5 - Upper airway, digestive tract and auditory apparatus

Question 1

What are the conchae?

Answer 1

also called the turbinate bones

specialised bones that stick out into the nasal cavity

Question 2

What type of epithelium lines the conchae?

Answer 2

Respiratory Epithelium

It increases the surface area for warming and humidifying the inspired air

Question 3

What name is given to the gaps between conchae?

Answer 3

Meati (superior, middle, inferior)

Question 4

Give the locations on the specific meati

Answer 4

superior meatus - between the superior and middle conchae
middle meatus - between the middle and inferior conchse
inferior meatus - inferior to the inferior concha

Question 5

What are the functions of the sinuses?

Answer 5

• warm and humidify the air
• immunological - help trap pathogens
• important in the drainage route of the sinuses

Question 6

What is the auditory/eustachian tube?

Answer 6

(also called the pharyngotympanic tube)

a tube that links the nasopharynx to the middle ear

Question 7

What is the name of the space superior to the superior concha?

Answer 7

Sphenoethmoidal Recess

Question 8

Which sinus drains into the sphenoethmoidal recess?

Answer 8

Sphenoidal Sinus

Question 9

What action does the epiglottis perform to close off the laryngeal inlet?

Answer 9

Retroflexion

Question 10

What is the role of the pharyngotympanic tube (Eustachian tube)?

Answer 10

Equalises the pressure on either side of the tympanic membrane by allowing a connection between the middle ear and the nasopharynx

Question 11

Name the functions of the paranasal sinuses

Answer 11

• to reduce the weight of the skull
• to provide a crumple zone
• help produce resonant sound and project the voice

Question 12

What significant structure is found inferior to the middle nasal concha?

Describe it

Answer 12

Semilunar Hiatus

a crescent-shaped groove in the lateral wall of the nasal cavity. It is the location of the openings for the frontal sinus, maxillary sinus, and anterior ethmoidal sinus.

Question 13

What is the main nerve of sensation to the face?

Answer 13

trigeminal nerve (V)

Question 14

Describe the innervation of the nasal cavities

Answer 14

trigeminal nerve
- V1 = anterior region
- V2 = posterior region
olfactory nerve = olfaction
facial nerve = glands
sympathetic nerves (from T1) = vascular smooth muscle

Question 15

What nerve innervates the paranasal sinuses?

Answer 15

trigeminal nerve

Question 16

Why is the blood supply of the nasal sinuses clinically significant?

Answer 16

the various sinuses drain into the cranial cavity

mean that pathogens from the air can enter into the cranial cavity - infection can have devastating consequences

Question 17

Where does the sphenoidal sinus drain?

Answer 17

Into the sphenoethmoidal recess

Question 18

Where does the nasolacrimal duct drain and what is its role?

Answer 18

To the lateral wall of the inferior meatus

It drains tears from the lacrimal sac to the nasal cavity (hence sniffling accompanies crying)

Question 19

What is the primary function of the larynx?

Answer 19

to close off the airways when swallowing occurs

Question 20

Through which membrane is a cricothyroidotomy performed?

Answer 20

Cricothyroid ligament

Question 21

What important cartilage is found attached to the top of the cricoid cartilage (from posterior aspect)?

Answer 21

Arytenoid cartilage

Question 22

What effect does tilting the thyroid cartilage forwards have on the vocal folds? Which muscles perform this action?

Answer 22

Puts tension on the vocal folds

Cricothyroid muscles

Question 23

What two things do the cricoid cartilage articulate with?

Answer 23

Arytenoid cartilage

Inferior horns of the thyroid cartilage

Question 24

What name is given to the protrusion between the laminae of the thyroid cartilage and what notches are found above and below this point?

Answer 24

Laryngeal prominence

Superior and inferior thyroid notch

Question 25

What are the two folds in the mucosa in the laryngeal inlet and how are they arranged?

