Larynx and Thyroid Flashcards
The vagus nerve courses through the _______ in the neck and provides motor innervation to ________ muscles, and sensory innervation to ________ and _____ of the neck
carotid sheath, laryngeal muscles, deep viscera, muscles
The larynx is at vertebral levels ________ and is continuous with ______. It opens superoposteriorly at the _______
C3-C6, trachea, laryngeal inlet (aditus)
The laryngeal inlet (aditus) is bounded by _________ of mucosa
aryepiglottic folds
The thyroid cartilage is ______ cartilage and its anteriormost point is called the _________, while the anterolateral walls are the ________ and the highest and lowest lateral points are called the ___________.
hyaline, laryngeal prominence, laminae, superior and inferior horns
The cricoid cartilage is _______ cartilage and sits _______ in relation to the thyroid cartilage.
The anteriormost point is called the _____, and the posteriormost wall is called the ______.
hyaline, lower, arch, lamina
The epiglottic cartilage is ______ cartilage and is anchored with ligaments to the _____ and _____ cartilages
elastic, hyoid, thryoid
The arytenoid cartilages are _______ cartilage and are ______ shaped. The base articulates with the _____.
The anteriormost point is the ______ process, and the posteriormost point is the ______ process. They are topped with the ______ cartilages
hyaline, pyramid-shaped, cricoid cartilage, vocal process, muscular process, corniculate cartilages
The epiglottis folds over the _______ which is within the ________ folds
cuneiform tubercle (cuneiform cartilages), aryepiglottic folds
The ________ ligament is located deep to the lateral parts of both the cricoid and thyroid cartilages
lateral cricothyroid ligament
The _______ ligament is located deep to both cricoid and thyroid cartilages and just anterior to the arytenoid cartilages
vocal ligament
The _______ and the ______ together form the conus elasticus which is an inverted funnel at the base of the larynx
lateral cricothyroid ligament, vocal ligament
The vestibular fold lies just superior to the ______ ligament
vocal ligament
The ________ is indicative of laryngotracheobronchitis (croup)
Steeple Sign
_________ results from the narrowing of subglottic treachea
Steeple sign
Laryngeal cavity divisions:
The _______ is the area between the aditus to the vestibular fold.
The ______ is the area between the vestibular and vocal folds.
The _______ cavity is area between the vocal fold and the inferior cricoid cartilage
vestibule, laryngeal ventricle (ventricle of Morgagni), infraglottic cavity
The laryngeal ventricle is the home of the ________ which is lined with mucosa and lubricates the vocal cords
saccule of larynx
A ________ is an abnormal expansion of the saccule of the larynx
laryngocele
larynx except vocal cords formed from ________ which is composed of __________ cells.
The vocal folds are formed from _______ epithelium
respiratory epithelium, ciliated pseudostratified columnar cells, stratified squamous epithelium
The identifying features of __________ of the larynx are a lamina propria with prominent mucus glands and lymphatic nodules.
respiratory epithelium
The prominent identifying features of the ______ of the larynx are the Reinke’s space in the lamina propria, the vocal ligament, and the vocalis muscle
vocal folds
Reinke’s space is composed of _________
dense connective tissue
The structure just posterior to the valleculae is the _______.
The structures just adjacent to the vocal folds are the ________.
epiglottis, vestibular fold
The _______ is sensitive mucosa responsible for the cough reflex
vestibular fold
The structures immediately anterior to the most posterior-superior part of the cricoid cartilage are the _________
aryepiglottic folds
The _________ and the _______ form the superior opening to the vestibule. This is called the ______
aryepiglottic folds, epiglottis, aditus
The _____ is the space between the vestibular folds.
The ______ is the space between the vocal folds.
rima vestibuli, rima glottidis
The ______ is the border between the rima glottidis and the vocal folds. Defines the boundary between the upper and lower larynx
Glottis
The boundary between the upper and lower larynx between the rima glottidis and the vocal folds is called the _____
Glottis
Blood supply to the larynx is via the superior laryngeal artery which is a branch of the _______ from the ______ and the _____ which is a branch of the ______ from the _______.
