Neck II (11.20.17)

Question 1

At what vertebral levels is the thyroid gland located?

Answer 1

C5-T1

Question 2

What does the superior thyroid artery branch off of?

Answer 2

External carotid artery

Question 3

What does the inferior thyroid artery branch off of?

Answer 3

thyrocervical trunk

Question 4

Where does the thyroid ima artery branch from?

Answer 4

Brachiocephalic trunk

*can be damaged with a tracheotomy

Question 5

Where do the superior thyroid vein and the middle thyroid vein drain?

Answer 5

Internal jugular vein

Question 6

Where does the inferior thyroid vein drain?

Answer 6

Brachiocephalic vein

Question 7

How many parathyroid glands are there?

Answer 7

4

• 2 superior parathyroid glands
• 2 inferior parathyroid glands

*located in the posterior thyroid

Question 8

Pharynx: Constrictor muscle action?

Answer 8

Constrict the pharynx during swallowing

Question 9

What is the innervation for the constrictor muscles?

Answer 9

Vagus nerve (CN X)

Question 10

Where do the constrictor muscles fuse posteriorly?

Answer 10

Raphe

Question 11

Origin of the supeior constrictor?

Answer 11

1. Pterygoid hamulus of sphenoid bone

2. mandible

Question 12

Origin of the middle constrictor?

Answer 12

Hyoid bone

Question 13

Origin of the inferior constrictor?

Answer 13

1. Thyroid cartilage

2. Cricoid cartilage

Question 14

Where does the stylopharyngeus insert?

Answer 14

Between superior and middle constrictor

Question 15

What is the action of the styopharyngeus muscle?

Answer 15

Elevates pharynx

Elevates larynx

Question 16

What is the innervation of stylopharyngeus?

Answer 16

Glossopharyngeal (CN IX)

Question 17

Where are the piriform recesses located?

Answer 17

Laryngopharynx

Question 18

Piriform recesses are depresseions on either side of what where food can commonly become lodged?

Answer 18

laryngeal inlet

Question 19

What is the laryngopharynx continuous with?

Answer 19

Esophagus

Question 20

What innervates the mucosa of the oropharynx?

Answer 20

Glossopharyngeal nerve (CN IX)

Question 21

What nerve is stylopharyngeus muscle innervated by?

Answer 21

Glossopharyngeal nerve (CN IX)

Question 22

What provides innervation to the mucosa of the laryngopharynx (including piriform recesses)?

Answer 22

Vagus nerve (CN X)

throat clearing

Question 23

Constrictor muscles (superior, middle and inferior) are supplied by what nerve?

Answer 23

Vagus nerve (CN X)

Question 24

What provides the sensory innervation of the Gag reflex?

Answer 24

glossopharyngeal CN IX

Question 25

What provides the motor portion of the Gag reflex?

Answer 25

Vagus nerve (CN X)

Question 26

What are the functions of the larynx?

Answer 26

-Phonation (sound production) -Respiration (protection), Prevents swallowed material from entering trachea

Question 27

At what spinal levels is the larynx located?

Answer 27

C3-C6

Question 28

What part of the thyroid cartilage is known as "Adam's Apple"?

Answer 28

laryngeal prominence

Question 29

Articulation between the inferior horns of the thyroid cartilage and cricoid cartilage permit what types of movement?

Answer 29

- Rotation of thyroid cartilage - Gliding of thyroid cartilage *affect length of the vocal folds

Question 30

Where does the epiglottic cartilage attach?

Answer 30

thyroid cartilage

Question 31

What type of cartilage is the epiglottic cartilage made of?

Answer 31

elastic cartilage (not hyaline)

Question 32

Why is movement at the base of the arytenoid cartilage significant?

Answer 32

Allows movement of arytenoid cartilages, which abduct/adducts & tenses vocal folds

Question 33

The base of the arytenoid cartilages articulates with what?

Answer 33

Cricoid cartilage

Question 34

The epiglottic cartilage and the arytenoid cartilage are connected by what?

Answer 34

Quadrangular membrane

Question 35

What is the border of the quadrangular membrane?

