1. LARYNX

2. • INTRODUCTION
• DEVELOPMENT OF LARYNX
• SKELETAL FRAMEWORK
• SUBDIVISON OF LARYNX
• MUSCLES
• HISTOLOGY
• BLOOD SUPPLY
• NERVE SUPPLY
• LYMPHATIC DRAINAGE
• APPLIED ANATOMY

3. SITUATION AND EXTENT
MEASURMENTS-
Male larynx V=44mm,T=43 mm,AP=36mm
Female larynx V=36mm,T=41 mm,AP=26mm

4. DEVELOPMENT
• Laryngotracheal tube
ventral wall of primitive pharynx-
28 days of development
• 4th arch-thyroid,cunieform,
corniculate
5th arch- cricoid
6th arch- arytenoid
Epiglottis- caudal part of
hypobranchial eminence
Muscles- 4 & 6 arches

5. CARTILAGES
Paired
• Arytenoid
• Corniculate
• Cuneiform
• Cartilago triticea
Unpaired
• Thyroid
• Cricoid
• Epiglottis
5

6. THYROID CARTILAGE
ANTERIOR ASPECT

7. POSTERIOR ASPECT
LATERAL ASPECT

8. EPIGLOTTIS

9. CRICOID CARTILAGE

10. ARYTENOID CARTILAGE

11. CORNICULATE AND
CUNEIFORM CARTILAGE
Corniculate cartilage
of Santorini
Cunieform cartilage
of Wrisberg
Cartilage
Tritiate
TRITIATE CARTILAGE

12. JOINTS:
Lateral View Antero-superior View
• CRICOTHYROID JOINT • CRICOARYTENOID JOINT
• ARTENOCORNICULATE JOINT

13. MEMBRANES & LIGAMENTS
• Extrinsic
• Thyrohyoid
• Cricotracheal
• Thyroepiglottic
• Hyoepiglottic
• Intrinsic
• Quadrangular membrane &
vestibular ligament
• Cricovocal membrane & vocal
ligament

14. EXTRINSIC
• Thyrohyoid
• Cricothyroid
• Cricotracheal

15. Sagittal section showing interior of left half of larynx
EXTRINSIC
Hyoepiglottic
Ligament
Thyroepiglottic
Ligament

16. INTRINSIC
Sagittal section of left side of larynx showing
laryngeal membranes

17. Coronal section through the larynx and cranial end of trachea
Posterior aspect
SUBDIVISIONS OF LARYNGEAL CAVITY
LARYNGEAL INLET
ARYEPIGLOTTIC FOLD
SACCULE
VESTIBULAR FOLD
VOCAL FOLD

18. PARALUMENAL SPACES
Pre-epiglottic space
Paraglottic space
Subglottic space

19. EXTRINSIC MUSCLES
Extrinsic attached to hyoid
(Depressors)
– Sternothyroid
– Sternohyoid
– Thyrohyoid

20. Extrinsic attached to thyroid
(Elevators )
– Palatopharyngeus
– stylopharyngeus

21. INTRINSIC
Muscles acting on VC
– Length and tension
• Cricothyroid
• Thyroarytenoids
– Abductor
• Post cricoarytenoid
– Adductors
• Lateral cricoarytenoid
• Thyroarytenoid
• Interarytenoideus
Muscles acting on epiglottis
– Aryepiglotticus
– Thyroepiglotticus

22. CRICOTHYROID MUSCLE

23. Posterior Aspect Superior Aspect
POSTERIOR CRICOARYTENOID MUSCLE

24. LATERAL CRICOARYTENOID MUSCLE

25. OBLIQUE ARYTENOID MUSCLE and ARYEPIGLOTTICUS

26. TRANSVERSE ARYTENOID MUSCLE

27. THYROARYTENOID and VOCALIS MUSCLE

28. SHAPE OF RIMA GLOTTIDIS DURING DIFFERENT MOVEMENTS
OF VOCAL CORDS

29. DURING PHONATION DURING WHISPERING

30. NERVE SUPPLY
Internal Laryngeal
Nerve :
only sensory
External Laryngeal
Nerve :
only motor
Recurrent Laryngeal
Nerve : sensory and
motor

31. ARTERIAL SUPPLY
Sup Laryngeal Artery
Inferior Laryngeal Artery

32. VENOUS DRAINAGE
Sup Thyroid Vein
Inf Thyroid Vein

33. LYMPHATIC DRAINAGE
• Above VC upper
deep cervical
{anterosuperior
group}
• Below VC lower
deep cervical
{posteroinferior
group}
Upper deep
cervical
Lower deep
cervical

34. HISTOLOGY
• Histology of Supraglottis
• Epithelium
• Mucous glands
• Rich vascularity & lymphatic
• Histology of Glottis
• Epithelium
• Lamina propria – 3 layers
• Muscle layer- vocalis
• No mucous gland in free edge of vocal cord
• Cartilages

35. HISTOLOGY OF EPIGLOTTIS
•Epithelium
•Lamina propria
•cartilage

36. INFANT LARYNX
• Size
• Position
• Cavity- funnel shaped & short
• Laryngeal cartilages-softer & pliable
• Epiglottis
• Thyroid
• Vocal cord

37. APPLIED ANATOMY

38. CONGENITAL ANOMALIES OF LARYNX
:CLASSIFICATION
• 1. SUPRAGLOTTIS
LARYNGOMALACIA
LARYNGEAL CYST
CONGENITAL LARYNGOCELE
2. GLOTTIS
LARYNGEAL WEB
VOCAL CORD PARALYSIS
3. SUBGLOTTIS:
SUBGLOTTIC STENOSIS
LARYNGOTRACHEAL CLEFT

39. LARYNGOMALACIA
• Excessive flaccidity of supraglottic larynx
• OMEGA SHAPED EPIGLOTTIS

40. LARYNGEAL CYST
• fluid filled smooth swelling in Supraglottic larynx

41. LARYNGOCELE
Air filled dialatation of saccule

42. ANTERIOR
GLOTTIC WEB
•Due to incomplete recanalisation of larynx
LARYNGEAL WEB

43. • SUBGLOTTIC STENOSIS
Abnormal thickening of cricoid cartilage or
fibrous tissue seen below vocal cords

44.  Requires laryngeal mirror and
head mirror
 Structures seen……………
LARYNGOSCOPY-
Indirect Laryngoscopy

45. Done under GA
Before endotracheal
intubation
Direct Laryngoscopy

46. SINGERS /SCREAMERS/CLERGYMENS
NODULES

47. REINKE’S EDEMA

48. CLASSIFICATION OF LARYNGEAL PARALYSIS
• May be unilateral or
bilateral and may involve
1. Recurrent laryngeal nerve
2. Superior laryngeal nerve
a. External LN
b. Internal LN

49. LARYNGEAL OBSTRUCTION

50. LARYNGOTOMY

51. INFLAMMATION OF LARYNX

52. MALIGNANCY OF LARYNX
• Supraglottic
• Glottic
• Subglottic