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Anatomy final > Larynx, laryngeal muscles > Flashcards

Larynx, laryngeal muscles Flashcards

1
Q

connections of larynx

A

-Covered anteriorly by : infrahyoid muscles
-laterally by lobes of thyroid gland (also closely related to
major vessels)
-posteriorly esophagus => clinical relevance; Sellick’s
manoeuvre

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2
Q

Sellick’s manoeuvre

A

aka. cricoid presure manoeuvre
During emergency intubation, pressure can be applied to the cricoid cartilage of larynx to occlude the esophagus =>prevents regurgitation of gastric content

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3
Q

What makes up the laryngeal skeleton?

A
  • Thyroid cartilage
  • Cricoid cartilage
  • Arytenoid cartilage
  • Epiglottis cartilage
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4
Q

Which parts of the laryngeal skeleton are Elastic cartilages?

A
  • Arytenoid

- Epiglottis

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5
Q

Which parts of the laryngeal skeleton are Hyaline cartilages?

A
  • Thyroid

- cricoid

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6
Q

Thyroid cartilage

A

-Hyaline cartilage
-composed of 2 laminae (R&L) on either side of superior
and inferior notch.
-Has an oblique line on each lateral side which divides it
into ant. and post. facets
-Has inf. horn => artuculates with cricoid cartilage
-Has sup. horn =>articulates with major cornu of hyoid
bone
-Thyrohyod membrane with lateral and medial thickenings.
Lat and median thyrohyoid ligaments.

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7
Q

Cricoid cartilage

A

-Ring-shapes, encircling airways
-has post surface; Lamina
-has Ant. surface; Arch
-Thyroid articular surface: at junction of lamina and arch on
either side (inferior most)
-Arytenoid articular surfaces: on up. border of each lamina

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8
Q

Cricothyroid joint

A
  • Inf. horn of thyroid cartilage + thyroid articular surface of cricoid cartilage.
  • Hinge type
  • 1 axis: transverse
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9
Q

Cricoarytenoid joint

A

-arytenoid articular facet of cricoid + articualar surface of
base of arytenoid cartilage
-Pivot type
-1 axis : vertical

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10
Q

Arytenoid cartilage

A

-Elastic cartilage
-Apex: -Tilted medially and posteriorly
-Carries the corniculate cartilage (of santorini) at
the tip -> sometimes apex is referred to as post.
process
-Base: articulate process with cricoid = has 2 processes:
-Muscular process: angled laterally and posteriorly.
-Vocal process: projects anteriorly-> attachment for vocal ligament mm

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11
Q

What does the muscular process give attachment to?

A

-Lateral cricoarytenoid m
-Post. cricoarytenoid muscle
(-Oblique arytenoid m(post aspect))
(-Thyroarytenoid m?)

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12
Q

What does the vocal process give attachment to?

A
  • VOCAL LIGAMENT

- Vocalis mucle

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13
Q

Epiglottis

A

-Elastic cartilage
-Has a stem/stalk (petidus) which attaches to inner surface
of thyroid cartilage => forms epiglottic tubercle on
mucosa and an oval lamina
-Ant.surface: faces pharynx and is lined with non-
keratinized stratified squamous epith.
Post surface: faces laryngeal inlet and is lined with
respiratory epithelium.
-Sieve- like character: has holes/perforations which allows
passage to small vessels and glandular tissue

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14
Q

Which are the extrinsic laryngeal ligaments

A
  • Thyrohyoid membrane (inc. median and lateral thyrohyoid ligaments)
  • Thyroepiglottic ligament
  • Hyoepiglottic ligament
  • Cricotracheal ligament
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15
Q

“Parts” of thyrohyoid membrane

A
  • Median thyrohyoid ligament: is a thicheming on the centre of the membrane-> from body of hyoid bone to thyroid notch?
  • Lateral thyrohyoid ligament: thickening between major cornu of hyoid bone to tip of superior horn of thyroid -> contains a small cartilage embedded :TRITICEAL catilage
  • Has an opening on each side for vessels and nerves
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16
Q

Thyroepiglottic ligament

A

from inner surface of body of thyroid bone

to stalk of epiglottis

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17
Q

Hyoepiglottic ligament

A

body of hyoid bone

to upper part on anterior surface of epiglottis

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18
Q

cricotracheal ligament

A

lower margin of cricoid cart.

to 1st tracheal cart?

