Anatomy Block II- Larynx

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1

what is the larynx

voice box

2

what is the larynx composed of in general

multiple cartilages held together by various membranes

3

what do the laryngeal muscles do?

help move cartilages and voice cords

4

from what is the larynx formed

mostly pharyngeal arches 4 and 6

5

where is the larynx

levels C3-C6
midline structure

6

where is the larynx in reference to other things

inferior to hyoid
superior to trachea/thyroid
anterior to esophagus
anterior to laryngopharynx
deep to skin and infrahyoid muscles

7

what is on lateral inferior sides of larynx

piriform recesses, blind pouch endings of laryngopharynx

8

what encapsulates the larynx

pretracheal layer of deep cervical fascia

9

what tissues compose the larynx

lined with mucosa (epithelium + lamina propria)

superior to vocal folds: mucosa with non keratinzed stratified squamous epithelium

inferior to vocal folds: mucosa with pseudostratified ciliated columnar epitheilum

10

what are most cartilages of the larynx formed from? what is the exception

mostly hyaline cartilage

epiglottis from elastic cartilage

11

how many cartilages make up larynx

9, 3 paired and 3 single

12

what are the cartilages that make up the larynx

single: thyroid, cricoid, epiglottis

paired: arytenoid

13

what is the thyroid cartilage like

single

looks like shield forming anterior and lateral walls of larynx

14

what does the thyroid cartilage come together and form

2 sides come together and form V shaped laryngeal prominence (adam's apple)

15

what is the cricoid cartilage like

single

circular cartilage inferior to thyroid cartilage and superior to trachea

16

what does cricoid cartilage surround

completely surrounds laryngeal opening

17

what rests on posterior part of cricoid cartilage

smaller cartilages (arytenoids) rest on top of posterior aspect of this cartilage

18

what is the epiglottis shaped like and what is it formed from

spoon shaped
only laryngeal cartilage from elastic cartilage

19

what is the function of the epiglottis

folds/closes over laryngeal opening when you swallow

20

what is epiglottitis

inflammation of epiglottis, usually caused by HIB

21

when is epiglottitis a medical emergency

medical emergency because as epiglottis swells it can obstrcut laryngopharynx and obstrcut breathing

22

with whom is epiglottis most common

most common kids ages 2-4 and adults 20-40

23

what are treatments of epiglottitis

treatment: antibiotics and/or airway intervention

24

what do the arytenoid cartilages look like

paired pyramidal shaped cartilages

25

where are the vocal folds relative to the arytenoid cartilage

vocal ligament runs from each arytenoid cartilage to thyroid cartilage

26

where are the arytenoid cartilages

located in posterior of larynx, rests on top of cricoid cartilage

27

what are some ligamentous structures and mucosal folds of the larynx? what is their function

help hold cartilages together

thyrohyoid membrane/ligament
medial cricothyroid membrane/ligament
quadrangular membrane/ligament
aryepiglottic ligaments
vestibular ligaments
vocal ligaments

28

where does the thyrohyoid membrane run

from thyroid cartilage to hyoid bone

29

where does median cricothyroid membrame/ligament run

from thyroid cartilage to cricoid cartilage

anteriorly located

30

where does the quadrangular membrane/ligament run? what are its free margins?

runs from epiglottis to arytenoid cartilages

free superior margin are aryepiglottic ligaments
free inferior margin are vestibular ligaments

31

what are the aryepiglottic ligaments

L and R ligaments, along with epiglottis, form circular superior ending for the larynx

aryepiglottic fold is this ligament covered with mucosa

32

from what view can you see the aryepiglottic ligaments clearly

aryepiglottic folds may be seen clearly when viewing the larynx from superior view

33

where do the vestibular ligaments extend?

L and R ligaments

extend from arytenoid cartilage to thyroid cartilage

34

what are the vestibular ligaments called

false vocal folds

35

what is a vestibular fold as opposed to a vestibular ligament

vestibular fold is a vestibular ligament covered with mucosa

36

what is the function of vestibular folds

protect/help cover rima glottidis

37

where do the vocal ligaments extend

L and R
extend from arytenoid cartilage to thyroid cartilage

38

where are the vocal ligaments in reference to the vestibular ligaments

inferior to vestibular ligaments

39

what are the vocal ligaments also called

"true vocal cords"

40

what is the function of the vocal ligaments

responsible for phonation

adduction/abduction of vocal folds regulates amount of air entering/leaving the larynx
when tightly adducted the vocal folds prevent the exit of air from trachea
when adducted and vibrate, phonation occurs

41

what do vocal folds do when adducted and vibrate

phonation occurs

42

what do the vocal folds do when tightly adducted

prevent the exit of air from trachea

43

what does the adduction or abduction of vocal folds regulate?

amount of air entering/leaving the larynx

44

what do the vocal folds contain

vocal folds contain the vocal ligament, vocalis muscle covered with mucosa

45

what are the cavities in the larynx, superior to inferior

laryngeal inlet
vestibule
laryngeal ventricles
rima glottidis
infraglottic space

46

what is the laryngeal inlet

superiormost opening of larynx
bordered by epiglottis and aryepiglottic folds

47

what is the vestibule

space inferior to laryngeal inlet
from epiglottis to vestibular folds

48

what are the laryngeal ventricles

lateral spaces between vestibular folds and vocal folds

49

what is the rima glottidis

opening directly between vocal folds

50

what is the infraglottic space

space inferior to vocal folds and superior to trachea

51

what do the vocal forlds do for the epithelial lining

function as dividing line

superior to VFs: nK StrSq
inferior: PCCE

52

what types of musculature are in the larynx? what are they innervated by

extrinsic and intrinsic

vagus

53

what are the extrinsic muscles of the larynx and what do they do

infrahyoids

move larynx as a whole

54

what do the intrinsic muscles of the larynx do?

