306 CLINICAL APPLIED ANATOMY. 



membrane being freely supplied with sensory nerves, laryngeal 

 spasm may be the result of catarrhal inflammation. 



(Edema of the larynx may be inflammatory, when it is either 

 infectious or traumatic, or a passive oedema of local or general 

 origin. It is most marked in situations where there is the most 

 submucous tissue, i.e., the aryteno-epiglottidean folds, the false 

 cords, the ventricles, and the laryngeal aspect of the epiglottis. 

 (Edema of the true cords is unknown, there being no loose con- 

 nective tissues in this region. (Edema may cause considerable 

 obstruction of the upper laryngeal aperture, and this is especially 

 apt to be the case in childhood, since the larynx is then small. 

 The laryngeal opening lies on the anterior wall of the pharynx, 

 consequently when cedema interferes with its proper closure 

 during deglutition, choking may occur, and at the same time pain 

 may be experienced if the swelling is of inflammatory nature. 



Foreign Bodies in the Larynx. Many large foreign bodies, 

 such as a bolus of food, obstruct the superior aperture of the 

 larynx without entering its cavity. A small foreign body, having 

 passed the upper strait, falls upon the edge of the true vocal 

 cords, thereby causing sudden closure of the glottis. It may 

 thus be immediately ejected. On the other hand, it may be 

 forced into one of the ventricles of the larynx, or when the rima 

 glottidis is opened, it may slip through during inspiration and drop 

 into a bronchus. Sharp bodies, if they reach the interior, are apt 

 to stick in the mucous membrane of the upper half of the larynx. 



Malignant disease of the larynx usually occurs as squamous- 

 celled carcinoma. The greater part of the laryngeal mucous 

 membrane is covered with columnar ciliated epithelium, but on 

 the true vocal cords the epithelial covering is squamous. 

 Squamous epithelium also lines the vestibule or upper sub- 

 division of the laryngeal cavity, the transition to columnar cells 

 occurring at the widest part of the epiglottis in front, and a line or 

 two above the false cords at the sides. Patches of squamous 

 epithelium are also found on the inner surfaces of the arytenoid 

 cartilages, and at the free borders of the false cords. 



New growths of the larynx are usually primary, but may extend 



