Arthritis of the laryngeal cartilage: characteristic symptoms and treatment. The largest cartilage of the larynx Unpaired cartilages of the larynx

One of the anatomical structures of the upper respiratory tract is the larynx. To the average person, it appears to be a movable tube, which somewhere in its depth contains the vocal cords involved in the formation of the voice. Usually this is where knowledge ends. In reality, things are a little more complicated. Therefore, it is worth talking about this in more detail.

Topography

The larynx is located opposite the IV, V and VI cervical vertebrae, starting immediately behind and passing along the anterior surface of the neck. Behind it is the pharynx. It communicates with the larynx through the entrance to the larynx, but in order to prevent food from entering the lungs and air from entering the stomach, nature has provided such an important detail as the epiglottis, which blocks the lumen of the pharynx during inhalation and moves the larynx during swallowing, separating thus the functions of these organs.

On the sides of the larynx there are large neurovascular bundles of the neck, and in front all this is covered by muscles, fascia and the thyroid gland. From below it passes into the trachea, and then into the bronchi.

In addition to the muscle component, there is also a cartilaginous component, represented by nine half rings, ensuring the reliability and mobility of the organ.

Features in men

A characteristic feature of the structure of the larynx in representatives of the stronger sex is the presence of an Adam's apple, or Adam's apple. This is a part that, for unknown reasons, is stronger in men than in women. Although it would be more logical to assume the opposite situation, because the muscular frame of the neck, which should cover the cartilage, is weaker in women.

Anatomy

The larynx is a cavity, which is covered from the inside with smooth and moist tissue - the mucous membrane. Conventionally, the entire organ cavity is divided into three sections: upper, middle and lower. The upper one is the vestibule of the larynx, they are narrowed downwards in the shape of a funnel. The middle is the gap between the false and true vocal folds. The lower part serves to connect with the trachea. The most important and complex department in structure is the middle one. Here are the cartilages and ligaments of the larynx, thanks to which the voice is formed.

Voice education

The space between is called the glottis. Contraction of the laryngeal muscles changes the tension of the ligaments, and the configuration of the gap changes. When a person exhales, air passes through the glottis, causing the vocal cords to vibrate. This is what produces the sounds we pronounce, particularly vowels. In order to pronounce a consonant sound, the participation of the palate, tongue, teeth and lips is also necessary. Their coordinated work allows them to speak, sing, and even imitate the sounds of the environment and imitate the voices of other people or animals. The rougher one is explained by the fact that anatomically their ligaments are longer, which means they vibrate with a greater amplitude.

Ontogenesis

Depending on the age of a person, the structure of the larynx may change. This is partly why men experience voice loss after puberty. Newborns and infants have a short and wide larynx, it is located higher than that of an adult. It does not contain carotid cartilages and thyrohyoid ligaments. It will take its final form only by the age of thirteen.

Laryngeal wall

If we consider from a topographical point of view, then from the outside to the inside its layers are arranged like this:

• Leather.
• Subcutaneous tissue.
• Cartilage, ligaments, muscles.
• Fibrous-elastic membrane (represented by connective tissue).
• The mucosa is a multinucleated ciliated epithelium and fibers of unformed connective tissue that grow together with the previous layer.
• The outer connecting plate is elastic and covers the cartilage of the larynx.

Rigid laryngeal frame

As mentioned above, there is a phylogenetically formed apparatus that supports the larynx. The cartilages of the larynx are dense half rings that hold the remaining tissues of this part of the neck and give the organ the appearance of a hollow tube. They are connected to each other by ligaments. There are single and paired cartilages of the larynx.

Single cartilages

In the anatomy of the organ, there are three cartilages that do not have twins. The unpaired cartilages of the larynx are located along the same axis, one above the other.

1. The epiglottis, or epiglottis, is a thin plate shaped like a leaf or flower petal. The wide part is located above the thyroid cartilage, and the narrow part, also called the stalk, is attached to its inner corner.
2. The thyroid is the largest cartilage of the larynx, located between the epiglottis and the cricoid cartilage. Its name corresponds to both the form and function of this part of the organ. The thyroid cartilage of the larynx serves to protect its internal part from trauma. It is formed by two quadrangular plates merging in the middle. At this point, a ridge is formed, at the top of which there is an elevation to which the vocal cords are attached. On the sides of the plates there are paired processes - horns (upper and lower). Those at the bottom articulate with the cricoid cartilage, and those at the top articulate with the hyoid bone. On the outer side of the cartilage there is an oblique line to which the external muscles of the larynx are partially attached.
3. The cricoid cartilage of the larynx is an organ. Its shape fully corresponds to its name: it looks like a man’s ring, turned backwards with a signet. On the sides there are articular surfaces for connection with the arytenoid and thyroid cartilage. This is the second major cartilage of the larynx.

