Surgical Anatomy of The Larynx

SURGICAL ANATOMY OF
THE LARYNX
DR.SABYASACHI PATI
PG (ENT)
SCB MCH,CUTTACK
INTRODUCTION
1. Larynx is the organ for production of voice or
phonation.
2. The larynx lies in the anterior midline of the neck
extending from the root of the tongue to the
trachea .
3. It lies in front of the C3-C6 but in children it is in
higher level.
Primary action is protection of lower resp.airway &

helps in respiration and phonation
Dimensions
Male Female
• Length – 44mm 36 mm
• Transverse diameter -43mm 41mm
• Ant-post diameter-36mm 36mm
EMBRYOLOGY
• Laryngeal developement starts by 4th week of
IUL
• Completed by 3rd month of IUL
• Laryngeal mucosa develops from the
endoderm of cephalic part of foregut.
• Cartilages and muscles from mesenchyme.
• The larynx descends down in the neck to
achieve its final position C3-C6 by 6 yrs.
EMBRYOLOGY(Contd.)
• Epiglottis- Hypobrachial eminence
• Upper part of thyroid cartilage- 4th arch
• Lower part of thyroid cartilage
• Cricoid,corniculate,cunieform 6th arch
• Intrinsic muscles of larynx
• Upper part of hyoid bone & lesser cornue-2nd arch
• Lower part hyoid bone & greater cornua-3rd arch
LARYNGEAL FRAMEWORK
• Laryngeal cartilages
• Laryngeal joints
• Laryngeal ligaments and membranes
• Cavity of the larynx
• Mucous membrane of the larynx
• Muscles of the larynx
LARYNGEAL CARTILGES
• Total 9 cartilages
• Paired –Corniculate,Cunieform & Arytenoid
• Unpaired-Thyroid,Epiglottis & Cricoid
Laryngeal
Cartilage
Yellow elastic
Hyaline cartlage
Epiglottis
Thyroid
Corniculate
Cricoid
Cunieform
Basal part of aretynoid
Process of aretynoid
Thyroid cartilages
• Largest laryngeal cartilage
• Two rectangular laminae that are fused anteriorly in the
midline with an angle 90 degree in male & 120 degree in
female.
• Incomplete fusion of the two laminae superiorly forms
the thyroid notch
• Attached to each lamina posteriorly are the superior and
inferior cornuae.
• The superior cornue articulate with the greater horns of
the hyoid bone, while the inferior cornua form a synovial
joint with the cricoid cartilage (the cricothyroid joint).
• The superior tubercle is of significance because it marks
the point 1 cm below which the superior laryngeal artery
and nerve cross over the lamina from laterally to pierce
the thyrohyoid membrane.
CRICOID CARTILAGES
ARETYNOID CARTILAGE
(NERVE OF SANTRONI)
(NERVE OF WRISBERG)
LARYNGEAL JOINTS
CRICOTHYROID JOINT CRICOARYTENOID JOINT
1. SYNOVIAL JOINT 1. SYNOVIAL JOINT
2. BETWEEN INFERIOR CORNUAE OF 2. BETWEEN BASE OF ARETYNOID AND

THYROID CARTILAGE AND SIDE OF UPPER BORDER OF LAMINA OF
THE CRICOID CARTILAGE. CRICOID CARTILAGE.
3. HELPS IN ROTATORY MOVEMENTS 3. HELPS IN ROTATORY MOVEMENTS

ALONG TRANSVERSE AXIS. ALONG VERTICAL AXIS.
4. GLIDING MOVEMENTS IN DIFFERENT 4. GLIDING MOVEMENTS IN DIFFERENT

DIRECTIONS. DIRECTIONS.
LARYNGEAL LIGAMENTS & MEMBRANES
EXTRINSIC INTRINSIC
 THYROHYOID MEMBRANE ARE PART OF BROAD SHEET OF FIBROELASTIC

TISSUE K/A FIBROELASTIC MEMBRANE OF THE
Its median and lateral parts are thickened LARYNX.
to form the median and lateral thyrohyoid
ligament CRICO VOCAL MEMBRANE (CONUS
ELASTICUS)
Triangular fibroelastic membrane whose
 CRICOTHYROID MEMBRANE upper border is free and forms the vocal
ligament and lower border attaches to the
cricoid cartilage.
 CRICOTRACHEAL MEMBRANE
QUADRANGULAR MEMBRANE
Lies deep to the mucosa of the
Aryepiglottic fold its lower border forms the
vestibular ligament which lies in the false
cord.
HISTOLOGY LARYNX
1.Ant.Surface of NON-
epiglottis KERATINESD
2.Upper 1/2 of STRATIFIED
post.surface of epiglottis SQUAMOUS
3.Vocal fold EPITHELIUM
4.Upper part of AEF
REST ARE LINED WITH PSEUDOSTRATIFIED CILLIATED COLUMNAR EPITHELIUM.

MUCOUS GLANDS ARE ABSENT IN THE VOCAL CORDS BUT ARE PLENTIFUL IN ANT.
SURFACE OF EPIGLOTTIS ,VESTIBULAR FOLD.
VOCAL LIGAMENT AND POST.SURFACE OF EPIGLOTTIS HAS FIRMLY ATTACHED
MUCOUS MEMBRANES .
Spaces of Larynx
1. Pre-epiglotic space of Boyer
2. Paraglotic space of Tucker
3. Reinke’s space
VOCALIS
Vocal ligament is absent in new born.
Maturly develops around 14 yrs.
UPTO THE VOCAL FOLDS BELOW THE VOCAL FOLDS
Blood supply Superior laryngeal vessel Inferior laryngeal vessel
Nerve supply (sensory) Internal laryngeal nerve Recurrent laryngeal nerve
Lymphatics drainage Anterior superior group of Posterior inferior group of

deep cervical lymph node deep cervical lymph node
Vocal cord has no lymphatics

All intrinsic mucles of larynx are supplied by RLN except
cricothyroid which is supplied by SLN.
THANK YOU

Surgical Anatomy of The Larynx

Uploaded by

Copyright:

Available Formats

Surgical Anatomy of The Larynx

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Surgical Anatomy of The Larynx

Uploaded by

Copyright:

Available Formats

SURGICAL ANATOMY OF

Primary action is protection of lower resp.airway &

2. BETWEEN INFERIOR CORNUAE OF 2. BETWEEN BASE OF ARETYNOID AND

3. HELPS IN ROTATORY MOVEMENTS 3. HELPS IN ROTATORY MOVEMENTS

4. GLIDING MOVEMENTS IN DIFFERENT 4. GLIDING MOVEMENTS IN DIFFERENT

 THYROHYOID MEMBRANE ARE PART OF BROAD SHEET OF FIBROELASTIC

REST ARE LINED WITH PSEUDOSTRATIFIED CILLIATED COLUMNAR EPITHELIUM.

Blood supply Superior laryngeal vessel Inferior laryngeal vessel

Nerve supply (sensory) Internal laryngeal nerve Recurrent laryngeal nerve

Lymphatics drainage Anterior superior group of Posterior inferior group of

Vocal cord has no lymphatics

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.