[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Epiglottis [Respiratory system](https://durgical.com/en/anatomy/system/respiratory-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Epiglottis The epiglottis is a leaf-shaped flap of cartilage behind the tongue; it tips back over the larynx when swallowing so food goes down the oesophagus. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=epiglottis&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A leaf-shaped flap of elastic cartilage behind the tongue. ## What it does Tips back over the larynx when swallowing so food goes to the oesophagus. ## Key points - Acute epiglottitis: fever, sore throat, drooling, muffled voice and a child sitting forward in the tripod position; the airway is secured in a controlled setting before the throat is examined - Classic in young children and much less common since Haemophilus influenzae type b (Hib) vaccination; adults now make up a larger share of cases - Elastic cartilage that does not ossify; its stalk (petiole) is tied to the back of the thyroid cartilage, and the valleculae separate it from the tongue base ## Key facts **Where** Behind the tongue base, top of the larynx **Blood supply** Superior laryngeal artery **Nerve** Internal laryngeal nerve (X) **Function** Covers the laryngeal inlet when swallowing ## Relations **In front** Valleculae, the paired pockets between it and the [tongue](https://durgical.com/en/anatomy/tongue/) base, either side of the median glossoepiglottic fold; lower down the pre-epiglottic space, with fat and the hyoepiglottic ligament **Below** Petiole, attached by the thyroepiglottic ligament to the inner angle of the [thyroid cartilage](https://durgical.com/en/anatomy/thyroid-cartilage/) just above the [vocal folds](https://durgical.com/en/anatomy/vocal-fold/) **Lateral** Aryepiglottic folds running back to the [arytenoid cartilages](https://durgical.com/en/anatomy/arytenoid-cartilage/); the [quadrangular membrane](https://durgical.com/en/anatomy/quadrangular-membrane/) hangs from its sides **Behind** Laryngeal vestibule and, below it, the vocal folds ## How to find it A laryngeal mirror or flexible endoscope shows its free edge behind the tongue base, with the valleculae in front of it, bounded by the median and lateral glossoepiglottic folds; during intubation it is the first landmark the laryngoscope blade looks for. ## On imaging Lateral neck radiograph in epiglottitis: a swollen, rounded epiglottis (thumb sign), thick aryepiglottic folds and loss of the air pocket in the vallecula (vallecula sign). Imaging is not allowed to delay securing the airway. ## Common problems - Epiglottitis: rare but dangerous swelling that can block the airway (drooling, muffled voice). - When it does not close well, food or liquid goes into the airway (aspiration). ## How it is diagnosed Careful airway exam by a specialist; swallowing studies. ## Treatment - Securing the airway and antibiotics for epiglottitis. - Swallowing therapy. ## Clinical notes - Laryngoscopy: a curved blade tip goes into the vallecula and lifts the epiglottis indirectly; a straight blade lifts it directly, often used in infants with a long, floppy epiglottis - The pre-epiglottic space in front of it is a route of spread for supraglottic cancer and changes staging and surgery - A curled, omega-shaped epiglottis in infants is part of laryngomalacia, the most common cause of inspiratory stridor in infancy ## Development Arises from the hypobranchial eminence, behind the developing tongue, at the level of the fourth pharyngeal arch. ## Related conditions - [Laryngeal cancer](https://durgical.com/en/conditions/laryngeal-cancer/) - [Anaphylaxis](https://durgical.com/en/conditions/anaphylaxis/) - [Foreign-body airway obstruction (choking)](https://durgical.com/en/conditions/foreign-body-airway-obstruction/) - [Hymenoptera stings (bees, wasps, ants)](https://durgical.com/en/conditions/hymenoptera-stings/) - [Oropharyngeal dysphagia in older adults](https://durgical.com/en/conditions/oropharyngeal-dysphagia-in-older-adults/) - [Acute epiglottitis](https://durgical.com/en/conditions/acute-epiglottitis/) ## Test yourself Think of the answer, then tap the question to see it. ## What is the classic presentation of acute epiglottitis in a child? Fever, sore throat, drooling, muffled voice and sitting forward in the tripod position; the airway is secured in a controlled setting before the throat is examined. ## What is the thumb sign on a lateral neck radiograph? A swollen, rounded epiglottis in epiglottitis, often with thick aryepiglottic folds and loss of the vallecular air pocket; imaging must not delay securing the airway. ## How do curved and straight laryngoscope blades lift the epiglottis? A curved blade tip goes into the vallecula and lifts it indirectly; a straight blade lifts the epiglottis directly, often used in infants with a long, floppy epiglottis. ## Which vaccine made acute epiglottitis much less common in children? Haemophilus influenzae type b (Hib) vaccine; adults now make up a larger share of cases. ## What nerve gives sensation to the epiglottis and what space in front of it matters in supraglottic cancer? The internal laryngeal nerve (X); the pre-epiglottic space in front of it is a route of tumour spread that changes staging and surgery. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/epiglottis/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** epiglottis TA2 3190 **Official Spanish (DeCS)** Epiglotis DeCS D004825 **English (TA2)** Epiglottis ## Related - [Tongue](https://durgical.com/en/anatomy/tongue/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=4905&filter=ths_termall&q=Epiglottis); [Epiglottitis](https://www.ncbi.nlm.nih.gov/books/NBK430960/); [Anatomy, Head and Neck: Larynx Cartilage](https://www.ncbi.nlm.nih.gov/books/NBK553185/); Anatomy of the Human Body (20th ed.): Surface Markings of Special Regions of the Head and Neck (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/epiglottis/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/epiglottis/