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Anatomy and Embryology CNS > Oral cavity, pharynx, larynx > Flashcards

Oral cavity, pharynx, larynx Flashcards

1
Q

Anatomic subdivision of the pharynx from top to bottom

A
  1. Nasopharynx (skull base to soft palate)
  2. Oropharynx (soft palate to pharyngoepiglotic fold)
  3. Hypopharynx (cricopharyngeus m)
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2
Q

Which layer DCF covers the nasopharynx?

A

ML-of DCF posteriorly but anteriorly it is free (laterally the SL-DCF of the masticator space)

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3
Q

Which are the paired lateral spaces close to the nasopharynx/pharyngeal mucosal space?

A 
Masticator
Parapharyngeal
Carotid space
Parotid spase 
all covered by SL-DCF 
Behind is RPS/DS
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4
Q

Describe the mucosa of the nasopharynx

A

Anterior to Eustachian tube like nasal cavity

Posterior like oropharynx

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5
Q

What are the contents of the nasopharynx?

A 
Mucosa
Minor salivary glands
Lymphatic tissue,  pharyngeal tonsil + lateral recess of Rosenmuller
Torius tubarius/eustachian tube
Superior constrictor muscle 
Hiatus Morgagni
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6
Q

What is the pharyngobasilar fascia?

A

Very thick upper aponeurosis between superior constrictor muscle and basi-occiput

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7
Q

What is the Fossa of Rosenmuller?

What is the Hiatus/sinus of Morgagni

A

Herniation of pharyngeal mucosa through sinus of Morgagni.

Gap in the upper/lateral wall of the pharyngobasilar fascia
Pass through: Eustachian tube, levator veli palatini m. and ascending palatine artery.

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8
Q

Structures lateral and posterolateral walls nasopharynx?

A

Lateral Wall:
Tensor veli palatini m.
Eustachian tube
Levator veli palatini m.

Posterolateral Wall:
Lateral recess of Rosenmuller
Retropharyngeal LN (Rouvier)
Muscle longus colli medial, longus capitis lateral

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9
Q

Roof of nasopharynx?

A

Foramen Lacerum
Foramen Ovale
Internal carotid artery

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10
Q

Which foramen is in continuity with Rossenmuller fossa?

A

Foramen lacerum and foramen ovale with masticator space

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11
Q

Embryology, importance of the squamus epithelium of the oropharynx? Contents?

A

Endoderm, poorly differentiated cancers

Post 1/3 tongue (circumvallate papilla), lingual tonsils, vallecula, soft palate, palatine tonsils, post.pharyngeal wall

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12
Q

Oropharynx carcinoma subsites location incidence

A

PALATINE TONSIL 50%
Base of tongue 20%
Soft palate 10%
Posterior Praryngeal wall 5-10%

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13
Q

Embryology and Subsites of the Oral cavity

A

Ectoderm, more differentiated cancers.

Mucosal lips
Ant 2/3 tongue
Buccal mucosa
Gingiva
Hard palate
Retromolar trigone
Floor of mouth
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14
Q

What is the incidence of oral cavity to oropharynx neoplasms ratio?

A

2:1 but oropharyngeal cancers tend to increase

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15
Q

Sublingual and Submandibular spaces; Which one is fascia lined?

A

SLS - Not fascia lined

Submandibular - Fascia lined

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16
Q

Name the extrinsic muscles of the floor of the oral cavity

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

17
Q

Which structures medially of hyoglossus muscle?

A

Hypoglossal n IX

Lingual artery

18
Q

Palatoglossus muscle forms

Where is Styloglossus muscle located?

A

Palatoglossal arch

Side of Tongue (styloid think laterally)

19
Q

What has changed in floor of oral cavity cancer staging?

A

Previous staging extrinsic muscle infiltration
Now is it the depth of infiltration that matters
T1 <5mm , T3>10mm

20
Q

Sublingual space posterior extension?

A

Extends posteriorly along mylohyoid m. to parapharyngeal space and deep lobe of submandibulal gland. The deep lobe of submandibular gland is in the SLS!

21
Q

Orifice of parotid duct?

A

2nd molar upper jaw

22
Q

An abscess from the sublingual space can extend to:

A

Submandibular and parapharyngeal spaces and medially in the other sublingual space

23
Q

What is the most common location for oral cavity carcinomas?

Other common locations?

A

The lip mucosa 30-40%

Floor of mouth 20%
Oral tongue 15%
Buccal mucosa 10%

24
Q

Which is the border of the laryngeal vestibule and the piriform sinus? Possible question

A

AryEpiglotic fold = dividing line

25
Q

What is the border of the hypopharynx and esophageal junction?

Anatomic subdivisions of hypopharynx

A

Inferior cricoid lamina

Piriform sinus, Post-cricoid, Posterior wall

26
Q

Anatomic structures hypopharynx

A

Pharyngo-Epiglotic fold - superiorly
Ary-Epiglotic fold - anteromedially
Para-glottic space - anteriorly

Thyroid membrane superolaterally
Thyroid cartilage inferolaterally

Lower apex at level of cricoid
Cricoid lamina anteriorly
Posterior wall

27
Q

Piriform sinus tumour postero-lateral infiltration sites

A

Thyroid lamina, carotid space, posterior wall

28
Q

Piriform sinus tumour anterior infiltration sites?

A

Paraglottic space, cricoid lamina

29
Q

Piriform sinus tumour extension

A

Medial - anterior wall: Supra- paraglottic extension

Lateral wall: Carotid-posterior cervical space, thyroid cartilage, extensive vertical extension to oropharynx

30
Q

Hypopharyngeal Post-cricoid tumour extension

A

Below the inter-arytenoid sulcus -> cricoid cartilage, cervical esophagus

31
Q

Post hypoparynx wall tumour extension

A

Prevertebral DL-DCF, extensive vertical extension, oropharynx, esophagus

32
Q

Incidence of hypopharyngeal ca sites

A

PIRIFORM SINUS 60%
Posterior wall 25%
Post-cricoid 15%

33
Q

Anatomic divisions of larynx

A

Supraglottis (epiglottis +aryepiglottic fold, false vocal cord) to floor of laryngeal ventricule
Glottis (true vocal cords & commissures) +5mm
Subglottis begins 5mm below true cord to inferior limit of cricoid

34
Q

What should be the anatomic coverage on imaging of the recurrent laryngeal n. palsy?

A

From orbital roof (neck skull base)to below aortic arch

35
Q

What is the lymphatic drainage of the supraglottic area?Question possible

A

Ipsi- and contra- lateral levels II-IV

36
Q

Most common site of laryngeal cancer ?

A

GLOTTIC (65%)
Supraglottic (30%)
Subglottic (2-5%)

37
Q

What is the lower border of the Retropharyngeal space?

A

T3

38
Q

Which fascia covers the visceral space?

A

Middle layer deep cervical fascia

Anatomy and Embryology CNS (22 decks)

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