أسئلة الـ Larynx (ريتين ثانية أناتومي)

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Questions and Answers

Which lymph nodes drain areas above the vocal fold?

Upper deep cervical lymph nodes

What muscle is responsible for opening the inlet of the larynx?

Thyro-epiglottic muscle

Identify the muscle that abducts the vocal cords.

Posterior crico-arytenoid muscle

What is the function of the cricothyroid muscle?

It tenses the vocal cords. Signup and view all the answers

How long is the trachea usually?

10 - 11 cm Signup and view all the answers

Which artery supplies the upper part of the trachea?

Inferior thyroid artery Signup and view all the answers

Which bronchus is shorter and wider?

Right bronchus Signup and view all the answers

At what vertebral levels does the right bronchus enter the hilum of the lung?

T5 Signup and view all the answers

What is the specific anatomical location of the larynx in relation to the cervical vertebrae?

The larynx extends opposite C4, C5, and C6. Signup and view all the answers

Name the single cartilage that is described as leaf-like and lies behind the tongue and hyoid bone.

The epiglottis. Signup and view all the answers

Identify the paired cartilage that has pyramidal shapes and features muscular and vocal processes.

The arytenoid cartilage. Signup and view all the answers

What forms the vocal cords in the larynx?

The cricothyroid ligament, specifically its thickened upper border. Signup and view all the answers

Which nerve is responsible for the motor supply of all laryngeal muscles except for the cricothyroid muscle?

The recurrent laryngeal nerve. Signup and view all the answers

Describe the clinical significance of the piriform fossa.

The piriform fossa is a common site for foreign body lodgment. Signup and view all the answers

What are the two main types of sensory nerve supply above and below the vocal folds?

Above the vocal folds is supplied by the internal laryngeal nerve, while below is supplied by the recurrent laryngeal nerve. Signup and view all the answers

What does a unilateral lesion of the recurrent laryngeal nerve cause, and what is its clinical significance?

It causes hoarseness of voice. Signup and view all the answers

How do the drainage patterns differ for lymph nodes above and below the vocal folds?

Lymph above the vocal folds drains into upper deep cervical lymph nodes, whereas lymph below drains into lower deep cervical lymph nodes. Signup and view all the answers

What is the relationship between the trachea and the esophagus in terms of anatomical position?

The trachea lies anterior to the esophagus. Signup and view all the answers

In terms of structure, how does the bronchial anatomy differ between the right and left bronchi?

The right bronchus is shorter and wider, while the left bronchus is longer and narrower. Signup and view all the answers

What is the significance of the 'carina' in the trachea?

The carina is the termination point of the trachea where it divides into right and left bronchi at the sternal angle. Signup and view all the answers

Which muscles are primarily responsible for adducting the vocal cords?

The vocal cords are adducted by the lateral crico-arytenoid muscle and the transverse arytenoid muscle. Signup and view all the answers

Identify the function of pre-tracheal and para-tracheal lymph nodes in relation to the trachea.

Pre-tracheal and para-tracheal lymph nodes are involved in the lymph drainage from the trachea. Signup and view all the answers

What roles do the sympathetic and parasympathetic nervous supplies play in the function of the trachea?

The sympathetic supply comes from the middle cervical sympathetic ganglion, while the parasympathetic supply is via the recurrent laryngeal nerve. Signup and view all the answers

Explain the clinical implications of foreign body lodgment in the right bronchus.

Foreign body lodgment is more common in the right bronchus due to its shorter and wider structure. Signup and view all the answers

What are the anatomical boundaries of the laryngeal inlet?

The anterior boundary is the epiglottis, the lateral boundaries are the aryepiglottic folds, and the posterior boundary is the arytenoid cartilage. Signup and view all the answers

Explain the significance of the quadrangular ligament in the larynx.

The quadrangular ligament thickens at its upper border to form the aryepiglottic fold and at its lower border to form the vestibular fold. Signup and view all the answers

What are the consequences of a bilateral lesion of the recurrent laryngeal nerve?

It may cause suffocation and typically necessitates a tracheostomy. Signup and view all the answers

Describe the sensorimotor innervation of the larynx above and below the vocal folds.

Above the vocal folds, the innervation is supplied by the internal laryngeal nerve; below, it is supplied by the recurrent laryngeal nerve. Signup and view all the answers

Identify the artery responsible for the arterial supply of the area above the vocal folds.

