The human larynx, often referred to as the voice box, is a vital anatomical structure that serves essential functions in breathing, phonation, and protecting the airway during swallowing. Structurally, it is supported and shaped by nine laryngeal cartilages, categorized into three unpaired and three paired cartilages. Mastering their names, functions, and relationships is crucial for medical students and healthcare professionals, particularly in fields like otolaryngology, surgery, and anesthesiology.
To aid in memory retention and simplify complex anatomy, this article introduces two playful and effective mnemonics:
- Unpaired cartilages: “Unfollow The Enemies that Criticize”
- Paired cartilages: “Pair with Actual Caring & Cute friends”
Let’s dive deeper into the structure, function, and clinical importance of these laryngeal cartilages.
Understanding the Basic Structure of the Larynx
The larynx is located in the anterior part of the neck, spanning from the level of the third to sixth cervical vertebrae (C3–C6). It is continuous superiorly with the pharynx and inferiorly with the trachea.
Key roles of the larynx include:
- Phonation (voice production)
- Airway protection during swallowing
- Regulation of airflow into the lungs
- Anchoring point for vocal cords and muscles
These functions are enabled and supported by a cartilaginous framework consisting of nine cartilages:
- 3 unpaired: Thyroid, Cricoid, Epiglottis
- 3 paired (6 total): Arytenoid, Corniculate, Cuneiform
Mnemonic for Unpaired Laryngeal Cartilages: "Unfollow The Enemies that Criticize"
Each unpaired cartilage begins with the initials TCE:
T – Thyroid Cartilage
The thyroid cartilage is the largest cartilage of the larynx and forms the laryngeal prominence (commonly known as the Adam’s apple), more prominent in males.
Key Features:
- Two laminae meet at an angle
- Superior and inferior horns articulate with hyoid bone and cricoid cartilage
- Forms anterior wall of the larynx
Function:
- Supports vocal cords anteriorly
- Shields internal structures of the larynx
Clinical Insight:
- Landmark for emergency cricothyrotomy
- Fracture may affect airway patency and voice
C – Cricoid Cartilage
Shaped like a signet ring, the cricoid cartilage is located below the thyroid cartilage and above the trachea.
Key Features:
- Only complete ring of cartilage in the airway
- Anterior part is narrow; posterior part is broad
- Articulates with arytenoid and thyroid cartilages
Function:
- Forms the base of the larynx
- Supports arytenoid movement for phonation
Clinical Insight:
- Site of pressure application in Sellick’s maneuver to prevent aspiration during intubation
- Location of cricothyroidotomy
E – Epiglottis
The epiglottis is a leaf-shaped elastic cartilage that acts as a protective flap during swallowing.
Key Features:
- Anchored to the thyroid cartilage
- Posterior to tongue and hyoid bone
- Covers the glottis when swallowing
Function:
- Prevents food and liquids from entering the trachea
- Directs bolus toward the esophagus
Clinical Insight:
- Inflammation (epiglottitis) in children can cause life-threatening airway obstruction
Mnemonic for Paired Laryngeal Cartilages: “Pair with Actual Caring & Cute Friends”
These cartilages come in pairs, totaling six:
A – Arytenoid Cartilages
These are pyramidal-shaped cartilages situated on the posterior cricoid.
Key Features:
- Base articulates with cricoid
- Apex supports corniculate cartilage
- Vocal process attaches to vocal cords
- Muscular process attaches to intrinsic laryngeal muscles
Function:
- Controls vocal cord position
- Enables adduction/abduction for phonation
Clinical Insight:
- Arytenoid dislocation affects voice and breathing
- Paralysis of attached muscles leads to hoarseness
C – Corniculate Cartilages
These are tiny conical cartilages that sit atop the arytenoids.
Function:
- Support and prolong arytenoids
- Help maintain the opening of the laryngeal inlet
Clinical Insight:
- Often seen during laryngoscopy as part of the aryepiglottic fold
C – Cuneiform Cartilages
These small rod-shaped cartilages are embedded in the aryepiglottic folds.
