🥇 ANATOMÍA DE LA LARINGE 1/2, (Cartílagos y Articulaciones). Fácil, Rápido y Sencillo

My dear anatomists, welcome once again to another anatomical video. My name is Juan José Sánchez and today we will talk about the first larynx delivery. We will talk first about the generalities of the larynx and then about the famous skeleton that protects this pharynx, as well as its different joints to this larynx.

So, the larynx is a very important organ. It is a hollow organ that continues upwards with what is the laryngopharynx and downwards it continues with what is the trachea. So, the first organ of the airway itself, although the airway begins in the nasal cavity, even in the oropharynx, including the nasopharynx and the oropharynx, these are structures that in some cases, such as in the oropharynx and in the oral cavity, they also belong to the digestive system.

So, in itself, the entrance to the respiratory system as such is the larynx. It fulfills very important functions since this larynx, first, allows the passage of air, which is what its first function says. In addition, it has a very important valve, which is the one we see here, which is the epiglottis, which is capable of closing the entrance to the larynx and thereby subsequently covering the entrance to the airways so that food will not remain.

nothing more to grab for the esophagus. The other thing is that, since the skeleton that makes it up is rigid, it makes the airways permeable and a very important function is that within it are the famous vocal cords and it is then also considered the speaking apparatus. Since the air that passes through it, in addition to serving us for breathing, also makes those vocal cords vibrate, which makes us speak.

So, anatomically, the pharynx is going to go from the upper edge of the epiglottic cartilage, which is what we see here at approximately the level of C3, to the lower edge of this very important cartilage, which is the cricoid cartilage, which is at the level of C6. So, it goes from C3 to C6, it is a small organ in men, it is much larger, which is why men have a slightly thicker voice. However, in women, an organ that is smaller and in size measures less than five centimeters.

Very well, in men it measures five or a little more and they are very underdeveloped in women. So, this larynx, as I told you, is protected by a group of cartilage. These cartilages are six groups.

We are going to divide them into two large groups. First, we will talk about single cartilages, that is, it is a single cartilage that is located in the midline. Those are the thyroid cartilages, which are one, cricoid and epiglottic.

These are only three cartilages that are found, all three, in the midline. We call the other three groups of cartilage the large group of paired cartilages, because they are two cartilages that each lie next to the midline. Those are then the caritenoid cartilages, the cornicles and the cuneate, also called cuneiform.

There are other ways to classify it, which is according to the type of cartilage that makes it up. So, we say that those that end in “oid”, look carefully at the mnemonic, are hyaline type cartilages, that is, thyroid, cricoid and arytenoid. Very important because they are the ones that can articulate with each other because they are the ones that are made of hyaline cartilage.

The second group, or the other three, which would then be the epiglottic, the corniculates and the cuneiforms, are made of elastic cartilage, so they cannot articulate with each other because that elastic cartilage does not have that function. We then start with the thyroid cartilage. That thyroid cartilage, well, shield-shaped cartilage, that's how the Greeks wrote it.

That thyroid cartilage, a single cartilage found in the front of the neck, below the level of C4. It is said that its upper edge corresponds to C4 and its lower edge corresponds to C6. So, it will be made up of two sheets, one sheet on the right side and one sheet on the left side.

We see that the upper edge is an edge that is not continuous, but is interrupted by a large central depression that is right in the midline. That depression, how she has that shape of neckline, just like you see a woman's neckline, That in anatomy is called notch. That is why we are going to call this the laryngeal notch or more anatomically, the superior thyroid notch.

It is whose vertex is located right on the midline. Then, in addition to this, we see that both sheets are interrupted by a line that goes in an oblique direction. That is what we are going to call the oblique line.

And we are going to see that two horns emerge from the upper edge that are called superior horns, but the most perfect anatomical name is superior horns. And from the lower edge come two lower horns or horns, which by the way, are the ones they use to articulate with the cartilage that I am going to explain to you right now, which is the cricoid cartilage. If we look at this lateral view, we see the upper edge, the upper horns, here the lower horns articulating with the cricoid.

