Throat

Question 1

What are the 2 parts of the oral cavity?

Answer 1

Oral vestibule (between lips and teeth)
Oral cavity proper

Question 2

What are the boundaries of the oral cavity?

Answer 2

Lips to palatoglossal arch
Palate to floor of mouth/tongue
Buccal mucosa

Question 3

How does the parotid duct reach the oral cavity?

Answer 3

Pierces the buccinator muscle then opens into oral cavity on inner surface of cheek opposite maxillary 2nd molar

Question 4

Where is the submandibular duct?

Answer 4

Lies superior to the digastric muscle, each submandibular gland is divided into superficial and deep lobes, which are separated by the mylohyoid muscle

Question 5

What does the lingual nerve supply?

Answer 5

General somatic afferent innervation from the anterior 2/3rds of the tongue
Carries nerve fibres that are not part of the trigeminal nerve including chorda tympani nerve (facial) - provides taste to anterior 2/3rds of tongue

Question 6

What are the functions of the oral cavity?

Answer 6

Taste
Mastication (teeth, tongue)
Speech (tongue, cheek, lips)
Digestion (salivary enzymes)
Swallowing (tongue, hard and soft palate)

Question 7

Where does the anterior 2/3rds of the tongue derive from?

Answer 7

1st branchial arch

Question 8

What innervates the anterior 2/3rds of the tongue?

Answer 8

Lingual nerve (sensation)
Chorda tympani (taste)

Question 9

Where does the posterior 1/3rd of the tongue derive from?

Answer 9

3rd branchial arch

Question 10

What innervates the posterior 1/3rd of the tongue?

Answer 10

CN IX

Question 11

What are the different papillae found on the tongue?

Answer 11

Filliform - do not contain taste buds
Fungiform - scattered throughout dorsum of tongue
Folliate - rudimentary
Circumvallate - row just anterior to sulcus terminalis

Question 12

What do intrinsic muscles do in the tongue?

Answer 12

Alter shape

Question 13

What do extrinsic muscles do in the tongue?

Answer 13

Alter position

Question 14

What is the nerve supply of the muscles in the tongue?

Answer 14

CN XII - hypoglossal supplies all but palatoglossus (supplied by pharyngeal plexus - CN iX - X)

Question 15

What are the extrinsic muscles of the tongue?

Answer 15

Genioglossus
Styloglossus
Hypoglossus
Palatoglossus

Question 16

What are the functions of the tongue?

Answer 16

Taste
Mastication
Swallowing
Speech

Question 17

What are the 4 muscles involved in mastication?

Answer 17

Lateral pterygoid
Medial pterygoid
Temporalis
Masseter

Question 18

What supplies the muscles of mastication?

Answer 18

CN V3

Question 19

What is the function of the muscles of mastication?

Answer 19

Act on TMJ - food positioned between teeth for grinding by action of tongue and cheek

Question 20

What are the boundaries of the oropharynx?

Answer 20

Lower border of soft palate to upper margin of epiglottis
Palatoglossal arch to posterior pharyngeal wall
Lateral = facial pillars and palatine tonsils

Question 21

What type of epithelium is in the oropharynx?

Answer 21

Stratified, non-keratinised squamous

Question 22

What is the nerve supply of the oropharynx?

Answer 22

Pharyngeal plexus (CN IX and X)

Question 23

What is the blood supply of the hypopharynx?

Answer 23

Superior thyroid artery
Lingual artery
Ascending pharyngeal artery

Question 24

What is the nerve supply of the hypopharynx?

Answer 24

Pharyngeal plexus

Question 25

What are the boundaries of the hypopharynx?

Answer 25

Superior margin of epiglottis to lower border of cricoid cartilage Continuous with oesophagus Anterior wall = back of larynx

Question 26

What are the 3 subsites of the hypopharynx?

Answer 26

Pyriform sinus Post-cricoid area Posterior pharyngeal wall

Question 27

What are the 3 phases of swallowing?

