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Flashcards in The Pharynx Deck (50):
1

What is the pharynx?

A muscular tube

Connects the larynx and oesophagus to the nasal cavities

2

What can pass down the pharynx?

Air and food

3

Where, precisely, does the pharynx begin and end?

Begins at the base of the skull

Ends inferior to the cricoid cartilage (C6)

4

Name the three parts of the pharynx

Nasopharynx

Oropharynx

Laryngopharynx

5

What are the muscles of the pharynx innervated by?

The vagus nerve (CN X)

Except for the stylopharyngeus, innervated by the glossopharyngeal nerve (CN IX)

6

What is the function of the circular muscles of the pharynx?

Contract sequentially from superior to inferior to constrict the lumen and propel bolus of food inferiorly into the oesophagus.

7

Structure of the circular muscles of the pharynx?

Stacked like glasses

Form an incomplete muscular circle

8

Name the circular muscles of the pharynx and the parts in which they are found.

Superior pharyngeal constrictor - oropharynx

Middle pharyngeal constrictor - laryngopharynx

Inferior pharyngeal constrictor - laryngopharynx

9

What are the two components of the inferior pharyngeal constrictor

Superior (thyropharyngeus) - has oblique fibres that attach to the thyroid cartilage

Inferior (cricopharyngeus) - horizontal fibres attaching to the cricoid cartilage

10

Generally, what is the structure of the wall of the pharynx?

Pharyngeal mucosa

Incomplete ring of lymphoid tissue

Longitudinal muscular layer

Circular muscular layer

Buccopharyngeal fascia

11

Function of the longitudinal muscles of the pharynx?

Shorten and widen the pharynx

Elevate it during swallowing

12

Attachements of the longitudinal muscles of the pharynx?

Stylopharyngeus - styloid process of temporal bone to the pharynx

Palatopharyngeus - hard palate of oral cavity to the pharynx

Salpingopharyngeus - Eustachian tube to pharynx

13

What extra function does the salpingopharyngeus perform?

Opens the Eustachian tube to equalise pressure in the middle ear with the atmosphere.

14

Sensory innervation of the pharynx?

Nasopharynx - maxillary

Oropharynx - glossopharyngeal

Laryngopharynx - vagus

15

Sympathetic innervation to the pharynx?

From the superior cervical ganglion

16

Arterial supply to the pharynx?

Branches of the external carotid

-ascending pharyngeal

-lingual

-facial

-maxillary

17

Venous drainage of the pharynx?

Pharyngeal venous plexus, drains into the internal jugular

18

Where does the nasopharynx run between?

Base of the skull to the soft palate

19

Function of the nasopharynx?

Extension of the nasal cavity

Conditions inspired air and propogates it into the larynx

20

Epithelium of the nasopharynx?

Ciliated pseudostratified columnar with goblet cells

21

Where are the adenoid tonsils found?

In the posterio-supeior nasppharynx

22

What can cause enlargement of the adenoid tonsils?

Viral infections of the upper respiratory tract

23

What can happen if the adenoids keep becoming infected and enlarged?

Obstruct the opening of the Eustachian tube

Prevents equalising of pressure in the middle ear and normal drainage of fluids for excretion

Glue ear

24

Where does the oropharynx run from and to?

Soft palate and supeior border of the epiglottis

25

What does the oropharynx contain?

Posterior third of the tongue

Lingual tonsils

Palatine tonsils

Superior constrictor muscle

26

What is the function of the oropharynx?

Voluntary and involuntary phases of swallowing

27

Where are the palatine tonsils found?

In the tonsilar fossa between the palatoglossal and palatopharyngeal arches of the oral cavity

28

Where are the lingual tonsils found?

Inferiorly to the tongue

29

What is inflammation of the palatine tonsils (tonsilitis) accompanied by? 

Enlarged jugulo-digastric lymph nodes

30

What can bleed during a tonsillectomy?

External palatine vein

Tonsilar branch of the facial artery

31

What can be damaged during a tonsillectomy?

Glossopharyngeal nerve

Internal carotid artery

32

If an infection spreads from the palatine tonsils to the peritonsilar tissue, what is this known as and what happens? 

Why is it an emergency?

Cause an abscess

Can get deviation of the uvula (quinsy)

Potential obstruction to the pharynx

33

How is quinsy treated?

Drain the abscess

Antibiotics

34

Where does the laryngopharynx run between?

Superior border of the epiglottis

Inferior border of the cricroid cartilage (C6)

Becomes continuous with the oesophagus

35

Where is the laryngopharynx found in relation to the larynx?

Posterior to the larynx

36

What does the laryngopharynx contain?

Middle and inferior pharyngeal constrictors

37

Where can foreign objects become lodged in the pharynx?

Valleculae in the nasopharynx

Piriform fossae in the laryngopharynx

38

How are objects in the piriform fossae visualised and removed?

With a pharyngoscope

39

What can be affected when something is lodged in the piriform fossa?

Can compress the internal laryngeal nerve and the recurrent laryngeal nerve

40

What happens during swallowing normally with the inferior pharyngeal constrictor?

The superior part - thyropharyngeus - contracts

The cricopharyngeus relaxes

This allows the bolus to be propelled into the oesophagus and prevent intrapharyngeal pressure from rising 

41

What can happen if there is not the relaxation of the cricopharyngeus during swallowing?

Intrapharyngeal pressure rises

Pharyngeal mucosa forms a midline diverticulum between the thyropharyngeus and cricopharyngeus

Food can accumulate here, leading to dysphagia

42

Where are the widest and narrowest parts of the pharynx?

Widest (5cm) opposite the hyoid

Narrowest (1.5cm) at the inferior end

43

What is between the muscle layer and the mucosa of the pharynx?

The pharyngobasilar fascia

44

What are the phases of swallowing?

Voluntary phase

Pharyngeal phase

Oesophageal phase

45

What happens in the voluntary phase of swallowing?

Tongue moves bolus to the back of the pharynx

46

What happens in the pharyngeal phase of swallowing?

Afferent info from pressure receptors in the palate and anterior pharynx reaches the swallowing centre in the brain stem

Triggers movements:

  • Inhibition of breathing
  • Raising of larynx
  • Closure of the glottis
  • Opening of the upper oesophageal sphincter 

47

What happens in the oesophaeal phase of swallowing?

  • Wave of peristalsis sweeps down the oesophagus, propelling the bolus into the stomach in about 9 seconds
  • Coordinated by extrinsic nerves from the swallowing centre of the brain
  • Lower oesophageal sphincter opens

48

What triggers the gag reflex and what is the pathway?

Touching the back of the oropharynx

Afferent pathway - glossopharyngeal

Efferent pathway - vagus nerve

49

Clinical features of enlarged adenoids?

  • Nasal obstruction
  • Mouth breathing and nasal speech
  • Feeding difficulty especially in infants
  • Snoring/obstructive sleep apnoea
  • Block opening of Eustachian tube

50