Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HNN > Session 10 > Flashcards

Session 10 Flashcards

1
Q

What are the functions of the larynx

A

Airway protection
Ventilation
Phonation
Cough reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anatomical features of the larynx

A

Suspended from and lies below hyoid bone

Part of the URT

Begins at laryngeal inlet, ends at lower border of cricoid cartilage C6

Continuous as trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are piriform fossae

A

Spaces within laryngopharynx - deep recesses

Where pharyngeal muscles have wrapped around back of opening of larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 subdivisions of larynx

A

Supraglottis, glottis, subglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which cartilages form the structural framework of the larynx

A

Epiglottis, thyroid, cricoid and arytenoid cartilages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Synovial joints between the cartilages allow movement between the

A

Thyroid and cricothyroid (A)

Cricoid-arytenoid (F)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Larynx is suspended from the hyoid bone via the

A

Thyrohyoid membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 other important membranes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does a cricothyroidotomy do

A

Provides emergency access to airway, beneath vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are aryepiglottic folds

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The borders of the membranes create

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The sides of the epiglottis are connected to the arytenoids by the

A

Aryepiglottic folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What forms the aditus or entrance of the larynx

A

Epiglottis along with aryepiglottic folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe thyroid cartilage

A

Shield like

2 lateral plates form laryngeal prominence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe cricoid cartilage

A

Signet ring shpaed, only complete ring of cartilage throughout respiratory Tract

Attached to trachea inferiorly by the cricotracheal membrane

Arytenoids sit on top, one either side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Space in the middle between the true vocal cords is the

A

Rima glottidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are highlighted arrows

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Positions of regions of larynx

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Supraglottic compartment is also known as the

A

Vestibule

(Includes false vocal cords)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of epithelium lines the larynx

A

Pseudostratified ciliated columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

True vocal cords are lined with

A

Stratified squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If a patient required incubation, larynx is viewed using

A

Laryngoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Insertion of endotracheal ET tube

A

Oral cavity, oropharynx, larynx, through vocal cords

Sits in the upper part of the trachea

Small balloon to keep tube in place, ET tube has lumen to allow for mechanical ventilation and oxygenation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do these pictures show

A

Vocal cords, abducted in left

Yellow - arytenoid cartilages (moved by intrinsic muscles of larynx and alter size and shape of rima glottidis)

Vocal cords will be abducted before intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is this recess called

A

valecula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Laryngeal anatomy labels

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

2 main actions of intrinsic laryngeal muscles

A

Alter size and shape of laryngeal inlet

Alter tension in and position of true vocal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do intrinsic laryngeal muscles alter size and shape of laryngeal inlet

A

Muscles within aryepiglottic folds contract

Narrow laryngeal inlet and flatten position of epiglottis

Protecting larynx during swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do instrinsic laryngeal muscles alter tension in and position of true vocal cords

A

Muscles within larynx alter position of arytenoid cartilages- vary position of cords

Vocal cords closed together (adducted)

Protecting larynx during swallowing and enables phonation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

All intrinsic laryngeal muscles are supplied by the

A

Recurrent laryngeal of vagus CN X

Right or left

With one exception of the cricothyroid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Vocal cords run from

A

Arytenoid cartilages to inner surface of thyroid cartilage (level of laryngeal prominence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Arytenoid cartilages move to alter position of

A

Vocal cords- narrowing or widening rima glottidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Majority of muscles that impact vocal cords act to

A

narrow rima glottidis by adducting vocal cords together

Only one abducts (widens) Posterior cricoarytenoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does this show

A

Arytenoids move relative to one another on cricoid cartilage

Alter position of true vocal cords

And size of aperture (rima glottidis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Cricothyroid is supplies by the

A

External laryngeal nerve, branch of the superior laryngeal nerve (branch of CN X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The internal laryngeal nerve (branch of superior laryngeal nerve) innervates the

A

Laryngeal mucosa able the vocal cords (supraglottis)

