Larynx Flashcards
What are the arytenoids?
Cartilaginous structures that surround the opening of the trachea, and adjust the vocal cords
What are the changes that occur with viral laryngitis?
Free edges become swollen
What causes vocal cord polyps?
Irritation of the vocal cords, causing a blood vessel inflammatory reaction which forms a polyp
True or false: vocal cord polyps are usually bilateral
False–unilateral
Are vocal cord polyps usually a slow onset or acute onset?
Acute
What is the treatment for vocal cord polyps?
Surgery
What is polypoid corditis?
Many polyps that cover the vocal cords
What are the causes of polypoid corditis?
- Reflux
- Smoking
- Talker
What is the treatment for polypoid corditis?
Surgery
What is the recurrence rate of polypoid corditis?
Very low
What are the issues with polypoid corditis?
Trouble breathing, and speaking
What are traumatic granulomas?
chronic irritation of the vocal cords causes a granulation tissue to form, which will eventually turn into a scar
What are the signs of acid reflux?
- Postcricoid and interarytenoid edema
- Thickening of the skin
- Reinke’s edema
What is Reinke’s edema?
Edema of the tissue beneath the vocal cords that causes vocal cord swelling
What is the treatment for early onset traumatic granuloma?
Steroids and reflux control can reverse the process
What is the point where surgery is absolutely indicated for traumatic granulomas?
If the granulation tissue becomes fibrotic
When should the vocal cords be visualized after intubation?
If hoarseness persists after 10 ish days
What are vocal cord nodules?
callouses of the vocal cords d/t repetitive motion and irritation
True or false: vocal cord nodules are almost always bilateral and symmetrical
True
What causes vocal cord nodules?
Rubbing of the vocal cords against each other causes chronic irritation
What usually causes vocal cord nodules?
-Acid reflux causes inflammation of the vocal cords
True or false: almost all patients who have reflux in the trachea have heartburn
False
What are the s/sx of vocal cord nodules?
- Quality of voice affected
- bolus/ chronic throat clearing
What is the treatment for vocal cord nodules?
- Reflux management
- Voice therapy for vocal hygiene
- NOT surgical
True or false: vocal cord nodules are a surgical fix
False
True or false: with appropriate treatment, vocal cord nodules usually diappear
True
True or false: laryngeal cancer is incurable
False–very curable when caught in the early stages
Smokers with a new onset of hoarseness always need to be evaluated for what?
Laryngeal cancer
What is the focus of treatment for laryngeal cancer?
Laryngeal preservation if possible
What is the treatment for laryngeal cancer?
Surgery, often combined with local XRT
True or false: laryngeal cancer tends to metastasize early
False–not until late in the disease course
True or false: laryngeal cancer is a smoker’s disease
true, for the most part
What causes pachyderm larynx?
Acid reflux
True or false: even a small amount of vocal fold edema can have a dramatic impact of vocal quality
True
True or false: swelling of the vocal cords must occur to have acid reflux causing edema
False
What are the s/sx of reflux laryngitis? (4)
- Dysphonia
- Globus
- Throat clearing
- Chronic cough
How common is reflux laryngitis?
Very
True or false: patients with reflux laryngitis often lack the heartburn or regurg sensation
True
What is the treatment for reflux laryngitis?
- Lifestyle modifications
- PPIs
What are the drinks that lead to reflux laryngitis?
- Coffee
- Spicy foods
- Orange juice
Do patients need to be on PPIs for life with reflux laryngitis?
Not usually
Child with a smoker’s voice = ?
Chronic reflux laryngitis
2 year old diagnosed with asthma = ?
Acid relfux
True or false: most kids who have reflux laryngitis will outgrow it
True
What is the treatment for reflux laryngitis in kids?
- PPIs
- Voice therapy
Laryngomalacia is more common in which gender?
Males
What are the usual s/sx of laryngomalacia?
- Hoarse cry
- Inspiratory stridor when upset
True or false: laryngomalacia is usually self limited
True
What are the signs of tracheomalacia?
- Folding of the arytenoids
- Curling of the epiglottis
Why inspiratory stridor with laryngomalacia?
Arytenoids are sucked in when breathing in
When does laryngomalacia usually present?
1st or 2nd month of life
True or false; there is a strong relationship of laryngomalacia with reflux disease
True
True or false: surgery is often indicated for laryngomalacia
False–very rare. For children who are fail to thrive
What type of stridor is had with laryngomalacia (inspiratory or expiratory)?
Inspiratory
How common is vocal cord dysfunction?
Very common
What are the s/sx of vocal cord dysfunction?
- Inspiratory stridor
- cough
- Variant asthma
- PVC motion
What are the causes of vocal cord dysfunction?
External irritants
Blunted inspiratory loop = ?
External obstruction
What is the treatment for vocal cord dysfunction?
- Control irritants
- Speech therapy
- Reflux control
What is the nerve that controls the vocal cord?
Recurrent laryngeal nerve
What are the symptoms of one vocal cord impairment?
Sudden onset Hoarse, breathy voice
What causes vocal cord paralysis? Prognosis?
- Viral inflammation of the nerve
- Self limited
The recurrent laryngeal nerve is a branch of what nerve?
CN X
What are the s/sx of bilateral vocal cord paralysis?
Voice is fine, but cannot breathe
What are the effects of vocal cord hemorrhages?
Edema, but unless professional voice user, not much lasting effects
What is the treatment for a vocal cord hemorrhage?
Self limiting, but can give steroids to prevent inflammatory changes
Who usually gets laryngeal papillomas?
Children
What causes laryngeal cysts?
The glands of the larynx gets inflamed
What is the treatment for vocal cord candidiasis?
Oral antifungals
What are the signs of vocal cord leukoplakia?
White patch of Leukoplakia on the vocal cords
