the larynx. the larynx the larynx constitutes the organ of phonation and forms a protective...
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TheThelarynxlarynxTheThe
larynxlarynx
The LarynxThe LarynxThe LarynxThe Larynx The larynx constitutes the The larynx constitutes the organ of phonationorgan of phonation
and forms a and forms a protective sphincterprotective sphincter to the to the respiratory system.respiratory system.
It lies in the median part of the front of the neck, It lies in the median part of the front of the neck, opposite the opposite the 33rdrd, 4, 4thth, 5, 5thth and 6 and 6thth cervical cervical vertebrae.vertebrae.
It extends from the It extends from the upper border of epiglottisupper border of epiglottis to the lower border of to the lower border of cricoid cartilagecricoid cartilage..
Its upper end opens into the laryngopharynx by Its upper end opens into the laryngopharynx by the the laryngeal inletlaryngeal inlet..
Its lower end is Its lower end is continuous with the tracheacontinuous with the trachea at the level of the sixth cervical vertebra.at the level of the sixth cervical vertebra.
The larynx constitutes the The larynx constitutes the organ of phonationorgan of phonation and forms a and forms a protective sphincterprotective sphincter to the to the respiratory system.respiratory system.
It lies in the median part of the front of the neck, It lies in the median part of the front of the neck, opposite the opposite the 33rdrd, 4, 4thth, 5, 5thth and 6 and 6thth cervical cervical vertebrae.vertebrae.
It extends from the It extends from the upper border of epiglottisupper border of epiglottis to the lower border of to the lower border of cricoid cartilagecricoid cartilage..
Its upper end opens into the laryngopharynx by Its upper end opens into the laryngopharynx by the the laryngeal inletlaryngeal inlet..
Its lower end is Its lower end is continuous with the tracheacontinuous with the trachea at the level of the sixth cervical vertebra.at the level of the sixth cervical vertebra.
The LarynxThe LarynxThe LarynxThe Larynx The larynx is formed by a The larynx is formed by a cartilaginouscartilaginous skeleton skeleton
attached together by attached together by jointsjoints and and ligamentsligaments and moved and moved by by musclesmuscles and all are covered by and all are covered by mucous mucous membranemembrane..
Laryngeal cartilages:Laryngeal cartilages:A.A. SingleSingle::
1.1. Thyroid cartilage.Thyroid cartilage.2.2. Cricoid cartilage.Cricoid cartilage.3.3. Epiglottis cartilage.Epiglottis cartilage.
B.B. Paired:Paired:1.1. Arytenoid cartilages.Arytenoid cartilages.2.2. Corniculate cartilages.Corniculate cartilages.3.3. Cuneiform cartilages.Cuneiform cartilages.
The larynx is formed by a The larynx is formed by a cartilaginouscartilaginous skeleton skeleton attached together by attached together by jointsjoints and and ligamentsligaments and moved and moved by by musclesmuscles and all are covered by and all are covered by mucous mucous membranemembrane..
Laryngeal cartilages:Laryngeal cartilages:A.A. SingleSingle::
1.1. Thyroid cartilage.Thyroid cartilage.2.2. Cricoid cartilage.Cricoid cartilage.3.3. Epiglottis cartilage.Epiglottis cartilage.
B.B. Paired:Paired:1.1. Arytenoid cartilages.Arytenoid cartilages.2.2. Corniculate cartilages.Corniculate cartilages.3.3. Cuneiform cartilages.Cuneiform cartilages.
Thyroid CartilageThyroid CartilageThyroid CartilageThyroid CartilageThe largest laryngeal cartilage.The largest laryngeal cartilage.Formed of 2 quadrilateral Formed of 2 quadrilateral laminaelaminae which are which are fused fused anteriorly.anteriorly.PosteriorlyPosteriorly, the 2 laminae are , the 2 laminae are separatedseparated by a wide gap by a wide gapThe The anterior borderanterior border forms a median forms a median projectionprojection, the , the laryngeal prominence.laryngeal prominence.The laminae present a median The laminae present a median V-shaped notchV-shaped notch, the , the superior thyroid notch.superior thyroid notch.The The posterior bordersposterior borders form upward and downward form upward and downward projectionsprojections, , superior and inferior horns.superior and inferior horns.The The outer surfaceouter surface of each lamina shows an oblique of each lamina shows an oblique ridge, the ridge, the oblique line.oblique line.The oblique line extends between two The oblique line extends between two tuberclestubercles, the , the superior and inferior superior and inferior thyroid tubercles.thyroid tubercles.
The largest laryngeal cartilage.The largest laryngeal cartilage.Formed of 2 quadrilateral Formed of 2 quadrilateral laminaelaminae which are which are fused fused anteriorly.anteriorly.PosteriorlyPosteriorly, the 2 laminae are , the 2 laminae are separatedseparated by a wide gap by a wide gapThe The anterior borderanterior border forms a median forms a median projectionprojection, the , the laryngeal prominence.laryngeal prominence.The laminae present a median The laminae present a median V-shaped notchV-shaped notch, the , the superior thyroid notch.superior thyroid notch.The The posterior bordersposterior borders form upward and downward form upward and downward projectionsprojections, , superior and inferior horns.superior and inferior horns.The The outer surfaceouter surface of each lamina shows an oblique of each lamina shows an oblique ridge, the ridge, the oblique line.oblique line.The oblique line extends between two The oblique line extends between two tuberclestubercles, the , the superior and inferior superior and inferior thyroid tubercles.thyroid tubercles.
