13 - Pharynx Flashcards

1
Q

The pharynx is a musculofascial half-cylinder that links the

A

oral and nasal cavities in the head to the larynx and esophagus in the neck. The pharyngeal cavity is common for the respiratory tract and digestive tract.

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2
Q

Pharynx : Extends from skull base to

A

inferior border of cricoid cartilage (level of C6)

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3
Q

Pharynx : Consists of

A

circular & longitudinal mm. wrapped in fascia

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4
Q

Pharynx : Lined with

A

mucous membrane containing mucous glands

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5
Q

Pharynx: Lies posterior to the

A

nasal and oral cavities & the larynx

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6
Q

Pharynx: There are 3 regions:

A

Nasopharynx
Oropharynx
Laryngopharynx

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7
Q

Pharynx: There are 5 layers:

A
Mucosa (mucous membrane)
Submucosa
Pharyngobasilar fascia
Muscular layer
Buccopharyngeal fasica
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8
Q

Pharynx: Muscular layer

A

3 longitudinal mm (stylo -, salpingo-, palato- pharyngeus mm.)
3 outer circular or constrictor mm.

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9
Q

Nasopharynx: Structures: Auditory (Eustachian or pharyngotympanic) tube orifice –

A

posterior to inferior concha

Serves as connection between pharynx & middle ear

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10
Q

Nasopharynx: Structures: Torus tubarius –

A

posterior to auditory tube orifice (cartilage of auditory tube)

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11
Q

Nasopharynx: Structures: Pharyngeal recess –

A

posterior to torus tubarius

Groove along lateral pharyngeal wall

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12
Q

Nasopharynx: Structures: Pharyngeal tonsil –

A

postero-superior to torus tubarius

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13
Q

Nasopharynx structures: Salpingopharyngeal fold –

A

mucous membrane covering the salpingopharyngeus m.

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14
Q

Oropharynx: Posterior extension of

A

oral cavity

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15
Q

Oropharynx: Between soft palate &

A

epiglottis

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16
Q

Oropharynx: Passes thru 2 sets of

A

arches laterally

Palatoglossal arch
Palatopharyngeal arch

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17
Q

Oropharynx: Palatoglossal arch separates

A

oral cavity & oropharynx

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18
Q

Oropharynx: Palatoglossal arch –

A

mucosal fold over palatoglossus m.

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19
Q

Oropharynx: Palatopharyngeal arch –

A

mucosal fold over palatopharyngeus m.

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20
Q

Oropharynx: Palatine Tonsil –

A

in tonsillar bed between 2 palatine arches

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21
Q

Oropharynx: Vallecula –

A

fold posterior to the root of the tongue and anterior to the epiglottis.

~= to a “spit trap”
a temporary hold place for saliva during breathing

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22
Q

Laryngopharynx: Route air and food into

A

trachea and esophagus

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23
Q

Functions of the larynx:

A
  1. Phonation
  2. Regulate size of the opening between the vocal folds
  3. Prevent foreign bodies from entering the airway
  4. Act as a sphincter
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24
Q

