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Anatomy Module IV > Larynx and Pharynx > Flashcards

Larynx and Pharynx Flashcards

1
Q

phayrnx

A

U shaped musculomembranous structure located posterior to the nasal cavity, oral cavity, and larynx

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2
Q

what does the pharynx join

A

joins the nasal and oral cavities TO the larynx and esophagus

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3
Q

location of pharynx

A

extends from base of skull to the C6 vertebral level, but is SUBDIVIDED into 3 regions

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4
Q

three subdivisions of the pharynx

A

nasopharynx, oropharynx, and laryngophayrnx

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5
Q

nasopharynx basic

A

posterior to nasal cavity and passageway for air

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6
Q

orophayrnx basic

A

posterior to oral cavity and passageway for air and food/liquid

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7
Q

laryngopharynx basic

A

posterior to larynx, passageway for food/liquid

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8
Q

air passes…

A

from the naso- and oro-pharynx –> through larynx–> trachea–> primary bronchi–> lungs

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9
Q

food liquid passes..

A

from the orophayrynx–> into the laryngopharynx –> esophagus –> stomach

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10
Q

nasopharynx specific location

A

base of skull –> to level of soft palate marked by the palatoglossal arch

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11
Q

torus tubarius

A

(lateral)
opening of pharyngotympanic tube or AUDITORY/EUSTACHIAN TUBE)
this allows communication between the nasopharynx and middle ear cavity

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12
Q

what assists in opening the pharyngotympanic tube?

A

the salpingopharyneus and levator veli palatini

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13
Q

pharyngeal recess

A

posterior to the torus tubarius; location of pharyngeal tonsils or adenoids; enlargement may interfer with nasal breathing

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14
Q

oropharynx specific

A

extends from the soft palate (palatoglossal arch) to the superior border of epiglottis C3

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15
Q

laryngopharynx specific

A

extends from the superior border of the epiglottis (C3) to the inferior border of the cricoid cartilage (C6)

this communicated with the larynx through the laryngeal inlet on its anterior wall

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16
Q

laryngeal inlet

A

how the laryngopharynx communicates with the larynx on is anterior wall

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17
Q

where is epiglottis

A 
c3 
pharynx itself (base of skull down to c6)
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18
Q

squamous cell carcinoma

A

can occur in orophaynx - 90% of this and oral cavity

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19
Q

circular skeletal muscles of the pharynx

A

superior, middle, and inferior pharyngeal constrictors

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20
Q

longitudinal skeletal muscles of the pharynx

A

stylopharyngeus, palatopharyngeus, and salpingopharyngeus

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21
Q

superior pharyngeal constrictor

attachments and action

A

pharyngeal tubercle (just anterior to the foramen magnum) and pharyngeal raphe (posterior) then moves anterior to attach to the pterygoid hamulus, and pterygomandibular raphe, and mandible

action - constrict the wall of the pharynx during swallowing - propel the bolus of food

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22
Q

middle pharyngeal constrictor

attachment and action

A

pharyngeal raphe (posterior) to the stylohyoid ligament and hyoid bone

constrict the wall of pharynx as swallow

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23
Q

inferior pharyngeal constrictor

attachment and action

A

attaches to the pharyngeal raphe (posterior) and goes to the thyroid cartilage and cricoid cartilage

action - constrict wall of pharynx as swallow

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24
Q

innervation to the pharyngeal constrictor muscles

A

CN X via the pharyngeal plexus (all 3)

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25
Q

inferior pharyngeal constrictor innervation

A

in addition to CN X via the pharyngeal plexus, this muscle also receives innervation from fibers of the external branch of the superior laryngeal nerve and recurrent laryngeal nerve

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26
Q

Opening associated with the superior to the superior pharyngeal constrictor

A

passage of the pharyngotympaninc tube and levator levi palatini muscle

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27
Q

opening between the superior and middle constrictor muscles of pharynx

A

passage of the stylopharyngeus and CN IX (9)

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28
Q

opening between the middle and inferior constrictor of the pharynx

A

passage of the internal branch of the superior laryngeal nerve and the superior laryngeal vessels