Cricoid CartilageCricoid CartilageCricoid CartilageCricoid CartilageSmaller, but thicker than the thyroid cartilage.Smaller, but thicker than the thyroid cartilage.Lies below and behind the thyroid cartilage.Lies below and behind the thyroid cartilage.It has the shape of a It has the shape of a signet ringsignet ring with a quadrilateral with a quadrilateral laminalamina posteriorly and a narrow posteriorly and a narrow archarch anteriorly. anteriorly.Its lower border is horizontal.Its lower border is horizontal.Its upper border is sloping.Its upper border is sloping.
Smaller, but thicker than the thyroid cartilage.Smaller, but thicker than the thyroid cartilage.Lies below and behind the thyroid cartilage.Lies below and behind the thyroid cartilage.It has the shape of a It has the shape of a signet ringsignet ring with a quadrilateral with a quadrilateral laminalamina posteriorly and a narrow posteriorly and a narrow archarch anteriorly. anteriorly.Its lower border is horizontal.Its lower border is horizontal.Its upper border is sloping.Its upper border is sloping.
Epiglottis CartilageEpiglottis CartilageEpiglottis CartilageEpiglottis CartilageA leaf-shaped lamella of elastic cartilage.It projects upwards behind the tongue and hyoid bone.Has an upper broad free end and a lower tapering end.Anteriorly, it is connected to:– The root of the tongue, by the median and lateral glosso-
epiglottic folds.– The hyoid bone, by the hyoepiglottic ligament.– The inner surface of the thyroid cartilage by the
thyroepiglottic ligament.
A leaf-shaped lamella of elastic cartilage.It projects upwards behind the tongue and hyoid bone.Has an upper broad free end and a lower tapering end.Anteriorly, it is connected to:– The root of the tongue, by the median and lateral glosso-
epiglottic folds.– The hyoid bone, by the hyoepiglottic ligament.– The inner surface of the thyroid cartilage by the
thyroepiglottic ligament.
Arytenoid CartilageArytenoid CartilageArytenoid CartilageArytenoid CartilageA pyramidal-shaped cartilage, with an apex, base and 3 A pyramidal-shaped cartilage, with an apex, base and 3 surfaces:surfaces:
– Posterior surface.Posterior surface.
– Anterolateral surface.Anterolateral surface.
– Medial surface.Medial surface.
The apex is directed upwards and articulates with the The apex is directed upwards and articulates with the corniculate cartilage.corniculate cartilage.
The base is directed downwards and articulates with the The base is directed downwards and articulates with the upper border of the lamina of cricoid cartilage.upper border of the lamina of cricoid cartilage.
The lateral angle of the base projects and forms the The lateral angle of the base projects and forms the muscular processmuscular process..
The anterior angle of the base projects to form the The anterior angle of the base projects to form the vocal vocal processprocess..
A pyramidal-shaped cartilage, with an apex, base and 3 A pyramidal-shaped cartilage, with an apex, base and 3 surfaces:surfaces:
– Posterior surface.Posterior surface.
– Anterolateral surface.Anterolateral surface.
– Medial surface.Medial surface.
The apex is directed upwards and articulates with the The apex is directed upwards and articulates with the corniculate cartilage.corniculate cartilage.
The base is directed downwards and articulates with the The base is directed downwards and articulates with the upper border of the lamina of cricoid cartilage.upper border of the lamina of cricoid cartilage.
The lateral angle of the base projects and forms the The lateral angle of the base projects and forms the muscular processmuscular process..
The anterior angle of the base projects to form the The anterior angle of the base projects to form the vocal vocal processprocess..
Corniculate CartilageCorniculate CartilageCorniculate CartilageCorniculate Cartilage A small cartilage on the apex of the arytenoid A small cartilage on the apex of the arytenoid
cartilagecartilage Enclosed in the aryepiglottic fold forming the Enclosed in the aryepiglottic fold forming the
corniculate tuberclecorniculate tubercle
A small cartilage on the apex of the arytenoid A small cartilage on the apex of the arytenoid cartilagecartilage
Enclosed in the aryepiglottic fold forming the Enclosed in the aryepiglottic fold forming the corniculate tuberclecorniculate tubercle
Cuneiform CartilageCuneiform CartilageCuneiform CartilageCuneiform Cartilage A small nodule enclosed in the aryepiglottic
fold forming the cuneiform tubercle A small nodule enclosed in the aryepiglottic
fold forming the cuneiform tubercle
Joints of the LarynxJoints of the LarynxJoints of the LarynxJoints of the LarynxCricothyroid joints:Cricothyroid joints:– One on each side.One on each side.– A synovial joint between the inferior horn of the A synovial joint between the inferior horn of the
thyroid cartilage and the side of the cricoid thyroid cartilage and the side of the cricoid cartilage.cartilage.
Cricoarytenoid joints:Cricoarytenoid joints:– One on each side.One on each side.– A synovial joint between the base of arytenoid A synovial joint between the base of arytenoid
cartilage and upper border of the lamina of cricoid cartilage and upper border of the lamina of cricoid cartilage.cartilage.
Arycorniculate joints:Arycorniculate joints:– One on each side.One on each side.– A joint between the apex of the arytenoid cartilage A joint between the apex of the arytenoid cartilage
and the corniculate cartilage.and the corniculate cartilage.
