Pharynx

Question 1

What is the pharynx?

Answer 1

muscular and fibrous tube between the base of the skull and lower border of cricoid cartilage (upper margin of C6)

Question 2

What is the function of the pharynx?

Answer 2

responsible for properly conducting food to the oesophagus and air into the lungs

Question 3

What are the 3 regions of the pharynx and what are they defined by?

Answer 3

• nasopharynx posterior to the nasal cavity - choana
• oropharynx, posterior to the oral cavity - oropharyngeal isthmus
• larygopharynx, at the level of the larynx - laryngeal inlet

Question 4

What muscles run between the torus tubaris and the pharynx and the palate?

Answer 4

salpingopharyngeus

salpingopalatine

Question 5

What is torus tubaris?

Answer 5

inverted U-shaped cartilage;

2 muscles attach to the posterior and anterior arm

Question 6

Answer 6

blue = torus tubaris

red = salpingophayngeus

green = salpingopalatine

Question 7

What is the piriform fossa?

Answer 7

recess between phayngeal wall and quadrangular membrane

Question 8

What are the circular muscles of the pharynx and what is their action?

Answer 8

• constrictor muscles
  
  • superior pharyngeal
  • middle pharyngeal
  • inferior pharyngeal

Question 9

What are the longitudnal muscles of the pharynx and what is their action?

Answer 9

• elevator muscles
  
  • stylophayrngeus
  • palatopharyngeus
  • salpingopharynegus

Question 10

Answer 10

red = superior pharyngeal

green = middle pharyngeal

blue = inferior pharyngeal

light blue = stylopharygeus

Question 11

What is the sinus of Morgagni?

Answer 11

the space between the base of the skull and upper free border of superior constrictor

Question 12

What is the sinus of Morgagni closed by?

Answer 12

pharyngobasilar fascia - keeps nasopharynx open

Question 13

What is the pharyngobasilar fascia attached to?

Answer 13

medial pytergoid plate, internal to the attachment of the superior pharyngeal constrictor

Question 14

What is the superior pharyngeal constrictor attached to?

Answer 14

pterygoid halmulus and pteryfomandibular raphe with the buccinator

Question 15

What is the middle pharyngeal constrictor attached to?

Answer 15

hyoid bone and stylohyoid ligament

Question 16

What is the inferior pharyngeal constrictor attached to?

Answer 16

oblqiue line of the thyroid cartilage, the cricoid cartilage

Question 17

What is Killian’s dehiscence and what is likely to occur here?

Answer 17

inferior-most region of the inferior constrictor muscle, where the superior pharyngeal constrictor ends

Pharygoesophageal diverticulum (Zenker’s diverticulum)

Question 18

Answer 18

Sinus of Morgagni closed by pharyngobasilar fascia

Question 19

Answer 19

black = pharyngobasilar fascia

red = superior pharyngeal constrictor

green = middle pharyngeal constrictor

purple = inferior pharyngeal constrictor

Question 20

Answer 20

Blue = pharyngeal raphe

Red = Killian’s dehisence

Question 21

What is passavant’s ridge? And what does it surround? And give its function

Answer 21

(or palatopharyngeal sphincter)

mucosal ridge caused by superior pharyngeal constrictor or the palatopharyngeus

encircles the posterior and lateral walls of the nasopharynx

During swallowing it tocuhes to the soft palate to isolate the oropharynx from the nasopharynx

Question 22

Answer 22

black = passavant’s ridge

Question 23

Where do the pharyngeal elevator muscles descend from?

Answer 23

the skull and out into the inner surface of the pharynx

Question 24

What is the action of palatopharyngeus? And why does it have unique actions?

Answer 24

• elevates pharynx and larynx
• draws the soft palate downwards
• brings the palatopharyngeal arch backwards
  
  • separates the oral cavity from the pharynx

As both attachments are soft structures the muscle fibres can contract in both directions

Question 25

Where does stylopharyngeus extend from?

