1) The document describes the radiological anatomy of the larynx, including its cartilages, relations to surrounding structures, and intrinsic muscles. 2) It details the unpaired and paired cartilages that make up the larynx, including the thyroid, cricoid, epiglottic, and arytenoid cartilages. 3) The supraglottic region includes structures like the false vocal cords, aryepiglottic folds, and preepiglottic space, while the subglottic region extends from the true vocal cords to the inferior cricoid cartilage.

1. RADIOLOGICAL
ANATOMY OF
LARYNX
BY DR RINSHA
RAFEEQUE

2. LARYNX
• The larynx is an inferior continuation
of the oropharynx.
• 5-7 cm structure
• Upper boundary starts at tip of
epiglottis opposite to 3rd to 4th
cervical vertebra
• Lower end at cricoid cartilage
opposite to 6th cervical vertebra.

3. RELATIONS
Anterior: strap muscles
Posterior: esophagus, laryngopharynx
Superior: hyoid bone, laryngopharynx
Inferior: trachea

5. LARYNGEAL CARTILAGES
UNPAIRED
• Thyroid cartilage
• Cricoid cartilage
• Epiglottic cartilage
PAIRED
• Arytenoid cartilage
• Accessory cartilages
1. Cuneiform cartilage
2. Corniculate cartilage

9. 1) EPIGLOTTIS
Superior most, midline leaf-shaped
cartilage.
Free margin and a fixed portion
(stem).
The free margin of the epiglottis is
closely related to the base of tongue –
the median glosso-epiglottic fold and
projects above the level of the hyoid

11. 2) THYROID CARTILAGE
• Largest
• 2 anterior lamina meet anteriorly at
acute angle
• Superior thyroid notch present at
anterior superior aspect
• Superior cornua are elongated and
narrow attaching to thyrohyoid
ligament
• Inferior cornua are short and thick
and articulating medially with cricoid
cartilage.

12. 3) CRICOID CARTILAGE
• Only complete ring in endolarynx
• Has 2 portions : anterior arch and
posterior lamina
• Lower border of cricoid cartilage is
junction between larynx above and
trachea below

13. ARYTENOID CARTILAGE
 Paired pyramidal cartilages that sit
at top of cricoid cartilage lamina
posteriorly
 VOCAL PROCESS: attaches to the
vocal fold
 MUSCULAR PROCESS: lateral
projection attaches to the
posterior and lateral
cricoarytenoid muscles
 SUPERIOR PROCESS: superior
projection articulates corniculate
cartilage
 CORNICULATE CARTILAGE :
rests on top of superior
process of arytenoid within
aryepiglottic folds
 CUNEIFORM CARTILAGE:
lateral and superior to
corniculate within ary
epiglottic folds.

14. PARTS OF LARYNX:
LARYNGEAL
VENTRICULAR
COMPLEX (LVC)

17. SUPRA GLOTTIS
 THE VENTRICLE itself is seen as a small air-filled
outpouching between the false and true cords
 FALSE VOCAL CORDS :
 ARY EPIGLOTTC FOLD : projects from tip of arytenoid
cartilage to inferolateral part of epiglottis
Represents superolateral part of supraglottis dividing into
pyriform sinus.

18. PRE-EPIGLOTTIC SPACE
Fat-filled space, rich in lymphatics.
Superiorly by the hyoepiglottic ligament
Anteriorly by the thyrohyoid membrane,
Inferiorly by the thyroepiglottic ligament
and
Posteriorly by the epiglottis.
The PES and PGS communicate with each
other superiorly.

19. THE PARAGLOTTIC SPACE
located deep to the true and false
cords and bound laterally by the
thyroid and cricoid cartilages
It extends upto the undersurface of the
true vocal cords
continuous with the extralaryngeal soft
tissues between the thyroid and cricoid
cartilages; an important pathway for
extralaryngeal tumor spread

20. GLOTTIS
 ANTERIOR COMMISSURE : midline anterior meeting point of the true vocal
cords. It comprises of the
1. Anterior cord,
2. The anterior junction of the two vocal cords,
3. The thyroid cartilage and
4. Broyle’s ligament, a fibrous structure connecting the vocal ligaments to
the cartilage
 POSTERIOR COMMISSURE is the mucosal surface on the anterior surface of
the cricoid cartilage between the arytenoid cartilages.
 Composed of THYROARYTENOID muscle

23. SUB GLOTTIS
 Extends from under surface of true vocal cord to inferior
cricoid cartilage
 CONUS ELASTICUS : fibro elastic membrane extending from
medial margin of true vocal cord to cricoid below.

24. INTRINSIC MUSCLES OF THE
LARYNX
1) Muscles of the inlet
 Aryepiglottic muscle
 Oblique arytenoid muscle
 Thyroepiglottic muscle

25. 2) Muscles of the vocal folds
 Cricothyroid muscle
 Thyroarytenoid muscle
 Posterior cricoarytenoid muscle
 Lateral cricoarytenoid muscle
 Interarytenoid muscle
 Vocalis muscle

26. VASCULAR SUPPLY
• Above the vocal
cords: superior
laryngeal vessels
• Below the vocal
cords: inferior
laryngeal vessels

27. LYMPHATIC SUPPLY
• Supraglottic: superior deep cervical nodes and the pre-epiglottic nodes
• Subglottic: inferior deep cervical nodes and the prelaryngeal (delphian) nodes
NERVE SUPPLY :
MOTOR: the recurrent laryngeal nerve supplies all the intrinsic muscles of
the larynx apart from the cricothyroid muscle
SENSORY:
• SUPRAGLOTTIC: internal laryngeal nerve (branch of the superior
laryngeal nerve)
• INFRAGLOTTIC: recurrent laryngeal nerve

42. CT FINDINGS IN LARYNX
Post contrast- no enhancement of mucosal surface of larynx but
hypopharyngeal mucosa enhances
False vocal cords, aryepiglottic folds , pre and para epiglottic spaces are fat
containing hence they appear hypo attenuating
Ossified cartilages appear hyperdense in outer and inner cortex with a
hypodense central area (medullary fat)
Cortical bone, fatty marrow and non ossified hyaline cartilage do not show
post contrast enhancement
Collapsed pyriform fossa may mimic a tumor on CT ( do Valsalva to exclude)

43. THANK YOU