ANATOMY OF LARYNX.pptx

anatomy of human larynx

1. ANATOMY OF HYPOPHARYX AND LARYNX

2. HYPOPHARYNX Also called as larygopharynx Upper border of epiglottis to lower border of cricoid cartilage

3. Boundaries anteriorly: post-cricoid mucosa posterior cricoarytenoid muscle posteriorly: mucosal wall, middle and inferior constrictor muscles superiorly: hyoid bone, glossoepiglottic and pharyngoepiglottic folds inferiorly: cricoid cartilage, cricopharyngeus muscle

4. Subsites Pyriform sinus Post cricoid region posterior wall

5. Boundaries of pyriform sinus Medially by the  aryepiglottic fold  and  arytenoid  and  cricoid cartilages Laterally by the  thyroid cartilage  and  thyrohyoid membrane Superiorly by the level of the  hyoid bone Inferiorly by the level of the inferior border of the cricoid cartilage

6. LARYNX A hollow musculoligamentous structure with a cartilaginous framework that caps the lower respiratory tract. Functions: 1.Protection of lower airway 2.Respiration 3.Phonation 4.Development of high intrathoracic Pressure

7. Extent :C3-C6 Upper border of epiglottis to lower margin of cricoid cartilage

8. FRAMEWORK 3 Unpaired and 3 paired cartilages

9. Unpaired -Thyroid - Cricoid -Epiglottis Paired -Arytenoids -Cuneiforms - Corniculate

10. Thyroid cartilage Two quadrilateral laminae which meet in the midline anteriorly at the thyroid angle , leaving a thyroid notch between them

11. Thyroid angle : thyroepiglottic ligament bilateral vestibular ligament bilateral vocal ligament Oblique line :Thyrohyoid Sternothyroid inferior constrictor muscles Superior border : thyrohyoid membrane Inferior border : cricothyroid muscle

12. Cricoid cartilage Only complete cartilaginous ring Narrow Arch and broad lamina

13. Articulates with thyroid and arytenoid cartilages to form bilateral synovial joints

14. Arytenoid cartilage Pyramidal shaped base apex anterolateral surface medial surface posterior surface 2 processes-vocal process -muscular process

15. Apex – articulate with corniculate cartilage aryepiglottic fold and aryepiglotticus muscle Base – cricoarytenoid joint Muscular process – lateral and posterior cricoarytenoid muscle Vocal process – vocal ligaments

16. Epiglottis Leaf like-elastic fibrocartilage Attached inferiorly to the thyroid cartilage Just below the thyroid notch in midline by the thyroepiglottic ligament

17. Attacmenmts of epiglottis Upper part of anterior surface – connected to tongue by three mucosal folds – median and lateral glossoepiglottic folds Lower part of anterior surface – connected to hyoid bone – hyoepiglottic ligament Anterior surface is separated from thyrohyoid membrane by – pre epiglottic space – filled with fat Lateral margin – attachment to aryepiglottic fold in lower part

18. Membranes Extrinsic Intrinsic

19. Extrinsic Membranes Thyrohyoid Cricothyroid Cricotracheal Hyoepiglottic

20. THYROHYOID MEMBRANE – upper border of thyroid cartilage to upper border of body and greater cornu of hyoid bone Internal laryngeal nerve and superior laryngeal vessels pierce it

21. Intrinsic Membranes Quadrangular membrane Cricovocal membrane

22. QUADRANGULAR MEMBRANE Stretching between epiglottis , thyroid angle and arytenoid cartilage UPPER MARGIN – is in aryepiglottic fold LOWER MARGIN – forms vestibular ligament between thyroid angle and vocal process of arytenoids above the attachment of vocal ligament

23. CRICOVOCAL LIGAMENT Stretches between cricoid , thyroid and arytenoid cartilages Its upper free margin : vocal ligament

24. Laryngeal cavity

25. Glottis Narrowest portion adult larynx Space b/n vocal cords anteriorly and vocal processes and the base of arytenoids posteriorly About 3/5 of its length is called intermemebranous part ( between the vocal cords ) and other intercartilaginous part Average length –males 23mm females 16 mm

26. Vocal folds From the middle of the angle of thyroid to vocal process of arytenoids TRUE VOCAL CORDS – take part in phonation Each fold contains – vocal ligament and vocalis muscle RIMA GLOTTIS Space between the vocal cords –

27. Reinke’s space- UNDER THE EPITHELIUM OF VOCAL CORDS IS A POTENTIAL SPACE WITH SCANTY SUBEPITHELIAL CONNECTIVE TISSUE Accumulation of fluid – fusiform swelling of folds – reinke’s edema

28. Vestibular folds False vocal cords – do not take part in phonation Each fold contains a vestibular ligament Space between the vestibular folds – rima vestibuli

29. Ventricle “Sinus of morgagni ” Small space b/n the true and false vocal cords From its anterior part a pouch –”saccule of hilton “extends b/n the vestibular folds and the thyroid cartilage

30. Abnormal dilatation of saccule- laryngocoele

31. PRE EPIGLOTTIC SPACE OF BOYER BOUNDARIES Anteriorly : Thyrohyoid lig and inner surface of thyroid lamina Posteriorly : Epiglottis Superiorly: Hyopepiglottic lig Inferiorly : Thyroepiglottic lig .

32. Lymphatics Deep cervical LN Supraglottis to upper cervical Glottic –devoid of lymphatics Subglottic -lower deep cervical , prelaryngeal para tracheal &pre tracheal

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