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FM 1030 > A L3 - > Flashcards

A L3 - Flashcards

1
Q

What are the 2 main triangles of the neck - what muscles divides it into these?
What are the boundaries of the anterior triangle?
What are the triangles within the anterior triangle and their boundaries?

A
  • Posterior and anterior
  • The SCM
    ANTERIOR BOUNDARIES:
    – Mandible
    – SCM
    – Imaginary midline of neck
    – Apex - where SCM meets imaginary midline
    Anterior Triangles:
    – Submental (Hyoid bone, anterior digastrics)
    – Submandibular ( Mandible, anterior and posterior digastric)
    – carotid (SCM, superior belly of omohyoid, posterior digastric)
    – Muscular (midline of neck, hyoid bone, SCM, superior omohyoid)
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2
Q

Origin + Insertion + action + nerve supply of SCM

A

O- Manubrium of sternum and medial 1/3 of clavicle
I- Mastoid process of skull
A - Rotates neck so face is turned superiorly to opposite side, tilts head laterally, flexes neck
N- Accessory nerve, upper cervical nerves

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3
Q

What are the infrahyoid muscles?
Origin + Insertion + action + nerve of them?

A

Muscles situated below the hyoid bone:
Omohyoid
O- superior border of scapula near the suprascapular notch
I- hyoid bone
A - depressed hyoid bone
N- cervical nerves

Sternohyoid
O- Manubrium of sternum
I- Hyoid bone
A - depresses the hyoid bone after swallowing
N- cervical nerves

Sternothyroid
O- Manubrium of sternum
I- thyroid cartilage
A - depresses larynx
N- cervical nerves

Thyrohyoid
O- Thyroid cartilage
I- hyoid bone
A - depresses hyoid bone
N- cervical nerves

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4
Q

What are the suprahyoid muscles?
Origin + Insertion + action + nerve of them?

A

Muscles that lie superior to the hyoid bone:

Digastrics:
O- Anterior —> Inner surface of mandible Posterior –> Mastoid process of skull
I- Intermediate tendon
A - Elevates hyoid bone ( directly up)
N- Anterior—> Mandibular division of trigeminal nerve (V3) Posterior —> Facial nerve

Mylohyoid:
O- Inner surface of mandible of each side
I- Hyoid bone and raphe
A - Elevates hyoid bone (up and forwards)
N- nerve to mylohyoid (branch of mandibular division of trigeminal n. - V3)

Stylohyoid:
O- Styloid process
I- Hyoid bone
A - Elevates hyoid bone (up and backwards)
N- Facial nerve

Geniohyoid:
O- Inner surface of mandible
I- Hyoid bone
A - Elevates hyoid bone (up and forwards)
N- cervical nerves

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5
Q

What is the only infrahyoid muscle that doesnt depress the hyoid bone?

A

The sternothyroid
it depresses the larynx

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6
Q

What muscles elevate the hyoid bone? what muscles depress them?

A

The suprahyoid elevate them and the infrahyoid depress them

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7
Q

What muscle depresses the larynx?

A

the sternothyroid muscle

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8
Q

Which suprahyoid muscles supplied by facial nerve?

A

The posterior digastric and stylohyoid

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9
Q

Which musc. helps open mouth?

A

Digastrics

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10
Q

Which musc. helps in swallowing?

A

The mylohyoid and the sternohyoid

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11
Q

Which musc. depresses the mandible?

A

geniohyoid

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12
Q

Which suprahyoid muscles supplied by mandibular division of trigeminal nerve?

A

Mylohyoid (nerve to mylohyoid)
anterior digastric

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13
Q

What are strap muscles?

A
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14
Q

What structure is responsible for voice production? what is continuous with above and below?

A

Larynx
Above - laryngopharynx
Below - trachea

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15
Q

What are the cartilages of the larynx? Which are paired and unpaired?

A

UNPAIRED:
Thyroid cart.
Cricoid cart.
Epiglottis

PAIRED:
Arytenoids
cuneiforms
Corniculates

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16
Q

Which is the only cartilage that forms a complete ring?

A

cricoid

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17
Q

Which cartilage forms the adam’s apple? why is this more prominent in males?

A

thyroid - the laryngeal prominence (formed by the fusion of the 2 thyroid laminae)
– More prominent in males because the angle made my the laryngeal prominence is more acute in males.

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18
Q

What is the anterior aspect of the cricoid cartilage called?

A

cricoid arch

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19
Q

What two part of the thyroid cartilage fuse to form the laryngeal prominence?

A

The two Laminae

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20
Q

How many processes do the arytenoid cartilages have? Which one of these is attached to the vocal cords?

A

They have 3 processes (vocal processes and muscular processes)
The anterior processes (vocal) are attached to vocal cords

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21
Q

What do the vocal cords/ligaments attach to?

A

Anterior processes of arytenoid cartilages and the posterior aspect of the thyroid cartilage

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22
Q

Which borders of the epiglottis are free? and where is attached?

A

The lateral and superior borders
inferiorly to the posterior aspect of the thyroid cartilage

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23
Q

Where do the paired cartilages (apart from arytenoid) lie?

