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Where is the larynx located? Posterior to sternohyoid. Anterior to laryngopharynx. Medial to carotid sheath & thyroid glands. Extends from C3-C6.
How many cartilages form the laryngeal skeleton? What type of cartilage make up most of the skeleton? The least? Nine. 3 single. 3 paired. Most of it is hyaline. The EPIGLOTTIS & other small stuff is elastic.
What are the cartilages (parts, I suppose) that make the laryngeal skeleton? Epiglottic cartilage, thyroid cartilage, cuneiform cartilage, corniculate cartilage, areytenoid cartilage & cricoid cartilage
What things are formed when the 2 laminae come together to form the thyroid cartilage? Will form laryngeal prominence (adam's apple), superior thyroid notch, inferior thyroid notch (less distinct).
What comes off the posterior limits of the thyroid cartilage? Posterolaterlally? Posteriorly, are the superior and inferior horns. Posterolaterally is the oblique line and the superior and inferior thyroid *tubercles* that are expansions of the line.
Which cartilage is the only one that completely encircles the airway? What is its function? Is it larger anteriorly or posteriorly The cricoid cartilage. Provides support to inferior part of larynx. Enlarged lamina in the back, thin arch in the front, so larger posteriorly.
Where do the arytenoid cartilage lie? What do they articulate with? In posterior aspect of larynx, in btwn the thyroid cartilage laminae. Base articulates with cricoid below. Apex articulates with corniculate cartilage.
What attaches to the vocal process of the arytenoid cartilage? What about the muscular processes? The vocal ligaments to vocal processes. Intrinsic laryngeal muscles ( posterior cricoarytenoids, lateral cricoarytenoids, transverse arytenoids & oblique arytenoids) to the muscular processes.
Where is the epiglottic cartilage located? Where does it attach? Posterior to root of tongue & hyoid. Is unattached superiorly. But will attach to thyroid cartilage (anteriorly internal surface) via thin cartilage stalk.
What do the corniculate cartilages articulate with? Their bases will articulate with the apices of the arytenoid cartilages
Where are the cuneiform cartilages located? Anterior to the corniculate cartilages. W/in aryepiglottic folds.
What are the changes you'll see in laryngeal cartilage as you age? More superior in babies and children. In puberty, laryngeal prominence more obvious in males b/c testosterone. These will start to ossify as you get old.
What are the extrinsic ligaments of the larynx? Thyrohyoid membrane. Hyoepiglottic ligament. Cricothyroid ligament.
Where is the thyrohyoid membrane thickened? What can you find in it? In the middle/midline, forming median thryohyoid ligament. In the posterior edges, making the lateral thyrohyoid ligament, which may contain triticeal cartilage. There will also be opening for superior laryngeal VESSELS & internal laryngeal NERVE
What are the intrinsic ligaments of the larynx? Conus elasticus/cricothyroid ligament. Quadrangular ligament. Thryoepiglottic ligament.
Where does the cricothyroid ligament attach? From superior surface of cricoid cartilage to vocal processes of the aryetenoid cartilages and the inner surface of angle btwn thyroid laminae.
Where is the cricothyroid ligament thick? What do we call the rest of the ligament that isn't thick? Anteriorly, where it forms the median cricothyroid ligament. The lateral cricothyroid ligament.
What is the vocal ligament? The upper edge of the cricothryoid ligament, formed by the attaching of it to the arytenoid cartilages & inner surface of angle btwn thyroid laminae.
Where is the quadrangular ligament located? Running in btwn lateral parts of epiglottic and arytenoid cartilages. Under the mucosa (b/c it's submucosal).
Where does the quadrangular ligament attach? To arytenoid cartilage posteriorly just inferior to apex. And then to thyroid cartilage just superior to where vocal ligaments attach along the inner surface of the angle btwn thyroid laminae.
What forms the vestibular ligament? The free inferior margins of the quadrangular ligament w/in the vestibular fold.
What forms the aryepiglottic ligament? The free superior margin of the quadrangular ligament w/in the aryepiglottic fold.
What does the aryepiglottic fold contain? Corniculate & cuneiform cartilages.
