Breathing Voice and Hearing Flashcards

1
Q

Upper respiratory tract includes

A

nose, nasal cavities, paranasal sinuses, pharynx and larynx.

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2
Q

The 2 nasal cavities: contains, shape, held open by

A

Contains olfactory receptors
Wedge shaped
Open by cartilage and bone

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3
Q

The anterior apertures of the nasal cavities are…and open onto

A

the nares

inferior surface of the external nose

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4
Q

The posterior apertures are the… and open into

A

Choanae

the nasopharynx

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5
Q

The nasal cavities are separated:
• From each other by
• From the oral cavity below by
• From the cranial cavity above by

A

midline nasal septum
hard palate
parts of the frontal, ethmoid and sphenoid bones

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6
Q

The lateral wall of the nasal cavity is characterized by

A

conchae - 3 curved shelves of bone, dividing the nasal cavity into 4 air chambers

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7
Q

Where are the paranasal sinuses’ openings

A

on the lateral wall and roof

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8
Q

Bones that contribute to the skeletal framework of the nasal cavities include:

A

Ethmoid – complex bones that lies between the two orbits –> the roof, lateral wall and medial
wall of both nasal cavities. Contains the ethmoidal sinuses. – forms the superior and middle conchae.
• Other unpaired bones = sphenoid, frontal bone, vomer
• Paired nasal, maxillary, palatine and lacrimal bones, and inferior conchae

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9
Q

4 paranasal sinuses

A

ethmoidal air cells
frontal sinus
maxillary sinus
sphenoidal sinus

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10
Q

paranasal sinuses are lined by

A

ciliated and mucous secreting respiratory mucosa

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11
Q

paranasal sinuses open into

A

the nasal cavities

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12
Q

paranasal sinuses are innervated by

A

branches of the trigeminal nerve

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13
Q

function of paranasal sinuses

A

reduce weight of skull

act as resonators for the voice

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14
Q

paranasal sinuses are connected to the pharynx by

A

small holes (route of infection)

build of mucus in the sinuses > pain + possible infection

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15
Q

Frontal sinuses drains via the

Innervated by

A

frontonasal duct

Branches of the supraorbital nerve from the ophthalmic branch of trigeminal (V1)

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16
Q

Ethmoidal cells Innervated by

A

branches of nasociliary nerve from the ophthalmic branch of trigeminal (V1)
AND maxillary branch of trigeminal (V2)

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17
Q

Maxillary sinuses - can often be infected by

A

tooth infections

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18
Q

Maxillary sinuses Innervated by

A

infra-orbital and alveolar branches of the ophthalmic branch of trigeminal (V1)

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19
Q

Sphenoidal sinus located

A

just posterior to the ethmoidal air cells in the sphenoid bone

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20
Q

Sphenoidal sinus Innervated by

A

posterior ethmoidal branch of the ophthalmic branch (V1)

AND the maxillary branch of the trigeminal nerve (V2)

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21
Q

Drainage of the sinuses:

Frontal, sphenoid, anterior middle and posterior ethmoidal, maxillary (nasolacrimal)

A

Sphenoid - Sphenoehtmoidal recess

Posterior ethmoidal air cells - superior meatus

Anterior & middle ethmoidal air cells; frontal; maxillary - middle meatus

Nasolacrimal - inferior meatus

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22
Q

Larynx is composed of the following bones:

Unpaired:

Paired:

A

Unpaired: Epiglottis, thyroid, cricoid

Paired: Arytenoid, corniculate, cuneiform

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23
Q

Movement of the larynx in the neck facilitates

A

closing of the laryngeal inlet and opening of the oesophagus during swallowing

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24
Q

Motor and sensory innervation of the larynx is provided by

A

vagus nerve

25
Q

The thyroid cartilage is formed by

A

right and left lamina which are widely separated posteriorly but converge and join anteriorly (superior anterior prominence = Adam’s apple)

26
Q

The angle between the two lamina is …. in men and ….in women

A

90 men

120 women

27
Q

The posterior margin of each lamina is elongated to form

A

a superior + inferior horn (which are associated with the cricoid cartilage and hyoid bone respectively)

28
Q

The epiglottis is a leaf-shaped cartilage attached

A

by its stem to the posterior aspect of the thyroid cartilage

29
Q

epiglottis function

A

acts as a flap which closes off the trachea during swallowing to direct food into the oesophagus

If food enters the trachea and contacts the vocal folds, it causes a cough reflex to expel the matter in order to prevent choking

30
Q

The two arytenoid cartilages: function

A

associated with the vocal folds + phonation

31
Q

Vocal folds are located….

attachments

A

located within the larynx at the top of the trachea

They are attached posteriorly to the arytenoid cartillages, and anteriorly to the thyroid cartilage
Their outer edges are attached to muscle within the larynx

32
Q

False vocal folds are the

A

Vestibular folds above both sides of the vocal folds

33
Q

False vocal folds role

A

minimal role in normal phonation, but rather in screaming or deep growling.

