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ANAT + PHYS (9610) > UNIT 4: Intrinsic and Extrinsic Laryngeal Musculature > Flashcards

UNIT 4: Intrinsic and Extrinsic Laryngeal Musculature Flashcards

1
Q

What are intrinsic laryngeal muscles?

A
  • have origin and insertion on laryngeal cartilages
  • control adduction-abduction of VFs
  • control tension-relaxation of VFs
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2
Q

what is the glottis?

A

a variable opening bw the true VFs (horizontal plane)

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3
Q

where does the glottis begin and end

A

from anterior commissure (at thyroid angle) to posterior commisure (bw arytenoids)

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4
Q

how large is the glottis?

A

about 20mm in adults

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5
Q

what is the membranous portion of the glottis

A

approx 3/5 of the length of the total glottis; bw the folds themselves

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6
Q

what is the cartilaginous portion of the glottis

A

approx 2/5 of the length of the glottis; bw the arytenoid cartilages

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7
Q

what part of the glottis is open/closed when we whisper?

A

cartilaginous portion open and membranous portion closed

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8
Q

are the interarytenoids intrinsic or extrinsic

A

intrinsic

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9
Q

what are the two interarytenoid muscles

A

transverse and oblique

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10
Q

Transverse interarytenoid: O, I, A, INN

A

O = lateral border of each arytenoid bw the muscular process and apex

I = lateral border of opposite arytenoid

A = medial approximation of arytenoids, closes the glottis (adduction)

Inn = RLN of CN X

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11
Q

Oblique interarytenoid: O, I, A, INN

A

O= posterior surface of the base of one arytenoid

I= apex of the opposite arytenoid

A= medial approximation (adduction) of the arytenoids

Inn= RLN of CN X

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12
Q

what shape do the transverse and oblique interarytenoids make

A

an X, they cross over each other

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13
Q

what 3 intrinsic muscles are adductors

A

transverse interarytenoid
oblique interarytenoid
lateral cricoarytenoid

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14
Q

Lateral cricoarytenoid: O, I, A, INN

A

O = superior surface of the anterolateral border of the cricoid arch

I = anterior surface of the muscular process of the arytenoids

A= adducts vocal folds by rotating the vocal processes of the arytenoids medially

Inn = RLN of CN X

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15
Q

lateral cricoaytenoid is _____ and is located _____ to the thyroid cartilage

A

paired
deep

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16
Q

if we just use the lateral cricoarytenoid it will close the ______ glottis, which will produce a ______

A

membranous

whisper

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17
Q

is the lateral cricoarytenoid intrinsic or extrinsic

A

intrinsic

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18
Q

is the posterior cricoarytenoid intrinsic or extrinsic

A

intrinsic

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19
Q

posterior cricoarytenoid: O, I, A, Inn

A

O = posterior quadrate lamina of the cricoid

I = posterior surface of the muscular process of the arytenoid

A= abducts the vocal folds and opens the glottis by rotating arytenoids laterally

Inn = RLN of X

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20
Q

which intrinsic muscle is an abductor

A

posterior cricoarytenoid (PCA)

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21
Q

posterior cricoarytenoid is ___ shaped, on the _____ surface of the _____, and it is _____

A

fan shaped, posterior, cricoid, paired

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22
Q

cricothyroid muscle is ______ shaped muscle located bw _____ and _____ cartilages, there are two divisions: _____ and ______

A

fan
cricoid and thyroid
pars oblique
pars recta

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23
Q

cricothyroid: O, I, A, Inn

A

O = cricoid arch, anterolateral region

I = inferior border of the lamina and inferior cornu of the thyroid

A = decreases the distance bw thyroid and cricoid; pulls thyroid anteriorly, lengthening and thinning the VFS, inc longitudinal tension and pitch

inn = external branch of the superior laryngeal nerve (eSLN) of CN X

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24
Q

why is the innervation of the cricothyroid special? what aspect of phonation would be affected by damage to this innervation?