What does the thyroepiglottic ligament do? Attaches the tapered part of epiglottic cartilage to internal middle part of thyroid midline.
What are the joints found in the larynx? What kind of joints are they? Cricothyroid joints & cricoarytenoid joint. They're both synovial.
Where is the cricothyroid joint? Formed btwn medial side of inferior horns of THYROID cartilage & lateral surfaces of cricoid cartilage.
What happens to the vocal folds when thyroid cartilage tilts anteriorly? Vocal folds are tensed when thyroid cartilage tilts anterior AT cricothyroid joint.
Where is the cricoarytenoid joint? Btwn base of arytenoid cartilages and posterosuperior aspect of cricoid cartilage.
Why is it important that the cricoarytenoid joint is synovial? Allows arytenoids to slide & pivot on cricoid, which allows abduction/adduction of the vocal ligaments.
What is the larynx continuous with? Pharynx superiorly. Trachea inferiorly.
Where does larynx open superiorly? What is the opening bound by? At laryngeal inlet/aditus, where it opens into ANTERIOR part of pharynx (just behind tongue). Bounded anteriorly by epiglottis, posteriorly by artyenoids and the aryepiglottic folds.
Where does larynx open inferiorly? Well...it's continuous with trachea...And always open. Is completely encircled by cricoid.
What are the divisions of the larynx? Vestibule. Middle pt of laryngeal cavity (laryngeal ventricle). Infraglottic space.
Where does the vestibule start and end? Superior boundary is laryngeal inlet. Inferior boundary are the vestibular folds. Can also say that the inferior boundary is the rima vestibuli.
What is the rima vestibuli? The space formed btwn the 2 vestibular ligaments enclosed in the vestibular folds.
Where is the middle part of laryngeal cavity? What does it contain? Narrow space btwn vestibular and vocal folds. The laryngeal ventricle, laryngeal saccule, and the glottis.
What is the laryngeal ventricle? What does it form? A gap btwn the vocal folds and vestibular folds. It forms an extension anterosuperiorly just behind the thyroid cartilage, into a kind of pouch. The saccule holds many mucous glands.
What do the vocal folds consist of? What is the space btwn the two folds called? The vocal ligament, vocalis muscle & mucosal covering. The space in btwn is called rima glottidis.
Are vocal folds true vocal cords? YES
What is the vocal apparatus? The vocal folds AND rima glottidis together. Apparatus is also called GLOTTIS.
What does the rima glottidis looks like when breathing normally? During forced breathing? When talking/making sounds? Narrow w/nl breathing. Wide when forcing breaths. Slit like during phonation.
Where does the infraglottic space extend to and from? Goes from vocal folds down to inferior opening of larynx, when we reach trachea.
What is the general function of the extrinsic muscles of the larynx? What were those muscles again? Muscles include suprahyoid & infrahyoid muscles. Gen function is to move ENTIRE LARYNX, esp raising/lowering it b/c swallowing or talking, b/c of attachment to hyoid.
What are the gen functions of intrinsic muscles of larynx? Gen function is to move PARTS of larynx *with respect to each other* so larynx can do what it is supposed to do. Like the actual talking and being a sphincter for lower resp tract.
What are the intrinsic muscles of the larynx? cricothyroid, thyroarytenoid, vocalis, thyroepiglottic, lateral cricoarytenoid, transverse arytenoid, and oblique arytenoid.
Where does the cricothyroid muscle attach? Where can you find it on the body? From arch of cricoid cartilage up to the inferior edge & inferior horn of thyroid cartilage. Is on external & lateral aspect of larynx.
What happens when the cricothyroid contracts? Contraction will cause thyroid cartilage to rotate anteriorly and inferiorly toward cricoid. That will tense the vocal folds and raise the pitch of your voice.
Where is the thyroarytenoid muscle? Where does it attach? Deep to thyroid laminae. Attaches from inferior pt of thyroid angle and adj cricothyroid ligament into anterolateral surface of arytenoid cartilage & lateral to quadrangular ligament.
