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BDS1 BAMS human systems > mouth, pharynx and oesophagus > Flashcards

mouth, pharynx and oesophagus Flashcards

1
Q

what does cervical mean?

A

neck

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2
Q

how many cervical vertebrae are there?

A

7

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3
Q

what are viscera?

A

internal organs

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4
Q

what are the three layers of the visceral region of the neck?

A

an endocrine layer (the thyroid and parathyroid glands, where secretions are made), a respiratory layer (the trachea and larynx), and an alimentary layer (the pharynx and oesophagus, digestion and absorption)

anterior –> posterior

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5
Q

what is the function of the thyroid hormone?

A

nerve development and metabolism

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6
Q

what is the structure of the pharynx?

A
  • muscular tube from base of the skull (just below the sphenoid air sinus) to the oesophagus
  • 6th cervical vertebrae
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7
Q

what is the function of the pharynx?

A
  • conducts air
  • allows for passage of food and drink to oesophagus
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8
Q

what are the 3 parts of the pharynx?

A
  • nasopharynx- behind nose
  • oropharynx- behind oral cavity
  • laryngopharynx- last part before the oesophagus
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9
Q

what are the parts of the nasopharynx?

A
  • nasolacrimal duct (tear duct- opens into lower nose, carries tears away from lacrimal sac to nasal cavity- communication between eyes and nose)
  • opening of auditory tube
  • tubal tonsils (sit around the auditory tube- responsible or equalising air pressure between middle ear and external ear)
  • pharyngeal tonsils (sometimes extracted)
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10
Q

what are tonsils made of?

A

a collection of lymphoid tissue and inflammatory cells

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11
Q

what is the function of the nasopharynx?

A

respiratory

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12
Q

what is the function of the oropharynx?

A

digestive (and respiratory)

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13
Q

what are the parts of the oropharynx?

A
  • superior (soft palate)
  • inferior (base of tongue- epiglottis)
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14
Q

what happens if the uvula doesn’t work?

A

the function of the uvula is to prevent prevent food and liquid from going up your nose when you swallow so when not working, this becomes a possibility

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15
Q

what is Waldeyer’s ring?

A

a collection of four types of tonsils:
- Pharyngeal tonsil – in roof of nasopharynx
- Tubal tonsils – also in roof of nasopharynx
- Palatine tonsils – in oropharynx
- Lingual tonsils - posterior one third of the tongue

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16
Q

what does a deviation of the uvula indicate?

A

a problem with the nerve supply

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17
Q

what are the parts of the laryngopharynx?

A
  • superior (epiglottis- elastic cartilage which closes of trachea during swallowing)
  • inferior (level of circoid cartilage (complete ring)- below thyroid cartilage)
  • pirifrom fossa (area where food can get trapped- either side of larygeal opening)
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18
Q

what are the two groups of pharyngeal constrictors?

A

longitudinal and circular

19
Q

what are the three pharyngeal constrictors?

A
  • superior
  • middle
  • inferior
    contract sequentially
20
Q

where does the superior constrictor run?

A

runs to mylohyoid muscle

21
Q

where does the middle constrictor run?

A

to the hyoid bone

22
Q

what is special about the hyoid bone?

A

one bone in the body not joined to any other bones

23
Q

where does the inferior constrictor run?

A

into the thyroid cartilage (largest of all of the laryngeal cartilages, vocal chords are attached here)

24
Q

where do the pharyngeal constrictors join?

A

at the back of the pharynx at the median raphe

25
Q

what nerves innervate the pharygeal constrictors?

A

the vagus nerve X

26
Q

what are the nerves involved with the pharynx?

A
  • motor- vagus nerve CN X
  • sensory- glossopharyngeal nerve CN IX
  • together form the pharyngeal plexus
27
Q

what clinical problems can involve the pharynx?

A
  • middle ear infection (otitis media)- related to the auditory tube
  • tonsillitis- inflammation of the tonsils- treated with tonsillectomy
28
Q

what is the oesophagus?

A

muscular tube 20-25cm long running from the pharynx to the stomach (lies in the neck, thorax and abdomen), behind the trachea and heart

29
Q

where is the diaphragm?

A

separating the thorax from the abdomen

30
Q

what are oesophageal sphincters?

A

muscular rings (upper and lower) which close when food is not being swallowed

31
Q

describe the upper oesophageal sphincter

A

This is an anatomical sphincter and is comprised of the lower fibres of the inferior pharyngeal constrictor. Although it is comprised of skeletal muscle, it is not under voluntary control, but rather is influenced under the swallowing reflex.

32
Q

describe the lower oesophageal sphincter

A

also called the gatro-oesophageal sphincter, or cardiac sphincter as it is found between the oesophagus and the stomach. It is a physiological, or functional sphincter. It is due to the angle that it enters into the stomach that helps it in its sphincter like function, rather than a thickening of the muscle. It is dysfunction of this lower oesophageal sphincter that causes GORD or gastro-oesophageal reflux disease and potential subsequent Barrett’s oesophagus and possibly even predispose to dysplasia or cancer.

33
Q

what is the epithelium in the oesophagus?

A

non-keratinised stratified squamous

34
Q

describe the histology of the oesophagus

A
  • epithelium
  • lamina propria
  • submucosal glands
  • muscularis mucosae
  • upper 1/3 skeletal muscle
  • middle 1/3 mixed muscle
  • lower 1/3 smooth muscle
    circular muscle on inside
    longitudinal muscle towards outside
35
Q

what are the clinical problems surrounding the gastro-oesophageal junction?

A

Metaplasia – change in epithelium from one type to another which is not typical of that site.
Dysplasia – abnormal growth or development of cells and/or organs
Gastro-oesophageal reflux disease – can result in metaplasia.

In the oesophagus this means a change of epithelium from its usual stratified squamous epithelium to that of the stomach, in the usual site of the oesophagus. That would mean a change to simple columnar epithelium and there would also be inflammatory cells in the lamina propria

36
Q

what is another word for swallowing?

A

deglutition

37
Q

what are the two functions of swallowing?

A
  • get food to the stomach
  • prevent food entering the airway
38
Q

what are the three phases of swallowing?

A
  • oral
  • pharyngeal
  • oesophageal
39
Q

what happens in the oral phase of swallowing?

A
  • food is moved posteriorly
  • some food can pass onto pharyngeal surface of tongue
  • liquid remains in the mouth in front of Waldever’s ring
40
Q

what happens in the pharyngeal phase of swallowing?

A
  • oro to laryngopharynx
  • the soft palate rises (prevent food through nose)
  • depression of epiglottis (covers airway)
  • contraction of vocal folds (pharyngeal constrictors)
  • relaxation of the upper oesophageal sphincter (to let bolus through)
41
Q

what happens in the oesophageal phase of swallowing?

A
  • involuntary
  • peristalsis
  • lower oesophageal constrictors relax to allow bolus into stomach
42
Q

what are clinical problems involving swallowing?

A
  • difficulty swallowing
  • neuromuscular disease
  • obstruction – Srictures, spasm
    - Tumours (30-50% reduction!)
    - Developmental abnormality
  • tracheooesophageal fistula
43
Q

what is tracheooesophageal fistula?

A

abnormal connection between the trachea and oesophagus
- risk that fluid passing into the oesophagus can go straight into the trachea, resulting inn choking and coughing when feeding. The baby may have a swollen abdomen, blue coloured (cyanosis) when feeding) and/or frothy bubbles in the mouth

BDS1 BAMS human systems (47 decks)

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