Anatomy questions for pharynx + larynx

Question 1

what is the sublingual caruncle?

Answer 1

a blob below the frenulum

the opening for the submandibular glands

Question 2

name 2 muscles that make up the floor of the mouth, and their innervation

Answer 2

geniohyoid - C1 via CN12

mylohyoid - CN V3

Question 3

what CN innervates the salivary glands?

Answer 3

subman + sublingual = CN 7

parotid = CN9, hitching on CNV3

Question 4

what nerve for taste + sensory of the anterior 2/3rds?

Answer 4

taste = CN7

general sensory = CN V3

Question 5

what nerve for the posterior 1/3rd of tongue?

Answer 5

CN 9

Question 6

what foramen foes the thyroid descend through’?

Answer 6

foramen caecum

Question 7

test for injury of the CN 12?

Answer 7

tongue out

moves towards side of injury

Question 8

test for CN 10 injury?

Answer 8

say ahhhh

moves away from side of injury

Question 9

what nerves supply the 5 muscles of the soft palate?

Answer 9

TVP = CN V3

ALL OTHERS = CN 10
includes LVP + palatoglossus + palatopharyngeus + musculus ulvulae

Question 10

what are the three longitudinal (paired) muscles of the pharynx?

what innervates them?

Answer 10

1. stylopharyngeus = CN 9
2. palatopharymgeus = CN10
3. salphingopharyngeus = CN10

all constrictors + longituninal of pharynx are CN10 except stylopharyngeus

Question 11

what do the longitudinal pharynx muscles do?

Answer 11

pull the larynx up to allow the pharynx to shorten during swallow

Question 12

what 3 things travel through the “gaps to the mouth” between the constrictor muscles?

Answer 12

1. stylopharyngeus longitunidual pharynx muscle
2. • its innervation, CN9
3. also the lingual artery which supplies the oral floor + the tongue

Question 13

what nerve has a pharyngeal plexus on the common carotid ?

Answer 13

CN 10

Question 14

where does the salpingopharyngeus muscle originate?

Answer 14

near the eustachian tube opening in the nasopharynx - starts at the salph. fold which is part of the curvy bit

Question 15

what lymph node drains the palatine tonsil?

Answer 15

Jugulodigastric lymph node

Question 16

what veins do the deep cervical + superficial cervical lymph nodes lie on?

Answer 16

deep = internal jugular vein
superficial = external jugular vein

Question 17

name the 4 tonsils from superior to inferior.

Answer 17

1. pharyngeal (AKA adenoid )
2. tubal
3. palatine
4. lingual tonsil

Question 18

what spinal levels is the larynx at?

Answer 18

C 4-6

Question 19

functions of the larynx

Answer 19

URT patent
Stops aspiration into LRT
Sounds - vocal cords
Cough reflex involvement

Question 20

what is “cricoid pressure”

Answer 20

a technique used in endotracheal intubation. pressing down on the cricoid cartilage onto C6 to obstruct the oesophagus while leaving the airway open.

it lowers risk of aspiration in the procedure

aka Sellick maneouvre

Question 21

what is the aryepiglottic fold?

Answer 21

the superior border of the quadrangular membrane…

which is between the Vestibular ligament (false VC) and the epiglottis.

Question 22

where is the conus elasticus?

Answer 22

between the vocal cords + the cricoid cartilage

Question 23

what is the name for the depression just behind the root of the tongue between the folds in the throat.

Answer 23

Vallecula

where the laryngoscope is put (between epi + tongue)

Question 24

innervation of the intrinsic larynx muscles?

Answer 24

CN 10 for all of them

• cricothyroid is external laryngeal nerve
• all others are internal laryngeal nerve

Question 25

when does inferior laryngeal nerve begin

Answer 25

at the cricothyroid level (from left recurrent laryngeal nerve)

Question 26

what muscle is used for forced respiration + loud speaking?

Answer 26

abductor = Posterior cricoaryntenoid

Question 27

what muscle is used for normal breathing + low pitch?

Answer 27

relaxors = thyroaryntenoid

Question 28

what muscle is used for high pitch?

Answer 28

tensors = cricothyroid

Question 29

what muscles contract to allow whispering?

Answer 29

adductors = specifically the lateral crico-aryntenoid

Question 30

a tumour starts growing just above the hyoid level. what LNs will it spread to?

Answer 30

supra glottic = superior deep cervical lymph nodes

Question 31

a tumour starts growing on the thyroid cartilage. what LNs will it spread to?

Answer 31

subglottic = paratracheal nodes. affect voice + airway

Question 32

a tumour starts growing on the epiglottis. where will it spread?

Answer 32

95% wont - just stay there. will affect voice + airway though

Question 33

explain how sound is made

Answer 33

1. controlled expiration helps build subglottal pressure
2. SG pressure threshold reached
3. air across the cords = vibrations
4. the vibration buzz is amplified by the oral/ nasal cavities + pharynx

Question 34

explain how sound can come out of the nose instead of mouth - what nerves are involved?

Answer 34

v3 = tenses the soft palate

CN 10 = descend the soft palate to close the oropharynx

CN12 alters tongue shape
CN 7 alters teeth + lips

Question 35

explain how sound can come out of the mouth instead of the nose - what nerves are involved?

Answer 35

V3 = tense the soft palate
CN 10 = elevate the soft palate to close the nasopharynx
CN 12 alters the tongue shape
CN7 alters teeth + lips

Question 36

the muscosa of the larynx is supplied by what 2 nerves?

where do they join?

Answer 36

above vocal folds = internal laryngeal
below = inferior laryngeal
join @ GALEN’S anastomosis at vocal folds

Question 37

CN10 innervates the palate + pharynx + larynx. how do you test that it is working in each site?

Answer 37

palate = SAY AHHHHH (moves away)
pharynx = sip some water - splutter?
larynx = are they hoarse?

also ask em to cough to test vagal control of diaphagm etc