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Head and Neck Anatomy > Larynx and Pharynx > Flashcards

Larynx and Pharynx Flashcards

1
Q

What does the pharynx share borders with?

A

The nasal cavity (choanae), oral cavity (facial isthmus), larynx (laryngeal inlet), and esophagus (entrance to esophagus)

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2
Q

What are the three regions of the pharynx?

A

Nasopharynx, Oropharynx, and Laryngopharynx

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3
Q

How many layers are there to the muscular wall of the pharynx? How do they differ?

A

Two layers. The outer layer consists mostly of circular-oriented constrictors, the inner layer is mostly longitudinally oriented muscles that shorten and widen the pharynx.

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4
Q

What are the three constrictor muscles of the pharynx? How are they oriented and where do they meet?

A

The superior pharyngeal constrictor m. : the middle pharyngeal constrictor m. : and the inferior pharyngeal constrictor m. - These muscles surround the pharynx, and meet along a posterior milling pharyngeal raphe.

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5
Q

What are the four parts of the superior pharyngeal constrictor m., and where are their anterior, and posterior attachments?

A

All four coalesce posteriorly to the superior portion of the pharyngeal raphe. They are: the pterygopharyngeal part (pterygoid hamulus), the buccopharyngeal part (pterygomandibular raphe), the mylopharyngeal part (posterior portion of mylohyoid line of the mandible), glossopharyngeal part (posterolateral tongue)

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6
Q

Where does the middle pharyngeal constrictor m. originate and insert?

A

originates on hyoid bone (greater and lesser horn) and stylohyoid ligament. Inserts on the pharyngeal raphe.

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7
Q

What are the parts, and attachments of the inferior pharyngeal constrictor m.?

A

the thyropharyngeal part (thyroid cartilage of larynx), and the cricopharyngeal part (cricoid cartilage of larynx)

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8
Q

What are the three longitudinal m. of the pharynx?

A

Stylopharyngeus m., palatopharyngeus m., salpingopharyngeus m.

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9
Q

Give the stylopharyngess m.’s attachments, efferent innervation, and actions.

A

Proximal : styloid process of temporal bone - Distal : thyroid cartilage of larynx - motor : glossopharyngeal n. (CN IX) - actions : elevates and widens larynx and pharynx during swallowing (deglutition)

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10
Q

Give the palatopharyngeus m.’s attachments, efferent innervation, and actions.

A

Proximal : palatine aponeurosis - Distal : superior margin of thyroid cartilage - motor : pharyngeal plexus (Vagus n. CN X) - actions : elevates and widens the pharynx and larynx during deglutition.

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11
Q

Give the salpingopharyngeus m.’s attachments, efferent innervation, and actions.

A

Proximal : distal pharyngotympanic tube - Distal : superior margin of thyroid cartilage - motor : pharyngeal plexus (Vagus n. CN X) - actions : Elevates and widens both the larynx and pharynx during deglutition (swallowing); can aid in opening the distal pharyngotympanic tube for equalizing pressure in the middle ear

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12
Q

What innervates the pharyngeal constrictor m.’s? Where do efferent/afferent innervations come from?

A

the pharyngeal plexus - this receives efferent from Vagus and afferent from glossopharyngeal.

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13
Q

Where does the cricopharyngeal part receive innervations from?

A

it gets dual innervations from the pharyngeal plexus and vagus n. via the recurrent laryngeal and superior laryngeal nn.

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14
Q

Where does the pharyngeal plexus receive autonomic fibers from?

A

Vagus (parasympathetic) and superior cervical ganglion (sympathetic)

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15
Q

What is the primary arterial supply of the pharyngeal constrictor mm.?

A

the ascending pharyngeal a. (branch of external carotid)

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16
Q

What arterial supply may the inferior pharyngeal constrictor m. have separate from the ascending pharyngeal a.?

A

the inferior thyroid a. (thyrocervical trunk)

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17
Q

Both _____________ and _____________ pharyngeal constrictor mm. may have arterial supply from _________________.

A

superior and middle : tonsillar br. and facial a.

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18
Q

What are the possible arteries that may supply the superior pharyngeal constrictor m.?

A

the ascending pharyngeal a., the tonsillar br. of facial a., and the ascending palatine a. br. of facial a.

