Pharynx

Question 1

The ______ is a musculofascial half-cylinder that links the oral and nasal cavities in the head to the larynx and esophagus in the neck.

Answer 1

pharynx

Question 2

The ______ is a common pathway for air and food.

Answer 2

pharyngeal cavity

Question 3

The pharynx is attached above to the ______ and is continuous below, approximately at the ______, with the top of the ______.

Answer 3

base of the skull, level of vertebra CVI, esophagus

Question 4

The walls of the pharynx are attached anteriorly to the margins of the ______, ______, and ______.

Answer 4

nasal cavities, oral cavity, larynx

Question 5

Based on these anterior relationships the pharynx is subdivided into three regions, the ______, ______, and ______.

Answer 5

nasopharynx, oropharynx, laryngopharynx

Question 6

The posterior apertures (______) of the nasal cavities open into the ______.

Answer 6

choanae, nasopharynx

Question 7

The posterior opening of the oral cavity (______) opens into the ______.

Answer 7

oropharyngeal isthmus, oropharynx

Question 8

The superior aperture of the larynx (______)
opens into the ______.

Answer 8

laryngeal inlet, laryngopharynx

Question 9

In addition to these openings, the pharyngeal cavity is related anteriorly to the posterior one-third of the ______ and to the posterior aspect of the ______.

Answer 9

tongue, larynx

Question 10

The ______ open into the lateral walls of the nasopharynx.

Answer 10

pharyngotympanic tubes

Question 11

______, ______, and ______ are on the deep surface of the pharyngeal walls.

Answer 11

Lingual, pharyngeal, palatine tonsils

Question 12

The pharynx is separated from the posteriorly positioned vertebral column by a thin retropharyngeal space containing ______.

Answer 12

loose connective tissue

Question 13

Although the ______ is generally considered as part of the roof of the oral cavity, it is also related to the pharynx.

Answer 13

soft palate

Question 14

The soft palate is attached to the posterior margin of the hard palate and is a type of “______” that can:

• ______ to close the pharyngeal isthmus, and seal off the nasopharynx from the oropharynx, and
• ______ to close the oropharyngeal isthmus and seal off the oral cavity from the oropharynx.

Answer 14

flutter valve, swing up (elevate), swing down (depress)

Question 15

The superior and anterior margins of the pharyngeal wall are attached to ______ and ______, and to ______.

Answer 15

bone, cartilage, ligaments

Question 16

The two sides of the pharyngeal wall are welded together posteriorly in the midline by a vertically oriented cord-like ligament (the ______).

Answer 16

pharyngeal raphe

Question 17

There is an irregular ______ line of pharyngeal wall attachment on the base of the skull.

Answer 17

C-shaped

Question 18

The open part of the C faces the ______.

Answer 18

nasal cavities

Question 19

Each arm of the C begins at the posterior margin of the medial plate of the pterygoid process of the sphenoid bone, just inferior to the cartilaginous part of the pharyngotympanic tube. The line crosses inferior to the pharyngotympanic tube and then passes onto the petrous part of the temporal bone where it is just medial to the roughening for the attachment of one of the muscles (______) of the soft palate. From here, the line swings medially onto the occipital bone and joins the line from the other side at a prominent elevation of bone in the midline (the ______).

Answer 19

levator veli palatini, pharyngeal tubercle

Question 20

The vertical line of attachment for the lateral pharyngeal walls to structures related to the nasal and oral cavities and larynx is ______ and in ______ parts.

Answer 20

discontinuous, three

Question 21

WHAT PART?

On each side, the anterior line of attachment of the lateral pharyngeal wall begins superiorly on the posterior edge of the medial pterygoid plate of the sphenoid bone just inferior to where the pharyngotympanic tube lies against this plate. It continues inferiorly along the edge of the medial plate of the pterygoid process and onto the pterygoid hamulus. From this point, the line descends along the pterygoman-dibular raphe to the mandible where this part of the line terminates. The ______ is a linear cord-like connective tissue ligament that spans the distance between the tip of the pterygoid hamulus and a triangular roughening immediately posterior to the third molar on the mandible. It joins a muscle of the lateral pharyngeal wall (______) with a muscle of the lateral wall of the oral cavity (______).

