H&N 11.1 The larynx Flashcards Preview

Skye's ESA 4 > H&N 11.1 The larynx > Flashcards

Flashcards in H&N 11.1 The larynx Deck (48)
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What position must the vocal cords be in to breath?

Abducted fully


What position must the vocal cords be in to swallow?

Fully adducted (further protection on top of the closure of the epiglottis)


What position must the vocal cords be in to allow for phonation?

Partially abducted.


How can the larynx be divided up into regions?

supraglottis (from the epiglottis to the vestibular folds)

Glottis (from the vestibular folds, containing the vocal cords, to 1cm below the true vocal cords)

subglottis (down to the lower border of the cricoid)


What is the sensory innervation of the different regions of the larynx?

Supraglottis- internal branch (from the superior laryngeal nerve)

Subglottis- recurrent laryngeal nerve

glottis is a mixture of the 2.


What is the motor innervation of the laryngeal muscles?

All innervated by the recurrent laryngeal nerve except the cricothyroid which is innervated by the external branch of the superior laryngeal nerve.


How does the superior laryngeal nerve enter the larynx?

By piercing the thyrohyoid membrane.


Where does the recurrent laryngeal nerve loop under?

Right- subclavian artery

Left- Arch of aorta


Why are the laryngeal nerves at risk of damage?

Due to their long course, pathology anywhere along that course can affect the nerves.


Which arteries accompany the superior laryngeal nerves?

Superior thyroid artery.


Which arteries accompany the recurrent laryngeal nerves?

Inferior thyroid artery.


What pathologies can cause recurrent laryngeal nerve palsy?

-Aortic aneurysm
-apical lung tumours
-thyroid surgery
-laryngeal cancer


who is most at risk of developping laryngeal cancer?

-alcohol drinkers
-people who live in the west


With regards to laryngeal cancer, which type is favourable?

Laryngeal cancer in the supraglottis, it is easier to remove and has a better prognosis.

The lymphatic drainage is minimal here so it is less likely to have spread.


What factors in someones history might lead you towards laryngeal cancer?

-hoarseness of voice
-feeling of a FB in the larynx
-weight loss
-otalgia (due to referred pain of the vagus nerve)


What is the result of a unilateral complete injury of the recurrent laryngeal nerve?

The corresponding vocal cord will assume the paramedian position, somewhere between adducted and abducted.

Breathing will be ok due to compensation of the other vocal cord.

speach may be hoarse, and coughing will be weaker.


What is the result of a bilateral complete injury to the recurrent laryngeal nerves?

both vocal cords will assume the paramedian position,

Rima glotidis will become much narrower, making breathing difficult- may cause stridor

Phonation wont be able to happen


What is the result of progressive lesions involving both nerves?

These are worse than complete lesions.

Abductors are knocked out first, so the patient is unable to abduct their vocal cords, inhibiting breathing all together.
An emergency tracheostomy may be required.

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