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Larynx and Trachea Flashcards

1
Q

Which will require less movement of vocal cords

A. Sniff
B. Vocal fry

A

A

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2
Q

Which of the following has the longest phonatory activity for vocal ligament?

A. “ah” /a/
B. “esss” /s/
C. “arrr” /r/
D. all of the above

A

A

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3
Q

You’re friend swallowed and choked with a piece of meat. Where is it easiest to incise using a small blade to provide temporary airway?

A. cricothyroid membrane
B. thyrohyoid membrane
C. trachea
D. chest

A

A

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4
Q

In children, the narrowest section of airway is the

A. supraglottis
B. Glottis
C. Subglottis
D. Epiglottis

A

C

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5
Q

Lymphatic drainage of the larynx?

A. Upper set, deep cervical
B. Retropharengeal
C. Upper set, parotid
D. Submaxillary

A

A

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6
Q

Weakest part of cricoid cartilage?

A. lamina
B. arch, upper
C. arch, middle
D. arch, lower

A

C

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7
Q

Motor innervation of cricothyroid

A. Recurrent laryngeal nerve
B. Internal laryngeal nerve, upper branch
C. Internal laryngeal nerve, lower branch
D. External laryngeal nerve

A

D

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8
Q

Conus Elasticus

A. Cricothyroid cartillage
B. Thyrohyoid
C. Quadrangular Ligament
D. Vocal Ligament

A

D

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9
Q

What innervates the mucous membrane above the vocal folds?

A. Superior laryngeal nerve
B. Inferior laryngeal nerve
C. Internal laryngeal nerve
D. Recurrent laryngeal nerve

A

C

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10
Q

Which of the following is true about the Parathyroid gland?

A. Superior parathyroid is usually behind superior poles of thyroid gland
B. Inferior parathyroid is found above the inferior poles of thyroid gland
C. Parathyroid gland is found posteriorly within thyroid sheath but outside capsule
D. SPT is more constant in position, usually at inferior border of thyroid cartilage
E. In thyroid lobectomy, inadvertent injury to Superior and inferior parathyroid would invariably lead to tetany and convulsiveness.

A

C

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11
Q

The viscera of the neck can be classified into these three primary functions

A

Endocrine, respiratory, alimentary

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12
Q

Largest endocrine gland

A

Thyroid gland

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13
Q

Thyroid secretions

A

Thyroid hormone and calcitonin

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14
Q

Organs not affected by the thyroid gland

A

Itself, spleen, testes, and uterus

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15
Q

Hormone produced by the parathyroid glands

A

Parathormone (PTH)

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16
Q

Target organs of the parathyroid glands

A

Skeleton, kidneys, intestine

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17
Q

The thyroid gland is deep to which muscles?

A

Sternothyroid and sternohyoid

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18
Q

Level of the thyroid gland

A

C5-T1

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19
Q

Lobes of the thyroid gland

A

Left and right

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20
Q

Which part unites the lobes of the thyroid gland?

A

Isthmus

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21
Q

Arteries of the thyroid gland

A

Superior and inferior thyroid arteries

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22
Q

Vessels from which the superior and inferior thyroid arteries originate

A

Superior: External cartorid artery
Inferior: Thyrocervical branch of the subclavian artery

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23
Q

Level of the isthmus

A

2nd and 3rd tracheal rings

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24
Q

The right and left superior and inferior thyroid arteries anastomose extensively to provide potential collateral circulation between the subclavian and internal carotid arteries. T/F

A

F

The collateral circulation is between the subclavian and external carotid arteries.

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25
Q

The artery that occasionally supplies the isthmus of the thyroid

A

Unpaired thyroid ima artery

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26
Q

Veins of the thyroid gland

A

Superior, middle inferior thyroid veins

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27
Q

Which vein of the thyroid gland has no corresponding artery?

A

Middle thyroid vein

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28
Q

From where are nerves of the thyroid gland derived?

