VOICE AND SPEECH. 



429 



larynx receive their motor impulses from the inferior laryngeal nerve. Much 

 of the nervous mechanism of the larynx is still in dispute. 



Laryngoscopic Appearance of the Larynx. — Much may be learned by 

 inspection of the larynx during life by means of the laryngoscopic mirror. It 

 is not difficult for an observer to examine his own larynx by placing himself 

 before a second mirror in which may be seen the image reflected from the 

 laryngoscope. To inspect the larynx the tongue must be held well out so 

 as to pull forward the epiglottis, then the structures below appear in the 

 laryngoscopic mirror in reversed position. Beneath the middle of the epiglottis 

 the cushion may be seen as a slight swelling, and continuing downward and 

 backward from the edges of the cartilage, may be seen the ary-epiglottic folds, 

 each marked at its extremity by two rounded nodules, the cartilages of AVris- 

 bergand Santorini (Fig. 215). In quiet breathing the glottis is nearly stationary 

 and opened to the extent of from 3 to 5 millimeters. The vocal cords bounding 

 it look white and glistening in contrast with the red color of the general mucous 

 membrane. The cartilages of Santorini are several millimeters apart, and a 

 sheet of mucous membrane reaches from one to the other. The ventricular 



17 



Pig. 215. — The laryngoscopic image in easy breathing (Stoerk): 1, base of the tongne; 2, median 

 glosso-epiglottic ligament ; 3, vallecula; -l, lateral glosso-epiglottic ligament; 5, epiglottis; 6, cushion of 

 epiglottis; 7, cornu major of hyoid bone; 8, ventricular band, or false vocal cord; 9, true vocal cord; 

 opening of the ventricle of Morgagni seen between 8 and 9; 10, folds of mucous membrane ; it, sinus 

 pyriformis; 12, cartilage of Wrisberg ; L8, aryteno epiglottic fold; L4, rima glottidis; 15, arytenoid carti- 

 lage ; 16, cartilage of Santorini ; 17, posterior wall of pharynx. 



bands are seen as red shelves reaching to the outer margin of the shining 

 cords and separated from the latter by a dark line which is the entrance into 

 the ventricles of Morgagni. 



When a deep inspiration is taken the glottis is widely opened, even to the 

 extent of half an inch; an angle is formed between the vocal process of the 

 arytenoid and the vocal cord, the space between the cartilages of Santorini is 

 widened, and the rings of the trachea, and ex-en its bifurcation may he seen 

 below. With the succeeding expiration the glottis again becomes narrow. 

 When the voice is sounded the picture at once changes. The space between 

 the cartilages of Santorini is obliterated, the vocal processes and cords are 



