DISCALIMER : This is a brute force method using coordinate geometry. A better method should exists.
Take the center of the large circle be $(0, 0)$. Then $P = (-4, 0)$ and $Q = (6, 0)$.
Now let $y = mx + c$ denote the line extending $LM$ on both sides, where $m, c \in \mathbb{R}$ are constants such that both the systems of equations,
$$y = mx + c$$
$$(x - (-4))^2 + y^2 = 6^2$$
and
$$y = mx + c$$
$$(x - 6)^2 + y^2 = 4^2$$
have only one unique solution.
From the first system we can work out, by substitution first and then by considering discriminant second, one required condition:
$$(2mc + 8)^2 - 4(m^2 + 1)(c^2 - 20) = 0$$
$$20 m^2 + 8mc - c^2 + 36 = 0$$
and similarly from the second system,
$$(2mc - 12)^2 - 4(m^2 + 1)(c^2 + 20) = 0$$
$$20m^2 + 12mc + c^2 - 16 = 0$$
Subtract the twice the second condition from thrice the first to eliminate $mc$:
$$3(20 m^2 + 8mc - c^2 + 36) - 2(20m^2 + 12mc + c^2 - 16)= 0$$
$$20m^2 -5c^2 + 140 = 0$$
$$c^2 = 4m^2 + 28$$
Now consider the sum of $4$ times the first condition and $9$ times the second condition to eliminate the constant term:
$$4(20 m^2 + 8mc - c^2 + 36) + 9(20m^2 + 12mc + c^2 - 16) = 0$$
$$52m^2 + 28mc + c^2 = 0$$
$$(2m + c)(26m + c)$$
From which we get either $c = -2m$ or $c = -26m$.
Using the results in the previous two parts, we see that there a few possibilities for $m$. Clearly $c = -2m$ has no solutions because
$$(-2m)^2 = 4m^2 + 28$$
has no solution for $m$. Hence $c = -26m$. Therefore
$$(-26m)^2 = 4m^2 + 28$$
$$672m^2 = 28$$
$$m = \pm \frac{1}{2\sqrt{6}}$$
Since from our geometric definition of $m$ being the gradient of the negatively sloped $LM$-extended, $m$ must be negative. Hence
$$m = -\frac{1}{2\sqrt{6}}$$
which leaves $$c = \frac{13}{\sqrt{6}}$$
Thus, the line $LM$ extended has equation $y = -\frac{1}{2\sqrt{6}}x + \frac{13}{\sqrt{6}}$
Now use the equation of $LM$ extended and the equation of the large circle (with radius $\frac{6 + 6 + 4 + 4}{2} = 10$,
$$x^2 + y^2 = 10^2$$
to find the coordinates of $L$ and $M$.
Finding the distance between $L$ and $M$ then becomes trivial (Pythagoras' Theorem).