These arteries anastamose
superior laryngeal artery, superior thyroid artery, carotid artery, inferior laryngeal artery, inferior thyroid artery, thyrocervical trunk
The superior larynx is drained via the _______ vein which drains to the _______ vein, then to the ______ vein.
The inferior larynx drains via the _____ vein which drains to the ______ vein, then to the _______ vein.
superior laryngeal vein, superior thyroid vein, internal jugular vein
inferior laryngeal vein, inferior thyroid vein, brachiocephalic vein
The ________ is a tracheostomy bleed concern
inferior laryngeal vein
Above the vocal cord level lymph drains to ________ nodes. Below the level of vocal cords lymph drains to _____ or ______ nodes, then to ______ nodes.
superior deep cervical nodes, pre-tracheal nodes, paratracheal nodes, inferior deep cervical nodes
Cancer of the larynx results in the following signs/symptoms:
hoarseness, swollen lymph nodes, and earache
If cancer develops in the lower larynx what lymph nodes might be a concern?
pre-tracheal or paratracheal nodes
Innervation of the larynx is accomplished ultimately through these 2 nerves:
superior laryngeal nerve of vagus, recurrent laryngeal nerve of vagus
The sensory nerve of the supraglottic mucosa and the sensory limb of the cough reflex is the _______ which is a branch of the ______ nerve. It pierces the _______ membrane.
internal branch, superior laryngeal nerve, thyrohyoid membrane
The motor innervation to the cricothyroid muscle is the _______ and is a branch of the _______ nerve.
external branch, superior laryngeal nerve
The innervation to the infraglottic larynx is the _____ nerve of ______.
recurrent laryngeal nerve, vagus (CN X)
The motor innervation to every intrinsic muscles of the larynx except the cricothyroid is the _____ nerve.
recurrent laryngeal nerve
The ______ nerve courses deep to the inferior pharyngeal constrictor muscle as the inferior laryngeal nerve
recurrent laryngeal nerve (of vagus CN X)
A patient presents with hoarseness of voice and a CT scan shows that he has an aneurism of the aorta. What nerve is involved?
recurrent laryngeal nerve
The ________ muscles and _______ raise the larynx which aids in high pitch vocal tones
suprahyoid muscles, thyrohyoid
The _____ muscles aid in lower pitch vocal tones
infrahyoid muscles
The ______ muscle stretches/tenses the vocal ligament and attaches from the anterolateral cricoid cartilage to the inferior margin, as well as to the inferior horn of the thyroid cartilage
cricothyroid
The _____ muscle attaches from the lamina of the cricoid cartilage to the muscular process of the arytenoid cartilage
posterior cricoarytenoid muscle
The action of the ______ muscle is to abduct the vocal cords for inhalation
posterior cricoarytenoid muscle
Asymmetric widening of the vocal ligaments during a deep breath suggests lesion of the _______
recurrent laryngeal nerve
The ________ muscle attaches from the superolateral margin of the cricoid cartilage to the muscular process of the arytenoid cartilage
lateral cricoarytenoid muscle
The adductors of the vocal ligaments are the _______ muscle, ______ muscle, and the _______ muscle
lateral cricoarytenoid, oblique arytenoid, transverse arytenoid
The _____ muscle attaches from the arytenoid cartilage to the other arytenoid cartilage
transverse arytenoid
The _____ muscle is an X-shaped vocal ligament adductor that attaches to both arytenoid cartilages
oblique arytenoid
The thyroarytenoid muscle has this action:
It’s attachments are the ______ cartilage and the ______ cartilage
relaxes vocal ligaments, internal surface of thyroid cartilage, arytenoid cartilage
The _____ muscle relaxes the posterior vocal ligament (tension remains in anterior portion of ligament).
