Larynx

Question 1

The larynx is continuous with the ____ posteriorly and superiorly, and with the ____ inferiorly

Answer 1

pharynx; trachea

Question 2

The larynx is located at vertebral body levels ___-___

Answer 2

C3-C6

Question 3

What are the 3 functions of the larynx?

Answer 3

1. passage of air
2. sphincter (close RT during swallowing)
3. phonation

Question 4

The laryngeal skeleton (9 cartilages) is formed by ____ cartilage, with the exception of the epiglottic cartilage formed by ____ cartilage

Answer 4

hyaline; elastic

Question 5

This is the largest of the laryngeal cartilage. It consists of two quadrangular laminae fused anteriorly with the adam’s apple

Answer 5

Thyroid cartilage

Question 6

The oblique line is a ridge on the posterolateral sides of the thyroid cartilage for attachment of what 3 muscles?

Answer 6

sternothyroid, thyrohyoid, inferior pharyngeal constrictor

Question 7

This is the only cartilage to completely encircle the airway. It has a thin anterior arch and an enlarged lamina posteriorly. The lamina articulates with the arytenoid cartilages

Answer 7

Cricoid cartilage

Question 8

This cartilage is a paired set, located posteriorly in the larynx, sitting atop the lamina of the cricoid. It has a three-sided pyramidal shape with a posterolateral projection for muscular attachment, an anterior projection for vocal ligaments, and a superior apex.

Answer 8

Arytenoid cartilage

Question 9

This cartilage is paired, sits atop the apices of the arytenoid cartilages and is conical-shaped.

Answer 9

corniculate cartilages

Question 10

This cartilage is single, paddle or teardrop-shaped, located posterior to the root of the tongue and hyoid bone, and is broad with a free superior part and an inferior stalk attached to the internal surface of the angle between laminae anteriorly

Answer 10

epiglottic cartilage

Question 11

The larynx grows from birth to childhood. At puberty, laryngeal cartilages enlarge and laryngeal prominences become more obvious in males due to influence of ____

Answer 11

testosterone

Question 12

These joints are synovial articulations of inferior horns of thyroid cartilage and the lamina of cricoid cartilage

Answer 12

cricothyroid joints

Question 13

In regards to the cricothyroid joints, as thyroid cartilage tilts anteriorly, the vocal folds are ____

Answer 13

tensed

note: posterior tilting loosens vocal folds

Question 14

These joints are synovial articulations of arytenoid cartilage and the lamina of cricoid cartilage

Answer 14

cricoarytenoid joints

Question 15

In regards to cricoarytenoid joints, the arytenoid cartilages slide transversely and pivot on cricoid cartilage which results in what?

Answer 15

abduction or adduction of the vocal processes

Question 16

The thyrohyoid membrane connects the ____ border of the thyroid cartilage to the ____ and ____ ____ of the hyoid bone

Answer 16

superior; body; greater horns

Question 17

The openings in the thyrohyoid membrane allow passage of what vessels/nerve

Answer 17

superior laryngeal vessels; internal laryngeal nerve

Question 18

This ligament attaches the inferior surface of the cricoid to the upper border of the 1st tracheal ring

Answer 18

cricotracheal ligament

Question 19

This ligament passes from anterior midline of epiglottis to the body of the hyoid bone. It limits epiglottic movement posteriorly

Answer 19

hyoepiglottic ligament

Question 20

The thryoepiglottic ligament attaches the ____ of the epiglottic cartilage to thyroid cartilage

Answer 20

stalk

Question 21

This is an elastic membrane that attaches to the superior surface of cricoid cartilage and projects superomedially inside the thyroid cartilage

Answer 21

conus elasticus

Question 22

The upper, free edges of conus elasticus are thickened to form ____ ____ which attach postiorly to the ____ ____ of the arytenoid cartilages and anteriorly to the thyroid laminae

Answer 22

vocal ligaments (cords); vocal processses

Question 23

The thickened anterior portion of conus elasticus is the ____ _____ ligament

Answer 23

median cricothryoid

Question 24

This ligament is a thin submucosal CT that supports the aryepiglottic fold. It is attached between epiglottic and arytenoid cartilages.

Answer 24

quadrangular ligament

Question 25

The free superior margin of the quadrangular ligament forms the _____ ligament, the free inferior margin forms the ____ ligament

Answer 25

aryepiglottic; vestibular

Question 26

The vestibular ligament attaches where?

Answer 26

below the apex of the arytenoid cartilage and to the thyroid cartilage above the vocal ligament

Question 27

The superior opening of the larynx is called what?

