Head and Neck 11 -- Larynx
Terms
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- What are the parts of the larynx?
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Supraglottis
Glottis
Subglottis - How are they viewed?
- Like the spleen, kidney, and liver. They are near each other, they together constitute the larynx, but they are treated very differently by surgeons and radiation oncologists.
- What is the larynx supported by?
- Cartilaginous backbone
- Where does the larynx begin?
- Hyoid
- In order, what are the cartilaginous structures of the larynx?
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Epiglottis
Thyroid cartilage
Arytenoids
Cricoid - What is the function of the epiglottis?
- Protect airway during swallowing
- What is the function of the thyroid cartilage?
- Protect vocal cords and vocal ligament
- What is the function of the arytenoids?
- Support the true vocal cords
- How do they do this?
- Via the vocal ligament
- What is the special trait of the cricoid cartilage?
- It makes a 360 degree ring around airway
- What is cricoid needed for?
- Only cartilage needed for providing airway patency
- What are the main parts of the thyroid cartilage?
- Two anterior laminae
- What do they do?
- Meet together in the midline at an acute outpouching angle
- What is at the top of the throid cartilage anteriorly
- The superior thyroid notch
- What happens posteriorly?
- Each lamina is elongated to form a superior and inferior cornua
- What does the superior cornua do?
- Provides attachment for the thyrohyoid ligament
- What does the inferior conua do?
- Articulates medially with the sides of the cricoid cartilage
- What is this articulation?
- Cricothyroid joint
- Which is wider, thyroid or cricoid?
- Thyroid is much wider. Cricoid is only a little wider than a tracheal ring
- What is between the thyroid and the hyoid anterolaterally?
- The thyrohyoid membrane
- What penetrates the thyrohyoid membrane?
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Superior laryngeal nerve
Laryngeal artery - What is located between the cricoid and thyroid?
- Cricothyroid ligament
- Where is the ligament located?
- Anteriorly
- What penetrates the cricothyroid ligament?
- The recurrent laryngeal nerve on its way to innervate the major laryngeal muscles
- Where is the arytenoid cartilage?
- Buried deep within the depths of the thyroid cartilage, posteriorly
- What does the arytenoid cartilage give rise to?
- The vocal ligament
- Where does the vocal ligament insert?
- Inner aspect of thyroid cartilage
- What does this look like diagrammatically?
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. - What is revealing about this picture?
- The superior tip of the epiglottis is actually superior to the hyoid!
- What does the vocal ligament support?
- The thyroarytenoid muscle
- What is the thyroarytenoid muscle?
- True vocal cord
- What constitutes the supraglottis?
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Epiglottis
Aryepiglottic folds
Arytenoids
False vocal cords
Laryngeal ventricle - What else is in the supraglottis?
- Two spaces
- What are these spaces?
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Pre-epiglottic space
Paraglottic space - What is the other name for paraglottic space?
- Paralaryngeal space
- Where is the actual extent of the supraglottis?
- Tip of the epiglottis to the laryngeal ventricle
- What is definitely not part of the supraglottis, despite its proximity?
- The valleculae and pyriform sinuses
- What are these then?
- The vallecula are in the lower oropharynx, and pyriform sinuses are part of the hypopharynx
- If they are so close, does it really matter?
- Crucial differences.
- Why?
- Because below the hyoid you get into the paraglottic and pre-epiglottic spaces.
- What is the epiglottis shaped like?
- A leaf
- What is crucial about epiglottic anatomy?
- If there is a tumor, you must state whether it is confined to the suprahyoid epiglottis or extends into infrahyoid epiglottis
- What is the difference
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If supraglottic only, they can do an epiglottectomy, or even laser surgery to treat it.
If it extends into the infrahyoid epiglottis, the game changes, and treatment is radically more complicated. - Where is the epiglottis in relation to the hyoid?
- Directly posterior
- What is directly posterior to the hyoid bone?
- The preepiglottic space
- What is posterior to the pre-epiglottic space?
- The valleculae
- What is posterior to the valleculae?
- The epiglottis
- What attaches the epiglottis to the hyoid?
- The hyoepiglottic ligament
- What covers this ligament?
- A mucosal fold
- What is this fold better known as?
- The glossoepiglottic fold
- What does this ligament/fold do?
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Attaches epiglottis to hyoid
Splits the vallecula into 2 separate structures - What connects the epiglottis to the pharynx?
- Pharyngoepiglottic fold
- What do the glossoepiglottic and pharyngoepiglottic ligaments do as a team?
- Separate the supraglottis from the oropharynx (tongue base and vallecula)
- What separates the pyriform sinus from the supraglottis?
- Aryepiglottic folds
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