Pharynx and Larynx

Question 1

what are the 3 phases of swallowing

Answer 1

1) oral phase: mastication
2) oropharyngeal phase: elevation floor of mouth and tongue to push bolus into oropharnx
3) pharyngeo-esophageal phase: bolus propolled down esophagus

Question 2

divisions of pharynx

Answer 2

nasopharynx
oropharynx
larynx

Question 3

nasopharynx location and communication

Answer 3

posterior to the nasal cavity
communicates with nasal cavity via choanae
communicates with middle ear cavity via auditory tube
communicates with oropharynx via PHARYNGEAL ISTHMUS

Question 4

oropharynx location and communication

Answer 4

posterior to oral cavity
communicates with oral cavity via faucial isthmus
communicates with nasopharynx via pharyngeal isthmus

Question 5

laryngeopharynx located ___
communicates with oropharynx at the level of what
communicates with larynx via what

Answer 5

posterior to larynx
hyoid
laryngeal aditus

Question 6

what is the piriform recess

innervated by what?

Answer 6

posterior and lateral to arytenoid cartilages in laryngeopharynx
-epithelium innervated by internal branch of superior laryngeal nerve

Question 7

stylopharyngeus muscle is a ___ of the pharynx

-location and innervation?

Answer 7

arises from the styloid process and inserts on wall btwn superior and middle constrictors
innervated by SVE of the glossophargyngeal n

Question 8

superior constrictor muscle location

Answer 8

attached laterally to pterygomandibular raphe near third molar

Question 9

middle constrictor location

Answer 9

attached laterally to hyoid and posteriorly to the midline pharyngeal raphe

Question 10

inferior constrictor location

Answer 10

laterally to oblique line of thyroid and cricoid cartilage

-horizontal fibers comprise cricopharyngeus muscle used during pharngeal speach

Question 11

what is killums triangle

Answer 11

transition between inferior constrictor mucsle and cricopharyngeus muscle

Question 12

zenker’s diverticulum

Answer 12

herniation of the mucosal lining of the esophagus between cricopharyngeal m and inferior constrictor muscle
-may be weakened area due to transition from skeletal to smooth m

Question 13

buccopharyngeal fascia

Answer 13

subdivision of pretracheal fascia, covers outer surface of buccinator muscle and pharynx
-part that covers middle constrictor contains pharyngeal plexus

Question 14

retropharyngeal space location and relevance

Answer 14

between buccopharyngeal fascia and prevertebral fascia

• continuous from the base of the skull to the mediastinum
• infections can spread through regions here
• in cervical fusion of vertebrae, anterior bodies of cervical vertebra are approached here

Question 15

innervation of the pharynx

Answer 15

sensory: GVA from the pharyngeal branch of glossopharyngeal n, convey afferent info for GAG reflex
motor: SVE from the pharyngeal branch of the vagus nerve

Question 16

branches of nerve IX in pharynx and what they do (3)

Answer 16

1) pharyngeal branch to the pharyngeal plexus
2) sensory GVA to mucosa of post 1/3 tongue and pharynx, SVA to taste buds of post 1/3 tongue
3) motor (SVE) to stylopharyngeus muscle

Question 17

Gag relex nerves involved

Answer 17

IX send afferents in
X send efferents to cause reflex
-assisted by intercostal, phrenic, and abdominal nerves

Question 18

superior laryngeal nerve is a branch off of what nerve

Answer 18

the vagus nerve

Question 19

the thyroid laminae form the ___ anteriorly
superior horn continous with ___ and forms ___
inferior horn articulates with ___ ___ and makes ___ __

Answer 19

laryngeal prominence
hyoid bone, thyrohyoid ligament
cricoid cartilage, cricothyroid joint

Question 20

arytenoid cartilages location, vocal and muscular process

Answer 20

pyramidal shaped on superior edge of cricoid cartilage

• vocal process attached to vocal ligament of vocal cord
• muscular process attached to posteior and lateral cricoarytenoids

Question 21

arytenoid cartilages and phonateion and respiration

Answer 21

phonation: tension of vocal folds
respiration: slide laterally to open rima glottidis

Question 22

piriform recesses ______ if the patient says “a-a-a” in a low voice. secretions may gather here but should disappear on swallowing. if they do not then patient has ___ sign which suggests ___

Answer 22

slightly dilate
pooling
obstruction or paralysis of upper esophagus

Question 23

valleculae epiglottica location
seperated by
bound laterally by

Answer 23

recess between tongue and epiglottis

• separated from each other by median glossoepidglottic fold
• bound laterally by lateral glossoepiglottic folds

Question 24

where is the blade often placed during intubation

opens what?

Answer 24

in the valleculae epiglottica, moved forward and theis moves tongue and epiglottis forward too
-opens laryngeal aditus

Question 25

the thyrohyoid membrane is piereced by what

Answer 25

internal branch of the superior laryngeal nerve

superior laryngeal artery

Question 26

what muscle of the larynx is the only abductor of the vocal cords

Answer 26

posterior cricoarytenoid muscle

Question 27

what muscles of the larynx are adductors of the vocal cords

Answer 27

lateral cricoarytenoid m

arytenoideus

Question 28

how to test cricothyroid muscle and what happens to width of membrane

Answer 28

have patient say eeee in a high pitched voice

causes contraction and decrease in the cricothyroid membrane

Question 29

what innervates the cricothyroid muscle

Answer 29

external branch of the superior laryngeal nerve

Question 30

after the RLN corsses the ___ and enters the ___ it is called the ____. conveys ___ fibers to laryngeal muscles except ____

Answer 30

cricothyroid joint, inferior laryngeal nerve

SVE cricothyroid muscle

Question 31

at what level does the oropharynx communicate with the laryngeopharynx

Answer 31

CV6

Question 32

layers of the pharyngeal wall from in to out

Answer 32

1) muccosa layer
2) pseudostratified and stratified non keratinized epithelia
3) submucosa layer
4) pharyngeobasilar fascia: forms inner layer of muscular fascia
5) inner elevators of pharynx
6) pharyngeal constrictor muscles
7) Buccopharyngeal fascia

Question 33

what is the chief sensory nerve to the interior of the larynx
-what kind of fibers

Answer 33

the internal branch of the superior laryngeal nerve

GVA fibers

Question 34

what can someone get if the laryngeal cough reflex is not working

Answer 34

aspiration pneumonia

Question 35

what nerve inervates the cricothyroid muscle

Answer 35

external branch of the superior laryngeal nerve

Question 36

after the recurrent laryngeal nerve crosses the _____ joint and enters the larynx it is called _____
-supplies what fibers

Answer 36

cricothyroid joint, inferior laryngeal nerve

-supplies laryngeal muscles except cricothyroid muscle

Question 37

what does paralysis of the recurrent laryngeal nerve cause

Answer 37

hoarseness and dysphagia

Question 38

the superior laryngeal nerve is the chief sensory nerve to what?

Answer 38

interior of the larynx and piriform recess

Question 39

laryngeal expiration reflex afferent component

Answer 39

internal branch of superior laryngeal nerve innervates receptors, afferents enter medulla with vagus nerve and terminate at NTS

Question 40

laryngeal expiration reflex efferent component

Answer 40

recurrent laryngeal, intercostal and abdominal nerves activate muscles and cause expiratory coughing