^ At the nostrils, extends through the nasal conchae to the nasopharynx, over the uvula to the hypopharynx and larynx, or, ^ At the lips, extends through the oral cavity, over the tongue and below the hard and soft palates, to the hypopharynx and larynx.
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Upper Airway: From Pharynx to Larynx
Lingual ½onsil
Midline guidance: Ơ½he uvula points to the epiglottis, the epiglottis leads into the larynxơ. c
½he Larynx ƥ ½he larynx is a 5- 5-7 cm long structure. ƥ Its upper boundary starts at the tip of the epiglottis, opposite the 3rd to 4th, cervical vertebra.
ƥ Its lower end is at the
lower border of the cricoid cartilage. ƥ ½his lies opposite the 6th cervical vertebra.
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½he Larynx Posterior Wall of Hypopharynx (Leading to Esophagus) Lateral Glossoepiglottic Folds Ôuperior surface anatomy:
Major Landmarks I
Ôuperior Ôurface of Epiglottis
Median Vallecula Glossoepiglottic Base of Fold ½ongue http://www.nyee.edu/top#top
½ime Out! Ʀ Why is it so important to recognize the surface anatomy? ^ As a bronchoscopist, we are responsible to report any nasal, oral, pharyngeal or laryngeal pathology that we observe en- en-route to the lungs. ^ We only know that we are correctly positioned and in the midline, when we know exactly where we are are.. ^ During a difficult intubation, either with a bronchoscope or a rigid laryngoscope, knowledge of surface anatomy ensures timely intubation and saves a life. ^ In a variety of conditions, such as GERD, changes in laryngeal anatomy and structures, are the best clues to pulmonary pathology. Ôhall we continue?
½he Larynx Cartilaginous Rings of ½rachea Ôuperior surface anatomy:
Major Landmarks to look for - VII Vocal Cord Ôulcus (on ½rue Vocal Cords)
False Vocal Cords Cricoid ½rue Ring Vocal Cords
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½his is the..
A. ½he epiglottis B. ½he ventricle C. ½he arytenoid cartilage D. ½he true vocal cord E. ½he false vocal cord
Click for correct answer: c
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½he Larynx: Anatomy ^ ½he structural rigidity of the larynx is provided by the three median cartilages: ^ ½he epiglottis ^ ½hyroid cartilage ^ Cricoid cartilage , along with the hyoid bone.
^ ½he thyrohyoid membrane forms a
C-shaped barrier around the anterior and lateral walls of the supraglottis, and inferiorly becomes confluent with the connective tissue in the perichondrium of the tracheal cartilaginous rings. OOO
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½he Larynx: Anatomy ^ ½he six smaller cartilages of the larynx ( 3 pairs) are functionally involved with the movements of the vocal cords. ½hese are: ^ ½he arytenoids ^ ½he corniculates ^ ½he cuneiforms
^ ½he ` cartilages are
pyramid--shaped and articulate pyramid with the superior margin of the cricoid lamina. On their summit, are the ` cartilages; on their anterior aspect, the cartilages www.polychondritis.com c
½he Larynx: Anatomy ^ ÷`
` ,, are ½he ÷`
` attached posteriorly to the apex of the arytenoids and corniculates. ½he cuneiforms extend laterally, between the layers of the vocal cords, from the anterior aspect of the arytenocorniculate complex.
^ ½he is attached to the base of the tongue by a median and two lateral glossoepiglottic folds.
Bilateral nasal administration of anesthetic provides partial posterior pharyngeal anesthesia by affecting the Ôphenopalatine nerve fibers, thus diminishing the gag reflex. Ask patient to inhale deeply through nostril
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" ½he Larynx: ½opical Anesthesia ½opical anesthetic usually affects the superior laryngeal nerve and blocks sensory Click here to view video presentation innervation to the base of the tongue epiglottis, pyriform fossa, and valleculae. Click to continue
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½he Larynx: ½opical Anesthesia ½he topical instillation of Lidocaine with the ƠÔpray as you goơ method numbs the submucosal plexus of Click here to view video presentation the larynx, derived from the external and internal branches of the superior laryngeal nerve. Click to continue
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Laryngeal function: Airway Protection
½he glottis: open for inspiration and closed for swallowing
Open Closed
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Laryngeal function: Phonation
½he vocal cords: Adducted for phonation; abducted for
inspiration
Adducted: ½alking Abducted: Breathing
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Laryngeal function: Phonation
½he vocal cords
Click here to view video presentation open and close while talking
Click to continue
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Which of the following defends against aspiration?
A. ½he epiglottis B. ½he false cords C. ½he true cords D. ½he ventricle E. All of the above
Click for correct answer: º
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½his presentation is part of a comprehensive curriculum for Flexible Bronchoscopy. Our goals are to help health care workers become better at what they do, and to decrease the burden of procedure--related training on procedure patients.
