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Dr. Thaaer Mohammed Daher Alsaad Specialist in General Surgery M.B.Ch.B. (MBBS) F.I.B.M.S. (PH.D.) Senior Lecturer
Dr. Thaaer Mohammed Daher Alsaad Specialist in General Surgery M.B.Ch.B. (MBBS) F.I.B.M.S. (PH.D.) Senior Lecturer
Dr. Thaaer Mohammed Daher Alsaad Specialist in General Surgery M.B.Ch.B. (MBBS) F.I.B.M.S. (PH.D.) Senior Lecturer
IMS MSU
Movements of the Larynx during Swallowing During swallowing the
elevation of the larynx folds the epiglottis over the glottis, steering
materials into the esophagus
Muscles that form the floor of the oral cavity, superior view
Origins and insertions on the mandible and hyoid
THE LARYNX
ANATOMY
OUTLINES
• Introduction.
• Cartilages.
• Ligaments.
• Sound production.
• Muscles.
• Associated terms.
• Blood supply.
• Nerve supply.
• Lymphatic drainage.
• Cricothyroidotomy + tracheostomy.
LARYNX
• 9 CARTILAGES.
–3 PAIRED
–3 UNPAIRED
• 8 MUSCLES.
• LIGAMENTS
LARYNX
• It is the musculocartilaginous structure,
• lined with mucous membrane,
• connected to the superior part of the trachea and to
the pharynx.
• inferior to the tongue and the hyoid bone;
• the essential sphincter guarding the
entrance into the trachea.
• functioning secondarily as the organ of voice.
• It is formed by nine cartilages connected
by ligaments and eight muscles.
The Larynx
Inspired (inhaled) air leaves the pharynx by
passing through a narrow opening, the glottis.
The larynx begins at the level of vertebra C4 or C5
and ends at the level of vertebra C7.
It is essentially a cylinder whose cartilaginous
walls are stabilized by ligaments or skeletal
muscles or both.
External view of the larynx: (a) anterior aspect; (b) anterolateral aspect.
Cartilages of the Larynx
Three large unpaired cartilages form the body
of the larynx:
the thyroid cartilage,
the cricoid cartilage,
the epiglottis.
The thyroid and cricoid cartilages are hyaline
cartilages;
the epiglottic cartilage is an elastic cartilage
The Thyroid Cartilage
The largest laryngeal cartilage is the thyroid (“shield-shaped”) cartilage.
It forms most of the anterior and lateral walls of the larynx .
The thyroid cartilage, when viewed in sagittal section, is incomplete
posteriorly.
The anterior surface of this cartilage bears a thick ridge, the laryngeal
prominence.
This ridge is easily seen and felt, and the thyroid cartilage is commonly
called the Adam’s apple.
During embryological development, the thyroid cartilage is formed by
two pieces of cartilage that meet in the anterior midline to form the
laryngeal prominence.
The inferior surface of the thyroid cartilage articulates with the
cricoid cartilage;
the superior surface has ligamentous attachments to the epiglottis and
smaller laryngeal cartilages.
The Cricoid Cartilage
The thyroid cartilage sits superior to the cricoid “ring-
shaped”) cartilage.
It is a complete ring whose posterior portion is greatly
expanded, providing support in the absence of the thyroid
cartilage.
The cricoid and thyroid cartilages protect the glottis and
the entrance to the trachea,
and their broad surfaces provide sites for the attachment
of important laryngeal muscles and ligaments.
Ligaments attach the inferior surface of the cricoid
cartilage to the first cartilage of the trachea.
The superior surface of the cricoid cartilage articulates
with the small paired arytenoid cartilages.
The Epiglottis
The shoehorn-shaped epiglottis projects
superior to the glottis
The epiglottic cartilage that supports it has
ligamentous attachments to the anterior and
superior borders of the thyroid cartilage and the
hyoid bone.
During swallowing, the larynx is elevated, and
the epiglottis folds back over the glottis,
preventing the entry of liquids or solid food into
the respiratory passageways.
Paired Laryngeal Cartilages
The larynx also contains three pairs of
smaller cartilages:
the arytenoid,
corniculate,
and cuneiform cartilages.
The arytenoids and corniculates are hyaline
cartilages;
the cuneiforms are elastic cartilages.
The Three Paired Cartilages
• The arytenoid "ladle-shaped” cartilages articulate with
the superior border of the enlarged portion of the
cricoid cartilage.
• The corniculate “horn-shaped”) cartilages articulate
with the arytenoid cartilages.
• The corniculate and arytenoid cartilages play a role in
the opening and closing of the glottis and the
production of sound.
• Elongate, curving cuneiform “wedge-shaped”)
cartilages lie within the aryepiglottic fold that extends
between the lateral aspect of each arytenoid cartilage
and the epiglottis.
Laryngeal Ligaments
• A series of intrinsic ligaments binds all nine
cartilages together to form the larynx.
• Extrinsic ligaments attach the thyroid cartilage to
the hyoid bone and the cricoid cartilage to the
trachea.
• The vestibular ligaments and the vocal ligaments
extend between the thyroid cartilage and the
arytenoids.
• The vestibular and vocal ligaments are covered by
folds of laryngeal epithelium that project into the
glottis.
• The vestibular ligaments lie within the superior pair
of folds, known as the vestibular folds.
Laryngeal Ligaments (continue)