Answer 35

vestibular fold

Question 36

When is a cricothyrotomy performed?

Answer 36

emergency situation (establishes airway between thyroid and cricoid cartilage) *above thyroid

Question 37

When is a tracheotomy performed?

Answer 37

if placing a tracheostomy tube for mechanically assisted breathing *below thyroid

Question 38

What are the 3 parts of the laryngeal cavity?

Answer 38

1. Vestibule 2. Ventricle 3. Infraglottic cavity

Question 39

False vocal cords are also known as what?

Answer 39

Vestibular folds

Question 40

Ventricle is between what two structures?

Answer 40

vestibular and vocal folds

Question 41

Vestibule of the laryngeal vacity is between what two structures?

Answer 41

- laryngeal inlet | - vestibular folds

Question 42

What is the name for the aperture between the vocal folds?

Answer 42

rima glottidis

Question 43

Where are the vestibular folds ("false vocal cords") in relation to the vocal folds?

Answer 43

Vestibular folds are superior to the vocal folds

Question 44

Which 2 muscles elevate the larynx?

Answer 44

1. Suprahyoid muscles | 2. Thyrohyoid

Question 45

Which infrahyoid muscle depresses the larynx?

Answer 45

Sternothyroid

Question 46

What nerve innervates the intrinsic muscles of the larynx?

Answer 46

Inferior laryngeal nerve Exception: cricothyroid muscle innervated by external branch of superior laryngeal nerve

Question 47

What is the action of aryepiglottic?

Answer 47

close laryngeal inlet

Question 48

What 3 muscles adduct the vocal folds (closes rima glottidis)?

Answer 48

1. Lateral cricoarytenoid 2. Transverse arytenoid 3. Oblique arytenoids

Question 49

Which muscle abducts the vocal folds?

Answer 49

Posterior cricoarytenoid

Question 50

Which muscle stretches/tenses the vocal folds?

Answer 50

Cricothyroid

Question 51

Which muscle relaxes the vocal folds?

Answer 51

Thyroarytenoid

Question 52

Name the 2 branches that innervate the larynx?

Answer 52

1. Superior laryngeal nerve | 2. Inferior laryngeal nerve

Question 53

What nerve does the superior laryngeal nerve arise from?

Answer 53

Vagus nerve (CN X)

Question 54

Where does the internal branch of the superior laryngeal nerve supply sensory to?

Answer 54

internal branch supplies sensory only to mucose of larynx superior to vocal folds

Question 55

The External branch of the superior laryngeal nerve supplies motor innervation to what muscle?

Answer 55

cricothyroid muscle (stretches/tenses the vocal folds)

Question 56

The inferior laryngeal nerve is a continuation of what nerve?

Answer 56

recurrent laryngeal nerve

Question 57

The inferior larygneal nerve supplies motor innervation to what?

Answer 57

intrinsic muscles of larynx

Question 58

The inferior larygneal nerve supplies sensory to what?

Answer 58

inferior laryngeal nerve suppllies sensory innervation to mucosa inferior to vocal folds

Question 59

Superior laryngeal artery is a branch from what?

Answer 59

supeior laryngeal artery is a branch of superior thyroid artery (which comes from external carotid) (travels with the internal branch of the superior laryngeal nerve (through thryohyoid membrane))

Question 60

Where does the inferior laryngeal artery branch from?

Answer 60

thyrocervical trunk > inferior thyroid artery > inferior laryngeal artery (travels with the inferior laryngeal nerve)

Question 61

Where are the sympathetic trunks located in relation to carotid sheath?

Answer 61

sympathetic trunks are posterior to the carotid sheath

Question 62

Unilateral damage of the sympathetic nervous system (cervical or thoracic) is the cause of what?

Answer 62

Horner's Syndrome

Question 63

Name 3 symptoms a patient with Horner's syndrome will present with?

Answer 63

1. Drooping upper eyelid 2. Constricted pupil (Miosis) 3. Decreased sweating (Anhidrosis)

Question 64

What vertebral level is the superior cervical ganglion located?

Answer 64

C1-C2