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Larynx is a cartilaginous structure located in the **anterior neck** at the level of **C3C6 vertebrae**.
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**Cartilages of the Larynx**
**Unpaired Cartilages:**
1. **Thyroid cartilage**:
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* 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.
**Vocal folds (true cords)** involved in sound production.ELECTROMYOGRAPHY.pptX by GOKULAKRISHNAN.
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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.
**Vocal folds (true cords)** involved in sound production.ELECTROMYOGRAPHY.pptX by GOKULAKRISHNAN.
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Electromyography is basically the study of motor unit activity.
In electromyography, the study of the electrical activity of contracting muscle provides information concerning the structure and function of the motor units.
Bias, Cofounding Bias, Matching , Blinding
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The slide contains small sippets about the bias, confounding bias, and the ways by which we can remove them. Like by using the methods such as matching and blinding. This slide can be useful as a reference for students in MBBS. Drug use in Peptic Ulcer_A complete review.pptx
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Open PPT for detail description: Peptic Ulcer Disease (PUD)
Peptic ulcer disease refers to mucosal erosions equal to or greater than 5 mm in the stomach or proximal duodenum, caused primarily by an imbalance between gastric acid/pepsin secretion and mucosal defense mechanisms. The most common etiologies include Helicobacter pylori infection, chronic use of NSAIDs, and physiological stress.
Classification of Peptic Ulcers
Based on Location
Gastric Ulcers Occur in the stomach lining.
Duodenal Ulcers Occur in the first part of the small intestine (duodenum).
Based on Etiology
H. pyloriAssociated Ulcers
NSAID-Induced Ulcers
Stress-Related Mucosal Disease (SRMD)
ZollingerEllison Syndrome (gastrinoma-related)
Cushings Ulcer (due to intracranial injury)
Curlings Ulcer (seen in burn patients)
Pharmacological Management
1. Acid Suppression Therapy
Class Examples Mechanism
Proton Pump Inhibitors (PPIs) Omeprazole, Pantoprazole Irreversibly inhibit H+/K+ ATPase pump
H2-Receptor Antagonists Ranitidine, Famotidine Block histamine-mediated gastric acid secretion
2. Mucosal Protective Agents
Class Examples Mechanism
Prostaglandin Analogues Misoprostol Increases mucus & bicarbonate; decreases acid; protects mucosa
Mucosal Coating Agents Sucralfate Forms protective barrier over ulcer site
Bismuth Compounds Bismuth subsalicylate Antimicrobial, mucosal protective, and anti-inflammatory
3. Eradication Therapy (for H. pylori)
Combination of:
PPI + Two Antibiotics (e.g., amoxicillin + clarithromycin OR metronidazole + tetracycline)
Duration: 714 days depending on local guidelines
See BNF regimens above for detailed protocols
4. Cytoprotective/Adjunctive Agents
Class Examples Role in PUD
Somatostatin Analogues Octreotide Used in bleeding ulcers; reduces splanchnic blood flow and gastric secretions
Antacids Magnesium hydroxide, Aluminium hydroxide Neutralize gastric acid; provide symptomatic relief
Non-Pharmacologic Measures
Avoid NSAIDs, smoking, alcohol, and spicy foods
Small, frequent meals in symptomatic patients
Stress reduction
Endoscopic therapy in case of bleeding or perforation
Surgical Indications (rarely needed)
Perforated ulcer
Gastric outlet obstruction
Refractory ulcers not responding to medical therapy
Severe bleeding unresponsive to endoscopic management
Summary
Peptic ulcer disease is primarily driven by H. pylori infection and NSAID use, with duodenal ulcers more common than gastric. Treatment is tailored based on etiology and includes acid suppression, H. pylori eradication, and mucosal protection. Advanced cases may require somatostatin analogues for hemorrhage control or surgery for complications. Prostaglandin analogues like misoprostol are especially valuable in preventing NSAID-induced ulcers.INTERPRETATION OF LABORATORY INVESTIGATIONS.pptx
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THE DOCUMENT SUMMARIZES THE KEY COMPONENTS OF INTERPRETING FULL BLOOD CUNTRatricharya according to ayurveda along with day and night pattern in various...
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COPD :LATEST GUIDELINES 2025
REFERENCE: Harrisons Principles of Internal Medicine
GOLD -2025 Guidelines
It highlights updated diagnostic criteria, pharmacological and non-pharmacological treatment options, and current best practices for resident doctors and healthcare professionals.
Ideal for medical students, residents, and practitioners seeking an up-to-date, evidence-based reference.
Download, share, and feel free to reach out for related study material!Irradiation to prevent TA-GvHD by Dr. Abrar Kabir Shishir.pptx
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This presentation discusses the role of irradiation in preventing transfusion-associated graft-versus-host disease (TA-GvHD). Covers pathophysiology, risk factors, investigation, prevention strategies, and irradiation procedures. Includes visuals and real-life context from Dhaka Medical College.Quality by Design Tools in Pharmaceutical Manufacturing Technology
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In Qbd why risk assessment needed that explained
Design Space and DoE relationship with each other.
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Chair and Presenter, Naval Daver, MD, Jessica K. Altman, MD, and Ghayas Issa, MD, Alice S. Mims, MD, MSCR, discuss acute myeloid leukemia in this CME/MOC/AAPA/IPCE activity titled Winning GAMBITS Against AML: Guidance on Advances & Medical Breakthroughs with Innovative Targeted Strategies. For the full presentation, downloadable Practice Aids, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/42f1QCa. CME/MOC/AAPA/IPCE credit will be available until June 30, 2026.Design of cosmeceuticals products;sunprotection,sunscreens
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