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Skye's ESA 4 > H&N 10.1 the pharynx > Flashcards

H&N 10.1 the pharynx Flashcards

1
Q

What are the superior and inferior borders of the pharynx?

A

From the base of the skull to the inferior border of the cricoid cartilage.

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2
Q

What is found immediately posterior to the pharynx?

A

The prevertebral fascia.

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3
Q

What are the division of the pharynx?

A
  • The naso pharynx
  • oropharynx
  • laryngopharynx
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4
Q

What are the borders of the nasopharynx?

A
  • superiorly- base of the skull
  • inferiorly- upper border of the soft palate.
  • anteriorly-nasal cavity
  • posteriorly- C1, 2
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5
Q

What structures can be found within the nasopharynx?

A
  • The opening to the auditary tube.

- The pharyngeal tonsil.

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6
Q

What is another name for ‘pharyngeal tonsil’?

A

Adenoid

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7
Q

When enlarged, how big can the pharyngeal tonsils get?

A

Golf-ball size.

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8
Q

What could enlarged adenoids cause?

A
  • mouth breathing (due to difficulty nasal breathing due to the obstruction)
  • snoring
  • blockage to the eustachian tube
  • chronic infection (due to acting as a resivoir for infection)
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9
Q

What is the classic theory of how otitis media with effusion develops?

A
  • the auditory tube is sdysfunctional
  • air is not being equilised between the middle ear and the atmosphere.
  • air cells of the middle ear absorb air, leading to negative pressure
  • a transudate forms, which is drawn from mucosa)
  • ideal place for infection to develop
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10
Q

What complications can arise from otitis media?

A
  • hearing loss (often temporary)
  • mastoiditis
  • cholesteatoma
  • meningitis, brain abscess
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11
Q

What type of hearing loss would be the result of otitis media?

A

Conductive, due to the effusion inhibiting air waves.

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12
Q

What epithelium lines the nasopharynx?

A

respiratory epithelium (cilliated, pseudocolumnar epithleium)

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13
Q

What are the superior and inferior borders of the oropharynx?
What lies inferiorly and posteriorly?

A
  • superior- soft palate
  • inferior- upper border of the epiglottis, the tongue
  • posteriorly- C2,3 vertebrae
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14
Q

What structures are found within the oropharynx?

A

pallatine tonsils

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15
Q

What are the stages of swallowing?

A
  • oral phase
  • oesohageal phase
  • involuntary phase
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16
Q

What happens in the oral phase of swallowing?

A

The tongue pushes the bolus to the back of the mouth until it touches the oropharynx.

The bolus gets compressed against the palate as it is moved to the oropharynx.

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17
Q

What happens in the oesophageal phase of swallowing?

What nerves cause what to happen?

A

The bolus touching the oropharynx sets of a reflex which is involuntary and leads to:

  • elevation of the soft palate (seal off the nasopharynx) (CN X)
  • elevation of the pharynx and larynx (mainly Cn X, CN IX)
  • closure of the epiglottis (seal off the larynx)
  • tongue being compressed against the palate (prevent bolus going back into oral cavity) (CN XII)
  • opening of the UOS.
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18
Q

What happens in the involuntary phase of swallowing?

A

contractions of the pharyngeal constrictors of the pharynx cause the bolus to move down towards the stomach.

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19
Q

Where do you find the palatine tonsils?

A

between the anterior and posterior pharyngeal arches.

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20
Q

What epithelium lines the oropharynx?

A

stratified squamous epithelium

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21
Q

What are the borders of the laryngopharynx?

A
  • superior- epiglottis
  • inferior- (anteriorly) cricoid cartilage, (posteriorly) C6.
  • posterior- C4,5,6.
22
Q

What structure does the laryngopharynx contain?

A

Piriform fossa.

23
Q

What is the piriform fossa?

A

also known as the piriform recess.

A channel, which diverts food, liquid etc around the larynx and into the oesophagus.

24
Q

If there is loss of co-ordination f swallowing, why can liquids still be swallowed fairly easily?

A

They run in the piriform fossae, which diverts them around the larynx.

25
Q

What broad catergories of muscle are found within the pharynx?

A
  • Inner longitudinal muscles

- outer circular muscles.

26
Q

What is the function of the longitudinal muscles of the pharynx?

A

To elevate the pharynx and larynx, which opens and shortens the pharynx during swallowing.

