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Head and Neck (Semester 5) > 11.1 Pharynx > Flashcards

11.1 Pharynx Flashcards

1
Q

How can the pharyx be divided into 3 sections and state the vertebral height of each

A
  1. Nasopharynx: 1 vertebral height (C1)
  2. Oropharynx: 2 vertebral heights (C2-3)
  3. Laryngopharynx (Hypopharynx): 3 vertebral heights (4-6)
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2
Q

What 2 structures comprise the nasopharynx?

A

Adenoids and Eustachian tube orifices

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3
Q

Where is the pharynx and where does it extend from and to?

A

A Musculofascial tube that is progressively longer and narrower from top to bottom and Incomplete anteriorly

It extends from the base of skull to oesophagus (C6) and is the common entrance to GI and respiratory tracts

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4
Q

Label the 3 sections of the pharynx

A
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5
Q

Give the boundries of the nasopharynx

A

Superior: skull base and sphenoid sinus

Inferior: soft palate and continuous below with oropharynx

Anterior: choanae of nasal cavities

Posterior: Body of C1

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6
Q

What type of epithelium lines the nasopharynx

A

Both respiratory type and stratified squamous epithelium

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7
Q

When does the pharynx open and close?

A

TRICK QUESTION… ALWAYS OPEN

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8
Q

What tonsils are found in the nasopharynx

Describe this

A

Nasopharyngeal Tonsil (Adenoids)

This is a collection of lymphoid tissue beneath posterior roof epithelium which produces IgA, IgG, IgM

(This along with palatine tonsils helps to form → Waldeyer’s Ring)

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9
Q

What elevation on the side wall is an opening connecting nasopharynx with middle ear?

Obstruction can lead to what?

A

Pharyngotympanic Tube (Eustachian Tube) Orifice

Obstruction can lead to “Glue Ear”

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10
Q

When is the max size of our adenoids reached and then what occurs?

Give another example of where these may enlarge

A

Maximal size 3-8 years (then regress)

Enlargement with viral/bacterial infections

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11
Q

Where is the oropharynx located and give its boundries

A

Behind oral cavity and tongue

Boundaries:

  • Superior – level of soft palate
  • Inferior – superior edge of epiglottis
  • Anterior – oral cavity
  • Posterior – C2 – C3
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12
Q

What epithelium lines the oropharynx?

A

Stratified squamous epithelium

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13
Q

What marks the boundary between the oral cavity and oropharynx

A

Palatoglossal folds (arches)

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14
Q

Give the contents of the oropharynx

Describe the structure, epithelium and muscles involved in these structures

A

1) Palatine tonsils are (encapsulated)
2) Anterior and posterior tonsillar (faucial) pillars

The tonsillar fossa floor is formed by the superior constrictor muscle. The lymphoid tissue is covered with squamous epithelium and there are many crypts found here.

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15
Q

Label the palantine arches

A
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16
Q

What tends to occur to the tonsils as we age

A

Atrophies after puberty

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17
Q

Where are the Palatine tonsils located?

A

Lie in tonsillar fossae (between ant. and post. pillars)

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18
Q

The Anterior pillar is also known as what arch?

Describe this

A

Palatoglossal arch:

  • Boundary between buccal cavity and oropharynx
  • Fuses with lateral wall of tongue
  • Contains palatoglossal muscle
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19
Q

The Posterior pillar is also known as what arch?

Describe this

A

Palatopharyngeal arch

  • Blends with wall of pharynx
  • Contains palatopharyngeus muscle
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20
Q

What is the blood supply to the Palatine tonsils?

A

Tonsillar branch of facial artery (branch of ECA)

Also lingual/ ascending palantine/ ascending pharyngeal BUT tonsilar is the main

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21
Q

What is the venous drainage of the Palatine tonsils?

A

pharyngeal plexus (also paratonsillar vein)

22
Q

What structure must we be carful of when removing the tonsils or draining a quinsy?

A

We must be carful of the ICA because this runs in close proximity

23
Q

Describe the lymph drainage of the Palatine Tonsils

A

Lymphatics pierce superior constrictor muscle ➞
Pass to nodes along internal jugular vein ➞ Jugulodigastric node (angle of mandible)

24
Q

What node is indicated by the arrow and what 3 structures does it drain?

A

Jugulo-digastric: drains tonsil, pharynx, posterior tongue

25
Q

What 2 structures is the piriform fossa located between and what is its function?

A

Recess between the central layrnx and lateral thyroid cartilage (in the laryngopharynx)

Functions to channel solids/liquids from oral cavity around raised laryngeal inlet INTO oesophagus

26
Q

What is the largest part of the pharynx and below what structure is this located?