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29
Q

opening inferior to the inferior constrictor of the pharynx

A

passage of the recurrent laryngeal nerve

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30
Q

how to identify CN IX - the glossopharyngeal nerve

A

it sits RIGHT ON TOP OF THE stylopharyngeus muscle in a posterior view and will then pass between the superior and middle constrictor muscles to gain access to

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31
Q

action of the longitudinal pharyngeal muscles

A

elevate and widen the pharynx during swallowing

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32
Q

palatopharyngeal muscle

attach and innervation

A

longitidunal muscle

attaches - posterior to the hard palate and palatine aponeurosis to the muscular wall of the pharynx and thyroid cartilage

innervation - CN X via pharyngeal plexus

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33
Q

salpinogopharyngeus

attachment and innervation

A

attachement - cartilagenous part of pharyngotympanic tube (auditory/eustachian tube)–> to the muscular wall of pharynx

innervation is CN X via the pharyngeal plexus

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34
Q

Stylopharyngeus

attachment and innervation

A

styloid process to –> muscular wall of the pharynx and thyroid cartilage

INNERVATION IS XN IX - glossopharyngeal

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35
Q

CN IX

A

glossopharyngeal - sits on top of the stylopharyngeus muscle

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36
Q

non-contractile tissue of pharynx

A

non-contractile tissue “seals off” spaces so air, liquid and food do not “leak” from the pharynx

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37
Q

what lines the internal and external surfaces of the pharyngeal muscles?

A

fascia

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38
Q

pharyngobasilar fascia

A

INTERNAL fascial lining of the pharynx
this layer extends superior to the superior constrictor, where it is thickened and most obvious

from the pharynx to the basilar portion of the occipital bone

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39
Q

buccopharyngeal fascia

A

the EXTERNAL fascial lining of the pharynx

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40
Q

attachments of the pharyngobasilar fascia

A

superiorly this fascia attaches to the occipital bone (basilar portion), petrous temporal bone, cartilagenous portion of the pharyngotympanic tube (eustachian), and medial pterygoid plate

thins inferiorly as it lines the constrictor muscles

seals off the space posterior to the nasal and oral cavities

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41
Q

phases of deglutition (swallowing)

A

oral cavity–> pharynx–> esophagus–> stomach

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42
Q

oral phase

A

voluntary

tongue compresses the bolus successively against the hard palate –> soft palate to expel it from the oral cavity

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43
Q

pharyngeal phase 1st part

A

bolus enters the oropharynx and the SOFT PALATE IS TENSED AND ELEVATED (via the tensor veli palatini and levator veli palatini) therby BLOCKING communication between the nasal and oral cavities

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44
Q

is the pharyngeal phase of deglutition voluntary or involuntary?

A

involuntary

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45
Q

what blocks the communication between the nasal and oral cavities during swallowing

A

the elevation and tension in the soft palate which is brought out by the tensor veli palatini and the levator veli palatini of the soft palate

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46
Q

after the soft palate elevates and tenses the….

A

phaynx elevates which brings the laryngopharynx towards the descending bolus

elevation of the pharynx (longitudinal muscles) is through the stylophargeus, palatopharyngeus, salpinopharyngeus, and thyrohyoid muscles)

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47
Q

after the soft palate is tensed and elevated, the pharynx is elevated, and then..

A

contraction of the pharyngeal constrictors occurs which will constrict the walls of the inner pharynx and propel the food doen inferiorly towards the esophagus

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48
Q

esophageal phase

A

also involuntary like the pharyngeal phase and this occurs through sequential waves of contraction which propels the bolus through to the esophagus–> towards stomach

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49
Q

what brings the laryngopharynx towards the descending bolus?

