- 1. Laryngeal Cartilages Paired Unpaired: Arytenoid Thyroid
cartilagecartilage Cricoid cartilage Corniculate
Epiglottiscartilage Cuneiformcartilage
2. Thyroid Cartilage Hyaline cartilage Largest Encloses the
larynxanteriorly and laterally Two alae, laryngealprominance,
thryroidnotch, inferior andsuperior horn, obliqueline,
thyrohyoidmembrane Ossification 3. Cricoid Cartilage Hyaline
cartilage Strongest Shape: Signet ring Ant. arch and post. lamina
Only complete annular support of the larynx Articulates w/ Inferior
cornu of the thyroid cartilage Cricothyroid and cricotrachel
ligament 4. Epiglottis Fibroelastic cartilage Leaf-shaped structure
Forms the sup. Part of the ant.Wall and sup. margin of theinlet
Petiole small narrow portionof the glottis Thyroepiglottic ligament
Hyoepiglittic membrane Medial and lat. Glossoepiglotticfolds,
epiglittic valleculae Epiglottic tubercle 5. Arytenoid Cartilage
Mostly hyaline cartilage Responsible for opening and closing of the
larynx Shape: three sided pyramidal Apex aryepiglottic fold
Muscular process post. and lat. Cricoarytanoid muscle 6.
Corniculate Cartilages Fibroelastic Small cartilages above the
arytenoid and in the aryepiglottic folds 7. Cuneiform Cartilages
Firboelastic cartilages Elongated pieces of small yellow elastic
cartilage in the aryepiglottic folds Triyicial cartilage in
thyrohyoid membrane 8. Laryngeal Joints Cricothyroid Joint
Cricoarytenoid Joint Between inferior cornu of bet. base of the
arytenoid the thyroid cartilage and cartilage and the facet on
facet on the cricoidthe upper border of the cartilage at the
junction oflamina of the cricoid the arch and lamina cartilage Two
movements: rotation, Two movements: rotation, glidingsliding,
tiltingResult in changes in theResult in approximating, length of
the vocal folds tensing and relaxing the vocal folds 9. Laryngeal
Ligaments Extrinsic Intrinsic Quadrangular Thyrohyoid membraneand
ligamentsmembrane Conus elasticus Cricothyroidmembrane and
(cricovocalligamentsmembrane) Median cricothyroid Cricotracheal
ligament ligament Epiglottis Vocal Ligament Thyroepiglottic lig.
10. Extrinsic Ligaments Thyrohyoid membrane pierced on each side
by:1. Superior laryngeal vessels2. Internal branch of superior
laryngeal nerve Median thyrohyoid ligament thickened median portion
Lateral thyrohyoid ligament thickened posterior border- where
cartilago triticea is often found helps to close the inlet of the
larynx during swallowing 11. Extrinsic Ligaments Cricothyroid
membrane and ligaments The fibrous median cricothyroid ligament
produces a soft spot and it is at this point the airway is closest
to the skin and is most accessible May be pierced for emergency
cricothyrotomy tracheotomy 12. Extrinsic Ligaments Cricotracheal
Ligament Attaches the cricoid cartilage to the first attached ring
Epiglottis suspended in position by membranous connections to the
hyoid bone, thyroid cartilage and base of the tongue 13. Intrinsic
Ligaments Fibro elastic membranes Divided into upper and lower
parts by theventricle of the larynx Quadrangular membrane Upper
part of the elastic membrane Boundaries Epiglottis , arytenoid,
corniculate cartilage, falsecord Free inf. margin constitute the
vestibularligament, covered loosely by vestibular fold 14. Vocal
ligamentExtend from the junction of the laminae of thethyroid
cartilages to vocal process of arytanoidIt forms the skeleton of
the vocal fold and thefree edge of the conus elasticus 15.
