Pharynx Flashcards
1
Q
The ______ is a musculofascial half-cylinder that links the oral and nasal cavities in the head to the larynx and esophagus in the neck.
A
pharynx
2
Q
The ______ is a common pathway for air and food.
A
pharyngeal cavity
3
Q
The pharynx is attached above to the ______ and is continuous below, approximately at the ______, with the top of the ______.
A
base of the skull, level of vertebra CVI, esophagus
4
Q
The walls of the pharynx are attached anteriorly to the margins of the ______, ______, and ______.
A
nasal cavities, oral cavity, larynx
5
Q
Based on these anterior relationships the pharynx is subdivided into three regions, the ______, ______, and ______.
A
nasopharynx, oropharynx, laryngopharynx
6
Q
The posterior apertures (______) of the nasal cavities open into the ______.
A
choanae, nasopharynx
7
Q
The posterior opening of the oral cavity (______) opens into the ______.
A
oropharyngeal isthmus, oropharynx
8
Q
The superior aperture of the larynx (______)
opens into the ______.
A
laryngeal inlet, laryngopharynx
9
Q
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 ______.
A
tongue, larynx
10
Q
The ______ open into the lateral walls of the nasopharynx.
A
pharyngotympanic tubes
11
Q
______, ______, and ______ are on the deep surface of the pharyngeal walls.
A
Lingual, pharyngeal, palatine tonsils
12
Q
The pharynx is separated from the posteriorly positioned vertebral column by a thin retropharyngeal space containing ______.
A
loose connective tissue
13
Q
Although the ______ is generally considered as part of the roof of the oral cavity, it is also related to the pharynx.
A
soft palate
14
Q
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.
A
flutter valve, swing up (elevate), swing down (depress)
15
Q
The superior and anterior margins of the pharyngeal wall are attached to ______ and ______, and to ______.
A
bone, cartilage, ligaments
16
Q
The two sides of the pharyngeal wall are welded together posteriorly in the midline by a vertically oriented cord-like ligament (the ______).
A
pharyngeal raphe
17
Q
There is an irregular ______ line of pharyngeal wall attachment on the base of the skull.
A
C-shaped
18
Q
The open part of the C faces the ______.
A
nasal cavities
19
Q
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 ______).
A
levator veli palatini, pharyngeal tubercle
20
Q
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.
A
discontinuous, three
21
Q
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 (______).
A
First part, pterygomandibular raphe, superior constrictor, buccinator
22
Q
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.
A
second part
23
Q
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.
A
third part
24
Q
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.
A
pharyngeal wall
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.
pharynx, constrictor, longitudinal
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.
superior, middle, inferior, pharyngeal raphe
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 ______.
constrictor, inferior constrictors, middle constrictors, middle constrictors, superior constrictors
28
Posterior attachment of the Constrictor muscles of the pharynx: Superior, middle, inferior constrictors.
Pharyngeal raphe
29
Anterior attachment of superior constrictor.
Pterygomandibular raphe and adjacent bone on the mandible and pterygoid hamulus
30
Anterior attachment of middle constrictor.
Upper margin of greater horn of hyoid bone and adjacent margins of lesser horn and stylohyoid ligament
31
Anterior attachment of inferior constrictor.
Cricoid cartilage, oblique line of thyroid cartilage, and a ligament that spans between these attachments and crosses the cricothyroid muscle
32
Innervation of the Constrictor muscles of the pharynx.
Vagus nerve [X]
33
Function of the Constrictor muscles of the pharynx.
Constriction of pharynx
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 ______.
pharyngeal cavity, esophagus, vagus nerve [X]
35
The ______ muscles together bracket the upper part of the pharyngeal cavity .
superior constrictor
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.
palatopharyngeal sphincter
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.
pharyngeal isthmus
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.
middle constrictor
39
Like the superior constrictors, the ______ muscles fan out posteriorly and attach to the pharyngeal raphe.
middle constrictor
40
The posterior part of the middle constrictors overlaps the ______.
superior constrictors
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.
inferior constrictor
42
Like the other constrictor muscles, the ______ muscles spread out posteriorly and attach to the pharyngeal raphe.
inferior constrictor
43
The posterior part of the inferior constrictors overlaps the ______. Inferiorly, the muscle fibers blend with and attach into the wall of the ______.
middle constrictors, esophagus
44
The parts of the inferior constrictors attached to the cricoid cartilage bracket the ______ part of the pharyngeal cavity.
narrowest
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.
stylopharyngeus, salpingopharyngeus, salpinx, palatopharyngeus
46
Origin of Stylopharyngeus.
Medial side of base of styloid process
47
Origin of Salpingopharyngeus.
Inferior aspect of pharyngeal end of pharyngotympanic tube
48
Origin of Palatopharyngeus.
Upper surface of palatine aponeurosis
49
Insertion of the Longitudinal muscles of the pharynx: Stylopharyngeus, Salpingopharyngeus, Palatopharyngeus.
Pharyngeal wall
50
Innervation of Stylopharyngeus.
Glossopharyngeal nerve [IX]
51
Innervation of Salpingopharyngeus.
Vagus nerve [X]
52
Innervation of Palatopharyngeus.
