Osteology |
|---|
| Bone/Cartilage |
Structure |
Description |
Notes |
| occipital |
|
the bone forming the posterior surface of the skull |
it articulates superolaterally with the parietal bones through the lambdoid
suture, anteroinferiorly with the temporal bone and anteriorly with the body
of the sphenoid bone |
|
pharyngeal tubercle |
projection located anterior to the foramen magnum |
attachment site for the superior pharyngeal constrictor m. |
| palate |
hard palate |
concave vaulted structure whose space is filled by the tongue when at rest |
| sphenoid |
|
an irregularly shaped bone forming the central portion of the skull |
it has many parts, including a body, greater wing, lesser wing and pterygoid plates (Greek, sphenoid = wedge-shaped) |
|
medial pterygoid plate |
thin plate of bone that projects posteriorly from the pterygoid process |
it is the attachment of the superior pharyngeal constrictor m. & the pharyngobasilar fascia (Greek, pterygoid = wing-shaped) |
|
pterygoid hamulus |
hook-like projection from the inferior end of the medial pterygoid plate |
it acts as a pulley for the tendon of the tensor veli palatini m. (Greek, pterygoid = wing-shaped; Latin, hamus = hook) |
|
sinus |
located in the body of the sphenoid and are separated by a bony septum; the sinuses make the sphenoid fragile (Greek, sphenoid = wedge-shaped) |
| hyoid |
|
a "U"-shaped bone consisting of several parts: body, 2 greater horns, 2
lesser horns |
the hyoid bone ossifies completely in middle life; the body articulates with the greater horns via cartilage and with the lesser horns via fibrous joints prior to ossification; an important site for muscle attachments (suprahyoid and infrahyoid muscle groups) (Greek, hyoid = U-shaped) |
|
body |
the middle portion of the "U"-shaped bone |
the body of the hyoid bone articulates with the greater horns posteriorly |
|
greater horn (cornu) |
posteriorly directed limbs of the "U"-shaped bone |
each greater horn articulates with the body and lesser horns anteriorly;
origin of middle pharyngeal constrictor m. and hyoglossus m. |
|
lesser horn (cornu) |
articulates with the greater horn at its junction with the body |
the inferior end of the stylohyoid ligament attaches to the lesser horn |
| arytenoid cartilage |
|
a pyramid shaped cartilage located on the superior margin of the cricoid lamina |
paired; each is connected to the epiglottis above via the aryepiglottic m. and to the thyroid cartilage anteriorly via the vocal ligament; paired arytenoid cartilages are pulled together (adducted) by the arytenoid m. (Greek, arytenoid = pitcher appearence, in certain animals, these two cartilages were noted to resemble the mouth of a pitcher with a large spout) |
|
vocal process |
projects anteriorly to provide attachment for the vocal ligament |
| cricoid cartilage |
|
the inferior & posterior cartilage of the larynx; it forms a complete cartilaginous
ring; its arch projects anteriorly and its lamina is broad and flat posteriorly |
connected: above to the thyroid cartilage via the inferior horn of the thyroid cartilage, to the conus elasticus, to the arytenoid cartilages which sit atop the lamina; connected below to the first tracheal ring via the cricotracheal ligament (Greek, cricoid = a ring form) |
| thyroid cartilage |
|
the large anterior cartilage of the larynx; it has several parts: laminae
(2), superior horns (2), inferior horns (2), oblique line, superior thyroid
notch, |
connected above to the hyoid bone via the thyrohyoid membrane; connected below to the cricoid cartilage via the inferior horn of the thyroid cartilage; connected posteriorly: to the arytenoid cartilage via the vocal ligament and thyroarytenoid m., to the epiglottic cartilage via the thyroepiglottic ligament; it tilts anteriorly to increase the length of the vocal ligament and raise the pitch of the voice |
|
lamina |
a broad flat plate of cartilage forming one side of the thyroid cartilage;
two laminae fuse anteriorly in the midline to form the thyroid cartilage |
the laryngeal prominence is the line of fusion of the two laminae; each lamina is connected superiorly to the hyoid bone by the thyrohyoid membrane (Latin, lamina = a thin plate) |
