05 Pharynx and Esophagus

Question 1

What are the 3 subsites of the hypopharynx

Answer 1

• Postcricoid area
• Posterior pharyngeal wall
• Piriform sinus

Question 2

what separates the hypopharynx from larynx

Answer 2

AE folds

Question 3

What structure in the hypopharynx marks the location of the CA joint?

Answer 3

Piriform apex

Question 4

What are the boundaries of the piriform fossa?

Answer 4

• Superiorly: inferior margin of hyoid
• Anteriorly: junction of ant and post halves of thyroid cartilage
• Posteriorly: Posterior edge of thyroid cartilage
• Apex: CA joint

Question 5

What are the layers of the posterior pharyngeal wall from superficial to deep

Answer 5

Mucosa
Constrictor muscles
Longus colli
Retropharyngeal space
Prevertebral fascia

Question 6

What are the boundaries of the parapharyngeal space?

Answer 6

Inferior – Hyoid bone.
Superior – Petrous bone.
Medial – Soft palate, tonsils, and superior pharyngeal constrictor.
Lateral – Medial pterygoid muscle, ramus of the mandible, and posterior belly of the digastric.
Dorsal – Vertebral column and paravertebral muscles.
Ventral – Pterygomandibular raphe

Question 7

Structures in the prestyloid compartment of PPS

Answer 7

• Medial pterygoid muscle
• Fat
• Lymphatics
• Minor nerves
• Vessels
• Deep lobe of parotid

Question 8

Structures in POSTstyloid compartment of PPS

Answer 8

• Carotid sheath

- Nerves: IX, X, XII, cervical SYMP

Question 9

What space does the PPS communicate with dorsally?

Answer 9

Retropharyngeal space

Question 10

What is the relationship of the fossa of Rosenmuller to the PPS

Answer 10

Lies at the convergence of the fascial planes that separate the PPS into its 3 compartments (prestyloid, retrostyloid, and retropharyngeal)

Question 11

Nasopharynx epithelium

Answer 11

At birth, pseudostratified columnar epith. By age 10, majority is replaced by stratified squamous

Question 12

What are boundaries of cervical esophagus

Answer 12

CP muscle to sternal notch

Question 13

Arterial supply to cervical esophagus

Answer 13

Thyroid branch of thyrocervical trunk

Question 14

Venous drainage of cervical esophagus

Answer 14

Inferior thyroid vein

Question 15

3 areas of esophageal narrowing

Answer 15

1. Superiorly, CP
2. Inferiorly, where esophagus enters the cardia
3. Middle, where left mainstem bronchus and aorta cross anteriorly

Question 16

What effect to Beta blockers have on LES pressure

Answer 16

Raise it

Question 17

What effect does smoking have on LES pressure

Answer 17

Lowers it

Question 18

Where is Auerbach’s plexus in the esophagus

Answer 18

b/w longitudinal and circular muscle

Question 19

Where is Meissner’s plexus in esophagus

Answer 19

submucosa

Question 20

What are the 3 layers of the esophageal mucosa

Answer 20

-Muscularis mucosa
-Lamina propria
-Epithelium
NO SEROSA

Question 21

“Retained secretions in the hypopharynx that fail to clear with swallowing indicate a___ disorder when thickened and mucoid and a___ disorder when frothy or foamy.

Answer 21

Neurological; structural

Question 22

What does chin tuck do to swallow

Answer 22

Pushes base of tongue and epiglottis anteriorly; causes airway to narrow