LARYNX
DR.HARILAL.M.D
INTRODUCTION
• SPHINCTER : PREVENTS ENTRY OF FOREIGN
BODY INTO RESPIRATORY PASSAGE : WATCH
DOG
• ORGAN OF PHONATION
EXTENT
• UPPER BORDER
OF EPIGLOTTIS
• LOWER
BORDER OF
CRICOID
CARTILAGE
• OPPOSITE C3 TO
C6 VERTEBRA
RELATIONS
• IN FRONT
INFRAHYOID MUSCLES
SUPERFICIAL IN MIDLINE
• LATERALLY
STERNOMASTOID
LATERAL LOBES OF THYROID
• BEHIND
LARYNGOPHARYNX
FUNCTIONS
• SPHINCTERIC VALVE
• CLOSES INLET
DURING
SWALLOWING
• PHONATION : Expired
air is used to produce
sound
FRAMEWORK
• MEMBRANEOUS TUBE
LINED BY MUCOUS
MEMBRANE
• SUPPORTED BY
CARTILAGES
• CONNECTED BY
LIGAMENTS &
MEMBRANES
• JOINTS
SKELETAL FRAME WORK
• CARTILAGES ( 9 )
• 3 PAIRED
ARYTENOID
CUNEIFORM
CORNICULATE
• 3 UNPAIRED
EPIGLOTTIS
THYROID
CRICOID
THYROID CARTILAGE
• PROTECTS LARYNX
FROM FRONT
• OPPOSITE C4 & C5
VERTEBRA
• ADAM’S APPLE \
THYROID ANGLE
THYROID CARTILAGE
• OUTER SURFACE : INSERTION OF
CRICOTHYROID
• POSTERIOR (inner)SURFACE OF ANGLE
ATTACHMENT OF THYROEPIGLOTTIC
LIGAMENT
PAIRED VESTIBULAR LIGAMENTS (FALSE
VOCAL CORD)
PAIRED VOCAL LIGAMENTS ( TRUE VOCAL
CORD)
EPIGLOTTIS
• LEAF LIKE
• UPPER END FORMS
LARYNGEAL INLET
• HYOEPIGLOTTIC LIG.
• THYROEPIGLOTTIC
LIG.
• ARYEPIGLOTTIC FOLD
CRICOID CARTILAGE
• SIGNET RING
• ANTERIOR ARCH
• POSTERIOR LAMINA
• ARTICULATES WITH
BASE OF ARYTENOID
CARTILAGE
• POST.LAMINA : POSTR.
CRICOARYTENOID
• ANT. ARCH : ORIGIN
OF CRICOTHYROID
ARYTENOID CARTILAGE
• APEX : CORNICULATE,
ATTACHMENT OF
OBLIQUE ARYTENOID
(from muscular process of
opposite arytenoid),
ARYEPIGLOTTICUS
• BASE : LAMINA OF
CRICOID CARTILAGE
• TRANSVERSE
ARYTENOID
ARYTENOID CARTILAGE
• VOCAL PROCESS : PROJECTS FORWARD
ATTACHMENT OF VOCAL LIG. & VOCALIS
MUSCLE
• MUSCULAR PROCESS : PROJECTS LATERALLY
INSERTION OF LATERAL CRICOARYTENOID &
POSTERIOR CRICOARYTENOID
• CORNICULATE & CUNEIFORM CARTILAGES
• DETTACHED PART OF ARYTENOID CARTILAGE
• CORNICULATE ARTICULATES WITH APEX OF
ARYTENOID
• CUNEIFORM LIES IN FRONT OF CORNICULATE
CARTILAGE
LIGAMENTS
• EXTRINSIC
THYROHYOID MEMBRANE
THYROHYOID LIGAMENT
• INTRINSIC
QUADRATE MEMBRANE
CRICOVOCAL MEMBRANE
INTRINSIC LIGAMENTS
• FIBROELASTIC MEMBRANE DIVIDED INTO 2
PARTS BY SINUS OF LARYNX
• LOWER BORDER OF QUADRATE MEMBRANE
THICKENED TO FORM VESTIBULAR
LIGAMENT
• UPPER BORDER OF CRICOVOCAL MEMBRANE
FORMS VOCAL LIGAMENT
INTERIOR OF LARYNX
• EXTENDS FROM LARYNGEAL INLET TO LOWER
BORDER OF CRICOID CARTILAGE
• LARYNGEAL INLET
