Larynx, Pharynx &Oesophagus Flashcards
The pharynx Extends from
the base of
skull to level of C6 vertebra(inferior border of cricoid cartilage
The pharynx is divided into
Nasopharynx
Oropharynx
Laryngopharynx
Ant. The pharynx is connected to
to the nose (called choanae)
to the mouth,
to the larynx (voice box).
through a tube called the auditory tube, the inner lining of the pharynx is also connected to the mucous membrane inside the middle ear cavity.(tympanic cavity)
Thenasopharynxis found between
the base of the skull and the soft palate
Function of nasopharynx
performs a respiratory function by conditioning inspired air and propagating it into the larynx.
The nasopharynx is linned with what epithelial cell
ciliated pseudostratified columnar epithelium with goblet cells.
Specified location of the nasopharynx
Posterior to nasal cavity
Inferior to sphenoid
bone
Superior to level of soft
palate
Closed off during swallowing by the soft
palates’ uvula And contains pharyngeal tonsils
The posterosuperior nasopharynx contains the____ tonsils, which enlarge between years of age and then regress.
adenoid
3-8
Location of the Oro pharynx
Postreior to the oral cavity
Extends inferiorly from level of the soft
palate to level of the
epiglottis
Functions of the Oro pharynx
Air passes through
Involved in voluntary and involuntary phases of swallowing
Epithelium
Stratified squamous epithelium
The Oro pharynx contain contains
Lymphoid Palatine and Lingual tonsil
1/3rd of the tongue
Sup. Constrictor muscles
The lateral wall is formed by
the thyroid cartilage
and the
thyrohyoid membrane.
laryngopharynxis located @
between the superior border of the epiglottis and inferior border of the cricoid cartilage (C6).
Where’s piriform fossae found
lat. to laryngeal inlet
What type of muscles are at the laryngopharynx
Middle & inf. Pharyngeal constrictor( Thyropharyngeus and cricopharyngeus)
What are the 4 groups of tonsils in the pharynx
Palatine
Lingual
Pharyngeal
Tubal
What are the classes of muscles in the pharynx
Circular– Sup. Mid. Inf. Constructor muscles
Longitudinal– Stylopharyngeus & Salpingopharyngeus
Whats the motor innervation of the circular muscles
Sup.(located@ oropharynx) = vagus & glossopharyngeal N
Mid.(laryngopharynx), Inf.(thyrophageous & cricopharyngeus)(Laryngopharynx)= vagus N
The longitudinal muscle receives motor innervation from
Stylo pharyngeal:the glossopharyngeus nerve (cranial nerve IX).
Palato pharyngeus & Salpingo pharyngeusfrom the vagus nerve (cranial nerve X).
Sensory innervation in the pharyngeal mucous membrane
Nasal pharynx:The maxillary nerve (V2)
Oral pharynx: The glossopharyngeal nerve
Laryngeal pharynx: The internal laryngeal branch of the vagus
nerve
What’s the blood supply ti the pharynx
Arterial supply to the pharynx is via branches of theexternal carotidartery via
Ascending pharyngeal artery
Tonsil Branches of the facial artery
Branches of the lingual and maxillary arteries.
Venous drainage if the pharynx is achieved by
thepharyngeal venous plexus, which drains into the internal jugular vein.
Adenoid hypertrophy
Obligatory mouth breathers
Affect the ear
LARYNX
Location of the larynx
It is situated below the tongue and hyoid bone
and btw the great blood vessels of the neck
and lies at the level
of C4 to C6
The
larynx is covered in front
by the
infrahyoid strap muscles and at sides by
the thyroid gland
The cartilage of the larynx consists of
9 cartilage
Thyroid, cricoid, epiglottis one each
Arytenoid, corniculte, cuneiform 2 each
is composed of two sheets (_______), which join anteriorly to form the
Laminae
Laryngeal prominence (Adams apple)
The posterior border of each sheet project superiorly and inferiorly to form thesuperiorandinferior horns(also known as cornu)
The superior horns are connected to _________ while the inferior horns articulate with_____.
Hyoid bone via Lat. Thyrohoid lig.
Cricoid cartilage
The cricoid cartilage is a complete circle
Articulating sup. With ______ & pst/inf with ______
inf. Conus/horn of thyroid cartilage
with the paired arytenoid cartilages
_________ is a leaf-shaped lamina of elastic cartilage lies
behind the root of the tongue
It’s stalk is attached to ____ back of the thyroid
Epiglottis
The sides
of the epiglottis are attached to the
arytenoid cartilages by the aryepiglottic folds of
mucous membrane.
The epiglottis mucous membrane extends onto the tongue as a fold in the middle called and on the sides called
These folds and extensions help to form different parts of the throat and create small depressions called .
(median glossoepiglottic fold)
(lateral glossoepiglottic fold)
vallecula
______ cartilage are triangular in shape and come in pairs. connected to the upper edge of another cartilage called the .
Arytenoid cartilage
cricoid cartilage
What are the 3 points of the arytenoid cartilage involved in
They have a top point, a front point involved in producing sound, and a large side point involved in muscle control.
____ are two small conical-shape cartilage that articulate with arytenoid cartilage and gives attachment to _______
Corniculate cartilage
Aryepiglottic folds
_________ are the 2 small rod shaped cartilage found in the aryepiglottic fold and strengthen them
Cuneiform cartilage
The vocal fold is composed of ____ fibres and run from _______ to____________
Elastic fiber
Arytenoid cartilage to thyroid cartilage
The force or strength of the air we exhale determines the _____ sound produced and ______ play’s a role in producing different pitches or tones.