A

the longitudinal pharyngeal muscles - elevating and widening the pharynx during swallowing

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50
Q

sensory fibers of the pharyngeal plexus

A

derived from CN IX - glossopharyngeal nerve and these fibers carry sensory information from the mucous membrane of the nasopharynx (in part), oropharynx, and laryngopharynx

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51
Q

sensory information from nasopharynx

A

CN IX - via the pharyngeal plexus AND additionally the mucosa of the nasopharynx also receives sensory fibers from the pharyngeal branch of V2 - from the PPG (pterygopalatine ganglion)

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52
Q

motor fibers of the pharyngeal plexus

A

derived from CN X which supplies all muscles of the pharynx BESIDES THE STYLOPHARYNGEUS which is innervated by CN IX

  • also the inferior pharyngeal constrictor also receives motor fibers from the recurrent and external branch of the superior laryngeal nerves)
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53
Q

overview of the larynx

A

located in the anterior neck - anterior to the pharynx
composed of carilages, membranes, and ligaments and is moved by several muscles

necessary for voice production and plays a vital role in guarding the airway

54
Q

location of larynx at rest

A

anterior to C3-C6 vertebra (superior extension of the epiglottis to inferior margin of the cricoid cartilage)

basically anterior to the laryngoppharynx portion (3) of the pharynx

55
Q

The larygneal skeleton is a …..

A

CARTILAGENOUS SKELETON

56
Q

how many cartilages of the larynx

A

9

three unpaired and three paired

57
Q

unpaired cartilages of the larynx

A

epiglottis
thyroid
cricoid

58
Q

paired cartilages of the larynx

A

arytenoid
corniculate
cuneiform

59
Q

thyroid cartilage

A

located at C4-C5 level
largest of the laryngeal cartilages and formed by 2 laminae that fuse in the midline

does NOT completely encircle the airway

60
Q

laryngeal prominence

A

prominent region on the external surface of the thyroid cartilage, where the two laminae fuse

  • most dinstinct superiorly where it is distinct in males
  • also known as the adams apple in males
61
Q

angle of the thyroid cartilage

A

the angle is on the INTERNAL surface and also a result of the fusing of the two laminae

  • the internal aspect is where the focal cords will attach
62
Q

superior and inferior horns of…

A

the thyroid cartilage and these extend from the laminae

the inferior horn has an articular facet for the cricoid cartilage

63
Q

epiglottic cartilage

A

most superior of the laryngeal cartilages at C3
the superior end is ‘free’

it bends to cover the airway during swallowing

64
Q

inferior end of the epiglottic cartilage

A

attached to the angle of the thyroid cartilage by the thyroepiglottic ligament

65
Q

thyroepiglottic ligament

A

connects the thyroid cartilage to the epiglottic cartilage

epiglottic is superior

66
Q

T/F the epiglottis is sufficient in protecting the airway during swallowing because it covers the airway

A

FALSE - it assists but alone is not sufficient enough

67
Q

cricoid cartilage

A

most inferior of the three unpaired cartilages and is at the level of C6

it is shaped like a signet ring (class ring) with the broad lamina positioned posteriorly and narrow arch anteriorly

it COMPLETELY encircles the airway and has articular surfaces for the inferior horn of the thyroid and the arytenoid cartilages

68
Q

arytenoid cartilages

components

A

pyramidal shaped and paired
very important

base
vocal process
muscular process
apex - superior portion

69
Q

base of arytenoid cartilage

A

articulates with lamina of the CRICOID CARTILAGE

70
Q

vocal process of arytenoid cartilages

A

projects ANTERIORLY and is the attachment site for a ligament - vocal ligament and a muscle - vocalis

71
Q

muscular process

A

of the arytenoid cartilage and projects LATERALLY and is teh attachment site for several muscles

72
Q

corniculate and cuneiform cartilages and location

A

other sets of paired cartilages of the larynx

corniculate - at the apex of the arytenoid cartilages

cuneiform cartilages - located within a mucosal fold

73
Q

cricothyroid joints

A

joint of the larynx which are synovial joints between the inferior horn of the thyroid cartilage and cricoid cartilage

74
Q

cricoarytenoid joints

A

synovial joints between the arytenoid and cricoid cartilages

75
Q

extrinsic ligaments and membranes of the larynx

A

thyrohyoid membrane
median thyrohyoid ligament
lateral thyrohyoid ligament
cricotracheal ligament

these are helping seal off the spaces

76
Q

thyrohyoid membrane

A

extends from the thyroid cartilage to the hyoid bone (which is superior)

