Part 8 Flashcards
Extrinsic vs intrinsic muscles of neck function
Extrinsic help with swallow and positioning of the larynx, intrinsic is for phonation subtle movements
Epiglottis definition
Flap of tissue in throat at base of tongue projecting out of the thyroid cartilage over the larynx above the glottis that is moved into a closed position upon elevation of the hyoid bone during swallowing to cap over the larynx and prevent aspiration ofmaterial
Glottis definition
Opening between the vocal folds within the larynx
Thyroid cartilage definition
Most prominent cartilage forming the anterior wall of the superior portion of the larynx below the hyoid bone connected via the thyrohyoid membrane, forms the adams apple
Thyrohyoid membrane definition
Connection between the thyroid cartilage and hyoid bone
True vocal folds
Bands of tissue that extend from the arytenoid cartilage to the thyroid cartilage’s posterior wall, the tighter they are stretched through the relaxation or stress of the arytenoid cartilage by the thyroarytenoid muscle the higher the pitch of sound
Thyroarytenoid muscle function, insertion, innervation
Function: relax the arytenoid cartilage and therefore the true vocal folds resulting in lower pitch
Insertion: Thyroid cartilage to arytenoid cartilage of larynx
Innervation: Recurrent laryngeal branch of vagus nerve
False vocal folds definition
Sit above the true vocal folds and are associated with forceful closure such as valsalva and reflex laryngeal closure due to choking or noxious stimuli
Recurrent laryngeal branch of vagus nerve pathway
From the vagus nerve’s descent, the left travels under the aortic arch and back upward to supply intrinsic muscles of the larynx, right travels under the right subclavian artery back upward to supply the same
Superior laryngeal branch of vagus nerve pathway
Branches off the vagus and travels deep to the internal carotid artery to then supply cricothyroid muscle and sensation to the vocal folds
If superior laryngeal nerve is lost, this complication could occur
Aspiration of a foreign body without coughing it back up because no sensation
Vagus nerve pathway
Provides sensory function at the external auditory canal and the hypopharynx as well as motor function of the pharynx before giving rise to the superior laryngeal branch and the recurrant laryngeal branches
Trachealis muscle
Smooth muscle at the posterior border of the trachea conjoining the ends of the c shaped rings, adjusts airflow by expanding or contracting
Aspirated objects are far more likely to end up in the…
Right lung
3 constrictions in the esophageal course
1) cricopharyngeal sphincter which relaxes to let food down at the 6th cervical vertebrae
2) At the chrossing of the aortic arch and left main bronchus
3) The lower esophageal spincter, LES where it pierces the diaphragm
5 phases of swallowing
1) buccal phase - begins in mouth and is voluntary contraction of tongue to force bolus into oropharynx
2) Uvula and larynx rise, tongue blocks off mouth, upper esophagus sphincter relaxes
3) Constrictor muscles of the pharynx contract forcing food into esophagus, upper esophageal sphincter contracts after entry
4) Food moves through esophagus to stomach by peristalsis
5) gastroesophagesal sphincter allows food to enter stomach
Stylohyoid muscle function, insertion, innservation
Function: initiate swallowing by pulling the hyoid posteriorally and superiorally
Insertion: Hyoid bone to styloid process of temporal bone
Innervation: facial nerve
Digastric muscle function, insertion, innervation
Function: depress mandible (open mouth) and elevate hyoid bone
Insertion: anterior inferior aspect of mandible to hyoid bone to mastoid process of temporal bone
Innervation: Anterior trigeminal nerve manidbular branch, posterior facial nerve
Mylohyoid muscle function, insertion, innervation
Function:Elevate hyoid bone and form floor of mouth
Insertion: Mylohyoid line of mandible to hyoid bone
Innervation: trigeminal nerve
Geniohyoid muscle function, insertion, innervation
Funciton: depress mandible and elevate hyoid bone
Insertion: medial surface of mandible to hyoid bone
Innervation: hypoglossal nerve
Suprahyoid muscle group (4)
- stylohyoid
- digastric
- mylohyoid
- geniohyoid
Infrahyoid muscle group (4)
- omahyoid
- sternohyoid
- sternothryoid
- thyrohyoid
Omohyoid muscle function, insertion, innervation
Function:depress hhyoid bone and larynx
Insertion: scapula and clavicle to hyoid bone
Innervation: C1-3
Sternohyoid muscle function, insertion, innervation
Function: depress hyoid bone and larynx
Insertion: sternum and sternoclavicular joint to hyoid bone
Innervation: C1-3
Sternothyroid muscle function, insertion, innervation
Function:depress thyroid cartilage
Insertion: Manubrium of sternum to thyroid cartilage
Innervation:c1-3
