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Laryngeal Anatomy 1 Phonation • Generation of a voiced sound • Accomplished with the larynx (voice box) • Voiceless sounds: open vocal folds • Voiced sounds: closed vocal folds 2 Vocal Folds • 5 layers of tissue (deep= muscle) • Glottis= space between the vocal folds • Subglottal= area below the vocal folds • Located at the end of the airstream at superior end of trachea 3 Structural Support of the Larynx • Larynx is suspended in the neck by a single bone, the hyoid bone. • There are 6 laryngeal cartilage's: – 3 paired – 3 unpaired – provide structural support for the larynx. 4 Laryngeal Cartilage's • Epiglottis: -shaped like a long leaf, -base attached to inner portion of anterior rim of the thyroid cartilage, -folds down over airway to protect during swallowing. -composed of elastic cartilage (does not ossify with age...must remain flexible). 5 Laryngeal Cartilage's • Thyroid Cartilage: -angled saddle-shaped curve, -anterior attachment of true vocal folds, -posteriorly there are 2 superior cornu and 2 inferior cornu (articulate with cricoid cartilage), -composed of hyaline cartilage- does ossify & limit flexibility with age, -lateral walls are laminae attach to midline 6 of notch. Laryngeal Cartilage's • Cricoid : -signet ring shaped, -2 sets of paired faces to allow connection (articulation) with other joints, -cricothyroid joint connects the cricoid to the inferior cornu of the thyroid cartilage. 7 Laryngeal Cartilage's • Arytenoids: – Pair of small cartilages shaped like pyramids – Mounted opposite each other on the rim of the signet portion of the cricoid cartilage – 2 motions: • rotation • gliding 8 Laryngeal Cartilage's • Corniculate & Cuneiform Cartilage's: – Corniculate: attached to superior tips of the arytenoid cartilage – Cuneiform: embedded in the muscular complex superior to the corniculate – Provide no clear function; may add to the stability to the abduction movement. 9 Laryngeal Cartilage's • 3 Unpaired Cartilage's -Epiglottis -Thyroid -Cricoid 10 • 3 Paired Cartilage's -Cuneiform -Corniculate -Arytenoid 11 Larynx & Trachea Hyoid Bone Thyroid Cartilage Cricoid Cartilage 12 Laryngeal Cartilages Thyroid Thyroid Notch Vocal Ligament Superior horn Cricoid Inferior horn 13 Arytenoid Movement • Rock= Front sides tilt toward or away from each other • Glide= Their back sides slide toward or away from each other • Abduction= open vocal folds (caused by rocking & gliding) • Adduction= closed vocal folds • Arytenoids have 2 processes: – Vocal process (vocal folds attach) – Muscular process (muscle attachment) 14 Arytenoid Movement Rocking Gliding Adducted Abducted 15 Laryngeal Membranes & Ligaments • Extrinsic Laryngeal Membranes: • Connect the laryngeal cartilages with adjacent structures – Hyothyroid membrane – Paired lateral hyothyroid ligaments – Hyoepiglottic ligament – Cricotracheal membrane 16 Hyothyroid Membrane & Ligaments • Occupies space between the hyoid bone and superior border of the thyroid cartilage • Membrane is thickened medially= Middle Hyothyroid Ligament • Posteriorly between the superior thyroid horns the membrane is thickened= Lateral Hyothyroid Ligament 17 Hyoepiglottic Ligament • Unpaired, midline, elastic ligament extending from anterior surface of the epiglottis to the upper border of the hyoid bone 18 Cricotracheal Membrane • Connects the lower border of the cricoid cartilage with the upper border of the first tracheal ring • More extensive then membrane attaching tracheal rings 19 Laryngeal Membranes & Ligaments • Intrinsic Laryngeal Membranes: • Interconnects the various laryngeal cartilages and helps regulate the extent & direction of their movement – Conus Elasticus – Quadrangle membrane – Aryepiglottic folds – Lateral cricothyroid membrane 20 Conus Elasticus • Cavity below the vocal folds is funnel or coneshaped • Continuous sheet of membrane that connects the thyroid, cricoid and arytenoid cartilages with one another • Divided into a medial cricothyroid ligament and two lateral cricothyroid membranes • Extends from superior border of the arch and lamina of the cricoid cartilage to the upper limits of the true vocal folds 21 Quadrangular Membranes • Arise from the lateral margins of the epiglottis and adjacent thyroid cartilage near the angle • Fibers coarse posteriorly downward and attach to the corniculate cartilage's 22 Aryepiglottic Folds • Superior margins of the quadrangular membranes • Cuneiform cartilages embedded here • Implicated in the mechanics of swallowing 23 Lateral Hyothyroid Ligament Hyothyroid Membrane Conus Elasticus Membranes & Ligaments Arytenoid Cartilage Epiglottis Middle Hyothyroid Ligament Throid Lamina Cricotracheal Membrane Hyoepiglottic Ligament Vocal ligament Conus Elasticus 24 Conus Elasticus T= Thyroid A= Arytenoid C A CE T C= Cricoid CE= Conus Elasticus 25 Quadrangular Membrane Heavy Lines= Aryepiglottic Folds & Quadrangualr Membrane 26 Reading/Assignments • Seikel: Pgs. 164-182 • Maue-Dickson: Pgs. 139-160 27