ANATOMY OF LARYNXDR VIJAY NAGDEVFCPS-II TRAINEEANAESTHESIOLOGYCIVIL HOSPITAL,DUHS KARACHI
LARYNX It is the musculocartilaginous structure, linedwith mucous membrane, connected to the superior part of the trache...
The Anatomy of the LarynxFigure 23.4pgmedicalworld.com
CARTILAGES There are 9 cartilages of larynx 3 are paired and 3 are unpairedUNPAIRED• Thyroid cartilage• Cricoid cartila...
THYROID CARTILAGE The largest laryngeal cartilage (“shield-shaped”) It forms most of the anterior and lateral wallsof th...
CARTILAGESA. THYROID CARTILAGE – Shield shaped- has Sup. & Inf. Horns from upper & lower edgesLaryngealProminenceSup.Horns...
CRICOID CARTILAGE “ringshaped” cartilage. It is a complete ring whose posteriorportion is greatly expanded, providingsup...
CARTILAGESB. CRICOIDcompletering ofcartilage hasnarrow Arch ant.,broad Lamina post.Cricoid meansSignet RingLamina ofcricoi...
EPIGLOTIS• Thin, leaf-like, elastic fibrocartilage• Projects upward behind tongue & hyoid• During swallowing, the larynx i...
LARYNX: CARTILAGESF. EPIGLOTTIS- leaf shapedcartilageposterior to rootof tongue- connected tobody of hyoidand post side of...
PAIRED CARTILAGES Arytenoid - 2pyramidal shapedcartilages abovelamina – havesynovial joints withCricoidCorniculate -nodul...
EXTRINSIC LIGAMENTS OFLARYNX1. Thyrohyoid ligamentlinks larynx to hyoid;2. Cricothyroid ligamentlinks thyroid to cricoid;3...
INTRINSIC LIGAMENTSEpiglottis1. QuadrangularMembrane linksArytenoidTo epiglottisForms the vestibular ligamentArytenoidpgme...
CAVITY OF LARYNX Cavity of larynx contains the vestibularfolds,vocal folds,glottis These vestibular folds and vocal fold...
Glottis It is the vocal apparaus of larynx Makes up the vocal folds and processestogether with rima glottidis
Vocal folds (true vocal cords)• These are the sharp edged folds of mucusmembrane• source of sound from larynx• They produc...
Vestibular folds(false vocalcords) They are protective in function No function in voice production They become swollen ...
INTRINSIC MUSCLES All the Intrinsic muscles of the larynx are pairedexcept tranverse inter arytenoid muscle. These are:...
EXTRINSIC MUSCLES These are divided into two groups: 1)cervical muscles: A)suprahyoid muscles,which act aselevators of ...
MUSCLES OF LARYNX1)THYROARYTENOIDMUSCLE -RelaxesVocal LigamentsDecreases pitchNOSEpgmedicalworld.com
MUSCLES OF LARYNX2) ARYTENOID(Transverse andoblique arytenoid) -Adduct vocal folds3) LATERAL CRICO-ARYTENOID- Adductvocal ...
NERVES OF LARYNX –Branches of VagusA. Superior Laryngeal N.divides to -1. Internal Laryngeal N.GVA Sensory to LarynxAbove ...
LARYNX - ARTERIAL SUPPLYSup. Laryngeal A.from Sup. ThyroidarteryInf. Laryngeal A.from Inf. Thyroidarterypgmedicalworld.com
LARYNX - LYMPHATICSSuperior DeepCervical NodesLarynx above truevocal foldsInferior DeepCervical Nodes-Larynx below truevoc...
LARYNGOSCOPE VIEW OF LARYNXAnt.TongueVocal Folds(true vocalfolds)EpiglottisPost.VestibularFolds(false vocalfolds)vocal fol...
LARYNGOSCOPY GRADING GRADE-I : All structures visible GRADE-II :Only posterior part of glottisvisible GRADE-III :Only e...