Cricothyroid joints:Cricothyroid joints:– One on each side.One on each side.– A synovial joint between the inferior horn of the A synovial joint between the inferior horn of the
thyroid cartilage and the side of the cricoid thyroid cartilage and the side of the cricoid cartilage.cartilage.
Cricoarytenoid joints:Cricoarytenoid joints:– One on each side.One on each side.– A synovial joint between the base of arytenoid A synovial joint between the base of arytenoid
cartilage and upper border of the lamina of cricoid cartilage and upper border of the lamina of cricoid cartilage.cartilage.
Arycorniculate joints:Arycorniculate joints:– One on each side.One on each side.– A joint between the apex of the arytenoid cartilage A joint between the apex of the arytenoid cartilage
and the corniculate cartilage.and the corniculate cartilage.
Membranes and ligamentsMembranes and ligamentsMembranes and ligamentsMembranes and ligaments
1.1. Thyrohyoid membrane and ligaments.Thyrohyoid membrane and ligaments.2.2. Fibroelastic membrane.Fibroelastic membrane.3.3. Quadrangular membrane.Quadrangular membrane.4.4. Vestibular ligament.Vestibular ligament.5.5. Cricothyroid ligament (conus elasticus).Cricothyroid ligament (conus elasticus).6.6. Vocal ligament.Vocal ligament.7.7. Hyoepiglottic ligament.Hyoepiglottic ligament.8.8. Thyroepiglottic ligament.Thyroepiglottic ligament.9.9. Cricotracheal ligament.Cricotracheal ligament.
1.1. Thyrohyoid membrane and ligaments.Thyrohyoid membrane and ligaments.2.2. Fibroelastic membrane.Fibroelastic membrane.3.3. Quadrangular membrane.Quadrangular membrane.4.4. Vestibular ligament.Vestibular ligament.5.5. Cricothyroid ligament (conus elasticus).Cricothyroid ligament (conus elasticus).6.6. Vocal ligament.Vocal ligament.7.7. Hyoepiglottic ligament.Hyoepiglottic ligament.8.8. Thyroepiglottic ligament.Thyroepiglottic ligament.9.9. Cricotracheal ligament.Cricotracheal ligament.
Thyrohyoid membraneThyrohyoid membraneThyrohyoid membraneThyrohyoid membraneExtends from the Extends from the upper borderupper border of thyroid cartilage to of thyroid cartilage to the the upper borderupper border of posterior surface of hyoid bone of posterior surface of hyoid bone
Separated from the posterior surface of hyoid bone Separated from the posterior surface of hyoid bone by the by the hyoid bursahyoid bursa..
The median part of the membrane is thickened to The median part of the membrane is thickened to form the form the median thyrohyoid ligamentmedian thyrohyoid ligament..
The posterior border is thickened to form the The posterior border is thickened to form the lateral lateral thyrohyoid ligamentthyrohyoid ligament..
The membrane is The membrane is piercedpierced by the by the superior laryngeal superior laryngeal vesselsvessels and the and the internal laryngeal nerveinternal laryngeal nerve..
The lateral thyrohyoid ligament contains a cartilage The lateral thyrohyoid ligament contains a cartilage nodule called the nodule called the cartilago triticeacartilago triticea..
Extends from the Extends from the upper borderupper border of thyroid cartilage to of thyroid cartilage to the the upper borderupper border of posterior surface of hyoid bone of posterior surface of hyoid bone
Separated from the posterior surface of hyoid bone Separated from the posterior surface of hyoid bone by the by the hyoid bursahyoid bursa..
The median part of the membrane is thickened to The median part of the membrane is thickened to form the form the median thyrohyoid ligamentmedian thyrohyoid ligament..
The posterior border is thickened to form the The posterior border is thickened to form the lateral lateral thyrohyoid ligamentthyrohyoid ligament..
The membrane is The membrane is piercedpierced by the by the superior laryngeal superior laryngeal vesselsvessels and the and the internal laryngeal nerveinternal laryngeal nerve..
The lateral thyrohyoid ligament contains a cartilage The lateral thyrohyoid ligament contains a cartilage nodule called the nodule called the cartilago triticeacartilago triticea..
Fibroelastic membraneFibroelastic membraneFibroelastic membraneFibroelastic membraneIts upper part is called Its upper part is called quadrangular membranequadrangular membrane and its and its lower parts is called lower parts is called cricothyroid ligament (conus cricothyroid ligament (conus elasticus).elasticus).
The quadrangular membrane:The quadrangular membrane:
– It extends between the lateral border of the epiglottis It extends between the lateral border of the epiglottis and the arytenoid cartilage.and the arytenoid cartilage.
– Its lower free border forms the Its lower free border forms the vestibular ligamentvestibular ligament..
The cricothyroid ligament (conus elasticus):The cricothyroid ligament (conus elasticus):
– An elastic band which lies below and on the inner An elastic band which lies below and on the inner aspect of the thyroid cartilage.aspect of the thyroid cartilage.
– It is connected to thyroid cartilage, cricoid cartilage It is connected to thyroid cartilage, cricoid cartilage and arytenoid cartilage.and arytenoid cartilage.
– Two parts of the ligament can be recognized:Two parts of the ligament can be recognized:
Its upper part is called Its upper part is called quadrangular membranequadrangular membrane and its and its lower parts is called lower parts is called cricothyroid ligament (conus cricothyroid ligament (conus elasticus).elasticus).
