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ANATOMY OF LARYNX
Dr Safika Zaman,
Dept of ENT & HNS , RKMSP, VIMS
INTRODUCTION
Anterior to the inferior portion of the pharynx and
superior to the trachea.
Protects the lower airway by closing abruptly upon
mechanical stimulation,
Production of sound (phonation),
Coughing,
Valsalva maneuver
Control of ventilation
Sensory organ
ZONES
1. Supraglottis – laryngeal inlet
to ventricle.
2. Glottis- true vocal volds.
3. Subglottis – true vocal fold to
lower border of cricoid.
EMBRYOLOGICAL DEVELOPMENT
4th week of life- laryngeal
development starts.
Tracheobronchial groove is a
outgrowth of primitive gut.
Supraglottis arises from
buccopharyngeal bud (4th
pharyngeal arch),Glottis and
sub-glottis from 6th arch.
CONT…
DEVELOPMENTAL ANOMALY OF
LARYNX
Laryngeal cleft
Laryngomalacia
Laryngeal web
Incomplete canalization
Tracheo- esophageal fistula
Subglottic haemangioma
FRAMEWORK OF LARYNX
Cartilages
Ligaments
Membranes
Muscles
RELATIONS OF LARYNX
Opposite 3rd to 6th vertebrae.
Anterior – skin, infrahyoid
muscles, pyramidal lobe of
thyroid.
Lateral – great vessels of neck,
thyroid.
Posterior – laryngopharynx, pre
vertebral fascia and muscles.
PAEDIATRIC VS ADULT
Positioned higher – inferior margin of cricoid
reaching C4 vertebra.
Thyroid cartilage is positioned almost inside the
arch of hyoid.
Simultaneous breathing and suckling.
Birth size is almost 1/3rd of adult size,
Subglottis is 5-7 mm in diameter.
Epiglottis is more tubular and omega shaped.
Shows acceleratated pattern of growth in the 1st
, 3 year .
MALE VS FEMALE LARYNX
CARTILAGES
Type of cartilage- fibroelastic &
hyaline
Paired and unpaired cartilage
EPIGLOTTIS
Fibroelastic cartilage.
It flops down to close
the airway during
swallowing.
Pre epiglottic space of
Boyer
THYROID CARTILAGE
Most prominent cartilage
Two laminae
Thyroid notch
Superior and inferior cornua
Vocal fold lies closer to the inferior
border of the thyroid cartilage
CONT…
Oblique line of thyroid
cartilage
CRICOID CRTILAGE
Signet ring
Only cartilage to completely encircle the airway
Lumen of the larynx is fixed at this point
In infant larynx this part is narrowest
ARYTENOID CARTILAGES
Pyramid-shaped cartilage
Vocal process
Lateral muscular process
Multi axial movement –
adduction , abduction ,
anterior and posterior sliding
& medial lateral tilting .
CORNICULATE CUNEIFORM
CARTILAGES
Provides additional support to the aryepiglottic folds.
MUSCLES
The intrinsic muscles- 1.
adductors 2.abductors 3. tensor
Adductors – lateral cricoarytenoid,
thyroarytenoid, interarytenoid.
Abductor – posterior
cricoarytenoid
Tensor – cricothyroid
The extrinsic muscles – suprahyoid
group , infrahyoid group .
LATERAL CRICOARYTENOID
MUSCLE
Anterior part of the muscular process of
arytenoid to the superior surface of
cricoid
Adduction and lengthening of the vocal
folds .
THYROARYTENOID
Allow larynx to produce pricise
changes in shape , position ,
tensioning .
Sphinteric action protects the
airway.
External belly is supplied by fast-
twitch nerve fibres- for coughing
and rapid protection of airway.
Vocalis is innervated by slow
twitch fibres – for accurate
movement of phonation.
INTERARYTENOID
Transverse and oblique fibers
Adducts the vocal folds by rotating
This muscle receives nerve supply
from both side RLN.
POSTERIOR CRICOARYTENOID
Sole abductor of the vocal folds
Horizontal belly
Vertical belly
Movement of arytenoid along 2
oblique axis.
CRICOTHYROID MUSCLE
The tensors of the vocal folds .
Laryngeal tilt / rocking – pivoting
the larynx – important for singers
while singing in high pitch .
EXTRINSIC MUSCLE OF LARYNX
Suprahyoid group- myelohyoid, digastric,
geniohyoid,
Stylohyoid.
Elevates the larynx.
Infrahyoid –sternohyoid, omohyoid,
thyrohyoid, sternothyroid.
Depress the larynx.
LIGAMENTS AND MEMBRANES
Thyrohyiod membrane-
Median and lateral thyrohyoid
ligaments
Pierced by neurovascular bundle.
Cricothyroid membrane-
Cricothyroid ligament
Cricothyrotomy
Reduces in MTD
CONT..
Quadrangular membrane – epiglottis to
arytenoid,
Aryepiglottic fold
False vocal cords
Medial wall of PFS.
Conus elasticus- cricovocal membrane –
thick fibroelastic support of glottis.
From superior border of cricoid to ant
commissure and vocal process
Forms vocal ligament.
VASCULAR SUPPLY
NERVE SUPPLY
LYMPHATIC DRAINAGE
SPACES IN THE LARYNX
Ventricle- space between true
and false vocal cords.
Paraglottic space- laterally by
perichondrium of thyroid
caetilage and cricothyroid
membrane.
Posterriorly by mucous
membrane of PFS.
Pyriform sinus- medially AE fold
, laterally thyroid cartilage and
thyrohyoid membrane.
ANTOMY OF VOCAL FOLDS
Thank you

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American College of physicians ACP high value care recommendations in rheumat...
 

Anatomy of larynx ppt