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Head and Neck > 8 - oral cavity and pharynx > Flashcards

8 - oral cavity and pharynx Flashcards

1
Q

describe the major features of the oral cavity e.g. the walls

A 
lateral - buccinators 
roof - hard and soft palate 
floor - muscles, soft tissues 
anterior - oral fissure 
posterior - oropharyngeal isthmus
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2
Q

what is the oropharyngeal isthmus and what are the sides formed from?

A

an arch formed by the soft palate above and the upper surface of the tongue below

sides are formed by the anterior and posterior pillars of fauces

anterior pillar:
palatoglossal arch
posterior pillar:
palatopharyngeal arch

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3
Q

what is found between the pillars of fauces?

A

the palatine tonsil

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4
Q

what is peritonsillar abscess and what signs and symptoms do you see (Quinsy)?

A

pus filled pocket that forms near one of your tonsils, can occur due to untreated tonsillitis or on its own. usually you see ulnar deviation, fever, sore throat, fever, bad breath, difficulty opening mouth, drooling

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5
Q

name the three salivary glands and where are they found anatomically?

A

parotid
submandibular
sublingual

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6
Q

what are salivary gland stones (sialolithiasis) in which gland do they most commonly occur and what are the signs and symptoms?

A

often occur in the submandibular gland

pain and swelling

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7
Q

what do the intrinsic muscles of the tongue do and what are their motor nerve innervation?

A

change the SHAPE of the tongue

hypoglossal nerve CNXII

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8
Q

what are the extrinsic muscles of the tongue, what do they do?

A 
change the POSITION of the tongue 
GENIOGLOSSUS 
HYPOGLOSSUS
STYLOGLOSSUS
PALATOGLOSSUS
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9
Q

what are the motor nerve innervations of the extrinsic muscles of the tongue

A

genioglossal is the most important - it contracts and protrudes the tongue and is used to test hypoglossal function

hypoglossal nerve innervates all the muscles of the tongue except the palatoglossal (vagus)

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10
Q

what is sensory and special sensory nerve innervation to the anterior 2/3 of the tongue?

A

sensory: lingual branch of Vc (mandibular) from trigeminal

special sensory: chorda tympani from facial nerve

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11
Q

what is sensory and special sensory innervation to the posterior 2/3 of the tongue?

A

sensory + special sensory = glossopharyngeal nerve

posterior 2/3 of the tongue also supplies parasympathetic fibres to the parotid gland

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12
Q

how do we test the integrity of CN IX and what abnormality is seen if there is a pathology?

A

taste and gag reflex

pathology is these dont occur

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13
Q

how how do we test the integrity of CN X and what abnormality is seen if there is a pathology?

A

speech, cough and and ability to swallow
ask patient to say ahh to check soft palate and uvular function
gag reflex can be used

pathology if uvular deviates to ones side - will indicate weakness of the contralateral soft palate and a vagus nerve lesion on the side that is weak

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14
Q

how do we test the integrity of CN XII and what abnormality is seen if there is a pathology?

A

genioglossus extrinsic muscle contracts when the tongue protrudes - ask patient to stick their tongue out

in pathology - if it affects one side of the tongue, when protruded it will deviate towards the side of the lesion
may see a wasted tongue

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15
Q

what are the afferent and efferent sensory limbs of the gag reflex?

A

afferent: IX glossopharyngeal
efferent: X vagus

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16
Q

what are the three sections of the pharynx?

A

NASOPHARYNX
OROPHARYNX
LARYNGOPHARYNX

17
Q

Where does the nasopharynx originate?
what is posterior?
what is anterior?
anatomical structures present?

A

base of the skull to the soft palate

C1 and C2 vertebrae lies posterior

nasal cavity lies anteriorly

pharyngeal tonsil

18
Q

Where does the oropharynx originate?
what is posterior?
what is anterior?
anatomical structures present?

A

soft palate to the epiglottis

C2 and C3 vertebrae lies posterior

anterior cavity anterior

palatine tonsil

19
Q

Where does the laryngopharynx originate?
what is posterior?
what is anterior?
anatomical structures present?

A

epiglottis to oesophagus at the level of the cricoid cartilage

C3-C6 vertebrae lies posterior

larynx is anterior

piriform fossa

20
Q

what kind of muscles elevate the pharynx and larynx during swallowing?

A

three longitudinal muscles

21
Q

what are the pharyngeal sphincters and name all three

A

3 circular muscles that help to propel food down into the oesophagus

SUPERIOR PHARYNGEAL SPHINCTER
MIDDLE PHARYNGEAL SPHINCTER
INFERIOR PHARYNGEAL SPHINCTER

inferior has 2 muscles bellies:

  • thyropharyngeus
  • cricopharyngeus
22
Q

what are the two muscle bellies of the inferior pharyngeal sphincters and what is found between them?

A
  • thyropharyngeus
  • cricopharyngeus

theres a point of weakness between the two called
KILLIAN’S DEHISCENCE

23
Q

What is the nerve innervation of all the sphincters?

A

VAGUS

24
Q

what is a pharyngeal pouch?

A

if there is incoordination between the thryopharyngeus and cricopharyngeus - if superior contracts while the inferior is closed it creates a build up of pressure and can cause protrusion of the pharynx mucosa through the killians dehiscene forming a pharyngeal pouch (diverticulum)

25
Q

what is the motor supply of the pharynx

A

vagus (it also supplies the soft palate and layrnx)

26
Q

what is the sensory supply of the three sections of the pharynx

A

nasopharynx - Vb (maxillary) branch of trigeminal
oropharynx - glossopharyngeal
laryngopharynx - vagus

27
Q

the pharyngeal, palatine and lingual tonsils form a ring, what is this ring called?

A

Waldeyer’s ring

28
Q

what are the adenoids?

A

they are the pharyngeal tonsils

29
Q

what happens when the pharyngeal tonsils become enlarged/ inflamed?

A

pharyngeal tonsils are prominent in children however they undergo atrophy after puberty. when chronically inflamed (adenoiditis) they may obstruct the passage of air from the nasal cavities and cause mouth breathing and a “nasal tone” to sppech

30
Q

what can the pharyngeal tonsils (adenoids) block?

A

the pharngotympanic membrane - causing middle ear infections (acute otitis media) or otitis media with effusion (glue ear)

31
Q

what is the piriform fossa?

A

potential site for foreign bodies entering the pharynx to lodge - potential site for pharyngeal cancers

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