The quadrangular membrane:The quadrangular membrane:
– It extends between the lateral border of the epiglottis It extends between the lateral border of the epiglottis and the arytenoid cartilage.and the arytenoid cartilage.
– Its lower free border forms the Its lower free border forms the vestibular ligamentvestibular ligament..
The cricothyroid ligament (conus elasticus):The cricothyroid ligament (conus elasticus):
– An elastic band which lies below and on the inner An elastic band which lies below and on the inner aspect of the thyroid cartilage.aspect of the thyroid cartilage.
– It is connected to thyroid cartilage, cricoid cartilage It is connected to thyroid cartilage, cricoid cartilage and arytenoid cartilage.and arytenoid cartilage.
– Two parts of the ligament can be recognized:Two parts of the ligament can be recognized:
1.1. Median cricothyroid ligament:Median cricothyroid ligament:– the the anterioranterior thickened part of the ligament which thickened part of the ligament which
connects the adjacent borders of the cricoid and thyroid connects the adjacent borders of the cricoid and thyroid cartilages.cartilages.
– The ligament is overlapped by the The ligament is overlapped by the cricothyroid musclecricothyroid muscle..2.2. Lateral cricothyroid ligament (crico-vocal membrane)Lateral cricothyroid ligament (crico-vocal membrane)
– this ligament is attached inferiorly to the upper border of this ligament is attached inferiorly to the upper border of cricoid cartilagecricoid cartilage
– superiorly, it has 2 attachments:superiorly, it has 2 attachments:to the inner surface of to the inner surface of thyroid cartilagethyroid cartilage, anteriorly., anteriorly.to the to the vocal processvocal process of arytenoid cartilage, of arytenoid cartilage, posteriorly.posteriorly.
– The free upper border of the crico-vocal membrane is The free upper border of the crico-vocal membrane is called the called the Vocal LigamentVocal Ligament..
– So, the So, the vocal ligamentvocal ligament is attached to the is attached to the inner surfaceinner surface of thyroid cartilage (anteriorly) and to the of thyroid cartilage (anteriorly) and to the vocal process vocal process of the arytenoid cartilage (posteriorly).of the arytenoid cartilage (posteriorly).
1.1. Median cricothyroid ligament:Median cricothyroid ligament:– the the anterioranterior thickened part of the ligament which thickened part of the ligament which
connects the adjacent borders of the cricoid and thyroid connects the adjacent borders of the cricoid and thyroid cartilages.cartilages.
– The ligament is overlapped by the The ligament is overlapped by the cricothyroid musclecricothyroid muscle..2.2. Lateral cricothyroid ligament (crico-vocal membrane)Lateral cricothyroid ligament (crico-vocal membrane)
– this ligament is attached inferiorly to the upper border of this ligament is attached inferiorly to the upper border of cricoid cartilagecricoid cartilage
– superiorly, it has 2 attachments:superiorly, it has 2 attachments:to the inner surface of to the inner surface of thyroid cartilagethyroid cartilage, anteriorly., anteriorly.to the to the vocal processvocal process of arytenoid cartilage, of arytenoid cartilage, posteriorly.posteriorly.
– The free upper border of the crico-vocal membrane is The free upper border of the crico-vocal membrane is called the called the Vocal LigamentVocal Ligament..
– So, the So, the vocal ligamentvocal ligament is attached to the is attached to the inner surfaceinner surface of thyroid cartilage (anteriorly) and to the of thyroid cartilage (anteriorly) and to the vocal process vocal process of the arytenoid cartilage (posteriorly).of the arytenoid cartilage (posteriorly).
Hyo-epiglottic ligamentHyo-epiglottic ligament:: connects the connects the anterior surface of epiglottis to the hyoid boneanterior surface of epiglottis to the hyoid bone
Thyro-epiglottic ligamentThyro-epiglottic ligament:: connects the connects the lower end of the epiglottis to the inner surface lower end of the epiglottis to the inner surface of thyroid cartilageof thyroid cartilage
Crico-tracheal ligamentCrico-tracheal ligament:: connects the lower connects the lower border of the cricoid cartilage to the first ring of border of the cricoid cartilage to the first ring of tracheatrachea
Ligaments of the jointsLigaments of the joints..
Hyo-epiglottic ligamentHyo-epiglottic ligament:: connects the connects the anterior surface of epiglottis to the hyoid boneanterior surface of epiglottis to the hyoid bone
Thyro-epiglottic ligamentThyro-epiglottic ligament:: connects the connects the lower end of the epiglottis to the inner surface lower end of the epiglottis to the inner surface of thyroid cartilageof thyroid cartilage
Crico-tracheal ligamentCrico-tracheal ligament:: connects the lower connects the lower border of the cricoid cartilage to the first ring of border of the cricoid cartilage to the first ring of tracheatrachea
Ligaments of the jointsLigaments of the joints..
