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MBBCh 2- ANAT2020A > Pharynx and Cervical Oesophagus > Flashcards

Pharynx and Cervical Oesophagus Flashcards

1
Q

What is the Pharynx?

A
  • Superior expanded part of the oesophagus posterior to the nasal and oral cavities
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2
Q

Pharynx
* Extent:
o Superior-
o Inferior-
o Anterior-
o Posterior-

A

o Superior- cranial base
o Inferior- inferior border of cricoid cartilage at the level of C6 vertebra
o Anterior- nasal cavity, oral cavity and larynx
o Posterior- buccopharyngeal fascia

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3
Q

Pharynx:
* Widest opposite hyoid (5 cm) and narrowest at junction with oesophagus (1.5 cm)
* flat posterior wall lies against the prevertebral layer of deep cervical fascia
* divided into 3 parts:

A

o Nasopharynx- posterior to the nose and superior to the soft palate
o Oropharynx- posterior to mouth
o Laryngopharynx- posterior to the larynx

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4
Q

What is the Nasopharynx? (2)

A
  • Has a respiratory function
  • Posterior extension of the nasal cavities
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5
Q

Nasopharynx:

  • Borders:
    o Anterior-
    o Posterior-
    o Roof-
A

o Anterior- choana and soft palate
o Posterior- basilar part of the occipital bone and C1 vertebra
o Roof- body of sphenoid

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6
Q

Nasopharynx:
o Tonsils (aggregates of lymphoid tissue): (2)

A
  • Pharyngeal (adenoid) tonsil- in the mucosa of the roof and posterior wall of the nasopharynx
  • Tubal tonsils- in the submucosa of the pharynx near the nasopharyngeal opening
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7
Q

Nasopharynx:
o Opening of the _________ tube

A

pharyngotympanic

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8
Q

Nasopharynx:
o Salpingopharyngeal fold: (3)

A
  • Extends inferiorly from the medial end of the pharyngotympanic tube
  • Vertical fold of the mucosa
  • Covers the salpingopharyngeus muscle
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9
Q

Nasopharynx:
o Torus tubarius:

A
  • Superior to the opening of the pharyngotympanic tube
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10
Q

Nasopharynx:
o Pharyngeal recess: (2)

A
  • Posterior to the torus tubarius and salpingopharyngeal fold
  • Extends laterally and posteriorly
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11
Q

What is the function of the Oropharynx?

A
  • Has a digestive function
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12
Q

Oropharynx:
Boundaries:

o Superior-
o Inferior-
o Lateral-
o Posterior-

A

o Superior- soft palate and uvula
o Inferior- base of the tongue and superior border of epiglottis
o Lateral- palatopharyngeal and palatoglossal arches
o Posterior- pharyngobasilar fascia over palatopharyngeus, superior constrictor and body of C2

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13
Q

Oropharynx:
Contents: (3)

A

o Palatine tonsils
- On each side of the oropharynx in the tonsillar bed between the palatine arches
(palatopharyngeal and palatoglossal arches)
o Tonsillar bed
- Formed by the superior pharyngeal constrictor and the thin, fibrous sheet of pharyngobasilarnfascia
* Fascia blends with the periosteum of the cranial base
o Lingual tonsils
- On the posterior third of the tongue

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14
Q

What does Pharyngeal lymphatic (Waldeyer’s) ring consist of? (5)

A

1 pharyngeal tonsil
2 tubal tonsils
2 palatine tonsils
1 lingual tonsil
2 lateral bands

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15
Q

Where does the Laryngopharynx lie?

