Larynx And Pharynx

Question 1

What forms the floor of the nasal cavity?

Answer 1

Hard palate

Question 2

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

Answer 2

Pseudostratified respiratory endothelium

Question 3

Where does the nasal cavity start and end?

Answer 3

Nares to choanae

Question 4

Which part of the nasal cavity is olfactory?

Answer 4

Superior concha, upper part of nasal cavity

Question 5

What is a nasal meatus?

Answer 5

Area under concha, passages for movement of air

Question 6

What do nasal concha do?

Answer 6

Create turbulent air flow
Warm and moisten air
Trap particulates

Question 7

What feature of nasal conchae help it warm air?

Answer 7

Highly vascular tissue

Question 8

Which part of nasal cavity produce resonance in the voice?

Answer 8

Cavity and paranasal sinuses

Question 9

Where does the sphenoid sinus drain to?

Answer 9

Sphenoethmoidal recess

Question 10

Which bones and cartilage form the nasal septum?

Answer 10

Perpendicular plate of ethmoid
Vomer
Septal cartilage

Question 11

Which concha does the ethmoid bone form?

Answer 11

Superior and middle

Question 12

What is the little area/Kisselbach plexus?

Answer 12

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

Question 13

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

Answer 13

Medial eyelid to inferior meatus

Question 14

What is dacrostenosis?

Answer 14

Mechanical obstruction of the nasolacrimal duct

Question 15

What are paranasal sinuses?

Answer 15

Open air filled cavities sitting within bones of cranium

Question 16

Which is the paranasal sinus not seen from the front?

Answer 16

Sphenoid

Question 17

What is the semilunar hiatus?

Answer 17

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

Question 18

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

Answer 18

Zygoma

Question 19

Which is the largest paranasal sinus?

Answer 19

Maxillary

Question 20

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

Answer 20

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

Question 21

Which sinus is most susceptible to chronic sinusitis and why?

Answer 21

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

Question 22

What can be a cause of peri orbital cellulitis?

Answer 22

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

Question 23

Which cranial nerves innervate the nasal cavity?

Answer 23

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

Question 24

What can fracture of the cribriform plate cause?

Answer 24

CSF rhinorrhoea

Question 25

What forms the borders of the nasopharynx?

Answer 25

Nasal choanae to lower border of soft palate

Question 26

What forms the borders of the oropharynx?

Answer 26

Lower border of soft palate Palatal arches Epiglottis

Question 27

What forms the border of the laryngopharynx?

Answer 27

Epiglottis to cricopharyngeus

Question 28

Which muscles control movement of the soft palate?

Answer 28

Tensor veli palatini - stretches | Levator veli palatini - lifts

Question 29

What is the role of the soft palate?

Answer 29

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

Question 30

What is the pharynx?

Answer 30

Muscular region connecting nasal and oral cavities with larynx and oesophagus

Question 31

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

Answer 31

Reduce size of pharynx | Squeeze food down pharynx, peristalsis

Question 32

Which muscle forms the true upper oesophageal sphincter?

Answer 32

Cricopharyngeus

Question 33

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

Answer 33

Motor supply from CNX vagus | Paralysis can cause lack of gag reflex, dysphagia, increased risk of aspiration

Question 34

What do the pharyngeal constrictors attach to?

Answer 34

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

Question 35

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

Answer 35

Pharyngeal pouch, diverticulum | Weak spot at point where muscle fibers change shape at cricopharyngeus

Question 36

What can happen if food gets into a pharyngeal diverticulum?

Answer 36

Feeling of something stuck in throat Halitosis Coughing up food

Question 37

Which pharyngeal muscles are not innervated by CNX?

Answer 37

Stylopharyngeus | Tensor veli palatini

Question 38

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

Answer 38

Salpingopharyngeus Palatopharyngeus Stylopharyngeus Elevate and widen pharynx

Question 39

Damage to which nerves can cause ipsilateral soft palate paralysis?

Answer 39

CN X - lavator veli palatini | CN Vc - tensor veli palatini

Question 40

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

Answer 40

Towards strong side, away from paralysed side

Question 41

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

Answer 41

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

Question 42

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

Answer 42

Waldeyer ring of lymphoid tissue

Question 43

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

Answer 43

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

Question 44

What lies between the palatoglossal and palatopharyngeal arches?

Answer 44

Palatine tonsils

Question 45

What are the main functions of the larynx?

Answer 45

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

Question 46

What vertebral level is the hyoid bone located at?

Answer 46

C3

Question 47

What vertebral level is the cricoid cartilage found at?

Answer 47

C6

Question 48

Why is fracture of the hyoid bone an emergency?

Answer 48

Occlude airway due to oedema

Question 49

Why is the cricothyroid membrane useful?

Answer 49

Can provide emergency airway entrance

Question 50

Where do synovial joints form in the larynx?

Answer 50

Between thyroid and cricoid cartilage | Between arytenoid and cricoid cartilage - muscular process of arytenoid

Question 51

What forms a mobile attachment point for the vocal ligaments?

Answer 51

Arytenoid cartilages - vocal processes

Question 52

What is the cricovocal membrane?

Answer 52

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

Question 53

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

Answer 53

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

Question 54

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

Answer 54

Ventricle and saccule

Question 55

What cell types form the vocal ligaments?

Answer 55

Stratified squamous

Question 56

Which parts make up the glottis?

Answer 56

Vocal folds and processes | Rima glottidis

Question 57

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

Answer 57

Rima glotidis | Trachea

Question 58

Which nerve provides sensory innervation above the vocal folds?

Answer 58

Superior laryngeal branches into internal laryngeal nerve

Question 59

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

Answer 59

Superior thyroid artery

Question 60

What is the function of the cricothyroid muscle?

Answer 60

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

Question 61

What is the nerve supply of the cricothyroid muscle?

Answer 61

External laryngeal, branch of superior laryngeal from CNX

Question 62

Which muscle abducts (opens) the vocal ligaments? | Which adducts them?

Answer 62

Posterior cricoarytenoid muscle | Lateral cricoarytenoid muscle

Question 63

Which muscles are supplied by recurrent laryngeal nerve?

Answer 63

All muscles of larynx apart from cricothyroid

Question 64

What do thyroarytenoid and vocalis muscles do?

Answer 64

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

Question 65

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

Answer 65

A hoarse or weakened voice

Question 66

What can bilateral injury to recurrent laryngeal nerves result in?

Answer 66

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

Question 67

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

Answer 67

Aspiration risk as cough reflex will not be initiated

Question 68

What happens to rima glottidis on phonation?

Answer 68

Gets smaller as vocal folds close

Question 69

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

Answer 69

Choanae separated by vomer