Laryngopharynx continues inferiorly to approximately the level of

A

cervical vertebra C6 & the top of the esophagus

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25
Laryngopharynx: Structures:
``` Epiglottis Laryngeal cartilages Piriform recess – Internal laryngeal n. – Superior laryngeal vessels – Recurrent laryngeal n. – Inferior laryngeal vessels – ```
26
Laryngopharynx: Piriform recess –
extends laterally to thyroid cartilage
27
Laryngopharynx: Internal laryngeal n. –
descends beneath mucous membrane
28
Laryngopharynx: Superior laryngeal vessels –
run with internal laryngeal n.
29
Laryngopharynx: Recurrent laryngeal n. –
ascends beneath mucous membrane
30
Laryngopharynx: Inferior laryngeal vessels –
run with recurrent laryngeal n.
31
Recall that the pharynx is a
drape of musculature that is suspended from the cranial base. The posterior midline is the attachment of the R & L pharyngeal muscles, which attaches at the pharyngeal tubercle.
32
A special band of muscle, the palatopharyngeal sphincter originates from the
anterolateral surface of the soft palate and circles the inner aspect of the pharyngeal wall, blending with the inner aspect of the superior constrictor.
33
Thus, the palatopharyngeus muscle functions to
elevate the pharynx and in closure of the oropharyngeal isthmus.
34
When the superior constrictor constricts during swallowing, it forms a prominent
ridge on the deep aspect of the pharygneal wall that catches the margins of the elevated soft palate, which then seals closed the pharyngeal isthums between the nasopharynx and oropharynx.
35
Superior Pharyngeal Constrictor m.: Arises from
pterygomandibular raphe & medial pterygoid plate & mandible
36
Superior Pharyngeal Constrictor m.: | Meets buccinator m.
anteriorly
37
Superior Pharyngeal Constrictor m.: | Anchored to
pharyngeal tubercle of skull superiorly
38
Middle Pharyngeal Constrictor m.: Arises from
greater horn of hyoid bone & inferior portion of stylohyoid ligament
39
Middle Pharyngeal Constrictor m.: | Overlaps
superior constrictor m.
40
Middle Pharyngeal Constrictor m.: | Stylohyoid ligament, Stylopharyngeus m & CN IX pass between
supr. & middle constrictor mm.
41
Inferior Pharyngeal Constrictor m.: | Arises from
thyroid & cricoid cartilages
42
Inferior Pharyngeal Constrictor m.: | Overlaps
middle constrictor m.
43
Inferior Pharyngeal Constrictor m.: | Internal laryngeal n. & superior laryngeal a. pass between
middle & inferior constrictor mm. | Then these pierce thyrohyoid membrane
44
Elevators – Pharyngeal musculature
longitudinally orientated | Palatopharyngeas m.
45
Stylopharyngeus m. -
arises from styloid process | Descends to blend with fibers of lower constrictor mm.
46
Salpingopharyngeus m. –
arises from auditory tube Descends to blend with fibers of palatopharyngeus m. Covered by salpingopharyngeal fold of mucosa
47
Pharynx: Arterial Supply: Predominantly via
ascending pharyngeal & superior thyroid aa. (brs. of ECA)
48
Pharynx: Arterial Supply: Additional supply via
brs. of facial & maxillary aa. (brs. of ECA)
49
Tonsillar brs of lingual & facial aa.
Both brs. of external carotid a.
50
Ascending pharyngeal a.
Br. of external carotid a.
51
Tonsillar br. of the
Ascending Palatine a.
52
Lesser palatine a.
Br. of descending palatine a.
53
Pharynx: Innervation: Supplied via
pharyngeal plexuses of nn.
54
Pharynx innervation: Superior cervical ganglion – supplies
symp. nn. to plexus
55
Pharynx innervation: CN X – supplies
motor to pharyngeal mm.
56
Pharynx innervation: CN IX – supplies
motor to stylopharyngeus m & sensory to pharynx
57
Loss of motor nn. to pharynx leads to
marked dysphagia (difficulty swallowing)
58
Loss of sensory nn. to pharynx may cause loss of
gag reflex
59
Pharyngeal Tonsil: Consists of lymphoid tissue in
roof of nasopharynx
60
Pharyngeal Tonsil: When enlarged, referred to as
adenoids
61
Pharyngeal Tonsil: Large adenoids obstruct
air flow from nose to nasopharynx Makes mouth breathing necessary May also impinge upon torus turbarius & auditory tube orifice Obstructs air exchange between nasopharynx & middle ear
62
Piriform Recess: Accidentally swallowed objects may become
trapped here
63
Piriform Recess: Induce
choking sensation & severe coughing | Due to stimulation of int. & rec. laryngeal nn.
64
Piriform Recess: Sharp objects may pierce
mucosa Leads to infection Injures underlying nn. &/or vessels
65
Pterygomandibular raphe
lateral attachment for superior constrictor,
66
Border of oropharynx and nasopharynx
soft palate
67
Border of oropharynx and laryngopharynx
epiglottis
68
Epiglottis is a soft
seal
69
Soft palate forms a
hard seal
70
Palatopharyngeal sphincter is where
soft palate seals
71
Internal laryngeal
sensory
72
External laryngeal
motor to cricothyroid
73
Pharyngeal raphe maintains
tension on posterior wall
74
Cricopharyngeal muscle
inferior specialization of inferior constrictor
75
Salpingopharyngeus, palatopharyngeus, stylopharyngeas
3 elevators of pharynx
76
internal laryngeal nerve
in fold below piriform recess
77
Pharyngealepiglotic fold - lateral aspect of
valeculla
78
Superior pharyngeal constrictor and buccinator share attachment at
pterygomandibular tubercle
79
Pharyngeal fossa
room for vasculature
80
Oropharyngeal triangle
exactly as it sounds
81
Pharynx extra arterial supply
inferior thyroid a., pharyngeal branches
82
Pharynx venous drainage to
IJV
83
lymph tissue in pharynx
palatine tonsil, lingual tonsil - forms ring
84
Deglutition
swallowing
85
Swallowing
press bolus to roof with tongue tense soft palate, depress around bolus, elevate soft palate against pharynx (palatopharyngeal isthmus is where it seals). Now superior pharyngeal constrictor starts to constrict, tongue to roof fully, moves bolus inferiorly which drops epiglottis over laryngeal inlet (not a valve seal). Constriction of MPconstrictor and IPconstrictor moves bolus to esophagus.