• ANTERIOR WALL IS LONGER DUE TO
OBLIQUITY OF INLET
• RIMA VESTIBULI : BETWEEN VESTIBULAR
FOLDS
• RIMA GLOTTIDIS : BETWEEN VOCAL FOLDS
SUBDIVISIONS
• VESTIBULE : ABOVE VESTIBULAR FOLD
• SINUS \ VENTRICLE : BETWEEN VESTIBULAR
FOLD ABOVE & VOCAL FOLD BELOW
• INFRAGLOTTIC PART : BELOW VOCAL FOLD
RIMA GLOTTIDIS
• NARROWEST PART OF LARYNX
• SPACE BETWEEN TWO VOCAL FOLDS
• LONGER IN MALE
• INTERMEMBRANEOUS ANTERIOR 3/5th
• INTERCARTLAGINOUS POSTERIOR 2/5th
• PEARLY WHITE IN COLOR
• LINED BY STRATIFIED SQUAMOUS EPITHELIUM
• DEVOID OF SUBMUCOUS TISSUE
• CONTAINS VOCAL LIGAMENT MEDIALLY &
VOCALIS MUSCLE LATERALLY
INTRINSIC MUSCLES OF
LARYNX
• CRICOTHYROID
• POSTERIOR CRICOARYTENOID
• LATERAL CRICOARYTENOID
• TRANSVERSE ARYTENOID
• OBLIQUE ARYTENOID
• ARYEPIGLOTTICUS
• THYROARYTENOID
CRICOTHYROID
• ONLY INTRINSIC MUSCLE PLACED
EXTERNALLY
• FROM CRICOID ARCH TO INFERIOR MARGIN &
HORN OF THYROID CARTILAGE
• TENSOR OF VOCAL CORD
• EXTERNAL LARYNGEAL NERVE
POSTERIOR
CRICOARYTENOID
• MOST IMPORTANT PAIRED MUSCLE
• FROM POSTERIOR SURFACE OF LAMINA OF
CRICOID CARTILAGE
• BACK OF MUSCULAR PROCESS OF ARYTENOID
• ABDUCTION OF VOCAL CORDS
• SOLE ABDUCTOR
• RECURRENT LARYNGEAL NERVE
LATERAL CRICOARYTENOID
• ARCH OF CRICOID CARTILAGE
• FRONT OF MUSCULAR PROCESS OF ARYTENOID
• ADDUCTION
• RECURRENT LARYNGEAL NERVE
TRANSVERSE ARYTENOID
• ONLY UNPAIRED LARYNGEAL MUSCLE
• FROM BACK OF ONE ARYTENOID TO THE
OTHER ARYTENOID CARTILAGE
• ADDUCTION
• RECURRENT LARYNGEAL NERVE
OBLIQUE ARYTENOID
• BACK OF MUSCULAR PROCESS OF ONE
ARYTENOID TO APEX OF OPPOSITE ONE
• CROSSES EACH OTHER
• EXTENSION : ARYEPIGLOTTICUS
MUSCLE
• CLOSES INLET , ADDUCTION
• RECURRENT LARYNGEAL NERVE
THYROARYTENOID
• POSTERIOR SURFACE OF THYROID ANGLE
• ANTEROLATERAL SURFACE OF ARYTENOID
CARTILAGE
• DEEPER FIBRES: VOCALIS
• RELAXATION \ SLACKENS VOCAL CORD
• ESSENTIAL FOR RAISING PITCH
• RECURRENT LARYNGEAL NERVE
MUSCLES OF LARYNX
ARTERIAL SUPPLY
• ABOVE LEVEL OF
VOCAL CORDS :
SUPERIOR
LARYNGEAL
• BELOW LEVEL OF
VOCAL CORDS :
INFERIOR
LARYNGEAL
VENOUS DRAINAGE
• INTERNAL
JUGULAR VEIN
NERVE SUPPLY
• ABOVE LEVEL OF
VOCAL CORDS :
INTERNAL
LARYNGEAL -
SENSORY
• BELOW LEVEL OF
VOCAL CORDS:
RECURRENT
LARYNGEAL –
NERVE SUPPLY
• MOTOR : RECURRENT LARYNGEAL NERVE EXCEPT
CRICOTHYROID – EXTERNAL LARYNGEAL
LYMPHATIC DRAINAGE
• ABOVE LEVEL OF
VOCAL CORDS UPPER
DEEP CERVICAL
NODES
• BELOW LEVEL OF
VOCAL CORDS LOWER
DEEP CERVICAL
NODES
APPLIED ANATOMY