Anatomy-Larynx, Nasal cavity w/ sinuses Flashcards
What is the opening to the larynx?
the aditus
What is the opening from the aditus to the vestibular folds?
vestibule
What is between the true and false vocal fold?
ventricle
What is below the true vocal folds?
infraglottic cavity
From the epiglottis to top fo crichoid cartilage is the (blank)
aditus
Will the aditus change size with swallowing?
yes
What is another name for the vestibular fold?
false vocal cord
What is the ventricle important for?
phonation
Does anythin contract the vocal folds?
no, the vibration of the vocal folds is caused by air moving past them (like a bassoon reed)
The area below vocal folds is the infraglottic cavity which takes you to the caudel end of the (Blank).
criocartilage
What is below the infraglottic cavity?
tracheal rings
What is the space between the epiglottis and the tongue?
valleculus
there is a very large cartilagenous mass called the (blank) which is a 2/3rd shield that is open (anteriorly/posteriorly)
thryoid cartilage
posteriorly
Which is more superior, the thryoid cartilage or cricoid cartilage?
thyroid cartilage
What is on top of the cricoid cartilage?
muscular process, arytenoids, vocal process
The vocal process has a (blank) that attaches between the vocal process and the anterior border of the thyroidcartilage.
ligament
Wat makes up a good part of the true vocal cords?
the vocal ligament
What does the muscular process do?
it has muscles attached to it which allows for the opening and closing of the vocal cords
Describe the orientation of the cricoid cartilage?
it is a complete ring with the posterior part being taller than the anterior part
What is between the thyroid cartilage and cricoid cartilage?
cricothyroid membrane
What is the core of the cricothyroid membrane made up of? What do the free edges of the cricothyroid membrane make up?
has an elastic core
part of the vocal ligament
Why type of joint is the cricoarytenoid joint and cricothyroid joint?
multiaxial synovial joint
What is the hole in the thyrohyoid membrane for?
it allows for the passageof the internal branch of the superior pharyngeal branch of the vagus
If you rock the cricocartilage forward towards the thyrocartilage,what will happen to the vocal ligament?
it will get tight
Who has a shorter vocal ligament, men or women?
women duhh
Insie the larynx there is a membranous mucous lining membrane that is called the (blank). This runs between the lateral aspect of the epiglotti and the arytenoid cartilage.
quadrangular membrane
What does the quadrangular membrane function in?
keep food from going into the aditus
What contains the cuneiform cartilage?
quadrangular membrane
What makes up the true vocal fold?
the conus elasticus
What makes up the false vocal fold?
the quadrangular membrane
The conus elasticus is a continuation of what membrane?
the cricothyroid membrane
What kind of effect does the quadrangular space have on the aditus?
purse string effect
What comes up between the cricocartilage and the thyroidcartilage?
the conus elasticus
Which is higher, the false or the true vocal cord?
the false vocal cord
What all does the free edge of the conus elasticus make?
true vocal fold and vocal ligament
The (blank) is the vocal fold plus the slit (rima glottidis) between the two folds.
glottis
What are all the structures that you find in the posterior side of the esophagus?
epiglottis aryepiglottic fold cuneiform tubercle corniculate tubercle arytenoideus lamina of cricoid cartilage (in order superior to inferior)
What are the structures you find in the anterior aspect of the esophagus?
vestibular fold ventricl vocal fold thryoid cartilage arch of cricoid cartilage (in order superior to inferior)
What kind of joint is the cricothyroid joint?
synovial joint
the movement of the cricothyroid joint occurs around what axis?
transverse axis
What does the cricothyroid joint articulate with?
the inferior cornu of thyroid and the cricoid cartilage
What is the only muscle not innervated by the recurrent laryngeal nerve?
the cricothyoid muscle (innervated by the external branch of the superior laryngeal branch of the vagus)
What does the cricothyroid muscle do?
tilts thyroid cartilage forward and allows for rocking, tension and elongation of vocal folds/cords
What is the only tensor muscle of the larynxand is a major rocker?
cricothyroid muscle
What kind of movement do you get around the cirocarytenoid joint?
abduction/adduction over a vertical or horizontal axis
with rotation or gliding
When you contract your cricothyroid what happens to your arytenoids and the vocal ligmanets?
they arytenoids go posteriorly and the vocal ligaments get stretched (adds tension)
What happens of your lose your recurrrent laryngeal nerve?
you will have a cricothyroid that will just cause tension and adduct your vocal ligaments (you lose your voice)
What does the posterior cricoarytenoid muscles do?
abduction of the vocal folds
What does the lateral circoarytenoid muscle do?
adduction of the vocal folds
What 2 muscles go in between the arytenoid cartilages?
the transverse and oblique arytenoids
What does the tranveres and obliqe arytenoids do?
adduct the vocal folds
What is a muscle that relaxes the vocal folds?
thyroarytenoids
What are the 2 mucles of the laryngeal inlet and what do they do?
