Clinical Anatomy Of The Karynx Flashcards

1
Q

What are the boundaries of the nasopharynx

A

Skull
Soft palate

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2
Q

Which part of the pharynx do the Eustachian tubes open into

A

Nasopharynx

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3
Q

4 Paranasal sinuses

A

Frontal
Ethmoidal
Maxillary
Sphenoid

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4
Q

Where do the paranasal sinuses drain to

A

Nasal cavity

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5
Q

What openings drain the paranasal sinuses

A

Ostia

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6
Q

Why is the maxillary sinus most at risk for infection

A

High up Ostia makes I hard to drain

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7
Q

Boundaries of the oropharynx

A

Soft palate
Epiglottis

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8
Q

Innervation to anterior 2/3 of tongue

A

General - lingual nerve
Special sensory - chorda tympani

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9
Q

Innervation of posterior 1/3 of tongue

A

Glossopharyngeal nerve

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10
Q

What is the lingual nerve a branch of

A

Mandibular nerve

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11
Q

What is the chorda tympani a branch of

A

Facial nerve

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12
Q

Boundaries of the laryngopharynx

A

Epiglottis
Oesophagus

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13
Q

Which part of the pharynx is continues opwith the eosophagus

A

Laryngopharynx

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14
Q

2 major functions of the larynx

A

Protects lower resp tract from aspiration of food
Vocal cords - sound production

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15
Q

How many cartilages in the larynx

A

9

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16
Q

Unpaired cartilages in the larynx

A

Thyroid
Epiglottis
Cricoid

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17
Q

Paired cartilages in the larynx

A

Arytenoid
Cuneiform - not important
Corniculate - not important

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18
Q

Is the hyoid bone above or below the cartilages of the larynx

A

Above

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19
Q

What vertebral level is the hyoid bone

A

C3

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20
Q

What vertebral levels does the larynx cover

A

C3-C7

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21
Q

Which cartilage forms the laryngeal prominence/ adams apple

A

Thyroid

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22
Q

Which cartilage do the vocal cords attach to anteriorly

A

Thyroid

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23
Q

What type of cartilage forms the epiglottis

A

Elastic

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24
Q

What shape is the epiglottis

A

Leaf

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25
Q

What does the epiglottis do during swallowing to prevent aspiration of food

A

Flattens and moves posteriorly to close off larynx

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26
Q

How many complete cartilaginous rings are present in the upper airway

A

1 - cricoid

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27
Q

Which cartilage forms the inferior border of the larynx

A

Cricoid

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28
Q

What structures does the cricoid cartilage articulate with

A

Inferior horns of Thyroid cartilage
Arytenoid cartilages
Cricothyroid membrane

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29
Q

What do the vocal cords attach to posteriorly

A

Arytenoids

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30
Q

What do the arytenoids sit on

A

Posterior aspect of cricoid cartilage

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31
Q

What is the function of the extrinsic laryngeal muscles

A

Allow larynx to move as a unit

32
Q

Function of the intrinsic laryngeal muscles

A

Control and refine sound production

33
Q

Where do extrinsic laryngeal muscles attach

A

Hyoid bone

34
Q

Where do intrinsic laryngeal muscles attach

A

Vocal cords

35
Q

2 groups of extrinsic laryngeal muscles

A

Suprahyoid
Infrahyoid

36
Q

How many Suprahyoid muscles are there

A

4

37
Q

How do the Suprahyoid muscles act on the hyoid bone and larynx

A

Elevate

38
Q

What are the attachments of the Suprahyoid muscles

A

Skull
Hyoid bone

39
Q

How many infrahyoid muscles are there

A

4

40
Q

Where do the infrahyoid muscles attach

A

Pectoral girdle, sternum, thyroid cartilage
Hyoid bone

41
Q

How do the infrahyoid muscles act on the hyoid bone and larynx

A

Depress

42
Q

How many intrinsic laryngeal muscles are there

A

6 paired muscles

43
Q

What alters the shape of the rima glottidis

A

Intrinsic laryngeal muscles

44
Q

How do cricothyoid muscles affect the vocal cords and rima glottidis

A

Lengthens cords
Decreases aperture
Increase sound pitch

45
Q

How do posterior cricoarytenoid muscles affect rima glottidis

A

Widens aperture for inhalation

46
Q

How does lateral cricoarytenoid affect rima glottidis

A

Narrows aperture for whispering

47
Q

How is sound produced in the larynx

A

Exhaled air builds up pressure below vocal folds -> expelled through rima glottidis -> vocal folds vibrate -> sound