|
superior horn |
the rounded, superior projection of the posterior border of the thyroid
lamina |
it is connected superiorly to the greater horn of the hyoid bone by the
lateral thyrohyoid ligament |
|
inferior horn |
the rounded, inferior projection of the posterior border of the thyroid
lamina |
it is connected inferiorly to the cricoid cartilage by the cricothyroid
articulation (a synovial joint) |
|
oblique line |
ridge which descends diagonally from superior to inferior on the lateral
surface of the thyroid lamina |
a line of muscle attachment |
|
laryngeal prominence |
the line of fusion of the thyroid laminae |
known to the lay person as the "Adam's apple"; the laryngeal prominence
is a secondary sexual characteristic - in postpuberal males the angle of the
laryngeal prominence is approximately 90o and in females the angle is approximately
120o |
|
superior thyroid notch |
the notch at the superior end of the laryngeal prominence |
it is connected to the hyoid bone by the median thyrohyoid ligament |
| epiglottis |
|
the superior part of the larynx |
epiglottic cartilage is covered by a mucous membrane (Greek, epiglottis = the mouth of the windpipe) |
Muscles
|
| Muscle |
Origin |
Insertion |
Action |
Innervation |
Notes |
| cricoarytenoid, posterior |
posterior surface of the lamina of the cricoid cartilage |
muscular process of arytenoid cartilage |
draws the muscular process posteriorly, abducting vocal folds |
inferior laryngeal nerve, from recurrent laryngeal nerve, a branch of the vagus nerve (X) |
posterior cricoarytenoid is the sole ABductor of the vocal cords |
| arytenoid, transverse |
posterior surface of arytenoid cartilage |
posterior surface of contralateral arytenoid cartilage |
draws arytenoid cartilages together, adducting vocal folds |
inferior laryngeal nerve, from recurrent laryngeal nerve, a branch of the vagus nerve (X) |
arytenoideus is considered one muscle with oblique and transverse parts |
| arytenoid, oblique |
muscular process of arytenoid |
posterior surface of contralateral arytenoid cartilage, near apices |
draws arytenoid cartilages together, adducting vocal folds |
inferior laryngeal nerve, from recurrent laryngeal nerve, a branch of the of vagus (X) |
arytenoideus is often considered one muscle with oblique and transverse fibers |
| thyroarytenoid |
inner surface of the thyroid cartilage anteriorly |
lateral border of the arytenoid cartilage |
draws the arytenoid cartilage forward, relaxing and adducting the vocal
folds |
inferior laryngeal nerve, from recurrent laryngeal nerve, a branch of the
vagus nerve (X) |
its subsidiary parts are the thyroepiglottic m. and the vocalis m.; the
medial most fibers of thyroarytenoid that insert along the vocal ligament are
called the vocalis muscle |
| lateral cricoarytenoid |
arch of the cricoid cartilage |
muscular process of the arytenoid cartilage |
draws the muscular process of the arytenoid cartilage anteriorly, which
pivots the arytenoid cartilage and adducts the vocal folds |
inferior laryngeal nerve, from the recurrent laryngeal nerve, a branch of
the vagus nerve (X) |
an antagonist of the posterior cricoarytenoid m.; the arteries that supply
the larynx anastomose within the larynx to supply the mucous membranes and
muscles |
| cricothyroid |
arch of the cricoid cartilage |
inferior border of the thyroid cartilage |
draws the thyroid cartilage forward, lengthening the vocal ligaments |
external branch of superior laryngeal nerve, a branch of the vagus nerve
(X) |
this is the only intrinsic muscle of the larynx that is not supplied by
the recurrent laryngeal n.; ALL other laryngeal muscles are innervated by recurrent
laryngeal nerve, via its inferior laryngeal branch |
Nerves
|
| Nerve |
Source |
Branches |
Motor |
Sensory |
Notes |
| superior laryngeal |
vagus (X) |
internal & external brs. |
cricothyroid, inferior pharyngeal constrictor, secretomotor to mucous glands of larynx above vocal folds |
mucous lining of larynx above vocal folds |
external br. supplies cricothyroid m.; all other intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve |
| inferior laryngeal |
