Test 2-6 Larynx & Trachea

In adults, the trachea is ~ _____ cm in diameter; smaller in _____ The trachea is ___ - ___ inches long

- 2.5 cm diameter, smaller in kids - 4-6 in. long

The skeleton of the larynx is formed by how many cartilages? How many are paired vs unpaired.

- 9 - 3 paired (6 total) - 3 unpaired

Cricoid cartilage: Located at the level of the _____ vertebrae - ______ and_____ processes are palpable here. Junction of _____ and _____ Level at which the _____ and _____ join Point where _____ enters the larynx

- C6, transverse & spinous - larynx & trachea - pharynx & esophagus - RLN (recurrent laryngeal nerve)

What is the vocal appartus of the larynx? It is composed of _____ _____ and _____ _____.

- Glottis - Vocal folds & rima glottidis.

The Larynx: _____ the airway Located in _____ neck Bodies of _____-_____ vertebrae Last segment of the _____ _____ Lower airway begins below _____ _____ _____ _____ is known as the "Adam's apple"

- Guards - Anterior - C3-C6 - Upper airway - Vocal Cords (should this answer be cricoid cartilage?) - Laryngeal prominence

Extrinsic laryngeal ligaments attach laryngocartilages to either the _____ _____ or _____. _____ ligament joins cricoid to tracheal rings _____ ligament joins thyroid cartilage to hyoid bone _____ ligament- joins hyoid bone to epiglottis

- Hyoid bone or Trachea - Cricotracheal - Thyrohyoid - Hyoepiglottic

-Intrinsic muscles of the larynx modify the laryngeal _____. -_____ and _____ _____ muscles narrow the inlet -_____ muscle widens the inlet

- Inlet - Aryepiglottic & oblique arytenoid - Thyroepiglottic

Laryngopharynx communicates with the larynx at the _____ _____: The laryngeal inlet is bounded: Anteriorly at the _____ Laterally - ______ ______ Posteriorly- ______ & ______

- Laryngeal inlet - Anteriorly: at the epiglottis - Laterally: at ary-epiglottic folds - Posteriorly: cuneiform & corniculate

One of our strongest reflexes: Combined action of _____ muscles of the laryngeal inlet result in a _____ _____ action. _____ of vocal cords occurs reflexively when liquid or particles approach the laryngeal vestibule.

- Most - protective sphincter - Adduction

Arytenoid cartilages: 2 pyramids in _____ larynx Sit atop the superior border of the _____ cartilage 2 significant processes: _____ process _____ process

- Posterior -Cricoid - Muscular process - Vocal process

Tracheal lymphatic drainage is via the _____ and _____ nodes

- Tracheal and tracheobronchial nodes

Extrinsic muscles of the larynx move the larynx as a _____: 1. _____ muscles are depressors 2. _____ muscles are elevators

- Unit 1. infrahyoid 2. Suprahyoid

Sensory Innervation of the larynx: -vocal cords and above is from _____ branch of _____ _____ nerve. -Below the vocal cords is from the _____ _____ nerve which branches off the _____ _____ nerve.

- Upper: Internal branch of superior laryngeal nerve - Lower: inferior laryngeal nerve which branches off the recurrent laryngeal nerve

What are the "false cords"? They are (superior/inferior) to the "true cords". These cords are _____ in color.

- Vestibular/ventricular folds - superior - Pink

1. What are the "true cords"? 2. Lack _____ 3. _____ colored appearance 4. Poor _____ = Less swelling in adults

- Vocal cords - submucosa - white - vascularity

Corniculate cartilages: Sit atop and articulate with _____ Located in _____ fold

- arytenoids - ary-epiglottic

Motor innervation to intrinsic muscles of the larynx: - Cricothyroid muscle is enervated via the _____ _____ nerve - All other muscles via the _____ _____ nerve - Mucous glands innervated by _____ nerves

- external branch of superior laryngeal nerve - recurrent laryngeal nerve - parasympathetic

What are the two types of Ligaments of the larynx? Their function is to hold the _____ _____ together.

- intrinsic and extrinsic - laryngeal cartilages

Laryngeal cavity extends from the _____ _____ to the inferior border of _____ _____.

- laryngeal inlet - cricoid cartilage

Intrinsic laryngeal ligaments connect _____ Median cricothyroid ligament is the site for _____ _____ placement.

- laryngocartilages - emergency airway

Epithelium of most of the larynx is _____ epithelium Exception to this is the _____ _____ _____, which are made of stratified squamous epithelium.

- respiratory - true vocal cords

The vocal ligament attaches to the _____ _____ of the arytenoid cartilage and extends to the _____ _____.

- vocal process - thyroid cartilage What she said in class: "The vocal ligament lies under the vocal cords; so that's that vocal process attachment of the arytenoid. The vocal cords are going to attach from the arytenoids down to the lower portion of the thyroid (cartilage?)." Moore Textbook says: "Each vocal fold contains a: vocal ligament, consisting of thickened elastic tissue that is the medial free edge of the conus elasticus... The vocal folds are the sharp-edged folds of mucous membrane overlying and incorporating the *vocal ligaments* and the thyroid-arytenoid muscles."