77
Q

median thyrohyoid ligament

A

more anterior and is a thickening of the thyrohyoid membrane

78
Q

lateral thyrohyoid ligament

A

thickening posterior aspect of the thyrohyoid membrane

79
Q

cricotracheal ligament

A

extends from cricoid cartilage to 1st tracheal cartilage

more inferior

80
Q

intrinsic membranes and ligaments of the larynx

A

quadrangular membrane
aryepiglottic ligament and vestibular ligament

cricothyroid ligament
vocal ligament

81
Q

quadrangular membrane

A

drapes down from the epiglottis to the arytenoid cartilage

82
Q

aryepiglotic ligament

A

free superior margin of the quadrangular membrane

83
Q

vestibular ligament

A

free inferior border of the quadrangular membrane

FALSE VOCAL CORD

84
Q

cricothyroid ligament

A

extends from the cricoid cartilage to thyroid cartilage and arytenoid cartilage

85
Q

vocal ligament

A

free superior border of the cricothyroid ligament

TRUE VOCAL CORD

86
Q

aryepiglotic fold

A

aryepiglotic ligament covered by mucosa

87
Q

vestibular fold

A

vestibular ligament covered by mucosa

aka FALSE vocal cords

88
Q

vocal fold

A

vocal ligament covered by mucosa aka TRUE vocal cords

this is positoned below the vesitbular fold

89
Q

rima vestibuli

A

the opening between the vestibular folds

90
Q

rima glottidis

A

the opening between the vocal folds

91
Q

laryngeal inlet

A

marks the opening between the larynx and pharynx

- this is internal space in the larynx and air will pass through here

92
Q

priform recess

A

depression located on either side of the laryngeal inlet, food may get trapped here

93
Q

supraglottic cavity

A

aka vestibule and extends from the inlet to the vestibular fold - like an entrance way into the more functional portion of the larynx

94
Q

middle laryngeal cavity

A

region between the vestibular folds and vocal folds

95
Q

laryngeal ventricle

A

associated with the middle laryngeal cavity and extends laterally from this cavity

96
Q

laryngeal saccule

A

elongated tubular extension of the ventricle; numerous mucous glands, which assist in lubricating the vocal folds

97
Q

infraglottic cavity

A

below vocal folds (continous with trachea)

98
Q

extrinsic laryngeal muscles

A

connect the larynx to neighboring structures and move it as a whole

infrahyoids and suprahyoids

99
Q

infrahyoid muscles

A

extrinsic muscles of the larynx and will move the larynx inferior

100
Q

thyrohyoid muscle action on larynx

A

elevates larynx - even though it is an infrahyoid

101
Q

suprahyoid muscles

A

extrinsic muscle of the larynx and elevates the hyoid and larynx

102
Q

intrinsic laryngeal muscles

A

move specific laryngeal cartilage, altering the length and position of the vocal ligaments and the size and shape of the rima glottidis

103
Q

Cricothyroid muscle
attachment
action
innervation

A

Intrinsic muscles
attachment - crocoid arch and thyroid cartilage

action - pulls the thyroid cartilage anteriorly and inferiorly so LENGTHEN the focal cords

innervation - external branch of the superior laryngeal nerve - AKA the external laryngeal nerve

104
Q

only muscle that opens the rima glottidis

A

posterior cricoarytenoid muscle - ABducts the vocal folds/ opening the rima glottidis

105
Q

all of the intrinsic muscles of the larynx are innervated by what nerve? what is the exception and what is its innervation?

A

all are innervated by the recurrent laryngeal nerve EXCEPT the cricothyroid muscle which is innervated by the external laryngeal nerve (branch of the superior laryngeal nerve)

106
Q

Posterior Cricoarytenoid muscle
attachment
action
innervation

A

attachment - POSTERIOR cricoid lamina and muscular process of the arytenoid cartilage

action - ABducts the focal folds/open the rima glottidis
can pull the aryentoids posteriorly and assist the cricothyroid muscles in tensing the vocal cords

innervation - recurrent laryngeal nerve

only muscle to open the rima glottidis

107
Q

lateral cricoarytenoid muscle
attachment
action
innervation

A

attachment - lateral cricoid arch and muscular process of the arytenoid cartilage

action - close/ adduct the rima glottidis / close vocal cords

innervation - recurrent laryngeal nerve

108
Q

transverse and oblique arytenoid muscles
attachment
action
innervation

A

instrinsic muscle
attachment - from one arytenoid cartilage to the contralteral arytenoid cartilage

action - adducts the arytenoid cartilages, so it closes the posterior part of the rima glottidis

innervation - recurrent laryngeal nerve

oblique - criss crossing and continues into the aryepiglottic fold and changes name to become the aryepiglottic muscle

