Nose, pharynx and larynx Flashcards
what do the nasal bones articulate with
- frontal bone - frontal process of the maxilla - lateral cartilages
what are the 3 cartilages that form the exterior of the nose
lateral cartilages septal cartilages - projects inwards to separate the nose into 2 halves alar cartilages - forms the nares
what separates the nose into 2 halves
vomer, ethmoid bone and septal cartilage
why are bad breaks of the ethmoid bone dangerous
can result in: meningitis bad nose bleeds rhinorrhea (CSF leaks into nasal cavity)
what is the importance of the vascular mucous membrane lining the medial wall of the inner nose
- helps warm up the air - helps humidify the air - helps catch foreign particles
explain the epithelium in the nose
top third = olfactor epihtelium rest: respiratory epithelium
where does the vascular mucous membrane of the nose line
all of the nasal cavity except for the very anterior part (skin and hair)
what is the function of the superior, middle and inferior concha of the nose
to create turbulence in the air we breath in, to help it stay longer in the cavity and therefore warm it up
what are the 4 paranasal sinuses
- frontal sinus - maxillary sinus - sphenoid sinus - ethmoid sinus
why is the maxillary sinus particularly hard to drain if fluid gets into it
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
what are the nerves associated with the paranasal sinuses
frontal, sphenoid and ethmoid = opthalmic division of the trigeminal nerve maxillary - maxillary division of the trigeminal nerve
where does the lacrimal glannd duct drain into the nasal cavity
in the inferior meatus
what is the vascular supply of the superior quadrant of the nose
branches of ethmoid arteries (branches of opthalmic arteries through the orbit)
what is the vascular supply of the posterior quadrant of the nose
sphenopalatine artery (big and thick)
what is the vascular supply of the inferior quadrant of the nose
branches of palatine arteries that come in through the mouth into the nose through a little hole in the floor of the nasal cavity
what is the vascular supply of the anterior quadrant of the nose
lateral wall - nasal branches of the facial artery medial wall - labial arteries
what is the fancy word for nose bleeds
epistaxis
explain the nerve supply to the nose
- anterior, superior half = nasociliary nerve (branch of V1) - posterior, inferior half = nasopalatine nerve (branch of V3)
where does the pharynx extend from and to
from the base of the skull all the way down to the lower border of the cricoid cartilage
where are the adnoids
just deep to the mucosa at the roof of the nasopharynx
what is the muscle of the pharynx that helps equalisation of the auditory tube
salpingopharyngeus
what forms the roof of the mouth and where do they “come from”
hard palate - (palatine process and horizontal plate) predominantly formed by the maxilla soft palate - hangs off the end of the horizontal plate
where do the alveolar arches project from
come from the maxilla
what are the 3 muscles that form the floor of the mouth
digastric muscle mylohyoid muscle geniohyoid muscle
what separates the tongue into anterior and posterior
the sulvus terminalis
where is the foramen caecum and what is it
is at the apex of the sulvus terminalis it is the closed off duct that once formed the thyroid gland
what are the 3 types of pupillae of the tongue
foliate - on the posterolateral surface fungiform - on the dorsal anterior aspect valate - up against the anterior of the sulcus terminalis
where are the taste buds located
within the base of the walls of the pupillae
what makes the posterior of the tongue nodulated
series of lymphoid nodules just sitting underneath the mucosa
where are the lingual tonsils
just posterior to sulcus terminalis
what are the 4 extrinsic muscles of the tongue and what are their origins and what are their function
- 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
explain the innervation of the extrinisic muscles of the tongue
all innnervated by CNXII except for styloglossus which is innervated by a branch of the vagus
what is the result of a lesion of the hypoglossal nerve
tongue deviation to the side of the lesion on protrusion of the tongue
what are the intrinsic muscles of the tongue
superior longitudinal inferior longitudinal transverse and vertical
function and innervation of the intrinsic muscles of the tongue
function - alter the shape of the tongue innervation - all innervated by CNXII
explain the sensory innervation to the post 1/3 of the tongue
both general sensory and special sensory are innervated through CNIX