Paired cartilages

There are also three of them, since nature loves symmetry and strives to show this love in every possible case:

1. Cherpalovdnye. The arytenoid cartilage of the larynx is shaped like a triangular pyramid, the apex of which faces back and slightly toward the center of the body. Its base is part of the joint surface with the cricoid cartilage. Muscles are attached to the corners of the pyramid: in front - the vocal muscles, and in the back - the posterior and anterior cricoarytenoid muscles.
2. The corniculates are located above the tips of the arytenoid cartilages.
3. The wedge-shaped ones are usually located in the aryepiglottic folds. The last two pairs of cartilages belong to the sesamoids and can vary in shape and location.

All these formations give shape to an organ such as the larynx. The cartilages of the larynx perform functions necessary to maintain normal human functioning. This is especially noticeable in relation to voice formation.

Joints

As mentioned above, cartilage is connected to each other through ligaments and joints. There are two paired joints in the larynx:

1. Between the cricoid and thyroid cartilage. They are formed by the lateral surfaces of the cricoid cartilage, which are adjacent to the lower horn of the thyroid. When moving in this joint, the tension of the ligaments changes, and therefore the pitch of the voice.
2. Between the cricoid and arytenoid cartilages. It is formed by the articular surfaces (lower parts of the pyramid) of the arytenoid cartilages and the articular platform of the cricoid cartilage. Moving relative to each other, these anatomical formations change the width of the glottis.

Ligaments

Being a mobile organ, the ligaments have a great influence on how the larynx is structured. The cartilages of the larynx are maintained in dynamic balance with the help of connective tissue cords:

1. The thyrohyoid ligament is part of the large thyrohyoid membrane, with which the entire larynx is attached to the hyoid bone. A neurovascular bundle passes through it, feeding the organ.
2. The thyroid epiglottis ligament serves to connect the epiglottis to the thyroid cartilage.
3. Hypoepiglottic ligament.
4. The cricotracheal ligament connects the larynx with the trachea and is attached to the first cartilage of the larynx.
5. The conical ligament unites the cricoid and thyroid cartilages. In fact, it is a continuation of the elastic membrane running along the inner surface of the larynx. It is a layer between cartilage and mucous membrane.
6. The vocal fold is also part of the elastic cone covering the vocal muscle.
7. The aryepiglottic ligament.
8. The lingualepiglottic ligaments connect the root of the tongue and the anterior surface of the epiglottis.

Muscles

There are two larynxes. The first is functional. She divides all muscles into:

• Constrictors, which narrow the glottis and laryngeal cavity, making it difficult for air to pass through.
• Dilators are necessary to widen the larynx and glottis, respectively.
• Muscles that can change the tension of the vocal cords.

According to the second classification, they are divided into external and internal. Let's talk about them in more detail.

External muscles

The external muscles seem to wrap the larynx. The cartilages of the larynx are supported not only from the inside, but also from the outside. Conventionally, anatomists divide the outer group into two more: the first includes those muscles that are attached to the thyroid cartilage, and the second - those attached to the bones of the facial skeleton.

First group:

• sternothyroid;
• thyrohyoid.

Second group:

• sternohyoid;
• scapular-hyoid;
• stylohyoid;
• digastric;
• geniohyoid.

Internal muscles

Necessary to change the position of the epiglottis and help it perform its functions, as well as to change the configuration of the glottis. These muscles include:

• The aryepiglottic, which forms the aryepiglottic fold. During swallowing, the contraction of this muscle changes the position of the epiglottis so that it blocks the entrance to the larynx and prevents food from entering there.
• The thyroid epiglottis, on the contrary, when contracting, pulls the epiglottis towards itself and opens the larynx.
• The lateral cricoarytenoid regulates the width of the glottis. When it contracts, the ligaments come closer together and the glottis becomes narrower.
• The posterior cricoarytenoid contracts during inhalation, and the vocal folds diverge, pulling back and to the sides, allowing air to pass further into the respiratory tract.
• The vocal muscle is responsible for the characteristics of the vocal cords, how long or short they are, tense or relaxed, whether they are equal in relation to each other. The timbre of the voice, its aberrations, and vocal abilities depend on the work of this muscle.