34
Q

When phonating, the arytenoid cartilages and vocal folds are

A

adducted

air is forced through between them

35
Q

What produces sounds

A

the vocal folds vibrating against each other

36
Q

Tension in the vocal folds can be adjusted by

A

laryngeal muscles

37
Q

Pitch depends on the relative position and tension in the vocal folds by the movement of

A

arytenoid cartilages and cricothyroid joint

38
Q

Intensity of sound depends on

A

the force with which air is pushed through the glottis

39
Q

During quiet respiration

arytenoid cartilages and vocal folds position

A

arytenoid cartilages abducted

Vocal folds open

40
Q

During forced inspiration

arytenoid cartilages position

A

the arytenoid cartilages are rotated laterally, and the rims glottides (opening between true vocal folds) widens into a rhomboid shape, which increases the diameter of the laryngeal airway

41
Q

During swallowing
position of the vocal folds, laryngeal inlet, larynx
This causes…

A

Vocal folds closed
laryngeal inlet narrowed
larynx moves up and forward (opens the oesophagus)

This action causes the epiglottis to close the laryngeal inlet

42
Q

Anatomy of outer ear

A

Pinna

External acoustic meatus (canal bit)

43
Q

Anatomy of middle ear

A

3 Auditory ossicles
o Malleus
o Incus
o Stapes

Tympanic membrane

44
Q

Anatomy of inner ear

A
Oval and round windows
Utricle and saccule
Cochlea
Semicircular canals
Auditory nerve (VIII)
Phanygotympanic/ Eustachian tube
45
Q

3 functional components of the facial nerve

A

Motor – to the muscles of facial expression

Sensory – branches to the cauda tympani where it joins the lingunal nerve (branch of V3) just after the acoustic meatus to supply the anterior 2/3rds of tongue

Parasympathetic secretor motor – to the salivary (not parotid-CN9) and lacrimal glands

46
Q

4 mechanisms that protect the airways from aspiration

A

Swallowing
Gag reflex
Sneeze
Cough

47
Q

2 main function mechanisms in swallowing

A

Levator veli palatine - muscle elevates the soft palate during swallowing, pushing the soft palate against the wall of the pharynx, thereby preventing the passage of the food into the nasal cavity

When swallowing, a peristaltic wave of constrictor muscles of the pharynx raises the larynx which becomes closed off by the epiglottis

48
Q

What is the soft palate

A

mucous membrane that tapers to

form uvula

49
Q

Explain the pathway for the sneeze reflex

A
  1. Inspiration
  2. Intrathoracic pressure raised
    (glottis closed, abdominal muscles contracted)
  3. Soft palate depressed against tongue (palatopharyngeus/palatoglossus)
  4. Sudden abduction of vocal folds to release intrathoracic pressure through nose
50
Q

Explain the pathway for the cough reflex

A
  1. Inspiration
  2. Intrathoracic pressure raised
    (glottis closed, abdominal muscles contracted)
  3. Soft palate raised and tensed against posterior wall of pharynx. (Levator veli palatini, tensor veli palatini, superior constrictor)
  4. Sudden abduction of vocal folds to release intrathoracic pressure through mouth
51
Q

Cough Reflex - Irritation of receptors in the larynx and trachea is sensed by

This causes…. nerves to initiate …

This results in

During exhalation, the …. is …. so that the air escapes through the mouth

A

Laryngeal branches of the vagus nerve (X)

the phrenic nerve (C3-C5) + thoracic nerves (T1-T12) to initiate a deep inhalation

a build up of pressure in the thorax against the closed glottis, followed by forced exhalation

The oropharyngeal isthmus. Open

52
Q

Sneeze reflex - …sense irritation of receptors in the nasal mucosa

This causes …nerves to initiate..

This results in

During exhalation, the …. is….so that the air escapes through the nose

A

The ophthalmic + maxillary branches of the trigeminal (V1 and V2)

the phrenic nerve (C3-C5) + thoracic nerves (T1-T12) to initiate a deep inhalation

a build up of pressure in the thorax against the closed glottis, followed by forced exhalation

Oropharyngeal isthmus. Closed.

53
Q

possible route of infection from the pharynx to the middle ear

A

The pharyngotympanic (auditory) tube

54
Q

The pharyngotympanic (auditory) tube connects what and what

A

the tympanic cavity of the middle ear to the nasopharynx

55
Q

The pharyngotympanic (auditory) tube is tonically….. but during swallowing and yawning it….so that…

A

closed by a sphincter

opens so that air can leave or enter the middle ear and equalize pressure with the nasopharynx and hence the atmosphere

56
Q

If the…. is visible through an auroscope, the ear is considered normal. Infection of the…..will result in a loss of…..

A

cone of light

middle ear ….the cone of light

57
Q

List the actions that may be taken to restore patency of the airway in an emergency

A

Chin lift/jaw thrust – this straightens + opens up the airway, making it easier for patient to breathe on their own
• Use of oropharyngeal or nasopharyngeal airway
• Endotracheal intubation – passing a tube into trachea through mouth
• Cricothyroidotomy
• Tracheotomy

58
Q

Cricothyroidotomy involves

A

piercing the cricothyroid membrane in the midline, between the thyroid and cricoid cartilage

59
Q

Tracheostomy involves

A

retracting the infrahyoid muscles, dividing the isthmus of the thyroid and piercing the trachea between the 1st and 2nd cartilaginous ring

A tracheostomy tube is then inserted, and secured with neck straps