Anatomy and Physiology of the Throat

Question 1

what do patients ussually present with to do with the throat?

Answer 1

sore throat
something stuck in my throat
difficulty swallowing
painful swallowing
hoarseness
pain radiating from throat to ear

Question 2

what is dysphagia?

Answer 2

Difficulty swallowing

Question 3

what is odynophagia?

Answer 3

Painful swallowing

Question 4

what is dysphonia?

Answer 4

I’m hoarse

Question 5

what is referred otalgia?

Answer 5

Pain going from my throat to my ear

Question 6

what are the different areas of the throat?

Answer 6

nasal cavity
oral cavity
larynx
nasopharynx
oropharynx
hypopharynx

Question 7

what is the structure of the mouth/oral cavity?

Answer 7

Everything anterior to tonsils and soft palate.
Includes whole tongue except tongue base (oropharynx).
Contains teeth, tongue and salivary glands.

Question 8

what is the function of the mouth/oral cavity?

Answer 8

Mastication
First part of swallow (oral phase)
Taste
Transform sound generated by the larynx into discernable words
(arthr = vocal articulation)

Question 9

what are the primary muscles of mastication?

Answer 9

temporalis
masseter
medial pterygoid
lateral pterygoid

Question 10

what are secondary muscles of mastication?

Answer 10

suprahyoid muscles
digastric muscle
mylohyoid muscle (oral diaphragm)
geniohyoid muscle

buccinator muscle is sometimes classed as one

Question 11

what are primary and secondary muscles of mastication innervated by?

Answer 11

Mandibular branch of Trigeminal Nerve (CN V3)

Question 12

What are the 2 parts of the tongue?

Answer 12

Anterior 2/3rds
From 1st branchial arch
Sensation by lingual nerve (CN V3)
Taste by chorda tympani (CN VII)
Posterior 1/3rd
From 3rd branchial arch
Supplied by CN IX

Question 13

Innervation of the tongue?

Answer 13

Anterior 2/3rds
From 1st branchial arch
Sensation by lingual nerve (CN V3)
Taste by chorda tympani (CN VII)

Posterior 1/3rd
From 3rd branchial arch
Supplied by CN IX

Question 14

What are the 2 categories of tongue muscles and what is their function?

Answer 14

Intrinsic muscles (after shape)
Extrinsic muscles (after position)

Question 15

what are the intrinsic muscles of the tongue?

Answer 15

superior longitudinal
inferior longitudinal
transverse
vertical

Question 16

what are the extrinsic muscles of the tongue?

Answer 16

genioglossus - chin to tongue
hyoglossus - hyoid bone to tongue
styloglossus - styloid to tongue
palatoglossus muscle (supplied by the vagus nerve (CN X)) - palatine bone to tongue

Question 17

what are the boundaries of the floor of the mouth?

Answer 17

Superiorly - oral mucosal space
Inferiorly - mylohyoid muscle
Anteriorly - mandibular gingiva
Posteriorly - anterior tonsillar pillars

Question 18

what glands are contained within the floor of the mouth?

Answer 18

Submandibular and subligual salivary glands

Question 19

where does the parotid duct open into the the buccal mucosa?

Answer 19

Parotid duct opens into buccal mucosa opposite upper 2nd molar

Question 20

what is the function of the nasopharynx\/

Answer 20

allows air into larynx

Question 21

what is the function of the soft palate and uvula

Answer 21

prevent regurgitation of food into nasopharynx on swallowing by closing against the posterior pharyngeal wall (failure = veloplataine insufficiency)

Question 22

what are the functions of oropharynx and hypopharynx?

Answer 22

Oropharynx & hypopharynx contribute to normal swallow
Allows passage of air and food

Question 23

what does the epiglottis do?

Answer 23

Epiglottis closes airway during swallow
Resonating chamber during phonation

Question 24

where does the hypopharynx lead to?

Answer 24

oesophagus

Question 25

what is the sensation of the oropharynx and hypopharynx from?

Answer 25

Glossopharyngeal (CN IX) and Vagus (CN X) nerves

Question 26

what are the pharyngeal constrictor muscles?

Answer 26

Superior, middle and inferior Motor supply by Vagus nerve (CN X)

Question 27

What are the boundaries of the oropharynx?

Answer 27

Lower border of soft palate to upper margin of epiglottis Palatoglossal arch to posterior pharyngeal wall Lateral is faucial pillars and palatine tonsils

Question 28

What is the structure of the epithelium of the oropharynx?

Answer 28

Stratified, non-keratinised squamous

Question 29

What is the nerve supply of the oropharynx?

Answer 29

Pharyngeal plexus (CN IX and X)

Question 30

Where does the hypopharynx receive blood supply from?

Answer 30

Blood supply is the superior thyroid artery, lingual artery and the ascending pharyngeal artery

Question 31

What are the boundaries of the hypopharynx?

