LARYNX
LARYNX
LARYNX
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<strong>LARYNX</strong>larynxtracheaCartilages connected bymembranes and ligaments,moved by musclesFunctions: 1) Soundproduction2) Closes of RespiratorySystem - allows increase inAbdominal PressureNote: In Respiration -Inspire - Diaphragm;Expire - Some muscles butlargely passive;Forced Expire - AbdominalMuscleWhen larynx closes off trachea, forced expiration producesincreased abdominal pressure: push-childbirth; defecation etc.
I. <strong>LARYNX</strong>: CARTILAGESA. THYROID CARTILAGE – Shield shaped- has Sup. & Inf. Horns from upper & lower edgesLaryngealProminenceSup.HornsInf.Horns- Inf. horns make synovial hinges joint with Cricoid Cartilage;- Laryngeal Prominence = Adam’s Apple, more prominent inmales
ANT VIEW<strong>LARYNX</strong>: CARTILAGESPOST VIEWB. CRICOIDcompletering ofcartilage hasnarrow Arch ant.,broad Lamina post.Cricoid meansSignet RingArch ofcricoidLamina ofcricoid
CuneiformCorniculateArytenoid<strong>LARYNX</strong>: CARTILAGESC. Arytenoid -2pyramidal shapedcartilages abovelamina – havesynovial joints withCricoid permitSwivel = RotateSliding = Ab/AdductD. Corniculate -nodules abovearytenoids inaryepiglottic foldsE. Cuneiform - rodshaped, abovecorniculate cartilages
<strong>LARYNX</strong>: CARTILAGESF. EPIGLOTTIS- leaf shapedcartilageposterior to rootof tonguePOST. VIEW- connected tobody of hyoidand post side ofthyroid cartilage
II. LIGAMENTS OF <strong>LARYNX</strong>A. Structural ligaments - hold larynx, hyoid, trachea togetherMedianThyrohyoidLigamentMedianCricothyroidLigament1. Thyrohyoid Membranelinks larynx to hyoid;Median ThyrohyoidLigament - thickenedmidline part2. Cricothyroid Membranelinks thyroid to cricoid;Median CricothyroidLigament - thickenedmidline part3. Cricotracheal ligamentlinks Cricoid to firsttracheal cartilage
STRUCTURAL LIGAMENTSEpiglottisArytenoid4. QuadrangularMembrane linksArytenoidTo epiglottis
STRUCTURAL LIGAMENTSEpiglottisArytenoidcartilageAryepiglotticFolds - overlieQuadrangularmembrane
STRUCTURAL LIGAMENTSCORONALSECTIONTHROUGH<strong>LARYNX</strong>Lower freeedge ofQuadrangularmembrane isCalledVestibularLigament; deepto Vestibular(False Vocal)Foldstrachea
STRUCTURAL LIGAMENTSNOSESUPERIORVIEWABOVE<strong>LARYNX</strong>5. ThyroepiglotticLigamentlinks epiglottis tothyroid cartilage
B. FUNCTIONAL LIGAMENTSNOSEVocalLigaments -Upper freeEdgesDeep toVocalFoldsFunctional ligaments:Conus Elasticus -Vibrating lips that arisefrom entire upper edge ofarch of cricoidAttach: ant. to Thyroid,post. to ArytenoidRima Glottidis -Opening BetweenVocal ligaments
FUNCTIONAL LIGAMENTS(In Coronal Section)Conus Elasticus Functions1) Sound Production –Vibratelike lips of trumpet player;2) Close Rima Glottidis stopsoutflow air, upward movement ofdiaphragm - when contractabdominal muscle pressureincreases in abdominal cavity;occurs in childbirth, defecation
LARYNGOSCOPE VIEW OF <strong>LARYNX</strong>Ant.EpiglottisTongueVocal Folds(true vocalfolds)Post.Vestibular Folds(false vocalfolds)vocal foldsadducted whentalking or singing
