B. Intrinsic Muscles

The crico-thyroideus (M. crico-thyreoideus) is a short muscle which fills the groove on the lateral surface of the cricoid cartilage; its fibers are directed dorsally and somewhat forward. It arises on the lower half of the lateral surface and posterior edge of the cricoid cartilage, and is inserted into the posterior border and adjacent part of the surfaces of the lamina of the thyroid cartilage. Its action is to draw the thyroid cartilage and the ventral part of the cricoid cartilage together. In this action the cricoid cartilage is probably rotated, carrying the bases of the arytenoid cartilages with it and thus tensing the vocal cords.

The crico-arytenoideus dorsalis s. posterior (M. crico-arytænoideus dorsalis) is a strong, somewhat fan-shaped muscle, which, with its fellow, covers the dorsal surface of the lamina of the cricoid cartilage. It is partially divisible into two layers. It has a broad origin on half of the lamina of the cricoid cartilage, and its fibers converge to be inserted into the processus muscularis of the arytenoid cartilage. Its action is to dilate the rima glottidis by rotating the arytenoid cartilage so as to carry the vocal process and cord outward.

The crico-arytenoideus lateralis (M. crico-arytænoideus lateralis) lies on the inner face of the thyroid lamina. It arises from the anterior border of the lateral part of the arch of the cricoid cartilage. The fibers pass in a dorsal direction and converge on the processus muscularis of the arytenoid cartilage. It closes the rima glottidis by rotating the arytenoid cartilage inward.

The arytenoideus transversus (M. arytænoideus transversus) is an unpaired muscle which stretches across the concave dorsal surface of the arytenoid cartilages. Its fibers are attached on either side to the processus muscularis and the ridge which extends forward from it. The right and left parts of the muscle meet at a fibrous raphé which is connected with the transverse arytenoid ligament. Filters of the thyro-arytenoideus muscle overlap its anterior part. It narrows the rima by drawing the arytenoid cartilages together.

The thyro-arytenoideus (Mm. ventricularis et vocalis) is situated in the lateral wall of the larynx, covered by the lamina of the thyroid cartilage. It consists of two parts, between which the mucous membrane of the lateral ventricle pouches to form the saccule. The anterior part (M. ventricularis) arises from the anterior part of the crico-thyroid membrane and the ventral border of the thyroid lamina. Its fibers pass upward and backward to end partly on the processus muscularis, partly on the arytenoideus transversus, meeting its fellow. The posterior part (M. vocalis) has a more extensive origin on the crico-thyroid membrane. Its direction corresponds with that of the true vocal cord. It is inserted into the outer surface of the arytenoid cartilage below the processus muscularis. The muscle closes the rima and slackens the vocal cords. With the arytenoideus transversus and crico-arytenoideus lateralis it forms a sphincter which closes the entrance to the larynx.

Cavity of the Larynx

The cavity of the larynx (Cavum laryngis) is smaller than one would expect from its external appearance. On looking into it through the pharyngeal end two folds are seen projecting from its lateral walls. These are termed the vocal cords, and they divide the cavity into two portions.

The aditus laryngis, or pharyngeal aperture, is a large, oblique, oval opening, which faces forward and upward into the ventral part of the pharynx. It is bounded in front by the epiglottis, behind by the arytenoid cartilages, and laterally by the aryteno-epiglottic folds of mucous membrane (Plicæ aryepiglotticæ), which stretch between the edges of the epiglottis and the arytenoid cartilages.

The vestibule of the larynx (Vestibulum laryngis) is that part of the cavity which extends from the aditus to the vocal cords. On its lateral walls are the false vocal cords (Plicæ ventriculares), each of which consists of a fold of mucous membrane covering the anterior part of the thyro-arytenoid ligament and the cuneiform process. Between the false and true vocal cord there is a pocket-like depression termed the lateral ventricle of the larynx (Ventriculus lateralis laryngis). This is the entrance to the laryngeal saccule (Appendix ventriculi laryngis), a cul-de-sac of the mucous membrane which is about one inch (ca. 2 to 3 cm.) long and extends upward and backward on the inner surface of the thyroid lamina. There is a small middle ventricle (Ventriculus laryngis medianus) at the base of the epiglottis.

The middle, narrow part of the cavity is termed the glottis or rima glottidis. It is bounded on either side by the true vocal cord and the inner surface of the arytenoid cartilage. The true vocal cords (Labia vocales) are situated behind the false cords and the lateral ventricles. They extend from the angle between the body and laminæ of the thyroid cartilage to the vocal processes of the arytenoid cartilages. They are prismatic in cross-section, and their free edges look forward and somewhat upward. The mucous membrane of the cord (Plica vocalis) is very thin and smooth, and is intimately attached to the underlying ligament. In ordinary breathing the rima is somewhat lanceolate in form; when dilated, it is diamond-shaped, the widest part being between the vocal processes. The narrow part of the glottis between the vocal cords is termed the glottis vocalis (Pars intermembranacea), while the wider part between the arytenoid cartilages is the glottis respiratoria (Pars intercartilaginea).

The posterior compartment of the laryngeal cavity is directly continuous with the trachea. It is inclosed by the cricoid cartilage and the crico-thyroid membrane. It is oval in form, the transverse diameter being an inch and a half to two inches (ca. 4 to 5 cm.), and the dorso-ventral diameter two to two and a half inches (ca. 5 to 6 cm.).

The mucous membrane which lines the larynx (Tunica mucosa laryngis) is reflected around the margin of the aditus to become continuous with that of the pharynx, and behind it is continuous with that which lines the trachea. It is closely attached to the pharyngeal surface of the epiglottis, but elsewhere in the aditus and vestibule it is loosely attached by submucous tissue which contains many elastic fibers. It is thin and very closely adherent over the vocal cords and the inner surfaces of the arytenoid cartilages. The epithelium is of the stratified squamous type from the aditus to the glottis, beyond which it is columnar ciliated in character. There are numerous mucous glands (Glandulæ laryngeæ), except over the glottis and the pharyngeal surface of the epiglottis, in which situations they are scanty.

Blood-supply.—Thyro-laryngeal artery.

Nerve-supply.—Superior laryngeal and recurrent laryngeal nerves (from the vagus).