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Clinical anatomy and topography of the larynx

The larynx (larynx) enters the initial part of the respiratory tract. The upper section opens to the throat, and the lower passes into the trachea. The upper edge of the larynx is at the level of the V cervical vertebra, and the lower is at the level of the VI cervical vertebra.

The laryngeal skeleton consists of cartilage connected by ligaments. Among them are three unpaired: epiglottis (cartilago epiglotica) thyroid (cartila "o thyreoidea), cricoid (cartilago cricoidea) and three paired:

a) scyphoid (cartilagmes arytenoideae),

b) carob (cariilagines coiniculatae),

c) wedge-shaped (cartilagines cuneiformes).

The basis of the skeleton of the larynx is cricoid cartilage. Cartilages of the larynx are interconnected by means of ligaments and joints, allowing their mobility with respect to each other. Laryngeal joints

• paired cricothyroid (art.cricothyreoidea) - between the lateral surfaces of the cricoid cartilage and the thyroid cartilage.

• unpaired cricillary (art.cricoarythenoidea) - between the base of the arytenoid cartilage and the plate of the cricoid cartilage. '

Laryngeal ligaments

1. Thyroid hyoid median and lateral - part of the thyroid hyoid membrane.

2. Epiglottis-thyroid - attaches the epiglottis to the upper edge of the thyroid cartilage.

3. Sublingual epiglottis.

4. Finger tracheal.

5. The median cricothyroid.

6. Sherpalonadgortannaya fold.

7. Lingual-epiglottis middle and lateral. Larynx muscles:

see question No. 24.

Laryngeal cavity:

Three floors are distinguished in the larynx:

1. The upper (vestibular) - above the vocal cords.

2. Medium - the area of ​​the vocal cords.

3. The lower is the sub-vocal cavity.

In the laryngeal cavity there are two pairs of horizontal folds of the mucous membrane: the upper ones are the folds of the vestibule (vestibular folds) and the lower ones are voice.
On each side between the vestibular and vocal folds are recesses - the laryngeal ventricles.

The mucous membrane of the larynx is covered with a multi-row cylindrical ciliated epithelium. In the area of ​​the vocal folds, the epithelium is stratified squamous. In the sub-vocal cavity, a loose submucosal layer is developed. Its inflammatory edema (more often in children) is called false croup.

Laryngeal topography

The larynx is suspended from the hyoid bone by a shield-hyoid membrane. In front, the larynx is covered with skin, subcutaneous tissue and superficial fascia of the neck. On the side of the midline on the thyroid and cricoid cartilages lie the sternum-hyoid muscles. Behind the larynx is bordered by the throat and pharynx and the entrance to the esophagus. The projection of the vocal folds corresponds to the lower third of the thyroid cartilage. On the sides of the larynx are neurovascular bundles.

Blood supply to the larynx comes from a.laryngea superior (large, a.laryngea media departs from it) and a.laryngea Inferior. Venous outflow goes through the superior thyroid vein into the internal jugular vein. Venous outflow occurs through a series of plexuses associated with the venous plexuses of the pharynx, tongue and neck.

Lymphatic drainage from the upper and middle floors occurs in the deep cervical nodes. From the lower floor, the lymph flows into the pretracheal nodes and nodes lying along the internal jugular vein.

The innervation of the larynx is carried out by the sensitive and motor branches of the sympathetic and vagus nerves.

• n.larryngeus superior departs from the vagus nerve and gives two branches - external (mixed) and internal (sensory tyuga);

• n.larryngeus inferior (n.recurrens) - departs from the vagus nerve and goes up.
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