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Z MD1 neurology > Nose, pharynx and larynx > Flashcards

Nose, pharynx and larynx Flashcards

1
Q

what do the nasal bones articulate with

A
  • frontal bone - frontal process of the maxilla - lateral cartilages
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2
Q

what are the 3 cartilages that form the exterior of the nose

A

lateral cartilages septal cartilages - projects inwards to separate the nose into 2 halves alar cartilages - forms the nares

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3
Q

what separates the nose into 2 halves

A

vomer, ethmoid bone and septal cartilage

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4
Q

why are bad breaks of the ethmoid bone dangerous

A

can result in: meningitis bad nose bleeds rhinorrhea (CSF leaks into nasal cavity)

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5
Q

what is the importance of the vascular mucous membrane lining the medial wall of the inner nose

A
  • helps warm up the air - helps humidify the air - helps catch foreign particles
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6
Q

explain the epithelium in the nose

A

top third = olfactor epihtelium rest: respiratory epithelium

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7
Q

where does the vascular mucous membrane of the nose line

A

all of the nasal cavity except for the very anterior part (skin and hair)

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8
Q

what is the function of the superior, middle and inferior concha of the nose

A

to create turbulence in the air we breath in, to help it stay longer in the cavity and therefore warm it up

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9
Q

what are the 4 paranasal sinuses

A
  • frontal sinus - maxillary sinus - sphenoid sinus - ethmoid sinus
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10
Q

why is the maxillary sinus particularly hard to drain if fluid gets into it

A

because unlike the others which all drain downwards into the nasal cavity, the opening for the maxillary sinus is high up on the medial wall

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11
Q

what are the nerves associated with the paranasal sinuses

A

frontal, sphenoid and ethmoid = opthalmic division of the trigeminal nerve maxillary - maxillary division of the trigeminal nerve

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12
Q

where does the lacrimal glannd duct drain into the nasal cavity

A

in the inferior meatus

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13
Q

what is the vascular supply of the superior quadrant of the nose

A

branches of ethmoid arteries (branches of opthalmic arteries through the orbit)

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14
Q

what is the vascular supply of the posterior quadrant of the nose

A

sphenopalatine artery (big and thick)

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15
Q

what is the vascular supply of the inferior quadrant of the nose

A

branches of palatine arteries that come in through the mouth into the nose through a little hole in the floor of the nasal cavity

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16
Q

what is the vascular supply of the anterior quadrant of the nose

A

lateral wall - nasal branches of the facial artery medial wall - labial arteries

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17
Q

what is the fancy word for nose bleeds

A

epistaxis

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18
Q

explain the nerve supply to the nose

A
  • anterior, superior half = nasociliary nerve (branch of V1) - posterior, inferior half = nasopalatine nerve (branch of V3)
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19
Q

where does the pharynx extend from and to

A

from the base of the skull all the way down to the lower border of the cricoid cartilage

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20
Q

where are the adnoids

A

just deep to the mucosa at the roof of the nasopharynx

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21
Q

what is the muscle of the pharynx that helps equalisation of the auditory tube

A

salpingopharyngeus

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22
Q

what forms the roof of the mouth and where do they “come from”

A

hard palate - (palatine process and horizontal plate) predominantly formed by the maxilla soft palate - hangs off the end of the horizontal plate

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23
Q

where do the alveolar arches project from

A

come from the maxilla

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24
Q

what are the 3 muscles that form the floor of the mouth

A

digastric muscle mylohyoid muscle geniohyoid muscle

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25
Q

what separates the tongue into anterior and posterior

A

the sulvus terminalis

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26
Q

where is the foramen caecum and what is it

A

is at the apex of the sulvus terminalis it is the closed off duct that once formed the thyroid gland

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27
Q

what are the 3 types of pupillae of the tongue

A

foliate - on the posterolateral surface fungiform - on the dorsal anterior aspect valate - up against the anterior of the sulcus terminalis

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28
Q

where are the taste buds located

A

within the base of the walls of the pupillae

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29
Q

what makes the posterior of the tongue nodulated

A

series of lymphoid nodules just sitting underneath the mucosa

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30
Q

where are the lingual tonsils

A

just posterior to sulcus terminalis

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31
Q

what are the 4 extrinsic muscles of the tongue and what are their origins and what are their function

A
  • styloglossus - origin on the styloid process posteriorly - retracts the tongue - palatoglossus - origin from the palate superiorly - elevates the tongue - hyoglossus - origin from the hyoid bone - depresses the tongue - genioglossus - origin from the back of the mandible in the midline - protrusion of the tongue
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32
Q

explain the innervation of the extrinisic muscles of the tongue

A

all innnervated by CNXII except for styloglossus which is innervated by a branch of the vagus

33
Q

what is the result of a lesion of the hypoglossal nerve

A

tongue deviation to the side of the lesion on protrusion of the tongue

34
Q

what are the intrinsic muscles of the tongue

A

superior longitudinal inferior longitudinal transverse and vertical

35
Q

function and innervation of the intrinsic muscles of the tongue

A

function - alter the shape of the tongue innervation - all innervated by CNXII

36
Q

explain the sensory innervation to the post 1/3 of the tongue

A

both general sensory and special sensory are innervated through CNIX

37
Q

explain the sensory innervation to the anterior 2/3 of the tongue

A

general sensory - provided by lingual nerve (branch of the mandibular division of the trigeminal nerve) special sensory - provided by chorda tympani branch of the facial nerve

