Larynx And Pharynx Flashcards

0
Q

What forms the floor of the nasal cavity?

A

Hard palate

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1
Q

What is the posterior nasal aperture called and what is it divided by?

A

Choanae separated by vomer

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2
Q

What type of cells line the nasal cavity apart from the front part nearest the nares?

A

Pseudostratified respiratory endothelium

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3
Q

Where does the nasal cavity start and end?

A

Nares to choanae

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4
Q

Which part of the nasal cavity is olfactory?

A

Superior concha, upper part of nasal cavity

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5
Q

What is a nasal meatus?

A

Area under concha, passages for movement of air

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6
Q

What do nasal concha do?

A

Create turbulent air flow
Warm and moisten air
Trap particulates

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7
Q

What feature of nasal conchae help it warm air?

A

Highly vascular tissue

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8
Q

Which part of nasal cavity produce resonance in the voice?

A

Cavity and paranasal sinuses

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9
Q

Where does the sphenoid sinus drain to?

A

Sphenoethmoidal recess

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10
Q

Which bones and cartilage form the nasal septum?

A

Perpendicular plate of ethmoid
Vomer
Septal cartilage

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11
Q

Which concha does the ethmoid bone form?

A

Superior and middle

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12
Q

What is the little area/Kisselbach plexus?

A

Area in nose rich in capillaries where all 5 arteries that supply septum anastamose
Site for profuse nose bleeds

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13
Q

Where does the nasolacrimal duct drain tear fluid from and to?

A

Medial eyelid to inferior meatus

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14
Q

What is dacrostenosis?

A

Mechanical obstruction of the nasolacrimal duct

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15
Q

What are paranasal sinuses?

A

Open air filled cavities sitting within bones of cranium

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16
Q

Which is the paranasal sinus not seen from the front?

A

Sphenoid

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17
Q

What is the semilunar hiatus?

A

Groove in lateral wall of nasal cavity inferior to ethmoid bulla
Location of opening for frontal, maxillary and anterior ethmoid sinuses

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18
Q

Which bone does the apex of the maxillary sinus extend into?

A

Zygoma

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19
Q

Which is the largest paranasal sinus?

A

Maxillary

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20
Q

During removal a molar tooth, fracture of a root may be driven superiorly into the maxillary sinus. What may this cause?

A

Communication may be created between oral cavity and maxillary sinus as a result and an infection may occur

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21
Q

Which sinus is most susceptible to chronic sinusitis and why?

A

Maxillary sinus because it drains superiorly and so has to drain against gravity. Only way to drain is via postural change. So infection more likely to linger here

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22
Q

What can be a cause of peri orbital cellulitis?

A

Spread of infection from ethmoid sinus as only separated by a thin plate of bone

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23
Q

Which cranial nerves innervate the nasal cavity?

A

CN Va - all sinuses except maxillary
CN Vb- maxillary sinus
CN I - olfactory

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24
Q

What can fracture of the cribriform plate cause?

A

CSF rhinorrhoea

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25
Q

What forms the borders of the nasopharynx?

A

Nasal choanae to lower border of soft palate

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26
Q

What forms the borders of the oropharynx?

A

Lower border of soft palate
Palatal arches
Epiglottis

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27
Q

What forms the border of the laryngopharynx?

A

Epiglottis to cricopharyngeus

28
Q

Which muscles control movement of the soft palate?

A

Tensor veli palatini - stretches

Levator veli palatini - lifts

29
Q

What is the role of the soft palate?

A

Separates naso and oropharynx during swallowing. Prevents food entering nasal cavity

30
Q

What is the pharynx?

A

Muscular region connecting nasal and oral cavities with larynx and oesophagus

31
Q

What do the 3 pharyngeal constrictors do? (Sup, middle, inf)

A

Reduce size of pharynx

Squeeze food down pharynx, peristalsis

32
Q

Which muscle forms the true upper oesophageal sphincter?

A

Cricopharyngeus

33
Q

Which nerve innvervates the pharyngeal constrictor muscles? And what happens if these muscles are paralysed?

A

Motor supply from CNX vagus

Paralysis can cause lack of gag reflex, dysphagia, increased risk of aspiration

34
Q

What do the pharyngeal constrictors attach to?

A

Midline raphe posteriorly which attaches to skull base
Superior - anterior attachment on mandible
Middle - anterior attachment on hyoid
Inferior - anterior attachment on thryoid cartilage

35
Q

What can happen at the weak spot of the posterior pharynx?

A

Pharyngeal pouch, diverticulum

Weak spot at point where muscle fibers change shape at cricopharyngeus

36
Q

What can happen if food gets into a pharyngeal diverticulum?