Functions of the larynx

The first function, of course, is respiratory. And it consists in regulating the air flow passing through the respiratory tract. Changing the width of the glottis prevents air from entering the lungs too quickly during inspiration. Conversely, air cannot leave the lungs too quickly until gas exchange has taken place.

The ciliated epithelium of the laryngeal mucosa takes on its second function - protective. It manifests itself in the fact that small particles of dust and food do not enter the lower respiratory tract thanks to the well-coordinated work of the cilia. In addition, the nerve endings, which are present in large numbers on the mucous membrane, are very sensitive to foreign bodies and, when irritated, provoke a coughing attack. At this moment, the epiglottis blocks the entrance to the larynx, and nothing foreign gets in there. If the object does get into the larynx, the cartilages of the larynx reflexively interact with each other, and the glottis is blocked. This, on the one hand, prevents food and other bodies from entering the bronchi, and on the other hand, it blocks the access of air. If help does not arrive quickly, the person dies.

The last one on our list is voice-forming. It completely depends on the anatomical structure of the larynx and on how much a person controls his vocal apparatus. As people grow and develop, they learn to speak, sing, recite poetry and prose, imitate animal voices or environmental sounds, and sometimes even imitate other people. The higher the level of control over one’s body, the more opportunities a person has.

This is, in brief, the normal topographic anatomy and physiology of the larynx. From the article you learned about the important function it performs in the activities of the human body and that the cartilages of the larynx play an important role here. Thanks to her, we breathe normally, speak and don’t choke every time we eat something. Unfortunately, she is more susceptible to infectious diseases and tumor processes than others.

Task No. 1. Complete these sentences.1. The process of gas exchange between the body and the environment - ...2. Nasal cavity, nasopharynx, larynx, trachea and

The bronchi make up...3. The largest cartilage of the larynx is ...4. A tube consisting of cartilaginous half-rings – ...5. Large paired cone-shaped organs that exchange gases between inhaled air and blood - ....6. The smallest bronchi end in microscopic air-filled pulmonary vesicles - ....7. On the outside, the lungs are covered with a dense membrane - ... .8. In a calm state, a person makes…..breathing movements every 1 minute.9. The maximum amount of air exhaled after the deepest inhalation is called...; it is determined using a special device - .... 10. The center located in the medulla oblongata and controls the functioning of the respiratory organs is….

Exercise. Choose one correct answer.

1. The essence of the process
breathing consists of:

A. Exchange of gases between
body and external environment

B. Oxidative processes in
cells that release energy

B. Transport of gases by blood

2. In the nasal cavity
air:

A. Cleaned from dust and
microorganisms

B. Moisturizes and warms up

B. Everything happens
the above processes

3. The larynx is formed:

A. Cross-striped
muscles, cartilage, mucous membrane

B. Smooth muscles and cartilage

B. Bone tissue,
striated muscles and mucous membrane

4. The largest
The cartilage of the larynx is:

A. Epiglottis

B. Thyroid

B. Granular

A. In the trachea

B. In the larynx

B. In the nasopharynx

A. Silent

B. Speaks in a whisper

B. Speaks loudly

7. Closes the entrance to
larynx when swallowing food:

A. Thyroid cartilage

B. Granular cartilage

B. Epiglottis

8. Length of human trachea
is:

B. 24–26 cm

H. 10–11 cm

9. The trachea is divided into
main bronchi at the level:

A. 3rd cervical vertebra

B. 5th thoracic vertebra

B. 1st lumbar vertebra

10. Lung tissue consists
from:

A. Alveolus

B. Bronchiole

B. Pulmonary pleura

12. Connection
hemoglobin with oxygen is called:

A. Carboxyhemoglobin

B. Oxyhemoglobin

B. Myoglobin

13. When inhaling, the diaphragm
becomes:

A. Flat

B. Convex

B. Does not change its shape

14. Vital capacity
lungs are:

A. Maximum volume
air exhaled after a quiet inhalation

B. Volume of air exhaled
after a calm breath

B. Maximum volume
air exhaled after a strong inhalation

15. Vital capacity is measured using:

A. Tonometer

B. Spirometer

V. Barometer

16. Respiratory center
located:

A. In the midbrain

B. In the spinal cord

B. In the medulla oblongata

17. Humoral
regulation of breathing is carried out due to the action of:

A. Carbon dioxide,
contained in the blood

B. Adrenaline

B. Acetylcholine

18. Defense centers
respiratory reflexes, breathing and coughing are located:

A. In the diencephalon

B. In the medulla oblongata

B. In the midbrain

Option 2

Exercise. Fill in the missing word.