We're looking at the right lamina here, the superior thyroid notch. We see that the vertex is cut into the midline, which also indicates the union of the two sheets. We see a prominence, it is the so-called laryngeal prominence, very prominent especially in men, and which in many cases is called the great Adam's apple.

And we also see this in this lateral image as the famous oblique line is evident in the sheet of the thyroid cartilage . In this later view, we see that the thyroid cartilage has a C shape, that is, it is not closed through an open cartilage, literally a shape, So, of shield, here you see its upper horns, here you see its horns lower. Let's talk then about the next cartilage, which is the cartilage that corresponds to the C6 vertebra.

It is important because its lower edge indicates the end, first of the larynx, and the end of the laryngopharynx as well. That is, he tells me the beginning of the trachea in front and the beginning of the esophagus behind. A very key cartilage in anatomy, that cricoid cartilage.

Well, cricoid means ring-shaped. Well, they form some rings, it is circular. See how circular is completely closed.

So, we are going to call the anterior part an arch because it looks like an arch, while the posterior part is called a sheet. They are the two parts that make up the cricoid cartilage. We see this lateral view, here we see the arch, while in the posterior part that widens we are going to call it the lamina.

And in this later vision we would only be seeing the plates. Then we talk about the epiglottic cartilage. Remember that it is the only cartilage of the midline that is not hyaline cartilage, but rather elastic cartilage.

Its function has to be a primer. So, it has an upper part that is wider and a lower part that becomes less wide until the tip of a pencil appears, which we are going to call that lower part precisely pedicle. He is important because he is the one who opens and closes my larynx.

He is the one that indicates the entry and exit of air. Ok, it's held there like that by some ligaments that we're going to see a little bit later. Let's now move on to the paired cartilages and talk first about the arytenoids, which means vessel-shaped and pitcher-shaped, rather .

These arytenoid cartilages have a conical shape, we see that it looks like a cone, a pyramid, and the base on which is resting on the cricoid shoulder. Yes, there is a biblical passage in Genesis that says that Elizabeth, Mary's cousin, carried on her shoulders a pitcher that was like a vessel, in the same way that the cricoid supports the arytenoid. An important biblical passage.

So, this arytenoid, as I told you, is going to have a base that rests on the cricoid cartilage, specifically on the lamina, and a vertex that serves to articulate with the next cartilage that I am going to explain to you right now, which is the corniculate. See that it is shaped like a horn. So, that base is important because the base has two processes, a middle one which is where the vocal ligament is inserted, which is called the vocal process, and a lateral one, which is where a group of muscle is inserted, which we would then call the muscular process.

Now, look at these cartilages that are at the apex of what It is the arytenoid cartilage articulating with them or joining them with fibrotic tissue, these are the famous corniculate cartilages because they have a horn shape, let's see this posterior view then cricoid, on which the arytenoid rests and on top of the arytenoid with its two vocal processes with the vocal ligament and this is the muscle. While at the vertex it articulates with the corniculate cartilage. Then we will talk about cuneiform cartilages, which are cartilages that are not found much in atlases.

They are separated from the corniculates of the rest of the cartilages, they are literally floating although they are supported by a ligamentous fiber. Those are the famous cartilages that are shapeless or cuneiform, which are very inconstant, not all people have them. So, look at this image so you understand.

This is the entrance to the larynx, the famous aditus. We see the posterior edge of the cricoid. This is what we are basically seeing.

So, see that the posterior border of the cricoid has the arytenoid. Similar and does not say the corniculate. He is the one who forms this tubercle that you see here, which is then what is called corniculate tubercle.

And this one you see up here would be the tuber cuneatus. So you see that the cuneatus is joined by fibrotic tissue or band both to the corniculates and above with the epiglottic cartilage, thus forming the famous aditus or entrance to the larynx. Let's now talk about the joints of the larynx to finish this video.

First let's talk about the two large synovial joints. Remember that the synovial cells must be in three hyaline type cartilages. Ok, so first the joint between the thyroid and cricoid cartilage in the cricothyroid joint that goes from the lower horn of the thyroid cartilage to the lateral surface of both lateral surfaces of the cricoid cartilages.

