Arytenoid cartilage

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The arytenoid cartilages (/ærɪˈtnɔɪd/) are a pair of small three-sided pyramids which form part of the larynx. They are the site of attachment of the vocal cords. Each is pyramidal or ladle-shaped and has three surfaces, a base, and an apex. The arytenoid cartilages allow for movement of the vocal cords by articulating with the cricoid cartilage. They may be affected by arthritis, dislocations, or sclerosis.

Arytenoid cartilage
The cartilages of the larynx seen from behind
Details
Precursor4th and 6th pharyngeal arch
Part ofLarynx
ArticulationsCricoid cartilage
Identifiers
Latincartilagines arytenoideae
MeSHD001193
TA98A06.2.04.001
TA2983
FMA55109
Anatomical terminology

Structure

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The arytenoid cartilages are part of the posterior part of the larynx.[1]

Surfaces

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The posterior surface is triangular, smooth, concave, and gives attachment to the arytenoid muscle and transversus.

The antero-lateral surface is somewhat convex and rough. On it, near the apex of the cartilage, is a rounded elevation (colliculus) from which a ridge (crista arcuata) curves at first backward and then downward and forward to the vocal process. The lower part of this crest intervenes between two depressions or foveæ, an upper, triangular, and a lower oblong in shape; the latter gives attachment to the thyroarytenoid muscle (vocal muscle).

The medial surface is narrow, smooth, and flattened, covered by mucous membrane.[1] It forms the lateral boundary of the intercartilaginous part of the rima glottidis.

Base and apex

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The base of each cartilage is broad, and on it is a concave smooth surface, for articulation with the cricoid cartilage.

The apex of each cartilage is pointed, curved backward and medialward, and surmounted by a small conical, cartilaginous nodule, the corniculate cartilage. It articulates with the cricoid lamina with a ball-and-socket joint.[1]

Function

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The arytenoid cartilages allow the vocal folds to be tensed, relaxed, or approximated. They articulate with the supero-lateral parts of the cricoid cartilage lamina, forming the cricoarytenoid joints at which they can come together, move apart, tilt anteriorly or posteriorly, and rotate.

Clinical significance

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Arthritis

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Rheumatoid arthritis and osteoarthritis can affect the cricoarytenoid joint.[1] This can cause airway obstruction, which may be life-threatening.[1]

Dislocation

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Rarely, the arytenoid cartilage may be dislocated.[2] This is most often caused by tracheal intubation,[2][3] major trauma to the larynx, [2] or more rarely a laryngeal mask airway.[4] This may cause symptoms with problems breathing, such as "breathiness" when breathing.[2] Electromyography and CT scans of the larynx may be used to assess a dislocation in detail.[2] Dislocations may be reduced using an endoscope.[2]

Laryngeal cancer

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Some cases of laryngeal cancer cause the arytenoid cartilage to appear sclerotic.[5] This may be observed, and is highly predictive of laryngeal cancer.[5]

History

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Etymology

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The term "arytenoid" comes from Ancient Greek ἀρύταινα arytaina meaning "ladle" and εἶδος eidos, meaning "form".[6] They are also often described as "pyramid" shaped.[1] The word "arytenoid" is pronounced /ærɪˈtnɔɪd/.[7]

Other animals

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The arytenoid cartilages are in the larynxes of many animals, including horses.[8]

Additional images

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References

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  This article incorporates text in the public domain from page 1075 of the 20th edition of Gray's Anatomy (1918)

  1. ^ a b c d e f g h Krohner, Robert G.; Ramanathan, Sivam (2007). "1 - Functional Anatomy of the Airway". Benumof's airway management: principles and practice (2nd ed.). Philadelphia: Mosby. pp. 3–21. doi:10.1016/B978-032302233-0.50005-6. ISBN 978-0-323-07017-1. OCLC 324998129.
  2. ^ a b c d e f Rubin, Adam D.; Hawkshaw, Mary J.; Moyer, Cheryl A.; Dean, Carole M.; Sataloff, Robert T. (2005-12-01). "Arytenoid Cartilage Dislocation: A 20-year Experience". Journal of Voice. 19 (4): 687–701. doi:10.1016/j.jvoice.2004.11.002. ISSN 0892-1997. PMID 16301111.
  3. ^ Yamakana, H.; Hayashi, Y.; Watanabe, Y.; Uematu, H.; Mashimo, T. (September 2009). "Prolonged hoarseness and arytenoid cartilage dislocation after tracheal intubation". British Journal of Anaesthesia. 103 (3): 452–455. doi:10.1093/bja/aep228. ISSN 0007-0912. PMID 19556269.
  4. ^ Rosenberg, Michael K.; Rontal, Eugene; Rontal, Michael; Lebenbom-Mansour, Miriam (December 1996). "Arytenoid Cartilage Dislocation Caused by a Laryngeal Mask Airway Treated with Chemical Splinting". Anesthesia & Analgesia. 83 (6): 1335–1336. doi:10.1213/00000539-199612000-00037. ISSN 0003-2999. PMID 8942611.
  5. ^ a b Muñoz, A; Ramos, A; Ferrando, J; Gómez, B; Escudero, L; Relea, F; García-Prats, D; Rodríguez, F (1 November 1993). "Laryngeal carcinoma: sclerotic appearance of the cricoid and arytenoid cartilage--CT-pathologic correlation". Radiology. 189 (2): 433–437. doi:10.1148/radiology.189.2.8210372. ISSN 0033-8419. PMID 8210372.
  6. ^ Farlex dictionary: arytenoid cartilage Citing: Mosby's Medical Dictionary, 8th edition.
  7. ^ Murry, James A. H. (1888). A New English Dictionary on a Historical Basis. Oxford: Clarendon Press. p. 477.
  8. ^ Rakestraw, P. C.; Hackett, R. P.; Ducharme, N. G.; Nielan, G. J.; Erb, H. N. (1991). "Arytenoid Cartilage Movement in Resting and Exercising Horses". Veterinary Surgery. 20 (2): 122–127. doi:10.1111/j.1532-950X.1991.tb00319.x. ISSN 1532-950X. PMID 2042281.