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Anatomy Head And Spine > Ear, Airways and Larynx > Flashcards

Ear, Airways and Larynx Flashcards

(108 cards)

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1
Q

what is the outer ear made of?

A

auricle

external acoustic meatus (EAM)

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2
Q

what is the function of the EAM?

A

collects vibrations and mediates their passage to the middle ear

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3
Q

what are the depressions, eminences and folds of the auricle?

A

Helix and lobule: Folded outer margin of the auricle
Antihelix: Parallel inner margin
Tragus and antitragus: Eminences anterior and inferior to the EAM respectively
Concha: The auricle’s hollow centre

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4
Q

within which bone does the middle and inner ear lie in?

A

petrous part of the temporal bone

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5
Q

from which structure does the middle ear conduct sound from to the oval window?

A

tympanic membrane

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6
Q

what are the 3 ossicles?

A

Malleus
Incus
Stapes

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7
Q

malleus muscle

A

Tensor tympani muscle (V3): Pulls the handle of the malleus medially. This tenses the tympanic membrane, reducing the force of vibrations in response to loud noises

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8
Q

stapes muscle

A

Stapedius (VII): Pulls the stapes posteriorly to prevent excessive oscillation

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9
Q

what is the function of the pharyngotympanic (Eustachian) tube connection the internal ear to the nasopharynx?

A

Equalises barometric pressure between the middle ear and the external environment

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10
Q

functions of the facial nerve?

A

Motor:

  • Muscles of facial expression and posterior suprahyoid muscles
  • Stapedius
  • Parasympathetic to lacrimal gland, salivary glands, mucous membranes of nasal cavity

Sensory:

  • Taste anterior 2/3 tongue
  • General sensation to external auditory meatus and auricle
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11
Q

nerves of the facial nerve

A 
Extracranial component of facial nerve
Posterior auricular nerve*
Greater petrosal nerve*
Chorda-tympani
Nerve to stapedius
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12
Q

journey of CNVIII in ear

A

Enters the middle ear through the internal acoustic meatus (along with VII) and then splits into the vestibular and cochlear nerves (both SSA).

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13
Q

branches of vestibular nerve

A

1) Upper branch, SSA fibres to the semi-circular canals and utricle
2) Lower branch, SSA fibres to the saccule

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14
Q

where are the vestibulocochlear nuclei located?

A

pons/medulla

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15
Q

VIII nuclei and branches

A

1) cochlear nucleus- cochlea

2) vestibular nuclei- semicircular canals and utricle (upper) + saccule (lower)

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16
Q

features of EAM and tympanic membrane

A 
pars flaccida
lateral process of malleus
posterior malleolar fold
handle of malleus
umbo
cone of light
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17
Q

what is the URT lined with?

A

resp epithelium

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18
Q

what are the two functions of respiratory epithelium?

A

1) removed trapped particles

2) warms and humidifies air

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19
Q

where does the larynx come from in the upper resp tract?

A

in the lower part of the tract

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20
Q

what are the two functions of the larynx?

A

1) sphincter of the lower resp tract

2) specialised for phonation in humans

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21
Q

how is the nose the first line of defence? [3]

A
  • Nasal mucosa and conchae, warm and humidify inhaled air
  • Hairs trap large particles
  • Cilia move rubbish laden mucus to the back to be swallowed
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22
Q

what are the four mechanisms that prevent aspiration?

A

1) gag reflex
2) swallowing
3) sneezing
4) coughing

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23
Q

what are the sensory and motor components of the gag reflex?

A

sensory: soft palate and back of tongue predominantly IX
motor: pharyngeal constrictors (X)

