Craniovertebral joints:pharynx Flashcards by Paige Johnson

Position of Atlanto-occipital joints

Synovial joints between occipital condyles and facets (superior surfaces of atlas)

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What joint is the “yes” movement at?

Atlanto-occipital joint

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Composition of Atlanto-atlas joint?

3 synovial joints, one ligamentous articulation

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What parts form the AA joint?

inferior articular facets of atlas, Superior articular facets of axis

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Orientation of lateral AA joint facets

transverse

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Parts articulating in the medial atlanto-axial joint

dens of axis (odontoid process) and anterior arch of atlas, transverse ligament of atlas

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Number of joint cavities in the medial atlanto-axial joint

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What joint is the “no” movement at?

Medial atlanto-axial joint

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Continuation of anterior longitudinal ligament

Anterior atlanto-occipital membrane

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Connects anterior arch of atlas and anterior margin of foramen magnum

anterior atlanto-occipital membrane

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Posterior atlanto-occipital membrane

Same relative position as ligamentum flavum. Connects posterior arch of atlas/posterior margin of foramen magum. Inferior margin is perforated by vertebral artery

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Continuation of posterior longitudinal ligament

Tectorial membrane

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Covers the deeper cruciate, alar, and apical ligaments

Tectorial membrane

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Cruiciate ligament

Strong transverse between lateral masses and anterior arch/dens (medial atlanto-axial joint). Weak vertical part (body of axis and anterior margin of foramen magnum)

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Alar ligament

Lateral side of dens and margin of foramen occipital bone. Minimizes rotation

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Apical ligament

Tip of dens and foramen magnum (weak connection)

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Jefferson’s Fx

aka burst fx. Arches of atlas are fx and lateral masses displaced laterally. Excessive axial compression

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Hangman’s Fx

Pedicals of axis. Hyperextension. 20% of all spinal Fx

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Beginning and end of pharynx

Sphenoidal body to the esophagus (C6, inferior border of cricoid)

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General composition of pharynx

Outer circular muscle, inner longitudinal muscle

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Waldeye’s ring

Ring of lymphoid tissue that guards pharynx

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Motor innervation of pharynx (primary)

vagus. (one motor comes from glossopharyngeal)

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Sensory innvervation of pharynx

Maxillary, glossopharyngeal, vagus

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Superior portion of superior constrictor

From the pterygoid hamulus/pterygomandibular raphe. Is continuous with the buccinator

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Attachment of the superior constrictor

Anterior to pharyngeal tubercle, midline to the pharyngeal raphe

Where is the pharyngobasilar fascia?

The gap between the base of the skull (anterior/posterior attachments)

What passes thru the pharyngobasilar fasic?

Levator veli palatini, pharyngotympatic tuve, ascending palatine artery

Superior portion of the middle constrictor

Lesser/greater horns of hyoid bon/lower part of stylohyoid ligament

Attachment of the middle constrictor

Posteriorly to pharyngeal raphe. Overlaps with superior constrictor

What passes thru the middle/superior constrictor gap?

Stylopharyngeus, stylohyoid ligament, glossopharyngeal nerve

Superior portion of inferior constrictor

Oblique line of thyroid cartilage, cricoid cartilage

What passes thru the gap between the middle and the inferior constrictors?

internal laryngeal nerve, superior laryngeal artery

Cricopharyngeus

Formed by inferior constrictor. Acts as sphinctor between pharynx and esophagus

What crosses the lower border of the cricophayngeus?

Recurrent laryngeal nerve/inferior laryngeal artery

Internal muscles of the pharynx

Salpingopharyngeus, palatopharyngeus. Stylopharyngeus

Arises from phayngotympanic tube (internal muscle)

Salpingopharyngeus

Arises from hard palate and aponeurosis

Palatopharyngeus

Arises from styloid process

Stylopharyngeus

Only muscle in pharynx not innervated by vagus

Stylopharyngeus (innervated by the only motor branch of glossopharyngeal)

Fasica between upper borders of superior constrictors and base of the skull

Pharyngobasilar fascia

Thin layer of loose connective tissue forming the outer covering of the pharynx

Buccopharyngeal fascia

Artery from ECA to pharynx

Ascending pharyngeal a.

Artery from facial artery to pharynx

Ascending palatine and tonsillar artery

Artery from maxillary to pharynx

Descending palatine and pharyngeal branch

Where do the veins of the pharynx frain into?

Form a minor plexus then drain into the paterygoid plexus

Source of much bleeding in the removal of the palatine tonsils

External palatine vein

What primarily innervates the pharynx?

pharyngeal plexus. Motor fibers from vagus, sensory from glossopharyngeal

Sensory innervation for upper part of nasopharynx

Maxillary n.

Lower part of pharynx innervated by what?

Glossopharyngeal n.

Gag reflex innervation

Sensory:glossopharyngeal. Motor: vagus

Most lymph drainage is to what?

Jugulodiagastric nodes (aka tonsillar nodes)

Bondaries of nasopharynx

Superior: body of sphenoid, continuous with nasal cavities via choanae, Inferior: soft palate

Contents of nasopharynx

Auditory tube opening/torus tubarius (cartilage of tube), salpingopharyngeal fold, salpingopalatine fold, torus levatorius, pharyngeal recess, pharyngeal tonsils

Salpingopharyngeal fold contains what?

Salpingopharyngeus muscles extending inferioposteriorly from auditory tube

Salpingopalatine fold contains what?

Tensor veli palatini

Function of tensor veli palatini

Modifies auditory tube for air exchange, V3 and otic ganglion site on it, hooks under the hamulus

Torus Levatorius contents

Levator veli palatini.

Slit-like space extending posteriorly/laterally behind torus tubarius

Pharyngeal recess

In the rood and posterior wall of the nasopharynx

Phayngeal tonsils. Aka adenoids

Boundaries of oropharynx

Tongue, palatoglossal/palatopharyngeal arches, superior: soft palate, inferior: superior border of epiglottis

Contents of oropharynx

Tonsillar cleft, palatine tonsils, tonsillar bed, lingual tonsils.

Forms the tonsilar bed

superior constrictor muscle/pharyngobasilar fascia

Boundaries of laryngopharynx

Posterior to larynx, superior: superior border of epiglottis, inferior: inferior border of cricoid artilage

Communication point between laryngopharynx and larynx

Laryngeal inlet

"pockets" bilateral to larnyx that are innervated by reccurent and laryngeal nerves

Piriform recess

Folds of the laryngopharynx

Median glossoepiglottic fold, 2 lateral glossoepiglottic folds

Depression between glossoepiglottic folds

valleculae

Stages of deglutition

1. food compressed between palate and tongue (voluntary) 2. Soft palate elevated to seal NP (involuntary) larynx elevated/epiglottis forced against pharyngeal wall 3. Constrictors close laryngeal aditus (involuntary)

Where is the deglutition center in the CNS?

medulla