recurrent laryngeal br. of vagus (X) |
|
all muscles of larynx except cricothyroid: thyroarytenoid, oblique & transverse arytenoid, posterior & lateral cricoarytenoid, aryepiglottic, thyroepiglottic, vocalis; secretomotor to mucous glands of larynx below vocal fold |
mucous lining of larynx below vocal fold |
continuous with recurrent laryngeal at inferior border of cricopharyngeus |
| recurrent laryngeal |
vagus (X) |
esophageal brs., tracheal brs., cardiac brs., pharyngeal brs., inferior laryngeal n. |
upper esophagus, lower pharynx, laryngeal ms. (except cricopharyngeus); smooth muscle of trachea; secretomotor to mucous glands in upper esophagus, lower pharynx, larynx below vocal fold, trachea; cardiac muscle of heart (slows rate, decreases force of contraction) |
upper esophagus, lower pharynx, larynx below vocal folds, GVA from heart |
right recurrent loops posteriorly around right subclavian a.; left recurrent loops posteriorly around aortic arch & ligamentum arteriosum; inferior laryngeal br. supplies all intrinsic muscles of the larynx EXCEPT cricothyroid m. |
Arteries
|
| Artery |
Source |
Branches |
Supply |
Notes |
| common carotid |
brachiocephalic trunk (right), aortic arch (left) |
external & internal carotid (terminal brs.) |
most of head & upper neck |
common carotid a. bifurcates at the level of the superior border of the thyroid cartilage; carotid sinus & body located at bifurcation |
| internal carotid |
common carotid |
none in the neck; in the head: ophthalmic, post. communicating, ant. & middle cerebral (terminal brs.) |
brain, eye, forehead |
primary blood supply to the brain; anastomoses with vertebral aa. |
| external carotid |
common carotid |
superior thyroid, ascending pharyngeal, lingual, facial, occipital, post. auricular, maxillary & superficial temporal (terminal brs.) |
upper neck, face & scalp |
primary blood supply to face & superficial head |
| superior thyroid |
external carotid |
infrahyoid br., sternocleidomastoid br., sup. laryngeal, cricothyroid br., ant., post. & lat. glandular brs. |
thyroid gland, upper larynx, infrahyoid muscles, sternocleidomastoid |
|
| ascending pharyngeal |
external carotid |
pharyngeal brs., inf. tympanic, post. meningeal |
pharynx |
arises from the medial side of the external carotid a. close to the birfurcation |
| lingual |
external carotid |
suprahyoid br., dorsal lingual brs., deep lingual, sublingual |
tongue, suprahyoid muscles, palatine tonsil |
(Latin, lingula = tongue) |
| occipital |
external carotid |
sternocleidomastoid brs., auricular br., mastoid br., descending br., occipital brs. |
lateral & post. neck, post. scalp |
anastomoses with deep cervical; joins greater occipital nerve posteriorly |
| facial |
external carotid |
ascending palatine a., tonsilar br., submental a., sup. & inf. labial as., lat. nasal br., angular a. |
lower part of palatine tonsil, submandibular gland, facial muscles & fascia |
its angular branch anastomoses with the ophthalmic a. |
| superior laryngeal | superior thyroid | | upper larynx internally | |
| inferior laryngeal |
inferior thyroid |
|
lower larynx internally |
|
Viscera/Fascia
|
| Organ |
Location/Description |
Notes |
| laryngeal inlet |
pathway through which the laryngopharynx communicates with the larynx |
|
| larynx |
located anterior to laryngopharynx at level of C4-6 vert.; composed of thyroid, cricoid, epiglottic, arytenoid, cuneiform & corniculate cartilages |
contains vocal ligaments |
| vestibular fold |
mucosal fold located between laryngeal vestibule & ventricle |
also known as: false vocal fold |
| vocal folds |
mucosal covering of vocal ligament & thyroepiglottic muscle (vocalis part) |
located inferior to laryngeal ventricle |
| laryngeal ventricle |
lateral diverticulum of larynx located between false & true vocal folds (or vestibular fold & vocal fold) |
|
| laryngeal vestibule |
part of larynx, located below epiglottis between aryepiglottic & vestibular folds |
lateral wall contains quadrangular membrane (submucosa) |
| quadrangular membrane |
submucosal lining of the laryngeal vestibule |
|
| rima glottidis |
the opening between the vocal folds |
|
| glottis |