Vagus nerve [X]
53
Function of Stylopharyngeus.
Elevation of the pharynx
54
Function of Salpingopharyngeus.
Elevation of the pharynx
55
Function of Palatopharyngeus.
Elevation of the pharynx; closure of the oropharyngeal isthmus
56
From their sites of origin, the ______ muscles descend and attach into the pharyngeal wall.
longitudinal
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.
longitudinal
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].
stylopharyngeus
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].
salpingopharyngeus
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.
palatopharyngeus
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.
palatopharyngeal arch, palatine tonsil
62
In addition to elevating the pharynx, the palatopharyngeus participates in closing the ______ by depressing the palate and moving the ______ toward the midline.
oropharyngeal isthmus, palatopharyngeal fold
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.
pharyngeal fascia, buccopharyngeal fascia, pharyngobasilar fascia
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 ______).
fascia, fascia, tensor, levator veli palatini
65
Gaps between muscles of the ______ provide important routes for muscles and neurovascular tissues.
pharyngeal wall
66
Above the margin of the superior constrictor, the pharyngeal wall is deficient in muscle and completed by ______.
pharyngeal fascia
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.
tensor, levator veli palatini, reinforce
68
The ______ passes through the pharyngeal fascia inferior to the pharyngotympanic tube and enters the soft palate.
levator veli palatini
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.
tensor veli palatini
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.
superior, middle, oropharyngeal triangle
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.
middle, inferior
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.
inferior constrictor
73
The ______ is behind the posterior apertures (______) of the nasal cavities and above the level of the soft palate.
nasopharynx, choanae
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 ______.
domed vault, open
75
The cavity of the nasopharynx is continuous below with the cavity of the ______ at the ______.
oropharynx, pharyngeal isthmus
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.
palatopharyngeal sphincter
77
Elevation of the ______ and constriction of the ______ closes the pharyngeal isthmus during swallowing and separates the nasopharynx from the oropharynx.
soft palate, palatopharyngeal sphincter
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.
pharyngeal tonsil, adenoids
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.
pharyngeal opening of the pharyngotympanic tube, mucosal elevations and folds
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.
pharyngotympanic tube
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 (______).
pharyngeal wall, torus tubarius, pharyngeal recess
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.
salpingopharyngeal fold, torus levatorius
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.
oropharynx
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.
palatoglossal folds, oropharyngeal isthmus, palatopharyngeal folds
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.
one-third, pharyngeal part, lingual tonsils, valleculae
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.
palatine tonsils, lymphoid tissue, palatine tonsils
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.
oropharyngeal isthmus, breathe
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.
oropharyngeal isthmus, palate, laryngeal cavity, esophagus
89
The ______ extends from the superior margin of the epiglottis to the top of the esophagus at the level of vertebra CVI.
laryngopharynx
90
The ______ opens into the anterior wall of the laryngopharynx. Inferior to the ______, the anterior wall consists of the posterior aspect of the larynx.
laryngeal inlet, laryngeal inlet
91
There is another pair of mucosal recesses (______) between the central part of the larynx and the more lateral lamina of the thyroid cartilage.
piriform fossae
92
The ______ form channels that direct solids and liquids from the oral cavity around the raised laryngeal inlet and into the esophagus.
piriform fossae
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 (______).
Waldeyer's tonsillar ring, tonsils
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.
pharyngeal tonsil, palatine tonsils, lingual tonsils
95
Small lymphoid nodules also occur in the ______ near its opening into the nasopharynx, and on the upper surface of the ______.
pharyngotympanic tube, soft palate
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.
pharyngeal, palatine, tonsillar, facial, maxillary, lingual, external carotid
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.
pharyngeal, inferior thyroid
98
The major blood supply to the palatine tonsil is from the ______ branch of the ______ artery, which penetrates the superior constrictor muscle.
tonsillar, facial
99
Veins of the pharynx form a plexus, which drains superi-orly into the ______ in the infratemporal fossa, and inferiorly into the ______ and ______ veins.
pterygoid plexus, facial, internal jugular
100
Lymphatic vessels from the pharynx drain into the ______ nodes and include ______ (between the nasopharynx and vertebral column), ______, and ______ nodes.
deep cervical, retropharyngeal, paratracheal, infrahyoid
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).
jugulodigastric
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.
vagus [X], glossopharyngeal [IX]
103
The pharyngeal plexus is formed by:
• the pharyngeal branch of the ______.
• branches from the ______ from the ______ of the ______, and
• pharyngeal branches of the ______.
vagus nerve [X], external laryngeal nerve, superior laryngeal branch, vagus nerve [X], glossopharyngeal nerve [IX]
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.
pharyngeal, vagus nerve [X], inferior
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 ______.
vagus nerve [X], glossopharyngeal nerve
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.
pharyngeal, maxillary nerve [V2], glossopharyngeal nerve [IX], vagus nerve [X]
107
The ______ nerve is related to the pharynx throughout most of its course outside the cranial cavity.
glossopharyngeal
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 ______.
glossopharyngeal, oropharyngeal triangle, tongue
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.
palatine tonsil
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 ______.
pharyngeal plexus, stylopharyngeus muscle, palatine tonsil, gag reflex