A

Superior, middle and inferior cervical (sympathetic) ganglia

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29
Q

Sympathetic innervation reach the thyroid gland through

A

Cardiac and superior and inferior thyroid periarterial plexuses

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30
Q

The nerves of the thyroid gland are secretomotor. T/F

A

F

They are vasomotor. Secretion of the thyroid gland is regulated by the pituitary gland.

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31
Q

How many parathyroid glands do people normally have?

A

Four

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32
Q

Which is more constant in position, the superior parathyroid glands or the inferior parathyroid glands?

A

Superior parathyroid glands

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33
Q

Arteries of the parathyroid gland

A

Branches from inferior thyroid arteries, sometimes also the superior thyroid arteries, thyroid ima artery or laryngeal, tracheal and esophageal arteries

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34
Q

Veins of the parathyroid glands

A

Parathyroid veins

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35
Q

The parathyroid veins drain to which vessels?

A

Thyroid plexus of veins of thyroid gland , and trachea.

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36
Q

Lymph vessels from the parathyroid glands drain into which lymph nodes?

A

Deep cervical lymph nodes and paratracheal lymph nodes

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37
Q

Nerves of the parathyroid glands

A

Thyroid branches of the cervical (sympathetic) ganglia

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38
Q

How many cartilages compose the larynx?

A

9

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39
Q

Level of the larynx

A

C3-C6

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40
Q

Most vital function of the larynx

A

Guards air passages, especially during swallowing

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41
Q

Cartilages of the larynx

A

Paired: arytenoid, corniculate, cuneiform
Unpaired: thyroid, cricoid, epiglottic

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42
Q

Largest of the cartilages

A

Thyroid cartilage

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43
Q

Which forms the Adam’s apple?

A

Laryngeal prominence of the thyroid cartilage

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44
Q

Superior divergence of the lamina of the thyroid cartilage into a V

A

Superior thyroid notch

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45
Q

The inferior thyroid notch is more conspicuous than the superior thyroid notch. T/F

A

F

It is less distinct.

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46
Q

Superior and inferior projection of the lamina of the thyroid cartilage posteriorly

A

Superior and inferior horns

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47
Q

The superior horn and the superior border of the thyroid cartilage attaches to the hyoid bone through which structure?

A

Thyrohyoid membrane

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48
Q

Parts of the thyrohyoid membrane

A

Median thyrohyoid ligament, lateral thyrohyoid ligaments

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49
Q

Articulation of the inferior horns of the thyroid cartilage with the lateral surfaces of the cricoid cartilage

A

Cricothyroid joints

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50
Q

Main movements at the cricothyroid joints

A

Rotation and gliding of the thyroid cartilage

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51
Q

Ring-like cartilage of the larynx and only complete ring of cartilage to encircle any part of the airway

A

Cricoid cartilage

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52
Q

The posterior part of the cricoid cartilage

A

Lamina

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53
Q

The anterior part of the cricoid cartilage

A

Arch

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54
Q

Attachment of the cricoid cartilage to the thyroid cartilage

A

Cricothyroid ligament

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55
Q

Attachment of the cricoid cartilage to the first tracheal ring

A

Cricotracheal ligament

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56
Q

The paired three-sided pyramidal carilages that articulate with the lateral parts of the superior border of the cricoid cartilage lamina

A

Arytenoid cartilage

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57
Q

Parts of the arytenoid cartilage

A

Apex (superior), vocal process (anterior), muscular process (lateral projection at base)

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58
Q

Articulation of the cricoid cartilage and arytenoid cartilages

A

Crico-arytenoid joints

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59
Q

Movements at the crico-arytenoid joints

A

Sliding of arytenoid cartilages towards or away from each other, tilting anteriorly and posteriorly of the arytenoid cartilages, and rotation of the arytenoid cartilages

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60
Q

Which is medial and which is lateral among the vocal processes and the muscular processes of the arytenoid cartilage?