Other ligamentsOther ligamentsOther ligamentsOther ligaments
Laryngeal InletLaryngeal InletLaryngeal InletLaryngeal InletThe opening of communication between the pharynx The opening of communication between the pharynx and larynx.and larynx.It is directed upwards and backwardsIt is directed upwards and backwardsBoundaries:Boundaries:– Upper border of Upper border of epiglottisepiglottis anteriorly.anteriorly.– Aryepiglottic foldsAryepiglottic folds on both sides. on both sides.– Mucous membrane between the arytenoid Mucous membrane between the arytenoid
cartilages posteriorly.cartilages posteriorly.Aryepiglottic fold:Aryepiglottic fold:– Is a fold of mucosa extending between the apex of Is a fold of mucosa extending between the apex of
arytenoid cartilage and the side of epiglottis.arytenoid cartilage and the side of epiglottis.– It encloses the It encloses the aryepiglottic musclearyepiglottic muscle, , cuneiform cuneiform
and and corniculatecorniculate cartilages. cartilages.
The opening of communication between the pharynx The opening of communication between the pharynx and larynx.and larynx.It is directed upwards and backwardsIt is directed upwards and backwardsBoundaries:Boundaries:– Upper border of Upper border of epiglottisepiglottis anteriorly.anteriorly.– Aryepiglottic foldsAryepiglottic folds on both sides. on both sides.– Mucous membrane between the arytenoid Mucous membrane between the arytenoid
cartilages posteriorly.cartilages posteriorly.Aryepiglottic fold:Aryepiglottic fold:– Is a fold of mucosa extending between the apex of Is a fold of mucosa extending between the apex of
arytenoid cartilage and the side of epiglottis.arytenoid cartilage and the side of epiglottis.– It encloses the It encloses the aryepiglottic musclearyepiglottic muscle, , cuneiform cuneiform
and and corniculatecorniculate cartilages. cartilages.
Laryngeal CavityLaryngeal CavityLaryngeal CavityLaryngeal CavityVocal fold:Vocal fold:
– A fold of mucous membrane extending from the inner A fold of mucous membrane extending from the inner surface of surface of thyroid cartilagethyroid cartilage to the to the vocal process of vocal process of arytenoid cartilage.arytenoid cartilage.
– The folds enclose the The folds enclose the vocal ligamentsvocal ligaments (upper border of (upper border of lateral cricothyroid ligaments).lateral cricothyroid ligaments).
– The fissure between the 2 vocal folds is called the The fissure between the 2 vocal folds is called the rima rima glottidis.glottidis.
Vestibular fold:Vestibular fold:– A fold of mucous membrane extending from the inner A fold of mucous membrane extending from the inner
surface of surface of thyroid cartilagethyroid cartilage to the to the anterolateral surface anterolateral surface of arytenoid cartilage.of arytenoid cartilage.
– It encloses a fibrous band called the It encloses a fibrous band called the vestibular ligament.vestibular ligament.Sinus of the larynx:Sinus of the larynx:
– A recess between the vestibular and vocal foldsA recess between the vestibular and vocal foldsVestibule of the larynx:Vestibule of the larynx:
– The part of the cavity between the inlet and the vestibular The part of the cavity between the inlet and the vestibular foldsfolds
Vocal fold:Vocal fold:– A fold of mucous membrane extending from the inner A fold of mucous membrane extending from the inner
surface of surface of thyroid cartilagethyroid cartilage to the to the vocal process of vocal process of arytenoid cartilage.arytenoid cartilage.
– The folds enclose the The folds enclose the vocal ligamentsvocal ligaments (upper border of (upper border of lateral cricothyroid ligaments).lateral cricothyroid ligaments).
– The fissure between the 2 vocal folds is called the The fissure between the 2 vocal folds is called the rima rima glottidis.glottidis.
Vestibular fold:Vestibular fold:– A fold of mucous membrane extending from the inner A fold of mucous membrane extending from the inner
surface of surface of thyroid cartilagethyroid cartilage to the to the anterolateral surface anterolateral surface of arytenoid cartilage.of arytenoid cartilage.
– It encloses a fibrous band called the It encloses a fibrous band called the vestibular ligament.vestibular ligament.Sinus of the larynx:Sinus of the larynx:
– A recess between the vestibular and vocal foldsA recess between the vestibular and vocal foldsVestibule of the larynx:Vestibule of the larynx:
– The part of the cavity between the inlet and the vestibular The part of the cavity between the inlet and the vestibular foldsfolds
Muscles of the larynxMuscles of the larynxMuscles of the larynxMuscles of the larynxExtrinsic muscle:Extrinsic muscle:
– Elevators:Elevators:Digastric, stylohyoid, mylohyoid, geniohyoid, Digastric, stylohyoid, mylohyoid, geniohyoid, stylopharyngeus, salpingopharyngeus and palatopharyngeus.stylopharyngeus, salpingopharyngeus and palatopharyngeus.
– Depressors:Depressors:Sternothyroid, sternohyoid, omohyoid muscles and the elastic Sternothyroid, sternohyoid, omohyoid muscles and the elastic recoil of the trachea.recoil of the trachea.
Intrinsic muscles:Intrinsic muscles:– Acting on the laryngeal inlet:Acting on the laryngeal inlet:
Narrowing:Narrowing: oblique arytenoid and aryepiglottic muscles. oblique arytenoid and aryepiglottic muscles.Widening:Widening: thyroepiglottic muscle. thyroepiglottic muscle.