Answer 25

extends from the styloid process to pass between the superior and middle pharyngeal constrictors and fan into tje internal pharyngeal surface

Question 26

Where does salpingopharygeus descend into? And what is its function

Answer 26

descends into the pahrynx from the torus tubarius opens the auditory tuve during swallowing

Question 27

Answer 27

green = salpingopharyngeus blue = palatopharyngeus red = stylopharyngeus

Question 28

Functions of the pharyngeal muscles

Answer 28

* elevators pull the pharynx superiorly and recieve bolus * constrictors compress the lumen of the pharynx to push bolus towards oesophagus (contract from superior to inferior)

Question 29

inferior pahryngeal constrictor has a lower circular part around the upper oesophagus called criciopharyngeal sphincter. What is its function

Answer 29

prevents air being drawn into the stomach during inhalation

Question 30

What causes pharyngoesophgeal diverticulum?

Answer 30

lack of co-ordination between pharyngeal constrictors and cricopharyngeal sphincter

Question 31

Answer 31

green = salpingopharyngeus red = stylopharyngeus

Question 32

Label the gaps and gateways

Answer 32

green = auditory tuve, levator palatini, tensor palatini blue = (oropharyngeal triangle) stylopharyngeus muscle, glossopharyngeus nerve and sylohyoid ligament black = internal branch of superior laryngeal nerve with superior laryngeal vessels (sensation to larynx above the vocal folds) Red = recurrent laryngeal nerve (motor to intrinsic laryngeal inlet muscles except cricothyroid) with inferior laryngeal vessels

Question 33

What is the arterial supply of the upper pharynx?

Answer 33

branches of the external carotid

Question 34

What is the arterial supply of the lower pharynx?

Answer 34

branches of the inferior thyroid artery of thyrocervical trunk of subclavian artery

Question 35

Describe the venous drainage of the pharynx

Answer 35

drainage by the pterygoid plexus will converge on the facial and internal jugular veins

Question 36

Describe the lymphatic drainage of the pharynx

Answer 36

retropharyngeal, paratracheal and infrahyoid nodes --\> on the deep cervical nodes

Question 37

Where do the palatine tonsils drain to?

Answer 37

jugulodigastric

Question 38

What is the only pharyngeal muscle innervated by the glossopharyngeal nerve?

Answer 38

stylopharyngeus

Question 39

What are all but one of the pharyngeal elevator muscle supplied by?

Answer 39

vagus nerve

Question 40

Where does the pharyngeal plexus lie and what does it include?

Answer 40

lies on the external pharyngeal wall includes branches of C-IX, CN-X and cervical sympathetics

Question 41

Where are the visceral efferents of the pharynx from?

Answer 41

vagus and facial nerves

Question 42

What is the sensory supply of the nasopharynx?

Answer 42

maxillary division of the trigeminal nerve

Question 43

What does the glossopharyngeal nerve give sensory supply to?

Answer 43

oropharynx, palatine tonsils, inferior surface of soft palate and posterior 1/3 of the tongue pain may be referred to the middle ear

Question 44

What is the sensory supply to the laryngopharynx, vallecula and epiglottis?

Answer 44

vagus

Question 45

During chewing food needs to be kept between the occusal surfaces of the molar teeth. What muscles are responsible for this?

Answer 45

buccalis muscle, together with the tongue

Question 46

During chewing the oropharyngeal isthmus must be closed. What muscles are responsible for this stating each of their actions?

Answer 46

* soft palate is pulled down: palatoglossus and palatopharyngeus * Tongue is drawn slightly upwards: palatoglossus and palatopharyngeus * palatoglossal and palatophayngeal arches moves medially like curtains

Question 47

During swallowing the bolus is pushed towards the back of the oral cavity by raising the tip and body of the tongue towards the palate. What muscles are responsible for this?

Answer 47

mylohyoid and tongue muscles

Question 48

During swallowing the tongue is pulled upwards and backwards to tip the bolus through the oropharyngeal isthmus and into the pharynx. What muscles are responsible for this?

Answer 48

styloglossus

Question 49

During swallowing the soft palate is stretched and elevated. What muscles are responsible for this?

Answer 49

tensor veli palatini and levator veli palatini

Question 50

elevated soft palate and passavant's rudge separate the nasopharynx from the oropharynx. What muscle is responsible for this?

Answer 50

superior pharyngeal constrictor

Question 51

the pharynx is elevated by the pharyngeal elevators

Answer 51

stylopharyngeus, salpingopharyngeus and palatopharyngeus as well as stylohyoid and digastric

Question 52

What muscles close the laryngeal inlet?

Answer 52

tongue, aryepiglottic and thyroepiglottic muscles

Question 53

What muscles push the bolus towards the oesophagus?

Answer 53

pharyngeal constrictors