A

in the Aryepiglottic fold

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24
Q

Name all the membranes of the larynx and what they are attached to/link together.

A

Cricothyroid membrane
Quadrangular membrane
Hyo-epiglottic fold
Thyrohyoid membrane
Cricotracheal membrane

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25
Q

What forms the vocal ligament?

A

The upper border of the cricothyroid membrane

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26
Q

What forms the vestibular ligament?

A

The lower border of the quadrangual membrane

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27
Q

What forms the true vocal cord/vocal fold and the false vocal cords?

A

Mucosal layer covering

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28
Q

Which membrane is frequently pierced in states of emergency where theres something blocking their airway above the level of the vocal cords?
What is this called?

A

The median cricothyroid ligament is pierced – cricothyroidectomy.
– Thickening of the cricothyroid ligament in front

29
Q

What is the laryngeal inlet?
What are its boundaries?

A

Entrance into larynx

Epiglottis
Aryepiglottic folds
Interarytenoid folds

30
Q

What is the aryepiglottic fold? Which structures are suspended in this?

A

It is a fold in the mucosa passing from the lateral borders of the epiglottis posteriorly to the arytenoid cartilages
It contains the cuneiform and the corniculate cartilages

31
Q

What is epiglottitis? What cld it result from? What structure does it narrow? What cld this result in?

A

Inflammation of epiglottis that may result from a viral infection of the larynx
– swelling narrows the laryngeal inlet which may result in breathing difficulties and require an emergency airway

32
Q

What are the 3 compartments of the larynx and their borders? What divides the larynx into these?

A

Vestibule:: Laryngeal inlet –> False vocal folds

Ventricle:: False vocal/Vestibular fold –> True vocal fold

Infraglottic cavity:: True vocal folds –> C6 level - it’s continuous with trachea

33
Q

What makes up the:
Glottis
Supraglottis
Subglottis

A

Glottis:: The true vocal folds and the rima glottidis

Supraglottis:: space above the true vocal folds (ventricle + vestibule)

Subglottis:: space below true vocal folds (infraglottic cavity)

34
Q

What are the spaces between the true and false vocal cords called?

A

true vocal cords:
– Rima glottidis

False vocal cords:
– Rima vestibuli

35
Q

What are the joints of the larynx? What type?
Articulations? What type of movement occurs at them? What do they do?

A

Synovial joints::

  1. Cricothyroid –> btwn cricoid and thyroid cartilages
    – move back and forth to alter vocal cord tension and length
  2. Cricoarytenoid –> btwn cricoid and arytenoid cartilages
    – slide and rotate to narrow or widen rima glottidis
36
Q

What are the intrinsic musc of larynx attached to? What are their 2 broad functions?

A

Muscles that alter the size and shape of the laryngeal inlet.
Muscles that alter the vocal cords - alter length and thus tension, abduct/adduct vocal cords.

37
Q

What intrinsic muscles:
- Alter tension of VCs
- Abduct VCs
- Adduct VCs

A

Tension:: Cricothyroid (vaires pitch). + Vocalis (vaires tonal qualities - used for animated speech)

Abduction:: posterior cricoarytenoids

Adduction:: lateral cricoarytenoids + Transverse arytenoid muscles

38
Q

What is the function of cricothyroid muscles? Nerve supply?

A

external branch of superior laryngeal nerve

Alter tension and length of VCs – regulate pitch of voice

39
Q

Which muscle is responsible for animated speech?

A

Vocalis muscle

40
Q

What do the posterior and lateral cricoarytenoid musc do?

A

Posterior – abduction
Lateral – adduction (also transverse arytenoid)

41
Q

Someone has lost the high pitch of their voice – What has most likely happened? What surgical procedure could have resulted in this and why?

A

Damage to the external laryngeal nerve – supplied the cricothyroid muscle which regulates tension of vocal cords and thus pitch of the voice

  • Can occur during thyroid surgery
  • Nerve is closely related to the superior thyroid artery
  • So can be damaged during thyroid surgery
42
Q

Muscles that change size and shape of inlet?

A

– aryepiglottic musc.
– thyroepiglottic musc.
– oblique and transverse arytenoids.

43
Q

Muscles that abduct/adduct/change tension of vocal cords

A

Change tension::
- Vocalis – used in animated speech.
- Cricothyroid – changes tension to increase the pitch of voice.

Abduct::
- Posterior cricoarytenoid

Adduct::
- Lateral cricoarytenoid
- Transverse arytenoid.

44
Q

What structure are the external laryngeal nerves closely related to?

A

Superior thyroid arteries

45
Q

What nerve(s) provides innervation to the larynx?

A

Motor:
External laryngeal nerve (branch of superior laryngeal n. which is a branch of vagus):
— Supplies the cricothyroid muscle which controls the tension of the vocal cords. —-> Injury to this nerve prevents high pitch of voice.