38
Q

explain the route of the chorda tympani nerve

A

passes through the middle ear, pierces through the base of the skull and then acceses the area of the oral cavity just medial to the temporomandibular joint, and then hitch hikes a ride with the lingual nerve to the anterior 2/3 of the tongue

39
Q

how many teeth are in each alveolar arch

A

16

40
Q

what is the innervation of the teeth

A

upper teeth from the maxilla = superior alveolar nerve (mandibular division of the trigeminal) lower teeth from mandible = inferior alveolar nerve (mandibular division of the trigeminal)

41
Q

where will tooth pain refer to if the tooth is in the: lower jaw upper jaw

A

lower jaw - through the mandibular division of the trigeminal nerve (eg external auditory meatus due to posterior auricular temporal nerve) upper jaw - through the maxillary division of the trigeminal nerve (eg. maxillary sinus)

42
Q

what are the 3 pairs of salivary glands

A

parotid submandibular sublingual

43
Q

where is the submandibular gland

A

sits around the mylohoid muscle

44
Q

where does the sublingual gland empty into

A

the floor of the mouth, just lateral to the tongue

45
Q

where does the submandibular gland empty in to

A

just lateral to the phrenium

46
Q

where does the parotid gland empty in to

A

just opposite the upper 2nd molar

47
Q

what forms the lateral walls of the oropharynx

A

palato-glossal and palato-pharyngeal arches (with palatine tonsils inbetween)

48
Q

function of the epiglottis

A

folds over the top of the airways and helps stop food entering the airways

49
Q

what is the role of the soft palate

A
  • elevates to seal off the nasal cavity during swallowing, coughing and suction - depresses to seal off the oral cavity to allow unimpeeded breathing when you are chewing
50
Q

what muscles elevate and depress the soft palate

A

elevate = tensor veli palatini and levator veli palatini depress = palatoglossus and palatopharyngeus

51
Q

innervation of the soft palate

A

all innervated by pharyngeal branches of vagus (except for tensory veli palatini which is innervated by trigeminal)

52
Q

what are the 4 sets of tonsils

A

pharyngeal tubal palatine lingual

53
Q

what are the anterior and posterior borders of the larynx

A

begins at the epiglottis ends at the cricoid cartilage

54
Q

4 parts (bone and cartilages) of the larynx

A

hyoid bone (superior) thyroid cartilage (middle) cricoid cartilage (inferior) arytenoid cartilages

55
Q

which part of the larynx is not closed off posteriorly

A

thyroid cartilage

56
Q

which two membranes are part of the larynx

A

hyothryoid membrane cricothyroid membrane

57
Q

where are the arytenoid cartilages

A

on the posteroir part of the cricoid cartilage

58
Q

where do the vocal cords attach

A

the anterior vocal processes of the arytenoid cartilage to the posterior aspect of the thyroid cartilage just underneath the epiglottis

59
Q

what is attached to the posterior process of the arytenoid cartilages of the larynx

A

the intrinsic muscles of the larynx

60
Q

how do you produce phonation

A

contraction of the intrinsic muscles of the larynx to pull on the vocal folds to adduct them and cause vibration with air

61
Q

which way do the vocal cords go for: - phonation - inspiration

A

phonation - adduction inspiration - abduction

62
Q

what forms the “false” vocal folds

A

mucosal membrane folds (just superior) to the vocal folds

63
Q

what is the intrinsic muscle of the larynx important for abduction of the vocal folds

A

posterior cricoarytenoid

64
Q

which intrinsic muscle of the larynx lengthens the vocal folds

A

cricothyroid

65
Q

which intrinsic muscles of the larynx adduct the vocal cords

A

lateral cricoarytenoid vocalis thyroarytenoid transvere arytenoid oblique arytenoid

66
Q

2 main nerves that innervate the larynx

A

superior laryngeal nerve (above) recurrent laryngeal nerve (below)

67
Q

what does the superior laryngeal nerve innervate

A

the cricothyroid muscle

68
Q

what does the recurrent laryngeal nerve innervate

A

all the intrinsic muscles of the larynx (except cricothyroid muscle)

69
Q

why do you get a hoarse voice if you damage your recurrent laryngeal nerve

A

because you cannot adduct you vocal cords (can only abduct via cricothyroid muscle) so to make a sound you need to use a lot of air behind the voice (hoarse)

70
Q

explain the blood supply to the larynx

A

above - branches of superior thyroid vessels below - inferior thyroid veins

71
Q

where should you do an emergency intubation?

A

in the cricothyroid membrane (not in the trachea - as lots of vessels lying on the trachea –> cut –> blood in the lungs –> drown)

72
Q

what defines the lateral border of the laryngeal inlet

A

the aryepiglottic folds (folds of mucosa that attach to the arytenoid cartilages)

73
Q

where does fluid go through the larynx

A

goes through the piriform recesses on either side of the laryngeal inlet

74
Q

sensory supply of the pharynx

A

mostly comes from CNIX (reinforced by some branches of the trigeminal (at the nasopharynx) and the vagus)

75
Q

motor supply of the pharynx

A

mostly from the vagus (Except for stylopharyngeus - innervated by CNIX)

76
Q

how is the bolus of food “shaped” and pushed backwards

A
  • the tongue - soft palate descends and palatal arches grip and push it backwards
77
Q

how does the body stop a bolus of food entering the nasal cavity

A

soft palate elevated and tightened

78
Q

what stops the bolus of food entering the trachea

A

laryngeal inlet closes

79
Q

how does the bolus of food get close to the oesophagus

A

larynx and pharynx elevated

Z MD1 neurology (17 decks)

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