Volume
The length and tension of the vocal cords also
What’s the sensory innervation of the larynx above and below the vocal cords
Above = internal laryngeal branch of sup. laryngeal branch of the vagus
Below = Recurrent laryngeal N
Whtas the motor innervation of the larynx
All intrinsic muscle of the larynx except cricothyroid muscle is supplied by supplied by the
Recurrent
Laryngeal nerve
The cricothyroid muscle is supplied by
the external laryngeal branch of the superior laryngeal branch of vagus
What’s the blood supply to the larynx
Upper half: Sup. Laryngeal branch of d Sup. Thyroid artery
Lower half: Inf. Laryngeal branch of the Inf. Thyroid artery
The oesophagus
The oesophagus begin @
Going down at the midline BT as it depends it moves to the ____
Cricoid cartilage @C6
The left
What are the dimensions of the oesophagus
Length- 25cm
Cervical-4cm
Thoracic-20cm
Abdominal-1.25cm
Width-2cm
The oesophagus is usually collapsed unless when eating or drinking
Which part of the oesophagus is the narrowest
the beginning of the esophagus where it meets the pharynx (pharyngo-esophageal junction)
And where the oesophagus enters the diaphragm
The trachea and esophagus initially form a single structure.
Two lateral septa (partitions) grow and divide this structure, giving rise to the trachea in the front and the esophagus at the back.
the esophagus has four layers:
And it’s covered by
mucous membrane, sub-mucosa, muscle coat, and an outer fibrous layer
Thin loose CT
the esophagus passes across completely to the left @ ____@___ vertebrae and then descends through the posterior mediastinum
the transverse part of the aortic arch (a major blood vessel),
T3-T4
At the level of _______ , the esophagus pierces through the diaphragm
(T10)
The esophagus ends at the _____, which is the upper part of the stomach, around the level of______.
cardiac end
(T11)
What are the curvature of the oesophagus and locations
Antero-posterior curvatures: These curvatures align with the cervicaland thoracic curvatures of the spine
Lateral curvatures: there are 2 lat. Curvatures both lying to the left
1st @ the level of C6, which is at the base of the neck.
2nd between the T5 and T7 vertebrae, which are in the middle and upper back.
The esophagus is the narrowest part of the digestive tract, except for the
vermiform appendix
There are how many constrictions of the oesophagus and their location
4
B– Beginning of the oesophagus 6inches from incisors
A– Aortic arch = 9inches from incisors
L– Left bronchus = 11inches from incisors
D– Diaphragm = 15 inches from incisors
These constrictions are important to consider when performing procedures like endoscopy in the esophagus.
What are the sphincters of the oesophagus
Upper oesophageal sphincter– btw pharynx and oesophagus relates to cricopharyngeal muscle
Lower oesophageal sphincter– just below the diaphragmatic hiatus.
Which sphincter is very important but not easily distinguishable
Lower oesophageal sphincter
What are the relations of the oesophagus
Ant. : trachea and recurrent
Laryngeal nerve assends on both sides beside the oesophagus via a groove
Pst. : Pre vertebral layer of deep cervical fascia, Longus coli & spine
Lat. : thyroid gland & carotid sheath
What’s the blood supply to the oesophagus@ cervical part, thorax& abdominal part
Cervical= Inf. Thyroid artery
Thorax= oesophageal branch of the aorta
Abdominal= Left grastric artery & Branches of Splenic artery
The left gastric artery & Splenic artery supplies the pst. Part of the abdominal oesophagus
What’s the venous drainage to the oesophagus
Upper part is brachiocephalic vein
Mid part is azygous vein
Lower part is left gastric vein
Lymphatic drainage of the oesophagus
Proximal 3rd is the deep cervical LN
Mid 3rd is the Sup. & Pst. Mediastinal N
Distal 3rd left gastric artery to the gastric and celiac LN
What’s the Nerve supply to the oesophagus
Sympathetic & parasympathetic
Para The upper half of the esophagus is supplied by the recurrent laryngeal nerve The lower half of the esophagus is supplied by the oesophageal plexus. This plexus is primarily formed by two vagus nerves
Symp The sympathetic nerve supply to the esophagus originates from the cervical and thoracic sympathetic chain
What’s the function of the sympathetic and parasympathetic innervation of the oesophagus
The sympathetic innervation helps regulate the sphincter tone and the relaxation of the esophageal wall, preventing reflux and ensuring proper swallowing.
Parasympathetic promotes the movement of food through the esophagus and the relaxation of the esophageal sphincters, facilitating digestion
The most common congenital anomaly in the oesophagus is
Toracho oesophageal fistula
approximately 90% of
cases), the superior part of the oesophagus ends
in a blind pouch and the inferior part
communicates with the trachea.
The most common presenting complaint of
cancer of the oesophagus which is not usually recognized
until the lumen is reduced by
The procedure to check is known as?
is dysphagia (difficulty
in swallowing),
30-50%.
Oesophagoscopy
Enlightenment of what lymph nodes cna suggest oesophageal cancer
Enlargement of the inferior deep cervical lymphnodes also suggests oesophageal cancer
Compression of the _____ nerves by
an oesophageal tumour produces Hoarsness
recurrent laryngeal
The most common symptom of gastroesophageal reflux disease
(GERD) is
Heartburn or pyrosis
The pain may radiate to the neck, throat, orjaw
What’s Achalasia Cardia
When someone with Achalasia Cardia eats, the lower end of the esophagus doesn’t open up properly to allow the food to pass into the stomach
What’s Oesophageal varices
It can be caused by what dxs
Oesophageal varices are enlarged veins in the lower part of the oesophagus due to high pressure in the portal vein this can be caused by liver cirrhosis
