Larynx

Question 1

What are the three single cartilages in the larynx?

Answer 1

1. Thyroid Cartilage
2. Cricoid Cartilage
3. Epiglottis

Question 2

What are the three paired cartilages in the larynx?

Answer 2

1. Arytenoid
2. Corniculate
3. Cuneiform

Question 3

What 3 muscles INSERT onto the posterior border of the Thyroid Cartilage?

Answer 3

1. Stylopharyngeus
2. Palatopharyngeus
3. Salpinopharyngeus

Question 4

What 3 muscles ATTACH to the oblique line of the Thyrohyoid?

Answer 4

1. Sternothyroid
2. Thyrohyoid
3. part of Inferior Pharyngeal Constrictor

Question 5

What is the name of the joint that attaches the cricoid and the thyroid?

Answer 5

Cricothyroid Joint

Question 6

What are the names of the folds behind the epiglottis and the “fossa” in between?

Answer 6

Median and Lateral Glossoepiglottic Folds

• Vallecullae in between

Question 7

What forms the laryngeal inlet?

Answer 7

The Aryepiglottic fold with the epiglottis and artynoids*

Question 8

What is the cricoarytenoid joint?

Answer 8

Arytenoid and Cricoid

Question 9

What are the names of the two processes of the Artynoid?

Answer 9

Muscular & Vocal

Question 10

What is pierced by the Internal Laryngeal N. and the Superior Laryngeal Artery?

Answer 10

Thyrohyoid Membrane (extrinsic)

Question 11

What is the extrinsic ligament of the larynx?

Answer 11

Crico-tracheal Ligament

Question 12

What is the name of the membrane that stretches between the Epiglottis and the Arytenoids?

Answer 12

QUADRANGULAR MEMBRANE

intrinsic

Question 13

What is the false vocal fold? True vocal fold?

Answer 13

false = Vestibular fold
true = Vocal fold

Question 14

To what structures does the Vestibular Ligament attach?

Answer 14

thryoid to Arytenoid

Question 15

What structure is formed by the upper free border of the Crico-thyroid ligament?

Answer 15

Vocal FOld!!

Question 16

What is the Rima Glottis?

Answer 16

Space between the vocal fold

Question 17

Where is the piriform fossa? What nerve can be injured upon removal of a foreign body from this area?

Answer 17

Lateral sides of the Aryepiglottic Fold

• can damage the INTERNAL LARYNGEAL N.
• lose sensation to upper 1/2 of larynx

Question 18

What are the two common areas that foreign bodies can be stuck?

Answer 18

1. PIRIFORM Fossa

2. Valleculae

Question 19

What is the function of the larynx? What vertebrae is it found in between?

Answer 19

The larynx serves as valve to guard the air passages and maintain a patent airway especially during swallowing.

The phonation mechanism.

• between C3-C6

Question 20

What is the reason men and women have different pitch?

Answer 20

Men have a smaller Thyroid Angle (90) vs females (120)

• men have lower pitch & longer vocal chords because of this

Question 21

What protests the larynx?

Answer 21

Epiglottis

Question 22

What are the two joints of the cricoid?

Answer 22

Cricothyroid joints (w/ inferior horn of Thyroid)
Cricoarytenoid joints (Arytenoid sits on top)

Question 23

Where do the vocal cords attach?

Answer 23

Vocal chord attach from:

1. vocal process of arytenoid to
2. angle of thyroid cartilage

Question 24

What fold contains the cuneiform and corniculate?

Answer 24

Aryepiglottic Fold

Question 25

What is the lower free edge of the QUADrangular membrane called?

Answer 25

Vestibular Fold

Question 26

The Vocal Fold is avascular. True or False?

