4 the larynx(anatomy)
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4 the larynx(anatomy) Presentation Transcript

  • 1. The Larynx (Anatomy and physiology) The First Affiliated Hospital of Sun –Yatsen University Aiyun jiang
  • 2. The Larynx
    • the meeting place of voice, swallow and airway.
    • The larynx is an arrangement of several cartilages held together by ligaments and muscles. It is connected above with the hypopharynx and below with the trachea.
    • Out side the cartilagous framework are the strap muscles of the neck.
    • Behind the larynx are the third,fourth, fifth and sixth cervical vertebrae.
  • 3.  
  • 4. The Larynx(Anatomy)
    • CONTENTS
    • Framework
    • Cartilages (*cricoid)
    • (Joints)
    • Muscles(*abductor)
    • Membranes and ligaments
    • * Laryngeal cavity
    • Nerve
    • Blood supply
    • Lymphatic drainage
  • 5. cartilages
    • There are four cartilages:
    • thyroid, cricoid,
    • arytenoid, epiglottic.
    • (1)Thyroid:the largest and
    • most prominent .The
    • thyroid cartilage shields
    • the intrinsic part of the
    • larynx anteriorly and laterally.
    • It consists of two flat lamina which fused in the midline anteriorlly and open posteriorly. Extending upward from each lamina is the superior cornu , and extending downward is the inferior cornu. At its top, is the thyroid notch
  • 6. .
    • (2)Cricoid:The cricoid
    • looks like a signet
    • ring,with a broad ,
    • flat, posterior lamina.
    • * It is the only complete
    • ring of cartilage in the
    • larynx. And it differs
    • from all other tracheal rings that it forms a complete circle. So it is the only rigid area in the respiratory tree. It is very important in maintaining the normal lumen of respiratory tract
  • 7. .
    • (3)Arytenoid. are a
    • pair of small
    • pyramid-shape
    • cartilages . Perch
    • on top of the
    • lamina of cricoid
    • Each Arytenoids cartilage has two processes: a vocal process, to which the posterior end of vocal ligaments is attached, and a muscular process, to which the intrinsic laryngeal muscle is attached.
  • 8. .
    • (4)Epiglottic cartilage:a pear-shaped,curved plate of cartilages covered by mucosa on both surfaces.
    • The superior half is above the level of hyoid bone and projects freely into the oropharynx.
  • 9. joints
    • There are just two pair of joints in the larynx,the cricoarytenoid(CA) and cricothyroid(CT),all the internal adjustments of the vocal cords are medeated through them.
    • CA: Enables the vocal cords to drawn away from the midline(abduction) or brought to midline(adduction).
    • CT: It is important in pitch control and provides a mechanism for regulating the
    • lengthening of the vocal folds.
    • When these two cartilages are
    • pulled towards each other, the
    • vocal folds are lengthened, when
    • towards apart,the vocal folds are
    • shortened.
  • 10. .
  • 11. Muscles(1)
    • (1)Abductor Muscles:posterior cricoarytenoid muscle(PCA).
    • The major muscles responsible for the arytenoid rocking
    • and gliding apart, and for the abduction of the vocal
    • folds.
    • (2)Adductor muscles:
    • 1) interarytenoid muscles(IA): Their action is to pull the
    • upper tips of the arytenoids together.
    • 2)lateral cricoarytenoid muscles(LCA): adduct the
    • arytenoids and are also able to squeeze the anterior tips of
    • the vocalprocesses tightly in a condition of medial
    • compression.
  • 12. Muscles(2)
    • (3)Tensor Muscles: Cricothyroid muscles(CT). Originate
    • from the front of the cricoid cartilages and insert into
    • the thyroid cartilage.
    • *J ust remember PCA is responsible for abduction of VC , IA and LCA are responsible for adduction of VC,CT is responsible for tense of VC
  • 13. Membranes and Ligaments
    • (1)Conus elasticus:Its free edge thickens to form the vocal ligaments (which lie between the arytenoid and thyroid cartilages ) and False vocal folds ( which is above the true vocal folds)
    • (2)Thyrohyoid membrane:between the hyoid bone and the thyroid cartilage.
    • (3)Cricothyroid membrane:between the cricoid and thyroid cartilages.At this point the lumen of the airway is closest to the skin of the neck and therefore, most accessible in an emergency.
  • 14. .
  • 15. Laryngeal cavity
    • (1)supraglottis: the part of
    • the larynx above the level
    • of the vocal cords.
    • It consists of the epiglottis,
    • the aryepiglottic folds,
    • the ventricular band and
    • the laryngeal ventricle.
    • (2)glottis:the space between the vocal cords.
    • (3)subglottis: the part of the larynx below the level
    • of the vocal cords.
  • 16. .
  • 17. Blood supply
    • The superior thyroid artery through its branch, superior laryngeal artery
    • The inferior thyroid artery through its branch, inferior laryngeal artery
    • Provide most of the blood supply to the larynx
  • 18. .
  • 19. Nerve supply
    • the entire laryngeal nerve supply
    • is from the vagus
    • (1)recurrent laryngeal nerves
    • provide the motor supply
    • to the intrinsic muscles of
    • the larynx and the sensory
    • innervation to the subglottis.
    • (2)Superior laryngeal
    • nerve are the motor
    • nerves of the cricothyroid
    • muscles and provide the sensory supply to the supraglottis and glottis.
    • .
  • 20. Lymphati drainage
    • (1)the supraglottis:is richly supplied with lymphatic vessels which drain into the ipsilateral midjugular lymph nodes.
    • (2)the vocal cords have few lymphatic spaces and poor lymphatic drainage.
    • (3)the subglottis is richly supplied with lymphatic vessels which empty into the paratracheal nodes and the Delphian node.
    • so carcinoma metastasis of the supraglottis may occur in early stage of the tumor
    • carcinoma metastasis of the glottis is not common if the tumor doesn’t involve the supraglottis and subglottis
  • 21. Chracters of larynx in children
    • 1 、 location: high 2 、 cartilages:soft 3 、 pultaceous connect tissue , richly supplied
    • with lymphatic vessels
    • 4 、 lumen(space): narrow 5 、 curved epiglottis 6 、 short VC, high pitch
  • 22. Physiology of the Larynx
    • 1 Protection:To protect the lower respiratory passages(cough reflex, sphincteric action—three levels)
    • 2 Respiration: To conduct air to and from the lungs
    • 3 phonation: To function as a vocal organ
    • 4 To fix the chest in heavy physical effort