Chapter 8 pt 3: Head and Neck Flashcards
what are the 3 longitudinal muscles?
- Stylopharyngeus
- Salpingopharyngeus
- Palatopharyngeus
from the syloid process
Stylopharyngeus muscle
from catilaginous pharyngotympanic tube
Salpingopharyngeus muscle
from soft palate
Palatopharyngeus muscle
origin: Medial side of base of styloid process
Stylopharyngeus muscle
insertion: Pharyngeal wall
- Stylopharyngeus
- Salpingopharyngeus
- Palatopharyngeus
innervation: Glossopharyngeal (IX)
-Stylopharyngeus
function: elevation of pharynx
- Stylopharyngeus
- Salpingopharyngeus
origin: Inferior aspect of pharyngeal end of pharyngeal tympanic tube
-Salpingopharyngeus
innervation: vagus nerve (X)
- Salpingopharyngeus
- Palatopharyngeus
origin: Upper surface of palatine aponeurosis
-Palatopharyngeus
function: Elevation of pharynx; closure of the oropharyngeal isthmus
-Palatopharyngeus
allows muscles, nerves, and vessels to pass in and out of the oral cavity`
The oropharyngeal triangle
behind the posterior apertures (choanae) of the nasal cavity
nasopharynx
closes the pharyngeal isthmus
Elevation of the soft palate and constriction of the palatopharyngeal sphincter
forms the pharyngeal (adenoids), palatine, and lingual tonsils
collection of lymph tissue
opens into the nasopharynx
opening to pharyngotympanic tube
Vessels that supply the upper part of the larynx include:
- ascending pharyngeal, -palatine
- tonsillar branches of the facial artery
- branches of the maxillary and lingual
lower part of larynx is supplied by:
pharyngeal branch (artery)
form a plexus
veins of pharynx
- Superiorly they drain into the pterygoid plexus
- Inferiorly they drain into the facial and jugular veins
veins of pharynx
drain into the deep cervical nodes, including:
- Retropharyngeal - Paratracheal - infrahyoid nodes
lymphatic vessels of pharynx
drain into jugulodigastric nodes
palatine tonsils
where does the innervation of the pharynx come from?
Motor and sensory innervation is mostly by branches of CN IX and X, forming a plexus
what is the pharyngeal plexus formed by?
- Pharyngeal branch of vagus (X) nerve
- External laryngeal nerve
- Superior laryngeal branch
- Pharyngeal branch of glossopharyngeal (IX)
- musculoligamentous structure
- continuous with the trachea and opens into the pharynx posterior and inferior to the tongue
larynx
It acts as both a valve to close off lower respiratory tract and as a sound producing structure
larynx
Composed of:
- cartilages (cricoid, thyroid, epiglottis, arytenoid, corniculate, and cuneiform), -membranes
- muscles
larynx
- completely closes airway
- most inferior cartilage
Cricoid
- enlarged and has 2 depressions separated by a vertical ridge that attaches to the esophagus
- has 2 facets on each side for articulation with thyroid and arytenoid cartilages
posterior surface of cricoid
- Largest cartilage formed by right and left lamina
- posteriorly set wide apart
- anteriorly converge at the laryngeal prominence
thyroid cartilage
extend towards cricoid cartilage and hyoid bone respectively
Inferior and superior horns of thyroid cartilage
forms the attachment for extrinsic muscles of the larynx
oblique line of thyroid cartilage
- is more acute in men (90°) than in women (120°)
- So the laryngeal prominence is more obvious in men (Adam’s apple)
thyroid angle
-Leaf shaped cartilage
epiglottis
- stem of epiglottis
- attaches the epiglottis to the midline of the posterior aspect of the thyroid cartilage
thyro-epiglottic ligament
raised to form the epiglottic tubercle
inferior half of the posterior surface of epiglottis
-are pyramid shaped
2 arytenoid cartilages
articulates with cricoid
base of arytenoid
articulates with the corniculate cartilage
apex of arytenoid
has 2 depressions for muscle and ligament attachment
lateral surface of arytenoid
face each other
medial surfaces of arytenoid
attaches to the vocal process
vocal ligament
-2 small conical cartilages that articulate with the arytenoid apices
Corniculate cartilages
project posteromedially towards each other
apices of corniculate cartilages
are club shaped and suspended in the fibro-elastic membrane that attaches arytenoids to lateral margin of epiglottis
cuneiform cartilages
what are the extrinsic ligaments of the larynx?