Let's see this lateral view, then lower horn of the thyroid with the lateral aspects of the cricoid. And in this later view, here we also see the cricothyroid joint. Remember that it is a joint that is synovial, it is surrounded by its fibrotic capsule and has its synovial fluid like any other synovial joint in the body that has a lot of movement.

Now I'm going to explain it to you. And finally, the second synovial joint is the joint between the cricoid and the arytenoid. But which part of the arytenoid is going to specifically articulate the muscular process.

That is the one that rests on the cricoid plate. So, this joint is called cricoarytenoid. She has fibrotic tissue and a very strong synovial membrane that joins me to this is the cricoid cartilage, which makes it good that this cartilage does not go to the larynx and goes there towards the trachea because it is supported very strongly.

What we see in the cricothyroid joint that are already united on a laterolateral axis. So, anatomically, the movement should be flexion and extension. But books write to us as a rotation movement.

They say that this joint can also have back-and-forth movements. So what's up. We see the vocal cords here, well, specifically the vocal ligament and through this joint and by the action of these muscles that are the cricothyroids.

See how they go from the cricoid to the thyroid. As they contract, they lower the larynx, specifically the thyroid cartilage, and lengthen the vocal cords so that we can give different tones with our voice. So, those muscles are the cricothyroids.

And then see the joint then between the muscular process of the arytenoid and the cricoid plate, the cricoarytenoid joint, which is what allows the opening, as we see here of the entrance to the larynx, the famous glottic cleft, that is what is responsible for the cricoarytenoid joint by the action of these muscles, which are the lateral cricoinoids and these are the posterior cricoarytenoids. Let's talk now about the ligaments of the larynx. See this membrane that is joining the upper edge of the thyroid cartilage to the hyoid bone, both with the body and with the greater antlers.

It is then the famous thyrohyoid membrane. This thyrohyoid membrane has a thickening in the anterior part that we are going to call. Part of the membrane is a thickening that is called the middle thyrohyoid ligament.

See thyrohyoid or middle. In the lateral part it will have the same thickening but it will then go from the greater horn of the thyroid to the greater horn of the bone. And today, from that time, the lateral thyroid ligament.

So you know, here in the anterior part, there is only one median thyroid ligament and one lateral thyroid ligament on each side. Now, that lateral thyrohyoid ligament surrounds a cartilage that we don't see here dissected, but there is a cartilage that is a little circle, that is the famous tritium cartilage that is named in some anatomical texts, tritium cartilage. And look at this middle cut, then This thickening of the middle thyrohyoid ligament, this is the thyrohyoid ligament, this little circle that is here in the tritium.

You see that the thyroid membrane on both sides has a perforation, a hole . What is that perforation for? This perforation is for the laryngeal neurovascular package to pass through, which are three structures.

Notice what this nerve is going to pass, which is the internal branch of the superior laryngeal nerve, a branch of the vagus nerve, it is going to pass the superior laryngeal artery, a branch of the face with superior laterality, which in turn is a branch of the external carotid and this vein that It is the superior laryngeal vein, pure superior laryngeal is in the upper area of ​​the upper thyroid and in turn it will drain into what is the internal jugular vein. So this is the order always the superior internal laryngeal nerve, then the superior laryngeal artery, that is, the superior laryngeal artery if below it and below the artery which is the superior laryngeal vein. Now we are going to talk about the thyroid critical ligament, which is a ligament that connects the upper edge of the cricoid cartilage with what is the thyroid cartilage.

It is made up of two fascicles, a middle ligament that is called the middle cricothyroid ligament and some lateral ones that are The ligaments you see there in red are the lateral cricothyroids. See in this lateral view this would be the medial cricothyroid ligament and this would be the lateral cricothyroid ligament. There is a very important structure, I need you to pay close attention in the following image, which is the elastic cone.

Look here we section the cricothyroid ligament , see that it is not there, here it is half visible but see that behind it there is another ligament that also goes from the upper edge of the cricodes but goes to the vocal ligament. Do you remember where the vocal cord was? that is the famous elastic cone.

See it here, a higher view. See how the upper edge of the cricoid gives a membrane that reaches what is the vocal ligament. Now, above the membrane are these two muscles, which are the vocal muscle and the thyroarytenoid muscle, I don't care about that, I care about this membrane, which is the famous elastic one.

