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    Ace Achievers: Larynx

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    aditryjee
    The larynx, also known as the voice box, is located in the neck and acts as a sphincter and protector of the trachea. It is composed of nine cartilages including the thyroid, cricoid, and arytenoid cartilages. The larynx contains vocal folds that vibrate to produce sound and openings that must be precisely controlled during swallowing and breathing. Injury to the recurrent laryngeal nerves can impair vocal fold movement and cause hoarseness or difficulty breathing.

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    Ace Achievers: Larynx

    Uploaded by

    aditryjee
    9 views5 pages
    The larynx, also known as the voice box, is located in the neck and acts as a sphincter and protector of the trachea. It is composed of nine cartilages including the thyroid, cricoid, and arytenoid cartilages. The larynx contains vocal folds that vibrate to produce sound and openings that must be precisely controlled during swallowing and breathing. Injury to the recurrent laryngeal nerves can impair vocal fold movement and cause hoarseness or difficulty breathing.

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    The larynx, also known as the voice box, is located in the neck and acts as a sphincter and protector of the trachea. It is composed of nine cartilages including the thyroid, cricoid, and arytenoid cartilages. The larynx contains vocal folds that vibrate to produce sound and openings that must be precisely controlled during swallowing and breathing. Injury to the recurrent laryngeal nerves can impair vocal fold movement and cause hoarseness or difficulty breathing.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    9 views5 pages

    Ace Achievers: Larynx

    Uploaded by

    aditryjee
    The larynx, also known as the voice box, is located in the neck and acts as a sphincter and protector of the trachea. It is composed of nine cartilages including the thyroid, cricoid, and arytenoid cartilages. The larynx contains vocal folds that vibrate to produce sound and openings that must be precisely controlled during swallowing and breathing. Injury to the recurrent laryngeal nerves can impair vocal fold movement and cause hoarseness or difficulty breathing.

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    of 5

    Ace Achievers

    Dental Academy

    LARYNX
    • Larynx is the upper expanded part of the lower respiratory tract, which is modified
    for producing voice, hence it is also called voice box/organ of phonation.
    • Acts as a sphincter for the lower respiratory tract- protects trachea and respiratory
    tract from entry of foreign material (most important) function

    Location and Extent


    • Location: Anterior midline structure
    • Extension in adults: From the root of the tongue to the trachea; 3rd - 6th cervical
    vertebrae. However, in children and females it lies at a little higher level.
    • Length:
    o Males- 44mm
    o Females-36mm

    Laryngeal Skeleton
    • Larynx is composed of nine cartilages, of which three are unpaired and three are
    paired. The principal cartilages of the larynx are, cricoid, thyroid, and two arytenoids
    1. Unpaired cartilages: The unpaired cartilages are large and comprise: (CET)
    (a) Thyroid
    (b) Cricoid
    (c) Epiglottis
    2. Paired cartilages: The paired cartilages are small and comprise: (ACC cement)
    (a) Arytenoid
    (b) Corniculate (of Santorini)
    (c) Cuneiform (of wrisberg)
    • Trititial Cartilages are sometimes present making paired 11.
    • The thyroid, cricoid and base of arytenoid cartilages are hyaline cartilages, rest all
    the cartilages are elastic cartilages. Epiglottic cartilage is fibroelastic cartilage.

    Thyroid cartilage
    • Shield like (wedge) shape; Is the largest laryngeal cartilage; Commonly called
    “Adam’s apple.”
    • In the male, the laminae of thyroid cartilage meet at an angle of 90°, whereas in the
    female the angle is 120°→ more prominent larynx in the male.
    Ace Achievers Dental Academy

    Attachments of Thyroid Cartilage


    Superiorly Inferiorly
    Thyrohyoid membrane and ligament. Cricoid cartilage at inferior cornua
    Greater cornua of hyoid bone at the tips. Cricothyroid ligament at the inferior
    border of lamina
    Cricothyroideus muscle: at the inferior
    margin of the lamina
    Inner surface Outer surface (anteriorly)
    Ventricular bands Omohyoid
    Thyroepiglottic ligament Sternothyroid
    Vocal ligaments via the Broyles' Inferior constrictor muscles
    ligament. They all attach along the oblique line
    Thyroarytenoid muscles (major
    adductors and tensors of the vocal fold).

    Epiglottic Cartilage
    • Leaf shaped; Situated posterior to the root of the tongue and the hyoid and anterior
    to the laryngeal inlet.
    • Tapered inferior end→ called the stalk of epiglottis.
    • Multiple perforations allow free access of lymphatics. This space is also known as
    Boyer’s space.

    Arytenoid Cartilage
    • They articulate with the lateral parts of the upper border of cricoid lamina.
    • Pyramidal in shape.
    • Presents two processes—muscular and vocal.
    o The muscular process projects laterally and backwards whereas the vocal
    process is directed forwards.
    • The base of arytenoid cartilage articulates with the upper border of cricoid cartilage.
    • The base is prolonged anteriorly to form the vocal process.
    • The apex is curved posteromedially and articulates with the corniculate cartilage.

    Joints of the Larynx


    Cricothyroid joint
    • Between the cricoid and thyroid cartilages.
    • Is a plane synovial joint - permits two types of movements, viz.
    1. Rotatory movement
    2. Gliding movement.

    Cricoarytenoid joint
    • Present between the arytenoid and cricoid cartilage.
    • This joint permits two types of movements, viz.
    1. Rotatory movement, allows abducting or adducting the vocal cords.
    2. Gliding movement, - allows closing or opening the posterior part of glottis.

