Larynx and Pharynx Flashcards
describe organization of larynx - cartilages gen
only cartilaginous skeleton
scaffold - add things on to build muscles
describe hyoid bone - organization of larynx
connected to larynx
allows for stretching of membrane
name cartilages of larynx
5 cartilages = 3 +1 pair
Thyroid, cricoid, epiglottis, and 2 arytenoids
describe thyroid - larynx cartilage
visible from outside
shield shaped
sits at anterior border on cricoid
laryngeal prominence = adams apple
describe cricoid - larynx cartilage
complete ring - top ring of trachea
Visible from outside
describe epiglottis - larynx cartilage
sits and articulates with thyroid cartilage = joint articulates epiglottis
describe arytenoids - larynx cartilage
2
mirror images
articulates with cricoid at posterior sides of cricoid ring (wide than anterior side)
what is thyrohyoid membrane - larynx
runs from thyroid cartilage to hyoid bone
anchor that suspends larynx from it
what is cricothyroid membrane - larynx
runs between thyroid cartilage and cricoid
related to vocal folds
how do larynx cartilages connect to each other
synovial joints= have cartilage and can move against each other - allows to modulate and produce sounds
describe cricothyroid ligament
from cricoid to thyroid (anterior) and arytenoid (posterior) with free superior margin = vocal ligament
3 anchor points but no anchor on superior aspect
describe quadrangular membrane
mucosa
from lateral border epiglottis to thyroid (anterior) and arytenoid posterior with free inferior margin = vestibular ligament
draped down from epiglottis
describe thyroid –> arytenoids
2 ligaments that stretch across space
describe what the ligaments create - (when covered in mucosa)
vocal and vestibular ligaments become vocal and vestibular folds and create a recess = laryngeal ventricle
what is laryngeal ventricle
created because of free margins - not stretched tightly enough
describe vestibular fold
over ligament
creates false vocal cords
not vocal cords that are stretched or changed in shape by laryngeal muscles
might modulate sound a bit
air through here does not do anything to sound
describe vocal fold
over ligament
true vocal folds
membrane stretches (cricoid to thyroid), ends in vocal ligament (free superior margin) –> one on either side - space between (rima)
can create resistance to flow = produce sounds
what is rima
opening between true vocal folds - rima glottidis
changing its size modulates sounds we produce (phonation)- intonation, pitch, volume, modulated by changing opening using laryngeal muscles
describe cricoarytenoids - gen - muscles of larynx
from cricoid cartilage to arytenoids on each side
posterior and lateral
describe posterior cricoarytenoids - muscles of larynx - gen
wrap towards anterior, attaches to arytenoid cartilage
arytenoids can move freely thanks to these muscles
describe lateral cricoarytenoids - muscles of larynx
reverse of posterior
compare posterior and lateral cricoarytenoids - muscles of larynx
antagonistic muscles
describe arytenoids - gen - muscles of larynx
transverse and oblique
describe transverse arytenoids - muscles of larynx
in coronal plane
straight across
describe oblique arytenoids - muscles of larynx
more superficial
describe cricothyroid muscle - more control of vocal folds
muscle from thyroid to cricoid (on outside)
rocks thyroid cartilage forward (anteriorly towards cricoid, since thyroid more mobile bone) to increase tension in vocal cords - increases pitch in phonation (higher pitches-frequencies)
describe thyroarytenoid muscle - muscles of larynx
thyroid to arytenoids along length of thyroid space (from front to back)
runs parallel to vocal ligament (with vocal fold)
pulls arytenoids (more mobile) towards thyroid (translate)
slackens vocal cords = lowers pitch in phonation
WHAT IS vocalis - muscles of larynx
sometimes considered individual muscle but actually same as thyroarytenoid
compare thyroarytenoid and cricothyroid muscles - muscles of larynx
Antagonistic muscles
how to modulate shape and tension of vocal folds
Changes how tight or closed rima is
relaxed = open rima
if need to open more = for deep inhalations - recruit posterior cricoarytenoids
describe vascular supply to larynx - eca
eca –> superior thyroid artery (1st branch eca)
runs with superior laryngeal nerve
upper part of larynx
describe vascular supply to larynx - subclavian
subclavian (major vessels to upper limb)–> inferior thyroid artery (early branch of subclavian)
describe nerve supply to larynx - gen
entirely cnX - vagus
superior laryngeal branch –> cricothyroid
Recurrent laryngeal branch –> all other larynx muscles
describe nerve supply to larynx - branches
vagus (motor to extrinsic muscles of larynx) –> superior laryngeal nerve and recurrent laryngeal nerves (left and right)
describe superior laryngeal nerve (innervation of larynx - vagus)
external branch = motor to cricothyroid muscle
internal branch = sensory to vocal folds
goes into hole in thyrohyoid membrane
describe left and right recurrent laryngeal nerve (innervation of larynx - vagus)
motor to all muscles of larynx except cricothyroid
Sensory below vocal folds
continues on to neck and then loops back to innervate rest of muscles of larynx (all ones on inside)
compare left and right recurrent laryngeal nerve (innervation of larynx - vagus)
left = loops under aorta before goes back
Right = short path, usually under brachiocephalic trunk
