The larynx Dr. Ayat El-Domouky

Function, site C4 C6

Contiuation

Hyoid Epiglottis Thyroid cartilage Cricoid cartilage

. Curniculate Arytenoid cartilage Cuneiform

Cartilages of the larynx 1.thyroid cartilage

Thyroid angle

Cartilages of the larynx 2.cricoid cartilage

Cartilages of the larynx 3. arytenoid cartilage

Corniculate cartilage Cunieform cartilage Apex Arytenoid cartilage Muscular process Vocal process Base

Cartilages of the larynx 4. epiglottis cartilage

Thyrohyoid and cricothyroid membranes

Quadrangular & cricothyroid membrane membrane

Vocal cords

Inlet of the larynx

Laryngeal vestibule Vestibular fold Vocal fold Infraglottic part sinus Vestibular fold Vocal fold Infraglottic part

Muscles of the larynx 1. oblique arytenoid (narrow the inlet) and 2 Muscles of the larynx 1. oblique arytenoid (narrow the inlet) and 2.thyroepiglottic (widens the inlet)

3.Cricothyroid muscle tense the vocal cord

4. Thyroarytenoid (vocalis) (relax) 5 4.Thyroarytenoid (vocalis) (relax) 5.lateral cricoarytenoid (adducts) 6.posterior cricoarytenoid (abduct) 7.trnsverse arytenoid

Muscles of the larynx Aryepiglottic Oblique arytenoid Transverse arytenoid Oblique arytenoid Post.cricoarytenoid

Nerve Supply of the Larynx Sensory Nerves Above the vocal cords: The internal laryngeal branch of the superior laryngeal branch of the vagus Below the level of the vocal cords: The recurrent laryngeal nerve Motor Nerves All the intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except The cricothyroid muscle is supplied by the external laryngeal branch of the superior laryngeal branch of the vagus. Blood Supply of the Larynx superior thyroid artery inferior thyroid artery

Sup.laryngeal N. Int.laryngeal N. Ext.laryngeal N. Recurrent Laryngeal N.

The position of the vocal folds after damage of vagus nerve

ENDOCRINE GLANDS

PITUTARY GLAND

Thyroid gland Site The thyroid gland consists of right and left lobes which extend from oblique line of thyroid cartilage to the level of 4th or 5th tracheal ring The isthmus infront of 2nd,3rd,4th tracheal rings

relations Antrolaterally : the sternomastoid and infrahyoid muscles

Postolaterally: carotid sheath medially: 2tubes, 2nerves and parathyroid glands

Blodd supply

The external laryngeal nerve the superior thyroid artery The inferior thyroid artery The recurrent laryngeal nerve

Work sheet Compare between the vocal and vestibular folds Vocal cord Fixed No voice Vascular and pink in colour Mobile concerned with voice production Avascular and white in colour

Enumerate medial relations of thyroid gland 2tubes: trachea and oesophagus 2 cartilages: thyroid and cricoid 2 nerves: recurrent and external laryngeal nerves 2 muscles: cricothyroid and inf. Constrictor muscle of pharynx

MCQ All muscles of the larynx are innervated by recurrent laryngeal nerve except----- Cricothyroid muscle thyroarytenoid muscle transverse arytenoid muscle thyroepiglottic muscles Regarding the arytenoid cartilage, all of the following are true except……………. Small and pyramid shaped Located at the back of the larynx Articulate with the upper border of the cricoid cartilage A muscular process give attachment to the vocal cord

Bilateral complete section of the recurrent laryngeal nerve results in………………….. Weak voice Loss of voice Acute respiratory distress No great effect Bilateral partial section of the recurrent laryngeal nerve results in………………….. unilateral section of the recurrent laryngeal nerve results in…………………..

The vocal cord is --------- The upper end of quadrangular membrane The lower end of quadrangular membrane The upper end of cricothyroid membrane The lower end of cricothyroid membrane The vestibular cord is --------- The aryepiglottic fold is ---------

Superior thyroid artery is branch of--------------- Internal carotid artery External carotid artery Common carotid artery Thyrocervical trunk inferior thyroid artery is branch of---------------