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19
Q

Intrinsic ligaments of larynx

A

the submucosal CT of larynx is abdindant with elastic fibers and iss collectiely referred to as the fibro elastic membrane.
firbroelastic membra is compoed of a Quadrangular membrane and the triangular membranes. (or just conus elasticus)

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20
Q

Quadrangular membrane

A

-Makes up the upper portion of the fibroelastic membrabe
-goes from lateral margin of epiglottis, within the
Aryepiglottic fold to the aryteonid (apex?) and the
corniculate cartilages.
-Has a free inferior border with a terminal thickening
which makes up the VESTIBULAR LIGAMENT. (false
vocal cord)
-Has a free superior margin as well which is covered
by/with Aryepiglottic fold mucosa.
-

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21
Q

borders of Quadrangular membrane

A
  • Anterior: fixed to lateral edge of Epiglottis
  • Posterior: Fixed to Arytenoid cartilages
  • Sup: free margin, embedded in aryepiglottic fold mucsa
  • Inferior: free margin, forms vestibular ligament. (last3d?)
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22
Q

Triangular ligament:

A

-old way to describe! its basically half a conus elasticus?

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23
Q

Conus elasticus

A
  • the lower half of the fibroelastic membrane
  • From inner surface of cricoid cartilages to vocal ligament.
  • superior edge is free forming the vocal ligament
  • lateral attachment goes from sup. inner border of cricoid to inner surface of thyroid angle
  • posteriorly it attaches to the tip of the vocal process of the arytenoids
  • Has a Median cricothyroid ligament
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24
Q

Median cricothyroid ligament

A

is the anterior (middle) thickening of conus elassticus (or and border of triangular memb?)
its composed mainly of elastic fibers.

25
Q

why is the vocal fold thicker than the vestibular fold?

A

Because of the vocalis muscle which runs right on the side of the vocal ligament.

26
Q

which are the extrinsic muscles of the larynx?

A

The Cricothyroid muscle is the only extrinsic muscle of the larynx

27
Q

what is the action and innervation of the Cricothyroid muscle?

A

It is located on anterios aspect of thyroid bone
it pulls the thyroid bone forward and downwards stretching the vocal ligament
-control the rough tension of the voice
responsible for high pitch sounds

-Its the only laryngeal muscle which is innervated by the (external branch of the) Superior laryngeal nerve (Vagus)

28
Q

origin and insertion of cricothyroid muscle

A

O: Anterior surface/arch of cricoid cartilage

I: Wing or inf horn of thyroid cartilage

29
Q

which are the intrinsic laryngeal muscles?

A

All the rest

  • Lateral cricoarytenoid
  • Posterior cricoarytenoid
  • Thyroarytenoid
  • Thyroepiglottis
  • Vocalis
  • Oblique/transverse arytenoids
30
Q

Posterior cricoarytenoid

A

O: Both sides of post sufrace (lamina) of cricoid cartilage
I: Muscular processes of arytenoids
Action: Pulls arytenoids backwards (and rotates them
laterally) causing rima glottidis to open (widen)
Innervation : ext. branch of inf. laryngeal n. (from recurrent
laryngeal nerve)

31
Q

Posterior cricoarytenoid

A

O: Both sides of post sufrace (lamina) of cricoid cartilage
I: Muscular processes of arytenoids
Action: Pulls arytenoids backwards (and rotates them
laterally) causing rima glottides to open (widen)
Innervation : ext. branch of inf. laryngeal n. (from recurrent
laryngeal nerve)

32
Q

which muscle is the only laryngeal muscle which opens (Widens) the Rima glottides?

A

posterior cricoarytenoid

33
Q

Lateral cricoarytenoid muscle

A

O:upper margin of ant surface (arch) of cricoid cartilage
I: muscular processes of arytenoids.
Action: pulls aryteonid forward (int. rotation) to close (narrow) Rima glottides

34
Q

Thyroarytenoid

A

O: inner surface of thyroid cartilage (from thyroid angle
and a little bit of the cricothyroid membrane)
I: outer (ant.) surface of arytenoid (and muscular process)
Action relaxes vocal cord controls soft tension of vocal cord => responsible for lower pitch sound.
(haythams says that it closes rima glottidis tho)

  • Action: relaxes vocal cord : lower pitch ounds
  • Some believe the thyroepiglottis muscle and the vocalis muscle are parts of the Thyroarytenoid muscle.
35
Q

Thyroepiglottic muscle

A

O: Inner surface of thyroid cartilage with thyroarytenoid m.
=>common origin
I: Epiglottis ( X surface)
Action: Depresses base of epiglottis, constricting the
laryngeal inlet
thought to be part of thyroarytenoid m.