A
  • Lies posterior to the larynx
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16
Q

Laryngopharynx
* Boundaries:

o Superior-
o Inferior-
o Anterior-
o Posterior-
o Lateral-

A

o Superior- superior border of the epiglottis and pharyngoepiglottic folds
o Inferior- inferior border of the cricoid cartilage
o Anterior- larynx
o Posterior- pharyngobasilar fascia, middle and inferior constrictor muscles and C4- C6 vertebrae
o Lateral- pharyngobasilar fascia and middle and inferior constrictor muscles

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17
Q

Laryngopharynx:
Features: (3)

A

o Laryngeal inlet
o Piriform fossa (recess)
o Aryepiglottic fold

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18
Q

Laryngopharynx:
o Laryngeal inlet:

A
  • Communication between the laryngopharynx and the larynx on the anterior wall
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19
Q

Laryngopharynx:
o Piriform fossa (recess): (3)

A
  • Small depression of the laryngopharyngeal cavity on either side of the laryngeal inlet
  • Laterally bounded by the medial surfaces of the thyroid cartilage and the thyroid membrane
  • Branches of the internal and recurrent laryngeal nerves lie deep to its mucosa
  • Vulnerable to injury when a foreign body lodges in the fossa
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20
Q

Laryngopharynx:
o Aryepiglottic fold:

A
  • Separates the piriform fossa from the laryngeal inlet
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21
Q

What are the features of the Pharyngeal muscles? (3)

A
  • Arranged with longitudinal muscles internally and circular muscles externally
  • Circular muscles are the pharyngeal constrictors
  • Internal longitudinal muscles elevate the larynx and shorten the pharynx during swallowing/speaking
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22
Q

Pharyngeal muscles:
* Fascial lining: (2)

A

o Strong internal pharyngobasilar fascia
o Thin external buccopharyngeal fascia (blends with the pretracheal layer of deep cervical fascia)
* Constrictors contract involuntarily for sequential contraction

23
Q

What are the External layer- pharyngeal constrictors?

A
24
Q

Pharyngeal constrictors:
Superior:
Origin:
Insertion:
Innervation:
Main Action:

A
  • Pterygoid hamulus
  • Pterygomandibular raphe
  • Adjacent part of mandible

Pharyngeal tubercle on basilar part of occipital bone

  • Pharyngeal br. of vagus n.
  • pharyngeal plexus

Constrict walls of pharynx during swallowing

25
Q

Pharyngeal constrictors:
Middle
Origin:
Insertion:
Innervation:
Main Action:

A
  • stylohyoid ligament
  • greater and lesser horns of hyoid

Pharyngeal raphe

  • Pharyngeal br. of vagus n.
  • pharyngeal plexus
  • br. of external and recurrent laryngeal nn. of vagus n.

Constrict walls of pharynx during swallowing

26
Q

Pharyngeal constrictors:
Inferior
Origin:
Insertion:
Innervation:
Main Action:

A
  • Oblique line of thyroid cartilage
  • Side of cricoid cartilage

Pharyngeal raphe

  • Pharyngeal br. of vagus n.
  • pharyngeal plexus
  • br. of external and recurrent laryngeal nn. of vagus n.

Constrict walls of pharynx during swallowing

27
Q

What are the Internal layer- longitudinal muscles? (3)

A
28
Q

Internal layer- longitudinal muscles
Palatopharyngeus
Innervation:
Main Action:

A
  • Pharyngeal br. of vagus n.
  • pharyngeal plexus

Elevate (shorten and widen) pharynx and larynx during swallowing and speaking

29
Q

Internal layer- longitudinal muscles
Salpingopharyngeus
Innervation:
Main Action:

A
  • Pharyngeal br. of vagus n.
  • pharyngeal plexus

Elevate (shorten and widen) pharynx and larynx during swallowing and speaking

30
Q

Internal layer- longitudinal muscles
Stylopharyngeus
Innervation:
Main Action:

A
  • Glossopharyngeal n.

Elevate (shorten and widen) pharynx and larynx during swallowing and speaking

31
Q

Gaps in the pharyngeal constrictor muscles:
1. Between superior pharyngeal constrictor and cranium

Contents: (3)

A
  • Levator veli palatini
  • Pharyngotympanic tube
  • Ascending palatine artery
32
Q

Gaps in the pharyngeal constrictor muscles:
2. Between superior and middle pharyngeal constrictors

Contents: (3)

A
  • Stylopharyngeus
  • Glossopharyngeal nerve (CN IX)
  • Stylohyoid ligament
33
Q

Gaps in the pharyngeal constrictor muscles:
3. Between middle and inferior pharyngeal constrictors

Contents: (2)

