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MD3001 Respiratory > Larynx > Flashcards

Larynx Flashcards

1
Q

Where does the larynx sit?

A
  • between the oropharynx and the trachea
  • between C3-6
  • hangs under hyoid
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2
Q

What is the larynx?

A

membranous fibro-elastic tube suspended between cartilages

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3
Q

What are the 3 main functions of the larynx?

A
  • transport of air
  • protective sphincter
  • phonation (sound)
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4
Q

What is the anatomical difference in the larynx of newborns?

A

slightly higher

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5
Q

What are the laryngeal cartilages? (know how to label diagram)

A
  • epiglottis
  • thyroid
  • cricoid
  • arytenoid
  • corniculate
  • cuneiform
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6
Q

What are the attachments of the epiglottis?

A
  • thyroid cartilage by thyroepiglottic ligament

- hyoid bone by hyoepiglottic ligament

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7
Q

Describe what makes up the thyroid cartilage

A
  • left and right laminae
  • superior horns attached to hyoid bone
  • inferior horns attached to cricoid cartilage
  • superior thyroid notch
  • oblique line for muscle attachment
  • thyroid angle which is the laryngeal prominence
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8
Q

What does the cricoid thyroid articulate with?

A
  • arytenoids and thyroid
  • has sloping shoulder on lamina for arytenoid articulation
  • ridge posteriorly for attachment with oesophagus
  • depression posteriorly for attachment of crico-arytenoid muscle
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9
Q

What does the arytenoid cartilage articulate with?

A
  • artciulates with sloping shoulder of cricoid and lamina
  • superiorly articulates with corniculate
  • vocal process anteriorly for vocal ligament
  • muscular process posterior for posterior and lateral crico-arytenoid muscles
  • 2 depressions anteriorly for vestibular ligament and vocalis muscle
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10
Q

Where is the thyro-hyoid membrane located?

A

between upper edges of thyroid laminae and superior horns, and greater horns of hyoid

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11
Q

What are the important features of the thyro-hyoid membrane?

A
  • thickened anteriorly and posterior to become median and lateral thyro-hyoid ligaments
  • pierced by superior laryngeal vessels and superior laryngeal nerve
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12
Q

What are the orders of the membranes from superficial to deep?

A

laryngeal mucus membrane then fibro-elastic membrane then cartilaginous skeleton

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13
Q

What separates the fibro-elastic membrane and what is it divided into?

A
  • fibro-elastic membranes separated by laryngeal ventricle
  • superiorly is the quadrangular membrane
  • inferiorly is conus elasticus
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14
Q

What does the quadrangular membrane cover and what are the edges?

A
  • between lateral aspects of epiglottis, arytenoid and corniculate cartilages
  • edges: aryepiglottic fold and vestibular fold
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15
Q

What structures form the vestibular fold?

A

vestibular ligament and mucous membrane

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16
Q

What is the clinical significance of the median cricothyroid ligament?

A

site of emergency access to airway (tracheotomy)

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17
Q

What are the 2 parts of the conus elasticus?

A
  • cricovocal membrane

- median cricothyroid ligament

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18
Q

What is the function of the vocal/vestibular cord?

A
  • speech
  • coughing/sneezing
  • raising the intra-abdominal pressure
19
Q

What is contained within the laryngeal cavity?

A
  • vesibule: between laryngeal inlet and vestibular folds
  • laryngeal ventricle: recess between vestibuar and vocal folds leading to the saccule
  • infraglottic cavity: between vocal folds and trachea
20
Q

What does the saccule do?

A

lubricates the vocal folds

21
Q

What is the boundary the laryngeal inlet?

A

aryepiglottic folds

22
Q

What is the rima glottis?

A

opening between the vocal cords and muscular processes of the arytenoid

23
Q

What are the functions of the muscles of the larynx?

