Professional Documents
Culture Documents
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INTRODUCTION
Respiratory organ modified to produce sound
Synonym: Voice box,organ of phonation
Anterior midline of upper neck infront of
laryngopharynx
Extent:upper border of epiglottis to lower
border of cricoid.
Lies:infront of C3-C6
Male larynxV=44mm,T=43 mm,AP=36mm
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FUNCTIONS
Phonation
Respiration
Protection
Deglutition
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DEVELOPMENT
Laryngotracheal
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DEVELOPMENT
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SKELETON OF LARYNX
Cartilages
Joints
Membranes & ligaments
Muscles
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CARTILAGES
Paired
Arytenoid
Unpaired
Thyroid
Corniculate
Cricoid
Cunieform
Epiglottis
Cartilago triticea
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THYROID CARTILAGE
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Cricoid
cartilage
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Epiglottis
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Arytenoid cartilage
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Hyaline cartilages:
Thyroid, Cricoid, basal part& muscular
process of Arytenoid
Elastic fibrocartilage:
Epiglottis,Corniculate,Cunieform,apices &
vocal process of Arytenoids
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JOINTS:
Cricothyroid joint
- Between inferior horn of thyroid and cricoid
- Synovial hinge
- Rocking movements{
Transverse
axis}
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Cricoarytenoid joint
Plane synovial
Movements:
Sliding
Rotatory
Arytenocorniculate
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Intrinsic
Quadrangular membrane
& vestibular ligament
Cricotracheal
Thyroepiglottic
Hyoepiglottic
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Extrinsic
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Extrinsic
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Intrinsic-Quadrate membrane
Boundaries:
Sup : aryepiglottic folds
Ant : lat margin of epiglottis
Post : arytenoid and corniculate
cartilage
Inf : free called as vestibular fold
Covered by mucous membrane to Form
False vocal folds
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Cricothyroid ligament
Attachments
Project up from arch of cricoid to
Anteriorly : Jn of thyroid lamina
Posteriorly: vocal pr of arytenoid
Cricovocal memb free b/t ant & post attachment is
thick
Form CV ligament, when covered with mucous
memb : form true Vocal cords
Conus elasticus : commonly includes all parts of the lig or just the anterior part of
VC
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Intrinsic
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Extrinsic
Geniohyoid
Mylohyoid
Digastric, ant and post belly
Stylohyoid
Thyrohyoid
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Palatopharyngeus
Salpingopharyngeus
stylopharyngeus
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Intrinsic
Acts on VC
Acts on epiglottis
Muscles acting on VC
Length and tension
Cricothyroid
Thyroarytenoids
Abductor
Post cricoarytenoid
Adductors
Lateral cricoarytenoid
Thyroarytenoid
Interarytenoideus
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MUSCLES OF LARYNX
Extrinsic
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Intrinsic
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Extrinsic
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Intrinsic
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EXCEPTIONS
Cricothyroid -> only muscle lying on outer
aspect of larynx
Transverse arytenoid-> only intrinsic
muscle of larynx which is unpaired
All intrinsic muscles adduct vocal cords
except post cricoarytenoid
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SUBDIVISIONS OF LARYNGEAL
CAVITY
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inlet
Boundaries
Ant : epiglottis
Post : arytenoid cart
Sides : aryepiglottic folds
Vestibule
Space b/t inlet & vestibular folds
Laterally : quadrate membrane
Ant : epiglottis
Lower : Rima of vestibule
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HISTOLOGY OF LARYNX
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NERVE SUPPLY
ILN : only
sensory
ELN : only
motor
RLN : sensory
and motor
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ARTERIAL SUPPLY
Sup Laryngeal
Artery
Inferior Laryngeal
Artery
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VENOUS DRAINAGE
Sup Thyroid
Vein
Inf Thyroid
Vein
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LYMPHATIC DRAINAGE
Above VC upper deep cervical {anterosuperior
group}
Below VC lower deep cervical {posteroinferior
group}
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Crux
Above VC
Arterial supply
Below VC
Lymph drainage
Upper Deep
cervical LN
Lower deep
cervical LN
Nerve supply
Sensory: ILN
Sensory: RLN
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MECHANISM OF PHONATION
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APPLIED
ANATOMY
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LARYNGOSCOPY-
Indirect laryngoscopy
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Done under GA
Sniff position
Macintosh Laryngoscope
Before orotracheal/
endotracheal intubation
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Direct laryngoscopy
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Cricothyrotomy
Emergency airway
establishment
Cricothyroid ligament
opened
Transverse
incision,pocketknife
Converted to standard
tracheotomy soon to
prevent laryngeal
stenosis
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Consequences of thyroidectomy on
larynx
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HEIMLICH MANEUVER
Foreign body in laryngeal cavity
Choking,asphyxia
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MALFORMATIONS OF LARYNX
Laryngomalacia:
Supraglottic structures(epiglottis,arytenoid
cartilages) abnormally soft & pliable Collapse
inwards during inspiration
S/S: feeding difficulty,stridor from birth,louder in
supine position
Diagnosis: laryngoscopy-Omega shaped
epiglottis
Treatment:
Resolve by 2 yrs
Temporary tracheostomy
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Others
Congenital laryngeal cyst
Congenital laryngocele
Congenital Subglottic stenosis
Congenital vocal cord paralysis
Subglottic hemangioma
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SINGERS /SCREAMERS/CLERGYMENS
NODULES
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LARYNGOCELE
Increased air pressure in laryngeal sinus
Trumpet players,glass blowers,weight lifters
Saccule dilates to produce air filled cystic swelling
External
Internal
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Bilateral
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SIMONS LAW
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Reinkes edema
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TUMOURS OF LARYNX
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Thank you
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