S10 L1 Applied Anatomy of the Larynx

Question 1

What are the functions of the larynx?

Answer 1

Question 2

Larynx

• Where does it go from and too?
• Where is it attach to and how is it attached to this structure?
• At which level does it continue at the trachea?

Order of: thyroid cartilage, hyoid bone. thyroid gland and cricoid cartilage

Answer 2

Largynx I Phraynx
C6: Trachea I Oesophagus

Larynx:
Upper border - Laryngeal inlet
Lower border - Cricoid cartilage (C6)

Order:
Hyoid bone, thyroid cartilage, cricoid cartilage, thyroid gland

Question 3

View of Larynx from behind

Answer 3

Question 4

What cartialge and connective tissue membranes make up the larynx? (4 main cartilage)

What are the types of joints between them? What are they called

Answer 4

ETAC

Epiglottis
Tracheal cartilage
Arytenoid cartilage
Cricoid cartilage

Trachea and tracheal rings

Synovial joints between the cartilages allowing movement between them:

• Thyroid-cricothyroid
• Cricoid-arytenoid

Question 5

What is the membrane or ligament called between:

• Hyoid bone and thyroid?
• Thyroid cartilage and cricoid cartilage?
• Under the cricoid cartilage?

Answer 5

Question 6

Surface Anatomy:
- Label the diagram

Answer 6

Question 7

Cricothyroidotomy:

• What is this procedure?
• Why/when is it done?
• Through which anatomy?

Answer 7

Question 8

Laryngeal inlet:
- Which structures form this?

Answer 8

Question 9

What structures form the following:

• Aryepiglottic fold
• False vocal cord
• True vocal cord

Answer 9

Question 10

Label the following diagram

Answer 10

Question 11

Larynx can be divided internally into three named regions.
Name them and state their borders

Answer 11

Question 12

What is the epithelium that lines the larynx?

What does the larynx look like using a flexible nasoendoscopy?

Answer 12

All: Pseudostratified ciliated columnar epithelium

EXCEPT: True vocal cords - Stratified squamous (due to movement vibrates aie -> open to friction, so lined with ‘tougher’ epithalim)
Therefore if get cancer of the vocal cords = squamous cell carcinoma

Question 13

What is the Valecular? When is it ‘used’?

Answer 13

Velecular = between the epiglottis and the root of the tongue, this is where the tip of the laryngoscope is palced, allowing you to get a better view of the larynx

Question 14

Label - Laryngeal Anatomy

Answer 14

Question 15

Intrinsic Laryngeal Muscles

• What are the 2 main actions of these muscles?
• And why are these actions important?

Answer 15

Question 16

What happens to the size and shape of the layngeal inlet during swallowing?

Answer 16

Question 17

Nerves:
What nerves are the intrinsic laryngeal muscles supplied by?

How can you access the function of the vagus nerve?

Answer 17

All EXCEPT ONE, are supplied by recurrent laryngeal nerve of vagus (CN X)

• Muscles of the right half of the larynx are supplied by: Right recurrent laryngeal nerve
• Muscles of the left half of the larynx are supplied by: Left recurrent laryngeal nerve

Ask them to:

• Swallow
• Speak
• Cough

Question 18

True vocal cords, movement, tension and position.
Which muscles are involved in moving the position of the true vocal cords?

VC run from ____ to ___

What is the role of most of the muscles that moving the true vocal cords?

Only one mucles ABducts, which muscle does this? Which nerve supplied it?

How does ABduction affect pitch?

Answer 18

ABducts: Posterior cricoarytenoid (supplied by Recurrent Laryngeal nerve)

ABduction increases tension = higher pitch (BUT PCA IS NOT THE MAIN MUSCLE INVOLVED IN PITCH)

Question 19

How is the position of the true vocal cords altered?

Answer 19

Intrinsic muscles of the larynx move arytenoid cartilages to alter the position of the true vocal cords

Question 20

True vocal cord movement:

• Position of the true vocal cords when breathing?
• Position of the true vocal cords when swallowing?

Answer 20

Question 21

True vocal cord movement:

• Position of the true vocal cords with phonation?
• Position of the true vocal cords when coughing?

Answer 21

Question 22

What determines the pitch?

• High pitched sounds caused by…
• Lower pitched sounds caused by…
• MAIN MUSCLE involved in pitch?

Answer 22

Cricothyroid muscle

Question 23

Cricothyroid muscle

• Supplied by which nerve?
• How does it help reach higher pitches?
• How is this nerve at risk of injury
• If this nerve is injuried, what symptoms will be caused?

Answer 23

External branch of Superior laryngeal nerve (branch of CN X)

Question 24

Larynx during swallowing - How does it protect the airway from food and fluid?

How do the suprahyoid muscles help to protect the airway when swallowing?

Answer 24

Suprahyoids act to elevate and anteriorly displace the larynx

Question 25

Summary of the nerve innervation in this region:

• Sensory (remember 3 sections of the phraynx)
• Motor

Answer 25

Question 26

Route fo the Superior Laryngeal nerve… (both branches)

Answer 26

Question 27

Route of the Right and Left Recurrent Laryngeal nerves?

Answer 27

Question 28

State 3 ways the Recurrent Laryngeal Nerve could be injuried?

Answer 28

Question 29

Unilateral Recurrent Laryngeal Nerve Injury:

• What position does this mean the vocal cords will be in?
• What ‘things’ can this affect? (how can you tell a person has a unilateral recurrent laryngeal nerve injury)

Answer 29

Question 30

Bilateral Recurrent Laryngeal Nerve Injury

• Which position do both VCs assume?
• What does this lead to…?
• Managment?

Answer 30

Question 31

Reminder: Cough reflex and vocal cord movement

Answer 31