Anatomy and Physiology of the Larynx

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Anatomy and Physiology of the Larynx
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• Tube occupying middle third of the neck
• Opposite 3rd,4th,5th,6th cervical vertebrae
• Framework of cartilages, not to allow for
  collapse with inspiration
• Cartilages are connected by ligaments membranes

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Larynx Cartilage
Cartilaginous Framework

• Unpaired
• 1- Epiglottis Cartilage
• 2- Thyroid Cartilage
• 3- Cricoid Cartilage

• Paired
• 1- Arytenoid Cartilage
• 2- Corniculate Cartilage
• 3- Cuniform Cartilage
• 4- triticeal Cartilage

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Larynx Cartilage

• Epiglottic cartilage
• A thin lamina of elastic cartilage
  forming the central portion of the epiglottis.
  attached to the thyroid cartilage of the larynx
  by the thyroepiglottic ligament it is the
  structural basis of the epiglottis.

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Larynx Cartilage

• Thyroid cartilage
• The largest cartilage of the larynx
  consisting of two laminae fusing anteriorly at an
  acute angle in the midline of the neck. The point
  of fusion forms a subcutaneous projection known
  as the adam's apple.

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Larynx Cartilage

• Carcoid cartilage
• It sits just inferior to the thyroid cartilage in
  the neck, and is joined to it medially by the
  median cricothyroid ligament and
  postero-laterally by the cricothyroid joints.
  Inferior to it are the rings of cartilage around
  the trachea (which are not continuous - rather
  they are C-shaped with a gap posteriorly). The
  cricoid is joined to the first tracheal ring by
  the cricotracheal ligament, and this can be felt
  as a more yielding area between the firm thyroid
  cartilage and firmer cricoid.
• The posterior part of the cricoid is slightly
  broader than the anterior and lateral parts, and
  is called the lamina, while the anterior part is
  the band this may be the reason for the common
  comparison made between the cricoid and a signet
  ring.

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• Arytenoids Cartilage
• One of a pair of small pyramidal cartilages that
  articulate with the lamina of the cricoid
  cartilage. The corresponding vocal ligament and
  several muscles are attached to it.

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Muscles of the Larynx

• Extrinsic
• 1- Thyrohyoid Muscles
• 2- Sternothyroid Muscles
• Raise and lower the larynx during deglutition

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Muscles of the Larynx

• According to the functions
• 1- Raise the larynx Thyrohyoid Muscles,
  Mylohyoid muscle, Digastric muscle, Stylohyoid
  muscle
• 2- Lower the larynx
• Sternothyroid Muscles,
• Sternohyoid M, supraomohyoid M, pharyngeal
  constrictor muscle

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Muscles of the Larynx

• Intrinsic
• All paired except the transverse arytenoid
• Abductor Post. Crico-arytenoid
• Adductors Lat. Crico-arytenoid, interarytenoid
  thyroarytenoid
• Tensors Internal part of thyroarytenoid
• Cricothyroid, adductor tensor

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Muscles of the Larynx

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Cavity of the Larynx

• Laryngeal Cavity
• 3 portions
• Supraglottic portion Glottic portion
  Infraglottic portion
• Supraglottic portion
• Epiglottis
• Aritenoepiglottic Fold
• Arytenoid area
• False Vocal Cord

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Cavity of the Larynx

• Glottic portion
• Vocal Cord
• Fissure of Glottis
• Anterior Commisure

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Cavity of the Larynx

• Infraglottic portion

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Mucosa of the larynx

• there are 5 layers of the vocal cord
  under the microscopeStratified squamous
  epithelium ,Reink layer,elastic fibre
  layer,Collagen fiber layer and muscle layer ?

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Space of the larynx

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Space of the larynx

• Reink space
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Blood Supply Lymphatics

• Blood Supply
• - Superior thyroid artery Ext. Carotid
• - Inferior Thyrocervical trunk
• Subclavian
• Lymphatics
• - Glottis No lymphatics
• - Supraglottic Pre-epiglottic UDC
• - Subglottic Pre-laryngeal
  pre-tracheal
• to the LDC

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Never of the Larynx

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• Superior Laryngeal
• Sensory above vocal folds, motor to
  Cricothyroid muscle

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Never of the Larynx

• Superior Laryngeal
• Sensory above vocal folds, motor to
  Cricothyroid muscle
• Inferior (Recurrent) Laryngeal
• Sensory below folds, motor to all muscles
  except cricothyroid

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Never of the Larynx ????

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The Infantile Larynx

• Smaller
• Funnel shaped with the narrowest area in the
  sub-glottis
• Loss submucosa, allow accumulation of exudates
• Cartilages more soft
• Lies high up under tongue
• Axis of air entry is more straight, more
  possibility of F.B. inhalation

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Physiology of the Larynx

• Protection of the lower respiratory passages
  (The primitive, embryonic most imp.)
• 1- Sphicteric Mechanisms (epiglottic-aryepiglo
  ttic, V.B. and V.F.)
• 2- Elevation of the larynx during
  swallowing
• 3- Cessation of respiration during
  swallowing
• 4- Cough reflex
• Phonation
• Respiration
• Fixation of the chest