H&N 8: Pharnyx

Question 1

Where does pharynx extend from?

Answer 1

cranial base to lower border of cricoid cartilage where it becomes continuous with oesophagus.

Question 2

What is pharynx?

Answer 2

• mucosa lined muscular tube lying behind + communicating with nasal, oral + laryngeal cavities
• part of digestive + resp system

Question 3

Where is opening of cartilaginous part of pharyngotympanic tube?

Answer 3

between base of skull + pharynx

Question 4

What is function of soft palate?

Answer 4

• sep oral from nasal cavity

- when swallow, raised against pharyngeal wall + blocks off nasal cavity so can’t breathe + swallow at same time

Question 5

What is Waldeyer’s ring?

Answer 5

lymphoid tissue between roof of mouth, palatine tonsil + back of tongue + is protective

Question 6

What does larynx do during swallowing?

Answer 6

moves up + forwards to get out of the way

Question 7

What prevents food entering larynx?

Answer 7

vocal + vestibular folds close to form sphincter

Question 8

What helps food + fluid get down into oesophagus?

Answer 8

epiglottis gets pulled under tongue which creates conduit

Question 9

Where does nasopharynx lie?

Answer 9

above the soft palate and behind the nares

Question 10

What is floor of nasopharynx formed by?

Answer 10

soft palate which is elevated during swallowing

Question 11

What forms major part of post. wall of nasopharynx?

Answer 11

sup. constrictor

Question 12

What is on the lat. wall of nasopharynx?

Answer 12

• opening of the pharyngotympanic (auditory) tube

- behind it lies a small mass of lymphoid tissue.

Question 13

What is in roof of nasopharynx?

Answer 13

more lymphoid tissue, the adenoid or pharyngeal tonsil.

Question 14

Where does oropharynx lie?

Answer 14

beneath soft palate and communicates anteriorly with the oral cavity.

Question 15

How is oropharynx sep from nasopharynx?

Answer 15

by the raising of the soft palate.

Question 16

What lies ant. in oropharynx?

Answer 16

• palatoglossal + palatopharyngeal arches

- palatine tonsil in space between them

Question 17

What is palatine tonsil supplied by + sig?

Answer 17

lingual, ascending pharyngeal + lesser palatine which anastomose freely in the tonsil + therefore haemorrhaging poses a threat during tonsillectomy.

Question 18

What is the laryngopharynx?

Answer 18

that part lying adjacent to the larynx projecting upwards into the pharynx

Question 19

Where does the laryngopharynx end?

Answer 19

at C6 by funnelling into the oesophagus

Question 20

Which system does pharynx belong to?

Answer 20

digestive system even though air passes through it.

Question 21

List 4 layers of phaynx

Answer 21

1. Mucosal coat
2. Submucosa
3. Muscular coat
4. Areolar coat

Question 22

What is the submucosa?

Answer 22

• contains a tough fibrous coat which anchors the pharynx to the base of the skull
• pharyngeal muscles attach to tubercle on basiocciput

Question 23

What is muscular coat?

Answer 23

5 pairs of muscles (sup., middle + inf. constrictor) which form an outer semicircular layer and two inner longitudinal muscles

Question 24

What is areolar coat?

Answer 24

covers the exterior of the pharynx termed the

buccopharyngeal fascia.

Question 25

List muscles of pharynx

Answer 25

• sup., middle + inf. constrictor

Question 26

What is function of constrictor muscles?

Answer 26

During swallowing, the muscles contract sequentially as peristaltic waves

Question 27

What is nerve supply to constrictor muscles?

Answer 27

vagus nerve with motor fibres contributed by the cranial part of accessory

Question 28

Where does palatopharygeus arise + insert?

Answer 28

• from palatal aponeurosis + auditory tube.

- passes inferiorly to insert into posterolat part of pharynx + also post. part of hyoid bone + thyroid cartilage

Question 29

What is course of stylopharyngeus?

Answer 29

originates from styloid process + passes inferomedially through gap between sup. + middle constrictors + enters pharynx where its fibres mingle with palatopharyngeus + insert in a similar fashion.

Question 30

What are + is function of long. muscles?

Answer 30

palatopharyngeus + stylopharyngeus - raise pharynx + larynx during swallowing

Question 31

Where is raphe along constrictor muscles attached?

Answer 31

to tubercle at base of skull

Question 32

Where does sup. constrictor arise?

Answer 32

• post. part of raphe + buccinator attaches to ant. part

Question 33

Where does middle constrictor arise?

Answer 33

hyoid bone

Question 34

Where does inf. constrictor arise?

Answer 34

thyroid + cricoid cartilage

Question 35

What is motor supply to pharyngeal muscles?

Answer 35

all except stylopharyngeus supplied by pharyngeal branches of vagus
- stylopharyngeus supplied by glossopharyngeal

Question 36

What is sensory supply to pharynx?

Answer 36

• glossopharyngeal nerve is main sensory supply
• V2 supplies soft palate + roof of pharynx
• vagus supplies area around pharyngeal inlet

Question 37

What is blood supply to pharynx?

Answer 37

• ascending pharyngeal + sup. thyroid (branches of ext. carotid)
• inf. thyroid (branch of subclavian)
• facial + maxillary arteries
• provide rich anastamosis

Question 38

What is venous drainage of pharynx?

Answer 38

veins form plexus + communicate with pterygoid plexus - deep to mandible

Question 39

Describe lymphatic drainage of pharynx

Answer 39

• many lymph vessels pass to deep cervical lymph nodes
• some post. ones enter retropharyngeal nodes which lie between prevert + buccopharyngeal fasciae
• lymph nodes track back into jugulo-digastric nodes
• ant. nodes drain into jugulo-omo-hyoid node