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Anatomy of larynx
The larynx is a cartilaginous structure located at the top of the trachea. It contains 9 cartilages including the thyroid and cricoid cartilage. The larynx protects the airway and is involved in phonation. It contains intrinsic muscles that abduct and adduct the vocal folds to modulate airflow and vocal cord vibration. The larynx receives innervation from the vagus nerve and branches of the superior and recurrent laryngeal nerves.
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Anatomy of larynx
- 1. ANATOMY OF LARYNX DRVIJAY NAGDEV FCPS-II TRAINEE ANAESTHESIOLOGY CIVIL HOSPITAL,DUHS KARACHI
- 2. LARYNX It isthe musculocartilaginous structure, lined with mucous membrane, connected to the superior part of the trachea and to the pharynx. the essential sphincter guarding the entrance into the trachea. functioning secondarily as the organ of voice. It is formed by nine cartilages connected `by ligaments and eight muscles. begins at the level of vertebra C4or C5and ends at the level of vertebra C7
- 3. The Anatomy ofthe Larynx Figure 23.4pgmedicalworld.com
- 4. CARTILAGES There are9 cartilages of larynx 3 are paired and 3 are unpaired UNPAIRED • Thyroid cartilage • Cricoid cartilage • Epiglottis PAIRED • Arytenoid • Corniculate • Cuneiform
- 5. THYROID CARTILAGE Thelargest laryngeal cartilage (“shield- shaped”) It forms most of the anterior and lateral walls of the larynx . The thyroid cartilage, when viewed in sagittal section, is incomplete posteriorly. The anterior surface of this cartilage bears a thick ridge, the laryngeal prominence. This ridge is easily seen and felt, and the thyroid cartilage is commonly called the Adam’s apple.
- 6. CARTILAGES A. THYROID CARTILAGE– Shield shaped - has Sup. & Inf. Horns from upper & lower edges Laryngeal Prominence Sup. Horns Inf. Horns - Inf. horns make synovial hinges joint with Cricoid Cartilage; - Laryngeal Prominence = Adam’s Apple, more prominent in males pgmedicalworld.com
- 7. CRICOID CARTILAGE “ringshaped”cartilage. It is a complete ring whose posterior portion is greatly expanded, providing support in the absence of the thyroid cartilage. Forms most of the posterior wall of larynx The cricoid and thyroid cartilages protect the glottis and the entrance to the trachea
- 8. CARTILAGES B. CRICOID complete ring of cartilagehas narrow Arch ant., broad Lamina post. Cricoid means Signet Ring Lamina of cricoid Arch of cricoid ANT .VIEW POST .VIEW pgmedicalworld.com
- 9. EPIGLOTIS • Thin, leaf-like,elastic fibrocartilage • Projects upward behind tongue & hyoid • During swallowing, the larynx is elevated, and the epiglottis folds back over the glottis, preventing the entry of liquids or solid food into the respiratory passageways. • Neonates & infants – omega shaped, long, floppy
- 10. LARYNX: CARTILAGES F. EPIGLOTTIS -leaf shaped cartilage posterior to root of tongue - connected to body of hyoid and post side of thyroid cartilage POST. VIEW pgmedicalworld.com
- 11. PAIRED CARTILAGES Arytenoid- 2 pyramidal shaped cartilages above lamina – have synovial joints with Cricoid Corniculate - nodules above arytenoids in aryepiglottic folds Cuneiform - rod shaped, above corniculate cartilages Cuneiform Corniculate Arytenoid pgmedicalworld.com
- 12. EXTRINSIC LIGAMENTS OF LARYNX 1.Thyrohyoid ligament links larynx to hyoid; 2. Cricothyroid ligament links thyroid to cricoid; 3. Cricotracheal ligament links Cricoid to first tracheal cartilage Median Thyrohyoid Ligament Median Cricothyroid Ligament pgmedicalworld.com Conects cartilages to hyoid and trachea
