Larynx (neuroanatomy 3.0) Flashcards

1
Q

How do you test function of Vagus Nerve?

A
  1. Open mouth and say ahh
  2. Testing function of Vagus nerve (CN10)
  3. Look at Uvula (soft tissue)
  4. Should go straight up in midline
  5. If it as it goes up it deviates to one side suggests problem with one of vagus nerves
  6. If the elevation is effective on this side ie to my right the uvula is deviating away from side of lesion
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2
Q

What is behind the uvula?

A
  • posterior wall of the oropharynx and that the first sign you can see of the pharynx
  • On either side folds of tissue
  • Most anteriorly have palatoglossal fold (from palate down to tongue)
  • Behind that have a palatopharynegeal fold from the palate to down to the pharynx
  • In between those two is palatine tonsil -By looking at tonsil can see if there has been any infection or inflammation and make diagnosis of tonsillitis
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3
Q

Where is the epiglottis what does it do?

A
  1. Behind tongue have epiglottis and when you swallow this retroflexed and comes back down and that covers the laryngeal inlet
  2. When you swallow it stops food going back down into airway so the food actually travels down the back of the pharynx all the way down to the to the esophagus
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4
Q

What fulls up the buckle cavity?

A

Tongue

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5
Q

What is the hard and soft palate?

A
  • Hard palate + during eating use tongue to move food up against hard palate to start breaking it down
  • At back have the soft palate
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6
Q

What are the three sections of the pharynx?

A
  1. Nasopharynx
  2. Oropharynx
  3. Larynogpharynx
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7
Q

What does the laryngopharnx open up into?

A

The oesophagus

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8
Q

What is in the laryngopharnx?

A
  • In laryngopharynx is the piriform fossa and this area has a strong sensory innervation
  • Here can get fish bones stuck and its a sensitive area so causes lots of distress
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9
Q

What are the muscles of the pharynx?

A
  1. The superior
  2. The middle
  3. Inferior constrictors
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10
Q

What nerves form the pharyngeal plexus?

A
  • Glosso-pharngeal
  • Vagus
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11
Q

Which nerves control movement of the contractors?

A
  • vagus
  • some contribution from accessory nerve cranial nerve number 11
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12
Q

How do we swallow?

A

-Swallowing all about coordinated action of the these muscles so superior middle and inferior constrictors act in sequence and they, in sequence allow a coordinated contraction and movement of the bolus of food form mouth down the oesophagus

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13
Q

What is the first part of the digestive process?

A

-First part of digestive process break down food in mouth and enzymatically produce sliava

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14
Q

What are the three pairs of salivary glands?

A
  1. Parotid gland
  2. Sublingual
  3. Submandibular
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15
Q

What is the parotid gland controlled by? What is the saliva like?

A
  • Parotid gland: biggest and saliva from this gland passed through parotid gland, poses into upper part of mouth and it passes through the buccinator muscle of the cheek and opens up to the second molar in the mouth
  • Saliva produced by parotid is thin, its serouss
  • innervation in the parotid gland glossopharyheal nerve
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16
Q

What is the sublingual gland controlled by? What is the saliva like?

A
  • Sublingual supplied by the facial nerve (under tongue)
  • produce more mucous saliva
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17
Q

What is the submandibular controlled by? What is the saliva like?

A
  • Submandibular supplied by the facial nerve (under mandible)
  • very thin serous saliva
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18
Q

What are the modules in the tongue supplied by?

A
  • Tongue fills buccal cavity
  • Tongue has own intrinsic musculature, the intrinsic muscles and the movement of these controlled by cranial nerve number 12: hypoglossal nerve, which runs down just beneath tongue
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19
Q

What other extrinsic muscles does the hypoglossal supply?

A
  1. Palatoglossus running from palate to tongue
  2. Styloglossus from the styloid process and the base of the skull all the way to the tongue
  3. Genioglossus from mandible to tongue
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20
Q

How do you test cranial nerve 12?

A
  • Ask patient to stick their tongue out and in doing so genioglossus contracts and the tongue protracts out of the mouth
  • If problem with one of hypoglossal nerve may be deviation of the tongue
  • If the tongue is working properly none side it will protract but deviate towards the site of the lesion
21
Q

What is tongue innervation and taste mapping?