Anatomy of larynx
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  1. 1. ANATOMY OF LARYNXDR VIJAY NAGDEVFCPS-II TRAINEEANAESTHESIOLOGYCIVIL HOSPITAL,DUHS KARACHI
  2. 2. LARYNX It is the musculocartilaginous structure, linedwith mucous membrane, connected to the superior part of the trachea andto the pharynx. the essential sphincter guarding the entrance intothe trachea. functioning secondarily as the organ of voice. It is formed by nine cartilages connected `byligaments and eight muscles. begins at the level of vertebra C4or C5and endsat the level of vertebra C7
  3. 3. The Anatomy of the LarynxFigure 23.4pgmedicalworld.com
  4. 4. CARTILAGES There are 9 cartilages of larynx 3 are paired and 3 are unpairedUNPAIRED• Thyroid cartilage• Cricoid cartilage• EpiglottisPAIRED• Arytenoid• Corniculate• Cuneiform
  5. 5. THYROID CARTILAGE The largest laryngeal cartilage (“shield-shaped”) It forms most of the anterior and lateral wallsof the larynx . The thyroid cartilage, when viewed insagittal section, is incomplete posteriorly. The anterior surface of this cartilage bears athick ridge, the laryngeal prominence. This ridge is easily seen and felt, and thethyroid cartilage is commonly called theAdam’s apple.
  6. 6. CARTILAGESA. THYROID CARTILAGE – Shield shaped- has Sup. & Inf. Horns from upper & lower edgesLaryngealProminenceSup.HornsInf.Horns- Inf. horns make synovial hinges joint with Cricoid Cartilage;- Laryngeal Prominence = Adam’s Apple, more prominent inmales pgmedicalworld.com
  7. 7. CRICOID CARTILAGE “ringshaped” cartilage. It is a complete ring whose posteriorportion is greatly expanded, providingsupport in the absence of the thyroidcartilage. Forms most of the posterior wall of larynx The cricoid and thyroid cartilages protectthe glottis and the entrance to the trachea
  8. 8. CARTILAGESB. CRICOIDcompletering ofcartilage hasnarrow Arch ant.,broad Lamina post.Cricoid meansSignet RingLamina ofcricoidArch ofcricoidANT .VIEW POST .VIEWpgmedicalworld.com
  9. 9. EPIGLOTIS• Thin, leaf-like, elastic fibrocartilage• Projects upward behind tongue & hyoid• During swallowing, the larynx is elevated,and the epiglottis folds back over theglottis, preventing the entry of liquids orsolid food into the respiratorypassageways.• Neonates & infants – omega shaped, long,floppy
  10. 10. LARYNX: CARTILAGESF. EPIGLOTTIS- leaf shapedcartilageposterior to rootof tongue- connected tobody of hyoidand post side ofthyroid cartilagePOST. VIEWpgmedicalworld.com
  11. 11. PAIRED CARTILAGES Arytenoid - 2pyramidal shapedcartilages abovelamina – havesynovial joints withCricoidCorniculate -nodules abovearytenoids inaryepiglottic foldsCuneiform - rodshaped, abovecorniculate cartilagesCuneiformCorniculateArytenoidpgmedicalworld.com
  12. 12. EXTRINSIC LIGAMENTS OFLARYNX1. Thyrohyoid ligamentlinks larynx to hyoid;2. Cricothyroid ligamentlinks thyroid to cricoid;3. Cricotracheal ligamentlinks Cricoid to firsttracheal cartilageMedianThyrohyoidLigamentMedianCricothyroidLigamentpgmedicalworld.comConects cartilages to hyoid and trachea
  13. 13. INTRINSIC LIGAMENTSEpiglottis1. QuadrangularMembrane linksArytenoidTo epiglottisForms the vestibular ligamentArytenoidpgmedicalworld.com2.CONUSELASTICUS:forms vocalligament ,framework ofvocal fold / truecordConnects cartilages to each other andforms the internal framework
