Palate, Tongue, Vocal Folds, Larynx, CN VII and CN IX pathways Flashcards
What does the palate do?
it blocks nasal cavities during swallowing and controls the degree of coupling between the nasal cavity and vocal tract during speech
What is the styloglossus muscle?
extrinsic tongue muscle; lifts sides of the tongue up and makes it move backward
What is the hyoglossus muscle?
extrinsic tongue muscle; pulls sides of the tongue down and retracts (i.e., pulls back) the tongue; it also elevates larynx by pulling hyoid bone superiorly.
What is the palatoglossus muscle?
extrinsic tongue muscle and depressor muscle of soft palate; pulls base of tongue up and back
What is the genioglossus muscle?
extrinsic tongue muscle; sticks out the tongue and brings the central part of it down
What innervates the styloglossus, hyoglossus, and genioglossus muscles?
hypoglossal muscle (i.e., CN XII)
What are the structures of the VFs from most superficial to deep?
squamous epithelium, lamina propria (superficial elastin fibers, intermediate elastin fibers, and collagen fibers), and thyroarytenoid muscle)
What two intrinsic parts of the larynx does the conus elasticus make up?
cricothyroid ligament and cricothyroid membrane
What does the larynx do?
acts as a valve for thoracic fixation; is a way for air to flow through for respiration; is a source of voice; protects airway from foreign objects entering it.
What CN innervates the cricothyroid muscle?
external branch of the superior laryngeal nerve of CN X
What CN innervates the levator veli palatini and musculus uvulae?
spinal accesory nerve via the pharyngeal branch of CN X and the pharygneal plexus
What CN innervates the tensor veli palatini? What is its functions?
CN V - Mandibular branch; flattens and tenses the soft palate and opens eustachian tube during yawning and swallowing
What CN innervates the palatoglossus muscle? What does it do?
Spinal accessory nerve via the pharyngeal branch of CN X; it brings the body of the tongue up and back; it depresses the soft palate
What CN innervates the palatopharyngeus muscle? What does it do?
Spinal accesory nerve via the pharyngeal branch of superior laryngeal nerve of CN X; it lifts the larynx and pharynx and direct bolus down into the pharynx during swallowing; it depresses the soft palate too.
What bones make up the hard palate?
2 maxillary bones and 2 palatine bones
What is the cavity (or space) in the larynx between the false vocal folds and true vocal folds?
Ventricle
Before entering the false vocal folds, you must pass through the _______ and then the _______
aditus laryngis (entryway of larynx) and vestibule
What cranial nerves innervates the tranverse interarytenoids, oblique interarytenoids, and lateral cricoarytenoids?
Recurrent laryngeal branch of CN X
The thyroarytenoid muscles consists of ____________ and ___________. Its function is to ___________. The CN that innervates both parts of it is _______ .
thyrovocalis muscle and thyromuscularis muscle; increase or decrease fundamental frequency; RLN of CN X
What is the function of the thyrovocalis muscle?
it works together with the cricothyroid muscle to control VF tension
What is the function of thyromuscularis muscle?
its medial fibers shorten and relax VFs and its lateral fibers helps adduct VFs
What are the two ways to control your voice?
medial compression for loudness (positive correlation) and longitudinal tension for pitch (inverse relationship)
What is the anterior belly and posterior belly of the digastricus muscle?
two parts of the digastric muscles that elevate and protrude the hyoid, thereby elevating the larynx.
What cranial nerve innervates the anterior belly of the digastricus muscle and mylohyoid?
mylohyoid nerve of the mandibular branch of the trigeminal nerve (CN V)
What cranial nerve innervates the posterior belly of the digastricus muscle?
digastric branch of the facial nerve (CN VII)
What is the mylohyoid muscle?
extrinsic laryngeal muscle that elevates the larynx by pulling the hyoid bone anteriorly and superiorly
What is the geniohyoid muscle?
extrinsic laryngeal muscle that elevates the larynx by pulling the hyoid bone anteriorly.
What cranial nerve innervates the geniohyoid muscle?
C1 travelling with the fibers of the hypoglossal nerve
What is the stylohyoid muscle?
extrinsic laryngeal muscle that elevates the larynx by elevating and retracting the hyoid bone
What cranial nerve innervates the stylohyoid muscle?
stylohyoid branch of the facial nerve
What cranial nerve innervates the superior and middle pharyngeal constrictor muscles?