What happens when the thryoarytenoid muscle contracts? Pulls arytenoid cartilages anteriorly toward thyroid cartilage via cricoarytenoid joint. This relaxes vocal ligament/fold, lowering the pitch of the voice.
Where is the vocalis muscle? Where does it attach? It runs parallel with vocal ligament towards thyroid cartilage. It attaches to anterolateral side of arytenoid cartilage & its vocal process to thyroid cartilage.
What is the vocalis muscle a part of? And what does the vocalis muscle do? Is part of thryoarytenoid muscle. It fine tunes tension on vocal folds & changes mass of the cords to change timbre of voice.
What is the thyroepiglottic muscle a part of? Where does it extend into? Part of thyroarytenoid muscle that extends into aryepiglottic fold.
What does the thyroepiglottic muscle do? Acts as sphincter for laryngeal vestibule.
Where does the lateral cricoarytenoid muscle attach? Superior aspect of arch of cricoid (above where cricothyroid muscle attached). Then goes back and up to the muscular processes of the arytenoids.
What does the cricoarytenoid muscle do when it contracts? Will bring vocal processes medial, causing vocal folds to adduct and close the rima glottis.
Where does the transverse arytenoid muscle attach? What does it do? To the lateral aspect of ea arytenoid cartilage, spanning btwn the two posteriorly as it joins them together. Will help adduct the vocal folds.
Where are the oblique arytenoid muscles? Where do they attach? They cross each other just posterior to the transverse arytenoids. Running from posterior surface of muscular process of one arytenoid to the apex of the other (contralaterally).
What do the oblique arytenoid muscles do? They also help adduct the vocal folds.
What is the blood supply to the larynx? Superior laryngeal artery (thru the thyrohyoid membrane, off superior thyroid artery) & inferior laryngeal artery (off inferior thyroid artery).
What is the path of the inferior laryngeal artery? Comes up deep to inferior border of inferior constrictor. Enters larynx by passing deep near cricothyroid joint.
Where does blood from larynx drain into? Superior laryngeal vein and inferior laryngeal vein.
What does superior laryngeal vein accompany? And what does it drain thru? Accompanies superior laryngeal artery. Will usually drain thru superior thyroid vein into IJV.
What does the inferior laryngeal vein drain into? Drains into inferior thyroid vein and will then usually empty into L brachiocephalic.
Where does lymph drain from areas above the vocal cord? They'll follow the superior laryngeal vessels to the SUPERIOR DEEP cervical lymph nodes.
Where does lymph from below the vocal cords (infraglottic region) drain? Will drain to PREtracheal or PARAtracheal nodes *then* to INFERIOR DEEP cervical lymph nodes.
What provides sensory and motor to the entire larynx? VAGUS.
Where are sensory neuron cell bodies for vagus? The inferior ganglion of vagus
Where are motor neurons and pregang parasympathetic neuron cell bodies for the laryngeal muscles? brainstem
What branches of vagus supply sensation and parasympathetic input to larynx at vocal folds and ABOVE. internal laryngeal off superior laryngeal
What innervates the cricothyroid muscle? external laryngeal off superior laryngeal. descends right on top of inferior constrictor.
What innervates all instrinsic muscles of larynx (except cricothyroid), as well as transmit sensory and parasympathetic fibers for inferior part of larynx? Inferior laryngeal nerve that continues off recurrent laryngeal.
Where is the inferior laryngeal nerve? Passes deep to inferior border of inferior constrictor into larynx. Will split into several branches to innervate the intrinsic muscles of the larynx.
Where are the sympathetic postgang cell bodies for the larynx at? In the superior or middle cervical sympathetic ganglia.
What will happen to the larynx if the internal laryngeal nerve gets damaged? Desensitization of superior larynx. Higher probability of laryngeal foreign bodies and choking.
What will happen to the larynx if the external laryngeal nerve gets damaged? Paralysis of cricothyroid muscle that causes lowered pitch and monotonous tone.
What will happen to the larynx if the inferior laryngeal nerve gets damaged? The vocal folds get paralyzed, so you can't control their tone....
Created by: h.pang00