Larynx and Trachea

Question 1

Answer 1

Question 2

Relationships around Larynx?

Answer 2

Hyoid superiorly
Inferior pharyngeal constrictor muscle (cricopharyngeus + thyropharyngeus) posteriorly
Trachea inferiorly
Strap muscles of the neck anteriorly

Question 3

Answer 3

Question 4

Thyroid Angle of men and women?

Answer 4

Thyroid angle male (90°) vs. female (120°)

Question 5

Answer 5

Question 6

Answer 6

Question 7

Arytenoid Cartilages Role?

Answer 7

2 pyramid-shaped small cartilages that articulate with the cricoid cartilage

Apex: articular facets for corniculate cartilages

Vocal Process: attachment for vocal cords (Elastic cartilage at tips)

Muscular Process: attachment for posterior & lateral cricoarytenoid muscles

Question 8

Role of Corciculate Cartiledges?

Answer 8

Small horn-like cartilages (elastic)

Serve to extend arytenoid cartilages medially & posteriorly

Sometimes fused with arytenoid cartilage

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

THE QUADRANGULAR MEMBRANE IS SUPERIOR TO THE VOCAL LIGAMENT/FOLD

THE CONUS ELASTICUS IS INFERIOR TO THE VOCAL LIGAMENT/FOLD

Question 12

Answer 12

Question 13

Answer 13

Question 14

Answer 14

Question 15

Answer 15

Question 16

Answer 16

Question 17

ONLY MUSCLE TO TENSION VOCAL CHORDS?

Answer 17

Cricothyroid Muscle

Innervation: External branch of superior laryngeal nerve (CNX)

Question 18

Innervation of Muscles Controlling Vocal Folds?

Answer 18

ALL Intrinsic muscles of the larynx receive recurrent laryngeal nerve

Cricothryroid is innervated by the Superior Laryngeal nerve

Question 19

Answer 19

Question 20

Where does the Superior Laryngeal Nerve arrise and what does it innervate?

Answer 20

Arises from inferior vagal ganglion in carotid triangle

Internal Branch: pierces thyrohyoid membrane with superior laryngeal artery. Supplies sensory fibers to the laryngeal mucosa of the laryngeal vestibule and middle laryngeal cavity (including the superior surface of the vocal folds)

External Branch descends posterior to the sternothyroid muscle with the superior thyroid artery. Initially the external branch lies on the inferior pharyngeal constrictor muscle (contributing to its innervation) before piercing and passing through it and continuing to supply the cricothyroid muscle

Question 21

Where does the Inferior Laryngeal Nerve arise and what does it innervate?

Answer 21

Inferior Laryngeal Nerve is the continuation of the recurrent laryngeal nerve. It enters the larynx by passing deep to the inferior border of the inferior pharyngeal constrictor and medial to the lamina of the thyroid cartilage. It divides into anterior and posterior branches which accompany the inferior laryngeal artery into the larynx

Anterior Branch supplies lateral cricoarytenoid, thyroarytenoid, vocalis, aryepiglottic and thyroepiglottic muscles

Posterior Branch supplies posterior cricoarytenoid, interarytenoid (transverse & oblique) muscles

Question 22

Vagal Nerve Asymmetry?

Answer 22

Left RLN loops around the arch of aorta

Right RLN loops around the subclavian artery

Question 23

Lymphatics of Larynx

Answer 23

Above the vocal folds, lymphatics accompany superior laryngeal artery, through thyrohyoid membrane to superior deep cervical nodes

Below vocal folds, lymphatics drain to the pretracheal or paratracheal nodes and subsequently to the inferior deep cervical nodes

Question 24

Trachea contains _____ C-shaped hyaline cartilaginous rings that maintain patency of airway. Posteriorly enclosed by _______ muscle.

Answer 24

Trachea contains ~16 C-shaped hyaline cartilaginous rings that maintain patency of airway. Posteriorly enclosed by trachealis muscle.

Question 25

Where is the incision made for an Emergency Cricothyroidotomy?

Answer 25

Incision made through median cricothyroid ligament to bypass the obstruction.