Larynx and Phonation

Question 1

The larynx opens into what section of the pharynx?

Answer 1

The laryngopharynx

Question 2

At what vertebral level does the larynx open into the pharynx?

Answer 2

At level C6

Question 3

The larynx is continous with what structure?

Answer 3

The trachea

Question 4

What are the three main parts of the pharynx?

Answer 4

The Nasopharynx

the Oropharynx and the

Laryngopharynx

Question 5

What are the functions of the the larynx?

Answer 5

Sphincter and phonation

Question 6

What is the space beside the inlet of the larynx?

Answer 6

The piriform fossa - food/water can get stuck in this area

Question 7

What tonsil sits just above the epiglotis?

Answer 7

The lingual tonsil

Question 8

What are the three large unpaired cartilages of the larynx?

Answer 8

Thyroid

Epiglottis

Cricoid

Question 9

What are the three small paired cartilages of the larynx?

Answer 9

Arytenoid cartilage

corniculate cartilages

cuneiform cartilages

Question 10

What nerves supply the larynx?

Answer 10

external laryngeal nerve (cricothyroid)

recurrent laryngeal nerve (motor everything else and sensory below vocal cords)

internal laryngeal (sensory above vocal cords)

Question 11

what cartilage of the larynx is a complete ring?

Answer 11

The cricoid cartilage

Question 12

Which cartilage is taller at the back and thinner in the front?

Answer 12

the Cricoid cartilage

Question 13

The vocal cords attach to which cartilage?

Answer 13

The arytenoid cartilages

Question 14

what ligament is attached to the cricoid cartilage and the thyroid cartilage?

Answer 14

the cricothyroid ligament

Question 15

What membrane is attached to the thyroid cartilage and the hyoid bone?

Answer 15

The thyrohyoid membrane

Question 16

The thyroid cartilage is made up of what?

Answer 16

hyaline cartilage

Question 17

What are the features of the thyroid cartilage?

Answer 17

2 lamina

superior/inferior horns

2 oblique lines

thyroid notch (superior and inferior)

laryngeal prominence

Question 18

The Thyrohyoid membrane has a hole in it for what structures to pass through?

Answer 18

for the superior laryngeal vessels and laryngeal nerve to pass through

Question 19

Do men have a larger or smaller thyroid angle?

Answer 19

They have a smaller thyroid angle making their laryngeal prominence more protruding

Question 20

The epiglotis is attached to what cartilage?

Answer 20

The thyroid cartilage - via the thyroepiglottic ligament

Question 21

the cricoid cartilage articulates with what?

Answer 21

With the arytenoid cartilages and the Thyroid cartilage

Question 22

What are the three extrinsic ligaments of the larynx?

Answer 22

The Thyrohyoid membrane, the hyo-epiglottic ligament, and the cricotracheal ligament

Question 23

What are the intrinsic ligaments of the larynx?

Answer 23

cricothyroid - attaches inferiorly to the cricoid arch, anteriorly to the thyroid cartilage and posteriorly to the vocal process (arytenoid)

Quadrangular membrane - attaches anteriorly to the epiglotis, posteriorly to the arytenoid and has two free margins (aryepiglottic fold at the laryngeal inlet, and the vestibular ligament)

Question 24

The upper free margin of the cricothyroid ligament is what?

Answer 24

the vocal ligament - from thyroid cartilage to the vocal process

Question 25

The cricothyroid joints allow for what movement?

Answer 25

They allow for the thyroid to move forward and tilt downwards on the cricoid - they lengthen and increase tension on vocal ligaments

Question 26

what is the middle chamber of the larynx?

Answer 26

called the ‘laryngeal ventricle (sinus)’

above the vocal folds but below the vestibular fold

Question 27

what movements are possible at the cricoarytenoid joints?

Answer 27

abduction/adduction (rotation and gliding laterally)

the arytenoids can rotate or just glide to the side

Question 28

there are true and false vocal folds… which one is more superior?

Answer 28

false vocal folds are more superior to the true vocal folds

Question 29

what muscles are present at the inlet of the larynx?

Answer 29

aryepiglottic muscle

oblique arytenoid muscle and

thyroepiglottic muscle

Question 30

what muscles are responsible for moving the vocal folds?

Answer 30

• posterior cricoarytenoid muscle
• lateral cricoarytenoid muscle
• transverse arytenoid muscle
• thyroarytenoid muscle
• cricothyroid muscle

Question 31

what are the various actions of the muscles of the vocal folds?

Answer 31

• Thyroaryteniod = shortens/relaxes the vocal folds
• Cricothyroid = stretches and tenses folds
• posterior cricoarytenoid = abducts vocal folds
• lateral cricoarytenoid = Adducts vocal folds
• transverse arytenoid = adducts the arytenoid cartilages

Question 32

what is the motor nerve supply to the larynx?

Answer 32

external laryngeal nerve = cricothyroid muscle

Recurrentl laryngeal = everything else!

Question 33

What is the sensory innervation to the larynx?

Answer 33

• internal laryngeal nerve (above vocal cords)
• recurrent laryngeal nerve (below vocal folds)

Question 34

what is ‘Semon’s Law”?

Answer 34

the abductors are paralyzed before the adductors - This means that in the case of partial paralysis, the cord will be brought to the midline by the adductors, but in complete paralysis it falls away to the paramedian position

Question 35

what is the blood supply to the larynx?

Answer 35

the superior laryngeal artery and the superior thyroid artery - both off of the external carotid

Question 36

what is the venous drainage of the larynx?

Answer 36

superior laryngeal vein and superior thyroid vein - directly into the internal jugular

Question 37

all of the larynx nerves, muscles etc. comes from which pharyngeal arch?

Answer 37

4th and 6th pharyngeal arches

Question 38

at what vertebral level do we find the hyoid bone??

Answer 38

C3

Question 39

at what vertebral level do we find the ‘arch of the cricoid’?

Answer 39

C6

Question 40

name the order of surface anatomy ‘bumps’ on the neck from superior to inferior

Answer 40

superior = hyoid bone

• thyroid cartilage

cricoid cartilage

Question 41

What is sellick’s manuevre

Answer 41

put pressure on the cricoid cartilage to prevent reflux through oesophagus when you’re intubating or visualising the vocal folds

Question 42

What is the term for the emergency procedure to open the airway?

Answer 42

cricothyroidotomy (tracheotomy) = careful not to hit thyroid as this will produce a significant amount of bleeding

Question 43

In an emergency where do we make an incision in a cricothyroidotomy?

Answer 43

between the thyroid cartilage and the cricoid cartilage - throiugh the cricothryoid membran3