– Acting on the vocal cords:Acting on the vocal cords:Sphincteric action:Sphincteric action:– Adduction:Adduction: lateral cricoarytenoid & transverse arytenoid. lateral cricoarytenoid & transverse arytenoid.– Abduction:Abduction: posterior cricoarytenoid. posterior cricoarytenoid.Change in length and tension:Change in length and tension:– Elongation and tension:Elongation and tension: cricothyroid. cricothyroid.– Shortening and relaxation:Shortening and relaxation: thyroarytenoid and vocalis. thyroarytenoid and vocalis.
Extrinsic muscle:Extrinsic muscle:– Elevators:Elevators:
Digastric, stylohyoid, mylohyoid, geniohyoid, Digastric, stylohyoid, mylohyoid, geniohyoid, stylopharyngeus, salpingopharyngeus and palatopharyngeus.stylopharyngeus, salpingopharyngeus and palatopharyngeus.
– Depressors:Depressors:Sternothyroid, sternohyoid, omohyoid muscles and the elastic Sternothyroid, sternohyoid, omohyoid muscles and the elastic recoil of the trachea.recoil of the trachea.
Intrinsic muscles:Intrinsic muscles:– Acting on the laryngeal inlet:Acting on the laryngeal inlet:
Narrowing:Narrowing: oblique arytenoid and aryepiglottic muscles. oblique arytenoid and aryepiglottic muscles.Widening:Widening: thyroepiglottic muscle. thyroepiglottic muscle.
– Acting on the vocal cords:Acting on the vocal cords:Sphincteric action:Sphincteric action:– Adduction:Adduction: lateral cricoarytenoid & transverse arytenoid. lateral cricoarytenoid & transverse arytenoid.– Abduction:Abduction: posterior cricoarytenoid. posterior cricoarytenoid.Change in length and tension:Change in length and tension:– Elongation and tension:Elongation and tension: cricothyroid. cricothyroid.– Shortening and relaxation:Shortening and relaxation: thyroarytenoid and vocalis. thyroarytenoid and vocalis.
Oblique arytenoid MuscleOblique arytenoid MuscleOblique arytenoid MuscleOblique arytenoid Muscle
OriginOrigin:: from the back of the muscular from the back of the muscular process of the arytenoid cartilage.process of the arytenoid cartilage.
InsertionInsertion:: into the apex of the opposite into the apex of the opposite arytenoid cartilage.arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: narrowing of the laryngeal inlet narrowing of the laryngeal inlet by bringing the two aryepiglottic folds by bringing the two aryepiglottic folds together.together.
OriginOrigin:: from the back of the muscular from the back of the muscular process of the arytenoid cartilage.process of the arytenoid cartilage.
InsertionInsertion:: into the apex of the opposite into the apex of the opposite arytenoid cartilage.arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: narrowing of the laryngeal inlet narrowing of the laryngeal inlet by bringing the two aryepiglottic folds by bringing the two aryepiglottic folds together.together.
Aryepiglottic MuscleAryepiglottic MuscleAryepiglottic MuscleAryepiglottic Muscle
OriginOrigin:: from the apex of the arytenoid from the apex of the arytenoid cartilage as a continuation of the oblique cartilage as a continuation of the oblique arytenoid muscle.arytenoid muscle.
InsertionInsertion:: into the side of the epiglottis into the side of the epiglottis cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: narrowing of the laryngeal inlet narrowing of the laryngeal inlet by shortening the aryepiglottic fold.by shortening the aryepiglottic fold.
OriginOrigin:: from the apex of the arytenoid from the apex of the arytenoid cartilage as a continuation of the oblique cartilage as a continuation of the oblique arytenoid muscle.arytenoid muscle.
InsertionInsertion:: into the side of the epiglottis into the side of the epiglottis cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: narrowing of the laryngeal inlet narrowing of the laryngeal inlet by shortening the aryepiglottic fold.by shortening the aryepiglottic fold.
Thyroepiglottic MuscleThyroepiglottic MuscleThyroepiglottic MuscleThyroepiglottic Muscle
OriginOrigin:: from the inner surface of the from the inner surface of the thyroid cartilage.thyroid cartilage.
InsertionInsertion:: into the side of the epiglottis into the side of the epiglottis cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: widening of the laryngeal inlet. widening of the laryngeal inlet.
OriginOrigin:: from the inner surface of the from the inner surface of the thyroid cartilage.thyroid cartilage.
InsertionInsertion:: into the side of the epiglottis into the side of the epiglottis cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: widening of the laryngeal inlet. widening of the laryngeal inlet.
Lateral Cricoarytenoid MuscleLateral Cricoarytenoid MuscleLateral Cricoarytenoid MuscleLateral Cricoarytenoid Muscle
OriginOrigin:: from the upper border of the arch from the upper border of the arch of cricoid cartilage.of cricoid cartilage.
InsertionInsertion:: into the muscular process of into the muscular process of the arytenoid cartilage.the arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Adduction of the vocal cords by Adduction of the vocal cords by rotation of the arytenoid cartilage.rotation of the arytenoid cartilage.
OriginOrigin:: from the upper border of the arch from the upper border of the arch of cricoid cartilage.of cricoid cartilage.
InsertionInsertion:: into the muscular process of into the muscular process of the arytenoid cartilage.the arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Adduction of the vocal cords by Adduction of the vocal cords by rotation of the arytenoid cartilage.rotation of the arytenoid cartilage.
Transverse Arytenoid MuscleTransverse Arytenoid MuscleTransverse Arytenoid MuscleTransverse Arytenoid Muscle
OriginOrigin:: from the back and medial surface from the back and medial surface of the arytenoid cartilage.of the arytenoid cartilage.
