Presentation on theme: "و ما أوتيتم من العلم إلا قليلا"— Presentation transcript:
1 و ما أوتيتم من العلم إلا قليلا LarynxDr. Hassan Shaibah
2 The pharynxa musculofascial half-cylinder that links oral & nasal cavities in the head to the larynx & esophagus in the neck.The pharyngeal cavity is a common pathway for air and 'food'.
3 pharynx is subdivided into three regions, nasopharynx,oropharynx,laryngopharynx
4 Nasopharynxis behind the choanae of the nasal cavities and above the level of the soft palate.There is a large collection of lymphoid tissue (the pharyngeal tonsil) in the mucosa covering the roof of the nasopharynx.Enlargement of this tonsil, known then as adenoids, can occlude the nasopharynx so that breathing is only possible through the oral cavityin the pharynx that the air and food pathwaysthe soft palate serves as a flap-valve which shuts off the mouth from the oropharynx
5 The larynxhollow musculoligamentous structure with a cartilaginous framework that caps the lower respiratory tract.The cavity is continuous below with the trachea, & above opens into pharynx immediately posterior & inferior to the tongue
6 The larynx is both a valve (or sphincter) to close the lower respiratory tract, and an instrument to produce sound.It is composed of:3 large unpaired cartilages (cricoid, thyroid, and epiglottis).3 pairs of smaller paied cartilages (arytenoid, corniculate, and cuneiform).a fibroelastic membrane and numerous intrinsic muscles.
7 The thyroid cartilage the largest one formed by right & left lamina, which are widely separated posteriorly, but converge and join anteriorly.They meet at laryngeal prominence ('Adam's apple').more apparent in men than women.
8 The cricoid cartilage most inferior one completely encircles the airwayIt is shaped like a 'signet ring'Landmark for tracheostomy.
9 The cricoid cartilagehas two articular facets on each side for articulation with other laryngeal cartilages.one facet posteriorly articulation with arytenoid cartilageLateraly facet articulation with the thyroid cartilage.
10 Epiglottisa 'leaf-shaped' cartilage attached to the thyroid cartilage.The upper margin of the epiglottis is behind the pharyngeal part of the tongue.The sides are attached to the arytenoid cartilages by aryepiglottic folds
11 Arytenoid cartilagesare pyramid-shaped cartilages with three surfaces, a base of arytenoid cartilage, an apex of arytenoid cartilage, vocal process, and muscular processArticulate with cricoid cartilage
12 Corniculate articulate with arytenoid cartilages & attach to aryepiglottic folds Cuneiform found the fold to give strength to it
14 Thyrohyoid membrane Connect thyroid cartilages with hyoid bone. Opening on in the lateral part of on each side for superior laryngeal arteries, nerves,Posteriorly thickened lateral thyrohyoid ligaments.thickened anteriorly form the median thyrohyoid ligament.Cricotracheal ligament connect cricoid to 1st ring to trachea
15 Quadrangular membrane: extends between epiglottis & arytenoid cartilagesits inferior margin forms the vestibular ligament covered by vestibular fold (false vocal cord)
16 Cricothyroid ligament its lower margin is attached to cricoid cartilageExtend superiorly as a free margin within the thyroid cartilageIt forms the important vocal ligament on each side.This ligament is covered by vocal folds (true vocal cords)The anterior end of each vocal ligament is attached to the thyroid cartilage, and the posterior end is attached to vocal process of the arytenoid cartilage.
17 Division into three major regions Two pairs of mucosal folds, the vestibular (pink) and vocal folds (white), which project medially from the lateral walls of the laryngeal cavity constrict it and divide it into three major regionsthe vestibule,a middle chamberthe infraglottic cavity
18 Inlet of the Larynx opening is wider in front than behind Bounded by: in front by epiglottislaterally by the aryepiglottic foldposteriorly by arytenoid, corniculate and cuneiform cartilages.
19 The Piriform Fossa is a recess on either side of the fold & inlet It is bounded medially by aryepiglottic fold laterally by thyroid cartilage & thyrohyoid membrane
20 laryngoscope 2 triangularshaped opening: rima vestibuli between two adjacent vestibular foldsrima glottidis between the two adjacent vocal folds).
21 muscles of the larynx cricothyroid muscles Vocalis Posterior cricoarytenoidLateral cricoarytenoidTransverse arytenoidThyro-arytenoidOblique arytenoid
22 Actions on the vocal folds Tightenscricothyroid musclesVocalisAbductPosterior cricoarytenoidAdductThyro-arytenoidTransverse arytenoidLateral cricoarytenoid
24 Cricothyroid muscles The fan-shaped cricothyroid muscles arch of the cricoid cartilage to the thyroid cartilageExternal branch of superior laryngeal nerve from the vagus nerve [X]Stretch the vocal cords
26 Nerves Sensory Nerves: Above the vocal cords: internal laryngeal branch of the superior laryngeal branch of the vagus●Below level of the vocal cords: The recurrent laryngeal nerve
27 Motor NervesAll the intrinsic muscles of the larynx except the cricothyroid muscle are supplied by the recurrent laryngeal nerve.The cricothyroid muscle is supplied by external laryngeal branch of the superior laryngeal branch of the vagus.
28 Superior laryngeal nerves The superior laryngeal nerves originate from the inferior vagal gangliadescend and divide into internal and external branches just above the level of the superior horn of the hyoid bone:the external branch (external laryngeal nerve) supplying the cricothyroid muscle;the internal branch (internal laryngeal nerve) penetrate the thyrohyoid membrane it is mainly sensory and supplies the laryngeal cavity down to the level of the vocal folds.
29 The recurrent laryngeal nerve sensation to the inferior half of the larynxMotor to intrinsic laryngeal musculature. (not CT)
30 BLOOD SUPPLYThe superior laryngeal artery is a branch of the superior thyroid artery, derived from the external carotid arteryThe inferior laryngeal artery derived from the inferior thyroid artery, which originates from the thyrocervical trunk of the subclavian artery.