37
Q

Recurrent laryngeal nerve innervates

A

The vocal cords and ifnraglottis

38
Q

Superior and recurrent laryngeal nerves are accompanied by

A

Arterial branches from the superior and inferior thyroid arteries

Important to avoid vocal cord paralysis in thyroidectomy

39
Q

Features of supra hyoid muscles

A

Anterior triangle

4 pairs of muscles all superiorly to hyoid bone (e.g. Digastric)

40
Q

Features of infra hyoid muscles

A

Anterior triangle

4 pairs, inferior to hyoid bone (e.g. omohyoid)

41
Q

Infra hyoid muscles are supplies by

A

Branches from C1-C3 from cervical plexus

42
Q

Infrahyoid muscles are also called

A

Strap muscles

43
Q

What has to be retracted when thyroid gland surgery happens

A

Infrahyoid

44
Q

Suprahyoid muscles purpose

A

Floor of the mouth

Move and stabilise the hyoid bone and therefore larynx along with infrahyoids

During swallowing, chewing and speaking

45
Q

Vocal cords when breathing

A

Abducted (open)

46
Q

Vocal cords when swallowing

A

Adducted (closed)

47
Q

Phonation vocal cords

A

Adducted

Expired air forced through closely adducted vocal cords

VC vibration creates sound waves

48
Q

Coughing vocal cord position

A

Adduct

49
Q

What determines pitch

A

tension

High pitched= taut
Low = less taut

Contraction of both cricothyroid muscles = increased tension in vocal cords

Muscle located outside of larynx

50
Q

Cardinal symptom of laryngeal disease

A

Hoarseness of voice

51
Q

Benign causes for a hoarse voice

A

Infection, inflammation, laryngitis, vocal cord nodules

52
Q

Concerning pathologies causing hoarseness of voice

A

Nerve damage, tissue damage

Complete or partial, unilateral or bilateral

Determines effects on phonation and breathing

53
Q

Features of increasing tension in vocal cords for high pitch

A

Cricothyroid muscles

Innervated by external branch of superior laryngeal nerve CN X

Closely related to superior thyroid artery

Risk of injury in thyroid surgery- causes hoarseness of voice when attempting higher pitched sounds

54
Q

Unilateral complete injury (e.g. Division of the nerve) to the recurrent laryngeal nerve causes

A

Vocal cord on affected side = immobile

Takes up a neutral or paramedical position between abduction and adduction

Opposite cord can compensate a bit

Some hoarseness and weaker cough, passage of air through glottis minimally affected

55
Q

Presentation if both recurrent laryngeal nerves completely damaged

A

Both vocal cords assume paramedical position with rima glottidis becoming extremely narrow (not completely closed)

Will impair speaking ability and breathing

56
Q

Recurrent laryngeal nerves and injury

A

Long courses in neck, especially left (loops under arch of aorta before ascending back up in groove between oesophagus and trachea)

Susceptible to disease and injury affecting neck and upper chest

57
Q

Left recurrent laryngeal nerve can be affected by

A

Aortic arch aneurysms

58
Q

Right recurrent laryngeal nerve can be affected by

A

Right apical lung tumours

59
Q

Features of carcinomas of larynx

A

Present with voice and/or airway problems

Hoarseness of voice often earliest presenting sign of lesions involving the vocal cords

60
Q

Prognosis of laryngeal cancer

A

Small and involves glottis = favourable prognosis as minimal lymphatic drainage

Supra and infra glottis regions drain to neck nodes and paratracheal nodes respectively and have poorer prognosis

61
Q

Larynx during swallowing

A

Tongue pushes epiglottis posteriorly and aryepiglottic muscles contract, Narrowing laryngeal inlet , Epiglottis position horizontally

Hyoid bone elevated and move anteriorly by Suprahyoid muscles, Soft pallets raises

