Oral cavity, pharynx, larynx Flashcards

(38 cards)

1
Q

Anatomic subdivision of the pharynx from top to bottom

A
  1. Nasopharynx (skull base to soft palate)
  2. Oropharynx (soft palate to pharyngoepiglotic fold)
  3. Hypopharynx (cricopharyngeus m)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which layer DCF covers the nasopharynx?

A

ML-of DCF posteriorly but anteriorly it is free (laterally the SL-DCF of the masticator space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which are the paired lateral spaces close to the nasopharynx/pharyngeal mucosal space?

A
Masticator
Parapharyngeal
Carotid space
Parotid spase 
all covered by SL-DCF 
Behind is RPS/DS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the mucosa of the nasopharynx

A

Anterior to Eustachian tube like nasal cavity

Posterior like oropharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the contents of the nasopharynx?

A
Mucosa
Minor salivary glands
Lymphatic tissue,  pharyngeal tonsil + lateral recess of Rosenmuller
Torius tubarius/eustachian tube
Superior constrictor muscle 
Hiatus Morgagni
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the pharyngobasilar fascia?

A

Very thick upper aponeurosis between superior constrictor muscle and basi-occiput

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Fossa of Rosenmuller?

What is the Hiatus/sinus of Morgagni

A

Herniation of pharyngeal mucosa through sinus of Morgagni.

Gap in the upper/lateral wall of the pharyngobasilar fascia
Pass through: Eustachian tube, levator veli palatini m. and ascending palatine artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Structures lateral and posterolateral walls nasopharynx?

A

Lateral Wall:
Tensor veli palatini m.
Eustachian tube
Levator veli palatini m.

Posterolateral Wall:
Lateral recess of Rosenmuller
Retropharyngeal LN (Rouvier)
Muscle longus colli medial, longus capitis lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Roof of nasopharynx?

A

Foramen Lacerum
Foramen Ovale
Internal carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which foramen is in continuity with Rossenmuller fossa?

A

Foramen lacerum and foramen ovale with masticator space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Embryology, importance of the squamus epithelium of the oropharynx? Contents?

A

Endoderm, poorly differentiated cancers

Post 1/3 tongue (circumvallate papilla), lingual tonsils, vallecula, soft palate, palatine tonsils, post.pharyngeal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Oropharynx carcinoma subsites location incidence

A

PALATINE TONSIL 50%
Base of tongue 20%
Soft palate 10%
Posterior Praryngeal wall 5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Embryology and Subsites of the Oral cavity

A

Ectoderm, more differentiated cancers.

Mucosal lips
Ant 2/3 tongue
Buccal mucosa
Gingiva
Hard palate
Retromolar trigone
Floor of mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the incidence of oral cavity to oropharynx neoplasms ratio?

A

2:1 but oropharyngeal cancers tend to increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sublingual and Submandibular spaces; Which one is fascia lined?

A

SLS - Not fascia lined

Submandibular - Fascia lined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the extrinsic muscles of the floor of the oral cavity

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

17
Q

Which structures medially of hyoglossus muscle?

A

Hypoglossal n IX

Lingual artery

18
Q

Palatoglossus muscle forms

Where is Styloglossus muscle located?

A

Palatoglossal arch

Side of Tongue (styloid think laterally)

19
Q

What has changed in floor of oral cavity cancer staging?

A

Previous staging extrinsic muscle infiltration
Now is it the depth of infiltration that matters
T1 <5mm , T3>10mm

20
Q

Sublingual space posterior extension?

A

Extends posteriorly along mylohyoid m. to parapharyngeal space and deep lobe of submandibulal gland. The deep lobe of submandibular gland is in the SLS!

21
Q

Orifice of parotid duct?

A

2nd molar upper jaw

22
Q

An abscess from the sublingual space can extend to:

A

Submandibular and parapharyngeal spaces and medially in the other sublingual space

23
Q

What is the most common location for oral cavity carcinomas?

Other common locations?

A

The lip mucosa 30-40%

Floor of mouth 20%
Oral tongue 15%
Buccal mucosa 10%

24
Q

Which is the border of the laryngeal vestibule and the piriform sinus? Possible question

A

AryEpiglotic fold = dividing line

25
What is the border of the hypopharynx and esophageal junction? Anatomic subdivisions of hypopharynx
Inferior cricoid lamina Piriform sinus, Post-cricoid, Posterior wall
26
Anatomic structures hypopharynx
Pharyngo-Epiglotic fold - superiorly Ary-Epiglotic fold - anteromedially Para-glottic space - anteriorly Thyroid membrane superolaterally Thyroid cartilage inferolaterally Lower apex at level of cricoid Cricoid lamina anteriorly Posterior wall
27
Piriform sinus tumour postero-lateral infiltration sites
Thyroid lamina, carotid space, posterior wall
28
Piriform sinus tumour anterior infiltration sites?
Paraglottic space, cricoid lamina
29
Piriform sinus tumour extension
Medial - anterior wall: Supra- paraglottic extension | Lateral wall: Carotid-posterior cervical space, thyroid cartilage, extensive vertical extension to oropharynx
30
Hypopharyngeal Post-cricoid tumour extension
Below the inter-arytenoid sulcus -> cricoid cartilage, cervical esophagus
31
Post hypoparynx wall tumour extension
Prevertebral DL-DCF, extensive vertical extension, oropharynx, esophagus
32
Incidence of hypopharyngeal ca sites
PIRIFORM SINUS 60% Posterior wall 25% Post-cricoid 15%
33
Anatomic divisions of larynx
Supraglottis (epiglottis +aryepiglottic fold, false vocal cord) to floor of laryngeal ventricule Glottis (true vocal cords & commissures) +5mm Subglottis begins 5mm below true cord to inferior limit of cricoid
34
What should be the anatomic coverage on imaging of the recurrent laryngeal n. palsy?
From orbital roof (neck skull base)to below aortic arch
35
What is the lymphatic drainage of the supraglottic area?Question possible
Ipsi- and contra- lateral levels II-IV
36
Most common site of laryngeal cancer ?
GLOTTIC (65%) Supraglottic (30%) Subglottic (2-5%)
37
What is the lower border of the Retropharyngeal space?
T3
38
Which fascia covers the visceral space?
Middle layer deep cervical fascia