36
Q

vocalis musle

A

0: post./inner surface of thyroid cart.
I: vocal process of arytenoids (and all along vocal lig)
Action: shortens (relaxes (relieves tension of) vocal cord => for lower pitch sound–> controls soft tension

37
Q

which are the inter arytenoid muscles?

A

oblique and transverse arytenoid musscles

38
Q

Oblique arytenoid muscle

A

O/I :post aspect of muscular process (or just post surface?)
of one arytenoid and the posterior aspect of the apex of opposite arytenoid.
Action: Narrows rima glottides

39
Q

Transverse arytenoid muscle

A

O/I: Posterior and lateral surface of each arytenoid cartilage
Action: Adducts the arytenoids (pushes them medially, closer to each other) thus closes the Rima glottides

40
Q

Aryepiglottic muscle

A

-thought to be an extension of oblique arytenoid
continuing from apex of arytenoids to sides of epiglottis
Action: assists funclior of aryepiglottic m => closes laryngeal inlet.

41
Q

Aryepiglottic folds

A

run from both sides of epiglottis to arytenoid carttilage

42
Q

Piriform recess

A

find them between aryepiglottic folds and thyroid cart.

they direct the food away from laryngeal inlet and down to esophagus.

43
Q

Plica Nervi Laryngei

A

Laryngeal nerve folds: they run across the piriform recess and are seen in the mucosa
they are formed by the underlying superior laryngeal nerve and vessels.

44
Q

Borders of laryngeal inlet

A

Ant: superior edges of epiglottis
Post: mucosa between arytenoid cartilages
Laterally: the Aryepiglottic folds

45
Q

vestibule of larynx

A

the cavity/space from inlet to vestibular folds or rima glottides.

46
Q

borders/walls of vestibule

A

Ant wall: epiglottis
Posterior wall: the mucosa over the arytenoids
Lateral walls: the Quadrangular membranes

47
Q

Rima vestibuli

A

is the space /interval between the 2 false vocal cords (vestibular folds)

48
Q

Rima glottides

A

is the space/ interval between the 2 true vocal cords.

-Has an intramembranous part and an intercartilagenous part.

49
Q

Glottis Vocalis

A
  • Is the intermembranous part of Rima Glottides
  • its the portion of the opening which is anterior to the vocal processes of the arytenoids, bounded by the vocal ligaments. (so in centre???)
50
Q

What mucle causses wispering and how

A

The Lateral cricoarytenoid m.

It closes the glottis vocalis.

51
Q

Glottis Respiratoria

A

Aka. interarytenoid space
Is the intercartilagenous part of Rima Glottides. (2/5ths)
-the part of the opening which is between the ocal processes of the arytenoid cartilages.
-its open during phonation and the valsava manoeuvre
-Its closed during wispering

52
Q

sensory innervation of larynx

A

-Internal branch of superior laryngeal nerve (vagus) innervate above vocal fold
-Internal branch of inferior laryngeal n (recurrent laryngeal)
innervate below vocal fold
OBS. remember that internal branches are sensory and external branches are motor

53
Q

Blood supply of larynx?

A
  • Superior laryngeal a: upplies mucosa and muscles of upper part of larynx
  • Inferior laryngeal a: suppliess muscles and mucosa of lower part of larynx
54
Q

Superior laryngeal a

A

ECA=>Superior thyroid a=>superior laryngeal a

=> enters through opening in thyrohyoid membrane together with superior laryngeal n

55
Q

Inferior laryngeal a

A

subclavian a=> thyrocervical trunk=> inferior laryngeal a
=>ascends to larynx with recurrent laryngeal n
enters beneath the lower border of inf. consstrictor m.

56
Q

Broyles ligament

A

A mass of collagenous tissue at the anterior most portion of the vocal fold
attaches to the inner area of the thyroid cartilage which is devoid of perichondrium.

57
Q

formal tracheosstomy

A

cut in 2nd and 3d tracheal rings when not emergency

58
Q

Emergency cricothyroidotomy

A

through cricothyroid membrane anteriorly where there are no muscles imp vessels and nrves .

Anatomy final (15 decks)

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