Anatomy

of
Larynx

Larynx (anterior)

Larynx (posterior)

Larynx (posterior)

Larynx (lateral)

Larynx (superior)

Larynx (superior)

Larynx (sagittal section)

Larynx (sagittal section)

Larynx (coronal section)

Vocal fold

Vocal fold

Laryngeal Cartilages
3 single & 3 paired
Single

Paired

Epiglottis

Arytenoid

Thyroid

Corniculate (Santorini)

Cricoid

Cuneiform (Wrisberg)

Cartilages (anterior)

Laryngeal Cartilages

Cartilages (posterior)

Cartilages (posterior)

Cartilage Histology
Elastic: Epiglottis, corniculate, cuneiform &
apex of arytenoid. Little or no calcification.
Hyaline: Thyroid, cricoid & remaining arytenoid.
Calcify as age advances. Ossification begins by
25-30 yr & is completed by 60 yr.

Indirect Laryngoscopy

Flexible Laryngoscopy
LEFT

RIGHT

Laryngeal cavity
1. Laryngeal inlet
2. Laryngeal Vestibule
3. Laryngeal Ventricle
4. Rima glottis
5. Subglottis

Pediatric Larynx
Conical in shape & subglottis is narrowest part
Positioned high (C3-C4)
Moves higher during swallowing allowing
simultaneous breathing & feeding
Loose sub-mucosal tissues (swell up easily)
Soft cartilages that collapse easily

Membranes & Ligaments

Extrinsic:
connect thyroid cartilage & epiglottis with
hyoid bone; cricoid cartilage with trachea.
Intrinsic:
connect cartilages of larynx to each other.

Extrinsic

Thyrohyoid
membrane

Hyoepiglottic
ligament

Cricotracheal
ligament

Intrinsic

Intrinsic

Intrinsic
1. Quadrangular membrane
Ary-epiglottic ligament Vestibular ligament
2. Crico-vocal membrane
Vocal ligament Cricothyroid membrane
3. Thyro-epiglottic ligament

Oncological Divisions
A. Supraglottis: laryngeal
inlet to apex of ventricle
B. Glottis: apex of
ventricle to 10 mm below
C. Subglottis: lower glottic
border to lower cricoid
border

Subsites
A. Supraglottis: 1. Epiglottis 2. Aryepiglottic
folds 3. Ventricular bands 4. Laryngeal
Ventricle
B. Glottis:

1. True vocal cords 2. Anterior

commissure
C. Subglottis

3. Posterior commissure

Intrinsic Muscles
A. Acting on vocal cords
Abduction Posterior crico-arytenoideus
Adduction Lateral crico-arytenoideus
Transverse inter-arytenoideus
Thyro-arytenoideus externa
Tension + lengthening Cricothyroid
Relaxation + shortening Vocalis

Intrinsic Muscles
B. Acting on laryngeal inlet

Opener Thyro-epiglottic
Closer Oblique inter-arytenoideus
Ary-epiglottic

Extrinsic Muscles
Primary Elevators
Stylopharyngeus

Secondary Elevators
Mylohyoid

Salpingopharyngeus Stylohyoid
Palatopharyngeus
Thyrohyoid

Geniohyoid
Digastric

Depressors
Sternohyoid Sternothyroid Omohyoid

Posterior cricoarytenoid

Lateral cricoarytenoid

Transverse Inter-arytenoid

Cricothyroid

Thyroarytenoid externa + Vocalis

Oblique Inter-arytenoid

Spaces of Larynx

Reinkes space

Pre-epiglottic space

Para-glottic space

Communications

Shape of Glottis

Shape of Glottis
Quiet Respiration

Forced Inspiration

Inspiration

Shape of Glottis
Normal voice

Whisper

Normal phonation

Whisper

Mucous Membrane
Stratified squamous epithelium:
Epiglottis (anterior surface + upper half of
posterior surface), upper part of aryepiglottic
folds & vocal cords
Pseudo-stratified ciliated columnar
(respiratory) epithelium:
Rest of laryngeal mucous membrane

Nerve Supply
Superior Laryngeal Nerve:
Internal: sensation to supraglottis & glottis
External: motor to cricothyroid muscle
Recurrent Laryngeal Nerve:
sensation to subglottis
motor to all intrinsic muscles but cricothyroid

Blood Supply
Arterial supply:
Laryngeal br. of superior & inferior thyroid
Venous drainage:
Superior thyroid vein internal jugular vein
Inferior thyroid vein innominate vein

Lymphatic Drainage
Supraglottis: via thyrohyoid membrane into upper
deep cervical nodes & thyroid gland
Subglottis: via cricothyroid membrane into
pretracheal + lower deep cervical nodes
Glottis: has no lymphatics