AP01 - Basic topo of upper resp tract

Question 1

What are the different paranasal sinuses?

Answer 1

1. Frontal sinus
2. Ethmoid sinus
3. Sphenoid sinus
4. Maxillary sinus

Question 2

What are the two main groups of muscles of the pharynx?

Answer 2

1. Longitudinal muscles

2. Circular muscles

Question 3

What muscles make up the longitudinal muscles of the pharynx?

Answer 3

1. Stylopharyngeus
2. Palatopharyngeus
3. Salpingopharyngeus

Question 4

Where does the stylopharyngeus arise from?

Answer 4

Arises from styloid process of temporal bone, inserts into the pharynx

Question 5

Which nerve innervates the stylopharyngeal muscle?

Answer 5

Glossopharyngeal nerve

Question 6

Where does the palatopharyngeus muscle arise from?

Answer 6

Arises from hard palate of oral cavity, inserts into the pharynx

Question 7

Which nerve innervates the palatopharyngeus

Answer 7

Vagus nerve

Question 8

Where does the salpingopharyngeus muscle arise from?

Answer 8

Arises from Eustachian tube, inserts into the pharynx

Question 9

Which nerve innervates the salpingopharyngeus?

Answer 9

Vagus nerve

Question 10

What muscles make up the circular muscle group of the pharynx?

Answer 10

1. Superior pharyngeal constrictors
2. Middle pharyngeal constrictors
3. Inferior pharyngeal constrictors

Question 11

Where is the superior pharyngeal constrictor muscle located?

Answer 11

Oropharynx

Question 12

Where is the middle pharyngeal constrictor muscle located?

Answer 12

Laryngopharynx

Question 13

Where is the inferior pharyngeal constrictor muscle located?

Answer 13

Laryngopharynx

Question 14

Which nerve innervates the pharyngeal constrictors?

Answer 14

Vagus nerve

Question 15

What are the four different types of tonsillar structures?

Answer 15

1. Pharyngeal
2. Tubal
3. Palatine
4. Lingual

Question 16

Function of paranasal sinuses?

Answer 16

• Humidify the inhaled air
• Contribute in voice resonance
• Reduce the weight of the skull

Question 17

What is the pharyngotmpanic tube?

Answer 17

• Aka Eustachian tube or auditory tube

- Links the nasopharynx to the middle ear

Question 18

Function of the pharyngotympanic tube?

Answer 18

Protect, aerate and drain the middle ear (and mastoid); equalises pressure on both sides of the tympanic membrane

Question 19

What is the innervation of the pharyngotympanic tube?

Answer 19

Tympanic plexus

- Tympanic nerve (branch of glossopharyngeal nerve)

Question 20

What is the function of the pharyngeal tonsils?

Answer 20

• aka adenoids

- Provide protection against infections and flush away unwanted particles

Question 21

What is the function of the tubal tonsils?

Answer 21

• Lymphoid tissue around the opening of the Eustachian tube in the lateral wall of the nasopharynx
• aka Gerlach tonsil
• Form the lateral aspect of Waldeyer’s ring

Question 22

What is the posterior opening to the nasal cavity called?

Answer 22

Choanae (posterior nasal apertures)

Question 23

What is the anterior opening to the nasal cavity called?

Answer 23

Nares (nostrils)

Question 24

Which paranasal sinus is the largest?

Answer 24

Maxillary sinus

Question 25

What cavity is inferior to the nasal cavities and what are they separated by?

Answer 25

Oral cavity

- Separated by the hard and soft palates

Question 26

What is the function of the palatine tonsil?

Answer 26

• Protecting the body against resp and gastrointestinal infections (entry of exogenous material through mucosal sites)
• One of the MALT (mucosa-associated lymphoid tissues)

Question 27

What is the function of the lingual tonsils?

Answer 27

• Prevent infections

- Contains B and T lymphocytes

Question 28

Where are the pharyngeal tonsils found?

Answer 28

In the mucous membrane of the roof and posterior wall of the nasopharynx

Question 29

What is the arterial blood supply of the pharyngeal tonsil?

Answer 29

Ascending palatine artery 
= Ascending pharyngeal artery (external carotid)
= Pharyngeal branch of maxillary artery
= Artery of pterygoid canal 
= Basisphenoid artery 
= Tonsillar branch of facial artery

Question 30

What is the neurovasculature of the tubal tonsil?

Answer 30

Arterial supply = Ascending pharyngeal artery
Venous drainage = Pharyngeal plexus
Lymphatic drainage = Retropharyngeal and deep cervical lymph nodes
Innervation = Maxillary ad glossopharyngeal nerves

Question 31

What is the neurovasculature of the palatine tonsil?

Answer 31

Arterial supply = Tonsillar branch of facial artery; pierces the superior constrictor muscle to reach the palatine tonsil
Venous drainage = External palatine vein (drains into facial vein) and numerous small vessels draining into the pharyngeal plexus
Lymphatic drainage = Jugulodigastric and upper deep cervical lymph nodes
Innervation = Maxillary and glossopharyngeal nerve

Question 32

What is the neurovasculature of the lingual tonsil?

Answer 32

Arterial supply = Lingual artery
Venous drainage =
Lymphatic drainage =
Innervation =

Question 33

What is the venous drainage of the pharyngeal tonsil?

Answer 33

Via numerous small veins which pierce the superior constrictor muscle to empty into the internal jugular vein

Question 34

What is the lymphatic drainage of the pharyngeal tonsil?

Answer 34

Drains into the retropharyngeal nodes (empties into the deep cervical chain) and direcetly into deep cervical nodes within the parapharyngeal space

Question 35

What is the innervation of the pharyngeal tonsil?

Answer 35

Vagus and glosspopharyngeal nerves via pharyngeal plexus

Question 36

What is tonsilitis?

Answer 36

• Inflammation of the palatine tonsils

- Usually caused by viral indection (bacterial 1/3 cases)

Question 37

What could be a complication for bacterial tonsilitis?

Answer 37

Peritonsillar abscess - a collection of pus in the peritonsillar space

• Will req drainage:
  1. Needle aspiration following topical local anaesthetic
  2. Incision and drainage with durther opening via use of Magill forceps