LarynxLectureff

8/3/2019 LarynxLectureff

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LARYNX

OUTLINE

I. CARTILAGESII. LIGAMENTSIII. MUSCLESIV. TERMS/AREASV. INNERVATIONVI. BLOOD SUPPLYVII. LYMPHATICS

VIII. OBSTRUCTION OFLARYNX

LARYNX IS SOUND GENERATOR; SOUNDS ARE EXTENSIVELYMODIFIED IN SPEECH AND SINGING BY RESONANCE OF

PHARYNX, NASAL CAVITY, ORAL CAVITY


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Cartilages connected bymembranes and ligaments,moved by muscles

Functions: 1) Soundproduction

2) Closes of RespiratorySystem - allows increase in

Abdominal Pressure

When larynx closes off trachea, forced expiration produces

increased abdominal pressure: push-childbirth; defecation etc.

LARYNX

larynx

trachea

Note: In Respiration -Inspire - Diaphragm;Expire - Some muscles but

largely passive;Forced Expire - AbdominalMuscle


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- Inf. horns make synovial hinges joint with Cricoid Cartilage;- Laryngeal Prominence = Adams Apple, more prominent inmales

A. THYROID CARTILAGE Shield shaped- has Sup. & Inf. Horns from upper & lower edges

LaryngealProminence

Sup.Horns

Inf.Horns

I. LARYNX: CARTILAGES


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ANT VIEW POST VIEWB. CRICOID-complete ring of

cartilage hasnarrow Arch ant.,broad Lamina post.

Cricoid meansSignet Ring

Arch ofcricoid

Lamina ofcricoid

LARYNX: CARTILAGES


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C. Arytenoid - 2pyramidal shapedcartilages abovelamina have

synovial joints withCricoid permitSwivel = Rotate

Sliding = Ab/AdductD. Corniculate -nodules abovearytenoids in

aryepiglottic folds

E. Cuneiform - rodshaped, above

corniculate cartilages

LARYNX: CARTILAGES

Cuneiform

Corniculate

Arytenoid


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F. EPIGLOTTIS- leaf shapedcartilageposterior to root

of tongue

- connected tobody of hyoid

and post side ofthyroid cartilage

LARYNX: CARTILAGES

POST. VIEW


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II. LIGAMENTS OF LARYNX

1. Thyrohyoid Membrane

links larynx to hyoid;Median ThyrohyoidLigament - thickenedmidline part

2. Cricothyroid Membranelinks thyroid to cricoid;Median CricothyroidLigament - thickenedmidline part

3. Cricotracheal ligamentlinks Cricoid to firsttracheal cartilage

A. Structural ligaments - hold larynx, hyoid, trachea together

MedianThyrohyoidLigament

Median

CricothyroidLigament


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Epiglottis

4. QuadrangularMembrane linksArytenoidTo epiglottis

Arytenoid

STRUCTURAL LIGAMENTS


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Arytenoidcartilage

Epiglottis AryepiglotticFolds - overlieQuadrangularmembrane



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Lower freeedge ofQuadrangularmembrane is

CalledVestibularLigament; deepto Vestibular(False Vocal)Folds


CORONALSECTIONTHROUGHLARYNX

trachea


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5. ThyroepiglotticLigamentlinks epiglottis tothyroid cartilage


SUPERIORVIEWABOVELARYNX

NOSE


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VocalLigaments -Upper free

EdgesDeep to

VocalFolds

Rima Glottidis -Opening BetweenVocal ligaments

Functional ligaments:

Conus Elasticus -

Vibrating lips that arisefrom entire upper edge ofarch of cricoidAttach: ant. to Thyroid,

post. to Arytenoid

B. FUNCTIONAL LIGAMENTS

NOSE


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(In Coronal Section)

Conus Elasticus Functions

1) Sound Production Vibratelike lips of trumpet player;

2) Close Rima Glottidis stopsoutflow air, upward movement ofdiaphragm - when contractabdominal muscle pressure

increases in abdominal cavity;occurs in childbirth, defecation

FUNCTIONAL LIGAMENTS


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Epiglottis

Post.