Intrinsic Ligaments Conus elasticus (cricovocal membrane) Composed
mainly of yellow elastic tissue Boundaries Inferior: superior
border of cricoid cartilage Superoanterior: deep surface of angle
thyroid cartilage Superoposterior: vocal process of arytenoid
cartilage Thyroepiglottic ligament 16. Cavity of the Larynx Divided
into 3 parts: Vestibule Ventricle Infraglottic cavity (subglottic
space) 17. Vestibule boundaries: Anterior: posterior surface of
epiglottis Posterior: interval between arytenoidcartilages Lateral:
inner surface of aryepiglottic foldsand upper surfaces of the false
cord 18. Ventricle Saccule conical pouch at anterior part Vocal
cords, Glottis Adduction: Abduction:Phonation,
slit-likeappearanceRespiration, wide andtriangular 19. Subglottic
space between vocal cords and lower borderof the cricoid
Preepiglottic space a wedge shaped space lying infrontof the
epiglottis Boundaries: Anterior: thyrohyoid membrane
Anteroasuperior: hyoid Superior: vallecula Posterior: part of the
epiglottis Lateral: hyoepiglottic ligament 20. False Cords
(ventricular bands), vestibular folds Anteriorly: angle of
thethyroid cartilage Posteriorly: bodies of thearytenoid cartilage
Space between them rima vestibuli Protect from entering
foodparticles to the larynx True cords, vocal folds Voice
production Protection of lower respiratory tract Anteriorly,: angle
of thyroid cartilage Posteriorly: vocal processes of the
arytenoidcartilages Enclose vocal ligament, and a major part ofthe
vocalis muscle Space between them rima glottis 21. Laryngeal
Muscles Extrinsic Muscles Intrinsic Muscles Depressor group Muscles
of the inlet of theinfrahyoid muscles larynx Transverse and oblique
arytanoid, Elevator group aryepiglottic, thyroepiglotticSuprahyoid
muscles, Muscles of the vocal foldsstylopharyngeus muscles
Adductors - lateral Thyrohyoid musclecricoarytenoid Abductors post.
Cricoarytenoid Tensors cricothyroidRelaxers Thyroarytanoid (oneband
of inferior deeper fibers are 22. DepressorOriginInsertion
ActionmusclesSternohyoid (C2, manubrium ofoblique line of
thedepresses/stabilizesC3)sternum and thyroid cartilagethe hyoid
bonemedial end ofclavicleThyrohyoid (C1) oblique line of the lower
border of the elevates the larynx;thyroid cartilage hyoid
bonedepresses/stabilizesthe hyoid boneOmohyoid (C2, superior border
inferior border ofdepresses, retractsC3) of scapula near hyoid
boneand steadies thethe hyoid duringsuprascapular swallowing
andnotch speaking 23. Elevator OriginInsertion Action
musclesGeniohyoidinferior mental body of hyoid pulls the hyoid
bonespine of mandible boneanterosuperiorly, and shortens(C1)the
floor of the mouth andwidens the pharynxDigastricsanterior
belly-intermediate depresses the mandible anddigastric fossa of
tendon to body raises the hyoid bone. Also, it(Ant. CN V;
mandible,and greater horn steadies the hyoid bone duringPost. N.
VII) posterior belly- of hyoid boneswallowing and speakingmastoid
notch oftemporal boneMylohyoid mylohyoid line ofraphe and body
elevates the hyoid bone, floor ofmandible of hyoid bonethe mouth
and the tongue(V) during swallowing and speakingStylohyoidstyloid
process of body of hyoidelevates and retracts the hyoidthe temporal
bone bone, thereby elongating the(VII) bonefloor of the mouth 24.
ElevatorOriginInsertionActionmusclesStylopharyngeus styloid
posterior andelevates the pharynx and(CN IX) process ofsuperior
borders oflarynx and expands thetemporalthyroid cartilage with
sides of the pharynxbonepalatopharyngeusmuscleSalpingopharyngeus
cartilaginousblends with elevates the pharynx and(pharyngeal
plexus) part of the palatopharyngeuslarynx and opens theauditory
tube muscleorifice of the auditory tubeduring
swallowingPalatopharyngeushard palate lateral wall of tenses the
soft palate andand palatinepharynx pulls the walls of
theaponeurosis pharynx superiorly,anteriorly and mediallyduring
swallowing 25. Muscles Controlling the Laryngeal
InletIntrinsicOrigin Insertion ActionMuscles Interarytenoidmuscular
process posterior surface of draws arytenoid m., oblique of the
arytenoid the contralateralcartilages together, cartilagearytenoid
cartilage, adducting the vocal (RLN)near its apexfolds (closure of
glottis) Thyroepiglottic inner surface of lateral surface of the
draws the epiglottic (ELN) the thyroidepiglottic cartilage
cartilage downward cartilage near the laryngeal prominence 26.
