Head & Neck 2 Flashcards

1
Q

label what u can from the pharynx and larynx

A
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2
Q

what are the 3 divisions of the pharynx and where are they?
their levels

A

nasopharynx - posterior to nasal cavity
oropharynx - postrior to oral cavity
laryngopharynx - posterior to larynx

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3
Q

what are the 3 divisions of the pharynx and where are they?
their levels

A

nasopharynx - posterior to nasal cavity c1-2
oropharynx - postrior to oral cavity c2-3
laryngopharynx - posterior to larynx c4-5

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4
Q

what is the most superior division of the pharynx?
what are its posterior, inferior and superior location

its function?
what is it lined by?

what are its prominent features

A

Location:
* Posterior to the nasal cavity
* Continuous with the nasal cavity via the choana
* Inferior to the sphenoid bone
* Superior to the level of the soft palate

function:
* Serves as an air passageway

  • Lined by ciliated pseudostratified columnar
    epithelium –> propelling mucus

Prominent features:
*Pharyngeal tonsils
*Opening of pharyngotympanic tube

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5
Q

what are choanae

A

opening between the nasal cavity and the nasopharynx
internal nares which connect the oral cavity to the nasal passages and are crucial for proper nasal respiration

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6
Q

what is the Pharyngotympanic Tube
its 3 functions
what does it consist of

A

one of the prominent features of teh nasopharynx
* Connects the middle ear to the nasopharynx
* Equalizes pressure on both sides of the tympanic membrane
* Drains mucus from the middle ear

Consists of:
* Bony part (1/3rd)
* Cartilaginous part (remaining 2/3rd)

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7
Q

Where is the cricoid cartilage located?

A

inferior to the thyroid cartilage at C6
It is a complete ring
Note that trachea starts at C6-T12 but is made of hyaline cartilage

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8
Q

What is the function of the different divisions of the pharynx?

A

Nasopharynx = respiration
Oropharynx = Digestion and respiration
Laryngopharynx = Digestion and respiration
cc to ss

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9
Q

Why is otitis media common in children?

A

Chronic infectious/inflammatory disease of the middle ear in kids bc 10 degrees of pharyngotympanic tube

pharyngotympanic tube opens at less acute angle (10 degrees). is more horizontal and flat
Therefore more likely to lead to stasis which can cause infections

in adults it opens at 35 degrees

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10
Q

what is the middle division of the pharynx?
its location?

function
what cell lining?

and prominent features

A

Location:
* Posterior to the oral cavity
* Inferior to the level of the soft palate
* Superior to the upper margin of the epiglottis

  • Serves as an air and food passageway
  • Lined by stratified squamous epithelium –> provides protection

Prominent features:
*Palatine tonsils
*Lingual tonsil

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11
Q

label correctly and what is shown?

A

the oropharynx

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12
Q

what is the most inferior division of the pharynx?
location?
function?
what is it lined by?

A

Laryngopharynx

Location:
* Posterior to the larynx
* Extends to the inferior edge of the cricoid cartilage
* Continuous with the esophagus and larynx

  • Serves as an air and food passageway
  • Lined by stratified squamous epithelium–> provides protection
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13
Q

what does the cell lining change from between nasophraynx to oropharynx?

A

from Ciliated pseudostratified Columnar epithelium to Stratified Squamous epithelium

CC to SS

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14
Q

what are the two types of muscle in the pharynx and the 3 types in each (with names)

A

outer circular:
pharyngeal constrictor muscles
- superior
- middle
- inferior (has 2 parts: thyropharayngeal and cricopharyngeal)

inner longtidudinal:
pharyngeal longtidudinal muscles
- stylopharyngeus
- palatopharyngeus
- salpingopharyngeus

STYLish PAL SAL

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15
Q

label the three constrictor muscles

A
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16
Q

origin, insertion, function and innervation of the three constrictor muscles:

A
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17
Q

origin, insertion, function and innervation of the three longtidudanal muscles

A
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18
Q

label the three longitudinal muscles of the pharynx

A
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19
Q

label all 6 muscles of the pharynx

A
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20
Q

what is this highlighted area? what is it?

A

soft palate - soft mobile flap that rises to close off teh nasopharynx during swallowing

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21
Q

what are the function of the soft palate muscles:
levator veni palatani muscle
tensor veli palatani muscle

A

levator - elevates palate during swallowing
tensor - tenses palate

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22
Q

what is the gag reflex?

