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Anatomy & Physiology of Larynx

Anatomy & Physiology of Larynx. Dr. Vishal Sharma. Larynx (anterior). Larynx (posterior). Larynx (posterior). Larynx (lateral). Larynx (superior). Larynx (superior). Larynx (sagittal section). Larynx (sagittal section). Larynx (coronal section). Vocal fold. Vocal fold.

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Anatomy & Physiology of Larynx

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  1. Anatomy & Physiology of Larynx Dr. Vishal Sharma

  2. Larynx (anterior)

  3. Larynx (posterior)

  4. Larynx (posterior)

  5. Larynx (lateral)

  6. Larynx (superior)

  7. Larynx (superior)

  8. Larynx (sagittal section)

  9. Larynx (sagittal section)

  10. Larynx (coronal section)

  11. Vocal fold

  12. Vocal fold

  13. Laryngeal Cartilages 3 single & 3 paired Single Paired Epiglottis Arytenoid Thyroid Corniculate (Santorini) Cricoid Cuneiform (Wrisberg)

  14. Cartilages (anterior)

  15. Laryngeal Cartilages

  16. Cartilages (posterior)

  17. Cartilages (posterior)

  18. Cartilage Histology Elastic: Epiglottis, corniculate, cuneiform & apex of arytenoid. Little or no calcification. Hyaline:Thyroid, cricoid & remaining arytenoid. Calcify as age advances. Ossification begins by 25-30 yr & is completed by 60 yr.

  19. Indirect Laryngoscopy

  20. Flexible Laryngoscopy RIGHT LEFT

  21. Laryngeal cavity 1. Laryngeal inlet 2. Laryngeal Vestibule 3. Laryngeal Ventricle 4. Rima glottis 5. Subglottis

  22. Pediatric Larynx • Conical in shape & subglottis is narrowest part • Positioned high (C3-C4) • Moves higher during swallowing allowing simultaneous breathing & feeding • Loose sub-mucosal tissues (swell up easily) • Soft cartilages that collapse easily

  23. Membranes & Ligaments • Extrinsic: connect thyroid cartilage & epiglottis with hyoid bone; cricoid cartilage with trachea. • Intrinsic: connect cartilages of larynx to each other.

  24. Extrinsic • Thyrohyoid membrane • Hyoepiglottic ligament • Cricotracheal ligament

  25. Intrinsic

  26. Intrinsic

  27. Intrinsic 1. Quadrangular membrane  Ary-epiglottic ligament  Vestibular ligament 2. Crico-vocal membrane  Vocal ligament  Cricothyroid membrane 3. Thyro-epiglottic ligament

  28. Oncological Divisions A. Supraglottis: laryngeal inlet to apex of ventricle B. Glottis:apex of ventricle to 10 mm below C. Subglottis: lower glottic border to lower cricoid border

  29. Subsites A. Supraglottis: 1. Epiglottis 2. Aryepiglottic folds 3. Ventricular bands 4. Laryngeal Ventricle B. Glottis:1. True vocal cords 2. Anterior commissure 3. Posterior commissure C. Subglottis

  30. Intrinsic Muscles A. Acting on vocal cords Abduction  Posterior crico-arytenoideus Adduction  Lateral crico-arytenoideus  Transverse inter-arytenoideus  Thyro-arytenoideus externa Tension + lengthening  Cricothyroid Relaxation + shortening  Vocalis

  31. Intrinsic Muscles B. Acting on laryngeal inlet Opener  Thyro-epiglottic Closer  Oblique inter-arytenoideus  Ary-epiglottic

  32. Extrinsic Muscles Primary Elevators Secondary Elevators  Stylopharyngeus  Mylohyoid  Salpingopharyngeus  Stylohyoid  Palatopharyngeus  Geniohyoid  Thyrohyoid  Digastric Depressors  Sternohyoid  Sternothyroid  Omohyoid

  33. Posterior cricoarytenoid

  34. Lateral cricoarytenoid

  35. Transverse Inter-arytenoid

  36. Cricothyroid

  37. Thyroarytenoid externa + Vocalis

  38. Oblique Inter-arytenoid

  39. Spaces of Larynx

  40. Reinke’s space

  41. Pre-epiglottic space

  42. Para-glottic space

  43. Communications

  44. Shape of Glottis

  45. Shape of Glottis Quiet Respiration Forced Inspiration

  46. Inspiration

  47. Shape of Glottis Normal voice Whisper

  48. Normal phonation

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