1.What is the name of the state of temporary disability that occurs as a result of muscle activity?

How does a bone grow in length and width? What is damage to the ligaments that connect the bones in a joint called? What is the name of the largest bone in our body? What bones make up the brain section of the skull? What is the usual position of a person at rest and when moving called? A type of connection between bones that is carried out using cartilage. Examples. What bones does the rib cage consist of? What is the name for severe displacement of bones in a joint? A substance that fills the heads of long bones? Its function. What bones form the shoulder girdle? What tissue is formed by the muscles of mastication and facial expression? What are the opposing muscles called? Sedentary lifestyle.

The highest mountain in Africa (name and height)
The largest desert in Africa and the entire planet
The longest river in Africa
The highest mountain of the North. America (name and altitude)
The largest river is the North. America
The wettest continent
The deepest river in South America and the world
Smallest continent
Australia's largest river
The coldest continent
The lowest temperature recorded in Antarctica and on the entire planet

Cartilages of the larynx, cartilagines laryngis , are divided into paired and unpaired.

TO unpaired cartilages include: thyroid cartilage, cartilago thyroidea; cricoid cartilage, cartilago cricoidea, And epiglottic cartilage, cartilago epiglottica.

TO paired cartilages include: arytenoid cartilage, cartilago arytenoidea; corniculate cartilage, cartilago corniculata, wedge-shaped cartilage, cartilago cuneiformis.

The cartilages of the larynx are mostly hyaline; The epiglottis, corniculate and sphenoid cartilages, as well as the vocal process of each arytenoid cartilage are formed by elastic cartilage.

The hyaline cartilage of the larynx can ossify in old age.

1. Thyroid cartilage , cartilago thyroidea(see Fig. , , ), is located above the arch of the cricoid cartilage, has the appearance of a shield, which has two symmetrical quadrangular plates, right and left, laminae dextra et sinistra, fused at an angle open posteriorly.

The upper edge of the angle protrudes anteriorly more than the lower one and has superior thyroid notch, incisura thyroidea superior.

This area of ​​cartilage can be easily felt through the skin and is called protrusion of the larynx, prominentia laryngea. Less deep inferior thyroid notch, incisura thyroidea inferior, located on the lower edge of the thyroid cartilage. The posterior, free edge of each plate is thickened and has processes directed upward and downward - upper and lower horns, cornu superius et cornu inferius. The upper horns face the overlying hyoid bone, the lower ones articulate with the lateral surface of the underlying cricoid cartilage. On the upper and lower edges of the plate, somewhat anterior to the horns, are located respectively superior and inferior thyroid tubercles, tubercula thyroidei superius et inferius.

On the outer surface of the plates there is oblique line, linea obliqua, – trace of attachment of the sternothyroid and thyrohyoid muscles. Near the upper edge of the plates it is sometimes found thyroid opening, foramen thyroideum, passing through the superior laryngeal artery, a. laryngea superior (usually it penetrates through the thyrohyoid membrane, membrana thyrohyoidea).

2. Cricoid cartilage , cartilago cricoidea(see Fig. , , , ), - unpaired cartilage of the larynx, has the appearance of a ring. Expanded part of cartilage – plate of cricoid cartilage, lamina cartilaginis cricoideae, facing posteriorly, and the narrowed part of the cartilage is arch of cricoid cartilage, arcus cartilaginis cricoideae, facing anteriorly. The lower edge of the cricoid cartilage, directed towards the first tracheal cartilage, is located horizontally.

The upper edge of the cricoid cartilage is parallel to the lower one only in the anterior semicircle; posteriorly it ascends obliquely, limiting the plate.

On the upper edge of the plate of the cricoid cartilage, on the sides of the midline, on each side there is arytenoid articular surface, facies articularis arytenoidea, – the place of articulation with the base of the arytenoid cartilage (see Fig.,). The posterior surface of the plate has a vertically running middle ridge, on the sides of which there are dimples in the plate.

On each lateral surface of the cricoid cartilage there is a rounded shape thyroid articular surface, facies articularis thyroidea, is the place of articulation with the lower horn of the thyroid cartilage.

