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The Larynx Table of Contents

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The Larynx Table of Contents The Larynx Table of Contents • Functions • Anatomy • Subdivisions • Cartilages • Vocal Cords • Muscles • Nerves • Vessels • Special Cases Functions Functions Anatomy • To produce voice Subdivisions • To protect the airway, Cartilages especially during swallowing Vocal Cords • To keep the airway patent Muscles Nerves Vessels Special Cases Anatomy Functions • The larynx is located at the point Anatomy where the respiratory and Subdivisions digestive tracts separate. Cartilages Vocal Cords • The entrance to the larynx, or Muscles laryngeal inlet, is in the anterior wall of the laryngopharynx. Nerves Vessels • Internally, the wall of the larynx is Special Cases modified to form the vocal cords. Anatomy Functions • The larynx lies in the Anatomy mid-line of the neck, Subdivisions deep to the Cartilages strap muscles and partly covered by the Vocal Cords thyroid gland. Muscles • At roughly the C Nerves vertebral level, the Vessels larynx is continuous Special Cases with the trachea. Subdivisions Functions • Vertically, the larynx is divided into 3 regions: Anatomy • 1. Supraglottis – Subdivisions Includes the epiglottis, Cartilages aryepiglottic folds, Vocal Cords false vocal folds, arytenoids, and Muscles ventricle Nerves • 2. Glottis – true vocal Vessels folds Special Cases • 3. Subglottis –below the true vocal folds to the inferior border of the cricoid cartilage Cartilages Functions • Total of 9 cartilages Anatomy • 3 single cartilages Subdivisions – Thyroid Cartilage (green) Cartilages – Cricoid (purple) Vocal Cords – Epiglottis (light Muscles blue) • 3 paired cartilages Nerves – Arytenoids Vessels (orange) – Corniculates & Special Cases Cuneiforms (black) Cartilages Functions Anatomy • The hyoid bone Subdivisions (yellow) and the Cartilages cartilages are Vocal Cords collectively Muscles referred to as Nerves the visceral Vessels skeleton of the neck. Special Cases Thyroid Cartilage Functions • Thyroid = shield-like • The largest cartilage Anatomy • The two laminae Subdivisions meet anteriorly at the Cartilages superior thyroid notch (Adam's Vocal Cords apple). Muscles • The inferior horns articulate with the Nerves cricoid cartilage at Vessels the cricothyroid joints. Special Cases • The thyroid cartilage <- Cartilages suspended from the hyoid bone by the thyrohyoid membrane. Cricoid Functions • Cricoid = ring- Anatomy shaped Subdivisions • The only complete ring of Cartilages cartilage in the Vocal Cords respiratory tract. Muscles • Cricoid pressure Nerves is applied to the esophagus during Vessels intubation to Special Cases prevent gastric <- Cartilages contents from refluxing into the airway. Cricoid Functions • Anteriorly - a Anatomy narrow arch. Subdivisions • Posteriorly - enlarges to form Cartilages the lamina. Vocal Cords • The cricoid lamina Muscles articulates with Nerves the inferior horns of the thyroid Vessels cartilage at the Special Cases crico-thyroid joints. <- Cartilages Epiglottis Functions • Guards the entrance Anatomy of the larynx. It folds posteriorly over the Subdivisions opening of the larynx Cartilages during swallowing. Vocal Cords • Leaf-shaped, flexible, elastic cartilage. Muscles • It attaches to the back Nerves of the thyroid cartilage Vessels via the thyroepiglottic ligament. Special Cases • Unlike the other cartilages, the epiglottis remains unossified. <- Cartilages Arytenoids Functions Anatomy • Paired and pyramidal in Subdivisions shape. Cartilages Vocal Cords • The base rests on the upper Muscles surface of the Nerves cricoid and forms Vessels the crico- Special Cases arytenoid joint. <- Cartilages Arytenoids Functions Anatomy • Postero-laterally - Subdivisions muscular process Cartilages • Anteriorly - vocal Vocal Cords process provides Muscles attachment for the Nerves vocal cords. Vessels • Superiorly - apex Special Cases <- Cartilages Corniculates & Cuneiforms Functions Anatomy Subdivisions Cartilages Vocal Cords Muscles Nerves • These small cartilages are both in the posterior part of the aryepiglottic folds Vessels • The corniculates attach to the apices of the Special Cases arytenoid cartilages • The cuneiforms (not shown) do not directly attach to any cartilages <- Cartilages Vocal Cords Functions Anatomy Subdivisions False Vocal Cartilages Epiglottis Cords Vocal Cords Muscles Ventricle Aryepiglottic Nerves Fold True Vessels Vocal Cords Special Cases Arytenoids Glottis True Vocal Cords Functions • Vocal folds (true vocal cords) control Anatomy sound production (tone). Each vocal Subdivisions fold includes: Cartilages Vocal Cords – Vocal ligament – elastic tissue that Muscles is the thickened medial free edge Nerves of the lateral cricothyroid ligament Vessels (conus elasticus) Special Cases – Vocalis muscle – fibres that form the most medial part of the thyroarytenoid muscle <- Photo False Vocal Cords Functions • Vestibular folds (false vocal cords) Anatomy extend between the thyroid and Subdivisions arytenoids. Cartilages – Have little to no part in voice Vocal Cords production Muscles – Serve a protective function Nerves Vessels • Vestibular folds are the mucous Special Cases membrane covering the lower border of the quadrangular membrane <- Photo Ventricle Functions Anatomy • Between the true vocal Subdivisions cords and false vocal Cartilages cords, on each side, is a Vocal Cords lateral depression, lined by Muscles Nerves mucous membrane, known Vessels as the ventricle of the Special Cases larynx. <- Photo Glottis Functions • Glottis (rima glottidis) - Anatomy the opening between Subdivisions the two true vocal cords Cartilages (or vocal folds). Vocal Cords Muscles Nerves Vessels Special Cases <- Photo Larynx – Sagittal View Functions Anatomy Aryepiglottic Subdivisions Fold Epiglottis Cartilages Quadrangular Membrane Vocal Cords False Vocal Muscles Arytenoids Cords Nerves Vessels Conus Ventricle Special Cases Elasticus True Vocal Cords Cricoid Thyroid Cartilage Larynx – Posterior View Functions Anatomy Epiglottis Subdivisions Hyoid Bone Cartilages Thyrohyoid Membrane Vocal Cords Aryepiglottic Muscles Fold Quadrangular Nerves Membrane Vessels Arytenoids Thyroepiglottic Ligament Special Cases Cricoid Thyroid Cartilage <- Photo Quandrangular Membrane (In more detail) Functions • The quadrangular membrane is a Anatomy sheet of fibrous connective tissue that Subdivisions extends from the arytenoids to the Cartilages epiglottis. Vocal Cords Muscles • The upper border, covered by mucous Nerves membrane, is the aryepiglottic fold. Vessels • The lower border is the vestibular Special Cases ligament. • The latter, together with its covering of mucous membrane, is the vestibular fold, or false vocal chord. <- Diagram Conus Elasticus (In more detail) Functions • The conus elasticus attaches to Anatomy the upper surface of the cricoid Subdivisions arch. Cartilages • Its upper border is the vocal Vocal Cords ligament which extends between Muscles the vocal process of the arytenoid Nerves cartilage and the thyroid lamina. Vessels • The vocal ligament, covered with Special Cases mucous membrane, is the vocal fold or true vocal chord. • The membrane between the thyroid cartilage and cricoid is the cricothyroid membrane. <- Diagram Vocal Cords Functions Anatomy Subdivisions Cartilages Vocal Cords Muscles Nerves Vessels Special Cases Abducted Adducted Vocal Cord Abduction & Adduction Functions Anatomy • The vocal cords are abducted Subdivisions during breathing Cartilages Vocal Cords • The vocal cords are tightly Muscles adducted in straining efforts and Nerves before a cough or sneeze. Vessels • Voice production is the result of Special Cases the escape of small amounts of air between the adducted vocal cords. <- Photos Phonation Physiology Functions Anatomy Subdivisions • Power source – Lungs & Diaphragm Cartilages • Pitch & quality – Larynx Vocal Cords Muscles • Articulation – Lips and Tongue Nerves Vessels Special Cases <- Photos Muscles Functions • The muscles of the larynx are classified Anatomy as extrinsic or intrinsic Subdivisions • Extrinsic laryngeal muscles Cartilages – Move the larynx as a whole – Depress or elevate the hyoid bone & larynx Vocal Cords – Infrahyoid strap muscles (omohyoid, sternohyoid, Muscles sternothyroid, thyrohyoid)– depressors Nerves – Palato-pharyngeus & stylopharyngeus muscles – elevators Vessels Special Cases • Intrinsic laryngeal muscles – Move parts of the larynx – Control the length/tension and movements of the vocal folds and may help in the closure of the laryngeal inlet Extrinsic Muscles Functions Anatomy Subdivisions Cartilages Vocal Cords Muscles Nerves Vessels Special Cases Intrinsic Muscles – Posterior View Functions Epiglottis Anatomy Subdivisions Hyoid Bone Cartilages Aryepiglottic Vocal Cords Thyroid Muscle Cartilage Muscles Nerves Arytenoids Interarytenoid Vessels Muscle Special Cases Posterior Cricoid Cricoarytenoid Muscle Intrinsic Muscles Lateral View from Inside Functions Arytenoids Anatomy Subdivisions Quadrangular Membrane Cartilages Thyroepiglottic Muscle Vocal Cords Muscles Aryepiglottic Fold Nerves Thyroid Cartilage Vessels Special Cases Thyroarytenoid Muscle Lateral Cricoarytenoid Muscle Cricoid Intrinsic Muscles Lateral View from Inside Functions Anatomy Subdivisions Cartilages Vocal Cords Muscles Thyroid Cartilage Nerves Vessels Special Cases Cricoid Cricothyroid Muscle Posterior Cricoarytenoid Muscle Functions Anatomy • From the posterior surface of Subdivisions the lamina of the cricoid, its Cartilages fibres converge to insert into Vocal Cords the muscular process of the Muscles Nerves arytenoid. Vessels • The two posterior
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