move different parts of larynx and/or vocal folds

most adduct the vocal folds for phonation
named for where they attach and/or direction of muscle fibers

55

what are the intrinsic muscles of the larynx innervated by

innervated by recurrent laryngeal nerve, a branch of vagus

56

what innervates the cricothyroid muscle

external laryngeal nerve, a branch of superior laryngeal branch of vagus

57

what are the intrinsic muscles of the larynx

cricothyroid
posterior cricoarytenoid
lateral cricoarytenoid
transverse and oblique arytenoids
thyroarytenoid
vocalis

58

what does the cricothyroid do?

tenses vocal cords

more taut, higher pitch

59

what is the cricothyroid m. innervated by

only larnyx muscle innervated by external laryngeal nerve

60

what does the posterior cricoarytenoid do

only muscle to abduct vocal folds

used for forced respiration

61

what does the lateral cricoarytenoid do

main adductor of vocal folds

also acts as sphincter to close off rima glottidis

62

what do the transverse and oblique arytenoids do?

adduct vocal folds

63

what does the thyroarytenoid do?

adduct vocal folds

64

what does the vocalis do

slightly tenses or relaxes vocal ligaments as needed for phonation

65

what is the vocalis muscle a part of

technically a specific part of the thyroarytenoid muscle

66

what is the dividing line for blood supply of the larynx

vocal folds

67

what gives and drains blood supply superior to the vocal folds

superior laryngeal artery (branch of superior thyroid artery)
superior laryngeal vein

68

what gives and drains blood supply inferior to vocal folds

inferior laryngeal artery (branch of inferior thyroid artery)
infeiror laryngeal vein

69

what supplies sensory innervatino to the larynx superior to the vocal folds

internal laryngeal nerve

70

what supplies sensory innervation to the larynx inferior to the vocal folds

recurrent laryngeal nerve

71

what supplies motor innervation to the cricothryoid muscle

external laryngeal nerve

72

what supplies motor innervavtion to the rest of the intrinsic laryngeal muscles

recurrent laryngeal nerve

73

what happens with normal respiration

vocal folds slightly abducted
rima glottidis open very slightly
laryngeal muscles relaxed

74

what happens with force respiratino

vocal folds abducted greatly by poserior cricoarytenoids
rima glottidis wide open

75

what happens with phonation

vocal folds adducted and rima glottidis almost sealed
most laryngeal muslces working
vibration of vocal folds produces sounds

76

what happens with whispering

vocal ligaments tightly adducted
but arytenoid cartilageds tilted by arytenoid muscles to produce a small posterior gap
air can pass through this gap producing sound
but since vocal cords arent vibrating there is no change in pitch when you whipser

77

what is laryngitis

inflammation of larynx due to overuse, irritation, or infectino
swollen vocal folds distort voice, producing hoarseness

78

what kinds of growths are vocal cord cysts, polyps, nodules? where are they

benign growths on vocal cords

79

what can vocal cord cysts, polyps, or nodules cause

can disrupt phonation, cause voice fatigue, create hoarse voice, throat pain

80

how are vocal cord cysts, polyps, or nodules treated

treatment includes rest, speech therapy, and surgery

81

what causes laryngeal cancer

smokeing most common cause
heavy alcohol also factor

82

what are symptoms of laryngeal cancer

symptom: sore through/persistent cough, chronic hoarse voice, lump in neck, trouble swallowing, ear pain

83

what happens with endotracheal intubation

inserting endotracheal tube into trachea for ventilation

84

why do you need to be careful with endotracheal intubation

be careful not to perforate larynx, or accidentally put tobe into esophagus

85

what happens with damage to external laryngeal nerve

cricothyroid muscle paralyxed but other laryngeal muscles ok

86

how can external laryngeal nerve be damaged

could be damaged in thyroidectomy as surgeon tries to secure superior thyroid artery

87

what is a symptom of external laryngeal nerve damage

symptom: monotone voice because lost ability to greatly tense vocal folds

88

what happens with damage to the recurrent laryngeal nervve

will result in sensory loss inferior to focal folds
paralysis of almost all of laryngeal muscles on affected side (and vocal fold paralysis on that side)

89

what are some symptoms of recurrent laryngeal nerve damage

symptoms: hoarse voice, potential breathing problems, increased likelihood of materials entering larynx (due to sensory info loss)

90

how can the recurrent laryngeal nerve be damaged

also can be damaged in thyroid surgery since it transverses posterior to gland

91

what is worse: recurrent laryngeal nerve damage or external laryngeal nerve damage

recurrent laryngeal nerve damage is much more serious injury to larynx

92

what is the larynx responsible for

phonation and regulating airflow to/from trachea

93

what muscles move vocal folds

intrinsic muscles primarily

94

what is the dividing line for epithelium, sensory innervaiton, and blood supply?

vocal folds


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