27
Q

What are the names of the longitudinal constrictors of the pharynx?

A
  • stylopharyngeus
  • palatopharyngeus
  • Salpingopharyngeus
28
Q

What are the attachments and innervation of the stylopharyngeus muscles?

A
  • from the styloid process of the tmeporal bone
  • to the posterior thyroid cartilage
  • innervated by the glossopharyngeal nerve.
29
Q

What are the attachments and innervation of the palatopharyngeus muscles?

A
  • from the hard palate
  • to the posterior border of the thyroid cartilage
  • Vagus nerve.
30
Q

What are the attachments and innervation of the salpingopharyngeus muscles?

A
  • from the distal eustachian tube
  • to blend with the palatopharyngeus nerve
  • Vagus nerve.
31
Q

What are the circular constrictors of the pharynx called?

A
  • superior pharyngeal constrictor
  • middle pharyngeal cosntrictor
  • inferior pharyngeal constrictor
32
Q

What is different about the inferior pharyngeal constrictor of the pharynx, with respect to the other constrictors?

A

It has 2 heads:

  • Thyropharyngeal
  • Cricopharyngeal

(all others only insert into 1 place)

33
Q

What is Killian’s dehiscence?

A

The area of potential weakness between the thyropharyngeus and the cricopharyngeus muscles, in the inferior pharyngeal constrictors.

34
Q

What pathology can arise from the inferior pharyngeal constrictor?

A

Pharyngeal pouch- an outpouching of the pharynx between the 2 heads of the inferior pharyngeal cosntrictor.

posterior-medial diverticulum

This can become a resivoir for food and liquid, leading to bad breath, dysphagia, regurgitation and occaisional choking.

35
Q

What is thought to be the cause of a pharyngeal pouch?

A

lack of co-ordination of constriction of the pharyngeal constrictors, leading to increased pressure in the laryngopharynx, which causes the diverticulum to form.

36
Q

What is the pharyngeal plexus?

A

A plexus of nerves founs on the middle pharyngeal constrictor.

provides:

  • glossopharyngeal nerve
  • vagus nerve
  • sympathetic nerves (cervical)
37
Q

What provides motor innervation to the pharynx?

A

-the Vagus nerve

exception! the glossopharyngeal nerve supplies the stylopharyngeus muscle

38
Q

What nerves provide sensory innervation to the pharynx?

A
  • nasopharynx- Maxillary nerve
  • oropharynx- glossopharyngeal nerve (gag reflex)
  • laryngopharynx-vagus nerve.
39
Q

What nerve is resposible for the oral phase of swallowing?

A

The hypoglossal nerve, it moves the tongue, allowing movement of the bolus.

40
Q

What causes closure of the epiglottis during swallowing?

A

-It is connected to the thyroid cartilage, when you elevate the larynx and pharynx, this leads to the epiglottis closing over the larynx.

41
Q

What are some of the major causes of dysphagia?

A
  • stroke
  • dementia, parkinsons, MS
  • COPD
42
Q

How could a stroke lead to pneumonia?

A

The resulting damage from a stroke may cause unco-ordianted swallowing

This increases the risk of aspiration of food

This is likely to be contaminated with lots of bacteria etc, so can cause an infection (pneumonia)

43
Q

What are some symptoms of dysphagia?

A
  • coughing
  • choking
  • drooling
  • pneumonia
  • voice changes (wet voice, fluid coating the vocal cords)
  • nasal regurgitation
44
Q

What is the medical term for drooling?

A

Sialorrhoea

45
Q

What interventions can you use for someone with dysphagia to help?

A
  • thickening liquid
  • Thinning food (blender)
  • modify feeding strategies
  • modify posture
  • improve oral hygiene
  • introduce strategies to reduce fear of choking.
46
Q

How many suprahyoid muscles are there?

A

4 pairs (so 8)

47
Q

What’s the innervation of the suprahyoid muscles?

A

-branches of various cranial nerves.

48
Q

How many infrahyoid muscles are there?

A

4 pairs (8)

49
Q

What’s the innervation of the infrahyoid muscles?

A

-branches from C1-C3 (directly from the cervical plexus)

50
Q

What are the functions of the hyoid muscles?

A

-moving and stabilising the larynx and hyoid bone.

suprahyoid muscles also help form the floor of the mouth

Skye's ESA 4 (48 decks)

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