -True vocal folds and space between them Intercartilagenous: - Vocal Processes of Arytenoid Cartilages and the Space between them
51
What is the space between the vocal cords called?
Rima Glottis
52
What muscles are flexed and relaxed during normal breathing?
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
**What muscles are contracted during normal Speaking?
1. Lateral Arytenoid | 2. Transverse and Oblique Arytenoid
54
**What is the status up the intermembranous and intercartilaginous parts of the larynx during speaking?
- CLOSED
55
**What regulates tension on the vocal Cords during normal speaking?
1. Thyroartenoid (loosens, deepens) 2. Vocalis (controls tone?) 3. Cricoarytenoid m.
56
What shaped the tone produced by the vocal cords into speech?
1. Pharynx 2. Oral Cavity 3. Nasal Cavity 4. Tongue 5. Lips
57
What 5 characteristics control the vibration of the vocal folds?
1. Level of ADduction 2. Thickness of Vocal Folds 3. Length of Vocal Folds 4. Tension on Vocal Folds 5. Breath
58
What controls the level of ADDUCTION of the vocal cords? | - what if these muscles are weak?
- How Strongly the Cricoarytenoids are contracting | - Weak muscles = Breathy sound
59
What controls the THICKNESS of vocal folds? - Thin vocal cord sound - Thick vocal cord sound
1. Cricothyroid mm. 2. Vocalis m. THIN: High Pitched Voice THICK: Deep voice
60
What aspect of the sound of speech is controlled by TENSION on the vocal folds?
- Affects tone PITCH | - Too much causes tightness in the throat and harsh tone
61
Describe how the following change moving from low to high tone?
1. Length INCREASES 2. Tension on Vocal folds INCREASES 3. Thickness of Vocal folds DECREASE
62
How can the intermembranous Glottis close Independently of the Intercartilaginous glottis?
Contract: LATERAL cricoarytenoids Relax: Transverse and Oblique arytenoids
63
T or F: the vocal cords vibrate during a whisper.
FALSE, the air passing through is shaped into recognizable sounds by the structures of Superior Larynx
64
What is the state intermembranous glottis and intercartilaginous glottis during coughing? - muscles controlling this?
- both are SHUT tight Flexed: - Lateral Arytenoids - Transvers and Oblique Arytenoids
65
What are the fiber types and action of the INTERNAL branch of the SUPERIOR LARYNGEAL n.?
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
What nerve descends under the tendinous arch between the thyroid and cricoid cartilages? - What does it innervate
- EXTERNAL SUPERIOR Laryngeal n. - Innervates Cricothyroid ***this happens after it pierces and innervates the inferior constrictor (which creates the arch)
67
What are the fiber types and action of the INFERIOR laryngeal n.?
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
What are the fiber types and actions of the EXTERNAL branch of the superior laryngeal n.?
1. BE - Cricothryoid Muscle
69
What nerve gives parasympathetic innervation to the epiglottis, tongue, laryngeal inlet, and vestibule?
- GVE fibers of Internal Superior Laryngeal n.
70
What is the terminal branch of the recurrent laryngeal nn.?
- Inferior Laryngeal n.
71
Give the path of blood from the subclavian a. to the laynx.
1. Subclavian a. 2. Thyrocervical trunk 3. Inferior Thyroid a. 4. Interior Laryngeal a.
72
Give the path of blood from the external carotid a. to the larynx.
1. External Carotid a. 2. Superior thyroid a. 3. Superior laryngeal a. (actually pierces thyroid membrane w/ the v. and n.)
73
What are some risk factors for laryngeal cancer?
1. Smoking 2. Drinking 3. Weak Immune System 4. GERD 5. Male
74
What causes a hemmoragic polyp on the vocal cords?
- Broken Capillaries **Polyp can hit the other side and cause some calluses to form
75
What is the key indicator that something could be wrong with the larynx or its innervation?
Hoarseness
76
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
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
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
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) 2. External Branch of Superior laryngeal n. - loss of function of Cricothyroid
78
What would a pancoast tumor affect?
1. RIGHT RECURRENT LAYNGEAL => inferior laryngeal a. on the right - Hoarseness of the voice
79
Would a pancoast tumor on the left lung apex have the same effect as the right?
- NO because on the left side the LEFT recurrent laryngeal is around the arch of the aorta and travels more medially
80
When would lung cancer affect the LEFT recurrent laryngeal?
- If they metastasize to the Mediastinum or to the Tracheobrochial lymph nodes
81
What should you think when you hear about a problem with the LEFT vocal cord?
- Cancer in the CHEST near Left Recurrent Laryngeal
82
What shoud you think when you hear about a problem with the RIGHT vocal cord?
- Pancoast tumor (ON RIGHT lung apex)

Anatomy Week 14 BT (6 decks)

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