Blood supply larynx: 1. branches of ______ _____ _____ 2. _____ _____ artery 3. _____ _____ artery 4. _____ artery Venous drainage of larynx: 5. _____ _____

-Blood supply: 1. branches of superior/inferior thyroid arteries 2. Superior laryngeal artery 3. Inferior laryngeal artery 4. Cricothyroid artery -Venous drainage: 5. Internal jugular

What is the organ of voice production

-Larynx

What are the names of the paired laryngeal cartilages? (3)

1. Arytenoid cartilages 2. Corniculate cartilages 3. Cuneiform cartilages

What are the three extrinsic laryngeal ligaments?

1. Cricotracheal 2. Thyrohyoid 3. Hyoepiglottic

What are the names of the unpaired cartilages of the larynx?

1. Epiglottis 2. Thryroid cartilage 3. Cricoid cartilage

What are the three areas of the laryngeal cavity?

1. Laryngeal vestibule 2. Laryngeal ventricle 3. Infraglottic/subglottic cavity

1. How many laryngeal folds are there? 2. What are their names?

1. Two 2. Vestibular/ventricular folds & Vocal folds

Tracheal rings are incomplete on the (anterior/posterior) side where the trachea is adjacent to the __2___. These gaps are filled by a flat wall of (smooth/skeletal) muscle called the __4___.

1. posterior 2. esophagus 3. smooth muscle 4. trachealis muscle

Cuneiform cartilages: 1. Define their shape 2. Lie lateral to the _____ cartilage and under the cuniform tubercle

1. small cylinders 2. corniculate

How many incomplete tracheal cartilages does the trachea have?

16-20

What is the term for epliglottic folds formed from lateral walls of the epiglottis?

Ary-epiglottic folds

Where is the inferior border of the cricoid cartilage? (at which vertebra?) This border separates what?

At C6 separates upper & lower airways (cricoid = lowermost part of the upper airway)

What is the only cartilage that completely encircles the airway?

Cricoid cartilage

What is the only non-expandable portion of the larynx? In infants, this is the narrowest fixed part of the upper airway.

Cricoid cartilage

What structure is at the junction of the larynx and the trachea?

Cricoid cartilage

Lymphatic drainage of the larynx is via....?

Deep cervical lymph nodes.

Where does the cricoid cartilage lie?

Immediately below the thyroid cartilage

Blood supply to the trachea is from which three arteries? Venous drainage is from which three veins?

Inferior thyroid arteries Bronchial arteries Intercostal arteries Veins are "their corresponding veins".

What area of the laryngeal cavity lies between the vocal folds and inferior border of cricoid?

Infraglottic/subglottic cavity

Innervation of the trachea: 1. Sensory- _____ nerve (_____ and _____ very sensitive) 2. Motor & Mucous glands via (sympathetic/parasympathetic) fibers

Innervation of the trachea: 1. Sensory- Vagus nerve (Carina and true vocal cords very sensitive) 2. parasympathetic

What are the two categories of muscles of the larynx?

Intrinsic and extrinsic

Intrinsic muscles that modify the laryngeal inlet: (A) _____ - *Main tensors of vocal cords* (B) _____ -Main relaxers of vocal cords Vocalis muscles- promotes relaxation of cords (superior fibers epiglottis) (C) _____ _____ -Sole abductors of the vocal cords. (D) _____ _____ -Primary adductors of vocal folds (E) _____ _____- Adducts arytenoid cartilages closes posterior rima glottidis (F) _____ _____ - Adducts arytenoid cartilages closes posterior rima glottidis

Intrinsic muscles that modify the laryngeal inlet: (A) Cricothyroid (B) Thyroarytenoid {Vocalis muscles} (C) Posterior cricoarytenoid (D) Lateral cricoarytenoid (E) Transverse arytenoid (F) Oblique arytenoid

What area of the laryngeal cavity is the recesses extending laterally between vestibular and vocal folds?

Laryngeal ventricle

The epiglottis is a ____ shaped elastic cartilage posterior to the ____ of the tongue.

Leaf-shaped Root of tongue

An emergency airway needs to be placed. What anatomical site should be used?

Median cricothyroid ligament

The epiglottis is attached to the tongue by the ____ fold.

Median glossoepiglottic fold

The epithelium of the trachea is _____ epithelium with _____ glands in the submucosa.

Respiratory mucous

What is the opening between true cords and arytenoid cartilages?

Rima Glottidis

The narrowest part of the adult upper airway is the _____ _____.

Rima glottidis

The shape of the cricoid cartilage is described as being like a _____ _____.

Signet ring

What attaches to the muscular process of the arytenoids in the larynx?

The posterior and lateral cricoarytenoids

The trachea extends from _____ to _____ or _____ intervetebral disc (AKA the sternal angle) ______ is the lowermost portion of trachea. It is located at T___-T___

The trachea extends from C6 - T4 or T5. The carina is the lowest portion of the trachea and is located at T4 - T5

What is the largest cartilage of the larynx? Where does the "V" shaped opening project?

Thyroid Projects posteriorly

During swallowing, what sort of movement does the epiglottis make?

Tips posteriorly

What is the fibrocartilaginous tube supported by 16-20 incomplete cartilages?

Trachea

The depressions on each side of the median glossoepiglottic fold are called?

Vellecula

What area of the laryngeal cavity lies between the laryngeal inlet and vestibular folds?

laryngeal vestibule

What type of epithelium do the true vocal cords have?

stratified squamous epithelium

The lower end of the epiglottis is attached to ____ cartilage by ____ ligament

thyroid cartilage Thyroepiglottic ligament