A

controls the position of the larynx to:

  • alter laryngeal diameter to allow passage of air only
  • control airflow for speech
  • raise intra-abdominal pressure
24
Q

What are the extrinsic laryngeal muscles?

A
  • suprahyoid

- infrahyoid

25
Q

What are the functions of the extrinsic laryngeal muscles?

A
  • arrange the position of the larynx

- facilitate closing of laryngeal inlet

26
Q

What are the functions of the intrinsic muscles?

A
  • adjust length/tension of vocal ligaments
  • open and close rima glottis
  • control inner dimensions of vestibule
  • facilitate closing of laryngeal inlet
27
Q

Where are the intrinsic laryngeal muscles?

A

extend between laryngeal cartilages

28
Q

What extrinsic laryngeal muscles elevate the pharynx?

A
  • salpingopharyngeus
  • palatopharyngeus
  • stylopharyngeus
29
Q

What extrinsic laryngeal muscles elevate the larynx?

A
  • stylohyoid
  • mylohyoid
  • geniohyoid
  • thyrohyoid
  • digastric
30
Q

What extrinsic laryngeal muscles depress the larynx?

A
  • sternothyroid
  • thyrohyoid
  • stylohyoid
31
Q

What laryngeal muscles close the laryngeal inlet?

A
  • salpingopharyngeus
  • palatopharyngeus
  • stylopharyngeus
  • stylohyoid
  • aryepiglottic muscle (purse string)
  • thyro-epiglottic muscle (superior fibres)
32
Q

Describe how the laryngeal inlet opens

A
  • larynx descends by elastic recoil

- hypoepiglottic ligament

33
Q

What muscle opens the vocal folds/rima glottis?

A

posterior crico-arytenoid muscle

34
Q

What muscles close the vocal folds/rima glottis?

A
  • inferior fibres of thyro-arytenoid
  • lateral crico-arytenoid
  • transverse arytenoid
35
Q

What lengthens the vocal folds?

A
  • rocking of the thyroid cartilage backwards and forwards at cricothyroid joint
  • cricothyroid muscles lengthens it
36
Q

What muscle increases tension of vocal folds to raise pitch of voice?

A

vocalis muscle (part of thyro-arytenoid)

37
Q

What shape is the rima glottis from quiet to forced inspiration?

A

it goes from triangular to rhomboid

38
Q

What can be seen during a laryngoscopy of phonation?

A
  • vocal folds adduct
  • air forced through vocal folds causes vibration
  • cord length and tension altered
39
Q

What can be seen during a laryngoscopy of effort closure?

A
  • vocal and vestibular folds adduct

- airway closed by lateral crico-arytenoid and transverse arytenoid muscles in valsalva maneover

40
Q

Describe what happens during swallowing

A
  • laryngeal elevation
  • laryngeal inlet closes by epiglottis
  • after larynx descends and epiglottis springs back hyoepiglottic ligament
41
Q

Describe the arterial supply of the larynx

A
  • superior laryngeal a (from superior thyroid a)

- inferior laryngeal a (from inferior thyroid a)

42
Q

Describe venous drainage of larynx

A
  • superior laryngeal v (from superior thyroid v from IJV)
  • inferior laryngeal v (from inferior thyroid v from BCV)
  • inferior thyroid veins at risk during tracheostomy
43
Q

What is the lymphatic drainage of the larynx?

A
  • above vocal cord: superior deep cervical lymph nodes
  • below vocal cord:
  • prelaryngeal, pretracheal
  • inferior deep cervical
  • supraclavicular
44
Q

Describe the neural supply of the larynx

A
  • superior laryngeal nerve:
  • internal branch: sensation of larynx down to above vocal folds
  • external branch: cricothyroid muscle
  • inferior laryngeal nerve (from recurrent larymgeal nerve from vagus)
  • recurrent laryngeal nerve:
  • all intrinsic muscles of larynx (except cricothyroid)
  • sensation to vocal cords and larynx below

MD3001 Respiratory (38 decks)

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