explain the sensory innervation to the anterior 2/3 of the tongue
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
explain the route of the chorda tympani nerve
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
how many teeth are in each alveolar arch
16
what is the innervation of the teeth
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)
where will tooth pain refer to if the tooth is in the: lower jaw upper jaw
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)
what are the 3 pairs of salivary glands
parotid submandibular sublingual
where is the submandibular gland
sits around the mylohoid muscle
where does the sublingual gland empty into
the floor of the mouth, just lateral to the tongue
where does the submandibular gland empty in to
just lateral to the phrenium
where does the parotid gland empty in to
just opposite the upper 2nd molar
what forms the lateral walls of the oropharynx
palato-glossal and palato-pharyngeal arches (with palatine tonsils inbetween)
function of the epiglottis
folds over the top of the airways and helps stop food entering the airways
what is the role of the soft palate
- 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
what muscles elevate and depress the soft palate
elevate = tensor veli palatini and levator veli palatini depress = palatoglossus and palatopharyngeus
innervation of the soft palate
all innervated by pharyngeal branches of vagus (except for tensory veli palatini which is innervated by trigeminal)
what are the 4 sets of tonsils
pharyngeal tubal palatine lingual
what are the anterior and posterior borders of the larynx
begins at the epiglottis ends at the cricoid cartilage
4 parts (bone and cartilages) of the larynx
hyoid bone (superior) thyroid cartilage (middle) cricoid cartilage (inferior) arytenoid cartilages
which part of the larynx is not closed off posteriorly
thyroid cartilage
which two membranes are part of the larynx
hyothryoid membrane cricothyroid membrane
where are the arytenoid cartilages
on the posteroir part of the cricoid cartilage
where do the vocal cords attach
the anterior vocal processes of the arytenoid cartilage to the posterior aspect of the thyroid cartilage just underneath the epiglottis
what is attached to the posterior process of the arytenoid cartilages of the larynx
the intrinsic muscles of the larynx
how do you produce phonation
contraction of the intrinsic muscles of the larynx to pull on the vocal folds to adduct them and cause vibration with air
which way do the vocal cords go for: - phonation - inspiration
phonation - adduction inspiration - abduction
what forms the “false” vocal folds
mucosal membrane folds (just superior) to the vocal folds
what is the intrinsic muscle of the larynx important for abduction of the vocal folds
posterior cricoarytenoid
which intrinsic muscle of the larynx lengthens the vocal folds
cricothyroid
which intrinsic muscles of the larynx adduct the vocal cords
lateral cricoarytenoid vocalis thyroarytenoid transvere arytenoid oblique arytenoid
2 main nerves that innervate the larynx
superior laryngeal nerve (above) recurrent laryngeal nerve (below)
what does the superior laryngeal nerve innervate
the cricothyroid muscle
what does the recurrent laryngeal nerve innervate
all the intrinsic muscles of the larynx (except cricothyroid muscle)
why do you get a hoarse voice if you damage your recurrent laryngeal nerve
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)
explain the blood supply to the larynx
above - branches of superior thyroid vessels below - inferior thyroid veins
where should you do an emergency intubation?
in the cricothyroid membrane (not in the trachea - as lots of vessels lying on the trachea –> cut –> blood in the lungs –> drown)
what defines the lateral border of the laryngeal inlet
the aryepiglottic folds (folds of mucosa that attach to the arytenoid cartilages)
where does fluid go through the larynx
goes through the piriform recesses on either side of the laryngeal inlet
sensory supply of the pharynx
mostly comes from CNIX (reinforced by some branches of the trigeminal (at the nasopharynx) and the vagus)
motor supply of the pharynx
mostly from the vagus (Except for stylopharyngeus - innervated by CNIX)
how is the bolus of food “shaped” and pushed backwards
- the tongue - soft palate descends and palatal arches grip and push it backwards
how does the body stop a bolus of food entering the nasal cavity
soft palate elevated and tightened
what stops the bolus of food entering the trachea
laryngeal inlet closes
how does the bolus of food get close to the oesophagus
larynx and pharynx elevated
