Neck II (11.20.17) Flashcards
At what vertebral levels is the thyroid gland located?
C5-T1
What does the superior thyroid artery branch off of?
External carotid artery
What does the inferior thyroid artery branch off of?
thyrocervical trunk
Where does the thyroid ima artery branch from?
Brachiocephalic trunk
*can be damaged with a tracheotomy
Where do the superior thyroid vein and the middle thyroid vein drain?
Internal jugular vein
Where does the inferior thyroid vein drain?
Brachiocephalic vein
How many parathyroid glands are there?
4
- 2 superior parathyroid glands
- 2 inferior parathyroid glands
*located in the posterior thyroid
Pharynx: Constrictor muscle action?
Constrict the pharynx during swallowing
What is the innervation for the constrictor muscles?
Vagus nerve (CN X)
Where do the constrictor muscles fuse posteriorly?
Raphe
Origin of the supeior constrictor?
- Pterygoid hamulus of sphenoid bone
2. mandible
Origin of the middle constrictor?
Hyoid bone
Origin of the inferior constrictor?
- Thyroid cartilage
2. Cricoid cartilage
Where does the stylopharyngeus insert?
Between superior and middle constrictor
What is the action of the styopharyngeus muscle?
Elevates pharynx
Elevates larynx
What is the innervation of stylopharyngeus?
Glossopharyngeal (CN IX)
Where are the piriform recesses located?
Laryngopharynx
Piriform recesses are depresseions on either side of what where food can commonly become lodged?
laryngeal inlet
What is the laryngopharynx continuous with?
Esophagus
What innervates the mucosa of the oropharynx?
Glossopharyngeal nerve (CN IX)
What nerve is stylopharyngeus muscle innervated by?
Glossopharyngeal nerve (CN IX)
What provides innervation to the mucosa of the laryngopharynx (including piriform recesses)?
Vagus nerve (CN X)
throat clearing
Constrictor muscles (superior, middle and inferior) are supplied by what nerve?
Vagus nerve (CN X)
What provides the sensory innervation of the Gag reflex?
glossopharyngeal CN IX
What provides the motor portion of the Gag reflex?
Vagus nerve (CN X)
What are the functions of the larynx?
-Phonation (sound production)
-Respiration (protection),
Prevents swallowed material from entering trachea
At what spinal levels is the larynx located?
C3-C6
What part of the thyroid cartilage is known as “Adam’s Apple”?
laryngeal prominence
Articulation between the inferior horns of the thyroid cartilage and cricoid cartilage permit what types of movement?
- Rotation of thyroid cartilage
- Gliding of thyroid cartilage
*affect length of the vocal folds
Where does the epiglottic cartilage attach?
thyroid cartilage
What type of cartilage is the epiglottic cartilage made of?
elastic cartilage (not hyaline)
Why is movement at the base of the arytenoid cartilage significant?
Allows movement of arytenoid cartilages, which abduct/adducts & tenses vocal folds
The base of the arytenoid cartilages articulates with what?
Cricoid cartilage
The epiglottic cartilage and the arytenoid cartilage are connected by what?
Quadrangular membrane
What is the border of the quadrangular membrane?
vestibular fold
When is a cricothyrotomy performed?
emergency situation (establishes airway between thyroid and cricoid cartilage)
*above thyroid
When is a tracheotomy performed?
if placing a tracheostomy tube for mechanically assisted breathing
*below thyroid
What are the 3 parts of the laryngeal cavity?
- Vestibule
- Ventricle
- Infraglottic cavity
False vocal cords are also known as what?
Vestibular folds
Ventricle is between what two structures?
vestibular and vocal folds
Vestibule of the laryngeal vacity is between what two structures?
- laryngeal inlet
- vestibular folds
What is the name for the aperture between the vocal folds?
rima glottidis
Where are the vestibular folds (“false vocal cords”) in relation to the vocal folds?
Vestibular folds are superior to the vocal folds
Which 2 muscles elevate the larynx?
- Suprahyoid muscles
2. Thyrohyoid
Which infrahyoid muscle depresses the larynx?
Sternothyroid
What nerve innervates the intrinsic muscles of the larynx?
Inferior laryngeal nerve
Exception: cricothyroid muscle innervated by external branch of superior laryngeal nerve
What is the action of aryepiglottic?
close laryngeal inlet
What 3 muscles adduct the vocal folds (closes rima glottidis)?
- Lateral cricoarytenoid
- Transverse arytenoid
- Oblique arytenoids
Which muscle abducts the vocal folds?
Posterior cricoarytenoid
Which muscle stretches/tenses the vocal folds?
Cricothyroid
Which muscle relaxes the vocal folds?
Thyroarytenoid
Name the 2 branches that innervate the larynx?
- Superior laryngeal nerve
2. Inferior laryngeal nerve
What nerve does the superior laryngeal nerve arise from?
Vagus nerve (CN X)
Where does the internal branch of the superior laryngeal nerve supply sensory to?
internal branch supplies sensory only to mucose of larynx superior to vocal folds
The External branch of the superior laryngeal nerve supplies motor innervation to what muscle?
cricothyroid muscle (stretches/tenses the vocal folds)
The inferior laryngeal nerve is a continuation of what nerve?
recurrent laryngeal nerve
The inferior larygneal nerve supplies motor innervation to what?
intrinsic muscles of larynx
The inferior larygneal nerve supplies sensory to what?
inferior laryngeal nerve suppllies sensory innervation to mucosa inferior to vocal folds
Superior laryngeal artery is a branch from what?
supeior laryngeal artery is a branch of superior thyroid artery (which comes from external carotid)
(travels with the internal branch of the superior laryngeal nerve (through thryohyoid membrane))
Where does the inferior laryngeal artery branch from?
thyrocervical trunk > inferior thyroid artery > inferior laryngeal artery
(travels with the inferior laryngeal nerve)
Where are the sympathetic trunks located in relation to carotid sheath?
sympathetic trunks are posterior to the carotid sheath
Unilateral damage of the sympathetic nervous system (cervical or thoracic) is the cause of what?
Horner’s Syndrome
Name 3 symptoms a patient with Horner’s syndrome will present with?
- Drooping upper eyelid
- Constricted pupil (Miosis)
- Decreased sweating (Anhidrosis)
What vertebral level is the superior cervical ganglion located?
C1-C2
