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Y2S1 RESP. > Larynx > Flashcards

Larynx Flashcards

1
Q

3 functions of the larynx

A

– Transport of air
– Protective sphincter
– Phonation

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2
Q

where is the larynx

A

Lies between the levels of ~C3- C6 vertebrae
Mobile
Slightly higher in newborns and
infants

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3
Q

EPIGLOTTIS

A

Attached to the thyroid cartilage by the thyroepiglottic ligament
Attached to the hyoid bone by the hyoepiglottic ligament

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4
Q

what makes up the thyroid cartilage

A 
Left and right laminae
 Superior and inferior horns
• Superior horns attached to the hyoid
• Inferior horns articulate with the cricoid cartilage
 Superior thyroid notch
 Thyroid angle  laryngeal
prominence (Adam’s apple)
The oblique line, for muscle attachment
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5
Q

CRICOID CARTILAGE

A

Shape of a signet ring with the lamina posteriorly
Articulates with the arytenoids and the thyroid
Note the “sloping shoulder” on the lamina for arytenoid articulation

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6
Q

ARYTENOID CARTILAGE

A

Articulates with the sloping shoulders of the cricoid lamina and, superiorly, the corniculate cartilage

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7
Q

Vocal process

A

Anteriorly, for attachment of the vocal

ligament

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8
Q

Muscular process:

A

posteriorly for the attachment of posterior and lateral crico-arytenoid muscles

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9
Q

THYRO-HYOID MEMBRANE

A

Extends between the upper edges of the thyroid laminae and superior horns and the body and greater horns of the hyoid
It is thickened anteriorly and posteriorly as the median and lateral thyro-hyoid ligaments

Pierced by superior laryngeal vessels and superior laryngeal nerve (internal branch)

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10
Q

FIBRO-ELASTIC MEMBRANE

A
  • Elastic connective tissue underneath the laryngeal mucous membrane stretches between laryngeal cartilages and form fibro-elastic membranes
  • Fibro-elastic membranes are separated from each other by laryngeal ventricle
    • Superiorly quadrangular membrane• Inferiorly conus elasticus
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11
Q

QUADRANGULAR MEMBRANE

A

Layer of submucosa
Extends between lateral aspects of the epiglottis, arytenoid and corniculate cartilages.
Edges: aryepiglottic fold, vestibular ligament (fold

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12
Q

what makes up the vestibular fold

A

the ligament and the mucous membrane

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13
Q

CONUS ELASTICUS

A

Also called cricovocal membrane
Blends anteriorly with the median cricothyroid ligament
- The median cricothyroid ligament is the site of emergency access to the airway (tracheotomy)

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14
Q

VOCAL CORD

A
  • Vocal cord controls laryngeal diameter for:
    − Speech
    − Coughing/sneezing
    − Raising the intra-abdominal pressure
  • Lined with stratified squamous epithelium
    Muscles within and adjacent to the vocal folds narrow or widen the opening between them (rima glottis or glottidis), or alter their tension
    Vestibular cord (false vocal cord)
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15
Q

LARYNGEAL CAVITY

A
  1. The vestibule: between the laryngeal inlet and the vestibular folds
  2. The laryngeal ventricle: Recess between the vestibular and vocal folds
    − Leads to the saccule, which provides lubricating mucus for the vocal folds.
  3. The infraglottic cavity: between the vocal folds and the trachea
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16
Q

Laryngeal inlet

A

bound by the aryepiglottic folds

17
Q

Rima glottis

A

is the opening between the vocal cords and muscular processes of the arytenoid

18
Q

role of the muscles in the larynx

A

Its position is controlled by muscles, which, in turn
– alter laryngeal diameters to allow the passage of air only
– control airflow for speech
– raise intra-abdominal pressure

19
Q

Extrinsic muscles laryngeal muscles

A
  • Suprahyoid and infrahyoid muscles
  • Arrange the position of the larynx as a whole
  • Facilitate closing of the laryngeal inlet
20
Q

intrinsic muscles laryngeal muscles

A
  • Extend between laryngeal cartilages
  • Adjust the length or tension of the vocal ligaments
  • Open and close the rimaglottis
  • Control the inner dimensions of the vestibule
  • Facilitate closing of the laryngeal inlet
21
Q
  • Elevators of pharynx
A
  • Salpingopharyngeus
  • Palatopharyngeus
  • Stylopharyngeus
22
Q