Answer 27

laryngeal inlet

Question 28

The vestibule of the larynx is the space between the ____ folds

Answer 28

aryepiglottic

Question 29

The space between the vestibular folds is called the ____ _____

Answer 29

rima vestibuli

Question 30

The narrow space between the vestibular and vocal folds is called the laryngeal ventricle. It extends anterosuperiorly as the ____, a blind pouch with numerous mucous glands

Answer 30

saccule

Question 31

The mucosa of the ventricle continues inferiorly to cover the vocal ligaments to form the ____ ____

Answer 31

vocal folds (true vocal cords)

Question 32

The opening between two vocal folds is ____ _____

Answer 32

rima glottidis

Question 33

The shape of rim glottidis is ____ during normal respiration and ____ during forced respiration, and _____-like during phonation

Answer 33

narrow; wide; phonation

Question 34

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Posterior cricoarytneoid muscle

Answer 34

origin: lamina of cricoid cartilage insertion: muscular process of arytenoid cartilage action: abduction of vocal folds -> opens rima glottidis

Question 35

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Lateral cricoarytenoid muscle

Answer 35

origin: cricoid cartilage insertion: muscular process of arytenoids action: adducting vocal folds -> closes rima glottidis

Question 36

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Transverse arytenoid muscle

Answer 36

attachments: spans between arytenoid cartilages posteriorly action: assists with adduction of vocal folds

Question 37

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: oblique arytenoid muscle

Answer 37

origin: muscular process of arytenoids insertion: apex of opposite arytenoid action: assists with adduction of the vocal folds

Question 38

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Cricothyroid muscle

Answer 38

origin: arch of cricoid cartilage insertion: inferior edge of thyroid cartilage action: stretches/tenses vocal folds (allowing pitch to be raised)

Question 39

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Thyroarytenoid muscle

Answer 39

origin: anterior thyroid cartilage (arises internally) insertion: anterolateral surface of arytenoid cartilage action: relaxing vocal folds

Question 40

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Vocalis muscle

Answer 40

origin: arytenoid cartilage (vocal processes) insertion: vocal ligament action: fine tunes tension on vocal folds

Question 41

For the following intrinsic muscle of the larynx, give the origin, insertion, and action: Thyroepiglottic muscle

Answer 41

origin: extension of thyroarytenoid muscle insertion: aryepiglottic fold action: sphincter for the aditus

Question 42

The superior laryngeal artery, which supplies most of the upper part of the larynx is usually a branch from this artery

Answer 42

superior thyroid artery

Question 43

The inferior laryngeal artery supplies the lower part of the larynx after arising form the inferior thyroid artery which is a branch from what?

Answer 43

thyrocervical trunk

Question 44

The inferior laryngeal artery ascends with what nerve?

Answer 44

recurrent laryngeal nerve

Question 45

The superior laryngeal vein drains through the ____ ____ vein into the ____ ____ vein

Answer 45

superior thyroid; internal jugular

Question 46

The inferior laryngeal vein drains through the ____ ____ vein to the ____ ____ vein

Answer 46

inferior thyroid; left brachiocephalic

Question 47

Sensory innervation of the larynx is entirely from branches of the vagus nerve. From the aditus to the vocal cords, the mucosa is supplied by the _____ ____ nerves; below the vocal cords the mucosa is innervated by the ____ ____ nerves

Answer 47

internal laryngeal; recurrent laryngeal

Question 48

Motor innervation to the cricothryoid muscle is by the ____ ____ nerve, while all other muscles in the larynx are innervated by the _____ ____ nerves

Answer 48

external laryngeal; recurrent laryngeal

Question 49

Motor neurons to laryngeal muscles, as well as preganglionic parasympathetic neuron cell bodies are in the ____ ____

Answer 49

brain stem

Question 50

What are the two branches of superior laryngeal nerve? What is the continuation of the recurrent laryngeal nerve?

Answer 50

superior laryngeal nerve: internal and external laryngeal nerves recurrent laryngeal nerve: inferior laryngeal nerve

Question 51

Damage to this nerve can cause desensitization of superior larynx and hence more likely to have difficulty swallowing yielding laryngeal foreign bodies and choking

Answer 51

internal laryngeal nerve

Question 52

Damage to this nerve can paralyze cricothryoid muscle, resulting in a weak voice, lowered pitch, or monotone voice

Answer 52

external laryngeal nerve

Question 53

Damage to this nerve can result in vocal fold paralysis

Answer 53

inferior laryngeal nerve

Question 54

Damage to this nerve results in the abductors being more affected than adductors which is known as Semon's law. This yields an adducted position of affected cords.

Answer 54

recurrent laryngeal nerve