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Z-Anatomy > Larynx > Flashcards

Larynx Flashcards

1
Q

Where is the location of the larynx?

A
  • Enclosed in the pretracheal fascia of the neck
  • in the visceral layer of the pretracheal fascia
  • very thin muscular layer lies anterior to the visceral layer
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2
Q

what is the larynx anterior to?

A

laryngopharynx

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3
Q

what is the larynx between?

A

carotid sheath structures

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4
Q

what level of the cervical vertebrae is the larynx found?

A

C4-C6

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5
Q

what does the ;larynx communicate with?

A
  • oropharynx and nasopharynx above
  • oral cavity
  • nasal cavity
  • trachea below
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6
Q

at what vertebral level does the larynx become the trachea?

A

C6

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7
Q

what is the skeleton of the larynx made of?

A

composed of cartilages suspended from hyoid bone

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8
Q

what are the functions of the larynx?

A

-maintaining patency of URT
:cartilages

-help prevent entry of foreign bodies into LRT
:vocal cords and cough reflex

-produce sound
:vocal cords

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9
Q

what is the membrane connecting the hyoid bone and thyroid cartilage?

A

thyrohyoid membrane

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10
Q

what is the membrane connecting the thyroid cartilage and the cricoid cartilage?

A

cricothyroid membrane - access point for cricothryoid puncture

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11
Q

what type of cartilage are all the cartilages and what is the exception?

A
  • Hyaline

- Exception : epiglottis is elastic

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12
Q

How many cartilages are there in the larynx?

A

9

  • 3 pairs
  • 3 individual
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13
Q

what is the only cartilage that is completely enclosed?

A

cricoid

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14
Q

what are the 2 horns of the thyroid cartilage?

A
  • superior

- inferior

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15
Q

what is the anterior structure of the thyroid cartilage?

A

laryngeal prominence

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16
Q

what allows the nodding movement between the thyroid and cricoid cartilages?

A

the capsule of the right cricothyroid joint (synovial)

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17
Q

what stretches the posterior and slightly lateral side of the cricoid cartilage?

A

lamina

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18
Q

what is the way into the larynx?

A

laryngeal inlet

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19
Q

what cartilage is found inside the larynx?

A

arytenoid cartilages

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20
Q

where do the vocal cords attach between?

A
  • thryoid cartilage

- vocal processes of arytenoid cartilages

21
Q

what do the anterior and lateral processes of the arytenoid cartilage attach to?

A
  • anterior- vocal cord

- lateral- muscule attaches

22
Q

what is the space between the vocal cords called?

A

rima glottidis

23
Q

what cartilages are located deep to the laryngeal mucosa and what is their function?

A
  • cuneiform and corniculate cartilages

- support the laryngeal inlet but play no part in moving the vocal cords

24
Q

what is the mucosal lining of the inside of the larynx mainly and whats the exception?

A
  • respiratory epithelium

- exception: the vocal cords - stratified squamous epithelium

25
Q

what is the mucociliary escalator?

A
  • mucous glands secrete mucous onto the epithelial surface
  • cilia beat to sweep the mucous (plus any foreign bodies stuck in the mucous) superiorly, towards the pharynx, to be swallowed
26
Q

Describe the vocal cords.

A

False vocal cords:

  • superior
  • vestibular folds

True vocal cords:

  • inferior
  • vocal folds
27
Q

what is the main sensory supply to the laryngeal mucosa?

A

CN X -vagus

28
Q

what branch of vagus supplies superior to vocal fold?

A

internal laryngeal branches of superior laryngeal branch of CN X

29
Q

what branch of vagus supplies vocal fold and inferior?

A

recurrent laryngeal branches of CN X

30
Q

what is the continuation of the recurrent laryngeal nerve that supplies the larynx?

A

inferior laryngeal nerve

31
Q

Describe the extrinsic muscles of larynx.

A

Suprahyoid muscles:

  • Elevators of the larynx (and hyoid)
  • Also stylopharyngeus

Infrahyoid muscles:
-Depressors of the larynx (and hyoid)

32
Q

where are the intrinsic muscles of the larynx found?

A

attach between cartilages

33
Q

what are the 4 types of intrinsic muscles of the larynx?

A
  • tensors (of the vocal cords)
  • relaxers(of the vocal cords)
  • adductors (of the vocal cords)
  • abductors (of the vocal cords)
34
Q

what are all the intrinsic muscles of the larynx supplied by?

A

(somatic) motor branches of the vagus nerves (CNs X)

35
Q

what muscle tenses the vocal cords?

A

-cricothryoid muscles -‘nodding’ the thyroid cartilage anteriorly at the cricothyroid joints, stretches vocal cord

36
Q

what muscle relaxes the vocal cords?

A
  • thyro-arytenoid muscles

- pull the arytenoid cartilages towards the thyroid cartilage

37
Q

what muscle adducts the vocal cords?

A
  • lateral cricoid-arytenoid muscles

- rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline

38
Q

what other muscles assist cricoid-arytenoid in adducting the vocal cords?

A
  • arytenoid muscles
  • transverse and oblique arytenoids
  • sphincter function
39
Q

what muscle abducts the vocal cords?

A
  • posterior cricoid-arytenoid muscles
  • rotate the arytenoid cartilages so that the vocal processes of the cartilages move laterally
  • widens the rima glottidis
40
Q

Describe the shape of the rima glottidis.

A

a) resting - laryngeal muscles relaxed
b) forced respiration - posterior crico-arytenoids contract
c) Phonation- arytenoids contract and assist lateral cricoid-arytenoids
d) whispering- lateral cricoid - arytenoids contract

41
Q

How is sound produced in the larynx (phonation)?

A
  • expire a stream of air across vocal cords

- length/tension of vocal cords dictates pitch of sound produced by vibration of the cords

42
Q

Describe the production of oral sounds.

A
  • soft palate tenses (CN V3) and elevates (CN X) to close off entrance into nasopharynx
  • directs stream of air through oral cavity
  • sound interrupted by the tongue (CN XII) and the teeth/lips (CN VII) to produce most vowels and consonants in English language
43
Q

Describe the production of nasal sounds.

A
  • soft palate tenses (CN V3) and descends (CN X) to close off entrance into oropharynx
  • directs stream of air through nasal cavities
  • produces one of three sounds: “m”, “n” or “ing” depending on position of tongue (CN XII), teeth and lips (CN VII)
44
Q

How can you clinically test the vagus nerve?

A

-listen to patient speak:
is voice hoarse?
are the intrinsic muscles of larynx functioning normally to move the vocal cords

-ask patient to swallow small sip of water:
watch larynx move up and down

-ask patient to cough:
is cough normal and powerful?
also requires functioning diaphragm, phrenic nerves, abdominal wall

45
Q

Describe the anatomy of coughing.

A
  • breathe in using the diaphragm (phrenic nerves)
  • close the vocal ligaments (CN X)
  • contract the abdominal wall to build up pressure beneath the closed vocal ligaments
  • suddenly open the vocal ligaments (CN X)
  • tense (CN V3) and raise (CN XI) the soft palate to direct the stream of air through the mouth
46
Q

what is aspiration?

A

Inhalation of liquid or solid into the lungs

47
Q

what are the symptons of a patient with damage to CN X ?

A
  • a hoarse voice
  • abnormal swallow
  • weak cough
48
Q

what are emergency airway manangment procedures during laryngeal obstruction?

A
  • Heimlich manoeuvre

- Cricothyroid puncture / tracheostomy

Z-Anatomy (25 decks)

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