Answer 26

TRUE

Question 27

``` List the Action and Innervation of the muscles of the larynx: 1- Cricothyroid 2- Posterior Cricoarytenoid (tagged*) 3- Lateral Cricoarytenoid. 4- Transverse Arytenoid. 5- Oblique Arytenoid. 6- Thyro-arytenoid and Vocalis ```

Answer 27

1. Crycothyroid - TENSES vocal ligament N: External Laryngeal N. of Superior Laryngeal of Vagus 2- Posterior Cricoarytenoid - only ABDUCTOR (of vocal folds) 3- Lateral Cricoarytenoid - ADDUCTOR 4- Transverse Arytenoid - ADDUCTOR 5- Oblique Arytenoid - ADDUCTOR 6- Thyro-arytenoid and Vocalis - RELAXOR of vocal ligament ALL INNERVATED BY RECURRENT LARYNGEAL* (or inferior laryngeal)

Question 28

What muscle developed from the 4th pharyngeal arch?

Answer 28

Cricothyroid - the rest are 6th pharyngeal arch & innervated by recurrent laryngeal (inferior laryngeal)

Question 29

What muscle is the only opener of Rima Glottis? What if this muscle is not functioning?

Answer 29

Posterior Crico-Arytenoid * ABDucts the vocal folds PATIENT WILL DIE IF CANT OPEN VOCAL FOLDS

Question 30

What is the sensory innervation and blood supply of the upper larynx (ABOVE vocal folds)?

Answer 30

Superior Laryngeal Artery (of Superior Thyroid of External Carotid) + Internal Laryngeal Nerve (both penetrate the Thyrohyoid membrane)

Question 31

What is the sensory innervation and blood supply of the lower larynx (BELOW vocal folds)?

Answer 31

Inferior Laryngeal Artery ( of Inferior Thyroid of Thyrocervical Trunk) + Recurrent Laryngeal Nerve of Vagus

Question 32

During a thyroidectomy which nerves need to be taken care of?

Answer 32

Recurrent laryngeal N. & Internal Laryngeal

Question 33

What side of the recurrent laryngeal nerve recurs around the aorta? The subclavian?

Answer 33

Left = AORTA Right = Subclavian Artery

Question 34

What nerve can be injured when removing a foreign body from the Piriform Fossa?

Answer 34

Internal Laryngeal Nerve ** of Superior Laryngeal of Vagus

Question 35

``` A 27- year-old woman with a goiter comes to the hospital for surgical treatment. The surgeon must ligate the superior laryngeal artery before surgically resecting the goiter, so care must be taken to avoid injury to which of the following nerves ? A- External laryngeal nerve. B- Internal laryngeal nerve. C- Superior laryngeal nerve. D- Vagus nerve. E- Hypoglossal nerve. ```

Answer 35

B - Internal Laryngeal

Question 36

What is goiter?

Answer 36

GOITER = enlargement of thyroid gland

Question 37

``` A young singer visits her physician and complains of vocal difficulties. During quiet breathing her vocal cords are adducted. She is unable to abduct the vocal cords. Which of the following muscles is most likely paralyzed? A-Vocalis muscle. B-Crico-thyroid muscle. C-Posterior Crico-arytenoid muscle. D-Lateral Crico-arytenoid muscle. E-Transverse Arytenoid muscle. ```

Answer 37

C - Posterior Crico-Arytenoid

Question 38

Which of the following is the primary tensor of the vocal cords? ``` A- Vocalis. B- Posterior cricoarytenoid. C- Transverse cricoarytenoid. D- Cricothyroid E- Thryoarytenoid ```

Answer 38

D- Cricothyroid

Question 39

The Cricothyroid muscle is associated with which branchial arch ? ``` A- First. B- Second. C- Fourth D-Third. E- Sixth. ```

Answer 39

C - Fourth

Question 40

What muscle is found by Torus Tuberius?

Answer 40

Salpingopharyngeus (by Eustachian tube)

Question 41

If the Rima glottis cannot open, which nerve is non-functioning?

Answer 41

Recurrent Laryngeal | innervates Posterior Crico-arytenoid

Question 42

What is a cricothyroidectomy?

Answer 42

Opening of the infraglottic area

Question 43

How many constrictors are there?

Answer 43

3

Question 44

What innervates the cricothyroid?

Answer 44

External Laryngeal

Question 45

The Lingual artery is deep to what muscle?

Answer 45

Hyoglossus

Question 46

What connects all three constrictors?

Answer 46

Raphe

Question 47

The retropharyngeal space is:

Answer 47

1. anterior to pre-vertebral fascia 2. Posterior to buccopharyngeal space 3. Continuous with the mediastinum