109
Q

aryepiglottic muscle

A

oblique fibers of the arytenoid muscle - cris-crossing and continues into the aryepiglottic fold and changes name to become the aryepiglottic muscle

has same action and innervation as the transverse and oblique arytenoid muscles

110
Q

what muscle can make minor or minute adjustments to the vocal cords

A

vocalis

- lies adjacent to the vocal cords

111
Q

vocalis and thyroarytenoid muscles
attachment
action
innervation

A

attachment - arytenoid cartilage (on the vocal process) to the angle of the thyroid cartilage
VOCALIS ALSO ATTACHES TO SOME OF THE VOCAL LIGAMENT

action - brings the arytenoid cartilage towards the thyroid cartilage so RELAXES the vocal ligaments

innervation - recurrent laryngeal nerve

112
Q

describe male vs female vocal cords

A

males have longer and thicker vocal ligaments

females have relatively shorter and thinner vocal ligaments

113
Q

when you first inhale what happens

A

vocal cords ABDUCT - open

114
Q

what happens prior to speaking?

A

vocal cords approximate, which results in INCREASED pressure from below (the subglottic pressure)

then air from the subglottic space moves through the glottidis, which then causes VIBRATION of the vocal folds –> frequency of this vibration is related to the sounds we here

115
Q

pitch of one’s voice is determined by?

A

determined by the length tension relationship of the vocal ligaments

116
Q

high pitch?

A

INCREASED TENSION in vocal ligaments –> increase vibration of the vocal ligaments as air passes through the larynx –> HIGH PITCH

117
Q

low pitch?

A

DECREASED TENSION in vocal ligaments –> decrease vibration of the vocal ligaments as air passes through the larynx –> LOW PITCH

118
Q

what determines the volume (loudness) of a sound?

A

related to the FORCE with which air passes through the vocal folds

119
Q

loud sound?

A

if a lot of air is forced through the rima glottidis - loud sound produced

120
Q

soft sound?

A

if little air moves through the rima glottidis - soft sound produced

121
Q

describe whispering

A

when you whisper, only the posterior part of the rima glottidis is opening and the vocal cords DO NOT VIBRATE, therefore all whispers have the same pitch

122
Q

T/F there is no vibration of the vocal cords when you whisper

A

TRUE - and because there is no vibration - there is only one pitch to whispers

123
Q

what does the larynx do during deglutition

A

elevates and moves anteriorly

124
Q

what does the epiglottis do during deglutition?

A

it approximates the base of the tongue causing the epiglottis TO BEND POSTERIORLY which covers the laryngeal inlet - however the epiglottis alone is NOT sufficient enough by itself to protect

125
Q

pathway of bolus at epiglottis

A

bolus slips over the ANTERIOR surface of the epiglottis before passing LATERALLY into the priiform recess (lateral food passageway) before entering the esophagus

126
Q

what is required to protect the airwaY from fluid or food particles from entering the lungs?

A

brief CLOSURE OF THE RIMA GLOTTIDIS IS REQUIRED

127
Q

piriform recess

A

lateral food passageway
food goes over anterior portion of the epiglottis and passes into the esophagus through the lateral openings which are called the piriform recess

128
Q

sensory innervation to the larynx

A

all laryngeal sensation ABOVE the level of the vocal fold is provided by the INTERNAL BRANCH OF THE SUPERIOR LARYNGEAL NERVE (aka the internal laryngeal nerve)

all sensation BELOW the vocal fold is carried by the recurrent laryngeal nerve

129
Q

motor innervation to the larynx

A

all intrinsic muscles EXCEPT THE cricothyroid muscle are innervated by the recurrent laryngeal nerve

crycothyroid muscle is innervated by the external branch of the superior laryngeal nerve (external laryngeal nerve)

130
Q

inferior laryngeal nerve

A

name of the recurrent laryngeal nerve as it passes to the larynx

Anatomy Module IV (12 decks)

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