5.1. LARYNX CLINICAL ANATOMY
Larynx is a hollow organ which opens with its superior part to the hypo-pharynx, while the inferior part transforms into the trachea. Larynx is located under the hyoid bone in the anterior part of the cervix. The larynx consists of the cartilaginous skeleton connected by ligaments, joints and muscles and is lined with the mucous membrane on the inside. The superior margin of the larynx is placed on the border between the fourth and the fifth cervical vertebrae, while the inferior margin corresponds to the sixth cervical vertebra. On the outside the larynx is lined with muscles, subcutaneous fatty tissue and skin which easily shifts enabling convenient palpation. During speaking, singing and swallowing, the larynx performs active upward and downward movements. Besides, it can be passively shifted to the right and to the left, with the so-called laryngeal cartilaginous crepitus. In case of malignant tumors, active mobility of the larynx diminishes, as well as its passive displaceability.
In males, the superior part of the thyroid cartilage forms an externally visible and palpable prominence, or elevation, called the Adam's apple (prominentia laryngea, s. pomum Adami). In women and children it is less prominent, soft, and difficult to find on palpation. In the inferior part of the larynx, anteriorly between the thyroid and cricoid cartilages, the conoid ligament region (lig. conicum, s. cricothyreoideum) can be easily palpated. Incision of this ligament (coniotomy) is performed in case of emergency - urgent establishment an airway in case of asphyxia.
Laryngeal Cartilages
The laryngeal skeleton consists of cartilages (cartilagines laringis) linked by ligaments (fig. 5.1). There are three paired and three nonpaired cartilages of the larynx: