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3 - RCA > Head and Neck 4 > Flashcards

Head and Neck 4 Flashcards

1
Q

What is the larynx?

A

Tube lined by mucous membrane
Closed in front
Open in back
Skeleton is cartilage

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2
Q

Which levels does the larynx run?

A

C3-C6

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3
Q

C3

A

Hyoid level

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4
Q

C6

A

Cricoid cartilage level

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5
Q

What is the closed cartilage of the larynx called and what level is it found?

A

Cricoid cartilage

C6

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6
Q

Name the cartilages of the larynx.

A

Thyroid (biggest, C4 to C5)
2 arytenoids (triangular shaped ontop of cricoid), corniculate ontop of arytenoid
Epiglottis
Cricoid

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7
Q

What happens at C6 level?

A

Larynx changes into trachea

Pharynx changes into oesophagus

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8
Q

What is the quadrate/quadrangular membrane?

A

Thin submucosal sheet of connective tissue

Extends from arytenoid cartilage to epiglottic cartilage

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9
Q

Name the 2 folds of the quadrangular membrane.

A 
Aryepiglottic fold (superior) 
Vestibular ligament covered by mucous membrane to form vestibular fold (inferior) = false vocal cords
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10
Q

What does the aryepiglottic fold surround?

A

Inlet of larynx (aditus of larynx)

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11
Q

What is the name of the vocal membrane?

A

Cricothyroid membrane

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12
Q

Explain the location of the cricothyroid membrane.

A

Extends from the cricoid cartilage to thyroid/arytenoid cartilages

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13
Q

What forms the vocal ligament?

A

Upper free edge that extends from the thyroid cartilage (close to midline) backwards to vocal process of arytenoid cartilage forms the vocal ligament

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14
Q

What is the vocal fold/cord formed of?

A

Cricothyroid membrane covered by mucous membrane

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15
Q

What is the skeleton of the vocal cord?

A

Cricothyroid membrane

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16
Q

What is the rima glottidis?

A

Gap between the two vocal folds (vocal cord)

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17
Q

Inlet/aditus

A

Space between aryepiglottic folds

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18
Q

Vestibule

A

Space below inlet as far as vestibular folds

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19
Q

Ventricle

A

Space between vestibular and vocal folds, indents laterally

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20
Q

Saccule

A

Small pouch of mucous membrane between vestibular folds and laryngeal lamina

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21
Q

Rima glottis

A

Space between vocal folds

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22
Q

Piriform Recess

A

Space between quadrangular membrane and lamina of thyroid cartilage

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23
Q

What is contained within the piriform fossa?

A

Internal laryngeal nerve

Superior laryngeal vessels

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24
Q

Where does the cricothyroid muscle run?

A

From anterolateral part of cricoid cartilage to inferior aspect of thyroid cartilage

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25
Q

What is the innervation of the cricothyroid muscle and how does this differ from the other muscles?

A

Innervated by external laryngeal nerve

All other muscles = recurrent laryngeal nerve

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26
Q

What is the action of the cricothyroid muscle?

A

Tenses and stretches vocal fold

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27
Q

Where is the thyroarytenoid muscle?

A

From posterior surface of thyroid cartilage

Insertion into muscular process of arytenoid cartilage

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28
Q

What is the action of the thyroarytenoid muscle?

A

Relaxes vocal fold

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29
Q

Location and action of lateral crico-arytenoid muscles.

A

From arch of cricoid cartilage to muscular process of arytenoid cartilage
Adducts vocal fold

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30
Q

Where does the transverse arytenoid run and what is its function?

A

Runs between arytenoid - adducts arytenoids (pulls them together)

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31
Q

Where does the oblique arytenoid run and what is its function?

A

Runs superficial to transverse arytenoid
Runs from muscular process of one arytenoid to the apex of the other (cross over)
Aids in adduction - draw arytenoids closer together

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32
Q

Where is the aryepiglottic muscle found and what are its functions?

A

Oblique arytenoids are continuous as this larger sheet of muscle to the side of the epiglottis
Muscle acts as a sphincter (together with interarytenoids & epiglottis) = narrows laryngeal aditus and prevents swallowed material from entering (pulls aryepiglottic folds together)

33
Q

What is the location of the posterior crico-arytenoid and its function?

A

From posterior surface of cricoid cartilage to muscular process of arytenoid cartilage
Action: abducts to bring in oxygen

34
Q

What is the tensor muscle?

A

Cricothyroid

35
Q

What is the relaxer muscle?

A

Thyro-arytenoid

36
Q

Which are the adductor muscles?

A

Lateral crico-arytenoid

Transverse and oblique arytenoids

37
Q

What is the abductor muscle?

A

Posterior crico-arytenoid

38
Q

What are the muscles innervated by?

A

All innervated by the recurrent laryngeal nerve, except the cricothyroid which is innervated by the external laryngeal nerve

39
Q

What is the supply of the mucous lining of the larynx?

A

Above the vocal cord: internal laryngeal

Below the vocal cord: recurrent laryngeal

40
Q

What are the laryngeal nerves derived from?

A

Vagus nerve X

41
Q

List the branches of the laryngeal nerve.

A 
Superior laryngeal - internal/external
Recurrent laryngeal (i.e. is actually the inferior laryngeal)
42
Q

What is the difference between the vagus nerve of the left and right sides?

A

Right side: very quickly gives off recurrent

Left side: recurrent given off later

43
Q

What membrane does the internal laryngeal nerve pierce?

A

Thyrohyoid membrane

44
Q

What does the internal laryngeal nerve supply?