A

ONLY ONE INNERVATED BY SUPERIOR LARYNGEAL NERVE OF CN X

If a patient cannot change pitch it may be due to cricothyroid or superior laryngeal nerve

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25
Q

if the RLN is damaged we would expect a patient to have issues with…

A

closing their airway

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26
Q

thyroarytenoud may function to increase or decrease _________ (depending on co-activation of other muscles)

A

fundamental frequency

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27
Q

what are the two portions of the thyroarytenoid?

A

thyrovocalis
thyromuscularis

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28
Q

thyrovocalis is the ______ portion of the thyroarytenoid

A

most medial

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29
Q

thyromuscularis is the _____ portion of the thyroarytenoid

A

most lateral

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30
Q

thyrovocalis: O, I, A, Inn

A

O = inferior border of the thyroid angle (inner surface)

I = vocal processes of arytenoids

A = controls tension of VFs w the cricothyroid muscle

Inn = RLN of CN X

31
Q

Thyromuscularis: O, I, A, Inn

A

O = inferior border of the thyroid angle (inner surface)

I = muscular processes of arytenoids

A = lateral fibres participate in adduction (rotate); medial fibers shorten/relax VFs

Inn= RLN of CN X

32
Q

what does it mean that the VFs are held in dynamic balance?

A

combinations of muscles pulling in different directions

33
Q

intrinsic laryngeal muscles tend to act in _____ and usually in _____ ______

A

pairs
complex groups

34
Q

is the aryepiglotticus intrinsic or extrinsic

A

intrinsic

35
Q

_____: a few fibres of the _____ ______ course superiorly and anteriorly in the lateral sides of the aryepiglottic folds

A

aryepiglotticus
oblique interarytenoids

36
Q

aryepiglotticus: O, I, A, Inn

A

O = muscular process of arytenoid

I = lateral margin of epiglottis

A = pull epiglottis downward over laryngeal vestibule

Inn = RLN of X

37
Q

____: A few fibers of the _____ _____ that course verticially w/i the aryepiglottic folds

A

thyroepiglotticus
thyroarytenoid muscles

38
Q

thyroepiglotticus: O, I, A, Inn

A

O = inferior border of thyroid angle

I= lateral margin of epiglottis and aryepiglottic folds

A = aids in pulling epiglottis downward

Inn = RLN of X

39
Q

is thyroepiglotticus intrinsic or extrinsic

A

intrinsic

40
Q

unilateral vocal fold paralysis is

A
  • paralyzed fold will not move or vibrate; mobile fold may compensate
41
Q

what symptoms does unilateral vocal fold paralysis cause?

A

breathy or hoarse voice, limited pitch and loudness; could affect swallowing safety

42
Q

bilateral vocal fold paralysis causes …. and has what symptom?

A

both folds sit in paramedian position (not open/not closed)

breathing and swallowing issue more noticeable, may have a trancheostomy tube

43
Q

what is vocal fold paralysis caused by?

A

nerve damage
either upper or lower motor neuron

44
Q

describe paradoxical vocal fold movement - what symps? cause?

A

vocal folds close when they should be open

inspiration is interrupted by adduction of vocal folds

rough voice quality, difficulty getting enough air in, stridor, lightheadedness

exact cause is unknown (ex. acid reflex, breathing in cold air, inhaled irritants, emotional stress)

45
Q

what are the two categories of extrinsic muscles of the larynx?

A

suprahyoid muscles
infrahyoid muscles

46
Q

the surprahyoid muscles are _________ elevators and _______ depressors, why?

A

hyoid (laryngeal) elevators OR jaw depressors

some muscles that act as elevators of the larynx act also as depressors of the mandible - when they mandible is fixed these muscles elevate the hyolaryngeal complex - if the hyoid bone is fixed these muscles depress the jaw

47
Q

the infrahyoid muscles include the _____ depressors and one _____ elevator

A

hyoid (laryngeal) depressors (strap muscles of the neck) and one laryngeal elevator

48
Q

what are the 5 suprahyoid muscles (one had 2 within it)

A

diagastricus = anterior and posterior bellies
stylohyoid
mylohyoid
geniohyoid
hypoglossus