A

Involuntary reflex involving bilateral pharyngeal muscle contraction and elevation of the soft palate to expel foreign substances/bodies that irritated the oropharynx, posterior 1/3rd of tongue or tonsillar area or soft palate

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23
Q

what level is the hyoid bone?

A

C3

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24
Q

what are the attachments of the larynx

A

superiorly = hyoid bone (C3)
inferiorly = trachea (C6)
posteriorlu = laryngopharynx

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25
Q

what are the two types of cartilage that the larynx is made of? what are these?

A

unpaired:
- thyroid
- cricoid
- epiglottis

paired:
- arytenoid
- corniculate
- cuneiform
cunts communicate arrogantly

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26
Q

label the cartilages, what type are they?

A

unpaired

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27
Q

what is the thyroid cartilage?
what is its location?
what type of cartilage?

A

Largest unpaired laryngeal cartilage
Connects to the hyoid bone via the thyrohyoid membrane

Location:
* Vertebral Level: C4/C5
* Inferior to the hyoid bone (C3)
* Superior to the cricoid cartilage (C6)

Type of cartilage:
* Hyaline

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28
Q

what are the major anatomical features of the thyroid cartilage?
label them:

A

Major Anatomical Features:
* Lateral laminae (n=2)
* Laryngeal prominence (Adam’s apple): Formed by the fusion of the 2 lateral laminae
* Thyroid notch
* Oblique line: attachment for sternothyroid, thyrohyoid and inferior pharyngeal constrictor
* Superior horns: Provides attachment for the thyrohyoid membrane
* Inferior horns: Articulates with the cricoid cartilage to form the cricothyroid joint

29
Q

differenec between men and women in regard to laryngeal prominence

A

females:
- laryngeal prominence (laminae of thyroid cartilage) meet at 120 degrees

males:
- laminae of thyroid cartilage meet at 90 degrees

30
Q

what cartilage is this? label its parts.
location?
major anatomical features?
type of cartilage?

A

unpaired - cricoid cartilage
Only laryngeal cartilage that forms a complete ring

Location:
Vertebral Level: C6

Major Anatomical Features:
Shape: Signet

Arch (anteriorly)
Lamina (posteriorly)
* Superior border of lamina : Articulates with the arytenoid cartilage to form the cricoarytenoid joint
*Inferior border of lamina: Articulates with the inferior horn of the thyroid cartilage to form the cricothyroid joint

Type of cartilage: Hyaline

31
Q

what cartilage is this?
shape?
function?
type of cartilage?

A

Shape: Pear

Function: Helps prevent foreign bodies from entering the larynx

Type of cartilage: Elastic

32
Q

what are the connections of the epiglottis? there is 2. USE THE NAMES of the things

A

Connections with the:
Thyroid cartilage via thyroepiglottic ligament
Hyoid bone via hyoepiglottic ligament

33
Q

label these cartilages, what are they?

A

paired cartlages - only seen posteriorly
* Arytenoid cartilages
* Corniculate cartilages
* Cuneiform cartilages

34
Q

what cartilages are these? label

A

Paired arytenoid
3 surfaces:
* Anterolateral
* Posterior
* Medial

Apex
* Superior extension of the cartilage
* Consists of elastic cartilage
* Articulates with the corniculate cartilage

  • Base
  • Broad surface of the cartilage
  • Articulates with the cricoid cartilage
  • Has a muscular process (lateral process) that extends laterally and serves as a muscular attachment for the posterior cricoarytenoid muscle
  • Has a vocal process (anterior process) that extends anteriorly and gives rise to the true
    vocal cords
  • Composed of hyaline cartilage except a small portion of the vocal process
35
Q

label and what are these (location)?

A

Corniculate cartilage
* Paired
* Lies on the apex of the arytenoid cartilage

Cuneiform cartilage
* Paired
* Lies superior to the corniculate cartilage

36
Q

what are the 2 membranes of the larynx

A

Membranes:
* Thyrohyoid membrane
* Quadrangular membrane

37
Q

label what u can and explain function

A

Thyrohyoid membrane
* Between the superior border of the thyroid laminae and superior horns to the body and great horns of the hyoid bone

  • Assists the ascent of larynx during swallowing
  • Medial portion of the membrane thickens to form the median thyrohyoid ligament
  • Lateral thyrohyoid ligaments form the posterior borders of the membrane
  • Allows passage of the internal branch of superior laryngeal nerve and superior laryngeal vessels
38
Q

whats labelled?
function
what does it consist of
what is ir surrounded by
what is superior to it?