A

Medial: vocal processes
Lateral: muscular processes

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61
Q

What structure attaches to the vocal process?

A

Vocal ligaments

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62
Q

Where are the vocal ligaments attached?

A

Anteriorly, the thyroid cartilage lamina

Posteriorly, the vocal process of the arytenoid cartilage

63
Q

Submucosal skeleton of the vocal folds

A

Vocal ligaments

64
Q

The opening between the vocal folds

A

Rima glottidis

65
Q

The vocal ligaments are part of which bigger structure?

A

Conus elasticus or cricovocal membrane

66
Q

Parts of the cricothyroid ligament

A

Medial and lateral cricothyroid ligament

67
Q

The epiglottis is inferiorly attached to the thyroid cartilage through which structure?

A

Thyro-epiglottic ligament

68
Q

Attachment of the epiglottis to the hyoid

A

Hyo-epiglottic ligament

69
Q

The thin, submucosal sheet of connective tissue that extends between the lateral aspects of the arytenoid and epiglottic cartilages

A

Quadrangular membrane

70
Q

Which cartilage attaches to the apices of the arytenoid cartilage?

A

Corniculate cartilage

71
Q

Which cartilage do not directly attach to the other cartilages?

A

Cuneiform cartilage

72
Q

True of the parathyroids

A. within the fibrous capsule of the thyroid gland
B. blood supply is from the inferior thyroid artery
C. Most people have six parathyroid glands
D. The inferior parathyroid gland is more constant in position than the superior parathyroid

73
Q

The vocal folds vibrate and generate sound thru a system of laryngeal muscles innervated by

A. CN 9 and CN 11
B. CN 10 and CN 11
C. CN 9 and CN 12
D. CN 10 only

74
Q

This is the cleft separating the vocal folds

A. superior laryngeal aperture
B. rima glottis
C. vestibule
D. ventricle

75
Q

The angle of the laryngeal protuberance of males is ___________ that of females.

A. cannot be determined
B. the same as
C. greater than
D. lesser than

76
Q

A small eminence in the ventral margin and ventrolateral surface of the arytenoid cartilages

A. arcuate crest
B. oblong pit
C. corniculate
D. fovea triangularis

77
Q

The lower end of the epiglottis tapering into a short stalk

A. petiole
B. epiglottic tubercle
C. cornu
D. cartilage triticea

78
Q

The most important function of the larynx

A. respiration
B. protection
C. phonation
D. articulation

79
Q

In phonation, as air rushes through the open cords, pressure between the folds drops sucking the folds back together. This is known as:

A. elastic property
B. Bernoulli Effect
C. Myoelastic Theory
D. Body Cover Theory

80
Q

Phonation is likely to occur if

A. medial surface of vocal cords are soft enough to yield
B. moderate airflow
C. the articulators are working properly
D. the glottis is wide

81
Q

What is the main part of the vocal folds?

A. vocal ligament
B. conus elasticus
C. thyroarytenoid muscles

82
Q

Cartilage directly above arytenoids

A. thyroid cartilage
B. epiglottic cartilage
C. corniculate cartilage 
D. cuneiform cartilage 
E. AOTA
83
Q

Movement of the thyroid cartilage towards the cricoid cartilage will result to

A. Vocal cord shortening
B. Vocal cord lengthening
C. Vocal cord abduction
D. Vocal cord adduction

E. NOTA

84
Q

A soprano presented with hoarseness. Upon operation she noticed that she cannot sing high notes anymore, although her voice isn’t hoarse. Which of the following nerves was affected?

A. internal laryngeal
B. external laryngeal
C. recurrent laryngeal

85
Q

Which artery supplies the larynx?

A. Common Carotid 
B. External Carotid
C. Subclavian 
D. B and C 
E. A, B and C
86
Q

What muscle is innervated by both branches of the recurrent laryngeal nerve?