Thyrohyoid muscle function, insertion, innervation
Function: depress hyoid
Insertion: thyroid cartilage to hyoid bone
Innervation: C1
Sternoclydomastoid muscle function, insertion, innervation
Function: flex neck, bend head to shoulder, rotate neck
Insertion: clavicle and manubrium to mastoid process
Innervation: accessory nerve
Isthmus definition
tissue conjoining 2 lobes of the thyroid
Thyroid arterial supply
Superior and inferior thyroid artery (derived from the external carotid and thyrocervical trunk of subclavian artery, respectively)
Thyroid venous drainage
Superior, middle, and inferior thyroid veins
T4 is converted to ____ at the target tissue
T3
Calcitonin function
Decrease blood Ca2+ levels
Hypothalamic pituitary thyroid axis
- TRH from hypothalamus stimulates TSH from anteiror pit
- TSH stimulates thyroglobulin conversion via iodine presence to T3/T4 in the thyroid
- Increased thyroid hormone causes decreased TRH and TSH
Parathyroid gland location
Posterior aspect of thyroid gland in 2 pairs (4 total)
Chief cells of the parathyroid
Parathyroid gland cells that release PTH
PTH function
Increase blood Ca2+ levels by enhancing reabsorption in the kidney, stimulating calcitrol secretion, mobilizes Ca2+ by inhibiting osteoblasts and increasing number of osteoclasts
Sensory, motor, or both?
Some say money matters, some say brains. My brother says big boobs matter most.
Borders of the anterior triangle of the neck
Mandible, midline of anterior neck, sternocleidomastaoid
Borders of the posterior triangle of the neck
Sternocleidomastoid, clavicle, trapezius
Vomer definition
Bone that forms the septum of the skull
Waters view xray
x ray beam shot 30 upward from below the horiziontal toward the face to allow for a clear view of sinuses (frontal and maxillary)
Atlas, axis, and dens
C1 and 2 respectively, with the dens sticking up from C2 into C1, very unstable for fractures
Transverse foramen definition
Holes in the cervical vertebrae where the vertebral artery can travel thru
Vertebra prominens definiiton
C7, palpable on the skin
Anterior longitudinal ligament definition
Continuous band of tissue across all the vertebrae at the body that prevents hyperextension of the spine
Posterior longitudinal ligament definition
Continous band along all the vertebrae at the body that resists hyperflexion of the spine, relatively weak
Ligamentum flavum definition
Connective tissue between adjacent vertebrae at the lamina, elastic and very strong with recoil ability
Jefferson fracture definition
C1 burst fracture of the bony ring, visible from an odontoid view
Hangman’s fracture definition
C2 body fracture, visible on a lateral view
Atlanto-occipital dislocation definition
orthopedic decapitation - ligamentous separation of the spinal column from the skull base, only thing keeping head on is treacheal tube to throat, also known as internal decapitation, do not confuse with atlanto-axial dislocation between atlas and axis
Clay shoveler’s fracture definition
Typically occurring between C6-T1, results from combination of hyperflexion sharp movement of paraspinal muscles resulting in fragment sitting adjacent to where it should be. Visible separation on a lateral view, appears as “ghost sign” on ap view (presence of 2 spinous processes). Typically a stable fracture
Atlanto-axial dislocation
degenerative or traumatic in nature, can be stable or unstable, typically treated with neck brace.
Internal intercostals
Involved in expiration (active expiration, which doesnt typically occur), innervated by intercostal nerves
External intercostals
Involved in inspiration, innervated by intercostal nerves
4 major centers of the brainstem (medulla and pons) associated with respiration
- Inspiratory center (dorsal, medulla)
- Expiratory center (ventral, medulla)
- Pneumotaxic center (pons)
- Apneustic center
Carotid and aortic bodies definition
Small thickened regions in the carotid and aorta that contain peripheral chemoreceptors detecting blood CO2 levels innervated thru glossopharyngeal nerve (carotid) and vagus (aortic)
Epithelium lining respiratory tract
Pseudostratified ciliated columnar epithelial cells
What blocks material from the oral cavity from entering the nasopharynx?
Uvula
Adenoids definition
Single pharyngeal tonsil, similar to the lingual and palatine tonsils, housed in the posterior nasopharynx, present in children but shrinks by adulthood, accessory
Carina definition
Inferior tracheal cartilage that separates primary bronchi at their orgin and forms an internal ridge
Left oblique fissure definition
Divides left lung into 2 lobes
Right oblique fissure definition
Divides the right lung middle and lower lobes
Right horizontal fissure definition
Divides the right lung upper and middle lobes
Intra-alveolar pressure at rest
760mmHg at sea level, equal with atmospheric pressure