Answer 21

First part, pterygomandibular raphe, superior constrictor, buccinator

Question 22

The ______ of the line of attachment of the lateral pharyngeal wall is related to the hyoid bone. It begins on the lower aspect of the stylohyoid ligament, which connects the tip of the styloid process of the temporal bone to the lesser horn of the hyoid bone. The line continues onto the lesser horn and then turns and runs posteriorly along the entire upper surface of the greater horn of the hyoid where it terminates.

Answer 22

second part

Question 23

The most inferior and ______ of the line of attachment of the lateral pharyngeal wall begins superiorly on the superior tubercle of the thyroid cartilage, and descends along the oblique line to the inferior tubercle. From the inferior tubercle, the line of attachment continues over the cricothyroid muscle along a tendinous thickening of fascia to the cricoid cartilage where it terminates.

Answer 23

third part

Question 24

The ______ is formed by skeletal muscles and by fascia. Gaps between the muscles are reinforced by the fascia and provide routes for structures to pass through the wall.

Answer 24

pharyngeal wall

Question 25

The muscles of the ______ are organized into two groups based on the orientation of muscle fibers.
The ______ muscles have fibers oriented in a circular direction relative to the pharyngeal wall, whereas the ______ muscles have fibers oriented vertically.

Answer 25

pharynx, constrictor, longitudinal

Question 26

The three constrictor muscles on each side are major contributors to the structure of the pharyngeal wall and their names indicate their position — ______, ______, and ______ constrictor muscles. Posteriorly, the muscles from each side are joined together by the ______. Anteriorly, these muscles attach to bones, cartilages, and ligaments related to the lateral margins of the nasal and oral cavities and the larynx.

Answer 26

superior, middle, inferior, pharyngeal raphe

Question 27

The ______ muscles overlap each other in a fashion resembling the walls of three flower pots stacked one on the other. The ______ overlap the lower margins of the ______ and, in the same way, the ______ overlap the ______.

Answer 27

constrictor, inferior constrictors, middle constrictors, middle constrictors, superior constrictors

Question 28

Posterior attachment of the Constrictor muscles of the pharynx: Superior, middle, inferior constrictors.

Answer 28

Pharyngeal raphe

Question 29

Anterior attachment of superior constrictor.

Answer 29

Pterygomandibular raphe and adjacent bone on the mandible and pterygoid hamulus

Question 30

Anterior attachment of middle constrictor.

Answer 30

Upper margin of greater horn of hyoid bone and adjacent margins of lesser horn and stylohyoid ligament

Question 31

Anterior attachment of inferior constrictor.

Answer 31

Cricoid cartilage, oblique line of thyroid cartilage, and a ligament that spans between these attachments and crosses the cricothyroid muscle

Question 32

Innervation of the Constrictor muscles of the pharynx.

Answer 32

Vagus nerve [X]

Question 33

Function of the Constrictor muscles of the pharynx.

Answer 33

Constriction of pharynx

Question 34

Collectively, the muscles constrict or narrow the ______.
When the constrictor muscles contract sequentially from top to bottom, as in swallowing, they move a bolus of food through the pharynx and into the ______.
All of the constrictors are innervated by the pharyngeal branch of the ______.

Answer 34

pharyngeal cavity, esophagus, vagus nerve [X]

Question 35

The ______ muscles together bracket the upper part of the pharyngeal cavity .

Answer 35

superior constrictor

Question 36

A special band of muscle (the ______) originates from the anterolateral surface of the soft palate and circles the inner aspect of the pharyngeal wall, blending with the inner aspect of the superior constrictor.

Answer 36

palatopharyngeal sphincter

Question 37

When the superior constrictor constricts during swallowing, it forms a prominent ridge on the deep aspect of the pharyngeal wall that catches the margin of the elevated soft palate, which then seals closed the ______ between the nasopharynx and oropharynx.

Answer 37

pharyngeal isthmus

Question 38

The ______ muscles are attached to the lower aspect of the stylohyoid ligament, the lesser horn of the hyoid bone, and the entire upper surface of the greater horn of the hyoid.

Answer 38

middle constrictor

Question 39

Like the superior constrictors, the ______ muscles fan out posteriorly and attach to the pharyngeal raphe.

