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Membranes of The Larynx: Extrinsic Membranes Connect The Laryngeal Apparatus With Adjacent Structures For
Membranes of The Larynx: Extrinsic Membranes Connect The Laryngeal Apparatus With Adjacent Structures For
Membranes of The Larynx: Extrinsic Membranes Connect The Laryngeal Apparatus With Adjacent Structures For
Extrinsic membranes connect the laryngeal apparatus with adjacent structures for
support.
The thyrohyoid membrane is an unpaired fibro-elastic sheet which connects the
inferior surface of the hyoid bone with the superior border of the thyroid cartilage.
The thyrohyoid membrane has an opening in its lateral aspect to admit the internal
laryngeal nerve and artery
The Cricotracheal membrane connects the most superior tracheal cartilage with the
inferior border of the cricoid cartilage
A B
The true vocal folds lie parallel to, and just beneath the ventricular folds,
separated from them by the laryngeal ventricle. The paired vocal folds take their origin
from the thyroid cartilage, near the angle and below the thyroid notch at the anterior
commissure (commissure = joining together). The folds diverge as they course
posteriorly toward their attachment to the vocal processes of the arytenoid cartilages. The
medial borders of the vocal folds are free and therefore able to vibrate during phonation.
Each vocal fold consists of a bundle of muscle tissue (thyroarytenoid) and a vocal
ligament (the upper border of the conus elasticus) overlain by the laryngeal mucosa.
Figure 12-14 The Glottis and vocal folds A. coronal view, B. superior view.
The Glottis.
The glottis extends from the anterior commissure to the bases of the arytenoid
cartilages. The anterior portion is bounded by the vocal ligament and is called the
membranous glottis. It comprises about 3/5ths of the total length of the glottis. At rest it
is about 15 mm in adult males and 12 mm in females. The posterior portion is bounded
by the vocal processes and the medial surfaces of the arytenoid cartilages, and is known
as the cartilaginous glottis. It is about 8 mm long in males and slightly shorter in females.
The dimensions and configuration of the glottis vary depending on laryngeal
activity.
Figure 12-15. Superior aspect of vocal folds A. glottis closed for phonation. B. Glottis
opened for breathing.
The activities of the intrinsic muscles of the larynx function to protect the airway
from the invasion of foreign objects and to produce sound. They can be categorized by
their effects on the shape of the glottis and on the vibratory behavior of the vocal folds.
Under normal circumstances, the intrinsic laryngeal muscles act in pairs.
• The abductors separate the arytenoids and the vocal folds for respiratory activities.
• The adductors approximate the arytenoid cartilages and the vocal folds for phonation
and protection.
• The tensors elongate and tighten the vocal folds.
• The relaxers shorten and relax the vocal folds.
The posterior arytenoid muscle is a broad muscle that originates from the shallow
depression on the posterior surface of the quadrate lamina. It inserts into the muscular
process of the arytenoid cartilage on the same side. It is described as having a fan-shaped
medial part and a vertical lateral part. This muscle is the only abductor of the vocal cords.
A branch of the recurrent laryngeal nerve innervates it.
Depending on other muscle action, this muscle can act as an adductor, a tensor or a
relaxer.
The thyroarytenoid muscle arises anteriorly from a narrow, vertically oriented
region of the inner surface of the angle of the thyroid cartilage. The superior fibers
(sometimes called the vocalis muscle) flank the vocal ligament, course backward to insert
into the lateral and inferior aspect of the vocal process of the arytenoid cartilage. The
inferior fibers (sometimes called the thyromuscularis) course backward to insert into the
lateral and inferior aspects of the vocal process. Depending of the activities of the other
laryngeal muscles, the thyroarytenoid muscles can act as adductors, tensors or relaxers.
This muscle is innervated by branches of the recurrent laryngeal nerve.