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1.14 The Larynx : Landmarks and Muscles, Blood vessels

and nerves  Cuneiform Cartilage
1st sem: Prelims  Cartilage of wrisberg
1st term Prelims  Fibroelastic
The larynx serves as protection, prevents fluid/ liquid from  Supports AE fold
entering  Hyoid bone – located posteriorly
 Specialized organ that provides a protective sphincter at  Epiglottis
the inlet of air passages  Fibroelastic cartilage (less strength, elastin)
 “voice production”  Attaches to thyroid cartilage and hyoid bone
 Above it opens to the laryngeal part of the pharynx:  Triteceous cartilage
continuous with the trachea below  Sometimes found in thyrohyoid ligament
 May be mistaken on x-ray as a foreign body when
Laryngeal Skeleton calcified
Membranes and Ligaments
 Thyrohyoid membrane
 Upper margin of thyroid cartilage to the
posterior surface of the body of the greater
cornu of the hyoid
 Cricotracheal ligament
 Lower margin of cricoid to 1st tracheal ring
 Fibroelastic membrane
 Quadrangular membrane
 Between epiglottis and arytenoid
 upper- aryepiglottic fold
 lower- vestibular fold / ligament
 Cricothyroid ligament
 Connects cricoid and thyroid anteriorly
 Superior edge forms part of the vocal
ligament
 Hyoepiglottic ligament
 Thyroepiglottic ligament
Laryngeal Joints
Cricothyroid Joints
 Synovial
 Permits tilting movement in sagittal plane
 Change in length and tension of vocal folds
Cricoarytenoid Joints
 Thyroid Cartilage
 Synovial
 Hyaline cartilage
 2 lamina meeting at the midline  Rocking motion (anteromedially for vocal fold
 Superior cornu and inferior cornu adduction and posterolaterally for vocal fold
 Oblique line: attachment of sternothyroid, abduction)
thyrohyoid and the inferior constrictor muscles LARYNGEAL MUSCES
 Cricoid Cartilage
 Hyaline cartilage EXTERNAL MUSCLES
 Adult: C6-C7; Child C3-C4  Depressors
 Signet ring with broader posterior lamina  Sternothyroid (c2,c3)
 Arytenoid Cartilage  Sternohyoid (c2,c3)
 Hyaline cartilage  Omohyoid (c2,c3)
 Paired pyramidal structures  Elevator
 Apex supports corniculate  Geniohyoid (c1)
 Base articulates with the cricoid  Genioglossus XII
 Corniculate Cartilage  Hyoglossus XII
 Fibroelastic cartilage  Digastric (V3, VII)
 Above arytenoid cartilage  Mylohyoid (V3)
 Provides rigidity to A-E folds  Stylohyoid VII
 Cartilages of santorini
Transcribers: Ginez, Jeffrey | Jeong, Min Seob | Kimpay, Kevin Page 1 of 2
 ________________________________________________________ ANATOMY
INTERNAL MUSCLES  Loose fibrous matrix (few fibroblasts) , gelatinous
 Interarytenoid consistency permits fluency of vocal fold vibration
 only unpaired muscle (mucosal wave)
 Adduction  Intermediate Lamina Propia
 innervation: recurrent laryngeal nerve  Elastin(some fibroblast)
 Lateral Cricoarytenoid  Deep Lamina Propia
 vocal fold adduction  Fibroblast and collagen (dense)
 Rotates the arytenoids medially  Thyroarytenoid Muscle Complex
 innervation: recurrent laryngeal nerve  Thyromuscular bundle (thyroarytenoid muscle)
 Thyroarytenoid  Thyvocalis bundle (vocalis muscle)
 increases vocal tension LARYNGEAL BLOOD SUPPLY
 Vocal fold adduction
 medial aspect is called vocalis External Carotid Artery
 innervation: recurrent laryngeal nerve  Superior thyroid artery
 Cricothyroid  Superior laryngeal artery
 adduction
Subclavian artery
 Increases vocal fold tension and length (chief pitch-
 Inferior thyroid artery
changing muscle)
 Inferior laryngeal artery
 Fan-shaped muscle b/w thyroid and cricoid
 LARYNGEAL BLOOD SUPPLY
 Innervation: external branch of superior laryngeal LARYNGEAL INNERVATION
nerve
Laryngeal Innervation
 Posterior cricoarytenoid
 Cranial Nerve X (vagus nerve)
 abduction
 Superior laryngeal nerve
 Internal branch : sensory to
supraglottic endolarynx
 External branch: motor to
cricothyroid muscle
 Recurrent laryngeal nerve
 Sensory to inferior mucosa of
glottis
 Motor to ALL intrinsic laryngeal
muscle except cricothyroid muscle

LARYNGEAL
VOCAL MUSCES
CORD STRUCTURE
LARYNGEAL MUSCE
Vocal Fold Layers (from superficial to deep)
 Squamous epithelium
 Stratified, nonkeratinizing
 Superficial Lamina Propia (SLP, Reinke’s Space)

Transcribers: Ginez, Jeffrey | Jeong, Min Seob | Kimpay, Kevin Page 2 of 2