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24
Q

the three phases of swallowing

A

1) oral (voluntary)
2) pharyngeal (reflex)
3) oesophageal

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25
oral phase nerves
V, VII, IX, X, XII
26
pharyngeal phase nerves
IX, X, XII
27
oesophageal phase nerves
IX, X
28
phase 1 of swallowing process
1) Food is chewed by the muscles of mastication (V3). Bolus is held on tongue. 2) Elevation of soft palate, tensor and levator palatini (Mandibular V3 and Vagus X, respectively). 3) Bolus into oropharynx, done by the tongue (XII). Airway is still OPEN.
29
phase 2 of swallowing process
1) Triggered when bolus hits pharyngeal arch, tongue (XII) retracts pushing bolus into pharynx 2) Airway CLOSED – action of pharyngeal muscles (X) 3) Bolus propelled through pharynx (pharyngeal constrictors, X)
30
phase 3 of swallowing process
Oesophagus opened, airway closed, breath held. Bolus propelled through oesophagus
31
afferents and efferents of coughing
afferent: X efferent: V3 and X
32
afferents and efferents of sneezing
afferent: V2 and I efferent: X
33
what are the conchae?
superior, middle and inferior from 3 recesses
34
what are the sinuses?
frontal sphenoidal maxillary ethmoidal cells
35
where does the sphenoidal recess drain?
sphenoethmoidal recess
36
where do the posterior ethmoidal cells drain?
lateral wall of the superior meatus
37
where do the middle ethmoidal cells drain? what also drains here?
middle meatus frontal sinus, anterior ethmoidal cells, maxillary sinuses
38
where does the lacrimal duct drain?
inferior meatus
39
which sinuses does the ophthalmic (V1) nerve supply?
Frontal, sphenoid + ethmoid sinuses
40
which sinuses does the maxillary (V2) supply?
maxillary sinus
41
frontal sinus innervation
Supraorbital branch of Frontal branch of V1
42
sphenoid sinus innervation
Post Ethmoidal branch of Nasociliary of V1
43
ethmoid sinus innervation
Ant and Post Ethmoidal branches of Nasociliary of V1
44
maxillary sinus innervation
Infraorbital branch of V2
45
frontal sinus
Superior to the orbit in the frontal bone Triangular; base parallel to midline and apex 1/3 along orbit - drains into middle meatus - innervated by supraorbital branch of V1 - blood supply: Anterior ethmoidal artery (branch of ophthalmic artery
46
sphenoidal sinuses
Within the body of sphenoid - drains into sphenoethmoidal recess - innervated by Posterior ethmoidal branches (of the nasocillary) of V1 - blood supply: Pharyngeal arteries (maxillary artery)
47
maxillary sinuses
Completely fill the bodies of their respective maxillae Largest paranasal sinus and is pyramidal - drains into Middle of semilunar hiatus of the middle meatus - innervated by Infraorbital and alveolar branches of V2 - blood supply: infra-orbital and superior alveolar branches of the maxillary arteries
48
what are the 3 parts of the ethmoid bone?
Cribriform plate Perpendicular plate Ethmoidal labyrinth
49
ethmoidal sinuses
Fill the ethmoidal labyrinth variable individual air cells (divided into anterior, middle and posterior) - drains into: 1) Anterior: Nasofrontal duct (15%) or ethmoidal infundibulum 2) Middle: Ethmoidal bulla (directly into the middle meatus) 3) Posterior: Superior meatus (directly) - innervated by: Anterior and posterior ethmoidal branches (of the nasocillary) of V1 (opthalmic division of trigeminal) - blood supply: Anterior and posterior ethmoidal (opthalmic)
50
summary of paranasal sinuses: 1) which ones are there? 2) where do most of them drain? 3) innervation?
frontal, sphenoidal, ethmoid air cells and maxillary Mostly drain into the middle meatus Except for the sphenoid sinus which drains into the sphenoethmoidal recess Frontal, sphenoid and ethmoid: Ophthalmic division of trigeminal (V1) Maxillary: Maxillary division of trigeminal (V2)
51
how can infection travel down the Eustachian tube?
to the mastoid antrum and air cells and then erode the temporal bone
52
infection from root of teeth
reach the maxillary sinuses due to proximity
53
how can pituitary tumours be accessed?
surgical route through the sphenoidal sinuses via the nose
54
two functions of larynx?
1) protects lower airways | 2) phonation
55
where is the larynx located?
under the hyoid bone and above the trachea
56
what is the innervation to the larynx?
X entirely
57
vagus branches that innervate the larynx
1) Superior Laryngeal | 2) Recurrent Laryngeal - sensation below vocal folds and all other muscles
58
superior laryngeal innervation of the larynx
Internal – sensation above vocal folds | External – one muscle, the cricothyroid
59
what is damage to the recurrent laryngeal associated with?
Damage to recurrent laryngeal is associated with hoarseness and deepening voice. Bilateral damage can be life-threatening.
60
what are the 3 unpaired cartilages of the larynx?
Cricoid Thyroid Epiglottis
61
what are the 3 paired cartilages of the larynx?
Arytenoid Corniculate Cuneiform
62
what are the 2 extrinsic membranes of the larynx?
Thyrohyoid membrane | Cricotracheal ligament
63
what are the 2 instrinsic membranes of the larynx?
Cricothyroid | Quadrangular
64
4 main muscles of the larynx
1) transverse arytenoid muscle 2) thryoarytenoid muscle 3) posterior cricoarytenoid muscle 4) lateral cricoarytenoid muscle
65
which is the lowest unpaired cartilage in the larynx?
cricoid (the only complete cartilaginous ring in all air passages)
66
thryoid angle
90-120 degrees
67
what does anterior movement of the thyroid result in? what joint facilities this?
stretching of the vocal ligament cricothryoid joint
68
what does the cricoid ligament connect?
cricoid to thyroid cartilages
69
what does the cricoid ligament form at the superior border?
vocal ligament (thickened)
70
what does the vocal ligament attach to?
vocal process of the arytenoid cartilage
71
what does the cricoarytenoid joint enable?
allows abduction and adduction of the vocal ligaments (and also vestibular, to a smaller degree)
72
