## Distinguishing True from False Vocal Cords ### Structural Comparison | Feature | True Vocal Cords | False Vocal Cords (Ventricular Folds) | |---------|-----------------|---------------------------------------| | **Core Structure** | Vocal ligament + thyroarytenoid muscle | Loose areolar tissue, no ligament | | **Epithelium** | Stratified squamous (anterior 2/3), respiratory (posterior 1/3) | Stratified squamous | | **Location** | Bound rima glottidis; form vocal folds | Superior to rima glottidis | | **Function** | Sound production via vibration | Protective; no phonatory role | | **Attachment** | Thyroid cartilage (anterior) to arytenoid (posterior) | Arytenoid to epiglottis | ### Key Point: **The presence of a vocal ligament (elastic fibre bundle) and thyroarytenoid muscle within the true vocal cord is the single most important discriminator.** False vocal cords lack this muscular-ligamentous core and are therefore incapable of vibrating to produce sound. ### Clinical Pearl: **High-Yield:** In laryngeal pathology, lesions on the true vocal cords (e.g. vocal nodules, polyps) cause hoarseness because they disrupt the vibrating edge. Lesions on false vocal cords are clinically silent unless they obstruct the airway. ### Mnemonic: **TVCs = Tense Vocal Cords** — they have the structural rigidity (ligament + muscle) needed for tension and vibration. **FVCs = Flabby Vocal Cords** — loose areolar tissue cannot sustain phonation. [cite:Gray's Anatomy 42e Ch Larynx] 
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