A

Sensory to laryngeal mucosa superior to vocal folds

45
Q

What does the external laryngeal nerve descend with and what does it supply?

A

Descends with the superior thyroid artery

Supplies the cricothyroid muscle

46
Q

What is the difference in location of the right and left recurrent laryngeal nerve?

A

Right originates in root of neck

Left originates in thorax

47
Q

Where does the recurrent laryngeal nerve ascend?

A

In the groove between the trachea and the oesophagus

48
Q

What surface is the recurrent laryngeal nerve related to?

A

Medial surface of the thyroid gland

49
Q

What is the function of the recurrent laryngeal nerve?

A

Supplies all intrinsic muscles of the larynx, except for the cricothyroid muscle
Supplies sensory innervation for the laryngeal mucous membrane inferior to the level of the vocal cords/folds

50
Q

What do the mylohyoid muscles form?

A

The floor of the mouth

51
Q

Where do the mylohyoid muscles lie?

A

Origin: mylohyoid line of mandible
Insertion: raphe and body of hyoid

52
Q

What is the function of the mylohyoid muscles?

A

Elevates hyoid bone, floor of mouth and tongue

With the hyoid bone fixed, it depresses the mandible

53
Q

What is the innervation of the mylohyoid muscles?

A

Mylohyoid nerve (branch of inferior alveolar nerve - V3)

54
Q

Where are the geniohyoid muscles located?

A

Superior to the mylohyoid muscles

From the inferior mental spine of the mandible to body of hyoid bone

55
Q

What is the innervation of the geniohyoid muscles?

A

C1 via the hypoglossal nerve (XII)

56
Q

What is the action of the geniohyoid bone?

A

Elevates hyoid bone, depresses mandible

57
Q

List the layers of muscles from inferior to superior.

A

Platysma, digastric, mylohyoid, geniohyoid

58
Q

Where does the lingual nerve arise from?

A

Mandibular nerve (V3)

59
Q

Where does the lingual nerve run?

A

Runs inferiorly between the medial pterygoid and ramus of mandible
Anterior to inferior alveolar nerve
Runs on the hyoglossus muscle

60
Q

What does the lingual nerve supply?

A

General sensation to mucosa of the anterior 2/3rds of the tongue and floor of the oral cavity

61
Q

What runs on the hyoglossus muscle?

A

Highest: lingual nerve
Submandibular duct
Hyoglossal nerve

62
Q

What is the chorda tympani a branch of?

A

Facial nerve (VII)

63
Q

Where does it run?

A

Joins the lingual nerve and runs anteriorly to its sheath

64
Q

What does the chorda tympani supply?

A

Special sensation to the anterior 2/3rds of the tongue

Parasympathetic fibres to submandibular ganglion

65
Q

What does the inferior alveolar nerve arise from?

A

Mandibular nerve V3 (trigeminal 5 nerve)

66
Q

Where does the inferior alveolar nerve run?

A

Inferiorly between the medial pterygoid muscle and the ramus of the mandible
Enters the mandible through the mandibular foramen
Runs forward in the mandibular canal supplying sensory to the lower teeth

67
Q

Where does the maxillary nerve come out from the skull?

A

Via the foramen rotundum

68
Q

Where does the maxillary nerve travel?

A

Within the pterygopalatine fossa and gives off two branches which suspend the parasympathetic pterygopalatine region
Sensory fibres of the maxillary nerve pass through the ganglion without synapsing
Supply nose, palate, nasopharynx

69
Q

Name the 5 branches coming out of the ganglion near the maxillary nerve.

A 
Greater and lesser palatine 
Nasopalatine 
Nasal nerves 
Pharyngeal nerves 
Alveolar nerves (posterior superior alveolar and anterior superior alveolar nerve)
70
Q

Where do the greater and lesser palatine nerves travel?

A

Pass inferiorly from the pterygopalatine ganglion, descend through the palatine canal and enter the palate through the greater and lesser palatine foramina

71
Q

What is the function of the greater and lesser palatine nerves?

A

Greater: supply sensory to hard palate
Lesser: supply sensory to soft palate

72
Q

Where does the nasopalatine nerve travel?

A

Runs medially and enters the nasal cavity

Runs on nasal septum and through a foramen to anterior part of the hard palate

73
Q

What do the nasal nerves supply?

A

Enter the nasal cavity to supply parts of the lateral wall and septum

74
Q

What is the function of the pharyngeal nerves?

A

Pass posteriorly

Supply the mucous membrane of the nasopharynx

75
Q

Posterior superior alveolar nerve

A

Arise from maxillary nerve within the pterygopalatine fossa

Descend to supply upper posterior teeth

76
Q

Anterior superior alveolar nerve

A

Arises from infraorbital nerve and supplies the upper anterior teeth

77
Q

Where does the glossopharyngeal nerve (IX) leave the skull?

A

Leaves the skull via the jugular foramen
Gives off pharyngeal branches to the pharyngeal plexus (sensory to mucosa of oropharynx)
Supplies one muscle = stylopharyngeus
Supplies general and special sensation (taste) to posterior third of tongue

78
Q

List some nerves which latch onto other nerves.

A
  • Chorda tympani (facial) on lingual nerve (mandibular) to submandibular, sublingual and anterior 2/3rds of tongue. Synapses in submandibular ganglion.
  • Greater petrosal (facial) on zygomatic of V2, then on lacrimal nerve to lacrimal gland. Synapses in pterygopalatine ganglion. Stimulation of this causes tears.
  • Lesser petrosal nerve (IX) on auriculotemporal nerve (V3) to parotid gland. Stimulation of lesser petrosal causes parotid secretion.

3 - RCA (5 decks)

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