Anatomy of the

Larynx

Michael aritonang, M.D.

Dept of Anesthesiology
Manila Adventist Medical Center

Outline

Description
Laryngeal Ossicles
Intrinsic Muscles
Vasculature
Innervation
Phonation

What is the larynx?

It is a compound sphincter
Closes the airway during
swallowing
Closes the airway during the
Valsalva manuever (coughing,
urination and defecation)
It constricts the airway
during phonation

Differences
Adults
C4-C6
Narrowest
portion is
the Cricoid

Infant/Child
C3-C5
Narrowest
portion is
the Vocal
folds

More differences in
infants/children
Epiglottis is longer, narrower
and stiffer
Aryepiglottic folds closer to
midline in infants
Vocal folds anterior angle
with respect to perpendicular
axis of the larynx
Pliable cartilage
Mucosa more vulnerable to
trauma

The Laryngeal
Ossicles
Hyoid bone
3 unpaired
Thyroid
Cricoid
Epiglottis

3 paired

Arytenoid
Corniculate
Cuneiform

Hyoid bone
U-shaped
Parts
Body
Lesser
horns
Greater
horns

Hyoid bone

Body

Medial
surface
attachment of
thyrohyoid
membrane

Hyoglossus
mylohyoid
middle
constrictor

Epiglottis

Epiglottis
Projects
posterosuperio
rly into the
hypopharynx
Anterior
surface linked
to the hyoid by
the
hyoepiglottic
ligament

Epiglottis
Function - during the
pharyngeal of deglutition,
elevation of the hyoid bone
draws the attached larynx
cranially so the epiglottis
assumes a more horizontal
position thus protecting the
glottic opening.

Epiglottis
Sensation from the upper
epiglottic surface is
carried by the
glossopharyngeal nerve
which provides the
afferent limb of the gag
reflex

Epiglottis
Sensation from the lower
surface carried by the
internal branch of the
superior laryngeal branch
of the vagus nerve,
afferent limb of the cough
reflex

Epiglottis
Epiglottic taste buds
innervated by the internal
branch of the superior
laryngeal nerve

Question
When inserting a mac
blade during
laryngoscopy, which
nerve on the epiglottis do
you stimulate?

Thyroid Cartilage
Median thyroid
notch
Laryngeal
prominence
Inferior horns
articulates
with the
cricoid
cartilage at
the
cricothyroid
joint

Cricoid Cartilage
From the
greek word
krikos
Broad
posterior
lamina and
narrow
anterior arch

Cricothyroid
Membrane
9mm in height
and 3 cm in width
1-1.5 finger
breadths below
laryngeal
prominence
In upper third,
crossed by
anastomosis of
the left and right
superior
cricothyroid
arteries