48
Q

Rima glottidis

A

Opening between vocal folds

49
Q

What does the internal division of the superior laryngeal nerve supply

A

Mucosa above vocal cords

50
Q

What does the external division of the superior laryngeal nerve supply

A

Cricothyroid

51
Q

What nerve supplies the mucosa below the vocal cords

A

Recurrent laryngeal nerve

52
Q

The recurrent laryngeal nerve supplies all intrinsic laryngeal muscles accept which

A

Cricothyroid

53
Q

What structures do the right and left recurrent laryngeal nerves hook under

A

R - right subclavian artery
L - arch of aorta

54
Q

Which nerve produces the gag reflex

A

Superior laryngeal nerve

55
Q

What effects does a laryngeal nerve palsy cause

A

Reduced gag reflex
Reduced range of pitch

56
Q

Effect of unilateral recurrent laryngeal nerve palsy

A

Hoarse voice

57
Q

Which nerve palsy causes a hoarse voice

A

Unilateral recurrent laryngeal nerve

58
Q

What does bilateral recurrent laryngeal nerve palsy cause

A

Loss of phonation
Difficulty breathing

59
Q

Which arteries supply the larynx

A

Superior thyroid artery
Inferior thyroid artery

60
Q

What vessel does the inferior thyroid artery branch of from

A

Thyrocervical rrunk

61
Q

What vessel does the superior thyroid artery branch from

A

External carotid artery

62
Q

Is the external or internal carotid artery more anterior

A

External

63
Q

What does ‘some anatomists like freaking out poor medical students’ mean

A

Branches of carotid artery -
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Post auricular
Maxillary
Superficial temporal

64
Q

What level is the laryngeal prominence

A

C4

65
Q

Where does the carotid artery bifurcate

A

Superior border of thyroid cartilage - C4

66
Q

What vertebral level is the cricoid cartilage

A

C6

67
Q

What vertebral level is the thyroid gland

A

C6

68
Q

What are the 2 options for an emergency airway

A

Surgical airway
Endotracheal tube

69
Q

What does ABCDE stand for

A

Airway
Breathing
Circulation
Disability
Exposure

70
Q

When does a patient need a definitive airway

A

Unable to maintain own airway
Risk of impending or potential airway compromise
Unable to maintain O2 levels with facemask
Presence of apnoea
Features of cerebral hypoperfusion
Suspected head injury / sustained seizure w risk of aspiration

71
Q

How is a definitive airway set up

A

Tube placed in trachea with cuff inflated below vocal cords -> tube connected to oxygen enriched assisted ventilation -> airway secured with appropriate stabilising method

72
Q

How can burns to the face or neck obstruct the airway

A

Direct tissue damage
Inhalation injury
Oedema and swelling from irritation from soot/debris

73
Q

How can anaphylaxis obstruct the airway

A

Angioedema of lips, tongue, or larynx can block airway

74
Q

How can face or neck trauma obstruct the airway

A

Laryngotracheal fracture - direct obstruction
Displacement of structures - secondary obstruction
Loose teeth, bone fragments - secondary obstruction
Post traumatic complications eg swelling, haematoma - secondary obstruction

75
Q

When is a cricothyroidectomy performed

A

Emergency access to airway required
Unable to intubate

76
Q

Where is a cricothyroidectomy performed

A

Cricothyroid membrane

77
Q

How is a cricothyroidectomy performed

A

Cricothyroid membrane palpated -> incision made -> bougie inserted -> broncheostomy tube inserted