3. Epiglottic cartilage (epiglottis) cartilago epiglottica(see Fig. , , , , , , , , , , , ), - unpaired elastic cartilage protruding above the superior notch of the thyroid cartilage behind and downward from the root of the tongue. Its shape is close to an oval. Its narrowed lower part is epiglottis stalk, petiolus epiglottidis. The elevation occupying the middle part of the epiglottis stalk is called epiglottic tubercle, tuberculum epiglotticum. On the posterior, slightly concave surface, the epiglottis has small depressions - the location of the mucous glands.

4. Arytenoid cartilage , cartilago arytenoidea(see Fig. , , , , , , , , ), paired, has the appearance of an irregular trihedral pyramid. Distinguish base of the arytenoid cartilage, basis cartilaginis arytenoideae, bearing an elliptical articular surface, facies articularis, articulating with the upper edge of the plate of the cricoid cartilage, and apex, apex cartilaginis arytenoideae, directed upward, posteriorly and medially.

Posterior surface, facies posterior, wide and concave anteriorly (in the vertical plane). Medial surface, facies medialis, small in size, directed towards the arytenoid cartilage of the opposite side. At the top anterolateral surface, facies anterolateralis, there is an elevation – mound, colliculus, from which inferiorly and medially follows arcuate comb, crista arcuata. It limits below triangular fossa, fovea triangularis. Below the ridge there is oblong fossa, fovea oblonga, – the place of attachment of the vocal muscle.

Of the three angles of the base of the arytenoid cartilage, two are most pronounced: the posterolateral angle - muscular process, processus muscularis, and front angle – vocal process, processus vocalis. The muscular process is the attachment point for a number of muscles of the larynx; The vocal cord and vocal muscle are attached to the vocal process.

5. Corniculate cartilage , cartilago corniculata(see Fig. , , , , , , , , ), – paired, small, conical, lies at the apex of the arytenoid cartilage in the thickness aryepiglottic fold, plica aryepiglottica, forming corniculate tubercle, tuberculum corniculatum(see Fig. 586).

6. Sphenoid cartilage , cartilago cuneiformis(see Fig., ), - paired, small, wedge-shaped, located anteriorly and above the corniculate cartilage in the thickness of the aryepiglottic fold, forming wedge-shaped tubercle, tuberculum cuneiforme. These cartilages are often absent.

Sesamoid cartilages, cartilagines sesamoideae, – unstable, small-sized formations.

Larynx- This is a kind of musical instrument of the human body that allows you to speak, sing, express your emotions in a quiet voice or a loud cry. As part of the respiratory tract, the larynx is a short tube with dense cartilaginous walls. The rather complex structure of the walls of the larynx allows it to generate sounds of different heights and volumes.

Structure of the larynx

The larynx is located in the anterior region of the neck at the level of the IV-VI cervical vertebrae. With the help of ligaments, the larynx is suspended from the hyoid bone, as a result of which it lowers and rises with it during swallowing. From the outside, the position of the larynx is noticeable by the protrusion, strongly developed in men and formed by the thyroid cartilage. In common parlance, this protrusion is called “Adam’s apple”, or “Adam’s apple”. Behind the larynx is the pharynx, with which the larynx communicates; large vessels and nerves pass along the side. The pulsation of the carotid arteries can be easily felt in the neck on the sides of the larynx. Below, the larynx passes into the trachea. In front of the trachea, reaching the larynx, is the thyroid gland.

The hard skeleton of the larynx consists of three unpaired cartilages - the thyroid, cricoid and epiglottis - and three paired ones, the most important of which are the arytenoids. The cartilages of the larynx are connected to each other by joints and ligaments and can change their position due to the contraction of the muscles attached to them.

The base of the larynx forms the cricoid cartilage, which resembles a horizontally lying ring: its narrow “arch” faces forward, and its wide “signet” faces back. The lower edge of this cartilage connects to the trachea. The thyroid and arytenoid cartilages join the cricoid cartilage from above. The thyroid cartilage is the largest and is part of the anterior and lateral walls of the larynx. It distinguishes two quadrangular plates, connected to each other at a right angle in men, forming an “Adam’s apple,” and at an obtuse angle (about 120°) in women.

The arytenoid cartilages are pyramid-shaped, their triangular base is movably connected to the plate of the cricoid cartilage. From the base of each arytenoid cartilage a vocal process extends forward, and a muscular process extends to the side. The muscles that move the arytenoid cartilage around its vertical axis are attached to the latter. This changes the position of the vocal process to which the vocal cord is connected.

The top of the larynx is covered by the epiglottis, which can be compared to a “lifting door” above the entrance to the larynx (see Fig. 1). The lower pointed end of the epiglottis is attached to the thyroid cartilage. The wide upper part of the epiglottis descends with each swallowing movement and closes the entrance to the larynx, thereby preventing food and water from entering the respiratory tract from the pharynx.

All cartilages of the larynx are hyaline and can undergo ossification, except for the epiglottis and the vocal process of the arytenoid cartilage, which are formed by elastic cartilaginous tissue. As a result of ossification, which sometimes occurs before the age of 40, the voice loses flexibility and acquires a hoarse, creaky tone.

For the production of sound, the vocal cords, which are stretched from the vocal processes of the arytenoid cartilages to the inner surface of the angle of the thyroid cartilage, are of utmost importance (Fig. 2). Between the right and left vocal cords there is a glottis through which air passes during breathing. Under the influence of muscles, the cartilages of the larynx change their position. The muscles of the larynx are divided into three groups according to their function: they expand the glottis, narrow the glottis, and change the tension of the vocal cords.

The cavity of the larynx is lined with a mucous membrane, which is extremely sensitive: the slightest touch of a foreign body to it reflexively causes a cough. Covers the mucous membrane of the larynx, excluding only the surface of the vocal cords, ciliated epithelium with a large number of glands.

Under the mucous membrane of the larynx lies a fibroelastic membrane. The laryngeal cavity is shaped like an hourglass: the middle section is strongly narrowed and limited above by the folds of the vestibule (“false vocal folds”), and below by the vocal folds (Fig. 3). On the lateral walls of the larynx between the fold of the vestibule and the vocal fold, rather deep pockets are visible - the ventricles of the larynx. These are the remains of voluminous “voice sacs” that are well developed in apes and apparently serve as resonators. Under the mucous membrane of the vocal fold are the vocal cord and vocal muscle, under the mucous membrane of the vestibular fold is the fixed edge of the fibroelastic membrane.

Functions of the larynx

It is customary to distinguish four main functions of the larynx: respiratory, protective, phonatory (voice-forming) and speech.

• Respiratory. When you inhale, air from the nasal cavity enters the pharynx, from it into the larynx, then into the trachea, bronchi and lungs. When you exhale, air from the lungs travels all the way through the respiratory tract in the opposite direction.
• Protective. The movements of the cilia covering the mucous membrane of the larynx continuously clean it, removing the smallest particles of dust that enter the respiratory tract. Dust surrounded by mucus is released as phlegm. Reflex cough is an important protective device of the larynx.
• Phonatornaya. The occurrence of sound is associated with vibration of the vocal cords during exhalation. The sound may vary depending on the tension of the ligaments and the width of the glottis. A person consciously regulates this process.
• Speech. It should be emphasized that only the formation of sound occurs in the larynx; articulate speech occurs when the organs of the oral cavity work: the tongue, lips, teeth, facial and masticatory muscles.

The first is the voice, the second is the melody

A person’s ability to produce sounds of different strength, pitch and timbre is associated with the movement of the vocal cords under the influence of a stream of exhaled air. The strength of the sound produced depends on the width of the glottis: the wider it is, the louder the sound. The width of the glottis is regulated by at least five muscles of the larynx. Of course, the force of exhalation itself, caused by the work of the corresponding muscles of the chest and abdomen, also plays a role. The pitch of the sound is determined by the number of vibrations of the vocal cords in 1 second. The more frequent the vibrations, the higher the sound, and vice versa. As you know, tightly stretched ligaments vibrate more often (remember a guitar string). The muscles of the larynx, in particular the vocal muscle, provide the necessary tension to the vocal cords. Its fibers are woven into the vocal cord along its entire length and can contract either as a whole or in separate parts. Contraction of the vocal muscles causes the vocal cords to relax, causing the pitch of the sound they produce to decrease.

Having the ability to vibrate not only as a whole, but also in individual parts, the vocal cords produce additional sounds to the main tone, the so-called overtones. It is the combination of overtones that characterizes the timbre of the human voice, the individual characteristics of which also depend on the condition of the pharynx, oral cavity and nose, movements of the lips, tongue, and lower jaw. The airways located above the glottis act as resonators. Therefore, when their condition changes (for example, when the mucous membrane of the nasal cavity and paranasal sinuses swells during a runny nose), the timbre of the voice also changes.

Despite the similarities in the structure of the larynx of humans and apes, the latter are not able to speak. Only gibbons are capable of producing sounds that are vaguely reminiscent of musical sounds. Only a person can consciously regulate the force of exhaled air, the width of the glottis and the tension of the vocal cords, which is necessary for singing and speech. The medical science that studies the voice is called phoniatry.

Even in the time of Hippocrates, it was known that the human voice is produced by the larynx, but only 20 centuries later Vesalius (16th century) expressed the opinion that sound is produced by the vocal cords. Even now, there are various theories of voice formation, based on individual aspects of the regulation of vocal cord vibrations. Two theories can be cited as extreme forms.

According to the first (aerodynamic) theory, voice formation is the result of vibrational movements of the vocal folds in the vertical direction under the influence of an air stream during exhalation. The decisive role here belongs to the muscles involved in the exhalation phase and the muscles of the larynx, which bring the vocal cords together and resist the pressure of the air stream. Adjustment of muscle function occurs reflexively when the mucous membrane of the larynx is irritated by air.

According to another theory, the movements of the vocal folds do not occur passively under the influence of an air stream, but are active movements of the vocal muscles, carried out by command from the brain, which is transmitted along the corresponding nerves. The pitch of the sound, associated with the frequency of vibration of the vocal cords, thus depends on the ability of the nerves to conduct motor impulses.

Some theories cannot fully explain such a complex process as voice formation. In a person who has speech, the function of voice formation is associated with the activity of the cerebral cortex, as well as lower levels of regulation, and is a very complex, consciously coordinated motor act.

Larynx in nuances

A specialist can examine the condition of the larynx using a special device - a laryngoscope, the main element of which is a small mirror. For the idea of ​​this device, the famous singer and vocal teacher M. Garcia was awarded the title of honorary doctor of medicine in 1854.

The larynx has significant age and gender characteristics. From birth to 10 years of age, the larynx of boys and girls is virtually no different. Before the onset of puberty, the growth of the larynx in boys increases sharply, which is associated with the development of the gonads and the production of male sex hormones. At this time, the boys’ voice also changes (“breaks”). Voice mutation in boys lasts about a year and is completed at the age of 14-15. In girls, the mutation occurs quickly and almost imperceptibly at the age of 13-14 years.

A man's larynx is on average 1/3 larger than a woman's, and the vocal cords are much thicker and longer (approximately 10 mm). Therefore, the male voice, as a rule, is stronger and lower than the female one. It is known that in the XVII-XVIII centuries. in Italy, 7-8 year old boys who were supposed to sing in the papal choir were castrated. Their larynx did not undergo any special changes during puberty and retained its child size. This achieved a high tone of voice, combined with masculine strength of performance and a neutral timbre (between childish and masculine).

Many organs and systems of the body take part in the formation of the voice, and this requires their normal functioning. Therefore, voice and speech are an expression not only of the normal activity of individual organs and systems, including the human psyche, but also of their disorders and pathological conditions. By changes in voice one can judge a person’s condition and even the development of certain diseases. It must be especially emphasized that any changes in hormonal levels in the body (in women - the use of hormonal drugs, menstruation, menopause) can lead to changes in voice.

The sound energy of the voice is very small. If a person talks continuously, it will take only 100 years to produce the amount of thermal energy needed to brew a cup of coffee. However, the voice (as a necessary component of human speech) is a powerful tool that changes the world around us!

The larynx is the upper part of the breathing tube, which is located in the front of the neck at the level of 4-7 vertebrae. The larynx is connected to the hyoid bone by the thyrohyoid membrane and is laterally adjacent to the thyrohyoid gland.

General characteristics of the larynx

The larynx plays an important role in the formation of human sounds and speech. The air entering through the larynx causes the vocal cords to vibrate and produce sounds. The circulating air flow in the mouth, pharynx and larynx is regulated by the nervous system and allows a person to speak and sing.

The larynx functions as a movement apparatus that has cartilage connected to ligaments and joints of muscles that allow the regulation of the vocal cords and changes in the glottis.

The structure of the larynx is a skeleton of unpaired and paired cartilages.

Unpaired cartilages are

• thyroid cartilage, which consists of wide plates located at a certain angle;
• the cricoid cartilage is the basis of the larynx and is connected to the trachea via a ligament;
• The epiglottic cartilage closes the entrance to the larynx during food intake and adheres to the surface of the thyroid cartilage with the help of a ligament.

Paired cartilages:

• the arytenoid cartilages are pyramid-shaped and connected to the cricoid-type cartilage plate;
• corniculate cartilages have a cone shape and are located in the aryepiglottic fold;
• The sphenoid cartilages are wedge-shaped and are located above the cornicular cartilages.

The cartilages of the larynx are connected to each other by joints and ligaments, and the free space is filled with membranes. When air moves, tension occurs on the vocal cords and each of the cartilages plays a specific role in the formation of sounds.

The movement of all cartilages of the larynx is controlled by the anterior neck muscles. These muscles change the position of the epiglottic cartilage during breathing, speaking, singing and swallowing.

The structure of the larynx is aimed at performing the speech function and ensuring the activity of the vocal apparatus.

• relaxation muscles of the vocal cords - the vocal muscle, designed to narrow the glottis, and the thyroarytenoid muscle, located in the anterior lateral part of the thyroid cartilage;
• tension muscles of the vocal cords - cricothyroid muscle;
• muscles that narrow the glottis - the lateral cricoarytenoid muscle, which changes the position of the arytenoid cartilage, and the transverse arytenoid muscle, which brings the arytenoid cartilages together and tightens them;
• muscles of dilatation of the glottis - the posterior cricoarytenoid muscle, which rotates the arytenoid cartilage and changes the position of its vocal processes.

Diseases of the larynx

Diseases of the larynx are inflammatory, infectious and allergic in nature.

The most common diseases of the larynx include the following.

Acute laryngitis, which is accompanied by inflammation of the mucous membrane of the larynx. This disease occurs as a result of exogenous and endogenous factors. Exogenous factors include irritation of the mucous membrane of the larynx, hypothermia, exposure to harmful substances on the mucous membrane (gas, chemicals, dust, etc.), ingestion of very cold or very hot food and liquid. Endogenous factors include reduced immunity, severe diseases of the digestive system, allergies, atrophy of the laryngeal mucosa.

Laryngitis often manifests itself in adolescence, especially in boys with voice mutation. A serious cause for the development of acute laryngitis can be bacterial flora - streptococcus, influenza virus, rhinovirus, coronovirus.

Infiltrative laryngitis is accompanied by inflammation of the mucous membrane of the larynx and underlying tissues. The inflammatory process takes place in the ligaments, perichondrium and muscles of the vocal apparatus. The main cause of infiltrative laryngitis is infections that penetrate the laryngeal tissue during infectious diseases and injuries.

Laryngeal tonsillitis is an acute infectious disease, which is accompanied by damage to the lymphatic tissues of the larynx, thickening of the mucous membrane and inflammation of the lingual surface of the epiglottis.

Laryngeal edema often develops during allergic reactions of various etiologies. Edema of the larynx manifests itself in the form of an inflammatory process of the mucous membrane and narrowing of the lumen of the larynx. This disease is the result of another inflammatory or infectious process in the larynx.

Acute laryngeal edema can develop under the influence of inflammatory processes, acute infectious diseases, injuries and tumors, allergic reactions and pathological processes that occur in the larynx and trachea.

Laryngeal stenosis leads to a narrowing of the lumen and impedes air circulation in the low airways. With laryngeal stenosis, there is a high risk of asphyxia as a result of insufficient air passage into the lungs.

Laryngeal and tracheal stenoses are considered and treated as a single disease. If the disease progresses rapidly and there is a high risk of severe respiratory dysfunction, emergency medical care is required.

Treatment of the larynx and voice restoration

The main factors for weakening of the ligaments and loss of voice are:

• viral infection;
• inflammation caused by ligament tension and overload;
• damage to ligaments in chemical or other production;
• loss of voice due to nervousness, due to neurosis;
• ligament irritation from spicy foods, hot or cold drinks.

Treatment of the larynx depends on the cause and type of disease. Usually the voice is restored without medical treatment; over time, the ligaments relax from tension and recover.

There are several main ways to restore your voice:

• eliminating the irritant or allergen (dust, smoke, spicy food, cold liquid, etc.);
• treatment of pharynx diseases - laryngitis, pharyngitis, sore throat;
• avoidance of ligament tension, silence for several days;
• rest and warmth, compresses on the neck area.

If the inflammation of the ligamentous apparatus and larynx is chronic, then you should seek help from an otolaryngologist, undergo a medicinal course of treatment of the larynx and do special exercises to restore the voice and strengthen the ligaments.