Answer 39

middle constrictor

Question 40

The posterior part of the middle constrictors overlaps the ______.

Answer 40

superior constrictors

Question 41

The ______ muscles attach anteriorly to the oblique line of the thyroid cartilage, the cricoid cartilage, and a ligament that spans between these two attachments to cartilage and crosses the cricothyroid muscle.

Answer 41

inferior constrictor

Question 42

Like the other constrictor muscles, the ______ muscles spread out posteriorly and attach to the pharyngeal raphe.

Answer 42

inferior constrictor

Question 43

The posterior part of the inferior constrictors overlaps the ______. Inferiorly, the muscle fibers blend with and attach into the wall of the ______.

Answer 43

middle constrictors, esophagus

Question 44

The parts of the inferior constrictors attached to the cricoid cartilage bracket the ______ part of the pharyngeal cavity.

Answer 44

narrowest

Question 45

The three longitudinal muscles of the pharyngeal wall are named according to their origins — ______ from the styloid process of the temporal bone, ______ from the cartilaginous part of the pharyngotympanic tube (______ is Greek for “tube”), and ______ from the soft palate.

Answer 45

stylopharyngeus, salpingopharyngeus, salpinx, palatopharyngeus

Question 46

Origin of Stylopharyngeus.

Answer 46

Medial side of base of styloid process

Question 47

Origin of Salpingopharyngeus.

Answer 47

Inferior aspect of pharyngeal end of pharyngotympanic tube

Question 48

Origin of Palatopharyngeus.

Answer 48

Upper surface of palatine aponeurosis

Question 49

Insertion of the Longitudinal muscles of the pharynx: Stylopharyngeus, Salpingopharyngeus, Palatopharyngeus.

Answer 49

Pharyngeal wall

Question 50

Innervation of Stylopharyngeus.

Answer 50

Glossopharyngeal nerve [IX]

Question 51

Innervation of Salpingopharyngeus.

Answer 51

Vagus nerve [X]

Question 52

Innervation of Palatopharyngeus.

Answer 52

Vagus nerve [X]

Question 53

Function of Stylopharyngeus.

Answer 53

Elevation of the pharynx

Question 54

Function of Salpingopharyngeus.

Answer 54

Elevation of the pharynx

Question 55

Function of Palatopharyngeus.

Answer 55

Elevation of the pharynx; closure of the oropharyngeal isthmus

Question 56

From their sites of origin, the ______ muscles descend and attach into the pharyngeal wall.

Answer 56

longitudinal

Question 57

The ______ muscles elevate the pharyngeal wall, or during swallowing, pull the pharyngeal wall up and over a bolus of food being moved through the pharynx and into the esophagus.

Answer 57

longitudinal

Question 58

The cylindrical ______ muscle originates from the base of the medial surface of the styloid process of the temporal bone and descends between the superior and middle constrictor muscles to fan out on, and blend with, the deep surface of the pharyngeal wall. It is innervated by the glossopharyngeal nerve [IX].

Answer 58

stylopharyngeus

Question 59

The ______ is a small muscle originating from the inferior aspect of the pharyngotym-panic tube, descending on, and blending into, the deep surface of the pharyngeal wall. It is innervated by the vagus nerve [X].

Answer 59

salpingopharyngeus

Question 60

The ______, in addition to being a muscle of the pharynx, is also a muscle of the soft palate. It is attached to the upper surface of the palatine aponeurosis, and passes posteriorly and inferiorly to blend with the deep surface of the pharyngeal wall.

Answer 60

palatopharyngeus

Question 61

The palatopharyngeus forms an important fold in the overlying mucosa (the ______). This arch is visible through the oral cavity and is a landmark for finding the ______, which is immediately anterior to it on the oropharyngeal wall.

Answer 61

palatopharyngeal arch, palatine tonsil

Question 62

In addition to elevating the pharynx, the palatopharyngeus participates in closing the ______ by depressing the palate and moving the ______ toward the midline.

Answer 62

oropharyngeal isthmus, palatopharyngeal fold

Question 63

The ______ is separated into two layers, which sandwich the pharyngeal muscles between them:

• A thin layer (______) coats the outside of the muscular part of the wall and is a component of the pretracheal layer of cervical fascia.
• A much thicker layer (______) lines the inner surface.

