Head And Neck Part 3 Flashcards
Where does the internal jugular vein begin?
The Jugular Foramen
*CN IX- glossopharyngeal
*CN X- Vagus
*CN XI- Accessory nerve
*These nerves all pass out the jugular foramen
Where does CN XI (Accessory Nerve) pass through?
Passes through
1. Foramen magnum then INTO
2. Posterior Cranial Fossa next passes OUT TO
3. Jugular foramen and into neck
*Supplies the SCM and Trapezius
Does the Vagus Nerve (CN X) supply the stylopharyngeus muscle?
No
*CN X motor to most pharyngeal muscles
What does the Glossopharyngeal Nerve (CN IX) supply?
- Stylopharyngeus muscle
- Sensory to pharyngeal mucosa
*sensory limb of gag reflex
Where is the sympathetic trunk located on the posterior side of the pharynx?
Between the pharynx and prevertebral muscles inthe neck
To get to the target of Superior Cervical ganglion where do the axons come from? (Pharynx posterior aspect)
Preganglionic sympathetic axons from T1 spinal cord
Where do the postganglionic sympathetic axons go to?
They jump on the Internal Carotid Artery to
1. Enter the head and SUPPLY
*Superior Tarsus muscle
*Dilator Pupillae
*Sweat glands
*Smooth muscle of skin vasculature
If there is a lesion of the sympathetic pathway of the head what will happen?
Horners syndrome ipsilateral
1. Mild ptosis of the upper eyelid
2. Pupillary contradiction
3. Anhidrosis (no sweating)
4. Flushed skin
What are the functions of the Larynx?
- Valve to regulate air flow to and from lungs
- Traps air during cough, sneeze or increase intrabdominal pressure
- Protects the airway during swallowing
- Phonation- sounds generated by vocal cord vibration
What is the difference between phonation, articulation and resonance?
Articulation and Resonance involve the
1. Tongue
2. Soft palate
3. Lips
4. Pharynx
5. Oral and nasal cavities
What is the origin and insertion of the Cricothyroid muscle?
O: Cricoid cartilage
I: Thyroid cartilage
What is the nerve supply and action of the cricothyroid muscle?
A: Tilts thyroid cartilage forward, lengthening the vocal folds, putting tension on them
Nerve Supply: External Laryngeal Nerve
At the Cricoarytenoid joint what movements can the Arytenoid cartilages do?
- Move medially and laterally
- Rotate in horizontal plane
- Move anteriorly and posteriorly
What are the vocal ligament differences between men and women?
Men:
1. visible laryngeal prominence
2. Longer vocal cords
Women:
1. Difficult to see laryngeal prominence
2. Shorter vocal cords
What is the vestibule between?
- Laryngeal inlet
- vestibular fold
What is the space between the vestibular folds called?
Ventricle
What is the Rima Glottids?
Slit between the vocal folds
What is the infraglottic cavity
Inferior to vocal folds
*between the vocal fold and trachea
What is the origin and insertion of the Posterior Cricoarytenoid muscle?
I: muscular process of the arytenoid cartilage
O: Cricoid cartilage
What is the action of the posterior Cricoarytenoid muscle?
Sole abductor of the vocal folds
1. Muscular process rotates in
2. Vocal process rotates out
3. Vocal folds move away from midline
What is the attachment point of the Arytenoid muscle?
Arytenoid cartilages
What is the action of the arytenoid muscles?
Adducts vocal folds
1. Arytenoid cartilages are drawn closer together
2. Rima glottidis becomes narrower
What is the origin and insertion of the lateral Cricoarytenoid muscle?
I: muscular process of the arytenoid cartilage
O: Cricoid cartilage
What is the action of the Lateral Cricoarytenoid muscle?
Adducts the vocal folds
1. Muscular process is pulled forward and laterally
2. vocal process is rotated toward the midline
3. Vocal folds are brought closer together reducing the width of the Rima glottidis
What is the origin and insertion of the thyroarytenoid muscle?
I: arytenoid cartilage
O: Thyroid cartilage
What is the action of the thyroarytenoid muscle?
Relaxes the vocal folds
1. vocal folds are shortened and laced
2. Arytenoid cartilage is pulled anteriorly
How is the Rima Glottidis in its normal position/
Narrow
How is the Rima Glottidis during forced respiration?
Wide
How is the Rima Glottidis during whispering?
Narrow anteriorly BUT
1. Open between the arytenoid cartilages
*allowed by the lateral Cricoarytenoid muscles
How is the Rima Glottidis during phonation (speech)?
narrow
*allowed by the Arytenoid muscles
During coughing what happens?
- Abduction of the vocal cords to allow for a gasp of air
- muscles contract to close off the Rima Glottidis
*there will be increased thoracic pressure - Sudden abduction of the vocal foes causes the trapped air to erupt as a cough
What happens during micturition, defecation and parturition?
- Rima glottidis is closed by the adductors of the vocal folds
- Abdominal musculature contract to build up intra-abdominal pressure
- Aids in the performance of the three actions
What is the nerve supply of the Cricothyroid muscle?
External Laryngeal nerve (branch of CN X (Vagus))
What pierces through the Thyrohyoid membrane?
Internal Laryngeal Nerve (branch of CN X (vagus))
*sensory to laryngeal mucosa superior to the vocal folds
What happens if the internal laryngeal nerve is damaged?
Diminished cough reflex
Where is the inferior and recurrent laryngeal nerve located?
Inferior: distal to cricothyroid joint
Recurrent: Proximal to Cricothyroid joint
What happens is there is unilateral or bilateral damage to the Recurrent laryngeal nerve?
Unilateral: Hoarseness of speech
Bilateral: Obstruction or airway