The area is supplied by the superior laryngeal artery, a branch of the superior thyroid artery. Signup and view all the answers

What clinical implications arise from the presence of the piriform fossa?

The piriform fossa is a common site for foreign body lodgment, which can lead to choking or obstruction. Signup and view all the answers

How do the rima vestibuli and rima glottidis differ in their anatomical locations?

The rima vestibuli is located between the two vestibular folds, while the rima glottidis is between the two vocal folds. Signup and view all the answers

What is the function of the cuneiform cartilage in the larynx?

Cuneiform cartilage supports the aryepiglottic folds, aiding in the function of the larynx during respiration and phonation. Signup and view all the answers

Study Notes

Larynx - Cartilages

Single Cartilages:
- Epiglottis: Leaf-like, behind tongue and hyoid bone
- Thyroid: Two laminae fused at midline ("Adam's apple")
- Cricoid: Ring-shaped, narrow anterior arch
Paired Cartilages:
- Arytenoid: Pyramidal, with muscular and vocal processes
- Corniculate: Found at arytenoid-epiglottic folds
- Cuneiform: Found at arytenoid-epiglottic folds

Larynx - Membranes

Crico-tracheal ligament
Cricothyroid ligament: Thickened at upper border, forms vocal cords
Quadrangular ligament: Thickened at upper border, forms aryepiglottic fold
Thickened at lower border, forms vestibular fold (false vocal cord)
Thyrohyoid membrane: Pierced by internal laryngeal nerve and superior laryngeal artery
Hyo-epiglottic ligament

Larynx - Laryngeal Inlet

Boundaries:
- Anterior: Epiglottis
- Lateral: Aryepiglottic fold
- Posterior: Arytenoid cartilage
Clinical importance: The piriform fossa (space beside the inlet) is a common site for foreign body lodgement.

Larynx - Laryngeal Cavity

Supraglottic (Vestibule): Contains laryngeal inlet and vestibular folds.
Glottic:
- Rima vestibuli: Between vestibular folds
- Sinus: Between vestibuler and vocal folds
- Saccule: Lateral extension of sinus
Infraglottic: Between vocal folds and the lower border of cricoid

Larynx - Nerve Supply

Motor: All laryngeal muscles (except cricothyroid) are supplied by the recurrent laryngeal nerve; the cricothyroid is supplied by the external laryngeal nerve.
Sensory:
- Above vocal fold: Internal laryngeal nerve
- Below vocal fold: Recurrent laryngeal nerve
Clinical notes: Unilateral recurrent laryngeal nerve lesion leads to hoarseness; bilateral lesions cause suffocation requiring tracheostomy.

Larynx - Arterial Supply

Above vocal fold: Superior laryngeal artery (branch of superior thyroid artery)
Below vocal fold: Inferior laryngeal artery (branch of inferior thyroid artery)

Larynx - Lymph Drainage

Above vocal fold: Drains to upper deep cervical lymph nodes
Below vocal fold: Drains to lower deep cervical lymph nodes

Larynx - Muscles

Inlet Control:
- Open: Thyroepiglottic muscle
- Close: Aryepiglottic muscle
Vocal Cord Control:
- Abduct: Posterior cricoarytenoid muscle
- Adduct: Lateral cricoarytenoid and transverse arytenoid muscles
Voice Tone Control:
- Tense: Cricothyroid muscle
- Lax: Thyroarytenoid and vocalis muscles

Trachea

Length: 10-11 cm
Beginning: Lower border of C6 (opposite cricoid cartilage)
Termination (Carina): At the sternal angle level (between T4 and T5), dividing into right and left bronchi.
Arterial Supply: Inferior thyroid arteries (upper part) and bronchial arteries (lower part)
Venous Drainage: Left brachiocephalic vein
Lymphatic Drainage: Pretracheal, paratracheal, deep cervical lymph nodes
Nerve Supply: Sympathetic (middle cervical ganglion), parasympathetic (recurrent laryngeal nerve)
Relation: Lies between the aortic arch anteriorly and the esophagus posteriorly.

Bronchi

Right Bronchus:
- Shorter
- Wider
- In line with trachea
- More common site for foreign body lodgement
- Divides before entering hilum of the lung (at T5)
Left Bronchus:
- Longer
- Narrower
- Angles with the trachea
- Less common site for foreign body lodgement
- Divides after entering hilum of the lung (at T6)

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