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Flashcards in Pharynx and Larynx Deck (62):
0

The opening to the larynx is called

laryngeal aditus

1

the three phases of swallowing are

the oral phase
the oropharyngeal phase
the pharyngo-esophageal phase

2

oral phase is synonymous with

mastication

3

oropharyngeal phase

involves elevation of the floor of the mouth and tongue i norder to push the bolus into the oropharynx
tongue acts as a piston

4

the pharyngo-esophageal phase

oropharynx elevates and constricts around the bolus and propels it down the esophagus

5

define the airway protective cough reflex

a series of expiratory cough triggered by a noxious stimulus to the supraglottic layngeal mucosa

6

why is the cough reflex a vital function in humans

uniqueness of the position of the human larynx, which makes it vulnerale to aspiration during swallowing or inhaliation

every particle of food and drink has to pass over the orifice of the trachea

7

2 evolutionarily important developments in humans

1. displacement of the larynx from the back of the neck to the throat (happens in the first year of life, has to do with vocal function and speech development.)
2. descent of the bladder from abdomen to pelvis as we become bipedal (bladder is in abdomen of children)

8

Is the epiglottis in the same place for children and adults?

no. in children, the epiglottis overlaps the soft palate

9

Vocal sounds in infants vs adults

Infants - nasalized vocal sounds, not peak frequencies that humans can pick up
adults - movement of the larynx to the throat allows for peak frequenceies - huge for development of language

10

Protection of the airway in children vs. adults

human infants have functional separation of the airway and swallowing function. the epiglottis articulates with the soft palate

human adults require neurological airway protection and RARs in the larynx

11

Why do we have spincters that close in places in the body

to protect the airway, urinary bladder, rectum

12

Respiratory afferents drive ______ abdominal pressure event (_____)

up
anticipation
stress urinary incontinence = increased abdominal pressure-->leak

13

Pharynx is divided into 3 regions

nasopharynx
oropharynx
laryngopharynx

14

Nasopharynx location

posterior to the nasal cavity

15

Nasopharynx communicates with the ________ via _____ (x3)

nasal cavity via the chonae
middle ear vie the auditory tube
oropharynx via the pharyngeal isthmus

16

anterior opening of the pharynx to the nasal cavity

chonae

17

inferior opening of the nasopharynx
closed over by

pharyngeal isthmus
soft palate - dont' want food up in your nasopharnx

18

Oropharynx is related to which major landmark of head and neck

hyoid bone

19

laryngopharynx is located

posterior to the larynx

20

laryngopharynx becomes continuous with the _____ at the important head and neck landmark____

esophagus
CV6

21

laryngopharyx communicates with the oropharynx at the level of what head and neck landmark

hyoid bone

22

Piriform recess

part of the laryngopharynx
posterior and lateral to the arytenoid cartilages
food flows down this gutter into the esophagus

23

piriform recess
the epithelium in this area is innervated by____ and its arterial supply is _____

internal laryngeal nerve
superior laryngeal artery
pooling sign suggest obstuction or paralysis of upper esophagus

24

Inner elevators of the pharynx

stylopharyngeus muscle
salpingopharyngeus muscle
palatopharyngeus muscle

25

vagal function in the pharynx

elevation (except styolopharyngeus muscle)

26

Stylophayngeus muscle

between superior and middle constrictors
innervated by SVE fibers of IX
ONLY ONE INN BY IX

27

Salpingophayngeus muscle and palatopharyngeus muscle

innervated by vagus n

28

Pharyngeal constictor muscles

superior constrictor (at pterygoid process and mandible)
middle constrictor (at hyoid)
inferior constrictor (at oblique line of thyroid cartilage and cricoid cartilage)

attach posteriorly to the midline pharyngeal raphe

29

Inferior constrictor

cricopharyngeus muscle is used during phayngeal speach. is the larges constrictor group. also transition level of orientation of horizontal fibers from pharynx, to vertical fibers of esophagus

30

Kilian's triangle

weak spot of transition at cricopharyngeus/ inferior constrictor level from oblique fibers to vertical fibers of the esophagus

31

Zenker's diverticulum

located just above cricopharyngeus mucslce (above the upper sphincter of the esophagus) it is a false diverticulum (not involving al layers of esophagus wall)

