TYPES OF LARYNNGEAL MUSCLES:
- Extrinsic muscles — which move the entire larynx,
- Intrinsic muscles — which move the vocal cords.
- ELEVATORS OF THE LARYNX:
- Thyrohyoid muscles
- DEPRESSORS OF THE LARYNX:
|Inner surface of mandible
|Stylohyoid||Styloid Process||Hyoid bone||Facial nerve|
|Mylohyoid||Mylohyoid line of mandible||Hyoid bone||Trigeminal Nerve|
|Geniohyoid||Genial tubercle of mandible||Hyoid bone||Trigeminal nerve|
|Thyrohyoid||Oblique line of thyroid cartilage||Hyoid bone||c1-c2(ansa)|
|Genioglossus||Genial tubercle of mandible||Tongue||Hypoglossal|
|Sternothyroid||Below sternohyoid on manubrium||Oblique line of thyroid cartilage||Ansa Cervicalis|
|Omohyoid||Suprascapular notch||Hyoid bone||Ansa Cervicalis|
- Posterior cricoarytenoid
- Lateral cricoarytenoid
- Arytenoid with its transverse and oblique fibers
- Thyroarytenoid and its thyroepiglottic and components
(Located on external aspect)
|Anterolateral part of cricoid cartilage||Inferior margin & inferior horn of thyroid cartilage||External laryngeal||stretches & tenses vocal fold|
(Safety muscle of larynx)
|Post. surface of lamina of cricoid cartilage||Muscular process of arytenoid cartilage||Reccurent laryngeal||Abduct vocal fold
Tensor of vocal cord during phonation
|Lateral cricoarytenoid||Arch of cricoid cartilage||Muscular process of arytenoid cartilage||Reccurent laryngeal||Adduct vocal fold|
|Arytenoidtransverse oblique fibers||One arytenoid cartilage||Another arytenoid cartilage||Reccurent laryngeal||Close intercartilagenous part of rima glottidis
Adduct vocal cord
control laryngeal inlet
|Thyroarytenoid||Post. surface of thyroid cartilage||Muscular process of arytenoid cartilage||Reccurent laryngeal||Relaxes vocal cord|
|Vocalis||Depression b/w laminae of thyroid cartilage||Part of vocal ligament & vocal process of arytenoid cartilage||Reccurent laryngeal||Relaxes pot. vocal ligament while maintaining tension of ant. part|
- Muscles Controlling the Laryngeal Inlet are Oblique arytenoid Aryepiglottic muscle
- ARTERIAL SUPPLY
- Upper Larynx
- External carotid artery
- Superior thyroid artery
- Superior laryngeal artery
- Lower Larynx
- Subclavian artery
- Thyrocervical artery
- Inferior thyroid artery
- Inferior laryngeal artery
- VENOUS DRAINAGE:
- Upper Larynx
- Superior laryngeal vein
- Superior thyroid vein
- Internal jugular vein
- Lower Larynx
- Inferior laryngeal vein
- Inferior thyroid vein
- Subclavian vein
- SUPRA GLOTTIC AREA
- Superior lymphatics drain to the upper deep cervical nodes, located at the level of the carotid bifurcation.
- Some drainage passes to prelaryngeal nodes.
- INFRA GLOTTIC AREA
- Drain to the pretracheal lymph nodes of the proximal trachea anteriorly paratracheal nodes laterally and then to the deep cervical and superior mediastinal nodes.
- GLOTIC AREA ( VOCAL FOLDS)
- It is relatively devoid of lymphatics.
- The space deep to the thin mucosa of the true vocal cords, which is called Reanke's space, has no direct lymphatic drainage.
- The spread of carcinoma is, likewise and fortunately, retarded until an invasive process involves tissue peripheral to the true vocal cord.
- DELPHIAN NODE :
- A midline prelaryngeal lymph node, adjacent to the thyroid gland, enlargement of which is indicative of metastasis from thyroid or laryngeal carcinoma.
- Supplied by Vagus nerve:
- Superior laryngeal nerve
- Internal branch (sensory) – areas above the glottis
- External branch (motor and sensory)
- Motor – Cricothyroid muscle
- Sensory – Anterior infraglottic larynx at level of cricothyroid membrane
- 2. Inferior (recurrent) laryngeal n.
- Motor – all intrinsic laryngeal muscles of SAME side (except cricothyroid) and interarytenoid muscle of Both sides
- Sensory – areas below the glottis
- Posterior arytenoid is the abductor of vocal cord
- Sternothyroid & thyrohyoid are attached to oblique line of thyroid
- Tensor of vocal cord are Cricothyroid and internal thyroarytenoid
- Cricothyroid is the only muscle that is located on the external aspect of larynx.
- Posterior cricoarytenoid is the Tensor of vocal cord during phonation
- Posterior cricoarytenoid is the Safety muscle of larynx
- Lateral cricoarytenoid adduct vocal cord.
- Cricothyroid is the only Intrinsic muscle of larynx supplied by External laryngeal nerve.
- Thyrohyoid , Digastric ,Stylohyoid, Mylohyoid, Geniohyoid, Hyoglossus & Genioglossus are elevator muscles of larynx
- Sensory nerve supply of larynx below the level of vocal cord is recurrent laryngeal
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