So, as this membrane goes from the cricoid to what is the vocal ligament, I also call it the cricovocal membrane, okay? since it finishes closing my larynx and leaves the only gap that we see there to be the glottal cleft, that is, between the vocal cords or between the vocal ligaments more specifically. See in this image, then upper edge of the cricoid to the vocal ligament that you see that goes from the thyroid cartilage to the arytenoid, that membrane is the elastic cone, so we are going to see it covered with mucosa, upper edge of the cricoid to what is the ligament vocal, that is what is then called elastic cone or membrane is cricovocal.

Now let's go with the vocal ligament, which is part of the vocal cords. It will then go from the thyroid cartilage to the vocal process of the arytenoid, which is why it is also called the vocal ligament, it is the same as the vocal ligament. See it here vocal ligament ligament or voca ligament, from the thyroid cartilage which is its back to the vocal process specifically the vocal of the arietenoid.

Then we go with the vestibular ligament, which is a very poorly formed fold that also goes on the back. from the thyroid cartilage to the lateral part of the arytenoid, if it is less resistant than the vocal and the one that forms the famous false vocal cords, okay? false vocal cords, this vocal ligament is always above the vestibular ligament, it is above the vocal ligament leaving a gap which is what we see there so see here vocal ligament from the vocal process of the arytenoid to the dorsum of the thyroid cartilage and the vestibular from the back of the thyroid to the lateral part of the arytenoid, see there is a gap that is the famous ventricle, which is called the laryngeal ventricle, that is why in some books they call the vestibular ligament the ventricular ligament, it is the same ventricular ligament that they form all false vocal cords ok?

Finally, let's talk about the ligaments that hold the epiglottis suspended. Let's first look at the ligament that goes from the pedicle of the epiglottis to the dorsum of the thyroid. So, this is the thyroepiglottic ligament because it goes to the thyroid to the epliglottis.

Then, we see one that grabs the back of the epiglottis with what is the back of the body, the hyoid bone, it is the ligament. So, hyoepiglottic, between the back of the epiglottis and the thyroid membrane there is a fat pad called the pre-epiglottic fat pad. Yes, we are going to see it here, you are going to see it in many atlases, a grease bearing that is there in this superior view.

This would be the epiglottic cartilage covered by mucosa. We see that we are not seeing it from the pharynx. We see that there is a ligament that attaches the epiglottis to the tongue, which is the medial glossoepiglottic and two lateral ones, which would be the lateral glossoepiglottic.

These spaces that remain between the medial and lateral glossopilot ligaments are the famous valeculas or epiglottic valleculas, okay? And finally, look at this membrane, here you have to have a little imagination to imagine the one that goes from the vestibular ligament to the lateral part of the epiglottic cartilage, as well as to the back of the thyroid cartilage. It is the famous quadrangular membrane.

That is, it is like the elastic cone of the vocal ligament but upwards. This is called a triangular membrane. Let's see here in this image then how it goes from the vestibular ligament below to the lateral edge of the epiglottis above.

This space that you see here happens to be lined with mucosa. That is the famous quadrangular ligament. Here, so that you can understand it better, take a good look at the critical cartilage and upper edge of the vocal ligament.

This would be the arytenoid of the cartilage. So what is here would be the elastic cone. So see here, this ligament that is up here is the vestibular and the membrane that goes from the vestibular ligament to what is the lateral edge of the epiglottic cartilage is what is called quadrangular membrane, okay?

covered by mucous membranes. So, this is a view of the posterior trachea that we cut along the midline and open it like cutting a fish in half and opening it, okay? And this here is a membrane a surgical click that was used to separate and keep dilated is behind.

So, well friends, this has been the entire video. Don't forget to like the thumbnail below, share it and subscribe in the little circle that appears here. Don't forget to follow me on Instagram at @juan_sanchez1315.

Likewise, here I will leave you the link so that you can see the pharynx videos and so that you can see the next larynx installment where we will talk about the muscles and the divisions of the mucosa. Thank you for your attention.