vocalis muscle
The _____ muscle attaches to the vocal process of the arytenoid cartilage and to the ipsilateral vocal ligament
vocalis muscle
The vocalis muscle is actually the ________
deep fibers of thyroarytenoid
The ______ muscle is a continuation of the oblique arytenoid muscles
aryepiglottic muscle
The ____ muscle attaches to the arytenoid cartilage and to the mucosa of the aryepiglottic folds
aryepiglottic muscle
The _____ muscle decreases the diameter of laryngeal inlet/aditus
aryepiglottic muscle
The ______ is deep to the infrahyoid (strap) muscles
thyroid gland
The thyroid gland extends through these vertebral levels:
C5-T1
The thyroid gland is within this layer of fascia:
within visceral portion of pretracheal fascia
The thyroid gland is derived of ______ at the floor of the pharynx and descends to the neck during development along the _______
epithelium, thyroglossal duct
The ______ lobe of the thyroid gland is a remnant of the descent of the thyroid gland during development
pyramidal lobe
Detached tissues along the thyroglossal duct are referred to as ________
aberrant thyroid tissue
A common cause of midline swelling in the anterior neck is a _______
thyroglossal cyst
The _____ artery also carries postganglionic sympathetics from the superior cervical ganglion
superior thyroid artery
The _____ artery from the ______ carries postganglionic sympathetics from the middle inferior cervical ganglia
inferior thyroid artery, thyrocervical trunk
The inferior thyroid artery carries postganglionic sympathetics from the ____________
middle inferior cervical ganglia
A surgical concern especially from tracheotomy is the _______
thyroid ima artery (10% of population, from the brachiocephalic trunk)
The superior thyroid veins and middle thyroid veins drain to the ______, while the inferior thyroid veins drain to ______
internal jugular vein, brachiocephalic vein(s)
The _______ are a surgical concern for bleeding
inferior thyroid veins
A cricothyrotomy is done by piercing the _______
medial cricothyroid ligament
Surgical concerns for children during a tracheostomy are the ______, ________, ______, and ________.
thymus, left brachiocephalic vein, jugular veinous arch, pleurae in area
The parenchymal tissue of the thyroid gland are the ______
follicles
The follicles of the thyroid gland are lined with _______ epithelium composed of follicular cells and have a lumen filled with ______
simple cuboidal epithelium, colloid
The follicular cells of the thyroid convert _________ to T3 and T4 in response to elevated _____
thyroglobulin, TSH
The _____ cells are located between follicles and are paler-staining.
parafollicular (C) cells
The ______ cells secrete calcitonin in response to elevated blood Ca2+ which suppresses osteoclasts and antagnizes parathyroid hormone
parafollicular (C) cells
Lymph in the thyroid gland drains in this order to these 5 structues:
prelaryngeal nodes & pretracheal nodes & paratracheal nodes —>
superior deep cervical nodes OR inferior deep cervical nodes
The ______ glands are deep to the visceral portion of pretracheal deep cervical fascia
parathyroid glands
There are ___ superior parathyroid glands, and __ inferior parathyroid glands in every person
2, 2
______ from the _______ form the thymus and parathyroid glands and cannot form these glands without first migrating to ________
endoderm cells, pharyngeal pouches, neural crest-derived tissue
The superior parathyroid glands are derived from endoderm cells from the ______
4th pharyngeal pouch
These cells are slightly eosinophilic-staining and secrete parathyroid hormone in response to low blood Ca2+
principle (chief) cells of the thyroid
The ______ cells are more eosinophilic than principle cells of the thyroid and accumulate with age, their function isn’t clear
oxyphil cells
_____ cells of the thyroid are more packed together than ______ cells
principle (chief) cells, oxyphil cells
A goiter may compress the _______
recurrent laryngeal nerves
The 3 structures that are concerns for a thyroidectomy are:
thyroid ima artery, inferior thyroid veins, recurrent laryngeal nerves
