Pharynx And Esophagus

Question 1

Define Pharynx

Answer 1

It is a musculomembranous tube which lies behind the nose, mouth and larynx

Question 2

Extent of the pharynx and length

Answer 2

extends from the base of the skull down to the 6th cervical vertebra
12-14 cm

Question 3

Nasopharynx extent

Answer 3

extends from the base of the skull down to the level of the soft pala

Question 4

Name two special features of Nasopharynx

Answer 4

At the junction of it’s roof and posterior wall the mucosa contains:
- nasopharyngeal tonsil

Question 5

On each lateral wall of the nasopharynx, there are:

Answer 5

Pharyngeal opening of the auditory tube

Question 6

The Pharyngeal opening of the auditory tube is situated where

Answer 6

1 cm behind the inferior nasal concha

Question 7

The Pharyngeal opening site

Answer 7

its bounded above and behind by the tubal elevation

Question 8

the tubal elevation is produced by

Answer 8

by the cartilage of the auditory tube

Question 9

What is Around the pharyngeal opening

Answer 9

the mucosa contains a collection of lymphoid tissue called the tubal tonsil

Question 10

The pharyngeal opening is between …… and ……
What’s it’s function

Answer 10

Between midlle ear and nasopharynx
Contains air and maintain pressure

Question 11

The lower end of the tubal elevation is continuous with a vertical mucous fold called the

Answer 11

salpingopharyngeal fold

Question 12

What structure is Behind the tubal elevation

Answer 12

pharyngeal recess of Rosenmuller

Question 13

Oropharynx lateral wall presents

Answer 13

Sinus tonsillar
Also called: tonsillar bed or tonsillar fossa

Question 14

Sinus tonsillar contains what

Answer 14

Palatine tonsil between the palatoglossal and palatopharyngeal arches

Question 15

Define palatine tonsils and location

Answer 15

Two masses of lymphoid tissue located in tonsillar fossa between palatoglossal and palatopharyngeal
arches

Question 16

Each palatine tonsil is covered by what on its medial surface

Answer 16

Mucous membrane on its free medial surface that projects into the pharynx

Question 17

Each palatine tonsil is covered by what on its lateral surface

Answer 17

By a fibrous capsule that is seperated from superior constrictor muscle by loose areolar tissue

Question 18

the loose areolar tissue that seperates the fibrous capsule from superior constrictor muscle contains what?

Answer 18

External palatine vein
Also called: paratonsillar vein

Question 19

External oalatine vein or paratonsillar vein descends from …… to ……

Answer 19

Soft palate to superior constrictor muscle

Question 20

Paratonsillar vein is between …… and ………

Answer 20

Superior constrictor muscle and palatine tonsil

Question 21

Blood supply of palatine tonsil

Answer 21

Tonsillar artery branch of facial artery
Veins pierces superior constrictor to join external palatine
Lymphatic drainage: by upper deep cervical l.n

Question 22

relations to the palatine tonsils
Ant-post-sup-inf-med-lat

Answer 22

Ant: palatoglossal arch
Post: palatopharyngeal arch
Sup: soft palate
Inf: posterior 3rd of the tongue
Med: cavity of the oropharynx
Lat(tonsillar bed): superior const. muscle, paratonsillar vein, tonsillar artery

Question 23

Laryngopharynx extent

Answer 23

It extends from epiglottis down to the lower border of the cricoid cartilage (C6 vertebra)

Question 24

What is Anteroinferiorly and inferiorly to the Laryngopharynx

Answer 24

AI: with the larynx via the laryngeal inlet
I: is continuous with the oesophagus

Question 25

The Muscular Coat of the Pharynx consists of :

Answer 25

• Outer layer formed of 3 constrictors
  (superior, middle, inferior)
• Inner layer formed of 3 longitudinal muscles
  • Stylopharyngeus
  • Salpingopharyngeus
  • Palatopharyngeus

Question 26

The 3 constrictors have different origins, but all are inserted?

Answer 26

posteriorly into the pharyngeal raphe

Question 27

pharyngeal raphe descends from?

Answer 27

the pharyngeal tubercle on the skull base down to the oesophagus

Question 28

The 3 long. muscles : have different origins, but all are inserted into?

Answer 28

the posterior border of the thyroid cartilage

Question 29

Mention the Nerve Supply of the Pharynx

Answer 29

all the constrictors and longitudinal muscles of the pharynx are supplied by the cranial accessory nerve through the pharyngeal plexus

Question 30

all the constrictors and longitudinal muscles of the pharynx are supplied by the cranial accessory nerve through the pharyngeal plexus except

Answer 30

stylopharyngeus, supplied by the glossopharyngeal nerve

Question 31

What is the action of the constrictors muscles?

Answer 31

have a propulsive swallowing action

Question 32

What is the action of the long. muscles?

Answer 32

The longitudinal 3 muscles elevate the larynx and pharynx upwards to close the laryngeal inlet

Question 33

In which stage does the muscles elevate the larynx and pharynx upwards to close the laryngeal inlet?

Answer 33

In the second stage of swallowing

Question 34

In the thorax, the esophagus passes?

Answer 34

downward and to the left Thoracic part

Question 35

At what level the esophagus gets pushed back to the midline

Answer 35

At the level of the sternal angle, the aortic arch and L.bronchi pushes the esophagus again to the midline

Question 36

There is a close relationship between the …… and esophagus

Answer 36

left atrium of the heart

Question 37

A barium swallow in the esophagus will help the
physician to?

Answer 37

assess the size of the left atrium (dilation) as in case of long standing mitral stenosis or heart failure

Question 38

In the abdomen The esophagus descends for?

Answer 38

1.3 cm and joins the stomach

Question 39

At the opening of the diaphragm, the esophagus
is accompanied by:

Answer 39

– The two vagus nerve
– Left gastric vessels

Question 40

The esophagus has 3 anatomic constrictions where are they?

Answer 40

• The first is at the junction with the pharynx (pharyngeoesophageal junction)
• The second is at the crossing with the aortic arch and the left main bronchus
• The third is at the junction with the stomach

Question 41

The esophagus 3 anatomic constrictions which have a considerable clinical importance, why?

Answer 41

1. They may cause difficulties in passing an esophagoscope
2. In case of swallowing of caustic liquids (mostly in
   children), this is where strictures develop
3. The esophageal strictures are a common sites of the development of esophageal carcinoma
4. GERG reflex
5. Foriegn body won’t pass through it

Question 42

Arterial supply of the esophagus

Answer 42

• Upper third by the inferior thyroid artery (Branch from subclavian artery)
• The middle third by the thoracic aorta
• The lower third by the left gastric artery (Branch from coelic trunk)

Question 43

Venous drainage of the esophagus

Answer 43

• The upper third drains in into the inferior thyroid veins
• The middle third into the azygos veins —> S.V.C
• The lower third into the left gastric vein, which is a tributary of the portal vein

Question 44

What is commonn In the lower part of the esophagus

In general what might occurs (related to veins)

Answer 44

• Columnar metaplasis and carcinoma
• Esophageal varices

Question 45

Lymphic drainage of the esophagus

Answer 45

• The upper third is drained into the deep cervical nodes
• The middle third is drained into the superior and inferior mediastinal nodes
• The lower third is drained in the celiac lymph nodes in the abdomen

Question 46

Carcinoma in the uppercpart of the Esop. will drain into?

Answer 46

deep cervical nodes

Question 47

Nerve supply if tge Esophagus

Answer 47

• It is supplied by sympathetic and parasympathetic
• sympathetic fibers from the sympathetic trunks.
• The parasympathetic supply comes form the vagus nerves