Posterior cricoarytenoid | |
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Details | |
Origin | Posterior part of the cricoid |
Insertion | Posterior surface of muscular process of the arytenoid cartilage |
Nerve | Recurrent laryngeal nerve branch of the vagus nerve (CN X) |
Actions | Abducts and laterally rotates arytenoid cartilage, pulling vocal ligaments away from the midline and forward and so opening rima glottidis |
Antagonist | Lateral cricoarytenoid muscle |
Identifiers | |
Latin | musculus cricoarytaenoideus posterior |
TA98 | A06.2.08.004 |
TA2 | 2196 |
FMA | 46576 |
Anatomical terms of muscle |
The posterior cricoarytenoid muscle is a (bilaterally paired) intrinsic muscle of the larynx. It arises from the cricoid cartilage; it inserts onto the arytenoid cartilage of the same side. It is innervated by the recurrent laryngeal nerve. Each acts to open the vocal folds by pulling the vocal fold of the same side laterally. It participates in the production of sounds.
The muscle is directed superiorly and laterally from its origin to its insertion. The muscle's fibres vary in orientation superoinferiorly: the superior-most fibres are nearly horizontally oriented, the intermediate fibres are obliquely oriented, and the inferior-most fibres are nearly vertically oriented; [1] the distinct orientations of muscle fibres may indicate that the muscle could produce different movements depending upon which portion of the muscle contracts. [2]
According to a cadaveric study, the muscle exhibits two distinct bellies - a medial belly and a lateral belly - which differ in the orientation of their muscle fibres and the site of insertion at the muscular process. [3]
The muscle originates from (the posterior aspect of) the lamina of cricoid cartilage. [1]
The muscle's fibres converge to insert onto (the superior, posterior and (minimally the) anterolateral aspects of) the muscular process of the ipsilateral arytenoid cartilage [4] (its medial belly and lateral belly insert onto the muscular process medially and laterally, respectively). [3]
The posterior cricoarytenoid muscle receives motor innervation from (the anterior division of) the recurrent laryngeal nerve (itself a branch of the vagus nerve (CN X)). [2] [5]
Different parts of the muscle (such as the medial and lateral muscle bellies) are often innervated by separate branches. [2] There may be 1-6 branches, but are usually 2-3. These may connect within the muscle. [5] This innervation modality may indicate that the different parts of the muscle can be activated at different times so that it can produce different movements. [2]
The muscle receives arterial supply from the laryngeal branches of the superior thyroid artery and inferior thyroid artery. [1]
The muscle rotates the arytenoid cartilages laterally, thereby abducting the vocal processes and the vocal folds that are attached to them. In this, the muscle is an antagonist of the lateral cricoarytenoid muscle. [1]
The muscle additionally draws the arytenoid cartilages posterior-ward, thus (assisting in) lengthening the vocal cords (here acting as synergist of the cricothyroid muscle). The lateral-most portion of the muscle also draws the arytenoid cartilages lateral-ward, making the rima glottidis into a triangular shape. [1]
The posterior cricoarytenoid muscles are the only muscles to open the vocal cords. [1] [6] By abducting the vocal folds, the muscle opens the rima glottidis. [7] : 9 This is important in breathing and speech. [6] The muscles participate in the production of unvoiced vocal sounds. [1]
Paralysis of the posterior cricoarytenoid muscles may lead to asphyxia, as they are the only laryngeal muscles to open the vocal cords (allowing breathing). [8] Denervation leads to a slow fibrosis that worsens over many months. [9]
The term phonation has slightly different meanings depending on the subfield of phonetics. Among some phoneticians, phonation is the process by which the vocal folds produce certain sounds through quasi-periodic vibration. This is the definition used among those who study laryngeal anatomy and physiology and speech production in general. Phoneticians in other subfields, such as linguistic phonetics, call this process voicing, and use the term phonation to refer to any oscillatory state of any part of the larynx that modifies the airstream, of which voicing is just one example. Voiceless and supra-glottal phonations are included under this definition.
The larynx, commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about 4–5 centimeters in diameter. The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus. The word 'larynx' comes from the Ancient Greek word lárunx ʻlarynx, gullet, throat.ʼ
The recurrent laryngeal nerve (RLN) is a branch of the vagus nerve that supplies all the intrinsic muscles of the larynx, with the exception of the cricothyroid muscles. There are two recurrent laryngeal nerves, right and left. The right and left nerves are not symmetrical, with the left nerve looping under the aortic arch, and the right nerve looping under the right subclavian artery then traveling upwards. They both travel alongside the trachea. Additionally, the nerves are among the few nerves that follow a recurrent course, moving in the opposite direction to the nerve they branch from, a fact from which they gain their name.