A

Feeling of something stuck in throat
Halitosis
Coughing up food

37
Q

Which pharyngeal muscles are not innervated by CNX?

A

Stylopharyngeus

Tensor veli palatini

38
Q

What are the 3 longitudinal muscles of the pharynx and what is their function?

A

Salpingopharyngeus
Palatopharyngeus
Stylopharyngeus
Elevate and widen pharynx

39
Q

Damage to which nerves can cause ipsilateral soft palate paralysis?

A

CN X - lavator veli palatini

CN Vc - tensor veli palatini

40
Q

Which direction will the soft palate be pulled towards if paralysed due to ipsilateral nerve damage to CNX or CNVc?

A

Towards strong side, away from paralysed side

41
Q

Name the 4 tonsillar tissue sites in the entrances to the pharynx

A

Palatine
Adenoid (pharyngeal)
Tubal (around Eustachian tube)
Lingual

42
Q

What are the tonsillar sites around the pharynx collectively known as?

A

Waldeyer ring of lymphoid tissue

43
Q

What are the consequences of an increase in size of the lymphoid tissue masses in pharynx? And give a clinical example

A

Blockage of drainage tubes

Eg glue ear in children due to blockage of Eustachian tube by enlarged tubal tonsillar tissue

44
Q

What lies between the palatoglossal and palatopharyngeal arches?

A

Palatine tonsils

45
Q

What are the main functions of the larynx?

A

Guard entrance to tracheobronchial tree
Prevent inhalation of fluids and solids - aspiration pneumonia risk
Allows regulation of intrathoracic and intraabdominal pressure - valsava manoeuvre
Enables phonation

46
Q

What vertebral level is the hyoid bone located at?

A

C3

47
Q

What vertebral level is the cricoid cartilage found at?

A

C6

48
Q

Why is fracture of the hyoid bone an emergency?

A

Occlude airway due to oedema

49
Q

Why is the cricothyroid membrane useful?

A

Can provide emergency airway entrance

50
Q

Where do synovial joints form in the larynx?

A

Between thyroid and cricoid cartilage

Between arytenoid and cricoid cartilage - muscular process of arytenoid

51
Q

What forms a mobile attachment point for the vocal ligaments?

A

Arytenoid cartilages - vocal processes

52
Q

What is the cricovocal membrane?

A

Elastic
Passes from cricoid to vocal process of arytenoids
Thickened free edge = vocal ligament

53
Q

What are the 2 strong membranes covered in respiratory mucosa in the larynx?

A

Aryepiglotic membrane - free lower border forms vestibular fold
Cricovocal membrane - free upper border forms vocal ligament

54
Q

What is the mucosal pouch between aryepiglotic & cricovocal membrane? Where things can get stuck or grow

A

Ventricle and saccule

55
Q

What cell types form the vocal ligaments?

A

Stratified squamous

56
Q

Which parts make up the glottis?

A

Vocal folds and processes

Rima glottidis

57
Q

What is the area between the vocal folds called? And what can be visualised here?

A

Rima glotidis

Trachea

58
Q

Which nerve provides sensory innervation above the vocal folds?

A

Superior laryngeal branches into internal laryngeal nerve

59
Q

During thyroid surgery, ligation of which artery may cause damage to internal and external laryngeal nerves?

A

Superior thyroid artery

60
Q

What is the function of the cricothyroid muscle?

A

Pivots thyroid cartilage forward and down on the cricoid & tenses the vocal folds. Tenses vocal fold so increases pitch of voice

61
Q

What is the nerve supply of the cricothyroid muscle?

A

External laryngeal, branch of superior laryngeal from CNX

62
Q

Which muscle abducts (opens) the vocal ligaments?

Which adducts them?

A

Posterior cricoarytenoid muscle

Lateral cricoarytenoid muscle

63
Q

Which muscles are supplied by recurrent laryngeal nerve?

A

All muscles of larynx apart from cricothyroid

64
Q

What do thyroarytenoid and vocalis muscles do?

A

Pull arytenoid cartilage anteriorly & thyroid cartilage posteriorly and superiorly. Relaxes vocal fold and lowers pitch of voice

65
Q

What can result from unilateral injury of the recurrent laryngeal nerve?

A

A hoarse or weakened voice

66
Q

What can bilateral injury to recurrent laryngeal nerves result in?

A

Cords paralysed in mid abduction-adduction position
Voice initially absent and later weak
Floppy cords can block the respiratory tract - emergency

67
Q

Why is loss of sensation from superior laryngeal nerve a potential emergency?

A

Aspiration risk as cough reflex will not be initiated

68
Q

What happens to rima glottidis on phonation?

A

Gets smaller as vocal folds close