Elevators of larynx

A
  • Stylohyoid
  • Mylohyoid
  • Geniohyoid
  • Thyrohyoid
  • Digastric
23
Q

Depressors of larynx:

A
  • Sternothyroid • Thyrohyoid

* Sternohyoid

24
Q

INTRINSIC LARYNGEAL MUSCLES roles

A
  1. Open/close the laryngeal inlet (aryepiglottic folds)
  2. Open/close the rima glottis (and rima vestibuli) - arytenoid gliding and rotation
  3. Lengthen the vocal folds - “rocking” at cricothyroid joints
25
Q
  1. Close the laryngeal inlet
A

Elevation of the larynx and pharynx by extrinsic muscles from skull to larynx and pharynx

  • Salpingopharyngeus - Palatopharyngeus
  • Stylopharyngeus
  • Stylohyoid

Ary-epiglottic muscle acts like a “purse-string”
Superior fibers of thyro- arytenoid muscle (a.k.a. thyro-epiglottic muscle)

26
Q

open the laryngeal inlet

A
  • Descent of larynx (and pharynx) by elastic recoil

- (Hyoepiglottic ligament)

27
Q

Open vocal folds or rima glottis

A

Posterior crico-arytenoid muscle

- the only muscle that opens the rima glottis

28
Q

Close vocal folds or rima glottis

A
  • Inferior fibres of thyro-arytenoid
  • Lateral crico-arytenoid
  • Transverse arytenoid
29
Q

Lengthen the vocal foldsalter the tension

A
  • The thyroid cartilage may be rocked forwards and backwards at the cricothyroid joint.
  • Crico-thyroid muscles lengthen, hence increase the tension of the vocal folds
30
Q

Alter the tension of vocal folds

A 
Vocalis muscle (part of Thyro-arytenoid muscle) change the tension of the vocal ligaments
- Increasing tension raises the pitch of the voice, while decreasing tension lowers it
31
Q

LARYNGOSCOPY

A
  • Vocal folds are adducted
  • Air forced through vocal folds causes vibration
  • Cord length and tension are altered by cricothyroid, thyro- arytenoid and vocalis muscles
  • Vocal and vestibular folds are adducted
  • he airway is closed by lateral crico-arytenoid and transverse arytenoid such as the Valsalva manoeuvre
32
Q

SWALLOWING

A

During swallowing:
− Laryngeal elevation
− Closure of the laryngeal inlet by epiglottis
As the larynx descends after swallowing the epiglottis springs back by hyoepiglottic ligament

33
Q

ARTERIAL SUPPLY

A

Superior laryngeal a. from Superior thyroid artery

Inferior laryngeal a. from Inferior thyroid artery

34
Q

VENOUS DRAINAGE

A

Superior laryngeal v. to superior thyroid v. to jugular internal v.

Inferior laryngeal v. to inferior thyroid v. to brachiocephalic v.

35
Q

what’s at risk during a tracheostomy

A

The inferior thyroid veins

36
Q

LYMPHATIC DRAINAGE

A

Above vocal cord to superior deep cervical lymph nodes

Below vocal cord to Prelaryngeal, pretracheal, inferior deep cervical and supraclavicular lymph nodes

No lymphatic connection between vocal cords

37
Q

NEURAL SUPPLY

A

The superior laryngeal nerve, a branch of vagus
– Internal branch (internal laryngeal nerve):
• Sensation of the larynx down to just above the vocal folds
• Accompanied by the superior laryngeal artery

– External branch (external laryngeal nerve):
• Supplies Cricothyroid muscle

  • Vagus recurrent laryngeal nerve inferior laryngeal nerve is accompanied by the inferior laryngeal artery
  • The recurrent laryngeal nerve supplies – all the intrinsic muscles of the
    larynx except cricothyroid
    – sensation to the vocal cords and larynx below

Y2S1 RESP. (38 decks)

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