InsertionInsertion:: into the back and medial into the back and medial surface of the opposite arytenoid surface of the opposite arytenoid cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Adduction of the vocal cords by Adduction of the vocal cords by approximating the arytenoid cartilages.approximating the arytenoid cartilages.
OriginOrigin:: from the back and medial surface from the back and medial surface of the arytenoid cartilage.of the arytenoid cartilage.
InsertionInsertion:: into the back and medial into the back and medial surface of the opposite arytenoid surface of the opposite arytenoid cartilage.cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Adduction of the vocal cords by Adduction of the vocal cords by approximating the arytenoid cartilages.approximating the arytenoid cartilages.
Posterior Cricoarytenoid MusclePosterior Cricoarytenoid MusclePosterior Cricoarytenoid MusclePosterior Cricoarytenoid Muscle
OriginOrigin:: from the posterior surface of the from the posterior surface of the lamina of the cricoid cartilage.lamina of the cricoid cartilage.
InsertionInsertion:: into the muscular process of into the muscular process of the arytenoid cartilage.the arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Abduction of the vocal cords by Abduction of the vocal cords by rotating the arytenoid cartilage.rotating the arytenoid cartilage.
OriginOrigin:: from the posterior surface of the from the posterior surface of the lamina of the cricoid cartilage.lamina of the cricoid cartilage.
InsertionInsertion:: into the muscular process of into the muscular process of the arytenoid cartilage.the arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: Abduction of the vocal cords by Abduction of the vocal cords by rotating the arytenoid cartilage.rotating the arytenoid cartilage.
Thyroarytenoid MuscleThyroarytenoid MuscleThyroarytenoid MuscleThyroarytenoid Muscle
OriginOrigin:: from the inner surface of thyroid from the inner surface of thyroid cartilage lateral to the cricothyroid cartilage lateral to the cricothyroid ligament.ligament.
InsertionInsertion:: into the antero-lateral surface into the antero-lateral surface of arytenoid cartilage.of arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve).(branch of vagus nerve).
ActionAction:: shortening and relaxation of the shortening and relaxation of the vocal fold.vocal fold.
OriginOrigin:: from the inner surface of thyroid from the inner surface of thyroid cartilage lateral to the cricothyroid cartilage lateral to the cricothyroid ligament.ligament.
InsertionInsertion:: into the antero-lateral surface into the antero-lateral surface of arytenoid cartilage.of arytenoid cartilage.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve).(branch of vagus nerve).
ActionAction:: shortening and relaxation of the shortening and relaxation of the vocal fold.vocal fold.
Vocalis MuscleVocalis MuscleVocalis MuscleVocalis Muscle
OriginOrigin:: deep fibers of thyroarytenoid. deep fibers of thyroarytenoid.
InsertionInsertion:: into the vocal process of into the vocal process of arytenoid cartilage and vocal ligament.arytenoid cartilage and vocal ligament.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: shortening and relaxation of the shortening and relaxation of the vocal fold.vocal fold.
OriginOrigin:: deep fibers of thyroarytenoid. deep fibers of thyroarytenoid.
InsertionInsertion:: into the vocal process of into the vocal process of arytenoid cartilage and vocal ligament.arytenoid cartilage and vocal ligament.
Nerve supplyNerve supply:: recurrent laryngeal nerve recurrent laryngeal nerve (branch of vagus nerve.(branch of vagus nerve.
ActionAction:: shortening and relaxation of the shortening and relaxation of the vocal fold.vocal fold.
Nerve Supply of the LarynxNerve Supply of the LarynxNerve Supply of the LarynxNerve Supply of the Larynx1.1. Superior laryngeal nerveSuperior laryngeal nerve (from vagus nerve) (from vagus nerve)
divides into:divides into:
A.A. External laryngeal nerveExternal laryngeal nerve (motor) (motor): supplies the : supplies the cricothyroid musclecricothyroid muscle..
B.B. Internal laryngeal nerveInternal laryngeal nerve (sensory) (sensory): supplies : supplies the the mucous membranemucous membrane aboveabove the level of the the level of the vocal folds.vocal folds.
2.2. Recurrent laryngeal nerveRecurrent laryngeal nerve (from vagus nerve) (from vagus nerve) divides into divides into motormotor and and sensorysensory branches: branches:– The motor branch supplies The motor branch supplies ALLALL intrinsic muscles intrinsic muscles
of the larynx (of the larynx (except cricothyroid muscleexcept cricothyroid muscle).).– The sensory branch supplies the The sensory branch supplies the mucous mucous
membrane membrane belowbelow the level of the vocal folds. the level of the vocal folds.
1.1. Superior laryngeal nerveSuperior laryngeal nerve (from vagus nerve) (from vagus nerve) divides into:divides into:
A.A. External laryngeal nerveExternal laryngeal nerve (motor) (motor): supplies the : supplies the cricothyroid musclecricothyroid muscle..
B.B. Internal laryngeal nerveInternal laryngeal nerve (sensory) (sensory): supplies : supplies the the mucous membranemucous membrane aboveabove the level of the the level of the vocal folds.vocal folds.
