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Anatomy of Head & Neck > Theme 6 > Flashcards

Theme 6 Flashcards

Pharynx and Larynx

1
Q

The Pharyngeal Wall

  1. Use
  2. What are the layers of the pharyngeal wall?
A
  1. Common passageway for food & air
  2. There are 4 layers:

Areolar: external fascial containing the pharyngeal plexus (of veins & nerves)

Muscular: 5 paired muscles

  • Circular & Longitudinal
  • Superior, middle & inferior constrictors - allowing swallowing. Innervated by CNX
  • Stylopharyngeus & Palatopharyngeus

Submucous

Muscosa

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2
Q

Semi-Circular Constrictor Muscles of the Pharynx

  1. Function
  2. Muscles
  3. Innvervation
A
  1. Swallowing
  2. All the muscles, posteriorly attach to the Pharyngeal Raphe

(which is attached to the pharyngeal tubercle)

Superior Constrictor:

Anterior attachments: Pterygomandibular Raphe, Post. border of Medial Pterygoid plate & posterior part of the mylohyoid line

Middle Constrictor: Between both horns of hyoid bone - overlapping the S.C muscle above

Inferior Constrictor: has 2 parts. Originate from Thyroid & Circoid

  • Thyropharyngeal: from thyroid cartilage oblique line
  • Cricopharyngeus: always closed (due to cricopharyngeus sphincter) relaxes during swallowing
  1. CNX
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3
Q

What are the three regions that compose the Interior of Pharynx?

A
  1. Nasopharynx
  2. Oropharynx
  3. Laryngopharynx
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4
Q

Nasopharynx

  1. Where is it located?
  2. Where is the opening located?
  3. What structures are located within it?
A
  1. Superior portion of the pharynx found above the soft palate
  2. Opening of auditory tube is located in the lateral wall, posterior & inferior to the inferior nasal concha

3.

Salpingopharyngeal Fold: Small, mucous covered muscle; part of palatopharyngeus a

Pharyngeal Recess: a cleft between the salpingopharyngeal wall & posterior wall of the pharynx

Pharyngeal tonsils

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5
Q

Oropharynx

  1. Where is it located?
  2. What does it contain?
A
  1. located beneath the soft palate

2.

  • Palatopharyngeal arch
  • Palatopharyngeal fold
  • Palatoglossal fold/arch
  • Palatine tonsils - found between the arches
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6
Q

Laryngopharynx

What structures are found within?

What is the function of these structures?

A

Epiglottis: covers laryngeal inlet

Vallecula: gap between the epiglottis & tongue where things can fall.

  • Bounded by Lat. & Median glossoepiglottic folds

Periform Excess: directs food & water from the lateral channels into esophagus

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7
Q

What is Waldeyer’s Tonsillar Ring?

A

Ring of Tonsillar tissue in the pharynx at the back of the oral cavity

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8
Q

Longitudinal Muscles of the Pharynx

A

Palatopharyngeus

  • From soft palate to pharynx wall, Hyoid & Thyroid cartilages

Stylopharyngeus IX

Function: act to raise Pharynx & Larynx during swallowing (as do the suprahyoids)

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9
Q

Innervation of the Pharynx

A

Motor:

All by Pharyngeal branch of CNX BUTStylopharyngeus is CNIX

Sensory:

CNIX: around mucosa

CNV2: soft palate & pharyngeal roof

CNX: around the laryngeal inlet

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10
Q

Blood Supply of the Pharynx

A
  1. Ascending Pharyngeal Artery
  2. Superior Thyroid Artery
  3. Inferior Thyroid Artery
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11
Q

Venous drainage of the Pharynx

A

Pharyngeal venous plexus into internal jugular vein

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12
Q

Muscles of the Soft Palate

  • What are they?
  • What are their functions?
A

Levator Veli Palatini: Elevates soft palate

  • Opening of the pharyngotympanic tube into the palatine aponeurosis (Soft palate)

Tensor Veli Palatini: Elevates soft palate

  • via the medial pterygoid & Hamulus

Palatopharyngeus: Raises pharynx & larynx in swallowing

  • Longitudinal pharynx muscle
  • Forms palatopharyngeal arch after attachment with Hyoid & Thyroid cartilage

Palatoglossus: raises tongue & lowers soft palate

  • From palatoglossal fold to the side of the tongue = palatoglossal arch
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13
Q

Innervation of the Soft Palate

A

Sensory:

Soft palate = Lesser Palatine

Motor:

Muscles = Pharyngeal plexus

Tensor Veli Palatini = CNV3

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14
Q

Stages of Swallowing

What tongue muscles are involved?

A
  1. Oral: Voluntary
  • Mastication
  • Tongue forms food into a bolus
  • Tongue pushes bolus into oropharynx
  1. Pharyngeal: involuntary
  • Soft Palate raised = Nasopharynx sealed off
  • Longitudinal muscles contract
  • Suprahyoids contract
    • = raising of pharynx & larynx

3.

  • Constrictor muscles contract

4.