A

true vocal cords - active in sound production?

  • Flaps of tissue located in the larynx
  • There are two true vocal cords/ folds in the laryngeal cavity
  • Allow for phonation
  • Each vocal cord consists of a:
    * Vocalis ligament
    * Vocalis muscle
    * Mucous membrane

Vocal cords are surrounded by laryngeal cartilages

Superior to the vocal cords are the paired false vocal cords/folds

39
Q

label

A
40
Q

what is this?
function?

A

Rima Glottis
* AKA rima glottidis
* Opening between the true vocal cords
* Vibration of the true vocal cords when air is forced through the rima glottidis produces sound

41
Q

how do true vocal cords look when at rest vs phonation?

A
42
Q

what is labelled in green?
function

A

False Vocal Cords
* AKA as vestibular folds
* Folds of mucosal membrane

  • Superior to the vocal cords (true cords)
  • Cover the vestibular ligaments
  • Do not contribute to phonation
  • Provide protection to true vocal cords
43
Q

there are two types of muscles, extrinsic and intrinsic - what are the various forms of extrinsic muscle of the larynx?

A

Suprahyoid muscles (N=4):
* Geniohyoid
* Mylohyoid
* Stylohyoid
* Digastric:
* Anterior belly
* Posterior belly

Generally My Style Digs

Infrahyoid muscles (N=4):
* Sternohyoid
* Sternothyroid
* Thyrohyoid
* Omohyoid:
* Superior belly
* Inferior belly

*The suprahyoid and infrahyoid muscles are paired (4 on each side)

44
Q

what muscle is shown?
origin
insertion
action
innervation

A

Geniohyoid muscle

Origin: inferior mental spine of mandible
Insertion: body of hyoid bone

Action: depresses mandible; elevates hyoid bone

Innervation: 1st cervical nerve via hypoglossal nerve

45
Q

which msucle is shown
origin
insertion
action
innervation

A

Mylohyoid muscle

Origin: mylohyoid line of mandible
Insertion: body of hyoid bone

Action: depresses mandible; elevates hyoid bone ;elevates floor of mouth

Innervation: mylohyoid nerve (branch of CNV3)

46
Q

hwo does mylohyoid muscle originate?

A

from mylohyoid line

47
Q

what muscle is shown?
origin
insertion
action
innervation

A

Stylohyoid muscle

Origin: styloid process of temporal bone
Insertion: body of hyoid bone

Action: elevates hyoid bone

Innervation: stylohyoid nerve (branch of CNVII)

48
Q

what muscle is shown?
how many parts?
origins
insertions
actions
innervations

A

Digastric muscle
*Anterior belly
*Posterior belly

Origin of anterior belly: digastric fossa of mandible
Insertion: intermediate tendon of digastric muscle
Action: depresses mandible; elevates hyoid bone
Innervation: digastric nerve (branch of CNV3)

Origin of posterior belly: mastoid notch of temporal bone
Insertion: intermediate tendon of digastric muscle
Action: depresses mandible; elevates hyoid bone
Innervation: digastric nerve (branch of CNVII)

49
Q

what muscles are shown?

A
50
Q

what muscle is shown?
origin
insertion
action
innervation

A

Sternohyoid muscle

Origin: sternal end of clavicle and posterior surface of manubrium of sternum
Insertion: inferior border of body of hyoid bone

Action: depresses hyoid bone

Innervation: Ansa cervicalis (C1-C3)

51
Q

what is ansa cervicalis?

A

Loop of nerve fibers from cervical nerves C1-C3

Begins as branches from the cervical nerve C1 join the hypoglossal nerve after it exits the skull

52
Q

what muscle is shown?
origin
insertion
action
innervation

A

Sternothyroid muscle

Origin: posterior surface of manubrium of sternum
Insertion: oblique line of thyroid cartilage

Action: depresses larynx

Innervation: Ansa cervicalis (C1-C3)

53
Q

what muscle is shown
origin
insertion
action
innervation

A

Thyrohyoid muscle

Origin: oblique line of thyroid cartilage
Insertion: inferior aspect of body and great horns of hyoid bone

Action: depresses hyoid bone; elevates larynx

Innervation: Branch of anterior rami of C1 which accompanies hypoglossal nerve

54
Q

what muscle is shown?
its parts
origin
insertion
action
innervation

A

Omohyoid muscle
*Superior belly
*Inferior belly

Superior belly:
Origin: intermediate tendon of omohyoid muscle
Insertion: body of hyoid bone

Inferior belly:
Origin: superior border of scapula, medial to suprascapular notch
Insertion: intermediate tendon of omohyoid muscle

Action: depresses hyoid bone

Innervation: Ansa cervicalis [* C1 for sup. belly & C1-C3 for inf. belly]

55
Q

what is shown?