49
Q

the digastric muscle has two parts and are connected by a …

A

anterior and posterior bellies
connected via a tendon

50
Q

anterior belly of the digastric: O, I, A, Inn

A

O = internal surface of the mandible, near midline

I = intermediate tendon at corpus and greater cornu of hyoid

A = elevates and protrudes hyoid bone

Inn = CN V - trigeminal

51
Q

posterior belly of the digastric: O, I, A, Inn

A

O = mastoid process of temporal bone

I = intermediate tendon at corpus/greater cornu of hyoid

A= elevates and retracts hyoid

Inn= CN VII - facial

52
Q

______ thin sheet that forms the muscular floor of the oral cavity, deep to digastric

A

mylohyoid

53
Q

mylohyoid: O, I, A, Inn

A

O= mylohyoid on internal surface of mandible

I = body of hyoid, midline raphe (w fibres of MH of opposite side)

A= pulls hyoid anteriorly and superiorly

Inn = CN V - trigeminal

54
Q

_____ narrow, cylindrically shaped muscle, paired, parallel

A

Geniohyoid

55
Q

Geniohyoid: O, I, A, Inn

A

O = Inferior mental spines on the internal surface of the mandible

I = anterior surface of the body of the hyoid

A = elevates and protrudes hyoid bone

Inn = C1 and CN XII -hypoglossal

56
Q

mylohyoid sandwich?

A

digastric most superficial under the chin, then mylo, then genio (closest to the tongue)

57
Q

____ long, thin muscle, approx parallel to posterior belly of digastric

A

stylohyoid

58
Q

stylohyoid: O, I, A, Inn

A

O = styloid process of temporal bone

I = body of the hyoid near the greater cornu (lateral edge)

A = elevates and retracts hyoid bone

Inn = CN VII facial

59
Q

what are the 5 infrahyoid muscles (one w two parts)?

A

omohyoid (superior and inferior bellies)
sternohyoid
sternothyroid
thyrohyoid

60
Q

______: thin, narrow muscle w superior and inferior bellies joined by a central tendon connected by fascia to the clavicle

A

omohyoid

61
Q

omohyoid looks like a

A

hockey stick

62
Q

omohyoid inferior belly: O, I, A, Inn

A

O = superior border of scapula

I = intermediate tendon

A = depresses hyoid and larynx

Inn = C1 to C3 ansa cervicallis

63
Q

omohyoid superior belly: O, I, A, Inn

A

O = intermediate tendon

I = inferior border of the body of the hyoid

A = depresses hyoid and larynx

Inn = C1 via ansa cervicalis

64
Q

______: long thin muscle on the anterior surface of the neck

A

sternohyoid

65
Q

sternohyoid: O, I, A, Inn

A

O = posterior surface of the manubrium of the sternum and medial border of the clavicle

I = inferior border of the body of the hyoid

A = lowers the hyoid and larynx

Inn = C1-C3 via ansa cervicalis

66
Q

____: long, flat muscle on anterior surface of the neck

A

sternothyroid

67
Q

sternothyroid: O, I, A, Inn

A

O = posterior surface of manubrium of sternum and 1st costal cartilage

I = oblique line of the thyroid lamina

A = lowers the thyroid cartilage

Inn = C1-C3 via ansa cervicalis

68
Q

____: broad, thin muscle on anterior surface of neck

A

thyrohyoid

69
Q

thyrohyoid: O, I, A, Inn

A

O = oblique line of thyroid lamina

I = inferior side of body and greater cornu of hyoid

A= lowers hyoid or elevates thyroid

Inn = spinal nerve C1

70
Q

Impaired hyolaryngeal elevation

A

insufficient hyolaryngeal elevation can inc risk of material entering the airway

can be caused neurogenically (ex. stroke, ALS), surgery disrupting suprahyoid musculature, irradiation of the neck

71
Q

swallowing safety and efficiency is related to a complex pattern of ______ _____ : upward and forward movement of the _____ and ____ pulls the airway out of harms way

A

sensorimotor events

hyoid

larynx

72
Q

extrinsic muscles of the larynx can ____ or _____ the hyolaryngeal complex

A

elevate or depress

73
Q

thyrohyoid muscle can _____ larynx to a greater extent

A

elevate

74
Q

disrupted function of the _____ ______ especially laryngeal elevator muscles can impact swallowing physiology

A

extrinsic muscles

ANAT + PHYS (9610) (16 decks)

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