Answer 63

pharyngeal fascia, buccopharyngeal fascia, pharyngobasilar fascia

Question 64

The ______ reinforces the pharyngeal wall where muscle is deficient. This is particularly evident above the level of the superior constrictor where the pharyngeal wall is formed almost entirely of ______. This part of the wall is reinforced externally by muscles of the soft palate (______ and ______).

Answer 64

fascia, fascia, tensor, levator veli palatini

Question 65

Gaps between muscles of the ______ provide important routes for muscles and neurovascular tissues.

Answer 65

pharyngeal wall

Question 66

Above the margin of the superior constrictor, the pharyngeal wall is deficient in muscle and completed by ______.

Answer 66

pharyngeal fascia

Question 67

The ______ and ______ muscles of the soft palate initially descend from the base of the skull and are lateral to the pharyngeal fascia. In this position, they ______ the pharyngeal wall.

Answer 67

tensor, levator veli palatini, reinforce

Question 68

The ______ passes through the pharyngeal fascia inferior to the pharyngotympanic tube and enters the soft palate.

Answer 68

levator veli palatini

Question 69

The tendon of the ______ turns medially around the pterygoid hamulus and passes through the origin of the buccinator muscle to enter the soft palate.

Answer 69

tensor veli palatini

Question 70

One of the largest and most important apertures in the pharyngeal wall is between the ______ and ______ constrictor muscles of the pharynx and the posterior border of the mylohyoid muscle, which forms the floor of the mouth. This triangular-shaped gap (______) not only enables the stylopharyngeus to slip into the pharyngeal wall, but also allows muscles, nerves, and vessels to pass between regions lateral to the pharyngeal wall and the oral cavity, particularly to the tongue.

Answer 70

superior, middle, oropharyngeal triangle

Question 71

The gap between the ______ and ______ constrictor muscles allows the internal laryngeal vessels and nerve access to the aperture in the thyrohyoid membrane to enter the larynx.

Answer 71

middle, inferior

Question 72

The recurrent laryngeal nerves and accompanying inferior laryngeal vessels enter the larynx posterior to the inferior horn of the thyroid cartilage deep to the inferior margin of the ______ muscle.

Answer 72

inferior constrictor

Question 73

The ______ is behind the posterior apertures (______) of the nasal cavities and above the level of the soft palate.

Answer 73

nasopharynx, choanae

Question 74

The ceiling of the nasopharynx is formed by the sloping base of the skull and consists of the posterior part of the body of the sphenoid bone and the basal part of the occipital bone. The ceiling and lateral walls of the nasopharynx form a ______ at the top of the pharyngeal cavity that is always ______.

Answer 74

domed vault, open

Question 75

The cavity of the nasopharynx is continuous below with the cavity of the ______ at the ______.

Answer 75

oropharynx, pharyngeal isthmus

Question 76

The position of the pharyngeal isthmus is marked on the pharyngeal wall by a mucosal fold caused by the underlying ______, which is part of the superior constrictor muscle.

Answer 76

palatopharyngeal sphincter

Question 77

Elevation of the ______ and constriction of the ______ closes the pharyngeal isthmus during swallowing and separates the nasopharynx from the oropharynx.

Answer 77

soft palate, palatopharyngeal sphincter

Question 78

There is a large collection of lymphoid tissue (the ______) in the mucosa covering the roof of the nasopharynx. Enlargement of this tonsil, known then as ______, can occlude the nasopharynx so that breathing is only possible through the oral cavity.

Answer 78

pharyngeal tonsil, adenoids

Question 79

The most prominent features on each lateral wall of the nasopharynx are:

• the ______, and
• ______ covering the end of the pharyngotympanic tube and the adjacent muscles.

Answer 79

pharyngeal opening of the pharyngotympanic tube, mucosal elevations and folds

Question 80

The opening of the ______ is posterior to and slightly above the level of the hard palate, and lateral to the top of the soft palate.

Answer 80

pharyngotympanic tube

Question 81

Because the pharyngotympanic tube projects into the nasopharynx from a posterolateral direction, its posterior rim forms an elevation or bulge on the ______. Posterior to this tubal elevation (______) is a deep recess (______).