Adduction of true vocal cords, closure of rima glottidis

62
Q

Food/fluid is directed over curved upper surface of epiglottis into

A

Piriform fossa of laryngopharynx

Can be a site for foreign bodies to get stuck e.g. fish bone

63
Q

Suprahyoids act to

A

Elevate and anteriorly displace the larynx

Ensures patency of pharynx so food can be safely directed into it and not larynx

64
Q

Sensory and motor nerves supplying larynx

A
65
Q

External branch of superior laryngeal nerve has a route close to

A

Superior thyroid artery

66
Q

Recurrent laryngeal nerves pass anteriorly to

A

Right subclavian SCA

67
Q

What happens in a cough

A

Explosion of compressed air

Inspire and fill lungs with air, vocal cords adduct, expiratory muscles contract, intrathoracic pressure builds, then cords suddenly abducted, explosive outflow of air

68
Q

What Laryngitis

A

Inflammation of the larynx, often involving true vocal cords

69
Q

How do you diagnosis laryngitis

A

Clinically from history

hoarse/weak voice and sore throat
History of URTI

70
Q

Typical causes of laryngitis

A

Infectious (viral typically), and non-infectious aetiology

usually self limiting: fully resolves within 2-3 weeks

71
Q

Features of laryngeal tonsils

A

Acute trauma or chronic irritation
Hoarseness of voice more than 3 weeks
requires visualisation of cords +/- biopsy

72
Q

Conditions affecting the larynx

A

Laryngitis
Laryngeal nodules
Laryngeal cancer
Laryngeal oedema
Epiglottis
Croup

73
Q

Causes of laryngeal oedema

A

Allergic reaction or swallowed foreign body (choking)

74
Q

certain conditions causing swelling of the larynx can present an immediate threat to the airway

Presentation?

A

Stridor, raised respiratory rate, distress, hypoxia +/- cyanosis

75
Q

Decreased conscious levels cause

A

Decreased tone and suppression of reflexes

Airway at risk

76
Q

2 forms of airway management

A

Planned (elective) = surgery
emergency = acute/immediate threat to airway or unconscious patient e.g. cardiac arrest

77
Q

What is Ludwig’s Angina

A

Rare infection of tissues of floor of oral cavity

78
Q

Simple airway manoeuvres

A

Head tilt chin lift

79
Q

Types of airway adjuncts

A

Maintain patent upper airway

Oropharyngeal airway (Guedel), contraindicated if minimal depression of consciousness (illicit gag reflex)

Nasopharyngeal airway

80
Q

Allowing for spontaneous ventilation offers no

A

Protection of Lower repository tract (from vomit/secretions)

81
Q

Supraglottic airway management

A

iGel

Maintains airway and affords some protection, minimal technical skills requires to insert, often first line in cardiac arrest, not for long-term ventilation e.g. if in ITU

82
Q

Definitive airway = intubation

A

Endotracheal tube

Technical skill = requires use of laryngoscope to visualise vocal cords

Secures and protects from secretions/vomit, lower respiratory tract

Patient (if not in cardiac arrest) anaesthetised prior to insertion

83
Q

What is this

A

Nasopharyngeal airway adjunct

Maintains patent airway

84
Q

What is this

A

Oropharyngeal airway adjunct

85
Q

What is this

A

Endotracheal tube

Definitive airway passing through vocal cords

86
Q

What is this

A

IGEL

Supraglottic airway device

Sits around laryngeal inlet

87
Q

What is croup

A

Common respiratory disease in children

Barking cough, worse with agitations (stridor may occur)

Caused by a virus

Single dose of corticosteroid

88
Q

What is Epiglottitis

A

Inflammation secondary to infection causing swelling of epiglottis and Supraglottic tissues

Rare

2-6 year olds

Stridor, drooling, difficulty breathing and swallowing, high fever, sore throat, sitting upright, sniffing position, mouth open

DO NOT EXAMINE THROAT

Intubation or tracheostomy

Caused by haemophliius influenza, needs antibiotics

HNN (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions