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The cartilages are the epiglottis, thyroid, cricoid, arytenoid, the two small, unimportant cornicula laryngis, or cartilages of Santorini, surmounting the arytenoids, and the two cuneiform, or cartilages of Wrisberg, in the folds of mucous membrane on each side of the arytenoids. The muscles are attached to the main cartilages.
It is of practical importance to remember that the larynx is free to a very considerable extent, otherwise it would go ill with the voice-producer in the vigorous use of the voice, not to mention the advantages of mobility as well as pliability in the movements of the neck generally. Shows the thyroid cartilage above and the cricoid below both viewed from the side.
Factors in the Production of the Voice. Muscles which pass from the cricoid cartilage to the outer angle of the arytenoids act to bring the vocal cords close together, and parallel to one another, so that the space between them is narrowed to a slit. A strong expiration now drives the air from the lungs through the slit, between the cords, and throws them into vibration.
The hyoid bone, or tongue-bone, is that hard structure just above the cricoid cartilage, and which one may easily demonstrate to be much more movable than the larynx itself. The tongue muscles are attached to it above, and from it, below, the larynx is suspended, as already explained.
Division of the carotid artery is fatal, and of the internal jugular vein very dangerous on account of entrance of air. Wounds of the larynx and trachea are not necessarily or immediately dangerous, but septic pneumonia is very apt to follow. Wounds of the throat inflicted by suicides are commonly situated at the upper part, involving the hyoid bone and the thyroid and cricoid cartilages.
Adams describes the case of a woman who attempted suicide with a common table-knife, severing the thyroid, cricoid, and first three rings of the trachea, and lacerating the sternohyoid and thyroid arteries; she finally recovered. There is a curious case of suicide of a woman who, while under the effects of opium, forced the handle of a mirror into her mouth.
THE GLOTTIS AND VOCAL CORDS VIEWED FROM ABOVE 1, Glottis. 2, True Cords. 3, False Cords. 4, Epiglottis. 5, Base of Tongue. V, Ventricles. T, Thyroid Cartilage. C, Cricoid Cartilage. W, Windpipe or Trachea. The laryngoscope should not, in fact, leave the hands of the physician.
View of the Cartilages in front project and form the lages and Ligaments of the "Adam's apple," plainly seen and Larynx. A, hyoid bone; B, thyro-hyoid membrane; C, thyroid cartilage; D, erico-thyroid membrane; E, cricoid cartilage, lateral ligaments seen on each side; F, upper ring of the trachea. The larynx has for a framework two cartilages, the thyroid and the cricoid, one above the other.
At the base is the 'cricoid cartilage, the support and bond of union of the rest. Above are the 'arytenoid cartilages, resting on the 'chorda vocales' and influencing their action.
Showing the parts indicated above; and of these the crico-thyroid muscle is to be especially observed. It is important to remember the relative position of parts and to bear in mind that most of the laryngeal structures are in pairs. To this last statement the thyroid and cricoid cartilages and the epiglottis are exceptions, being single.
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