Recurrent laryngeal nerve (branch of vagus):
— Supplies all intrinsic muscles of larynx apart from the cricothyroid. —> Damage to this nerve will affect muscles that cause adduction and abduction of vocal cords and alter size and shape of laryngeal inlet

Sensory:
Mucous memb. above true vocal folds :
– Internal laryngeal nerve (branch of superior laryngeal n. of vagus n.)

Mucous memb. below true vocal folds :
– Recurrent laryngeal n. (branch of vagus n.)

46
Q

Describe the motor innervation to the larynx. What happens if these nerves are injured?

A

External laryngeal nerve (branch of superior laryngeal n. which is a branch of vagus):
— Supplies the cricothyroid muscle which controls the tension of the vocal cords. —-> Injury to this nerve prevents high pitch of voice.

Recurrent laryngeal nerve (branch of vagus):
— Supplies all intrinsic muscles of larynx apart from the cricothyroid. —> Damage to this nerve will affect muscles that cause adduction and abduction of vocal cords and alter size and shape of laryngeal inlet

47
Q

Describe the sensory innervation to the larynx.

A

Mucous memb. above true vocal folds :
– Internal laryngeal nerve (branch of superior laryngeal n. of vagus n.)

Mucous memb. below true vocal folds :
– Recurrent laryngeal n. (branch of vagus n.)

48
Q

Damage to which nerve would result in a problems of abduction, adduction of vocal cords and changing size and shape of laryngeal inlet

A

recurrent laryngeal nerves

(branches of this nerve supply all intrinsic musc. of larynx except cricothyroid)

49
Q

Which nerve supplies sensory innervation to the mucous membrane below the vocal folds and which one above?

A

Mucous memb. above:
– Internal laryngeal nerve (branch of superior laryngeal n. of vagus n.)

Mucous memb. below:
– Recurrent laryngeal n. (branch of vagus n.)

50
Q

Pathway of vagus nerve? Its innervation in the thorax and path of right and left vagus nerves?

A
51
Q

Branches of vagus nerve?

A
  • Pharyngeal branch (motor innervation to most of the pharynx and soft palate)
  • Superior laryngeal n. (External and internal branches)
  • Recurrent laryngeal
52
Q

What do the vagus nerves provide parasympathetic innervation to?

A

Provides parasympathetic innervation to the thoracic viscera and carries sensory fibres from here.

53
Q

What structure do the vagus nerves do they pass to enter the superior mediastinum and from where?

A

Vagus nerves enter the superior mediastinum by passing posterior to the brachiocephalic veins.

54
Q

Pathway of right and left vagus nerves

A
55
Q

What do the vagus nerves pass thru to enter the abdomen?

A

Pass thru the diaphragm via the T10 opening.

56
Q

Where do the left and right recurrent laryngeal nerves branch off and where do they pass through?

A

right – loops under r subclavian
left – loops under aortic arch

57
Q

What type of injuries/diseases are more likely to affect the left vagus only?

A
  • Disease of the thorax – ex. cancer of the thorax - leads to enlarged lymph nodes and more likely to compress left vagus over right.
  • Aneurysm in the aortic arch – in the area of the aortopulmonary window – compresses left vagus.
58
Q

What type of injuries/diseases are more likely to affect the right vagus only?

A

— Cancer of the right apex of the lung - can result in injury/compression of R. vagus.

59
Q

What groove do the right and left recurrent laryngeal nerves ascend in?

A

Descend in the groove btwn the oesophagus and trachea.

60
Q

what procedures can risk damage to both recur. laryng. nerves? and why?

A

Carcinoma of the oesophagus – may affect recurrent laryngeal nerves

Surgery to the thyroid gland – Injury to thyroid arteries may result in injury to recurrent laryngeal nerves or the internal and external laryngeal nerves.
—- Recurrent laryngeal n - inferior TA
—- External L.n. - Superior TA
—- Internal L.n. - superior laryngeal A.

61
Q

What is the blood supply to the larynx by?

A

– Superior laryngeal artery (branches of superior thyroid which is a branch of ECA)
– Inferior laryngeal artery (branch of Inferior thyroid A. which is a branch of subclavian A.)

62
Q

Laryngoscopy - What is it? Why is it done? What are the 2 types?

A
63
Q

What is the piriform fossa? where? clinical significance?

A

located of either side of the epiglottis at the entrance to the larynx
sharp ingested bodies can get dislodged here like fish bones

64
Q

what may result in the hoarseness/loss of voice?

A

Damage to external laryngeal nerve (supplies cricothyroid)

65
Q

How many groups of lymph nodes in the neck? Name them and where they’re located?

A

8 cervical lymph nodes

66
Q

In the mediastinum, name the vessels which cross the trachea on each side.

A

Arch of aorta on left side and arch of the azygos vein on right side

67
Q
A
68
Q

What structures are the following closely related to:
- external laryngeal n. (branch of superior laryngeal n)
- recurrent laryngeal nerves
- Internal laryngeal n.

A
  • external laryngeal n. –> superior thyroid A.
  • recurrent laryngeal nerves –> Inferior thyroid A.
  • Internal Laryngeal n —> Superior laryngeal A. (branch of sup. Thyroid A.)

FM 1030 (18 decks)

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