The vocal ligament is a thickened free edge of which membrane in the larynx?

Explanation

## Vocal Ligament and Conus Elasticus **Key Point:** The vocal ligament is the thickened, free superior edge of the conus elasticus (cricothyroid ligament), which stretches between the thyroid and cricoid cartilages. ### Anatomy of the Conus Elasticus **Conus Elasticus (Cricothyroid Ligament):** - **Extent:** Stretches between the superior border of the cricoid cartilage and the inferior margin of the thyroid cartilage - **Composition:** Elastic fibers in a fibrous matrix - **Superior Free Edge:** Thickened and forms the **vocal ligament** - **Inferior/Lateral Portions:** Remain as the cricothyroid ligament proper ### Layers of the Vocal Fold 1. **Mucosa** (epithelium + lamina propria) 2. **Vocal ligament** (thickened conus elasticus) 3. **Vocalis muscle** (medial thyroarytenoid) 4. **Lateral thyroarytenoid muscle** **High-Yield:** The vocal ligament is NOT a separate structure — it is the superior thickened edge of the conus elasticus. This distinction is frequently tested. **Clinical Pearl:** The conus elasticus is clinically important because: - It is the site of **cricothyrotomy** (emergency airway access between thyroid and cricoid) - Tension in the vocal ligament is controlled by the cricothyroid joint and muscles, which regulate pitch - Damage to the vocal ligament results in voice changes ### Comparison: Laryngeal Ligaments | Ligament | Origin | Insertion | Contains | | --- | --- | --- | --- | | Conus elasticus | Superior cricoid border | Inferior thyroid margin | Vocal ligament (superior edge) | | Cricothyroid | Cricoid cartilage | Thyroid cartilage | Elastic fibers | | Aryepiglottic | Arytenoid cartilage | Epiglottis | Elastic fibers; forms aryepiglottic fold | | Thyrohyoid | Thyroid cartilage | Hyoid bone | Fibrous; forms thyrohyoid membrane | **Mnemonic:** **VCE** = Vocal ligament is the **C**onus **E**lasticus's superior edge.