Answer 81

pharyngeal wall, torus tubarius, pharyngeal recess

Question 82

Mucosal folds related to the pharyngotympanic tube include:

• the small vertical ______, which descends from the tubal elevation and overlies the salpingopharyngeus muscle, and
• a broad fold or elevation (______) that appears to emerge from just under the opening of the pharyngotympanic tube, continues medially onto the upper surface of the soft palate, and overlies the levator veli palatini muscle.

Answer 82

salpingopharyngeal fold, torus levatorius

Question 83

The ______ is posterior to the oral cavity, inferior to the level of the soft palate, and superior to the upper margin of the epiglottis.

Answer 83

oropharynx

Question 84

The ______ (arches), one on each side, that cover the palatoglossal muscles, mark the boundary between the oral cavity and the oropharynx. The arched opening between the two folds is the ______. Just posterior and medial to these folds are another pair of folds (arches), the ______, one on each side, that overlie the palatopharyngeus muscles.

Answer 84

palatoglossal folds, oropharyngeal isthmus, palatopharyngeal folds

Question 85

The anterior wall of the oropharynx inferior to the oropharyngeal isthmus is formed by the upper part of the posterior ______ or ______ of the tongue. Large collections of lymphoid tissue (the ______) are in the mucosa covering this part of the tongue. A pair of mucosal pouches (______), one on each side of the midline, between the base of the tongue and epiglottis, are depressions formed between a midline mucosal fold and two lateral folds that connect the tongue to the epiglottis.

Answer 85

one-third, pharyngeal part, lingual tonsils, valleculae

Question 86

The ______ are on the lateral walls of the oropharynx. On each side, there is a large ovoid collection of ______ in the mucosa lining the superior constrictor muscle and between the palatoglossal and palatopharyngeal arches. The ______ are visible through the oral cavity just posterior to the palatoglossal folds.

Answer 86

palatine tonsils, lymphoid tissue, palatine tonsils

Question 87

When holding liquid or solids in the oral cavity, the ______ is closed by depression of the soft palate, elevation of the back of the tongue, and movement toward the midline of the palatoglossal and palatopharyngeal folds. This allows a person to ______ while chewing or manipulating material in the oral cavity.

Answer 87

oropharyngeal isthmus, breathe

Question 88

On swallowing, the ______ is opened, the ______ is elevated, the ______ is closed, and the food or liquid is directed into the ______. A person cannot breathe and swallow at the same time because the airway is closed at two sites, the pharyngeal isthmus and the larynx.

Answer 88

oropharyngeal isthmus, palate, laryngeal cavity, esophagus

Question 89

The ______ extends from the superior margin of the epiglottis to the top of the esophagus at the level of vertebra CVI.

Answer 89

laryngopharynx

Question 90

The ______ opens into the anterior wall of the laryngopharynx. Inferior to the ______, the anterior wall consists of the posterior aspect of the larynx.

Answer 90

laryngeal inlet, laryngeal inlet

Question 91

There is another pair of mucosal recesses (______) between the central part of the larynx and the more lateral lamina of the thyroid cartilage.

Answer 91

piriform fossae

Question 92

The ______ form channels that direct solids and liquids from the oral cavity around the raised laryngeal inlet and into the esophagus.

Answer 92

piriform fossae

Question 93

Collections of lymphoid tissue in the mucosa of the pharynx surrounding the openings of the nasal and oral cavities (______) are part of the body’s defense system. The largest of these collections form distinct masses (______).

Answer 93

Waldeyer’s tonsillar ring, tonsils

Question 94

Tonsils occur mainly in three areas:

• The ______, known as adenoids when enlarged, is in the midline on the roof of the nasopharynx.
• The ______ are on each side of the oropharynx between the palatoglossal and palatopharyngeal arches just posterior to the oropharyngeal isthmus. (They are visible through the open mouth of a patient when the tongue is depressed.)
• The ______ refer collectively to numerous lymphoid nodules on the posterior one-third of the tongue.

Answer 94

pharyngeal tonsil, palatine tonsils, lingual tonsils

Question 95

Small lymphoid nodules also occur in the ______ near its opening into the nasopharynx, and on the upper surface of the ______.

