Larynx

Question 1

What functions is the larynx involved with?

Answer 1

• respiration
• phonation
• swallowing
• effort closure (coughing)

Question 2

What is the position of the larynx with relation to the pharynx, trachea, carotid sheaths and thyroid gland?

Answer 2

continuous with pharynx posterioly and superiorly

continuous with the trachea inferiorly

meidal to carotid sheaths and thyroid glands

Question 3

Identify the indicated features of the thyroid cartiledge

Answer 3

Question 4

Identify the indicated features of the cricoid cartilage

Answer 4

Question 5

What is the name of these pieces of cartiledge that fit on the superior portion of the criboid cartiledge?

Identify the indicated features.

Answer 5

Arytenoid Cartilages

Question 6

What is the name of the pair of cartilagenous features located on the apex of the Arytenoid Cartilage?

What is the name of the pair of cartilagenous features that are embedded in the mucosa?

Answer 6

corniculate (tells you where Arytenoid Cartilage is)

cuneiform

Question 7

Identify the indicated features of the epiglottis.

What is the function of it?

What type of cartilage is is formed by? How is this different from the other party of the larynx?

Answer 7

coverd by mucosa that acts as a flap to cover the trachea

elastic cartilage– everything else is hyaline cartilage

Question 8

What are the articulations of the cricothyroid joint?

What happens as the thyroid cartilage tilts at this joint?

Answer 8

inferior horn of thyroid cartilage adn lamina of cricoid cartilage

as thyroid cartilage tilts anteriorly at joint, the coval folds are tensed, as it tilts posteriorly, the vocal folds loosen

Question 9

What is the primary joint for affecting the vocal ligament?

What are its articulations?

Answer 9

Cricoarytenoid joints

arytenoid cartilage and lamina of cricoid cartilage

arytenoid slid transversely and pivot on cricoid cartilage, which results in abduction and adduction of vocal processes

Question 10

Identify the extrinsic ligaments of the larynx

What neurovasculature travels through the opening indicated by the green membrane?

Answer 10

superior laryngeal vessels adn internal laryngeal nerve

Question 11

Identify the intrinsice ligaments of the larynx. What is the name for this whole structure?

The vocal folds are formed from what structure?

Answer 11

conus elasticus

superior edge of conus elasticus

Question 12

What is the name of the ligament that holds the epiglottis to the angle of the thyroid cartilage?

Answer 12

Thyroepiglottic cartilage

Question 13

Identify the intrinsic ligaments of the larynx from a superior view

Answer 13

Question 14

Identify the indicated ligaments formed by the edges of the quadrangular ligament.

What is the an additional name for the yellow ligament?

Answer 14

lateral margin of epiglotic cartilage (purple line)

vestibular ligament is a false vocal cord (secondary functioning phonation)

Question 15

Identify the indicated features of the interior larynx

Answer 15

Question 16

What is the name of the opening that allows air to enter from the pharynx to the larynx?

Answer 16

laryngeall inlet or aditus

Question 17

What is the clinical significange of the space between the vocal and vestibular folds?

What is the name of the space between the vestibular folds?

What is the name of the space between the vocal folds?

Answer 17

cysts can develop here b/c natual outpouching and it is not reinforced

Rima vestibuli

Rima glottis

Question 18

Identify the indicated features of the larynx

Answer 18

Question 19

What muscles appears to be an extrinsic laryngeal muscle but is functionally an intrinsic muslce?

Answer 19

cricothyroid

Question 20

What is the name of the muscle indicated by the photo?

attchment points?

What is the resulting action when this muscle is contracted?

Answer 20

Posterior Cricoarytenoid

cricoid cartilage to the muscle process on the arytenoid cartilage

When muscle is contracted, it will pull arytenoid cartilage toward midline, causing abduction of the vocal cords via external rotation

Question 21

What muscle is indicated by the photo?

attachment points?

function?

Answer 21

cricoid cartilage to muscular process of arytenoid

swing muscular process externally, causing vocal fold adduction through internal rotation

Question 22

What musscles are indicated via pink and green shading?

What muscle is the pink one continuous with?

Answer 22

• Transverse Arytenoid muscle
  
  • function
    
    • adduct via translation
• Oblique Arytenoid muscle
  
  • function
    
    • adduct via translation
  • attachment
    
    • apexes in an oblique fashion, act as sphincter
    • continuous with the arepiglottic muscle
      
      • from arytenoid through aryepiglotic fold
      • can squeeze down laryngeal inlet (acting as a spincter)

Question 23

What muscle is shaded green in the image provided?

Attachment?

Function?

Answer 23

cricothyroid

anterior arch cricoid and inferior margin thyroid cartilage

tenses the vocal cords via tilting

Question 24

What muscles are indicated by the green and yellow shading?

Function?

Answer 24

• Thyroartytenoid
  
  • attachment
    
    • thyroid cartilage and arytenoids
  • Function
    
    • Pully arytenoids forward: relax vocal cords
• Vocalis
  
  • attachment
    
    • parallel to and attaches to vocal ligament
    • anterolateral side of arytenoid cartilage and its vocal process
  • function
    
    • relax vocal cord
    • independently adjust b/c individual fiber control to pull on different parts of hte cord

Question 25

What is the name of the muscles that is an extension from thyroarytenoid muscle into the arepiglttic fold? What is it function?

Answer 25

thyroepiglottic muscle acts as sphincter from aditus, along with arepiglottic muscle

Question 26

Identify the arterial branches that supply the larynx. Which branches runs with the recurrent laryngeal nerve? What muscle is this projection deep to?

Answer 26

inferior laryngeal artery runs with the recurrent laryngeal nerve deep to cricopharyngeus muscle

Question 27

Idenfity the veins involved with drainign the larynx

Answer 27

Question 28

Lymphtic drainage from supraglottic structures goes to which nodes? Lympatic drainage from infraglottic structure goes to which nodes?

Answer 28

* supraglottic * superior deep cervical lymph nodes * infraglottic * inferior deep cervical lymph nodes

Question 29

What branch of the vagus provides sensory innervation for laryngeal structures superior to the glottis? inferior to glottis? What problems could occur form a lesion/loss of sensation from these nerves?

Answer 29

* supraglottis * superior laryngeal * to internal laryngeal nerve * loss of sensation could lead to choking problems * infraglottis * recurrent laryngeal nerve * not really an issue for swallowing

Question 30

Identify the branches of the nerves shown in the image that provide motor innervation of the larynx. What nerve provies almot all of the innervation for the internal laryngeal muscles? What landmark indicates a name change for this neve? What is the only muscle not innervated by this nerve? What nerve is this muscle innervated by?

Answer 30

* past cricoid cartilage turns from **recurrent laryngeal** to **inferior laryngeal nerve**, which provides motor innervation for all internal laryngeal muscles (other than cricothyroid) * providing both sensory and motor to the larynx * lesions can cause problems with phonation * **superior laryngeal muscles** provides innervation to **cricothyroid** * **​**problems with this nerve prevent the vocal cords from tensing, leading to a deeper voice * damaged during thyroidectamy or carotid sheath surgery

Question 31

Damage of the following nerves can have what clinical impact? Internal laryngeal nerve External laryngeal nerve inferior laryngela nearve recurrent laryngeal nerve

Answer 31

* Internal laryngeal nerve * desensitization of upper larynx * swallowing issues * External laryngeal nerve * low pitch, monotone (can't tense) * inferior laryngeal nerve (vocal fold paralysis) * unilateral: breathy, some compensation * bilateral: no voice and hard to breathe * recurrent laryngeal nerve bruising * abductors more affected (Semon's law); leads to adduction-- not going to let air go through very easily