- thyrohyoid membrane
- triticeal cartilage
- hyo-epiglottic
- cricotrracheal ligament
tough fibro-elastic ligament spanning between superior margin of thyroid and hyoid bone above
thyrohyoid membrane
allows nerves and lymphatics to pass through
aperture of thyrohyoid membrane
thickened to form the lateral thyrohoid and median thyrohyoid ligaments
posterior and anterior borders of thyrohyoid
-occasionally a small cartilage in the lateral thyrohyoid ligament
triticeal cartilage
between hyoid and epiglottis
hyo-epiglottic ligament
between cricoid and 1st tracheal cartilage
cricotracheal ligament
what are the intrinsic ligaments of the larynx?
- fibro-elastic membrane
- Lower cricothyroid ligament
- upper quandrangle membrane
-links together the laryngeal cartilages and completes the architecture of the laryngeal cavity
- composed of:
- Lower cricothyroid ligament
- upper quandrangle membrane
fibro-elastic membrane
- attaches to the superior margin of cricoid and ends as free margin within space of thyroid cartilage
- Attaches anteriorly to the thyroid cartilage and posteriorly to vocal processes of arytenoids
Lower cricothyroid ligament
Forms vocal ligament, vocal fold, median cricothyroid ligament
Lower cricothyroid ligament
- Attaches to the lateral margin of epiglottis and anterolateral surface of arytenoid cartilage
- forms vestibular fold (false vocal cords)
Quadrangular membrane
Has an upper free margin and lower free margin
-Lower free margin is thickened to form vestibular ligament
Quadrangular membrane
is lateral to the vocal ligament when viewed from above
vestibular ligament
-Joints between the thyroid and cricoid, cricoid and arytenoids are synovial joints
Cricothyroid Joints
puts tension on the vocal ligament
Forward movement and downward rotation of the thyroid cartilage
-arytenoids slide toward and away from each other and pivot the vocal processes toward or away from each other
~abducts and adducts the vocal ligaments
Crico-arytenoid Joints
- opens into the anterior aspect of the pharynx
- Divided into the vestibule, middle part, and infraglottic space
laryngeal inlet
- protrude laterally
- house mucous glands that lubricate the vocal folds
laryngeal ventricle and saccule
opening between vocal folds
rima glottidis
opening between vestibular fold
rima vestibular
control tension of vocal folds, open and close the rima glottidis, control linear dimension of the vestibule, close rima vestibule, help close laryngeal inlet
intrinsic muscles of larynx
-pull thyroid forward and rotate it down
~lengthen (apply tension) the vocal folds
cricothyroid muscles
abduct and externally rotate arytenoids, opening rima glottidis
Posterior crico-thyroid muscles
internally rotates arytenoids adducting (closing) vocal folds
Lateral crico-arytenoid muscle
narrow the laryngeal inlet by constriction
Oblique arytenoid muscle
adjust tension in vocal folds
vocalis
- act as a sphincter and pushing soft tissues medially and narrowing the laryngeal inlet
- pulls the epiglottis towards the arytenoid cartilages
Thyro-arytenoid muscles
origin: Anterolateral aspect of arch of cricoid cartilage
Cricothyroid muscle
insertion: Oblique part- inferior horn of the thyroid cartilage; straight part- inferior margin of thyroid cartilage
Cricothyroid muscle
innervation: External branch of superior laryngeal nerve from the vagus nerve (X)
Cricothyroid muscle
function: Forward and downward rotation of the thyroid cartilage at the cricothyroid joint
Cricothyroid muscle
origin: Oval depression on posterior surface of lamina of cricoid cartilage
Posterior crico-arytenoid muscle