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19
Q

What vein drains the pharyngeal constrictor mm.? Where does it drain to?

A

the pharyngeal venous plexus : the IJV

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20
Q

What two bodies of fascia support the pharynx?

A

the pharyngobasilar fascia (deep, investing layer of external pharyngeal mm.), and the buccopharyngeal fascia (superficial investing layer of external pharyngeal mm.).

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21
Q

What is the pharyngobasilar fascia responsible for?

A

It suspend the superior pharyngeal constrictor m. from the basilar part of the occipital bone and the adjacent temporal bone.

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22
Q

Where is the pharyngobasilar fascia found?

A

it is found closely associated with the pharyngeal raphe at the pharyngeal tubercle

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23
Q

What is the pterygomandibular raphe?

A

A condensed band of the buccopharyngeal fascia that extends from the pterygoid hamulus to the posterior end of the mylohyoid line of the mandible

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24
Q

What does the pterygomandibular raphe connect?

A

the buccinator m. with the superior pharyngeal constrictor m.

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25
Q

Where is the retropharyngeal space?

A

Posterior to the muscular wall of the pharynx and its investing buccopharyngeal fascia, anterior to the prevertebral fascia, and spanning the distance between the base of the skull and the mediastinum

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26
Q

What two potential spaces is the retropharyngeal space composed of?

A

Anteriorly : the “true” retropharyngeal space - Posteriorly : the “danger space”

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27
Q

What makes the retropharyngeal space important clinically?

A

It represents a potential pathway for metastasis of disease between the head & neck and the thorax.

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28
Q

What are the major targets and functions of the glossopharyngeal n. (CN IX)?

A

Efferent to stylopharyngeus m.
Afferent from carotid sinus and carotid body
Afferent from pharynx (not nasopharynx which is maxillary n.)

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29
Q

What are the major targets and functions of the vagus n. (CN X)?

A

Efferent to pharyngeal plexus: pharyngeal mm. excluding stylopharyngeus m.

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30
Q

What nerves make up the pharyngeal plexus? What are their innervations?

A

The Vegas n. (efferent), Glossopharyngeal n. (efferent to sylopharyngeus/afferent to plexus), and branches from the superior cervical sympathetic ganglion. (Maxillary n. gives afferent to nasopharynx, not pharyngeal plexus)

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31
Q

What is the carotid sheath?

A

a condensation of deep cervical fascia that surrounds the major vasculature of the neck.

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32
Q

What is found in the carotid sheath?

A

IJV, common carotid/internal carotid, Vagus n (CN X), deep cervical lymph nodes

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33
Q

The carotid sheath is found:

A

Deep to the SCM m.,
Lateral to the larynx, trachea, pharynx, esophagus, & infrahyoid mm.,
Posterior to the ansa cervicalis (sometimes ansa is embedded within the sheath), and
Anterolateral to the cervical sympathetic trunk.

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34
Q

What two sources supply the larynx with blood?

A

Superior laryngeal a. (External carotid a. > Superior thyroid a. > superior laryngeal a.) and the Inferior laryngeal a. (1st part of SCA > thyrocervical trunk > inferior thyroid > inferior laryngeal a.)

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35
Q

What accompanies the superior laryngeal a. on its way to the larynx? What does it go through?

A

the internal branch of the superior laryngeal n.. It goes through the thyrohyoid membrane.

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36
Q

What three cartilages make up the larynx?

A

Thyroid, cricoid, epiglottic

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37
Q

Describe the thyroid cartilage.

A

the thyroid cartilage is formed from two laminae that join anteriorly along the midline. (posteriorly incomplete)

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38
Q

What suspends the thyroid cartilage from the hyoid bone?

A

thyrohyoid membrane

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39
Q

What forms the cricothyroid joint?

A

The inferior horns of the thyroid cartilage, and the cricoid cartilage.

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40
Q

What movement does the cricothyroid joint allow for?

A

It allows the thyroid cartilage to tip forward.

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41
Q

Describe the orientation of the cricoid cartilage in the larynx, and where it is most robust.

A

The cricoid cartilage forms a complete ring around the airway. most robust in posterior.

42
Q

Describe the epiglottic cartilage’s shape, orientation, and purpose.

A

Leaf shaped cartilage. sits posterior to thyroid cartilage. forms the epiglottis by forming a lit that covers the laryngeal inlet during deglutition.