A
  • Internal laryngeal nerve
  • Superior laryngeal artery and vein
34
Q

Gaps in the pharyngeal constrictor muscles:
4. Inferior to the inferior pharyngeal constrictor

Contents: (2)

A
  • Recurrent laryngeal nerve
  • Inferior laryngeal artery and vein
35
Q

Gaps in the pharyngeal constrictor muscles:
4. Inferior to the inferior pharyngeal constrictor

Contents: (2)

A
  • Recurrent laryngeal nerve
  • Inferior laryngeal artery and vein
36
Q

What are the arteries of the pharynx? (4)

A
  • tonsillar branch of facial a.
  • Ascending & descending palatine a.
  • From external carotid a.
  • Inferior thyroid a. from subclavian a.
37
Q

What are the arteries that extend from the external carotid a.? (3)

A

o Lingual a.
o Superior thyroid a.
o Ascending pharyngeal a.

38
Q

What are the veins of the pharynx?

A
  • Inferior part:
    o External palatine v. to pharyngeal
    venous plexus to pterygoid venous
    plexus
    o Thyroid vv. to IJV
39
Q

Nerves of the pharynx
* Derives from pharyngeal nerve _______

A
40
Q

Nerves of the pharynx
* Motor fibres: (3)

A

o From vagus n. to all muscles of
pharynx and soft palate except
tensor veli palatini and stylopharyngeus
o From glossopharyngeal n. to stylopharyngeus
o From mandibular n. to tensor veli palatini

41
Q

Nerves of the pharynx
* Sympathetic vasomotor fibres:

A

o From superior cervical ganglion to blood vessels

42
Q

Nerves of the pharynx
* Sensory fibres:

A

o From glossopharyngeal n. to all parts of the pharynx
o From maxillary nerve to mucosa of anterior and superior nasopharynx

43
Q

What is the Cervical Oesophagus?

A
  • Muscular tube connecting the pharynx to the stomach
44
Q

Where does the Cervical Oesophagus begin? (2)

A
  • Begins at the pharyngo-oesophageal junction
    o Narrowest part of the oesophagus
    o Cricopharyngeal part of the inferior pharyngeal constrictor acts as a sphincter
45
Q
  • First third is ______, middle is mixed, last third is _______.
A

voluntary
involuntary

46
Q

Cervical Oesophagus:

  • Cervical oesophagus- part of the voluntary upper third
    o Begins immediately posterior to the inferior border of the ______ cartilage
  • Level of ___ vertebra
    o Inclines slightly to the left as it descends into the superior ________
  • Enters through superior _____ aperture and becomes thoracic oesophagus
A

cricoid
C6
mediastinum
thoracic

47
Q

Cervical Oesophagus:
* Slit-like ____ when empty
* Lumen expands for food bolus which elicits reflex _____ in the inferior two thirds

A

lumen
peristalsis

48
Q

Cervical Oesophagus:
* Anterior relations: (2)

A

o Trachea (attached by loose connective tissue)
o Recurrent laryngeal nerves (in tracheo-oesophageal groove)

49
Q

Cervical Oesophagus:
* Posterior relations:

A
  • Posterior- cervical vertebrae
50
Q

Cervical Oesophagus:
* Lateral relations: (3)

A

o Right and left lobes of thyroid gland
o Carotid sheath and its contents
o Thoracic duct on the left

51
Q

Cervical Oesophagus:
* Inferior relations: (2)

A

o Cervical pleura at the root
o Thoracic duct

52
Q

Cervical Oesophagus:
Arteries:

A
  • Branches of the inferior thyroid aa.
    o Gives off ascending and descending branches that anastomose and cross the midline
53
Q

Cervical Oesophagus:
Veins:

A
  • Inferior thyroid vv.
54
Q

Cervical Oesophagus:
Nerves: (3)

A
  • Somatic motor and sensory to upper half and autonomic and visceral sensory to lower half
  • somatic fibres via branches from the recurrent laryngeal nerves
  • vasomotor fibres from the cervical sympathetic trunks via the plexus around the inferior thyroid artery

MBBCh 2- ANAT2020A (60 decks)

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