A. Posterior cricoarytenoid
B. Lateral cricoarytenoid
C. Interarytenoids
D. Thyroarytenoid

87
Q

The extent of the laryngeal cavity

A

Laryngeal inlet to inferior border of cricoid cartilage

88
Q

To which cavity does the laryngeal cavity communicate through the laryngeal inlet?

A

Laryngopharynx

89
Q

What cavity is between the laryngeal inlet and the vestibular folds?`

A

Laryngeal vestibule

90
Q

What cavity is between the vestibular and vocal folds?

A

Laryngeal ventricle

91
Q

The blind pocket opening into each ventricle that is lined with mucosal glands

A

Laryngeal saccule

92
Q

The inferior cavity of the larynx between the vocal folds and the inferior border of the cricoid cartilage

A

Infraglottic cavity

93
Q

Vocal folds are the same as the vocal cords. T/F

94
Q

Each vocal fold is composed of which structures?

A

Vocal ligament and vocalis muscles

95
Q

Longer vocal folds produce higher vocal pitch. T/F

A

F

They produce lower pitch.

96
Q

False vocal cords

A

Vestibular folds

97
Q

Main inspiratory sphincter of the larynx when tightly closed

A

Vocal folds

98
Q

Complete abduction of the vocal folds form an effective sphincter that prevents entry of air. T/F

A

F

It is adduction that does that.

99
Q

The vocal aparatus of the larynx

100
Q

Shape of the rima glottidis during normal breathing

A

Narrow and wedge-shaped

101
Q

Shape of the rima glottidis during forced respiration

A

Wide and trapezoidal

102
Q

The vestibular folds contain the vocal ligaments. T/F

A

F

They contain the vestibular ligaments. The vocal ligaments are contained in the vocal folds.

103
Q

The space between the vestibular ligaments

A

Rima vestibuli

104
Q

Shape of rima during phonation

105
Q

Extrinsic laryngeal muscle groups

A

Infrahyoid, and suprahyoid muscles

106
Q

Extrinsic muscles move the laryngeal components, altering the tension and length of the vocal folds and the size and shape of the rima glottidis. T/F

A

F

Intrinsic laryngeal muscles did that. Extrinsic laryngeal muscles moved the larynx as a whole

107
Q

Intrinsic muscles of the larynx

A 
Lateral and posterior crico-arytenoid
Cricothyroid
Thyro-arytenoid
Transverse and oblique arytenoids
Vocalis
108
Q

Action of the lateral crico-arytenoid

A

Adducts vocal folds

109
Q

Action of transverse and oblique arytenoid muscles

A

Adducts arytenoid cartilages, closing the posterior rima glottidis

110
Q

To close the rima glottidis, which muscles must act together?

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles

111
Q

Intrinsic muscles of the larynx

A 
Lateral and posterior crico-arytenoid
Cricothyroid
Thyro-arytenoid
Transverse and oblique arytenoids
Vocalis
112
Q

Action of the lateral crico-arytenoid

A

Adducts vocal folds

113
Q

Action of transverse and oblique arytenoid muscles

A

Adducts arytenoid cartilages, closing the posterior rima glottidis

114
Q

To close the rima glottidis, which muscles must act together?

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles

115
Q

Laryngeal muscles for whispering

A

Lateral crico-arytenoids

116
Q

Action of the posterior crico-arytenoids

A

Abducts vocal folds

117
Q

Muscles that adduct vocal folds

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles

118
Q

Contraction of which muscles occur as reflexive response to presence of liquid or particles approaching or within the laryngeal vestibule?

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles, ary-epiglottic muscles

119
Q

What happens when lateral crico-artytenoids contract, but the transverse and oblique arytenoid muscles do not?

A

The arytenoid cartilages remain apart, though the vocal folds close

120
Q

Muscles that attach to the muscular process of the arytenoid cartilage

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles

121
Q

When the posterior crico-arytenoid muscles act, the rima glottidis widens. T/F

122
Q

Contraction of which muscles occur as reflexive response to presence of liquid or particles approaching or within the laryngeal vestibule?