III. MUSCLES OF <strong>LARYNX</strong> - well namedA. Extrinsic muscles (ex. hyoid muscles) - Move wholelarynx as in swallowingB. Intrinsic Muscles 1) change tension in vocal lig--- changes pitch: increase tension raises pitch,decreased tension lowers pitch2) open & close Rima Glottidis1) CRICOTHYROID M. -TensesVocal LigamentIncreasing PitchSlackTense
MUSCLES OF <strong>LARYNX</strong>NOSE2)THYROARYTENOIDMUSCLE -RelaxesVocal LigamentsDecreases pitch
MUSCLES OF <strong>LARYNX</strong>5) ARYTENOID(Transverse andoblique arytenoid) -Adduct vocal folds4) LATERAL CRICO-ARYTENOID - Adductvocal folds3) POSTERIOR CRICO-ARYTENOID – Abductsvocal foldArytenoidsCan rotate/slideAdduct closes rima glottidisAbduct opens rima glottidis
MUSCLES OF <strong>LARYNX</strong>5) ARYEPIGLOTTICMUSCLEPulls epiglottis downduringswallowing- Covers inlet to larynx- Not necessary inadult humans
IV. TERMS ASSOCIATED WITH <strong>LARYNX</strong>BisectLarynx to seeinteriorstructures
NOSETERMS ASSOCIATED WITH <strong>LARYNX</strong>epiglottisVESTIBULE - inlet above falsevocal foldsVESTIBULAR (FALSE VOCAL)FOLDS - overlie vestibularligamentsVENTRICLE - area between trueand false vocal folds; lateralextension is LaryngealSinusVOCAL (TRUE VOCAL) FOLDS- overlie vocal ligaments
LARYNGOSCOPE VIEW OF <strong>LARYNX</strong>TRUE VOCAL FOLDSFALSE VOCAL FOLDSARYEPIGLOTTICFOLD
TERMS ASSOCIATED WITH <strong>LARYNX</strong>ARYEPIGLOTTICFOLDS - OverlieUpper Edge ofQuadrangularmembranePiriformRecess - lateralto laryngeal inlet
TERMS ASSOCIATED WITH <strong>LARYNX</strong>VALLECULAE-depressions (2)Between Med & LatGlossoepiglotticFolds-Food/objectsLodge inValleculaeValleculaMedialGlossoepiglotticfoldLateralGlosso-Epiglottic
V. NERVES OF <strong>LARYNX</strong> – Branches of VagusSUP. LARYNG. N.Int. Laryng. N.Ext. Laryng. N.RECURRENTLARYNG. N.A. Superior Laryngeal N.divides to -1. Internal Laryngeal N.GVA Sensory to LarynxAbove True Vocal Folds2. External Laryngeal N.SVE Motor to CricothyroidB. Recurrent Laryngeal N.- GVA Sensory to LarynxBelow True Vocal Folds- SVE motor to all otherMuscles of Larynx
VI. <strong>LARYNX</strong> - ARTERIAL SUPPLYSup. Laryngeal A.from Sup. ThyroidarteryInf. Laryngeal A.from Inf. Thyroidartery
VII. <strong>LARYNX</strong> - LYMPHATICSSuperior DeepCervical NodesLarynx above truevocal foldsInferior DeepCervical Nodes-Larynx below truevocal foldsNote: Mucosa Tightly Attached to vocal foldsAnaphylactic Shock Swell Vestibular folds --Suffocation
VIII. OBSTRUCTION OF <strong>LARYNX</strong>: TRACHEOTOMYopen airway to lungs below obstructed larynxTracheotomy- cut between1 st & 2 nd or 2 nd –3 rd Trachealcartilages
BLEEDING IS PROBLEM: MIDLINE THYROID VEINS1) Sup. Thyroid veinfollows artery2) Middle Thyroidvein- to Int Jugular3) Inf. Thyroid veinBoth sides join atmidline -> L.Brachiocephalic Vein
OBSTRUCTION OF <strong>LARYNX</strong>: CRICOTHYROTOMYCrico-ThyrotomyLittle bleedingCricothyroid Membrane
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