EQ Pharynx and Larynx

Question 1

Draw the normal anatomy of the larynx

Answer 1

Question 2

What is the function of the pharynx

Answer 2

Transmits air to the larynx and food bolus to the oesophagus

Question 3

What nerves supply the pharynx?

Answer 3

Pharyngeal vagus, mandibular trigeminal, hypoglossal

Taste from glossopharyngeal

Question 4

Name in order from rostral to caudal the laryngeal cartilages.

Answer 4

Epiglottis

Thyroid

Cricoid

Arytenoid

Question 5

Muscle which opens the larynx by abducting the arytenoids.

Answer 5

Cricoarytenoid dorsalis

Question 6

Muscle which closes the larynx by adducting the arytenoid cartilage.

Answer 6

Cricoarytenoid lateralis muscle

Question 7

Slap test

Answer 7

Thoraco-laryngeal reflex

Question 8

Clinical signs associated with pharyngeal pathology

Answer 8

Noise

Dysphagia

Discharge

Cough

Dyspnoea

Question 9

DDSP

Answer 9

Dorsal displacement of the soft palate - into the nasopharynx

May be intermittent or persistence

Intermittent - thyroid hormone problem, X, hyoid apparatus, inflammation

Persistent - secondary to congenital abnormality, neuromuscular

Question 10

Tie forward surgery

Answer 10

Basihyoid to thyroid

DDSP

Question 11

Staphylectomy

Answer 11

Soft palate resection

DDSP

Question 12

Myectomy

Answer 12

Resection of the sternohyoid/ omohyoid to prevent caudal retraction of the larynx

DDSP

Question 13

Palatal fibrosis

Answer 13

Cautery - increases stiffness of the soft palate

DDSP

Question 14

Arytenoid chondritis

Answer 14

Ulceration, infection, progressive, obstructive - kiss lesions (due to compression of normal cartilage)

Caused by trauma or low grade infection

Question 15

Answer 15

Sub-epiglottic cyst

May lead to DDSP?

Question 16

ADAF

Answer 16

Axial displacement of the aryepiglotic folds - mucosal folds between the arytenoids and epiglottis

Question 17

VCC

Answer 17

Vocal cord collapse

Question 18

Describe the pathogenesis of RLN

Answer 18

Leads to atrophy of the cricoarytenoid dorsalis muscle and therefore failure to abduct the arytenoid cartilages. This causes the noise known as roaring.

Dx - noise, endoscopy, negative slap test, ultrasound

Question 19

Tie back surgery

Answer 19

Dorsocaudal cricoid to muscular arytenoid cartilage process

Question 20

Hobday surgery

Answer 20

Ventriculo-cordectomy

Question 21

4BAD

Answer 21

Forth brachial arch defect - laryngeal cartilage defects - rostral displacement

Question 22

Answer 22

Epiglottic entrapment - under sub-epiglottic tissues