A

Lateral crico-arytenoids, and transverse and oblique arytenoid muscles, ary-epiglottic muscles

123
Q

Principal adductors of the larynx

A

Lateral crico-arytenoid

124
Q

Action of the thyro-arytenoid muscles

A

Relaxes vocal ligament

125
Q

Action of cricothyroid muscles

A

Tenses and stretches vocal ligament

126
Q

Effect of the action of the cricothyroid muscles on the voice

A

Higher pitch

127
Q

Principal relaxers of the larynx

A

Thyro-arytenoid muscles

128
Q

Which muscles lower the pitch of the voice?

A

Thyro-arytenoid muscles

129
Q

The vocalis muscles is medial or lateral the thyro-arytenoid muscles?

130
Q

Cricothyroid artery is from which vessel?

A

Superior thyroid artery

131
Q

Arterial supply of the internal surface of the larynx

A

Laryngeal arteries

132
Q

Arterial supply of the cricothyroid muscle

A

Cricothyroid artery

133
Q

Cricothyroid artery is from which vessel?

A

Superior thyroid artery

134
Q

Inferior laryngeal artery supplies which structures?

A

Mucus membrane, and muscles in the inferior larynx

135
Q

Veins of the larynx

A

Superior and inferior laryngeal veins

136
Q

Where the veins of the larynx drain

A

Superior and inferior thyroid veins

137
Q

Where the lymphatic vessels of the larynx superior to the vocal cords drain

A

Superior deep cervical lymph nodes

138
Q

Where the lymphatic vessels of the pharynx inferior to the vocal cords drain

A

Inferior deep cervical lymph nodes

139
Q

Which nerve divides onto terminal branches internal laryngeal and external laryngeal nerves?

A

Superior laryngeal nerve (CN X)

140
Q

Which provides sensory and autonomic innervation to the larynx: internal laryngeal or external laryngeal nerve?

A

Internal laryngeal

141
Q

Which provides motor innervation to the larynx: internal laryngeal or external laryngeal nerve?

A

External laryngeal

142
Q

The internal laryngeal nerve pierces which structure with the superior laryngeal artery?

A

Thyrohyoid membrane

143
Q

The external laryngeal descends posterior to which structure with the superior thyroid artery?

A

Sternothyroid muscle

144
Q

The internal laryngeal pierces the thyrohyoid membrane along with which structure?

A

Superior laryngeal artery

145
Q

The external laryngeal descends posterior to which structure together with which structure?

A

Superior thyroid artery

146
Q

The superior laryngeal nerve arises directly from which nerve?

A

Inferior vasal ganglion

147
Q

The inferior laryngeal nerve is a continuation of which vagal branch?

A

Recurrent laryngeal nerve (CN X)

148
Q

Structures supplied by the anterior branch of the inferior laryngeal nerve?

A

Lateral crico-arytenoid, thyro-arytenoid, vocalis, ary-epiglottic and thyro-eppiglottic muscles

149
Q

Structures supplied by the posterior branch of the inferior laryngeal nerve?

A

Posterior crico-arytenoid, transverse and oblique arytenoid muscles

150
Q

Cancerofthelarynxmanifestsasearpainbecauseof

a. Chordatympani
b. arnold’snerve
c. Jacobson’snerver
d. Facialnerve

151
Q

Botlinum toxin needs to react on what muscles to reduce contraction

A. bilateral PCA
B. bilateral lateral CA
C. Bilateral thyroaretinoid
D. Bilateral cricothyroid

152
Q

The cervical viscera of infants are located more superiorly than in adults because of the infatnts’ short neck. T/F

153
Q

The duct that connects the foramen cecum to the thyroid gland as the gland descends onto the lower neck

A

Thyroglossal duct

Head and Neck (12 decks)

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