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ENT Advanced > The Larynx > Flashcards

The Larynx Flashcards

1
Q

What structures does the larynx connect?

A

The inferior oropharynx with the trachea

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2
Q

Where does the larynx extend from and to?

A

Laryngeal inlet to the level of the inferior border of the cricoid cartilage

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3
Q

Function of the larynx?

A

Guard the air passages, especially during swallowing, where it serves as a sphincter of the lower resp tract

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4
Q

What is the laryngeal skeleton made up of?

A

Hyoid bone

9 cartilages

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5
Q

Name the cartilages of the larynx

A

3 unpaired

  • epiglottis
  • thyroid
  • cricoid

Paired

  • arytenoid cartilage
  • corniculate cartilage
  • cuneiform cartilage
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6
Q

What is the epiglottis attached to?

A

Back of the hyoid bone and thyroid cartilage by ligaments

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7
Q

What level is the upper border of the thyroid cartilage at?

A

C4

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8
Q

What important anatomical landmarks are there at the superior border of the thyroid cartilage?

A

Bifurcation of the common carotid artery

Level of the carotid body

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9
Q

What shape is the cricoid cartilage said to be?

A

Signet ring shaped

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10
Q

What vertebral level does the cricoid cartilage mark?

A

C6

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11
Q

What articulates with the two articular facets on either side of the cricoid cartilage?

A

Inferior horn of thyroid cartilage

Arytenoid cartilage

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12
Q

What shape is the arytenoid cartilage said to be?

A

Pyramid

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13
Q

What is on the anterior and lateral sides of the arytenoid cartilage?

A

Anterior - vocal process

Lateral - muscular process

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14
Q

Which cartilage is important for vocal cord ligament?

A

Arytenoid cartilage

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15
Q

Where does the cricovocal ligament/membrane run between?

A

Deep surface of the angle of the thyroid cartilage to the vocal process of the arytenoid cartilage

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16
Q

What are the divisions of the internal larynx?

Features of each division?

A

Supraglottic space

  • laryngeal inlet
  • vestibular folds (false vocal cords)

Glottis

  • vocal cords
  • rima glottis (space between vocal cords)

Subglottic space

17
Q

Which groups can the laryngeal muscles be divided into?

A

Extrinsic and intrinsic muscles

18
Q

What is the function of the extrinsic muscles of the larynx?

A

Move the entire larynx

  • infrahyoid muscles depress it
  • suprahyoid muscles elevate it
19
Q

Function of the intrinsic muscles of the larynx?

A

Open and close the glottis by acting on the vocal folds

Help to close the laryngeal inlet by acting on the aryepiglottic folds

20
Q

Innervation of the intrinsic muscles?

A

Recurrent laryngeal nerve

Except for the cricothyroid muscle supplied by the external laryngeal nerve

21
Q

What are the layers of the vocal cords?

A

Stratified squamous epithelium
Vocal ligament
Vocalis muscle

22
Q

What are the implications of a lack of submucosa of the vocal cords?

A

Vocal cords look pearly white on laryngoscopy
No oedema during infections
Delayed spread of carcinoma of vocal cords

23
Q

Which muscles carry out abduction of the vocal cords?

A

Posterior cricoarytenoid

24
Q

Which muscles carry out adduction of the vocal cords?

A

Lateral cricoarytenoid

Cricothyroid

25
Q

The branches of which cranial nerve is the larynx innervated by?

A

Branches of the vagus nerve

26
Q

Function of the superior laryngeal nerve in the larynx?

A
  • internal laryngeal nerve - sensory to the larynx above the true vocal cord
  • external laryngeal nerve - motor to cricothyroid muscle
27
Q

Function of the recurrent laryngeal nerve?

A

Sensory to below the true vocal cord

28
Q

Which vessels do the right and left recurrent laryngeal nerves loop around?

A

Right - descends to T2 and loops around subclavian artery

Left - descends to T4 and loops around the arch of the aorta

29
Q

What does the recurrent laryngeal nerve run upwards in?

A

Tracheo-oesophageal groove

30
Q

Causes of hoarse voice?

A

Recurrent laryngeal nerve palsy

  • aortic aneurysm
  • apical lung tumour
  • bronchial carcinoma (only on left as right doesn’t go low enough)

Laryngitis (viral or streptococcal)
GORD
Benign nodules on vocal cords

31
Q

Blood supply to the larynx?

A

External carotid artery - superior thyroid artery - superior laryngeal artery

Subclavian artery - inferior thyroid artery - inferior laryngeal artery

32
Q

Venous drainage of the larynx?

A

Superior laryngeal vein - superior thyroid vein - internal jugular
Inferior laryngeal vein - inferior thyroid vein - left brachiocephalic vein

33
Q

What can an upper airway/laryngeal obstruction be caused by?

A

Laryngeal oedema
-infection - acute epiglottitis, croup, anaphylaxis
Inhalation of a foreign body
Tumours

34
Q

Where is a cricothyroidotomy performed?

A

In an emergency situation

Opened through the cricothyroid membrane

ENT Advanced (24 decks)

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