A

infrahyoid muscles

56
Q

what are the intrinsic muscles of the larynx?

A

Cricothyroid muscle
Posterior cricoarytenoid muscle
Lateral cricoarytenoid muscle
Transverse arytenoid muscle
Oblique arytenoid muscle
Thyroarytenoid muscle
Vocalis muscle

57
Q

what is this?
its parts
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Cricothyroid muscle
- Straight part
- Oblique part

Origin: arch of cricoid cartilage
Insertion:
-Straight part: inferior margin of thyroid cartilage
-Oblique part: inferior horn of thyroid cartilage

Function:
Draws thyroid cartilage anteroinferiorly
Lengthens and tenses vocal ligament

Innervation:
External branch of superior laryngeal nerve (branch of CNX)

58
Q

what is this?
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Posterior cricoarytenoid muscle

Origin: posterior surface of lamina of cricoid cartilage
Insertion: posterior surface of muscular process of arytenoid cartilage

Function:
Abduction and external rotation of the arytenoid cartilages (lengthens vocal folds & opens glottis)

Innervation:
Recurrent laryngeal nerve (branch of CNX)

59
Q

what is this
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Lateral cricoarytenoid muscle
Origin: superior surface of arch of cricoid cartilage
Insertion: anterior surface of muscular process of arytenoid cartilage

Function:
Internal rotation of arytenoid cartilages
Adduction of vocal folds (shortens vocal folds)

Innervation:
Recurrent laryngeal nerve (branch of CNX)

60
Q

what is this?
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Transverse arytenoid muscle

Origin:
Lateral border of posterior surface of arytenoid cartilage
Insertion:
Lateral border of posterior surface of opposite arytenoid cartilage

Function:
Adduction of arytenoid cartilages

Innervation:
Recurrent laryngeal nerve (branch of CNX)

61
Q

what is this
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Oblique arytenoid muscle

Origin:
Posterior surface of muscular process of arytenoid cartilage
Insertion:
Posterior surface of apex of adjacent arytenoid cartilage

Function:
Sphincter of the laryngeal inlet
Oblique arytenoid muscles are highlighted in green

Innervation:
Recurrent laryngeal nerve (branch of CNX)

62
Q

what is this
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Thyroarytenoid muscle

]Origin:
Angle of thyroid cartilage
Insertion:
Vocal process of arytenoid cartilage

Function:
Decreases tension on vocal ligaments

Innervation:
Recurrent laryngeal nerve (branch of CNX)

63
Q

what is this?
origin
insertion
function
innervation

A

Intrinsic Muscles of the Larynx
Vocalis muscle

Origin:
Lateral surface of vocal process of arytenoid cartilage
Insertion:
Vocal ligament and thyroid angle

Function:
Adjusts tension in vocal folds

Innervation:
Recurrent laryngeal nerve (branch of CNX)

64
Q

what does the vagus nerve give rise to?

A

superiror laryngeal nerve
inferior laryngeal nerve (aka recurrent laryngeal)

65
Q

what is the superiro laryngeal nerve? its branches

A
  • Originates from the inferior vagal trunk in the neck

Branches:
* Internal branch = Supplies sensory innervation to the larynx up until the level of the vocal folds

  • External branch = Supplies motor innervation to the cricothyroid muscle
66
Q

differnece between right and left course of laryngeal nerve

A
67
Q

what is function of the recurrent laryngeal nerves

A
  • Sensory innervation to the larynx below the level of the vocal folds
  • Motor innervation to all intrinsic laryngeal muscles except the cricothyroid m.
68
Q

what is thyroidectomy?

A

remove thyroid gland (partial or fully) in case of tumour

  • the structures close by are at risk of damage during the procedure
    Structures that can be potentially damaged during thyroidectomy:
  • Parathyroid glands
  • Nerves within the carotid sheath
  • Recurrent laryngeal nerves*
  • Cervical ganglia
69
Q

what does injury to the Recurrent laryngeal nerve cause?

A

injury to 1 = hoarse voice
injury to 2 = vocal cord paralysis