LARYNX
- Also called voice box
- Cartilaginous structure
- Lies at the level of C3- C6 vertebrae
- In males 44 mm
- In females 36 mm
Function
- Air passage
- Phonation (voice production)
- Sphincter for lower respiratory passage
Cartilages of larynx
9 cartilages
3 paired ACC
Arytenoid
Corneculate
Cuneiform
3 unpaired ETC
Epiglottis
Thyroid
Cricoid
Thyroid:
Largest cartilage
Hyaline type
2 lamina right and left
Prominence in the centre called laryngeal protuberance: ADAMS APPLE (more prominent in males
than females)
Cricoid cartilage:
The only cartilage that forms a complete ring
Anteriorly: narrow portion arch of cricoid
Posteriorly flattened and forms lamina of cricoid
Epiglottis:
Unpaired cartilage
Elastic type
Leaf like structure
Situated behind the hyoid bone
Works as a flap while swallowing
Thus prevents the entry of food in the airway
Arytenoid:
Paired
Pyramid shaped
Hyaline
Sits posteriorly above the lamina of cricoid cartilage
3 processes
- Apex: above which the corneculate cartilage sits
- Muscular process: for muscle attchments
- Vocal process: for attachment of vocal cord
Corneculate:
Paired
Elastic type
Cuneiform:
Paired, elastic
Suspended in the aryepiglotic fold
Between epiglottis and arytenoid there is a mucosal fold
This along with epiglolttis and arytenoid
Forms the inlet of larynx
Hyoid bone
Thyrohyoid membrane
Thyroid cartilage
Cricothyroid membrane
Cricoid cartilage
Division:
- Supraglottic- vestibule from inlet of larynx to the vestibular fold
- Glottic- ventricle/ sinus of larynx vestibular fold to vocal fold
- Infraglottic- from vocal cord to cricoid cartilage
Muscles
Extrinsic:
- Sternohyoid
- Sternothyroid
- Thyrohyoid
- Omohyoid
- Inferior constrictor
- Stylopharyngeal
Intrinsic
- Vocalis (V)
- Transverse arytenoid (Tr A)
- Oblique arytenoid (OA)
- Lateral cricothyroid (LCA)
- Posterior cricothyroid (PCA)
- Thyroarytenoid (TA)
- Cricothyroid (CT)
- Thyroepiglolttic (TE)
- Aryepiglotticus (AE)
Laryngeal joints:
- Cricothyroid joints:
Synovial
Between inferior cornua of throid cartilage and side of cricoid cartilage
Rotatory movement around transverse axis
Gliding movement
- Cricoarytenoid joint:
Synovial
Between base of arytenoid and upper border of lamina of cricoid
Rotatory movements around vertical axis
Gliding in all directions
Ligaments:
Extrinsic
- Hyoepiglottic:
Upper end of epiglottis to hyoid bone
- Cricotracheal ligament
Intrinsic
Quadrate membranefrom arytenoid to epiglottis: lower free border vestibular fold
Upper end aryepiglottic fold
Conus elasticus or cricovocal membrane upwards and medially from arch of cricoid: anteriorly
thickens to form cricothyroid ligament
Upper free border becomes vocal fold
INTRINSIC MUSCLES OF LARYNX
AE
TE
V
T A A
TA
Tr A, OA
CT
LCA CA
C C
Some fibres of OA make the AE
And some fibres of TA make the upper fibres of TE
FUNCTIONS
Muscles contracts towards the origin
1. Opening inlet of larynx: TE(pulls the epiglottis)
2. Closing the inlet of larynx: AE, OA
3. Abductor: PCA
4. Adductor: LCA, Tr A, OA, CT, TA
5. Tensor: CT; important for voice modulation
6. Relaxer: TA, Vocalis
7. Elevation of larynx: thyrohyoid, mylohyoid
8. Depression: sternohyoid
PCA: safety muscle (Any paralysis difficulty in breathing)
TA: unpaired muscle
CT: outside larynx; tuning fork
Blood supply of larynx:
Through superior and inferior laryngeal artery (branches of superior and inferior thyroid artery)
Nerve supply:
Superior laryngeal nerve: external root only to CT, and internal rot gives sensory to supraglottic
region
Recurrent laryngeal nerve: all intrinsic muscles except CT; sensory to infraglottic region