Answer 31

Superior margin of epiglottis to lower border of cricoid cartilage Continuous with oesophagus Anterior wall back of pharynx

Question 32

What are the 3 subunits of the hypopharynx?

Answer 32

Pyiform sinus Post-cricoid area Posterior pharyngeal wall

Question 33

What is the nerve supply of the hypopharynx?

Answer 33

Pharyngeal plexus (CN IX and X)

Question 34

where is the larynx located?

Answer 34

C3-6

Question 35

what are the cartilages of the larynx

Answer 35

Epiglottis Thyroid Cricoid Arytenoid Corniculate Cuneiform

Question 36

what are the functions of the larynx?

Answer 36

Allow of air between trachea and mouth Movements of vocal cords produce voice (phonation) and alter pitch and volume (Mouth/oral cavity and pharynx also contribute to sound) Protect the airway from aspiration Epiglottic closure – food directed to hypopharynx Cough reflex

Question 37

what are all muscles of the larynx innervated by?

Answer 37

Recurrent laryngeal nerve

Question 38

what is the exeption of muscles of the pharynx which is instead innervated by superior lryngeal nerve?

Answer 38

cricothyroid muscle = Superior laryngeal nerve (external branch)

Question 39

In the larynx sensation si carried via vagus nerve where is innervation from above and below the vocal chords?

Answer 39

Above vocal cords (glottis & supraglottis) = Superior laryngeal nerve Below vocal cords (subglottic) = Recurrent laryngeal branch

Question 40

function of cricothyroid muscle?

Answer 40

lengthen and tense the vocal cords

Question 41

what is the function of posterior cricoartyenoid muscle?

Answer 41

abduct and externally rotate the arytenoid cartilages, resulting in abducted vocal cords.

Question 42

what is the function of the lateral cricoartenoid muscles?

Answer 42

adduct and internally rotate the arytenoid cartilages, increase medial compression.

Question 43

what is the function of trnasverse artyenoid muscles?

Answer 43

adduct the arytenoid cartilages, resulting in adducted vocal cords.

Question 44

what are the functions of oblique artenoid muscles?

Answer 44

narrow the laryngeal inlet by constricting the distance between the arytenoid cartilages.

Question 45

what is the function of thyoartyenoid muscles?

Answer 45

narrow the laryngeal inlet, shortening the vocal cords, and lowering voice pitch.

Question 46

what three things must you have to produce a recognisable voice?

Answer 46

Air flow to the larynx (generated by the lungs & diaphragm). Vibration / mucosal wave (eg. on the vocal fold in the larynx during vocal cord adduction). Resonance in the upper aerodigestive tract & use of the pharynx, mouth, tongue and lips to manipulate the sound produced by the larynx into words and sounds.

Question 47

what are the 3 parts of the larynx?

Answer 47

Supraglottis Extends from the superior tip of the epiglottis to the floor of the ventricular fold (junction of respiratory and squamous epithelium) Glottis Begins superior at the true vocal fold and extends inferiorly to a horizontal plane 5mm inferior to the vocal cord Subglottic Begins 5mm below the free edge of the true vocal cord and proceeds to the inferior border of the cricoid cartilage

Question 48

What are the segments of cartilage in the larynx?

Answer 48

7 segments of cartilages: Cricoid cartilage Thyroid cartilage Epiglottis Paired arytenoid cartilages (corniculate and cuneiform)

Question 49

What are the muscles of the larynx?

Answer 49

Extrinsic Infrahyoid, suprahyoid and thyrohyoid Move the entire laryngeal complex Intrinsic Regulate movement of the vocal folds

Question 50

Innervation of the larynx?

Answer 50

Motor innervation: CN X All intrinsic muscles supplied by recurrent laryngeal nerve except for cricothyroid muscle (external laryngeal) Sensory innervation: Supraglottic by internal laryngeal nerve Glottic and subglottic by recurrent laryngeal nerve

Question 51

What are intrinsic larynx muscles supplied by for motor innervation?

Answer 51

All intrinsic muscles supplied by recurrent laryngeal nerve except for cricothyroid muscle (external laryngeal)

Question 52

What is the sensory innervation of: supraglottic larynx glottic larynx subglotic larynx

Answer 52

Supraglottic by internal laryngeal nerve Glottic and subglottic by recurrent laryngeal nerve

Question 53

What are the different steps of speech?

Answer 53

Respiration Source of energy, from air flow Inhalation and exhalation Phonation Flow of air through different voice cord position, tension, vibration and length Resonation Oral/nasal speech balance Depend on nasopharynx, nasal cavity and oral cavity Articulation Production of speech, determined by action of lips, tongue and jaw Prosody Production of syllable stress and emphasis Provide effective speech tone