Neck II

Question 1

Where is the thyroid gland located?

Answer 1

C5-T1 vertebral levels, deep to sternohyoid and sternothyroid

Question 2

What connects the right and left lobes of the thyroid?

Answer 2

the isthmus

Question 3

What is a pyramidal lobe of the thyroid?

Answer 3

present in 50% of ppl, extends superiorly from the isthmus

Question 4

What supplies blood the the thyroid?

Answer 4

superior thyroid a. (off external carotid)

inferior thyroid a. (thyrocervical trunk

10% of ppl- thyroid ima a.

Question 5

What is the thyroid ima artery a branch off of? How can it be damaged?

Answer 5

brachiocephalic trunk in 10% of ppl

tracheotomy can damage

Question 6

What drains the thyroid gland?

Answer 6

superior thyroid vein > IJV

middle thyroid vein > IJV

inferior thyroid vein > brachiocephalic v.

Question 7

Parathyroid glands

Answer 7

endocrine glands located posterior to thyroid gland

2 superior parathyroid glands, to inferior parathyroid glands

Question 8

What are the three parts of the pharynx?

Answer 8

nasopharynx
oropharynx
laryngopharynx

Question 9

What are the constrictor muscles of the pharynx?

Answer 9

superior, middle and inferior constrictor

fuse posteriorly at raphe, gaps allow for passage of NV structures

Question 10

What do the constrictor muscles do? What innervates them?

Answer 10

constrict pharynx during swallowing to move food to esophagus

vagus (CN X)

Question 11

Where does the superior constrictor originate?

Answer 11

pterygoid hamulus of sphenoid bone and mandible

Question 12

Where does the middle constrictor originate?

Answer 12

hyoid

Question 13

Where does the inferior constrictor originate?

Answer 13

thyroid cartilage and cricoid cartilage

Question 14

What is the internal muscle of the pharynx? Where does it attach?

Answer 14

stylopharyngeus

origin: styloid process

passes down to enter the walls of the pharynx btwn superior and middle constrictors

Question 15

Action of stylopharyngeus? Innervation?

Answer 15

elevates pharynx and larynx

glossopharyngeal (CN IX)

Question 16

What are piriform recesses?

Answer 16

depressions on either side of the laryngeal inlet

common site for food to become lodged, continuous with esophagus

Question 17

What does the glossopharyngeal n. innervate in the pharynx?

Answer 17

sensory from mucosa of oropharynx

motor to stylopharyngeus

Question 18

What does the vagus nerve innervate in the pharynx?

Answer 18

sensory from mucosa of laryngopharynx (including piriform recesses)

motor to constrictor muscles

Question 19

What can initiate throat clearing?

Answer 19

foreign objects in piriform recesses

Question 20

What nerves can you check with gag reflex?

Answer 20

sensory: glossopharyngeal (CN IX)
motor: vagus (CN X)

Question 21

What are the functions of the larynx?

Answer 21

phonation (sound production), respiration, prevents swallowed material from entering the trachea

Question 22

Where is the larynx located?

Answer 22

inferior to the hyoid bone, C3-C6 vertebral levels

Question 23

Name the types of laryngeal cartilages

Answer 23

thyroid cartilage, cricoid cartilage, epiglottic cartilage, arytenoid cartilage

Question 24

Describe cricoid cartilage

Answer 24

inferior to thyroid cartilage

complete ring of cartilage

Question 25

Function of epiglottic cartilage? Where does it attach?

Answer 25

close off laryngeal inlet, prevents material from entering the larynx during swallowing attached inferiorly to the thyroid cartilage via a narrow stalk

Question 26

Function of arytenoid cartilage

Answer 26

base allows movement of arytenoid cartilages which abducts/adducts and tenses vocal folds

Question 27

What does the quadrangular membrane connect?

Answer 27

epiglottic and arytenoid cartilages

Question 28

What does the cricotracheal ligament connect?

Answer 28

the inferior border of the cricoid to the 1st tracheal ring

Question 29

What is a tracheotomy?

Answer 29

establishes airway by creating an opening between tracheal rings, usually used to insert a tracheostomy tube for mechanically assisted breathing

Question 30

What is a cricothyrotomy? When is this used?

Answer 30

establishes airway through cricothyroid membrane btwn cricoid and thyroid cartilage emergency airway puncture

Question 31

What are the 3 parts of the interior laryngeal cavity?

Answer 31

vestibule, ventricle, infraglottic cavity

Question 32

Vestibular folds are also known as...

Answer 32

false vocal cords

Question 33

Where is the ventricle located

Answer 33

between the vestibular folds and vocal cords

Question 34

vocal folds are also called...

Answer 34

vocal cords

Question 35

What is the rima glottidis?

Answer 35

aperture between vocal folds

Question 36

Function of the extrinsic muscles of the larynx?

Answer 36

move larynx as a whole

Question 37

What are the infrahyoid muscles? What do they do?

Answer 37

thyrohyoid-elevate larynx sternothyroid-depress the larynx

Question 38

Function of suprahyoid muscles?

Answer 38

elevate the larynx

Question 39

Function of intrinsic muscles of the larynx?

Answer 39

move individual parts of the larynx

Question 40

What innervates the intrinsic muscles of the larynx?

Answer 40

inferior laryngeal nerve exception: cricothyroid innervated by external branch of superior laryngeal nerve

Question 41

Name the intrinsic muscles of the larynx

Answer 41

aryepiglottic lateral cricoarytenoid, transverse arytenoid, oblique arytenoids posterior cricoarytenoid cricothyroid thyroarytenoid

Question 42

Action of aryepiglottic muscle

Answer 42

close laryngeal inlet

Question 43

Action of lateral cricoarytenoid, transverse arytenoid and oblique arytenoids?

Answer 43

adduct vocal folds

Question 44

Action of posterior cricoarytenoid?

Answer 44

abduct vocal folds

Question 45

Action of cricothyroid muscle?

Answer 45

stretch/tense vocal folds

Question 46

Action of thyroarytenoid? Where is it located?

Answer 46

relax vocal cords runs parallel to vocal folds

Question 47

What innervates the larynx?

Answer 47

two branches of vagus (CN X) superior laryngeal nerve (internal and external branch) inferior laryngeal nerve

Question 48

What does the internal branch of superior laryngeal nerve innervate? How does it enter the larynx?

Answer 48

sensory to mucosa of larynx superior to the vocal folds pierces the thyrohyoid membrane

Question 49

What nerve does the cough reflex test?

Answer 49

vagus nerve- motor and sensory

Question 50

What does the external branch of superior laryngeal n. innervate?

Answer 50

motor to cricothyroid muscle, functions to tense vocal cords

Question 51

the inferior laryngeal nerve is a continuation of which nerve?

Answer 51

recurrent laryngeal n.

Question 52

What does the inferior laryngeal nerve innervate?

Answer 52

motor to most of the intrinsic muscles of the larynx (except cricothyroid) sensory to mucosa inferior to the vocal folds

Question 53

What supplies blood to the larynx?

Answer 53

superior laryngeal a. inferior laryngeal a.

Question 54

Where is the sympathetic trunk located? Name the 3 cervical paravertebral ganglia

Answer 54

posterior to carotid sheath superior cervical ganglion (C1/C2 levels) middle cervical ganglion inferior cervical ganglion

Question 55

What causes Horner's syndrome? presentation?

Answer 55

results from unilateral damage to sympathetic nervous system (cervical or thoracic) drooping upper eyelid, decreased sweating (anhidrosis), constricted pupil (miosis)