A

Laryngopharynx (Hypopharynx) located below epiglottis

27
Q

Give the boundries of the Laryngopharynx

A

Superior – superior edge of epiglottis

Inferior – level of inferior edge of cricoid cartilage

Anterior – larynx

Posterior – C3 – C6 vertebrae

28
Q

What is the laryngopharynx continuous with inferiorly?

A

The oesophagus

29
Q

What epithelium lines the laryngopharynx?

A

Stratified squamous epithelium

30
Q

What are the 2 main muscles groups of the pharynx and how are they arranged?

A

There are 2 layers of muscle which supply the pharynx:

  • Inside we have longitudinal
  • Outside we have have constrictor muscles
31
Q

What are the 3 constrictor muscles of the pharynx?

A
  • Superior Constrictor
  • Middle Constrictor
  • Inferior Constrictor
32
Q

The 3 constrictor muscles _____ each other and are located Immediately anterior to the _________

They open _______ to nasal, buccal and _______and are attached posteriorly by the _______

They sequentially contract to propel food down the _______

A

overlap, prevertebral fascia, anteriorly, laryngeal cavities, median raphe, oesophagus

33
Q

Label the 3 contrictor muscles + other addition impt muscle

A
34
Q

Which contrictor muscle forms the floor of the tonsilar fossa?

A

Superior Constrictor

35
Q

What are the 3 stages of swallowing?

A

Oral (voluntary)
Pharyngeal (involuntary/reflex)
Oesophageal (involuntary/reflex)

36
Q

What is the function or the oral phase?

What occurs during this phase?

A

Lubrication and formation of food bolus by mastication

  • Tongue pushes bolus to back
  • Oesophageal sphincter contracted
  • (Epiglottis raised)
37
Q

What occurs during the pharyngeal phase?

A

1) Soft palate raised (nasopharynx closed off and eustachian tube opens)
2) Hyoid and Larynx raised
3) Epiglottis down and Tongue blocks off mouth
4) Sequential contraction of constrictors moves bolus into hypopharynx
6) Oesophageal sphincter relaxed

38
Q

What 3 muscles raise the Hyoid and Larynx during the pharyngeal phase

A

Action of tongue, longitudinal pharyngeal muscles and suprahyoid muscles

39
Q

What protects the larynx during the pharyngeal phase of swallowing?

A

Overhanging tongue, Epiglottis, Vocal cords

40
Q

When the nasopharynx closes why does our eustachian tube open?

A

To equalise pressure!

41
Q

What separates the nasopharynx from the oropharynx during swallowing?

A

Elevation of soft palate + constriction of the palatopharyngeal sphincter

This is why food doesn’t go up our nose when we swallow!!

42
Q

What happens with the Oropharynx AFTER chewing?

A

1) When holding food in mouth: oropharynx is sealed off
2) Opens for swallowing → THEN Oropharyngeal opening CLOSES
3) Laryngeal cavity is CLOSED
4) Food is directed towards oesophagus

43
Q

Can we breathe and swallow at the same time and why?

A

You CANNOT breathe and swallow at same time because airway is closed at 2 sites → the pharyngeal opening and the larynx

44
Q

What occurs during the oesophageal phase?

A

1) Epiglottis up
2) Hyoid and Larynx down
3) Oesophageal sphincter (cricopharyngeus) contracted
4) Peristalsis moves bolus to stomach

45
Q

What anatomical considerations must be made for swallowing and breathing

A

Pathway of breathing shown by yellow line
Pathway of swallowing is red line

There is overlap!! Hence we must consider where things may go wrong here… Eg. after a stroke we can get swallowing difficulties which can lead to aspiration pneumonia

Also in aesthetics we MUST protect the airways from anything going down airway (NBM)

46
Q

What is the sensory supply to each of the 3 sections of the pharynx?

A

Nasopharynx – Maxillary division of Trigeminal (V2)

Oropharynx – Glossopharyngeal (IX)

Layrngopharynx – (X)

47
Q

What is the motor supply to muscles of the pharynx?

A

All pharynx muscles = Vagus (X)

EXCEPT:

  • Stylopharyngeus - Glossopharyngeal (IX)
  • Tongue - Hypoglossal (XII)
  • Stylohyoid - Facial (VII)
48
Q

What is the blood supply to the pharynx

A

Superior Thyroid and Ascending Pharyngeal

*Both branches off ECA

49
Q

What is the venous drainage of the pharynx?

A

Pharyngeal venous plexus → Drains into IJV

50
Q

Label this X-ray

A

A.epiglottis

B. hyoid

C.laryngeal vestibule

D.cricoid

E.trachea

F.Cx6

Head and Neck (Semester 5) (22 decks)

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