Infective endocarditis
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Infective endocarditis is a serious condition where the inner lining of the heart valves become infected. A 67-year old male patient presented with fever and fatigue and was subsequently diagnosed with infective endocarditis caused by Staphylococcus aureus bacteria based on blood culture tests. The patient was started on antibiotic treatment and further tests will be done to assess the need for valve replacement surgery.
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Anatomy of the Larynx
Larynx is a cartilaginous structure located in the **anterior neck** at the level of **C3C6 vertebrae**.
* Also called the **voice box**responsible for **phonation**, **airway protection**, and **breathing regulation**.
**Cartilages of the Larynx**
**Unpaired Cartilages:**
1. **Thyroid cartilage**:
* Largest cartilage; forms the **Adams apple (laryngeal prominence)**.
* Composed of two laminae that fuse anteriorly.
2. **Cricoid cartilage**:
* Ring-shaped; **only complete ring** around the airway.
* Located below thyroid cartilage; articulates with thyroid & arytenoid cartilages.
3. **Epiglottis**:
* Leaf-shaped elastic cartilage.
* Covers the laryngeal inlet during swallowing.
**Paired Cartilages:**
1. **Arytenoid**:
* Pyramid-shaped; sit on top of cricoid.
* Attach vocal cords and muscles.
2. **Corniculate**:
* Small cartilages sitting atop the arytenoids.
3. **Cuneiform**:
* Embedded in the aryepiglottic folds; provide structural support.
**Intrinsic Muscles of the Larynx**
> Responsible for controlling **vocal cord movement**.
| Muscle | Action | Nerve Supply |
| **Cricothyroid** | Tenses vocal cords | External laryngeal nerve |
| **Thyroarytenoid** | Relaxes vocal cords | Recurrent laryngeal nerve |
| **Posterior cricoarytenoid** | Abducts vocal cords (opens glottis) | Recurrent laryngeal nerve |
| **Lateral cricoarytenoid** | Adducts vocal cords | Recurrent laryngeal nerve |
| **Transverse & oblique arytenoids** | Closes the posterior glottis | Recurrent laryngeal nerve |
| **Vocalis** | Fine-tunes pitch | Recurrent laryngeal nerve | **Nerve Supply*
* **Motor**:
* All intrinsic muscles (except cricothyroid): **Recurrent laryngeal nerve** (branch of vagus nerve).
* Cricothyroid: **External branch of superior laryngeal nerve**.
* **Sensory**:
* Above vocal cords: **Internal branch of superior laryngeal nerve**.
* Below vocal cords: **Recurrent laryngeal nerve**.
**Blood Supply**
* **Superior laryngeal artery** (branch of superior thyroid artery).
* **Inferior laryngeal artery** (branch of inferior thyroid artery).
**Laryngeal Cavity & Folds**
Divided into 3 regions:
1. **Vestibule** from inlet to vestibular folds (false cords).
2. **Ventricle** between vestibular and vocal folds.
3. **Infraglottic cavity** below vocal cords to trachea.
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