Answer 25

``` Vestibular Fold (false vocal fold) Vocal Fold (true vocal fold) Vestibular folds are lateral to the vocal folds ```

Question 26

What membranous outpouching is formed between the two folds of the laryngeal inlet (vestibular and vocal folds?

Answer 26

Laryngeal ventricle and laryngeal saccule

Question 27

Which muscles are attached only to the arytenoids?

Answer 27

Transverse and Oblique Arytenoid muscles

Question 28

Which muscles are involved in abducting and adducting the vocal folds?

Answer 28

Posterior cricoarytenoid muscle – abduction (outwards) | Lateral cricoarytenoid muscle – adduction (inwards)

Question 29

What is the function the cricothyroid muscles?

Answer 29

its action (shortening) tilts the thyroid forward to help tense the vocal cords

Question 30

How does the vocals muscle differ in function to the rest of the muscles?

Answer 30

reduces tension and bring the thyroid cartilage closer to the cricoid - the thyroid tilts back (could be considered an antagonist muscle of the cricothyroid muscle)

Question 31

Which nerve provides sensory and motor control of the larynx?

Answer 31

Vagus Nerve

Question 32

What are the different laryngeal branches of the vagus nerve and what do these branches do?

Answer 32

Superior Laryngeal Nerve – separates into internal and external laryngeal -----> Internal Laryngeal – sensory above the vocal folds -----> External Laryngeal – motor to cricothyroid muscles Recurrent Laryngeal – sensory below the vocal folds + motor to all other muscles of the larynx

Question 33

Which arteries do the superior and recurrent laryngeal nerves run alongside?

Answer 33

Superior – Superior thyroid artery | Recurrent – Inferior thyroid artery

Question 34

Why is the left recurrent laryngeal nerve more susceptible to damage by bronchial/oesophageal tumours and swollen mediastinal lymph nodes than the right recurrent laryngeal nerve?

Answer 34

Because the left recurrent laryngeal nerve branches off the vagus much more inferiorly than the right so it has more of its length that is near the bronchus, oesophagus and mediastinal lymph nodes

Question 35

What are the common changes that occur during sneezing and coughing?

Answer 35

Inspiration Closed glottis and contraction of abdominal muscles Increase in intrathoracic pressure Sudden abduction of the vocal folds to release the intrathoracic pressure

Question 36

What is the difference in the oropharyngeal isthmus in coughing compared to sneezing?

Answer 36

In coughing, the oropharyngeal isthmus is open | When sneezing, it is closed

Question 37

How is the movement of the soft palate different in cough reflex compared to a sneeze?

Answer 37

Cough – soft palate is raised and tensed against the posterior wall of the pharynx Sneeze – soft palate is depressed against the tongue

Question 38

Which afferents take information from laryngeal receptors to trigger the cough reflex?

Answer 38

Vagus

Question 39

Which afferents take information from laryngeal receptors to trigger the sneeze reflex?

Answer 39

V2 - Maxillary branch of the Trigeminal nerve

Question 40

The soft palate is depressed against the tongue when sneezing to prevent the release of the pressure through the mouth. Which nerve and muscles are involved in this?

Answer 40

Vagus – palatoglossus/palatopharyngeus

Question 41

What happens to the vocal folds when sneezing and coughing?

Answer 41

They abduct

Question 42

What is the significance of the mastoid air cells in infection?

Answer 42

provide another route of infection to the cranial cavity ear infection -> infection of the mastoid process -> destruction of air cells can erode into the cranial cavity

Question 43

Name the arteries that that supply the superior parts of the nasal cavity and branch from arteries in the cranial cavity, providing a possible route of infection from the air

Answer 43

anterior ethmoidal artery | posterior ethmoidal artery

Question 44

What are the mastoid air cells and describe their connection with the middle ear.

Answer 44

They are small sinuses within the mastoid part of the temporal bone The mastoid air cells communicate with the middle ear via the aditus ad antrum (aditus to mastoid antrum) and the mastoid antrum This is a possible route for infection of the middle ear