- 13. INTRINSIC LIGAMENTS Epiglottis 1. Quadrangular Membranelinks Arytenoid To epiglottis Forms the vestibular ligament Arytenoid pgmedicalworld.com 2.CONUS ELASTICUS: forms vocal ligament , framework of vocal fold / true cord Connects cartilages to each other and forms the internal framework
- 14. CAVITY OF LARYNX Cavity of larynx contains the vestibular folds,vocal folds,glottis These vestibular folds and vocal folds divide cavity of larynx into 3 compartments o Superior vestibule o Ventricle / sinus of the larynx o Subglottic space
- 15. Glottis It isthe vocal apparaus of larynx Makes up the vocal folds and processes together with rima glottidis
- 16. Vocal folds (truevocal cords) • These are the sharp edged folds of mucus membrane • source of sound from larynx • They produce audible vibrations • Act as sphincter when tightly adducted
- 17. Vestibular folds(false vocal cords) They are protective in function No function in voice production They become swollen during anaphylactic shock causing suffocation
- 18. INTRINSIC MUSCLES Allthe Intrinsic muscles of the larynx are paired except tranverse inter arytenoid muscle. These are: 1)abductors of vocal cords=posterior crico-arytenoid. 2)adductors of vocal cords=lateral crico- arytenoid,interarytenoid,thyroarytenoid,cricothyroid. 3)tensors & adductors of vocal cords=cricothyroid,vocalis & thyro-arytenoid. 4)openers of the laryngeal inlet=thyroepiglottic 5)closers of the laryngeal inlet=interarytenoid & aryepiglottic.
- 19. EXTRINSIC MUSCLES Theseare divided into two groups: 1)cervical muscles: A)suprahyoid muscles,which act as elevators of the larynx B)infrahyoid muscles(strap muscles),which acts as depressors of the larynx. 2)pharyngeal muscles including the inferior constrictor muscle.
- 20. MUSCLES OF LARYNX 1)THYROARYTENOID MUSCLE- Relaxes Vocal Ligaments Decreases pitch NOSE pgmedicalworld.com
- 21. MUSCLES OF LARYNX 2)ARYTENOID (Transverse and oblique arytenoid) - Adduct vocal folds 3) LATERAL CRICO-ARYTENOID - Adduct vocal folds 4) POSTERIOR CRICOARYTENOID – Abducts vocal fold Adduct closes rima glottidis Abduct opens rima glottidisArytenoids Can rotate/slide pgmedicalworld.com
- 22. NERVES OF LARYNX– Branches of Vagus A. Superior Laryngeal N. divides to - 1. Internal Laryngeal N. GVA Sensory to Larynx Above True Vocal Folds 2. External Laryngeal N. SVE Motor to Cricothyroid B. Recurrent Laryngeal N. - GVA Sensory to Larynx Below True Vocal Folds - SVE motor to all other Muscles of Larynx GVA=GENERAL VISCERALAFFERENT SVE=SPECIAL VISCERAL EFFERENT SUP. LARYNG. N Int. Laryng. N. Ext. Laryng. N. RECURRENT LARYNG. N. pgmedicalworld.com
- 23. LARYNX - ARTERIALSUPPLY Sup. Laryngeal A. from Sup. Thyroid artery Inf. Laryngeal A. from Inf. Thyroid artery pgmedicalworld.com
- 24. LARYNX - LYMPHATICS SuperiorDeep Cervical Nodes Larynx above true vocal folds Inferior Deep Cervical Nodes- Larynx below true vocal folds VII. Note: Mucosa Tightly Attached to vocal folds Anaphylactic Shock Swell Vestibular folds --Suffocation pgmedicalworld.com
- 25. LARYNGOSCOPE VIEW OFLARYNX Ant. Tongue Vocal Folds (true vocal folds) Epiglottis Post. Vestibular Folds (false vocal folds) vocal folds adducted when talking or singing pgmedicalworld.com
- 26. LARYNGOSCOPY GRADING GRADE-I: All structures visible GRADE-II :Only posterior part of glottis visible GRADE-III :Only epiglottis seen GRADE-IV : No reconizable structure