Answer 27

Oral phase (voluntary) Pharyngeal Oesophageal

Question 28

What is the oral phase of swallowing?

Answer 28

Tongue propels food in pharynx | Triggers swallowing reflex

Question 29

What is the pharyngeal phase of swallowing?

Answer 29

Soft palate pulled upwards Epiglottis covers larynx, larynx moves upward Upper oesophageal sphincter relaxes Respiration is reflex inhibited

Question 30

What is the oesophageal phase of swallowing?

Answer 30

Once bolus passed UOS, sphincter constricts | Bolus propelled downwards by peristaltic motion, reflex via myenteric plexus

Question 31

What is myenteric plexus?

Answer 31

Provides motor innervation to both layers of the tunica muscularis - both sympathetic and parasympathetic input

Question 32

What are the functions of the larynx?

Answer 32

Part of respiratory tract Voice Swallowing

Question 33

What are the 3 parts of the larynx?

Answer 33

Supraglottis Glottis Subglottic

Question 34

Where is the supraglottis?

Answer 34

Extends from superior tip of epiglottis to floor of ventricular fold

Question 35

Where is the glottis?

Answer 35

Begins superiorly at true vocal fold and extends inferiorly to horizontal plane 5mm inferior to the vocal cord

Question 36

Where is the subglottis?

Answer 36

Begins 5mm below the free edge of the true vocal cord and proceeds to the inferior border of the cricoid cartilage

Question 37

What are the 7 segments of cartilages in the larynx?

Answer 37

Cricoid Thyroid Epiglottis Paired arytenoid cartilages (corniculate and cuneiform)

Question 38

What are the extrinsic muscles of the larynx?

Answer 38

Infrahyoid Suprahyoid Thyrohyoid

Question 39

What is the difference between the roles of extrinsic and intrinsic muscles in the larynx?

Answer 39

``` Extrinsic = move the entire laryngeal complex Intrinsic = regulate movement of vocal folds ```

Question 40

What is the motor innervation of the larynx?

Answer 40

All intrinsic muscles are supplied by recurrent laryngeal nerve except for cricothyroid muscle (external laryngeal nerve)

Question 41

What is the sensory innervation of the larynx?

Answer 41

Supraglottic: internal laryngeal nerve | Glottic + subglottic: recurrent laryngeal nerve

Question 42

Why is the left recurrent laryngeal nerve at a higher risk of injury during operative chest procedures?

Answer 42

It has a longer course - it loops around the aortic arch instead of right subclavian

Question 43

Where does the superior laryngeal nerve divide into external and internal branches?

Answer 43

At the level of the greater cornu of the hyoid

Question 44

What is the role of the internal superior laryngeal nerve branch?

Answer 44

Travels with superior laryngeal artery through the thyrohyoid membrane and allows supraglottic sensation and increased airway protection

Question 45

What is the role of the external superior laryngeal nerve branch?

Answer 45

Supplies subglottic mucosal sensation and motor fibers to the cricothyroid muscle

Question 46

What are the 5 steps of speech?

Answer 46

1. Respiration (source of energy) 2. Phonation (different VC position, tension, vibration and length) 3. Resonation (oral/nasal balance, depend on nasopharynx, nasal and oral cavity) 4. Articulation (production of speech) 5. Prosody (syllable stress + emphasis, speech tone)

Question 47

What is the pulmonary phase of speech?

Answer 47

Creates energy flow with inflation and expulsion of air. Provides larynx with a column of air

Question 48

What is the laryngeal phase of speech?

Answer 48

Vocal folds vibrate at certain frequencies to create sound that is then modified in the supraglottic/oral/nasal phase

Question 49

How are words formed?

Answer 49

By the action of the pharynx, tongue, lips and teeth

Question 50

What is prosody?

Answer 50

Rhythm, stress and intonation of speech | Associated with areas 44 and 45 (Broca's area) of the left frontal lobe