  • Cricopharyngeus relaxes to allow the bolus to enter Oesophagus
  • Peristalsis of the Oesphargeal wall

Tongue muscles involved: palatoglossus, styloglossus, palatopharyngeal, hyoglossus & geniohyoid

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15
Q

Laryngeal Cartilages

A

Unpaired

C3-C4 level: under Adams apple

  • Epiglottis
  • Cricoid cartilage
  • Thyroid cartilage

Paired

  • Arytenoid
    • Sits on posterior cricoid bt facet on its
    • Leans against the posterior wall of thyroid
  • Corniculate
    • Elastic
  • Cuneiform
    • Elastic
    • Thickenings within the quadrangular membrane
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16
Q

What are the Extrinsic & Intrinsic Laryngeal Membranes?

A

Extrinsic:

  • Cricotracheal
  • Thyrohyoid

Intrinsic:

  • Conus elasticus (cricothyroid)
  • Quadrangular (aryepiglottic)
17
Q

Cricothyroid Joint

  1. What type of joint is it?
  2. Where is it located?
  3. How does it function?
A
  1. Synovial: has a capsule

2.

  • Inferior cornu of thyroid cartilage
  • Facet on cricoid cartilage

3.

  • Rotation about an axis between the two inferior cornuae & some gliding
  • Lengthen & shorten vocal folds
18
Q

Cricoartenoid Joint

  1. What type of joint is it?
  2. Where is it located?
  3. How does it function?
A
  1. Synovial

2.

  • Facet on base of arytenoid
  • Face on shoulder of cricoid
  • Oval/concave/convex facet
  • Cricoarytenoid ligaments & oblique line is part of this joint

3.

  • Rocking & sliding
  • Open & close vocal folds (abduction & adduction)
19
Q

How is the Laryngeal Inlet controlled?

A

Aryepiglottic: contracts to close the inlet by drawing down the epiglottis

Thyroepiglottic: closes inlet

20
Q

How are the Vocal Folds controlled?

A

Posterior cricoarytenoid (abduction)

  • Inferiorly attached to post. Aspect of the lamina of the cricoid fossa
  • Superiorly attached to the muscular process of the arytenoid cartilage

Lateral cricoarytenoid (adduction)

Interarytenoid (adduction)

21
Q

How is it lengthened & shortened?

A

Cricothyroid (lengthen)

  • Contained numerous glands that secrete mucous and protect true vocal folds by keeping them moist

Thyroarytenoid (shorten)

22
Q

Motor Innervation of Larynx

A

Two nerves, branches of vagus nerve

Recurrent Laryngeal:

  • Motor to all intrinsic muscles apart from cricothyroid

External Laryngeal (of superior laryngeal)

  • Cricothyroid muscle
23
Q

Sensory Innervation of Larynx

A

Important in protective reflexes & voice production

Recurrent laryngeal: - below the vocal fold

To the mucous membrane covered true vocal folds and infraglottic cavity below vocal folds

  • Right: turns & passes under the right subclavian artery
  • Left: turns & passes under & around the aortic arch and then runs upwards

Internal Laryngeal: - above vocal folds

To the mucous membrane of the cavity of the larynx above the true vocal folds

24
Q

What are the different cavities found in the larynx?

A

Vestibule: supraglottic

  • Pits at the back of Epiglottis
  • Above true & false vocal folds

Ventricle: Laryngeal sinus

  • Keeps vocal cords moist
  • Sit between ventricular and vocal ligaments
  • Lies between true & false vocal folds

Infraglottic:

  • A comparement of the larnyx
  • Lies below the true vocal folds
25
Q

Functions of the Larynx

A
  1. Ventilatory when fully open - Inspiration & expiration
  2. Phonatory when Half open
  • Voice production
  • Articulation
  1. Sphincteric when fully closed
  • Protection from swallowing
  • Fixation in thorax
  • Regulation of abdominal pressure
  • Ingestion of foreign bodies
26
Q

Phonation

  1. What is Phonation?
  2. How does Phonation occur?
  3. What is the role of Arytenoids?
A
  1. Voice Production

2.

  1. Vocal folds adducted during expiration
  2. Pressure Rises
  3. Vocal fold abduct & air is released
  4. Vocal folds adduct & cycle repeats

3.

Rotation of arytenoids open and closes vocal cord

  • Normal breathing: vocal opening is diamond shape
  • Forced respiration: vocal opening widens
  • Phonation: vocal opening is closed
27
Q

When does the Larynx provide protection? & How?

A

During swallowing:

  1. Larynx raises due to suprahyoids, infrahyoids & longitudinal muscles of the pharynx
  2. Epiglottis lowers passively
  3. Larynx inlet closes
  4. Vocal fold adduct
  5. Ventilation suspends
  6. Cough reflex
28
Q

Cough reflex

A
  1. Foreign body enters supraglottic cavity/near to laryngeal inlet- could cause asphyxiation by obstructing the airways
  2. Presence of foreign body is detected by sensory receptors and relayed to brain
    • Done by sensory innervation
  3. Initial deep inspiration so vocal folds are tightly closed
  4. Increase in thoracic pressure by forceful expiration against closed vocal folds
  5. Pressure below vocal folds rises
  6. Vocal folds suddenly abducted (opened)
  7. Foreign body dislodges by rapid rise in air pressure, spat out or swallowed

Anatomy of Head & Neck (12 decks)

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