Answer 95

pharyngotympanic tube, soft palate

Question 96

Numerous vessels supply the pharyngeal wall.
Arteries that supply upper parts of the pharynx include:

• the ascending ______ artery,
• the ascending ______ and ______ branches of the ______ artery, and
• numerous branches of the ______ and the ______ arteries.

All these vessels are from the ______ artery.

Answer 96

pharyngeal, palatine, tonsillar, facial, maxillary, lingual, external carotid

Question 97

Arteries that supply the lower parts of the pharynx include ______ branches from the ______ artery, which originates from the thyrocervical trunk of the subclavian artery.

Answer 97

pharyngeal, inferior thyroid

Question 98

The major blood supply to the palatine tonsil is from the ______ branch of the ______ artery, which penetrates the superior constrictor muscle.

Answer 98

tonsillar, facial

Question 99

Veins of the pharynx form a plexus, which drains superi-orly into the ______ in the infratemporal fossa, and inferiorly into the ______ and ______ veins.

Answer 99

pterygoid plexus, facial, internal jugular

Question 100

Lymphatic vessels from the pharynx drain into the ______ nodes and include ______ (between the nasopharynx and vertebral column), ______, and ______ nodes.

Answer 100

deep cervical, retropharyngeal, paratracheal, infrahyoid

Question 101

The palatine tonsils drain through the pharyngeal wall into the ______ nodes in the region where the facial vein drains into the internal jugular vein (and inferior to the posterior belly of the digastric muscle).

Answer 101

jugulodigastric

Question 102

Motor and most sensory innervation (except for the nasal region) of the pharynx is mainly through branches of the ______ and ______ nerves, which form a plexus in the outer fascia of the pharyngeal wall.

Answer 102

vagus [X], glossopharyngeal [IX]

Question 103

The pharyngeal plexus is formed by:

• the pharyngeal branch of the ______.
• branches from the ______ from the ______ of the ______, and
• pharyngeal branches of the ______.

Answer 103

vagus nerve [X], external laryngeal nerve, superior laryngeal branch, vagus nerve [X], glossopharyngeal nerve [IX]

Question 104

The ______ branch of the ______ originates from the upper part of its ______ ganglion above the origin of the superior laryngeal nerve and is the major motor nerve of the pharynx.

Answer 104

pharyngeal, vagus nerve [X], inferior

Question 105

All muscles of the pharynx are innervated by the ______ mainly through the pharyngeal plexus, except for the stylopharyngeus, which is innervated directly by a branch of the ______.

Answer 105

vagus nerve [X], glossopharyngeal nerve

Question 106

Each subdivision of the pharynx has a different sensory innervation:

• The nasopharynx is innervated by a ______ branch of the ______ that originates in the pterygopalatine fossa and passes through the palatovaginal canal in the sphenoid bone to reach the roof of the pharynx.
• The oropharynx is innervated by the ______ via the pharyngeal plexus.
• The laryngopharynx is innervated by the ______ via the internal branch of the superior laryngeal nerve.

Answer 106

pharyngeal, maxillary nerve [V2], glossopharyngeal nerve [IX], vagus nerve [X]

Question 107

The ______ nerve is related to the pharynx throughout most of its course outside the cranial cavity.

Answer 107

glossopharyngeal

Question 108

After exiting the skull through the jugular foramen, the ______ nerve descends on the posterior surface of the stylopharyngeus muscle, passes onto the lateral surface of the stylopharyngeus, and then passes anteriorly through the gap (______) between the superior constrictor, middle constrictor, and mylohyoid muscles to eventually reach the posterior aspect of the ______.

Answer 108

glossopharyngeal, oropharyngeal triangle, tongue

Question 109

As the glossopharyngeal nerve [IX] passes under the free edge of the superior constrictor, it is just inferior to the ______ lying on the deep surface of the superior constrictor.

Answer 109

palatine tonsil

Question 110

Pharyngeal branches to the ______ and a motor branch to the ______ are among branches that originate from the glossopharyngeal nerve [IX] in the neck. Because sensory innervation of the oropharynx is by the glossopharyngeal nerve [IX], this nerve carries sensory innervation from the ______ and is also the afferent limb of the ______.

Answer 110

pharyngeal plexus, stylopharyngeus muscle, palatine tonsil, gag reflex