CN XI via pharyngeal branch of CN X
What cranial nerve innervates the inferior pharyngeal constrictor muscle?
thyropharyngeus: CN XI via pharyngeal branch of CN X
cricopharyngeus: pharygeal branch and eSLN and RLN of CN X
What is the cricopharyngeus muscle?
one of two muscles part of the inferior pharyngeal constrictor muscle that keeps the esophagus closed at the upper esophageal sphincter
What is the thyropharyngeus muscle?
one of two muscles part of the inferior pharyngeal constrictor muscle that constricts the pharynx
What muscles elevate the pharynx?
salpingopharyngeus muscle, stylopharyngeus muscle, and palatopharyngeus muscle
Which pharyngeal muscles elevate the larynx and pharynx?
stylopharyngeus muscle and palatopharyngeus muscle
What is the function of the salpingopharyngeus muscle?
elevates the pharynx and shortens it; it keeps the eustachian tube closed
What is the function of the palatopharyngeus muscle?
elevates the pharynx and larynx; directs bolus to the pharynx during swallowing
What is the function of the stylopharyngeus muscle?
elevates the larynx and pharynx
Why is swallowing important?
It allows for the upper aerodigestive tract to change transiently which allows for support for feeding and protection of the respiratory systems.
What are features of the quadrangular membrane?
Its inferior free edges make up the ventricular ligaments; its superior portion forms the aryepiglottic folds; it connects the lateral portion of the epiglottis to the apex and medial portion of the arytenoids
What are features of conus elasticus?
It is made up of the cricothyroid ligament and cricothyroid membrane; it connects the cricoid arch to the upper limits of the VFs.
What are common neurological conditions that could impact voice?
acquired brain injury (e.g., stroke and TBI); Laryngeal dystonia; Parkinson’s disease; vocal fold paralysis; essential tremor
What is the vestibule?
one of two cavities in the larynx that is between the entryway of the larynx (aditus laryngis) and the ventricular or vestibular vocal folds. It is wide at the entryway and narrow at the ventricular vocal folds
What is the ventricle?
vertical space between the true vocal folds and false vocal folds; it has an extended portion that has a saccule which produces glands that moisten the VFs.
The body of the VF is the _________ whereas the cover is the ____________
thyroarytenoid muscle; epithelium and the 1st layer of the lamina propria
The muscles involved in epiglottic deflection (phase 5 of pharyngeal swallow) are
aryepiglotticus and thyroepiglotticus
What CNs innervate the aryepiglotticus and thyroepiglotticus, two muscles involved in epiglottic deflection?
V, VII, X, XII, and ansa cervicalis (C1-C2)
When the larynx closes in the 3rd phase of swallowing, what structures close?
true VFs, false VFs, arytenoid cartilage to the epiglottic base (laryngeal vestibule closure), and epiglottic deflection
What is epiglottic deflection?
phase 5 of the pharyngeal phase of swallowing in which the epiglottis becomes horizontal, thereby moving the bolus out of the valleculae. Then the epiglottis move from its horizontal position and directs the bolus laterally to the pyriform sinuses and away from the laryngeal vestibule.
What is the pathway of the visceral motor nerve for CN VII?
UMNs in the hypothalamus send its axons to the superior salivary gland in the brainstem —-> axons there travel through the internal auditory meatures —– axons travel through the foramen lacerum and innerve the nasal glands, lacrimal glands, and soft/hard palate glands. Axons also travel through the petrotympanic fissure and innerve the sublingual and submandibular glands
What does pepsin do?
It stops the stomach from producing acid by acting as a proton pump inhibitor
What is the pathway of the special sensory branch of CN VII?
Gustatory cortex —- > gustatory nucleus — > Internal auditory meatus — > petrotympanic fissure – > anterior 2/3 of the tongue
What is the pathway of the branchial motor branch of CN VII?
Primary motor cortex –> motor nucleus —> IAM — Stapedius muscle and styloidmastoid foramen —-> occipitalis, temporalis, zygomatic, buccal, mandibular, cervical, stylohyoid muscle, posterior digastric belly
What is the pathway of the general sensory branch of CN VII?
sensory cortex — > nuclei in spinal tract —- > IAM —- > stylomastoid foramen — > skim around outer ear and parotid plexus
What is the pathway of the general sensory branch of CN IX?
sensory nucleus —- > trigeminal sensory nucleus in the pons —-> jugular foramen —- > superior glossopharyngeal ganglion cell —> inferior glossopharyngeal ganglion cell — > posterior pharyngeal wall, pharyngeal tonuge, and faucial pillar
What is the pathway of the special sensory branch of CN IX?
gustatory cortex —- > gustatory nucleus —> jugular foramen —> superior glossopharyngeal ganglion cell —> inferior glossopharyngeal ganglion cell—-> posterior 1/3 of the tongue
What is the pathway of the branchial motor branch of CN IX?
primary motor cortex —- >Nucleus ambiguus in the medulla — jugular foramen —- > stylopharyngeus muscle
What is the pathway of the visceral motor branch of CN IX?
Hypothalamus —- > inferior sensory nucleus —- > jugular foramen —-> parotid gland
