LARYNX REVIEW: LOCATION

LARYNGEALPROMINENCE OF THYROID CARTILAGE =ADAM'SAPPLE - LEVELC4

HYOID BONE

TRACHEA

THRYOID GLAND

Larynx Functions- produces sound- regulates opening to trachea, respiratory system

STERNOCLEIDO-MASTOID MUSCLE

CLINICAL - OBSTRUCTION OF LARYNX CAN PRODUCE SUFFOCATION

LARYNX: IMAGINGCADAVER SECTION CT SECTION

LARYNX

PHARYNX +ESOPHAGUS

LARYNX

COMMONCAROTID A.,IJV

BODIESOF CERVICALVERTEBRAE

CLINICAL: PALPATE CAROTID BIFURCATION LATERAL TO LARYNGEAL PROMINENCE- NERVES TO LARYNX CAN BE DAMAGED DURING CERVICAL DISC REPAIR

LARYNX REVIEW: CARTILAGES

THYROID CARTILAGE - shield shaped - has Sup. and Inf. Horns- Laryngeal prominence

CRICOID = signet ring - complete ring of cartilage- narrow Arch ant., broad Lamina post.

ARYTENOID - 2 pyramidal shaped cartilages above lamina of cricoid

Sup. Horn

Laryngeal prominence= Adam'sapple

Inf. Horn

Arytenoid

Cricoid

lamina

CorniculateCartilages

HINGEJOINT

JOINTS PERMIT ROTATION AND SLIDING: - OPEN OR CLOSE LARYNX (ABDUCT OR ADDUCT VOCAL LIGAMENTS)

SYNOVIALJOINT BETWEEN ARYTENOID AND CRICOID

LARYNX REVIEW: SYNOVIAL JOINTS

THYROID and CRICOID ARYTENOID and CRICOID

JOINTS PERMIT TILTING OF THYROID-CRICOID:- CHANGE PITCH OF SOUND (TENSE OR RELAX VOCALLIGAMENTS)

SLIDING

ROTATION

TILT

SOUND PRODUCTION: CONUS ELASTICUS

CONUS ELASTICUS -= INTERNAL ELASTIC MEMBRANE ATTACHED TO CRIOCID; UPPER FREE EDGES = VOCALLIGAMENTS

VOCAL LIGAMENTS EXTEND FROM ARYTENOID TO THYROID, ACROSSTWO JOINTS

CONUS ELASTICUS

VOCAL LIGAMENTS = FREE EDGE OF CONUS

RIMA GLOTTIDIS = opening

top view

CHANGE PITCH BY TILTING AT HINGE JOINT –Thyroid cartilage tilts down; cricoid tilts up

HINGEJOINT

HINGEJOINT

Tilting - STRETCHESvocal ligaments

STRETCH vocal ligament INCREASE PITCH -CRICOTHYROID

RELAX vocal ligamentDECREASE PITCH -THYROARYTENOID

THYROID

CRICOID

ARYTENOID

CRICOTHYROID M. - Tenses Vocal Ligament Increasing Pitch

HINGEJOINT

Tilting - STRETCHESvocal ligaments

STRETCH vocal ligament INCREASE PITCH -CRICOTHYROID

MUSCLES OF LARYNX

THYROARYTENOIDMUSCLES - adjacent to vocal ligament -RelaxesVocal LigamentsDecreases pitch

HINGEJOINT

RELAX vocal ligamentDECREASE PITCH -THYROARYTENOID

THYROID

CRICOID

MUSCLES OF LARYNX NOTSEE

OPEN AND CLOSE RIMA GLOTTIDIS BYROTATING/SLIDING ARYTENOIDS -

Rotate laterally opens; Rotate medially or slide closes

POSTERIORCRICO-ARYTENOID

LATERALCRICO-ARYTENOID

ARYTENOIDEUS

ROTATELATERALLY

ROTATEMEDIALLY

SLIDE

RESTPOSITION

OPEN CLOSE CLOSE

Larynx open for deep breathing; close for speech; completely close to raise abdominal pressure (Valsalva maneuver)

5) ARYTENOID (Transverse and oblique arytenoid) - Adduct vocal folds4) LATERAL CRICO- ARYTENOID - Adduct vocal folds

3) POSTERIOR CRICO-ARYTENOID – Abducts vocal fold

MUSCLES OF LARYNX

Adduct closes rima glottidisAbduct opens rima glottidisPOSTERIOR

CRICO-ARYTENOID

LATERALCRICO-ARYTENOID

ARYTENOIDEUS

Epiglottis

Post.

Ant.Tongue

Vocal Folds(true vocalfolds)

LARYNGOSCOPE VIEW OF LARYNX

Vestibular Folds(false vocalfolds)

Corniculate cartilage

Cuneiform cartilage

Pyriform recess

NOSE

VIEW FOR INTUBATION

VESTIBULE - inlet above false vocal folds

VESTIBULAR (FALSE VOCAL) FOLDS - overlie vestibular ligaments (lower edge of Quadrangular membrane)

VOCAL (TRUE VOCAL) FOLDS - overlie vocal ligaments (upper edge of Conus elasticus)

Conus elasticus

Quadrangular membrane

VENTRICLE - lateral outpocketing

CORONAL SECTION

CLINICAL - MUCOSA SWELLS IN ANAPHYLAXIS; OBSTRUCTION CAN RESULT FROM SWELLING AT VESTIBULAR (FALSE VOCAL FOLDS)

1) Superior Laryngeal N.a) Internal Laryngeal N.Visceral Sensory (GVA) to LarynxAbove (true vocal folds)b) External Laryngeal N.Branchial motor (SVE) to

Cricothyroid

2) Recurrent Laryngeal n.- Visceral Sensory (GVA) to Larynx Below True Vocal Folds- Branchial motor (SVE) to all other Muscles of Larynx

SUP. LARYNG. N.

RECURRENTLARYNG. N.

Int. Laryng. N.

Ext. Laryng. N.

NERVES OF LARYNX – Branches of Vagus

Clinical - damage to RecurrentLaryngeal nerve in Thyroid surgery

NERVES OF LARYNX – Branches of Vagus

X X

SUPERIORLARYNGEALNERVE - piercesthyrohyoidmembrane

RIGHTRECURRENTLARYNGEALNERVE - passesunderSubclavianArtery

LEFTRECURRENTLARYNGEALNERVE - passesunderArch ofAorta

SUPERIORLARYNGEALNERVE

CLINICAL - IN OBSTRUCTION OF LARYNX, EMERGENCY OPENING MADE IN CRICOTHYROID MEMBRANE (CRICOTHYROTOMY); AVOIDS BLLEDING THAT CAN OCCUR IN TRACHEOTOMY (FROM INFERIOR THYROID VEINS)

Cricothyroid Membrane

OBSTRUCTION OF LARYNX: CRICOTHYROTOMY

Good luck!