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    Ace Achievers Dental Academy

    Arytenocorniculate joint
    • It is a synovial joint between the arytenoid and corniculate cartilages. It is of no
    functional significance.

    Extrinsic ligaments of larynx


    • Thyrohyoid membrane
    • Fibro-elastic ligament; Connects the superior margin of the thyroid cartilage
    inferiorly and the hyoid bone superiorly.
    • Pierced by superior laryngeal artery, the internal branch of the superior laryngeal
    nerve and lymphatics.
    • Posterior borders are thickened to form the lateral thyrohyoid ligaments while
    the thickened anterior section forms the median thyrohyoid ligament.
    • May occasionally enclose a small cartilage (triticeal cartilage).
    • Hyo-epiglottic ligament
    • Cricotracheal ligament

    Intrinsic ligaments of larynx


    • Fibro-elastic membrane of the larynx
    • Links together the laryngeal cartilages and completes the architectural
    framework of the laryngeal cavity.
    • Composed of two parts:
    ▪ Lower cricothyroid ligament
    ▪ Upper quadrangular membrane.
    • Cricothyroid ligament (cricovocal membrane; Cricothyroid membrane)
    • Attaches to the arch of cricoid cartilage inferiorly
    • It extends superiorly to end in a free upper margin within the space enclosed by
    the thyroid cartilage.
    • On each side, this upper free margin attaches anteriorly to the thyroid cartilage,
    and posteriorly to the vocal processes of the arytenoids cartilages thus forming
    the vocal ligament, which is under the vocal fold (true vocal cord) of the larynx.
    • Quadrangular membrane
    • On each side it runs between the epiglottis and arytenoid cartilage.
    • It is also attached to the corniculate cartilage.

    Laryngeal Cavity
    • Extends from inlet of larynx, to the lower border of
    the cricoid cartilage, where it is continuous with the
    lumen of the trachea.
    • The anterior wall of laryngeal cavity is longer than
    the posterior wall.
    • Laryngeal inlet is obliquely placed, sloping
    downwards and backwards. It opens into the
    laryngopharynx.

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    Ace Achievers Dental Academy

    Boundaries
    • Anterior: Epiglottis.
    • Posterior: Inter-arytenoid fold of the mucous membrane.
    • Lateral (on each side): Aryepiglottic fold of the mucous membrane.
    ❖ The upper folds are produced by vestibular ligament and called vestibular folds
    or false vocal cords. The space between vestibular folds is called rima vestibuli.
    ❖ The lower folds are produced by the vocal ligaments and vocalis muscle, and
    called vocal folds or true vocal cords. The space between the right and left vocal
    folds is called rima glottidis, the narrowest part of the laryngeal cavity.

    Mucous Membrane of Larynx


    • Larynx is lined by pseudostratified ciliated columnar epithelium except at the
    following areas where we find Stratified squamous epithelium:
    o Anterior surface of larynx
    o Upper half of posterior surface of epiglottis
    o Vocal folds.
    • Saccule: known as the Oil can of Larynx

    Muscles of Larynx
    1. Intrinsic Laryngeal muscles - Move the laryngeal components
    2. Extrinsic Laryngeal muscles - Move the larynx as a whole

    Infrahyoid muscles: sternohyoid muscle, omohyoid muscle,


    Extrinsic sternothyroid muscle, thyrohyoid muscle
    muscles Suprahyoid muscles: stylohyoid muscle, digastric muscle, mylohyoid
    muscle, geniohyoid muscle
    Adductors: lateral cricoarytenoid muscle, transverse arytenoid muscle
    Abductors: posterior cricoarytenoid muscle
    Intrinsic Sphincters: transverse arytenoid muscle, oblique arytenoid muscle,
    muscles aryepiglottic muscle
    Tensors: cricothyroid muscle
    Muscles that relax vocal cords: thyroarytenoid muscle, vocalis muscle
    Action Muscles involved
    Muscles which open glottis (abductors of vocal cord) Posterior cricoarytenoids
    Muscles which close the glottis (adductors of vocal • Lateral cricoarytenoids
    cord) • Transverse arytenoids,
    (TLC) • Thyroarytenoids
    Muscles which tense the vocal cord (CT) Cricothyroids
    Muscles which relax the vocal cord • Thyroarytenoids
    • Vocalis
    Muscles which open the inlet of larynx Thyroepiglotticus
    Muscles which close the inlet of larynx • Aryepiglotticus
    • Oblique arytenoids

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    Ace Achievers Dental Academy

    Blood Supply and Lymphatic Drainage of Larynx


    Arterial Supply:
    - Superior + Inferior laryngeal artery
    - Cricothyroid artery
    Nerve Supply:
    - Internal + External laryngeal nerve
    - Recurrent laryngeal nerve
    Veins of Larynx
    - Superior + Inferior laryngeal vein
    Lymphatic Drainage
    - Superior + Inferior deep cervical lymph nodes

    Injury to Laryngeal Nerves


    Recurrent laryngeal nerve paralysis
    - Moderate trauma produces only abductor paralysis
    - Severe injury cause both adductor and abductor paralysis
    - Phonation is completely lost
    - Semon’s law: Progressive moderate lesion,
    : Abductor – First to paralyze, last to recover.
    ➢ Unilateral injury to RLN causes Hoarseness of voice
    ➢ B/L paralysis of RLN causes stridor- it is a medical emergency as the vocal cords
    come in cadaveric position leading to complete closure of airway- immediate
    intubation is required to save the patient.

    Superior Laryngeal Nerve Paralysis


    • Causes loss of timbre of voice- a voice that is monotonous in character because
    cricothyroid muscle is paralyzed.

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