Larynx: mini-review 2012zillmusom I. Cartilages



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LARYNX: MINI-REVIEW © 2012zillmusom

I. CARTILAGES



CARTILAGE

ANATOMY/JOINTS

Thyroid

Shield, shaped; hinge joints with cricoid

Cricoid

Ring of cartilage; rests on first tracheal cartilage

Arytenoid (paired)

Rests above cricoid; joints permit rotation and sliding

Corniculate (paired)

Nodules above cricoid; view in laryngoscope

Cuneiform (paired)

Nodules ant. to corniculate; view in laryngoscope

II. VOCAL LIGAMENTS - Conus elasticus   elastic membrane forming vibrating lips; attached anteriorly to thyroid cartilage, posteriorly to arytenoids; upper free edges form vocal ligaments; vocal folds (true vocal folds) overlie vocal ligaments; opening between vocal ligaments is called rima glottidis.


III. INTRINSIC MUSCLES OF THE LARYNX   All innervated by branches of Vagus Nerve (X)

1. Superior Laryngeal Nerve - divides into Internal Laryngeal nerve (sensory above vocal folds) and External Laryngeal Nerve (motor to Cricothyroid)



2. Recurrent Laryngeal Nerve - Sensory below vocal folds and motor to all other laryngeal muscles


MUSCLE

ORIGIN

INSERTION

ACTION

NERVE

Cricothyroid

Cricoid cartilage

Thyroid cartilage

Tenses vocal fold, raises pitch of sound

External Laryngeal n. (X)

Thyroarytenoid

Thyroid cartilage

Arytenoid cartilage

Relaxes vocal fold, decreases pitch of sound

Recurrent Laryngeal n. (X)

Posterior cricoarytenoid

Cricoid cartilage

Arytenoid cartilage

Abducts vocal folds, opens rima glottidis

Recurrent Laryngeal n. (X)

Lateral cricoarytenoid

Cricoid cartilage

Arytenoid cartilage

Adducts vocal folds, closes rima glottidis

Recurrent Laryngeal n. (X)

Arytenoid (Transverse arytenoid)

Arytenoid cartilage

Arytenoid cartilage of opposite side

Adducts vocal folds, closes rima glottidis

Recurrent Laryngeal n. (X)

Aryepiglottic muscle

Arytenoid cartilage

Epiglottic cartilage

Pulls down epiglottis during swallowing

Recurrent Laryngeal n. (X)


IV. CLINICAL/ANATOMICAL CONDITIONS OF LARYNX

Clinical

Occurs in

Anatomical

Bad News

Damage to Recurrent Laryngeal Nerve

Thyroid surgery (also can be damaged in cervical disc replacement)

Recurrent Laryngeal nerve courses with Inferior Thyroid Artery

Paralyze all laryngeal muscles on one side (except Cricothyroid)

Suffocation in Anaphylactic Shock

Allergic (immune) reaction; swelling at False Vocal folds (superior to True Vocal Folds)

Mucosa of larynx is loosely attached to Vestibular (False Vocal) Folds, Tightly attached to Vocal Folds

Impede airway if swelling is extreme; perform emergency cricothyrotomy (open between cricoid and thyroid)







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