insertion: Posterior surface of muscular process of arytenoid cartilage
Posterior crico-arytenoid muscle
innervation: Recurrent laryngeal branch of the vagus nerve (X)
Posterior crico-arytenoid muscle
function: Abduction and external rotation of the arytenoid cartilage. The posterior crico-arytenoid muscles are the primary abductors of the vocal folds
Posterior crico-arytenoid muscle
origin: Superior surface of arch of cricoid cartilage
Lateral crico-arytenoid muscle
insertion: Anterior surface of muscular process of arytenoid cartilage
Lateral crico-arytenoid muscle
innervation: Recurrent laryngeal branch of vagus nerve (X)
Lateral crico-arytenoid muscle
function: Internal rotation of the arytenoid cartilage and adduction of vocal fold
Lateral crico-arytenoid muscle
origin: Lateral border of posterior surface of arytenoid cartilage
Transverse arytenoid muscle
insertion: Lateral border of posterior surface of opposite arytenoid cartilage
Transverse arytenoid muscle
innervation: Recurrent laryngeal branch of vagus nerve (X)
Transverse arytenoid muscle
function: Adduction of arytenoid cartilages
Transverse arytenoid muscle
origin: Posterior surface of muscular process of arytenoid cartilage
Oblique arytenoid muscle
insertion: Posterior surface of apex of adjacent arytenoid cartilage
Oblique arytenoid muscle
innervation: Recurrent laryngeal branch of vagus nerve (X)
Oblique arytenoid muscle
function: Sphincter of the laryngeal inlet
Oblique arytenoid muscle
origin: Thyroid angle and adjacent cricothyroid ligament
Thyro-arytenoid muscle
insertion: Anterolateral surface of the arytenoid cartilage
Thyro-arytenoid muscle
innervation: Recurrent laryngeal branch of vagus nerve (X)
Thyro-arytenoid muscle
function: Sphincter of vestibule and of laryngeal in let
Thyro-arytenoid muscle
origin: Lateral surface of vocal process of arytenoid cartilage
vocalis muscle
insertion: Vocal ligament and thyroid angle
vocalis muscle
innervation: Recurrent laryngeal branch of vagus nerve (X)
vocalis muscle
function: Adjusts tension on vocal folds
vocalis muscle
what are the functions of the larynx?
- Respiration/forced inspiration
- Phonation
- Effort closure
- Swallowing
what is the major arterial supply to the larynx?
superior and inferior laryngeal arteries
accompanies the superior laryngeal nerve through the thyrohyoid membrane to the larynx
superior artery
- areas above the vocal folds follow superior laryngeal artery and drain into deep cervical nodes
- areas below vocal folds drain into deep nodes
lymphatics of larynx
what veins drain into the larynx?
- superior laryngeal
- inferior laryngeal
drains into superior thyroid and into internal jugular
superior laryngeal
drains into inferior thyroid veins and into left brachiocephalic
inferior laryngeal
what nerves innervate the larynx?
- Sensory and motor innervation is by 2 branches of the vagus (X) nerve
- superior laryngeal nerve
- recurrent laryngeal nerve
originates from the inferior vagal ganglion and divides into internal and external branches
superior laryngeal nerve
sensory to laryngeal cavity below vocal folds and motor innervation to all intrinsic muscles except cricothyroid
recurrent laryngeal nerve
- the upper most parts of the respiratory tract
- contain olfactory receptors
- separated by the nasal septum
2 nasal cavities
open onto the inferior surface of the nose
the nares
open into nasopharynx
Posterior apertures (choanae)
form floor and roof of nasal cavities
Hard palate and parts of frontal, ethmoid, and sphenoid bones
- characterized by 3 curved shelves of bone (conchae)
- inferior
- middle
- superior
lateral wall of nasal cavity