43
Q

What three cartilages support the structure/function of the larynx?

A

Arytenoid cartilage, corniculate cartilage, cuniform cartilage.

44
Q

Describe the arytenoid cartilage’s shape, orientation, and processes.

A

pyramid shaped. sits atop the cricoid laminae. the vocal process attaches to the vocal ligament. the muscular process allows for muscle attachment.

45
Q

What movements are the arytenoid cartilages capable of?

A

rotation or gliding for either abduction (pull apart) or adduction (put together) of the vocal cords.

46
Q

Where is the corniculate cartilage

A

it sits on top of the arytenoid cartilage.

47
Q

What does the corniculate cartilage do?

A

Extend the structure provided by the arytenoids posteromedially

48
Q

where are the cuneiform cartilages?

A

within the art-epiglottic folds on lateral portions of laryngeal inlet

49
Q

What two membranes give shape to the walls of the larynx?

A

the quadrangular membrane, conus elasticus

50
Q

What and where is the quadrangular membrane?

A

A poorly defined fibre-elastic sheet. It spans the space between the lateral margins of the epiglottis and the arytenoid cartilages

51
Q

What is formed by the inferior most extent of the quadrangular membrane?

A

vestibular ligaments

52
Q

What and where is the conus elasticus?

A

A fibro-elastic sheet that shapes the walls of the larynx as a funnel. It’s found between the thyroid and cricoid cartilages

53
Q

What is the superior most aspect of the conus elasticus?

A

the vocal ligaments and the walls of the laryngeal ventricle

54
Q

What is the anteromedial aspect of the conus elasticus?

A

the median cricothyroid ligament

55
Q

What muscles make up the intrinsic mm. of the larynx.

A

Cricothyroid, posterior crico-arytenoid, transverse arytenoid, oblique arytenoid, lateral crico-arytenoid, thyro-arytenoid, thyro-epigllotic part of thyro-arytenoid, vocalis

56
Q

Cricothyroid: action, innervation, effect on rima glottidis, and effect on speech

A

Tips thyroid cartilage anteriorly, thus increasing tension on vocal ligaments : external branch of exterior laryngeal (w/ inferior laryngeal constrictor m.) : none : increases pitch

57
Q

Posterior crico-arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Lateral rotation of arytenoids & abduction (opening) of vocal folds : Efferent - Recurrent laryngeal n. : Expands glottis : none ONLY MUCSLE THAT CAN OPEN VOCAL CORDS

58
Q

Transverse arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Adduction of arytenoids & vocal folds : recurrent laryngeal n. : narrows glottis : approximate vocal folds for phonation

59
Q

Oblique arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Adduction of arytenoids & vocal folds : recurrent laryngeal n. : narrows glottis : approximate vocal folds for phonation

60
Q

Lateral crico-arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Medial rotation of arytenoids & adduction of vocal folds; Shortens & relaxes vocal ligaments : recurrent laryngeal n. : narrows glottis : approximate vocal folds for phonation, decreases pitch

61
Q

Thyro-arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Glides arytenoids toward thyroid cartilage : recurrent laryngeal : none : decreases pitch

62
Q

Thyro-epiglottic part of tyro-arytenoid: action, innervation, effect on rima glottidis, and effect on speech

A

Draws the ary-epiglottic folds inferolaterally (slightly dilates the laryngeal inlet) : recurrent laryngeal n. : none : none

63
Q

Vocals: action, innervation, effect on rima glottidis, and effect on speech

A

Adds lateral tension to the vocal ligament : recurrent laryngeal n. : none : Finely increases pitch; affects timbre

64
Q

What does the sympathetic nervous system consist of?

A

pre- and postganglionic fibers which typically synapse in ganglia of the sympathetic trunk

65
Q

Where is the sympathetic trunk?

A

the entire spinal cord

66
Q

How do preganglionic fibers get to the sympathetic trunk?

A

IML nucleus (lateral horn) of spinal cord > ventral roots of spinal nerves > VPR > white rami

67
Q

Once in the sympathetic trunk, preganglionic fibers either:

A

synapse at that level, leave the trunk as part of the splanchnic n., ascend the trunk as part of the splanchnic n., descend the sympathetic trunk and synapse or leave the trunk.

