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Y2 LCRS Anatomy of the Head, Neck and Spine > upper airway > Flashcards

upper airway Flashcards

larynx: describe the laryngeal cartilages and how they are linked together by membranes, describe the intrinsic and extrinsic muscles and how they function during phonation, laryngeal closure, cough/sneeze reflexes and regulation of intra-thoracic pressure, describe the origin, course and functions of the nerve supply and functional consequences of nerve injury

1
Q

principle function of larynx

A

prevent airway ingesting food (valve)

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2
Q

what condition may cause food to be asparated into the lungs, causing pneumonia

A

Parkinson’s disease

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3
Q

secondary function of larynx

A

sound producer

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4
Q

what 3 things is hollow larynx composed of

A

cartilages, membrane, muscles

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5
Q

bone between underside of mandible and thyroid cartilage

A

hyoid bone

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6
Q

shape and features of thyroid cartilage

A

two large flat cartilages joining at midline (similar to boat keel structure), with laryngeal prominence anterior

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7
Q

what is the cartilage below thyroid cartilage, and shape

A

cricoid cartilage, shaped like a signet ring (larger part posterior)

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8
Q

what is the gap between thyroid and cricoid cartilage, and clinical significance

A

cricothyroid membrane, where insertion of instrument to open airway in emergency (cricothyroidotomy)

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9
Q

significance of larger part of cricoid cartilage at posterior, forming cricothyroid joint

A

thyroid cartilage rocks backward and forward on it via medial surface of inferior thyroid horn into facet, partially altering tension on vocal folds (changing distance between anterior and posterior attachments)

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10
Q

effect of altering tension on vocal folds

A

change in pitch

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11
Q

what is below cricoid cartilage

A

tracheal rings

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12
Q

2 cartilages on top of epiglottis

A

arytenoid cartilages

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13
Q

shape and movement of arytenoid cartilages, and significance

A

small cones with large bases attached via facets, which swivel from side to side; attached to vocal folds, so when swivel (due to muscle contraction) they open or close the airway

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14
Q

what are vocal folds formed from

A

mucosal tissue draped over larynx and epiglottis

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15
Q

shape of mucosal tissue to form vocal folds (superior to inferior)

A

folded in (aryepiglottic fold) then folded out to form vestibule (vestibular fold), before folding back in again (vocal fold)

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16
Q

what ligament does vestibular fold mucosa overly

A

vestibular

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17
Q

what ligament does vocal fold mucosa overly

A

vocal

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18
Q

endoscopic view down throat (anterior to posterior) to form triangle

A

back of tongue, epiglottis, 2 pairs of lines (vestibular and vocal folds)

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19
Q

what is the opening between vocal folds called (middle of triangle) during breathing

A

rima glottidis

20
Q

what muscles are involved in creating vocal sounds and moving vocal folds, changing tension

A

intrinsic muscles of larynx

21
Q

anterior intrinsic muscle of larynx

A

cricothyroid muscle

22
Q

what happens to thyroid cartilage when cricothyroid muscle shortens

A

rocks forward on cricothyroid joint, putting tension on vocal folds

23
Q

4 muscles attached to arytenoid

A

transverse arytenoid, oblique arytenoid, posterior crico-arytenoid, lateral crico-arytenoid, vocalis muscle

24
Q

function of transverse and oblique arytenoids

A

abduct and adduct vocal folds

25
Q

function of posterior crico-arytenoid

A

swivel arytenoids to abduct and open up vocal folds and airway

26
Q

function of lateral crico-arytenoid

A

swivel arytenoids to adduct and close vocal folds and airway

27
Q

function of vocalis muscle (attaches directly to vocal ligament)

A

reduces tension on vocal folds

28
Q

cranial nerve supplying larynx

A

vagus

29
Q

branches of vagus nerve supplying larynx

A

superior laryngeal nerve, which branches to form internal and external laryngeal nerve; recurrent laryngeal nerve

30
Q

significance of recurrent laryngeal nerve

A

as is also located very far away from larynx, changes in voice (e.g. hoarseness) can indicate issue elsewhere along recurrent laryngeal nerve pathway (e.g. left lung)

31
Q

which recurrent laryngeal nerve is longer and why

A

left, as loops around ligamentum arteriosum (junction between aortic arch and pulmonary trunk), whereas right only loops around right subclavian artery

32
Q

which branch of the superior laryngeal nerve has more involvement

A

internal

33
Q

what does a lesion of the vagus before branching result in

A

complete paralysis (on one side)

34
Q

what does a lesion of the internal laryngeal nerve result in

A

loss of sensation above vocal cords

35
Q

what does a lesion of the external laryngeal nerve result in

A

paralysis of cricothyroid

36
Q

what does a lesion of the recurrent laryngeal nerve result in

A

paralysis of all muscles of larynx except cricothyroid, and loss of sensation below vocal cords

37
Q

what artery does superior laryngeal nerve (and branches) travel with

A

superior thyroid artery (first branch of external carotid artery)

38
Q

what artery does recurrent laryngeal nerve travel with

A

inferior thyroid artery

39
Q

examples of pathologies which left recurrent laryngeal nerve could be associated with

A

bronchial/oesophageal tumour, swollen mediastinal lymph nodes

40
Q

4 protective mechanisms for airway

A

(protection during) swallowing, gag reflex, sneezing, coughing

41
Q

nerve supplying afferent sensation of sneezing

A

V2

42
Q

nerve supplying afferent sensation of coughing

A

X

43
Q

common pathway of sneezing and coughing after afferent sensation

A

inspiration, raising intrathoracic pressure (glottis closed, abdominal muscles contracted)

44
Q

what happens to soft palate when sneezing, what muscles cause this and what are they innervated by

A

depresses against tongue by palatopharyngeus and palatoglossus supplied by vagus

45
Q

what happens to soft palate when coughing, what muscles cause this and what motor nerve(s) are they innervated by

A

raises and tenses against posterior wall of pharynx by levator veli palatini (X), tensor veli palatini (V3) and superior constrictor (X)

46
Q

common pathway of sneezing and coughing after soft palate movement

A

sudden abduction of vocal folds to release intrathoracic pressure through nose and mouth

47
Q

5 methods of intubation of airway

A

chin lift/jaw thrust, oropharyngeal or nasopharyngeal airway, endotracheal intubation, cricothyroidotomy, tracheostomy

Y2 LCRS Anatomy of the Head, Neck and Spine (39 decks)

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