Muscles Controlling Movements of the Vocal CordsIntrinsic
OriginInsertion ActionMusclesCricothyroid arch of the cricoid
inferior border of the draws the thyroid(ELN)cartilage thyroid
cartilagecartilage forward,lengthening the vocalligaments,
tensesvocal cordsThyroarytenoid inner surface of the lateral border
of the relaxes and adducts(vocalis, ILN) thyroid cartilagearytenoid
cartilage the vocal foldsLateralarch of the cricoid muscular
process of Adducts the vocalcricoarytenoid cartilage the arytenoid
cartilage cords by rotating the arytenoid cartilage(ILN) 27.
Intrinsic OriginInsertionActionMusclesPosteriorposterior surface of
muscular process ofAdducts the vocalcricoarytenoid the lamina of
the the arytenoid cartilage cords by rotating the cricoid cartilage
arytenoid cartilage(ILN)Interarytenoid m., posterior surface of
posterior surface of Closes posterior parttransverse (ILN) the
arytenoidthe contralateralof rima glottidis by cartilagearytenoid
cartilageapproximating arytenoid cartilages 28. Nerve Supply
Supplied by Vagus nerve: Superior laryngeal n. Internal branch
(sensory and autonomic) areas abovethe vocal folds including its
sup. Surface (pierces thethyrohyoid membrane with sup. Laryngeal A.
andlymphatics) External branch (motor) Motor Cricothyroid muscle
Recurrent laryngeal n., inferior laryngeal n. (sensory,motor fibers
from CN XI) Motor all intrinsic laryngeal muscles of SAME
side(except cricothyroid) and interarytenoid muscle of BOTHsides
Sensory areas below the vocal cords 29. Recurrent laryngeal nerve
is vulnerable to damage duringthyroidectomy, carotid
endarterectomy, etc. because its ascendsin the groove between
trachea and oesophagus and itsrelationship to the medial surface
the thyroid gland Damage may cause temporary aphonia, reduction of
the voiceto a whisper, choking of food and laryngeal obstruction
30. Blood Supply Upper Larynx External carotid artery Superior
thyroid artery Superior laryngeal artery Lower Larynx Subclavian
artery Thyrocervical artery Inferior thyroid artery Inferior
laryngeal artery 31. Venouos Drainage Upper Larynx Superior
laryngeal vein Superior thyroid vein Internal jugular vein Lower
Larynx Inferior laryngeal vein Inferior thyroid vein Innominate
vein 32. Lymphatic Drainage Superior to vocal cords Lymph vessels
accompany superior laryngeal artery through thyrohyoid membrane to
upper deep cervical lymph nodes Inferior to the vocal cords Through
the prelarnygeal, pretracheal, and paratracheal lymph nodes to
lower deep cervical lymph nodes 33. Mucous Membrane Stratified
squamous epith.: over vocal cords and upperpart of vestibule of
larynx Ciliated columnar epith.: remainder of the cavity Mucous
glands: Ventricles and sacculi Posterior surface of epiglottis
Margins of aryepiglottic folds 34. Basic Functions Protection
Respiration Phonation Fixation of chest Closure of glottis 35.
Protection Acts as a sphincter Closure of thelaryngeal inlet
Closure of the glottis Cessation ofrespiration Cough
relfex,expulsion ofsecretions and foreignbodies 36. Respiration
Assists in regulation of gaseous exchange with the lungand
maintenance in acid-base balance Glottis opens a fraction of a
second before air is drawn inby descent of the diaphragm Posterior
cricoarytenoids Phasic inspiratory abduction Synchronous
w/respiration Cricothyroid muscle Phasic inspiratory
contraction/adduction Increases AP diameter of glottic chink 37.
Phonation Voice produced byvibration of the vocalcords Fundamental
toneproduced at the larynx Modified by resonatingchambers of the
upperaerodigestive tract 38. Phonation Cricothyroid muscles
Thyroarytenoid muscles Position the vocal cords Provide finer
isometric near the midlinemodifications Lengthens true cords as
Increases internal pitch increases tension of true cord, producing
cord thinning 39. Thank You