Function:
- Provide structural support to the aryepiglottic fold
- Keep laryngeal inlet open
Clinical Insight:
- Their collapse can contribute to airway obstruction in conditions like laryngomalacia
Summary Table: Laryngeal Cartilages Mnemonics
| Category | Mnemonic | Cartilages |
|---|---|---|
| Unpaired | “Unfollow The Enemies that Criticize” | Thyroid, Cricoid, Epiglottis |
| Paired | “Pair with Actual Caring & Cute friends” | Arytenoid, Corniculate, Cuneiform |
Detailed Anatomical Relationships
| Cartilage | Shape | Articulation Partners | Related Muscles | Key Clinical Points |
|---|---|---|---|---|
| Thyroid | Shield-like | Cricoid, Hyoid | Cricothyroid | Adam’s apple, cricothyrotomy landmark |
| Cricoid | Ring | Thyroid, Arytenoid | Posterior cricoarytenoid | Sellick’s maneuver, airway obstruction |
| Epiglottis | Leaf-like | Thyroid | Aryepiglottic fold | Epiglottitis risk in children |
| Arytenoid | Pyramidal | Cricoid | Vocalis, lateral cricoarytenoid | Vocal cord movement and phonation |
| Corniculate | Conical | Arytenoid | - | Support to aryepiglottic fold |
| Cuneiform | Rod-like | Embedded in fold | - | Maintains laryngeal inlet |
Functional Role of Each Cartilage in Phonation and Breathing
- Thyroid: Anchor point for vocal cords and muscles
- Cricoid: Forms posterior support and allows movement of arytenoids
- Epiglottis: Closes airway during swallowing
- Arytenoids: Move vocal cords for sound production
- Corniculate & Cuneiform: Provide stability to the upper larynx
Clinical Conditions Related to Laryngeal Cartilage Dysfunction
1. Laryngeal Trauma
- Fracture of thyroid or cricoid cartilage may lead to airway obstruction
- Emergency airway management may be required
2. Epiglottitis
- Rapid swelling of epiglottis in children due to Haemophilus influenzae type b
- Requires immediate airway support
3. Vocal Cord Paralysis
- Due to recurrent laryngeal nerve injury affecting arytenoid movement
- Common during thyroidectomy or neck surgery
4. Laryngomalacia
- Soft cuneiform cartilages collapse during inspiration
- Most common cause of stridor in infants
Frequently Asked Questions (FAQs)
How many cartilages are there in the larynx?
There are 9 laryngeal cartilages: 3 unpaired (thyroid, cricoid, epiglottis) and 3 paired (arytenoid, corniculate, cuneiform).
What is the largest cartilage in the larynx?
The thyroid cartilage is the largest. It forms the anterior wall of the larynx and the prominent Adam’s apple.
What is the only complete ring in the airway?
The cricoid cartilage is the only complete cartilaginous ring in the airway, providing structural integrity.
Which cartilage is leaf-shaped and protects the airway during swallowing?
The epiglottis prevents aspiration by covering the glottis during swallowing.
What is the role of arytenoid cartilages?
Arytenoids allow the movement of vocal cords, enabling speech and regulating airflow.
Bonus Mnemonics Recap
Unpaired:
"Unfollow The Enemies that Criticize"
- T: Thyroid
- C: Cricoid
- E: Epiglottis
Paired:
"Pair with Actual Caring & Cute Friends"
- A: Arytenoid
- C: Corniculate
- C: Cuneiform
Conclusion
Understanding the laryngeal cartilages is foundational to both anatomy and clinical practice. With their direct involvement in breathing, swallowing, and phonation, any pathology involving these cartilages—whether congenital, traumatic, or inflammatory—can have life-altering consequences. By using simple mnemonics like "Unfollow The Enemies that Criticize" and "Pair with Actual Caring & Cute Friends", medical students can retain this complex information efficiently.
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