  14. 14. CAVITY OF LARYNX Cavity of larynx contains the vestibularfolds,vocal folds,glottis These vestibular folds and vocal foldsdivide cavity of larynx into 3compartmentso Superior vestibuleo Ventricle / sinus of the larynxo Subglottic space
  15. 15. Glottis It is the vocal apparaus of larynx Makes up the vocal folds and processestogether with rima glottidis
  16. 16. Vocal folds (true vocal cords)• These are the sharp edged folds of mucusmembrane• source of sound from larynx• They produce audible vibrations• Act as sphincter when tightly adducted
  17. 17. Vestibular folds(false vocalcords) They are protective in function No function in voice production They become swollen during anaphylacticshock causing suffocation
  18. 18. INTRINSIC MUSCLES All the Intrinsic muscles of the larynx are pairedexcept tranverse inter arytenoid muscle. These are: 1)abductors of vocal cords=posterior crico-arytenoid. 2)adductors of vocal cords=lateral crico-arytenoid,interarytenoid,thyroarytenoid,cricothyroid. 3)tensors & adductors of vocalcords=cricothyroid,vocalis & thyro-arytenoid. 4)openers of the laryngeal inlet=thyroepiglottic 5)closers of the laryngeal inlet=interarytenoid &aryepiglottic.
  19. 19. EXTRINSIC MUSCLES These are divided into two groups: 1)cervical muscles: A)suprahyoid muscles,which act aselevators of the larynx B)infrahyoid muscles(strapmuscles),which acts as depressors of thelarynx. 2)pharyngeal muscles including theinferior constrictor muscle.
  20. 20. MUSCLES OF LARYNX1)THYROARYTENOIDMUSCLE -RelaxesVocal LigamentsDecreases pitchNOSEpgmedicalworld.com
  21. 21. MUSCLES OF LARYNX2) ARYTENOID(Transverse andoblique arytenoid) -Adduct vocal folds3) LATERAL CRICO-ARYTENOID- Adductvocal folds4) POSTERIORCRICOARYTENOID– Abductsvocal foldAdduct closes rima glottidisAbduct opens rima glottidisArytenoidsCan rotate/slide pgmedicalworld.com
  22. 22. NERVES OF LARYNX –Branches of VagusA. Superior Laryngeal N.divides to -1. Internal Laryngeal N.GVA Sensory to LarynxAbove True Vocal Folds2. External Laryngeal N.SVE Motor to CricothyroidB. Recurrent Laryngeal N.- GVA Sensory to LarynxBelow True Vocal Folds- SVE motor to all otherMuscles of LarynxGVA=GENERAL VISCERALAFFERENTSVE=SPECIAL VISCERAL EFFERENTSUP. LARYNG. NInt. Laryng. N.Ext. Laryng. N.RECURRENTLARYNG. N.pgmedicalworld.com
  23. 23. LARYNX - ARTERIAL SUPPLYSup. Laryngeal A.from Sup. ThyroidarteryInf. Laryngeal A.from Inf. Thyroidarterypgmedicalworld.com
  24. 24. LARYNX - LYMPHATICSSuperior DeepCervical NodesLarynx above truevocal foldsInferior DeepCervical Nodes-Larynx below truevocal foldsVII.Note: Mucosa Tightly Attached to vocal foldsAnaphylactic Shock Swell Vestibular folds --Suffocation pgmedicalworld.com
  25. 25. LARYNGOSCOPE VIEW OF LARYNXAnt.TongueVocal Folds(true vocalfolds)EpiglottisPost.VestibularFolds(false vocalfolds)vocal foldsadducted whentalking or singingpgmedicalworld.com
  26. 26. LARYNGOSCOPY GRADING GRADE-I : All structures visible GRADE-II :Only posterior part of glottisvisible GRADE-III :Only epiglottis seen GRADE-IV : No reconizable structure

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