purse string muscles that form thin muscle mass in the aryepiglottic fold made up of the quadrangular membrane
When what two muscles contract, will they pull in the walls of the aryepiglottic folds to decrease the size of the laryneal aditus?
aryepiglotics and thyroepiglottic muscles
What muscle is important for determining pitch?
the vocalis muscle
All the vocal cord movers are adducotrs in some form except for the (blank)
posterior cricoarytenoid muscle
All of the muscles of the larynx are innervated by the recurrent laryngeal nerve except for the (blank) which is by the (blank)
circothyroid (main tensor)
external branch of the superior laryngeal nerve
If something gets into the additus what is the reflex on?
in on 10 out on 10 and phrenic
all intrinisc muscles of the larynx are innervated by the (blank) except the criothyroid via the superior laryngeal
recurrent laryngeal nerve
What gives sensory innervation above the vocal folds?
the superior laryngeal nerve
What gives sensory innervation below the vocal folds?
recurrent laryngeal nerve
Where does the superior laryngeal artery come from?
the superior thyroid artery
Where does the inferior laryneal artery come from?
the inferior thryoid off the thyrocervical trunk
What artery follows the inferior laryngeal nerve?
the inferior laryngeal artery
What all does swallowing involve?
tongue, supra and infrahyoid muscles, organized contraction of pharyngeal constrictors
What happens when a bolus of food enters the throat?
the bolus pushes the the tongue posteriorly and deflects the epiglottis and will then run into the piriform recesses (epiglottis and piriform recesss help prevent food from entering the trachea)
On an MRI, how can you tell the difference between the pharynx and larynx?
the larynx is longer vertically and the pharynx is longer horizontal (pharynx is fat)
Developmental stages of nasal cavity include a period when it is continuous with the (blank)
oral cavity
the nasal prominence and olfactory placode form the nasal and oral cavity. What causes the induction of the nasal (olfactory) placode (blank)
forebrain
The oral cavity and the nasal cavity are contiguous and then we have to develop a hard and soft palate to divide two attachments from each other. the division of ths hard and soft palate is the critical development of the (blank)
face
How many prominences does the face develop from?
5 prominences (4 paired and 1 unpaired)
What are all the prominences and which is unpaired?
o Frontal – unpaired
o Medial and lateral nasal prominences (paired)
o Maxillary prominence (paired)
o Mandibular prominence (paired)
What is the prominence that is most important for normal facial development?
nasal (medial and lateral) and maxillary prominences and the frontonasal prominence
What causes cleft palate?
improper fusion of facial prominences
What is created by the growing together of the medial nasal prominences?
the philtrum of the upper lip, the incisor portion of the upper jaw, trianular primary palate back to incisive canal
Where will you most likely get a cleft palate problem?
with the upper prominance
What does the maxillary prominence fuse with?
the medial nasal prominence and lateral nasal prominence
What becomes the nostrils?
the frontonasal prominence
What will the medial nasal prominence become? What might a deformation cause here?
the bridge of the nose and the nostril flares (ala)
Brain damage
What will the maxillary promience become?
part of upper lip and bulk of palatine shelves that make up hard palate
If the maxillary and lateral dont fuse properly what kind of cleft palate can you get?
oblique
What are the 3 points of fusion?
o b/w 2 medial nasal
o medial nasal and maxillary on each side
o maxillary with lateral nasal
If you get a cleft due to improper fusion of the lateral nasal cavity and the maxillary prominence what can this lead to?
disruption of the nasolacrimal duct
What does the frontonasal prominence form?
the nasal septum
What does the incisive canal gives us a landmark for?
between the primary palate and the secondary palate
The philtrum of the upper lip, the incisor portion of the upper jaw and the triangular primary palate back to the incisive canal are formed by the growing together of the (blank)
medial nasal prominences
What make all the stuff anterior to the incisive canal (i.e primary palate and upper lip)
the medial nasal prominence
As you go posterior to incisive canal (dividing line between primary and secondary palates) there will be a contribution from the (blank)
maxillary prominence and the nasal septum of frontonasal prominence
Is cleft lip more common in males or females? Is this maternal age dependent?
males
yes, this is maternal age dependent
Is Isolated cleft palate more or less common and found in males or females and is this maternal dependent?
less common, females, not maternal dependent.
Do clefts have a genetic or environemental component?
yes, both
Are cleft palate associated with mental retardation?
some are (usually the midline varieties)
What is a midline cleft problem?
the 2 median nasal prominence and palatine shelf isnt coming together so there in incomplete formation of neural tube
What is the most severe cleft palate and why?
midline cleft problem because it is associated with mental retardation
Any defect in the vicinity of the primary palate is due to failure to fuse of the (blank) and (Blank). what kind of cleft is this?
medial nasal and maxillary prominences
cleft lip, cleft primary palate
Cleft secondary palate is due to fusion failure of the (blank)
palatine shelves of the maxillary prominence
Can you get combined clefts?
yes
Oblique clefts are from fusion failure between (blank) and (Blank) exposing the (blank) duct.
maxillary
lateral nasal prominence
nasolacrimal duct
Are midline cleft common?
no they are rare
What makes up the lateral wall of the nasal cavity?