Different courses due to asymmetric configuration of aorta and its first branches
name the 3 phases of deglutition
oral
pharyngeal
Esophageal
describe oral phase of deglutition - gen
Moment of tongue in anterior to posterior sequence against palate
initiation = voluntary control
breathing possible
describe oral phase of deglutition - specifics
send foo to back of mouth - push bolus in preparation of swallowing
soft palate depressed
nasal cavity not sealed off
describe pahryngeal phase of deglutition - gen
closure of nasal and laryngeal cavities via soft palate
involuntary control
brief interruption of breathing
describe pharygneal phase of deglutition - specifics
close nasal = elevate soft palate (lvp, tvp)
Close larynx - using epiglottis
involuntary = glossopharyngeal and vagus
brief interruption of breathing
describe esophageal phase of deglutition - gen
coordination of muscle contraction of pharyngeal wall and esophagus to propel bolus inferiorly to stomach (peristalsis - coordinated movement of pharyngeal muscles)
involuntary control (pharynx to esophagus)
naso and laryngopharynx open - breathing resumes (relax soft palate and larynx can now open again)
what is the role of epiglottis - movements
seals off larynx momentarily
trachea pulled superiorly/anteriorly via connections to hyoid and larynx (action of suprahyoid muscles) *epiglottis
whole neck column rises and falls –> right at swallow = pharyngeal phase
what is the role of epiglottis - depression
trapdoor- then opens quick
due to aryepiglottic muscle (continuation of oblique arytenoid) up to end of epiglottis
along margin of quadrangular membrane
pulls quickly - flaps epiglottis shut (posteriorly attached at front)
what happens during swallowing for safety
adductors seal off rima and larynx with epiglottis = double SAFETY MEASURE
Contraction assists in depression of epiglottis
elevation of hyoid bone assists in depression of epiglottis
name the muscles of pharynx
Constrictors
longitudinal muscles
what is role of pharyngeal constrictors
contract above bolus and relax below bolus
wave like fashion to move bolus inferiorly - narrow space in eso and laryngeopharynx
name and describe attachments/things about pharyngeal constrictors - 3
superior pharyngeal constrictor = aponeurosis of spc on occipital bone (mandible to sphenoid)
middle pharyngeal constrictor = raphe to hyoid
inferior pharyngeal constrictor = raphe to larynx (mostly on thyroid and some on cricoid)
all meet contralateral muscle in middle = pharyngeal raphe, some ct, connects muscles mainly
describe longitudinal pharyngeal muscles compared to constrictors
perpendicular to constrictors (90 degrees)
mostly vertical
blend with pharyngeal wall
name and describe attachments/things about longitudinal pharyngeal muscles
stylopharyngeus = styloid process –> pharynx
salpingopharyngeus = auditory tube ostium (on cartilagenous support) –> pharynx
palatopharyngeus = soft palate –> pharynx
what is function of longitudinal pharyngeal muscles
helps elevate soft palate and pharynx
shortening and dilating pharynx ahead of bolus
opens up space - contracts - shortens
tightly coordinated with constrictors = promotes movement of bolus from superior to inferior
describe action of pharyngeal constrictors - gen, behind and ahead
squeeze behind - contract
motion away from contraction
ONE DIRECTION
ahead - relax, left open so space for bolus to pass through
coordinated by action of glossapharyngeal and vagus
what is pharynx innervated by - gen
Pharyngeal plexus
most cnX
but stylopharyngeus = from cnIX (glossopharyngeal, gag reflex - touch back of oropharynx)
name all spinal nerves - for pharynx
cn XI - spinal accessory - motor sternocleidomastoid
cn x vagus
cn IX - glossopharyngeal —> sensory to pharynx
cn XII - hypoglossal - motor to extrinsic muscles of tongue, pass ant to tongue
what else can be seen in innervation to pharynx
superior cervical ganglion = one big ganglion
sympathetic chain = nerves into skull, motor innervation as it goes down - motor to constrictors and longitudinal muscles (thoracolumbar)
describe thyroid and parathyroid glands - gen
opposed against larynx
located in visceral compartment of neck, against anterior trachea, on inferior border of larynx
straddles cricoid and lower thyroid cartilage *butterfly shapes, sits on trachea
describe thyroid - thyroid and parathyroid glands
major endocrine gland
produces hormones that regulate metabolism and growth (thyroid hormone) and calcium homeostasis (calcitonin) - adjusts calcium
BONE HOMEOSTASIS
describe parathyroid - thyroid and parathyroid glands
next to thyroid
4x pea shaped glands embedded in posterior thyroid
produces parathyroid hormone (pth) –> regulates calcium homeostasis
describe posterior cricoarytenoids - muscles of larynx - function
abduction of vocal folds
widens rima during forced expiration
expel more air, speak louder, keeps open - breathe in
moves vocal folds further apart
shorten = makes back swing open
describe lateral cricoarytenoids - muscles of larynx - function
adduction of vocal folds
closes rima (narrows)
during expiration, whispering, reduce amplitude of speech
describe function of oblique and transverse arytenoids - muscles of larynx
pulls arytenoids closer together - translators
adduction of vocal folds = narrow rima by translating entire arytenoids towards each other
Similar to lateral cricoarytenoids (but those rotate anterior tips towards each other)
phonation - pitch and volume
