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Flashcards in Pharynx and Larynx Deck (40)
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1
Q

what are the 3 phases of swallowing

A

1) oral phase: mastication
2) oropharyngeal phase: elevation floor of mouth and tongue to push bolus into oropharnx
3) pharyngeo-esophageal phase: bolus propolled down esophagus

2
Q

divisions of pharynx

A

nasopharynx
oropharynx
larynx

3
Q

nasopharynx location and communication

A

posterior to the nasal cavity
communicates with nasal cavity via choanae
communicates with middle ear cavity via auditory tube
communicates with oropharynx via PHARYNGEAL ISTHMUS

4
Q

oropharynx location and communication

A

posterior to oral cavity
communicates with oral cavity via faucial isthmus
communicates with nasopharynx via pharyngeal isthmus

5
Q

laryngeopharynx located ___
communicates with oropharynx at the level of what
communicates with larynx via what

A

posterior to larynx
hyoid
laryngeal aditus

6
Q

what is the piriform recess

innervated by what?

A

posterior and lateral to arytenoid cartilages in laryngeopharynx
-epithelium innervated by internal branch of superior laryngeal nerve

7
Q

stylopharyngeus muscle is a ___ of the pharynx

-location and innervation?

A

arises from the styloid process and inserts on wall btwn superior and middle constrictors
innervated by SVE of the glossophargyngeal n

8
Q

superior constrictor muscle location

A

attached laterally to pterygomandibular raphe near third molar

9
Q

middle constrictor location

A

attached laterally to hyoid and posteriorly to the midline pharyngeal raphe

10
Q

inferior constrictor location

A

laterally to oblique line of thyroid and cricoid cartilage

-horizontal fibers comprise cricopharyngeus muscle used during pharngeal speach

11
Q

what is killums triangle

A

transition between inferior constrictor mucsle and cricopharyngeus muscle

12
Q

zenker’s diverticulum

A

herniation of the mucosal lining of the esophagus between cricopharyngeal m and inferior constrictor muscle
-may be weakened area due to transition from skeletal to smooth m

13
Q

buccopharyngeal fascia

A

subdivision of pretracheal fascia, covers outer surface of buccinator muscle and pharynx
-part that covers middle constrictor contains pharyngeal plexus

14
Q

retropharyngeal space location and relevance

A

between buccopharyngeal fascia and prevertebral fascia

  • continuous from the base of the skull to the mediastinum
  • infections can spread through regions here
  • in cervical fusion of vertebrae, anterior bodies of cervical vertebra are approached here
15
Q

innervation of the pharynx

A

sensory: GVA from the pharyngeal branch of glossopharyngeal n, convey afferent info for GAG reflex
motor: SVE from the pharyngeal branch of the vagus nerve

16
Q

branches of nerve IX in pharynx and what they do (3)

A

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

17
Q

Gag relex nerves involved

A

IX send afferents in
X send efferents to cause reflex
-assisted by intercostal, phrenic, and abdominal nerves

18
Q

superior laryngeal nerve is a branch off of what nerve

A

the vagus nerve

19
Q

the thyroid laminae form the ___ anteriorly
superior horn continous with ___ and forms ___
inferior horn articulates with ___ ___ and makes ___ __

A

laryngeal prominence
hyoid bone, thyrohyoid ligament
cricoid cartilage, cricothyroid joint

20
Q

arytenoid cartilages location, vocal and muscular process

A

pyramidal shaped on superior edge of cricoid cartilage

  • vocal process attached to vocal ligament of vocal cord
  • muscular process attached to posteior and lateral cricoarytenoids
21
Q

arytenoid cartilages and phonateion and respiration

A

phonation: tension of vocal folds
respiration: slide laterally to open rima glottidis

22
Q

piriform recesses ______ if the patient says “a-a-a” in a low voice. secretions may gather here but should disappear on swallowing. if they do not then patient has ___ sign which suggests ___

A

slightly dilate
pooling
obstruction or paralysis of upper esophagus

23
Q

valleculae epiglottica location
seperated by
bound laterally by

A

recess between tongue and epiglottis

  • separated from each other by median glossoepidglottic fold
  • bound laterally by lateral glossoepiglottic folds
24
Q

where is the blade often placed during intubation

opens what?

A

in the valleculae epiglottica, moved forward and theis moves tongue and epiglottis forward too
-opens laryngeal aditus

25
Q

the thyrohyoid membrane is piereced by what

A

internal branch of the superior laryngeal nerve

superior laryngeal artery

26
Q

what muscle of the larynx is the only abductor of the vocal cords

A

posterior cricoarytenoid muscle

27
Q

what muscles of the larynx are adductors of the vocal cords

A

lateral cricoarytenoid m

arytenoideus

28
Q

how to test cricothyroid muscle and what happens to width of membrane

A

have patient say eeee in a high pitched voice

causes contraction and decrease in the cricothyroid membrane

29
Q

what innervates the cricothyroid muscle

A

external branch of the superior laryngeal nerve

30
Q

after the RLN corsses the ___ and enters the ___ it is called the ____. conveys ___ fibers to laryngeal muscles except ____

A

cricothyroid joint, inferior laryngeal nerve

SVE cricothyroid muscle

31
Q

at what level does the oropharynx communicate with the laryngeopharynx

A

CV6

32
Q

layers of the pharyngeal wall from in to out

A

1) muccosa layer
2) pseudostratified and stratified non keratinized epithelia
3) submucosa layer
4) pharyngeobasilar fascia: forms inner layer of muscular fascia
5) inner elevators of pharynx
6) pharyngeal constrictor muscles
7) Buccopharyngeal fascia

33
Q

what is the chief sensory nerve to the interior of the larynx
-what kind of fibers

A

the internal branch of the superior laryngeal nerve

GVA fibers

34
Q

what can someone get if the laryngeal cough reflex is not working

A

aspiration pneumonia

35
Q

what nerve inervates the cricothyroid muscle

A

external branch of the superior laryngeal nerve

36
Q

after the recurrent laryngeal nerve crosses the _____ joint and enters the larynx it is called _____
-supplies what fibers

A

cricothyroid joint, inferior laryngeal nerve

-supplies laryngeal muscles except cricothyroid muscle

37
Q

what does paralysis of the recurrent laryngeal nerve cause

A

hoarseness and dysphagia

38
Q

the superior laryngeal nerve is the chief sensory nerve to what?

A

interior of the larynx and piriform recess

39
Q

laryngeal expiration reflex afferent component

A

internal branch of superior laryngeal nerve innervates receptors, afferents enter medulla with vagus nerve and terminate at NTS

40
Q

laryngeal expiration reflex efferent component

A

recurrent laryngeal, intercostal and abdominal nerves activate muscles and cause expiratory coughing