2.2. Recurrent laryngeal nerveRecurrent laryngeal nerve (from vagus nerve) (from vagus nerve) divides into divides into motormotor and and sensorysensory branches: branches:– The motor branch supplies The motor branch supplies ALLALL intrinsic muscles intrinsic muscles
of the larynx (of the larynx (except cricothyroid muscleexcept cricothyroid muscle).).– The sensory branch supplies the The sensory branch supplies the mucous mucous
membrane membrane belowbelow the level of the vocal folds. the level of the vocal folds.
Blood supply of the Blood supply of the larynxlarynx
Blood supply of the Blood supply of the larynxlarynx
Arterial supply of the larynxArterial supply of the larynx::
1.1. Superior laryngeal artery (from superior Superior laryngeal artery (from superior thyroid artery from external carotid artery).thyroid artery from external carotid artery).
2.2. Inferior laryngeal artery (from inferior thyroid Inferior laryngeal artery (from inferior thyroid artery from thyrocervical trunk from 1artery from thyrocervical trunk from 1stst part part of subclavian artery).of subclavian artery).
Arterial supply of the larynxArterial supply of the larynx::
1.1. Superior laryngeal artery (from superior Superior laryngeal artery (from superior thyroid artery from external carotid artery).thyroid artery from external carotid artery).
2.2. Inferior laryngeal artery (from inferior thyroid Inferior laryngeal artery (from inferior thyroid artery from thyrocervical trunk from 1artery from thyrocervical trunk from 1stst part part of subclavian artery).of subclavian artery).
Lymph drainage of the Lymph drainage of the larynxlarynx
Lymph drainage of the Lymph drainage of the larynxlarynx
To the deep cervical lymph nodes.To the deep cervical lymph nodes.
Clinical Points of the LarynxClinical Points of the LarynxClinical Points of the LarynxClinical Points of the Larynx1.1. Injury of the external laryngeal nerve:Injury of the external laryngeal nerve:
Paralysis of the cricothyroid muscle which Paralysis of the cricothyroid muscle which affects the voice (weakness) with no effect affects the voice (weakness) with no effect on air pathway.on air pathway.
2.2. Injury of the recurrent laryngeal nerve:Injury of the recurrent laryngeal nerve:
1.1. Unilateral complete sectionUnilateral complete section: the affected : the affected vocal cord will be between adduction and vocal cord will be between adduction and abduction (cadaveric position). The other abduction (cadaveric position). The other cord will compensate and crosses to the cord will compensate and crosses to the other side and this will not affect the voice other side and this will not affect the voice or respirationor respiration
1.1. Injury of the external laryngeal nerve:Injury of the external laryngeal nerve:
Paralysis of the cricothyroid muscle which Paralysis of the cricothyroid muscle which affects the voice (weakness) with no effect affects the voice (weakness) with no effect on air pathway.on air pathway.
2.2. Injury of the recurrent laryngeal nerve:Injury of the recurrent laryngeal nerve:
1.1. Unilateral complete sectionUnilateral complete section: the affected : the affected vocal cord will be between adduction and vocal cord will be between adduction and abduction (cadaveric position). The other abduction (cadaveric position). The other cord will compensate and crosses to the cord will compensate and crosses to the other side and this will not affect the voice other side and this will not affect the voice or respirationor respiration
Clinical Points of the LarynxClinical Points of the LarynxClinical Points of the LarynxClinical Points of the Larynx2.2. Bilateral complete sectionBilateral complete section: both vocal : both vocal
cords will be between adduction and cords will be between adduction and abduction (cadaveric position). The voice abduction (cadaveric position). The voice will be lost and the respiration is slightly will be lost and the respiration is slightly affected.affected.
3.3. Unilateral partial sectionUnilateral partial section: the affected : the affected side will show paralysis of the abductor side will show paralysis of the abductor muscle (posterior cricoarytenoid), the muscle (posterior cricoarytenoid), the affected vocal cord will stay in adduction affected vocal cord will stay in adduction position, the other cord will compensate.position, the other cord will compensate.
2.2. Bilateral complete sectionBilateral complete section: both vocal : both vocal cords will be between adduction and cords will be between adduction and abduction (cadaveric position). The voice abduction (cadaveric position). The voice will be lost and the respiration is slightly will be lost and the respiration is slightly affected.affected.
3.3. Unilateral partial sectionUnilateral partial section: the affected : the affected side will show paralysis of the abductor side will show paralysis of the abductor muscle (posterior cricoarytenoid), the muscle (posterior cricoarytenoid), the affected vocal cord will stay in adduction affected vocal cord will stay in adduction position, the other cord will compensate.position, the other cord will compensate.
Clinical Points of the LarynxClinical Points of the LarynxClinical Points of the LarynxClinical Points of the Larynx
4.4. Bilateral partial sectionBilateral partial section: : a severe a severe conditioncondition because both vocal cords will because both vocal cords will be paralyzed in adducted position). The be paralyzed in adducted position). The patient will suffer from stridor and patient will suffer from stridor and asphyxia and tracheostomy or asphyxia and tracheostomy or cricothyriodotomy is life saving process.cricothyriodotomy is life saving process.
4.4. Bilateral partial sectionBilateral partial section: : a severe a severe conditioncondition because both vocal cords will because both vocal cords will be paralyzed in adducted position). The be paralyzed in adducted position). The patient will suffer from stridor and patient will suffer from stridor and asphyxia and tracheostomy or asphyxia and tracheostomy or cricothyriodotomy is life saving process.cricothyriodotomy is life saving process.