32

Buccopharyngeal fascia

covers outer surface of buccinator muscle and the pharynx

33

pharyngeal plexus

embedded in the portion of the buccopharyngeal fascia covering the middle constrictor

34

Retropharyngeal space

between buccophayngeal fascia and prevertebral fascia - it is continuous from the base of the skull to the mediastinum

infections can spread from either region via this space
in srugical fusion of cervical vertebrae, the anterior bodies of the vervical vertebrae are approaced via the retropharyngeal space

35

Gag reflex

remember not everyone has a gag relflex
afferent IX, efferent X

36

Blood supply to pharynx

ascending pharyngeal and inferior thyroid arteries

37

Innervation of the Pharynx
________plexus embeded in ________
receives sensory (GVA) from ___________
receives motor (SVE) from _________
afferent information for the _____ reflex

pharyngeal plexus embedded in buccopharyngeal fascia
GVA from pharyngeal branch of glossopharyngeal nerve
SVE from the pharyngeal branch of vagus nerve
gag

38

Branches of IX (3)

1. pharyngeal nerve to pharyngeal plexus
2. sensory (GVA) to mucosa of post 1/3 tongue and pharynx
sensory (SVA) to taste buds of post 1/3 tongue
3. motor (SVE) to stylopharyngeus muscle

39

why do we need neurological airway protection of the larynx

because of its displacement from the back of the eck to the torat in the first year of life

40

movement of the laryx has to do with

vocal function and speech development

41

The _____ acts as a teeter totter between _____ and _____

hyoid
tongue and larynx

42

Thyroid cartilage

thyroid laminae form the laryngeal prominence
superior horn continuous with hyoid bone
inferior horn articulates with cricoid cartilage (cricothyroid joint)
may show ossifications on X-rays after age 30

43

Cricoid cartilage

most of this cartilage is posterior
cricoid lamina located on posterior aspect of larynx, articulates with the arytenoid cartilages

44

cricoid arch

formas main supporting element of laryngeal airway

45

arytenoid cartilages

turnstyle configuration
vocal process attached to vocal ligament of vocal cord
muscular process attached to posterior and lateral cricoarytenoids

46

posterior attachement of vocal ligaments

arytenoid cartilages

47

during phonation arytenoid cartilages

rotate along a vertical axis to control tension on the vocal folds

48

during respiration arytenoid cartilages

slide laterally to poen the rima glottidis

(vocal cords apart for breathing)

49

Why dont you want to direct your cut upwards during a cricothyrotomy

you will hit the vocal cords

50

What happens when you swallow (with the epiglottis)

tongue pushes back over the larynx and pushes epiglottis over the larynx
vocal folds close also

51

Only abductor of vocal cords

posterior cricoarytenoid muscle (cricoid lamina to the muscular process of the arytenoid)

52

GERD

acid is damaging to larynx (digestion of lining of upper airway)
will complain of cough

53

MOST important nerve in the body. will keep you alive

internal branch of superior laryngeal nerve
ibSLN

54

ibSLN course

pierces thyrohyoid membrane along with superior laryngeal artery

55

ibSLN function

CHIEF SENSORY NERVE TO THE INTERIOR OF THE LARYNX
supplies GVA fibers to interior of larynx and it is involved in the cough reflex
also supplies GVE to the saccule glands of the larynx

56

afferent component of the laryngeal cough reflex (LCR)

laryngeal receptors and afferent fibers of the ibSLN

57

If ibSLN not functional during initiation of protective cough reflex,

protective value of LCR is compromised, and there is an increased risk of developing aspiration pneumonia in neurologically impaired patients

58

External branch of superior laryngeal nerve

innervates cricothyroid muscle

59

recurrent laryngeal nerve course

crosses cricothyroid joint and enters larynx, is then called inferiror laryngeal nerve

60

inferior laryngeal nerve function

conveys SVE fibers to the laryngeal muscles except CRICOTHYROID
these fibers originate from the nucleus ambiguus

61

paralysis of recurrent laryngeal nerve

result in hoarseness and dysphagia.
there may also be coughing or choking due to the collapse of the aryepiglottic fold and subsequent drainage of fluids into the larynx.