Head & Neck 2 Flashcards
label what u can from the pharynx and larynx
what are the 3 divisions of the pharynx and where are they?
their levels
nasopharynx - posterior to nasal cavity
oropharynx - postrior to oral cavity
laryngopharynx - posterior to larynx
what are the 3 divisions of the pharynx and where are they?
their levels
nasopharynx - posterior to nasal cavity c1-2
oropharynx - postrior to oral cavity c2-3
laryngopharynx - posterior to larynx c4-5
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
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
what are choanae
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
what is the Pharyngotympanic Tube
its 3 functions
what does it consist of
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)
Where is the cricoid cartilage located?
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
What is the function of the different divisions of the pharynx?
Nasopharynx = respiration
Oropharynx = Digestion and respiration
Laryngopharynx = Digestion and respiration
cc to ss
Why is otitis media common in children?
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
what is the middle division of the pharynx?
its location?
function
what cell lining?
and prominent features
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
label correctly and what is shown?
the oropharynx
what is the most inferior division of the pharynx?
location?
function?
what is it lined by?
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
what does the cell lining change from between nasophraynx to oropharynx?
from Ciliated pseudostratified Columnar epithelium to Stratified Squamous epithelium
CC to SS
what are the two types of muscle in the pharynx and the 3 types in each (with names)
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
label the three constrictor muscles
origin, insertion, function and innervation of the three constrictor muscles:
origin, insertion, function and innervation of the three longtidudanal muscles
label the three longitudinal muscles of the pharynx
label all 6 muscles of the pharynx
what is this highlighted area? what is it?
soft palate - soft mobile flap that rises to close off teh nasopharynx during swallowing
what are the function of the soft palate muscles:
levator veni palatani muscle
tensor veli palatani muscle
levator - elevates palate during swallowing
tensor - tenses palate
what is the gag reflex?
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
what level is the hyoid bone?
C3
what are the attachments of the larynx
superiorly = hyoid bone (C3)
inferiorly = trachea (C6)
posteriorlu = laryngopharynx
what are the two types of cartilage that the larynx is made of? what are these?
unpaired:
- thyroid
- cricoid
- epiglottis
paired:
- arytenoid
- corniculate
- cuneiform
cunts communicate arrogantly
label the cartilages, what type are they?
unpaired
what is the thyroid cartilage?
what is its location?
what type of cartilage?
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
what are the major anatomical features of the thyroid cartilage?
label them:
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
differenec between men and women in regard to laryngeal prominence
females:
- laryngeal prominence (laminae of thyroid cartilage) meet at 120 degrees
males:
- laminae of thyroid cartilage meet at 90 degrees
what cartilage is this? label its parts.
location?
major anatomical features?
type of cartilage?
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
what cartilage is this?
shape?
function?
type of cartilage?
Shape: Pear
Function: Helps prevent foreign bodies from entering the larynx
Type of cartilage: Elastic
what are the connections of the epiglottis? there is 2. USE THE NAMES of the things
Connections with the:
Thyroid cartilage via thyroepiglottic ligament
Hyoid bone via hyoepiglottic ligament
label these cartilages, what are they?
paired cartlages - only seen posteriorly
* Arytenoid cartilages
* Corniculate cartilages
* Cuneiform cartilages
what cartilages are these? label
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
label and what are these (location)?
Corniculate cartilage
* Paired
* Lies on the apex of the arytenoid cartilage
Cuneiform cartilage
* Paired
* Lies superior to the corniculate cartilage
what are the 2 membranes of the larynx
Membranes:
* Thyrohyoid membrane
* Quadrangular membrane
label what u can and explain function
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
whats labelled?
function
what does it consist of
what is ir surrounded by
what is superior to it?
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
label
what is this?
function?
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
how do true vocal cords look when at rest vs phonation?
what is labelled in green?
function
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
there are two types of muscles, extrinsic and intrinsic - what are the various forms of extrinsic muscle of the larynx?
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)
what muscle is shown?
origin
insertion
action
innervation
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
which msucle is shown
origin
insertion
action
innervation
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)
hwo does mylohyoid muscle originate?
from mylohyoid line
what muscle is shown?
origin
insertion
action
innervation
Stylohyoid muscle
Origin: styloid process of temporal bone
Insertion: body of hyoid bone
Action: elevates hyoid bone
Innervation: stylohyoid nerve (branch of CNVII)
what muscle is shown?
how many parts?
origins
insertions
actions
innervations
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)
what muscles are shown?
what muscle is shown?
origin
insertion
action
innervation
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)
what is ansa cervicalis?
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
what muscle is shown?
origin
insertion
action
innervation
Sternothyroid muscle
Origin: posterior surface of manubrium of sternum
Insertion: oblique line of thyroid cartilage
Action: depresses larynx
Innervation: Ansa cervicalis (C1-C3)
what muscle is shown
origin
insertion
action
innervation
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
what muscle is shown?
its parts
origin
insertion
action
innervation
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]
what is shown?
infrahyoid muscles
what are the intrinsic muscles of the larynx?
Cricothyroid muscle
Posterior cricoarytenoid muscle
Lateral cricoarytenoid muscle
Transverse arytenoid muscle
Oblique arytenoid muscle
Thyroarytenoid muscle
Vocalis muscle
what is this?
its parts
origin
insertion
function
innervation
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)
what is this?
origin
insertion
function
innervation
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)
what is this
origin
insertion
function
innervation
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)
what is this?
origin
insertion
function
innervation
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)
what is this
origin
insertion
function
innervation
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)
what is this
origin
insertion
function
innervation
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)
what is this?
origin
insertion
function
innervation
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)
what does the vagus nerve give rise to?
superiror laryngeal nerve
inferior laryngeal nerve (aka recurrent laryngeal)
what is the superiro laryngeal nerve? its branches
- 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
differnece between right and left course of laryngeal nerve
what is function of the recurrent laryngeal nerves
- Sensory innervation to the larynx below the level of the vocal folds
- Motor innervation to all intrinsic laryngeal muscles except the cricothyroid m.
what is thyroidectomy?
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
what does injury to the Recurrent laryngeal nerve cause?
injury to 1 = hoarse voice
injury to 2 = vocal cord paralysis