A

Actual mapping of taste sensation on the tongue:

  • Salty taste perceived right at front of tongue
  • Bitter, pepper style is at back
  • Front of tongue area for sweet sensation
  • Slightly acidic bitter or sour citric taste picked up on lateral part of tongue
  • Unami is part of taste of tomatoes maps all over the tongue
22
Q

What is the innervation of the anterior two this of tongue?

A

-For touch sensation take finger touch tongue and feel it and this for the anterior two thirds of tongue: trigeminal nerve

23
Q

What is the innervation for the posterior third of the tongue?

A

-glossopharyngeal that provides sensory touch sensation

24
Q

What is taste for anterior two third of tongue?

A

Facial nerve

25
Q

What is taste for posterior third of tongue?

A

Glossopharyngeal

26
Q

What does both the facial and glossopharyngeal do?

A
  • Both of these nerves send fibres back to the nucleus solitarius in brainstem whit is our taste perception centre
  • Little bit of innervation back at base of tongue and on epiglottis form the vagus
27
Q

What is the first stage of the swallowing process?

A

Oral preparatory phase

28
Q

What is the oral preparatory phase?

A
  • Food and liquid chewed and formed into bold which held on centre of tongue
  • To do this lip, jaw and tongue and palate (all sensory innervation and motor function require and the dentition)
29
Q

Which cranial nerves are involved in oral preparatory phase?

A

-Voluntary task and involving cranial nerves 5,7,9,10,12

30
Q

What is the oral transit phase?

A
  • Bolus of food propelled to back of mouth
  • Palate seals entry to nasal cavity so soft palate is raised (stop food going into back of nose)
  • Lip, jaw, tongue and palate sensory intervention and motor function required
31
Q

Which cranial nerves are involved in oral transit phase?

A
  • Voluntary process and airway still open
  • Cranial nerves involved: 5,7,9,10,12
32
Q

What is the first pharyngeal phase of swallowing?

A
  • Triggered when bolus of food reaches faucial arches at back of mouth
  • Palate stays elevated
  • Tongue retracts to push bolus of food into pharynx
  • Requires tongue, palate and laryngeal sensory info and motor function also needed
33
Q

Which cranial nerves are involved in the first pharyngeal phase of swallowing?

A

-The airways closes and under reflex control - down to activity of cranial nerve 9 and 10 (in pharynx) and 12 (with tongue)

34
Q

What is the second pharyngeal phase of swallowing?

A

-When bolus is propelled through the pharynx the tongue palate and laryngeal sensory again needed and there is the motor function this is very much a reflex activity

35
Q

Which cranial nerves are involved in the second pharyngeal phase of swallowing?

A
  • At this stage the airway closed, the epiglottis has retroflex over laryngeal inlet to stop any food going into the upper airway agin
  • 9,10,12 cranial nerves
36
Q

What happens in the oesophageal phase?

A

-Esophagus opens up

37
Q

Which cranial nerves are involved in the oesophageal phase?

A
  • Airway still closed and the breath is held and bolus of food propelled through into oesophagus again still under reflex control
  • Cranial nerve 9,10 when this has happened respiration resumes with an exhalation to clear any food particles that may be around the airway entrance
38
Q

What is the larynx?

A

Larynx is hollow structure composed of number of different muscle and membrane

39
Q

What does the larynx act as?

A
  • Larynx acts as valve and is at top of airway and allows air in and out of the airway
  • In so doing this air passes last vocal fold therefore producing sounds which is basis of speech
40
Q

What are the three most important laryngeal cartilages?

A
  1. Cricoid cartilage
  2. Arytenoid cartilage
  3. Thyroid cartilage
41
Q

What is the cricoid cartilage?

A

sits at top of reach (but like a signet ring with its band at the front and a more substantial plate at the back

42
Q

What is the arytenoid cartilage?

A

important in movement of vocal folds, in terms of movement of the attached muscles

43
Q

What is the thyroid cartilage?

A

Biggest cartilage involved in larynx, also called laryngeal province (Adams apple)

44
Q

What is the structure in the mouth?

A
45
Q

Describe the oro-pharyngeal region

A
46
Q

What is the posterior view of pharynx?

A
47
Q
A
48
Q

What are the glands?

A
49
Q

Label a diagram of the tongue

A