Ethmoid bone Palatine bone Lacrimal bone Maxillarybone Inferior concha Sphenoid bone Frontal bone Nasal bone
How many concha are there? and what is under each one of these?
3 (superior, middle and inferior concha) a meatus (superior meatus, middle meatus, inferior meatus)
Where is the biggest space?
under the inferior concha
What opening is in the inferior meatus?
the nasolacrimal duct
What opening is found within the middle meatus and is the opening for the frontal and maxillary sinus?
the hiatus semilunares
Where do you find the bulla?
in the middle meatus
How does the sphenoid sinus get into the superior meatus?
through the sphenoethmoidal recess
When we tand in the erect posture is the maxillary sinus above or below the meatus?
below the meatus
How do you get stuff to drain out the maxillary sinus if the sinus is below the opening into the middle meatus?
there is cilia that beats up toward the opening
What are the four paranasal sinuses and describe where they are located?
maxillary -> under eyes next to nose (big circles)
frontal-> located above eyes
ethmoidal-> between your eyes and go posteriorly
sphenoid-> right in front of optic chiasm
are sinuses present in newborns?
no
when do sinuses begin to form?
1 year
What is the sinus that appears at 1 year?
maxillary sinus
What are the sinuses that are present at 6 years?
sphenoid sinus
ethmoid sinuses
maxillary sinuses
What are teh sinuses that are present at 10 years?
sphenoid sinus
ethmoid sinus
frontal sinus
maxillary sinus
When are sinuses completely developed?
at 21
What is th nerve supply to the lateral wall nasal wall?
ethmoid nerves from nasociliary branch of V1
posterior nasal branches from palatine nerves and ganglion
What does the anterior ethmoidal nerves do?
gives sensory innervation to the mucosa lining of the lateral nasal cavity (sympathetics are on there too)
What do the posterior branches form the palatine ganglion do?
gives sensory innervation to mucous membrane and carry some parasympathetics to the mucous glands
Where does the posterior nasal nerve coem from?
from pterygopalatine ganglion or palatine nerves
What branch of the trigeminal also gives sensory innervation to the lateral wall?
V2
What makes the bony and cartilaginous septum of the medial wall of the nasal cavity?
perpendicular plate of ethmoid
septal cartilage
vomer
Where do you find these structure:
nasal septum
choanae
nasopharynx
medial wall of nasal cavity
What is the blood supply of the nasal cavity?
branch of maxillary artery (sphenopalatine)
ethmoidal arteries
facial artery
Where do the ethmoidal arteries come from?
the opthalmic artery
Why are nose bleeds that come from the facial artery easier to stop than other types of nose bleeds?
because the facial artery is compressible will the sphenopalatine and ethmoidal arteries arent
What is the nerve supply to the medial wall of the nasal cavity?
anterior ethmoidal branch
nasopalatine nerve
nasopalatine nerve in incisive canal
What nerve goes through the incisive canal?
the nasopalatine nerve
Where does the anteiror ethmoidal branch come from?
v1
Where does the nasopalatine nerve come from?
V2
What does the pterygopalatine fossa contain?
maxillary nerve
maxillary artery
pterygopalatine ganglion
What does the pterygopalatine fossa do?
sends innervation and blood supply to nasal cavity, palate, teeth and skin of face
There are (blank) openings of the pterygopalatine fossa
6
What needs to enter the pterygopalatine fossa?
an artery
a nerve
parasympathetic and sympathetics
What artery enters the pterygopalatine fossa and how?
maxillary artery-> pterygomaxillary fissure
What nerve enters the pterygopalatine fossa and how?
V2 (maxillary nerve) through foramen rotundum
How do sympathetics/parasympathetics get into the pterygopalatine fossa?
greater petrosal (parasympathetics) and deep petrosal (sympathetics) pterygoid canal
What does the infraorbital nerve give off before entering the orbit?
the anterior, middle, and posterior superior alveolar nerves
What comes off of the pterygopalatine ganglion?
the lesser and greater palatine nerves
What does the lesser palatine nerve innervate and is located anteriorly or posteriorly?
posterior and soft palate
What does the greater palatine nerve innervate and where is it located?
the hard palate and is anterior
What needs to leave the pterygopalatine fossa and how?
infraorbital nerve-> infraorbital fissure
greater and lesser palatine nerve, branches of V2-> palatine canal
nerves (nasopalatine) and blood supply to nasal cavity-> sphenopalatine foramen.
What comes off the pterygopalatine ganglion?
palatine nerves, some lateral nasal branches, nasopalatine nerve
Does the maxillary nerve carry pre or post ganglionic parasympathetics?
postganglionic parasympathetics