Ant.Tongue Vocal Folds

(true vocalfolds)

LARYNGOSCOPE VIEW OF LARYNX

vocal foldsadducted when

talking or singing

Vestibular Folds(false vocal

folds)


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B. Intrinsic Muscles 1) change tension in vocal lig

--- changes pitch: increase tension raises pitch,decreased tension lowers pitch2) open & close Rima Glottidis

A. Extrinsic muscles (ex. hyoid muscles) - Move wholelarynx as in swallowing

1) CRICOTHYROID M. -TensesVocal Ligament

Increasing Pitch

Slack Tense

III. MUSCLES OF LARYNX - well named


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2)THYROARYTENOIDMUSCLE -Relaxes

Vocal LigamentsDecreases pitch

MUSCLES OF LARYNX

NOSE


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ArytenoidsCan rotate/slide

5) ARYTENOID(Transverse and

oblique arytenoid) -Adduct vocal folds

4) LATERAL CRICO-ARYTENOID - Adductvocal folds

3) POSTERIOR CRICO-ARYTENOID Abducts

vocal fold

MUSCLES OF LARYNX

Adduct closes rima glottidis

Abduct opens rima glottidis


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5) ARYEPIGLOTTICMUSCLE

Pulls epiglottis downduringswallowing

- Covers inlet to larynx

- Not necessary in

adult humans

MUSCLES OF LARYNX


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BisectLarynx to seeinteriorstructures

IV. TERMS ASSOCIATED WITH LARYNX


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VESTIBULE - inlet above falsevocal folds

VESTIBULAR (FALSE VOCAL)FOLDS - overlie vestibularligaments

VENTRICLE - area between trueand false vocal folds; lateralextension is Laryngeal

Sinus

VOCAL (TRUE VOCAL) FOLDS- overlie vocal ligaments

TERMS ASSOCIATED WITH LARYNX

epiglottis

NOSE


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LARYNGOSCOPE VIEW OF LARYNX

TRUE VOCAL FOLDS

FALSE VOCAL FOLDS

ARYEPIGLOTTICFOLD


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ARYEPIGLOTTIC

FOLDS - OverlieUpper Edge ofQuadrangularmembrane

PiriformRecess - lateralto laryngeal inlet



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VALLECULAE

-depressions (2)Between Med & LatGlossoepiglotticFolds

-Food/objectsLodge inValleculae

Vallecula

MedialGlossoepiglotticfold

LateralGlosso-Epiglottic



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V. NERVES OF LARYNX Branches of Vagus

A. Superior Laryngeal N.

divides to -1. Internal Laryngeal N.GVA Sensory to LarynxAbove True Vocal Folds

2. External Laryngeal N.SVE Motor to Cricothyroid

B. Recurrent Laryngeal N.

- GVA Sensory to LarynxBelow True Vocal Folds- SVE motor to all otherMuscles of Larynx

SUP. LARYNG. N.

RECURRENTLARYNG. N.

Int. Laryng. N.

Ext. Laryng. N.


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Sup. Laryngeal A.from Sup. Thyroidartery

Inf. Laryngeal A.from Inf. Thyroid

artery

VI. LARYNX - ARTERIAL SUPPLY


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Superior DeepCervical NodesLarynx above truevocal folds

Inferior DeepCervical Nodes-Larynx below true

vocal folds

VII. LARYNX - LYMPHATICS

Note: Mucosa Tightly Attached to vocal foldsAnaphylactic Shock Swell Vestibular folds --Suffocation


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Tracheotomy

- cut between1st & 2nd or 2nd3rd Trachealcartilages

VIII. OBSTRUCTION OF LARYNX: TRACHEOTOMY

open airway to lungs below obstructed larynx


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BLEEDING IS PROBLEM: MIDLINE THYROID VEINS

1) Sup. Thyroid veinfollows artery

2) Middle Thyroidvein- to Int Jugular

3) Inf. Thyroid vein

Both sides join atmidline -> L.Brachiocephalic Vein


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Crico-Thyrotomy

Little bleeding

Cricothyroid Membrane

OBSTRUCTION OF LARYNX: CRICOTHYROTOMY

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