The rima glottidis is the opening between the two true vocal cords anteriorly, and the two arytenoid cartilages posteriorly. It is part of the larynx.
The lateral cricoarytenoid is an intrinsic muscle of the larynx. It attaches at the cricoid cartilage anteriorly, and at the arytenoid cartilage of the same side posteriorly. It is innervated by the recurrent laryngeal nerve. It acts to close the rima glottidis, thus closing the airway.
The cricoid cartilage, or simply cricoid or cricoid ring, is the only complete ring of cartilage around the trachea. It forms the back part of the voice box and functions as an attachment site for muscles, cartilages, and ligaments involved in opening and closing the airway and in producing speech.
The cricothyroid muscle is the only tensor muscle of the larynx aiding with phonation. It is innervated by the superior laryngeal nerve. Its action tilts the thyroid forward to help tense the vocal cords, thus increasing the pitch of the voice.
The arytenoid cartilages 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.
The inferior pharyngeal constrictor muscle is a skeletal muscle of the neck. It is the thickest of the three outer pharyngeal muscles. It arises from the sides of the cricoid cartilage and the thyroid cartilage. It is supplied by the vagus nerve. It is active during swallowing, and partially during breathing and speech. It may be affected by Zenker's diverticulum.
The arytenoid muscle or interarytenoid muscle is a composite intrinsic muscle of the larynx, consisting of a transverse part and an oblique part - the two parts may be considered as separate muscles: an unpaired transverse arytenoid muscle, and a bilaterally paired oblique arytenoid muscle.
The aryepiglottic muscle or aryepiglotticus muscle is an intrinsic muscle of the larynx.
The oblique arytenoid is bilaterally paired intrinsic muscle of the larynx. It is superficial to the transverse arytenoid; the oblique and transverse arytenoids are often considered two parts of a single muscle - the interarytenoid muscle.
The superior laryngeal nerve is a branch of the vagus nerve. It arises from the middle of the inferior ganglion of vagus nerve and additionally also receives a sympathetic branch from the superior cervical ganglion.
The aryepiglottic folds are triangular folds of mucous membrane of the larynx. They enclose ligamentous and muscular fibres. They extend from the lateral borders of the epiglottis to the arytenoid cartilages, hence the name 'aryepiglottic'. They contain the aryepiglottic muscles and form the upper borders of the quadrangular membrane. They have a role in growling as a form of phonation. They may be narrowed and cause stridor, or be shortened and cause laryngomalacia.
The transverse arytenoid is an unpaired intrinsic muscle of the larynx. It is situated deep to the two oblique arytenoids; the oblique and transverse arytenoids are often considered two parts of a single muscle - the interarytenoid (arytenoid) muscle.
The cricoarytenoid joint is a joint connecting the cricoid cartilage and the arytenoid cartilage. It is a very shallow ball-and-socket joint. It allows for rotation and gliding motion. This controls the abduction and adduction of the vocal cords.
In the human larynx, the vocal process is the anterior angle of the base of the arytenoid cartilage, as it projects horizontally forward and gives attachment to the vocal ligament.
Endoscopic laser cordectomy, also known as Kashima operation, is an endoscopic laser surgical procedure performed for treating the respiratory difficulty caused as a result of bilateral abductor vocal fold paralysis. Bilateral vocal fold paralysis is basically a result of abnormal nerve input to the laryngeal muscles, resulting in weak or total loss of movement of the laryngeal muscles. Most commonly associated nerve is the vagus nerve or in some cases its distal branch, the recurrent laryngeal nerve. Paralysis of the vocal fold may also result from mechanical breakdown of the cricoarytenoid joint. It was first described in by Kashima in 1989.
Thyroplasty is a phonosurgical technique designed to improve the voice by altering the thyroid cartilage of the larynx, which houses the vocal cords in order to change the position or the length of the vocal cords.
Arytenoid adduction is a surgical procedure used to treat vocal cord paralysis. A suture is used to emulate the action of the lateral cricoarytenoid muscle and position the paralyzed vocal cord closer to the midline. This allows the two vocal cords to meet and can improve speaking and swallowing ability for affected patients. Arytenoid adduction is often performed in conjunction with medialization thyroplasty.
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