Lecture 32: Pharynx & Soft Palate

Question 1

Where is the pharynx?

Answer 1

Base of skull to infer border of cricoid cartilage

Question 2

What is pharyngobasilar fascia?

Answer 2

Fascia that runs between inner and outer muscle laters and covers deficient areas

Question 3

What are the constrictor muscles and their attachments?

Answer 3

• Superior constrictor has attachments along the raphe (over top of buccinator)
• Middle constrictor attaches along the surface of the hyoid bone
• Inferior constrictor attaches to lamina of thyroid cartilage and cricoid cartilage

(All project posteriorly to the midline raphe)

Question 4

What is cricopharynxgeus?

Answer 4

Infeior part of inferior constrictor (hard to separate) supplied by lower branches of vagus

Question 5

What are the internal pharyngeal muscles and their attachments?

Answer 5

• Salpingopharyngeus – cartilaginous part of the auditory tube to the muscular wall of the pharynx
• Palatopharyngeus – soft palate to the pharynx
• Stylopharyngeus – attaches to the inside of the pharynx and the styloid process, penetrates gap between superior and inferior constrictors and becomes internalised

Question 6

What happens when all of the internal pharyngeal muscles contract?

Answer 6

Elevate pharynx

Question 7

What are the borders of the nasopharynx?

Answer 7

Roof - body of sphenoid
Floor - soft palate
Lateral - mucosa
Posteriorly - PB fascia and superior constrictor

Question 8

What is in the roof of the nasopharynx?

Answer 8

Pharyngel/adenoid tonsils

Question 9

What sits above the auditory tube opening?

Answer 9

Tubal elevation - cartilaginous part of auditory tube projecting into mucosa wall

Question 10

What muscle can contract to pop the ear?

Answer 10

Salpingopharyngeus

Question 11

What are the borders of the oropharynx?

Answer 11

Roof- soft palate and uvula
Floor – posterior third of tongue and epiglottis
Lateral wall – mucosa
Posterior – superior constrictor

Question 12

Why is the posterior third of the tongue nodular?

Answer 12

Lingual tonsils sit here

Question 13

What is the vallecula?

Answer 13

Space between posterior third of tongue and epiglottis, food comes down and sits in here to push down epiglottis and move into the posterior oesophagus

Question 14

What are the actions of palatoglossus and palatopharyngeus?

Answer 14

Palatoglossus - elevates tongue when contracted

Palatopharyngeus - elevating pharynx or depressing soft palate

Question 15

What helps the epiglottis cover the laryngeal inlet?

Answer 15

Epiglottis pushed down, larynx is elevated, small muscles that sit in aryepiglottic fold that help pull in the side walls of the laryngeal inlet

Question 16

How does water get into the oesophagus?

Answer 16

Water cannot weigh down the epiglottis, moves through piriform recess (channel lateral to aryepiglottic folds) to get to oesophagus

Question 17

What is the nerve supply to the pharynx?

Answer 17

Glossopharyngeal

Nasopharynx has additional supply from trigeminal V2 and laryngopharynx has additional supply from vagus

Question 18

What forms the afferent and efferent arcs of the gag reflex?

Answer 18

Afferent - glosopharyngeal

Efferent - vagus

Question 19

What nerve supplies the muscles of the pharynx?

Answer 19

Vagus (glossopharyngeal for stylopharyngeus)

Question 20

What happens when you elevate and depress the soft palate?

Answer 20

Elevate - seals of the nasal cavity during coughing and swallowing
Depress -helps seal off the oral cavity from the pharynx during chewing to allow unimpeded breathing

Question 21

What are the muscles that support the soft palate?

Answer 21

• Tensor veli palatini & Levator Veli Palatini come into side of soft palate from above, when contracting it pulls soft palate up (close association with auditory tube, change dimensions of tube when they contract)
• Musculus uvulae
• Palatoglossus
• Palatopharyngeus

Question 22

What is fauces?

Answer 22

Space between palatoglossal and palatopharyngeal arches

Question 23

What is Waldayers ring?

Answer 23

Incomplete ring of lymphoid tissue that guards the pharynx – lingual, palatine, pharyngeal and tubal tonsils. First line of defense to set up response for things entering mouth – important for developing immune system in children, may not be so important in adults

Question 24

What are the stages of swallowing?

Answer 24

Shaping bolus, preparing bolus of food in oropharynx, pushing bolus of food through into the oesophagus, recoil of the larynx

Question 25

What nerve supplies tensor veil palatini?

Answer 25

Trigeminal (manidbular)