Vocal cord position

By
B.Praveen kanna
and
nanbargal
VOCAL CORDS
The vocal cords, also known as vocal folds composed of two
infoldings made up of three structures namely outer epithelium,
lamina propria and vocalis ligament and thyroarytenoid muscle.
They vibrate, modulating the flow of air being expelled form the
lung during phonation. They are attached anteriorly to the thyroid
cartilage and posteriorly to the arytenoid cartilage. The space between
two vocal folds are called as rima glottids.
There are five different position of vocal cords changing the shape
of rima glottids with the help of intrinsic muscles which are supplied
by recurrent and superficial laryngeal nerves.
• Median
• Paramedian
• Intermediate
• Slight abduction
• Full abduction
Position of vocal cords
Median position

• The cords are located in the midline with almost closed

rima glottids.
• Normally it is seen during phonation
• During complete recurrent laryngeal nerve paralysis
which results in loss of function of all intrinsic muscle
except cricothyroid muscle (supplied by external laryngeal
nerve a br. of superficial laryngeal nerve) focal cord
remains in median position.
• In case of unilateral one remains In median and other
compensates but results in horsness of voice and loss of
involuntary reflexes. Bilateral results in complet closure
and causes serious problems.
Paramedian position

• The cords are located 1.5 mm from the midline

causing funnel shaped rima glottids.
• It is normally seen during whispering which requires
mild vibration of vocal cords.
• During partial or incomplete paralysis of recurrent
laryngeal nerve the vocal folds remain in this
position.
• It may result due various tumors in thyroid and
oesophagus.
Intermediate or Cadaveric position

• The cords are located 3.5 mm from the

midline.
• This is the neutral position of cricoatytenoid
joint. This position is usually found after death
• Paralysis of both recurrent and superficial
laryngeal nerve results in this position cause
loss of phonation and deep inspiration.
Gently abducted

• The cords are located 7 mm from the midline.

• Normally it is seen in quite respiration . This
state is maintained by posterior cricoarytenoid
muscles which is the safety muscle of larynx
causing pentagon shaped rima glottids.
• This position also results during paralysis of
adductor muscles like lateral cricoarytenoid
and oblique and transverse arytenoids.
Full abduction

• The cords are positioned 9.5 mm away from

the midline.
• It is seen during deep inspiration
• It I due the forcible action of posterior
cricoarytenoid causing diamond shaped rima
glottids.
Various shapes of rima glottids
 Summay

Table 60.2 photo eduthu paste

pannidu