the vocal folds plus the space between them |
|
| infraglottic cavity |
the portion of the laryngeal cavity that lies inferior to the vocal folds; it is bounded superiorly by the glottis and opens inferiorly into the trachea |
|
| aryepiglottic fold |
cover aryepiglottic muscles between lateral margin of epiglottis & arytenoid cart. |
|
| conus elasticus |
elastic submucous membrane attaching on upper margin of arch of cricoid cart. |
thickened upper margin is vocal ligament (Latin/Greek, conus elasticus = elastic cone-shaped structure) |
| vocal ligaments |
located in larynx within (true) vocal folds; connect inner anterior surface of thyroid cart. to vocal process of arytenoid cart.; represents thickened superior margin of conus elasticus |
vibration creates sound; brought together by arytenoid & lateral cricoarytenoid ms., moved apart by posterior cricoarytenoid ms. |
| pharynx |
connects nasal & oral cavities with larynx & esophagus |
divided into 3 parts: nasopharynx, oropharynx & laryngopharynx |
| nasopharynx |
connects nasal cavity with oropharynx; located posterior to posterior nasal apertures and superior to pharyngeal isthmus (soft palate & posterior wall of pharynx) |
contains torus tubarius, pharyngeal recess, pharyngeal tonsil |
| torus tubarius |
mucosal fold covering the anteromedial end of the auditory
tube cartilage |
torus tubarius projects toward the midline from the lateral wall of the nasopharynx (Latin, torus = knot) |
| uvula |
conical process that is the posteroinferior extension of the soft palate |
(Latin, uva/uvula = a grape) |
| oropharynx |
connects: anteriorly with oral cavity through oropharyngeal isthmus (palatoglossal arch), superiorly with nasopharynx through pharyngeal isthmus (posterior margin of soft palate), inferiorly with laryngopharynx at superior margin of epiglottis |
contains palatine tonsil in tonsilar bed between palatoglossal & palatopharyngeal arches |
| palatoglossal fold |
fold of mucosa covering the palatoglossus m. |
palatoglossal fold marks the anterior boundary of the bed of the palatine tonsil |
| palatopharyngeal fold |
fold of mucosa covering the palatopharyngeus m. |
palatopharyngeal fold marks the posterior boundary of the bed of the palatine tonsil |
| laryngopharynx |
connects: superiorly with oropharynx at superior border of epiglottis, anteriorly with larynx through laryngeal inlet (epiglottis, aryepiglottic folds, arytenoid cartilages), inferiorly with esophagus at lower border of cricoid cartilage |
contains piriform recesses lateral to aryepiglottic folds |
| lateral glossoepiglottic fold |
located between base of tongue & epiglottis lateral to valleculae epiglottica |
|
| median glossoepiglottic fold |
located between base of tongue & epiglottis |
separates the paired valleculae epiglottica |
| piriform recess |
located lateral to aryepiglottic folds |
(Latin, pirum = pear + forma = form) |
| esophagus |
connects: superiorly with laryngopharynx at lower border of cricoid cartilage, inferiorly through diaphragm at t10 vert. level to reach stomach; upper third is skeletal muscle innervated by recurrent laryngeal |
lower 2/3rds is smooth muscle innervated by vagus via esophageal plexus |
Lymphatics
|
| Structure |
Location |
Afferents from |
Efferents to |
Regions drained |
Notes |
| tonsil, pharyngeal |
roof and posterior wall of the nasopharynx |
lymphatic vessels of the wall of the pharynx |
superior deep cervical nodes |
"guards" the entrance to the nasopharynx |
part of the tonsillar ring (of Waldeyer); known as adenoids when inflamed |
| tonsil, palatine |
lateral wall of the oropharynx between the palatoglossal and palatopharyngeal arches |
lymphatic vessels of the posterior tongue and palatoglossal/palatopharyngeal arch region |
superior deep cervical nodes, especially the jugulodigastric node |
"guards" the entrance of the oropharynx |
part of the tonsillar ring (of Waldeyer); often referred to as "the" tonsils |
| tonsil, lingual |
superior surface of root of tongue |
lymphatic vessels of the root of tongue and valleculae epiglottica |
superior deep cervical nodes |
"guards" entrance of oropharynx |
part of tonsillar ring (of Waldeyer) |
