Week 1 - J - Anatomy of the Larynx

Question 1

What fascia of the neck is the larynx located in?

Answer 1

The visceral layer of the pretrachial fascia

Question 2

What layer of the neck is the pretrachial fascia deep to? What else is located in the pretrachial fascia?

Answer 2

The pretracheal fascia is located deep to the investing fascia Also contains the oesophagus, pharynx, recurrent laryngeal nerve , strap muscles and thyroid gland

Question 3

The strap muscles are ensheathed in the pretrachial fascia by a thin muscular layer What are the strap muscles also known as and what is the function of strap muscles?

Answer 3

Strap muscles aka infrahyoid muscles They function as accessory muscles of breathing

Question 4

What are the 4 strap muscles?

Answer 4

Omohyoid Thyrohyoid Sternothyroid Sternohyoid

Question 5

What vertebral levels does the larynx lie between? The larynx is located anteriorly to the laryngopharyx

Answer 5

The larynx lies between vertebral levels C4-6 The hypopharynx in this picture is the laryngopharynx

Question 6

Where is the trachea palpated and when may it be deviated?

Answer 6

Trachea is palpated in the jugular notch May be deviated in a tension pneumothorax - deviates away from side of tension pneumothorax

Question 7

What bony prominence lies directly behind the ear? What is the first palpable spinous process? What gives rise to the adam’s apple?

Answer 7

Bony prominence behind the ear - mastoid process C7 - vertebra prominens is the first palpable spinous process The thyroid cartilage gives rise to the adam’s apple

Question 8

Raising of the larynx towards to oesophagus reduces the chance of aspiration Which muscles raise the larynx?

Answer 8

The longtitudional muscles

Question 9

What is the opening from the laryngopharynx into the larynx known as?

Answer 9

The laryngeal inlet

Question 10

The nasal cavities are separated by the nasal septum What makes up the nasal septum?

Answer 10

The perpendicular plate of the ethmoid bone superiorly The vomer bone inferiorly The septal cartilage - anterior to the two bones

Question 11

What is featured on the lateral wall of the nasal cavity which increase the surface area and helps with warming and humidification?

Answer 11

The conchae

Question 12

The larynx helps to maintain the patency of the URT What does the cartilage help to prevent?

Answer 12

Helps prevent the entry of foreign bodies into LRT

Question 13

What connects the thyroid cartilage and the hyoid bone? What connects the thryoid and cricoid cartilage? anterior or posterior?

Answer 13

The thyrohoid membrane Thyroid and cricoid connected by the cricothyroid joint which is located posteriorly - the inferior horn of the thyroid cartilage inserts into the cricoid cartilage

Question 14

What cartilages lie behind the thyroid cartilage?

Answer 14

The arytenoid cartilage

Question 15

What does pressure on the cricoid cartilage cause?

Answer 15

Causes closure of the oesophagus - crcioid cartilage presses on C6vertebra

Question 16

What are the two folds of the larynx? (one is a true fold and one is a false)

Answer 16

False vocal cord (vestibular fold) True vocal cord

Question 17

Are vocal cords muscle or connective tissue?

Answer 17

The vocal cords are connective tissue

Question 18

What is the membranous sheet between cricoid cartilage and the vocal ligament which prevents air escaping during respiration?

Answer 18

Conus elasticus

Question 19

What is the space between the vocal folds known as? What is the space between the vocal folds + the vocal folds known as?

Answer 19

The rima glottidis Known as the glottis

Question 20

The extrinsic muscles of the larynx are the ones associated with the hyoid, the strap muscles and the pharynx The intrinsic muscles of the larynx have an impact on vocal cord movements What supplies the intrinsic muscles of the larynx?

Answer 20

Intrinsic muscles of the larynx supplied by CN X

Question 21

The impact on vocal cord movements caused due to the intrinsic muscles of the larynx are: Tension Relaxation Adduction Abduction What do these movements do to the sound produced?

Answer 21

Tension causes a higher pitch of sound Relaxation causes a lower pitch of sound Adduction makes the noise quieter Abduction makes the noise louder

Question 22

The intrinsic muscles include Crciothyroid muscle Thyroarytenoid muscles Lateral crico-arytenoid muscles Arytenoid muscles Posterior Crico-arytenoid muscles Which intrinsic muscle cause an increased pitch?

Answer 22

The cricothyroid muscle It tilts the thyoid forward causing tensing of the vocal folds

Question 23

Which muscle aids with relaxation of the vocal folds causing reduced phonation?

Answer 23

The thyoroarytenoid muscles

Question 24

Which two muscles cause adduction of the vocal cords (vocal cords move via movement of the vocal ligament which is found inside the cords) and therefore make noise quieter via closing of the rima glottidis?

Answer 24

The arytenoid muscles and the lateral crico-arytenoid muscles

Question 25

What is the only muscle to cause abduction of the vocal cords (aka vocal folds) making the voice louder?

Answer 25

The posterior crico-arytenoid muscles

Question 26

When the lateral crico-arytenoids are contracted however the arytenoid muscles are relaxed, what sound is produced?

Answer 26

Whsipering

Question 27

All intrinsic muscles apart from Cricothyroid are supplied by Inferior laryngeal nerve. (this is a branch of the recurrent laryngeal nerve) What supplies the cricothyroid muscle?

Answer 27

Cricothyroid muscle is supplied by the superior laryngeal nerve (branch of the vagus nerve)

Question 28

Which embryological pharyngeal arch gives rise to the cricthyroid muscle? Which embryological pharngeal arch gives rise to the intrinsic muscles of the larynx?

Answer 28

Pharyngeal arch 4 gives rise to the cricothyroid Pharyngeal arch 6 gives rise to the intrinsic muscles of the larynx

Question 29

What is the inferior laryngeal nerve a branch of? At what level does this nerve become the inferior pharyngeal nerve?

Answer 29

Branch of the recurrent laryngeal nerve which is a branch of the vagus nerve Becomes inferior laryngeal n. at the level of cricothyroid joint.

Question 30

What in the soft palate does CN V3 supply? (tenses the soft palate) What muscle causes elevation of the soft palate?

Answer 30

Muscle that tenses the soft palate - tensor veli palatini Levator veli palatini causes elevation of palate to close off entrance into the nasopharynx