❖ Extrinsic laryngeal muscles ❖ Intrinsic laryngeal muscles ✓ adductors ✓ abductors ✓ sphincters ✓ tensors ✓ relaxers
❖ Rima Glottis ❖ Vocal lig.
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Muscles of larynx
Tracheoesophageal Fistula
Cases
• 当John完成了第一次解剖学考试后，父亲决定带他去吃牛排以示庆 祝。在喝了一点酒后，他注意到父亲说话有些含糊不清，进食速度 加快。过了一会儿，他发现父亲脸色突然改变，然后突然倒在地板 上。开始他怀疑父亲可能是休克、心脏病或癫痫发作。但他还发现 父亲脉搏很强，脸色开始发青。这时他意识到可能是窒息。他将父 亲的嘴张开，看到一大块牛排卡在喉的后部。他将示指深入父亲口 中，试图取出牛排，但未成功。然后他将父亲翻到俯卧位，实施海 姆利克操作法。
• 问题：1. 扁桃体的定义？ 2. 患者耳痛的解剖学基础？ 3. 该病例中，哪个淋巴结可能肿大？
Cases
• 冰球淘汰赛中，一名未戴头盔的队员被击倒，头部剧烈 碰撞冰面，短暂头晕，视觉模糊约20秒。休息后，除迟 发性头痛没有别的主诉。
• 问题：1. 你认为有颅顶骨折吗？为什么？ 2. 迟发性头痛提示什么？ 3. 如果检测到鼻腔流出清亮液体，可能来源于何
Muscles of larynx
Muscles and nerves of larynx
Nerves and vessels
❖ Branches of Vagus n
sup. inf. ext. int. recurrent
❖ Branches of the superior and inferior thyriod a. sup. inf.
Intrinsic ligaments
Cricothyoid membrane
Intrinsic ligaments
Vocal ligaments
Vocal fold, Glottis
rima glottidis
Variations in shape of rima glottidis
Muscles of larynx
Internal laryngeal cavity
❖ Vestibule of larynx ❖ Intermedial laryngeal cavity
(ventricle of the larynx)
❖ Infraglottic cavity
Clinical correlation
Heimlich Maneuver
Laryngoscopy
Trachea
tracheal rings trachealis muscle from C6 to sternal angle
Tracheostomy & its anatomical relationships
Anatomical relationships
Larynx Trachea Esophagus
Dept. of Anatomy Zhou Hong Ying
General arrangement of neck
Viscera of the Neck
Larynx
Position Relationship Function
Skeleton of larynx:
Cervical Esophagus
Vessels & nerves of the Cervical Esophagus
➢inferior thyroid a. & v. ➢paratracheal & inferior deep cervical lymph nodes ➢recurrent laryngeal n. & cervical sympathetic trunks
Vestibular folds
Cricothyoid membrane
vocal ligament, vocal fold, cricothroid ligament
Joints of larynx
Membrane and ligaments
Extrinsic ligaments
Intrinsic ligaments Quadrangular membrane
Cartilages of larynx
Cartilages of larynx
Joints of larynx
❖Cricothyroid joints ❖Crico-arytenoid joints
ligaments of larynx
• Thyrohyoid membrane • Quadrangular membrane
cartilages connected by membranes and ligaments paired: thyroid, cricoid, epiglottic unpaired: arytenoid, corniculate, cuneiform
❖ Cricoid cartilage ❖ Thyroid cartilage ❖ Arytenoid cartilage ❖ Epiglottic cartilage
• The inferior thyroid veins • A small thyroid inferior most artery • in infants and children: the left
brachiocephalic vein, jugular venous arch, pleurae, esophagus
处？
• 问题：1. 这块牛排可能会滞留在哪个部位？ 2. 如果海姆利克操作法没有成功，此时又有一位医生来帮助，
你认为他还可以采取什么急救措施？ 3. 此类事件可造成所谓“餐馆死亡”，试讨论之。
Cases
• 一个10岁的男孩因喉痛和耳痛被送到医院。伴有高热、 脉搏快、呼吸节律快。查体发现咽喉有广泛红肿，特别 是腭扁桃体红肿明显。左侧鼓膜突出。病史发现该男孩 曾经有鼻粘膜慢性炎症症状，经常用口呼吸，还患过扁 桃体周围脓肿。诊断：扁桃体炎 治疗：抗生素治疗后炎 症消失。3个月后对其行T和A。
❖ lymph sup. inf. deep cervical lymph nodes
Vessels, nerves, and lymph nodes of larynx
recurrent laryngeal nerves: • sensory to the laryngeal cavity below the level of the vocal folds; • motor to all intrinsic muscles of the larynx except for the cricothyroid