what is the space between the vocal ligaments called?
rima glottides
73
how is the epiglottis attached to the thyroid?
thyroepiglottic ligament
74
what motion of the epiglottis carries out its function?
Retroflexes over the pharyngeal isthmus to protect it during swallowing
75
superior and inferior attachments of quadrangular membrane?
It is superiorly connected to epiglottis and inferiorly to the thyroid and arytenoids
76
what does the quadrangular membrane form at the inferior border?
vestibular ligament (thickened)
77
membranes and the ligament they form
cricothyroid ligament forms the vocal ligament (superior) quadrangular membrane forms the vestibular ligament (inferior)
78
which nerve innervates the larynx? | what are there main branches
vagus - superior laryngeal nerve - recurrent laryngeal nerve
79
what are the branches of the superior laryngeal nerve and what do they provide?
Internal laryngeal nerve: All sensation above the vocal folds External laryngeal nerve: Cricothyroid muscle only
80
what is the function of the recurrent laryngeal nerve?
All sensation below the vocal folds | All muscles of the larynx except cricothyroid
81
what is the effect of movement of the cartilages?
the movement of the thyroid and arytenoid will cause movement of the vocal ligaments and results in altered phonation
82
what does the movement of the arytenoid also caused alongside movement of the vocal ligament?
movement of the vestibular ligament this provides the protective function of the airway
83
what will the movement of the epiglottis cover?
cover the pharyngeal isthmus | serves as protection
84
what innervates the cricothyroid muscle?
external laryngeal nerve (inferior to the internal)
85
the movement of the cricothyroid muscle?
forward and downward movement of thyroid cartilage along cricothyroid joint (made of straight and oblique parts) increases tension on vocal ligaments
86
what muscle adjusts tension on the vocal ligaments?
vocalis
87
movement go the posterior crico-arytenoid? what is the purpose of this movement?
Abduction of the vocal ligaments Increased air flow = increased volume of sound
88
movement of the lateral crico-arytenoid?
Adduction of the vocal ligaments
89
movement of the transverse arytenoid?
adduction of the arytenoid cartilages
90
movement of thyroid-arytenoid and oblique arytenoid muscles?
Sphincter of laryngeal inlet Narrows the laryngeal inlet by pulling arytenoid cartilages forward while pulling the epiglottis toward the arytenoid cartilages Contraction occurs as part of pharyngeal phase of swallowing
91
what is the effect of damage to the vagus before branching to the superior laryngeal nerve?
complete paralysis
92
what is the effect of lesion of the internal laryngeal nerve?
loss of sensation above the vocal folds
93
what is the effect of lesion of the external laryngeal nerve?
paralysis of the cricothyroids
94
what is the effect of lesion of the recurrent laryngeal nerve?
paralysis of all muscles of the larynx except cricothyroid loss of sensation below the vocal folds
95
which artery does the superior laryngeal nerve travel alongside? what is this artery a branch of? what is an effect of a lesion of this artery?
superior thyroid artery branch of the external carotid artery can affect action the cricothyroid
96
which artery does the recurrent laryngeal nerve travel past upwards then behind? how is this relevant in surgery?
inferior thyroid artery the nerve is vulnerable in surgery that involves ligating the inferior thyroid artery
97
what can cause compression of the recurrent laryngeal? what is the effect of this compression?
a bronchial/oesophageal tumour mediastinal lymphadenopathy results in hoarseness, breathlessness or both (inferior thyroid artery supply superior oesophagus and trachea)
98
sneeze reflex
via afferents via maxillary division (V2) inspiration intrathoracic pressure increased by glottis closure, abdominal muscle contraction soft palate depression against tongue via palatopharyngeus/palatoglossis (branch of X) sudden abduction of the vocal folds to release the intrathoracic pressure via nose or mouth
99
cough reflex
via afferents via vagus branches inspiration intrathoracic pressure increased by glottis closure, abdominal muscle contraction soft palate raised and tensed against posterior wall of pharynx via Levator veli palatine (X), tensor veli palatine (V3), superior constrictor (X) sudden abduction of the vocal folds to release the intrathoracic pressure via nose or mouth
100
how can the airways be managed in an emergency?
- Chin lift/ Jaw thrust - Oropharyngeal/Nasopharygeal airway - Endotracheal intubation - Cricothyroidotomy (through the Cricothyroid membrane) - Tracheostomy
101
where is a tracheostomy performed?
Between tracheal rings skin --> superficial cervical fascia --> platysma --> Deep cervical fascia --> strap muscles --> pretracheal fascia --> thyroid isthmus --> stoma in 2nd , 3rd & 4th rings
102
6 functions of the facial nerve
1) salivation 2) lacrimation 3) facial expression 4) taste 5) mastication and swallowing 6) general sensation also provides tension to middle ear bones (innervation to stapedius)
103
salivation via CNVII
VII provides GVE fibres from the superior salivary nucleus destined for submandibular and sublingual salivary glands via the SUBMANDIBULAR ganglion
104
lacrimation via CNVII
VII provides GVE fibres from the superior salivary nucleus destined for LACRIMAL gland via PTERYGOPALATINE ganglion.
105
taste via CNVII
SVA fibres from anterior two thirds of tongue to the solitary nucleus via the geniculate ganglion
106
mastication and swallowing via CNVII
SVE fibres to the buccinator (mastication), raising larynx during swallowing, innervates stylohyoid and posterior belly of digastric
107
nucleus for salivation, lacrimation, taste
superior salivatory nucleus
108
nucleus for stapedius and facial expression
facial nucleus

Anatomy Head And Spine (5 decks)

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