68
Q

What carries signals back to the VPR from the synapse?

A

postganglionic fibers

69
Q

From the synapse, how do postganglionic fibers carry signals back to the VPR?

A

via grey rami communications

70
Q

Where are white rami communications restricted to?

A

T1-L2

71
Q

What levels of the spinal cord do grey rami conduct postganglionic fibers back to VPR?

A

the entire spinal cord (or entire sympathetic trunk)

72
Q

How many sympathetic ganglia are there in the neck compared to the spinal cord?

A

the neck typically has 2-3, the spinal cord has them at every spinal level.

73
Q

What are splanchnic nn.?

A

collections pre-ganglionic fibers that pass through the sympathetic trunk without synapsing

74
Q

Where do splanchnic nn. typically synapse?

A

in the pre-aortic ganglia of the abdominopelvic cavity.

75
Q

what is Horner’s syndrome?

A

an interruption of a cervical sympathetic trunk

76
Q

What are symptoms of Horner’s syndrome?

A

unilateral: Miosis (constricted pupil), Ptosis (droopy eyelid), Pseudo-enopthalmos (appearance of sunken globe of eye), and Anhydrosis (lack of sweating).

77
Q

What splits the retropharyngeal space, and what does it get split in to?

A

the Alar Fascia

the “true retropharyngeal” space (anterior) and danger space (posterior)

78
Q

what fascia are the constrictor mm. of the pharynx sandwiched between?

A

the buccopharyngeal (posterior) and pharyngobasilar (anterior)

79
Q

What muscle will the glosspharyngel n. likely be associated with?

A

the stylopharyngeus m. (where it is efferent)

80
Q

the afferent innervation of the pharynx comes from the ___________________, except for the _______________ which gets it from the ________________.

A

glossopharyngeal : nasopharynx : maxillary n.

81
Q

What two ligaments make up the conus elasticus?

A

the vocal ligament and lateral cricothyroid ligament

82
Q

What are two ways to get an airway? (emergency and surgical)

A

Cricothyrotomy and Tracheotomy
crico is through the median cricothyroid ligament
tracheo is a vertical incision of the trachea

83
Q

What does the trachea connect?

A

the larynx (C6) to the primary bronchi (T4/5)

84
Q

What divides the retropharyngeal space?

A

the Alar Fascia

85
Q

What might clinicians refer to the laryngopharynx as?

A

the Hypopharynx

86
Q

Where does the nasopharynx begin/end?

A

at the Choanae to the bottom margin of the soft palate

87
Q

Where does the oropharynx begin/end

A

at the palatine fossa, including the palatine/lingual tonsil and uvula then ending at the height of the epiglottis.

88
Q

What is the larynx inlet?

A

where gasses can pass through to the lungs.

89
Q

Where will you likely find the glossopharyngeal n.?

A

lying on the stylopharyngess m.

90
Q

where are your spit traps, and where are they found?

A

epiglottic vallecula. On the superior part of the epiglottis between the median and lateral gloss-epiglottic folds

91
Q

What is the clinical name for the “false vocal cords”?

A

the Vestibular fold

92
Q

what is the space between the vestibular fold?

A

the Rima Vestibuli

93
Q

Moving upward through the larynx, what area to we come to after we pass the vestibular fold?

A

the laryngeal vestibule

94
Q

What fold is located inferiorly to the vestibular fold?

A

the vocal fold (cords)

95
Q

What is the space between the vocal folds?

A

the Rima Glottidis

96
Q

What is the space between the ventricular fold and vocal folds?

A

the laryngeal ventricle

97
Q

What cavity in the larynx is contiguous with the trachea?

A

the infraglottic cavity

98
Q

What makes up the glottidis?

A

the rima glottidis and the vocal folds

99
Q

What are the areas that host the superior, middle, and inferior cervical ganglion?

A

C1-4, C5-6, C7-8+T1 (sometimes to T4)`

100
Q

Where do branches of the Superior cervical ganglion go?

A

the Head and Pharyngeal plexus

101
Q

Where do branches of the middle cervical ganglion go?

A

its frequently absent, but when there it goes to the thyroid

102
Q

Where do the inferior cervical ganglion go to?

A

the subclavian and vertebral aa.

Head and Neck Anatomy (15 decks)

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