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Nerve supply

  1. Superior laryngeal nerve: arises from the inferior ganglion of vagus divides into:
    1. Internal branch — Sensory supply to larynx above the level of vocal cords.
    2. External branch -  Motor to cricothyroid
  2. Recurrent laryngeal nerve:
    1. Motor branch: Supplies all the muscles of the larynx except cricothyroid
    2. Sensory branch: Afferent from below the level of the vocal folds

Fig.: Recurrent and superior laryngeal nerves

Special features of vocal cords:
  1. Stratified sq, Epithelium.                           
  2. Sub-epithelial space called Reinke’s   space.  
  3. Narrowest part of adult larynx.                               
  4. No lymphatic supply.
  5. It forms water shed area of larynx.

MCQ. Galen’s anastomosis. It is anastomosis between superior and recurrent laryngeal nerves.



Extra Edge. Ortner’s syndrome is paralysis of recurrent laryngeal nerve and cardiomegaly.
Extra Edge. Posterior cricoarytenoid is the only abductor muscle of the larynx. It is supplied by recurrent laryngeal nerve.


  1. Laryngeal muscles:      
    1. Extrinsic group (attach larynx to other structures)
      1. Elevators                          
        • Primary
          - Stylopharyngeus                  
          - Palatopharyngeus
          - Salpingo- pharyngeus                                                   
        • Secondary                                                                         
          - Mylohyoid
          - Digastric                                                                             
          - Geniohyoid
      2. Depressor
        1. Sternohyoid                      
        2. Thyrohyoid              
        3. Sternothyroid                  
        4. ​Omohyoid (sup. belly)
    2. Intrinsic group (attach laryngeal cartilages to each other). (all muscles are paired except transverse arytenoid)
      1. Abductor : Posterior cricoarytenoid
      2. Adductors : Lateral cricoarytenoid,Interarytenoid (transverse arytenoid),Thyroarytenoid (external part)
      3. Tensor : Cricothyroid
        Vocalis (Internal part of the thyro-arytenoid muscle)
      4. Opener of the laryngeal inlet: Thyroepiglotticus (part of the thyroarytenoid)
      5. Closer of the laryngeal inlet : Aryepiglotticus : (posterior oblique part of the interarytenoid)

EXTRA EDGES : The only intrinsic muscle of the larynx which lies outside the laryngeal cartilages framework is cricothyroid


Galen’s Anastomosis: the ascending branch of recurrent laryngeal nerve unites with internal branch of the superior laryngeal nerve.
In thyroidectomy, the nerve commonly injured: External branch of superior laryngeal nerve
Functions of the Larynx:
  1. Respiration
  2. Protection of the lower airway
  3. Fixation of the chest
  4. Phonation
Primary function of larynx is protection of lower airways.

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