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Gross Anatomy Module 4 > Pharynx and Larynx > Flashcards

Pharynx and Larynx Flashcards

1
Q

Pharynx

A

“U-shaped” musculomembranous structure located posterior to nasal cavity, oral cavity and larynx
Extends from base of skull –> C6

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2
Q

Pharynx joins nasal and oral cavities to

A

larynx and esophagus

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3
Q

Nasopharynx

A

pathway for air

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4
Q

Oropharynx

A

pathway for air and food/liquids

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5
Q

Air passes from..

A

oropharynx –> larynx –> trachea –> primary bronchi –> lungs

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6
Q

Food/liquid passes from oropharynx –>

A

laryngopharynx (pathway for food only), continuous with esophagus

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7
Q

Nasopharynx

A

continuous with nasal cavity

Extends from base of skull -> soft palate (marked by palatoglossal arch)

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8
Q

Torus tuberous (lateral)

A
  • opening of pharyngo-tympanic tube (auditory tube)
  • communication between nasopharynx and middle ear cavity
  • salpingopharyngeus and elevator veil palatine assist in opening pharyngotympanic tube
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9
Q

Pharyngeal recess

A

posterior to torus tuberous; location of pharyngeal tonsils (enlargement - adenoids may interfere with nasal breathing)

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10
Q

Oropharynx

A

posterior to oral cavity

Extends from soft palate (palatoglossal arch) to superior border of epiglottis (c3)

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11
Q

Laryngopharynx

A

posterior to larynx
-Extends from superior border of epiglottis (C3) to inferior border of cricoid cartilage (C6)

communicates with larynx via laryngeal inlet on its anterior wall

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12
Q

Pharynx muscles Types

A

Circular and longitudinally oriented SKELETAL muscle

circular: superior, middle, inferior pharyngeal costrictors

longitudinal directed muscles: stylopharyngeus, palatopharyngeus, salpingopharyngeus

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13
Q

Superior pharyngeal constrictor

A

Attachments:
pharyngeal tubercle and pharyngeal raphe (posterior) –> pterygoid hamulus, pterygomandibular raphe and mandible
Innervation: CN-X via pharyngeal plexus

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14
Q

Middle pharyngeal constrictor

A

Attachments: pharyngeal raphe (posterior) –> stylohyoid ligament and hyoid bone
Innervation: CNX via pharyngeal plexus

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15
Q

Inferior pharyngeal constrictor

A

Attachments: pharyngeal raphe (posterior) –> thyroid cartilage and cricoid cartilage
Innervation: CNX via pharyngeal plexus, recurrent laryngeal n and external laryngeal nerve

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16
Q

Action of all 3 pharyngeal constrictors

A

Constricts wall of pharynx during swallowing

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17
Q

Superior to superior constrictor opening

A

Passage of pharyngotympanic tube, levator veli palatini and ascending palatine a (Branch of facial a)

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18
Q

Opening between superior and middle constrictors

A

passage of stylopharyngeus and CN 9

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19
Q

Opening between middle and inferior constrictors

A

passage of internal laryngeal nerve and superior laryngeal vessels

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20
Q

Inferior to inferior constrictor

A

passage of recurrent laryngeal nerve and inferior laryngeal artery (branch of inferior thyroid a)

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21
Q

Stylopharyngeus

A

Attachment: styloid process –> muscular wall of pharynx and thyroid cartilage
Innervation: CN-9

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22
Q

Palatopharyngeus

A

Attachments: posterior hard palate and palatine aponeurosis –> muscular wall of pharynx and thyroid cartilage
Innervation: CNX via pharyngeal plexus

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23
Q

Salpingopharyngeus

A

Attachment: cartilaginous part pharyngotympanic tube –> muscular wall of pharynx
Innervation: CNX via pharyngeal plexus

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24
Q

action of 3 longitudinal pharyngeal muscles

A

Elevate and WIDEN pharynx during swallowing

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25
Noncontractile membranes/fascia of pharynx
non-contractile tissue "seals off" spaces so air, liquid and food do not "leak" from pharynx - fascia lines internal and external surface of pharyngeal muscles
26
Pharyngobasilar fascia
Internal fascial lining of pharynx - extends superior to superior constrictor, where it's thickened Superior attaches to occipital bone, petrous temporal bone, cartilaginous portion of pharyngotympanic tube and medial pterygoid plate --> thins inferiorly as it lines constrictor muscles
27
Buccopharyngeal fascia
external fascial lining of pharynx
28
Deglutition (swallowing)
transfer of bolus: oral cavity -> pharynx -> esophagus -> stomach 1. ORAL PHASE (voluntary): tongue compresses bolus against hard-> soft palate 2. PHARYNGEAL PHASE (involuntary) - bolus enters oropharynx and soft palate tensed/elevated (Via tensor veli palatini and levator veli palatini), blocks communication between nasal and oral cavities - - pharynx elevates, which brings laryngophrynx toward descending bolus - --Contraction of pharyngeal constrictors propel bolus inferiorly to esophagus - ---Airway must be protected 3. ESOPHAGEAL PHASE (involuntary) contraction propels bolus to esophagus-> stomach
29
Innervation of Pharynx
1. Sensory and motor innervation - pharyngeal plexus (CN9 and 10) 2. Sensory fibers from CN9. sensory info from mucous membrane of nasopharynx, oropharynx and laryngopharynx. (mucosa of nasopharynx also receives sensory fibers from pharyngeal branch of V2 - from PPG) 3. Motor fibers from CN-10 - supply all muscles of pharynx EXCEPT stylopharyngeus (9) - -inferior pharyngeal constrictor also receives motor fibers from recurrent and external laryngeal nerves
30
Larynx
- Located in anterior neck (anterior to pharynx) - Cartilages, membranes, ligaments and moved by several muscles - Necessary for voice production -Guards airway AT REST, anterior to C3-C6 vertebra (superior extension of epiglottis to inferior margin of cricoid cartilage)
31
Laryngeal skeleton 9 cartilages
3 unpaired: 1. Epiglottis 2. Thyroid 3. Cricoid 3 paired 1. arytenoid 2. corniculate 3. cuneiform
32
Thyroid cartilage
Largest, formed by 2 laminae that fuse in midline Laryngeal prominence: prominent region on external surface of thyroid cartilage, where 2 laminae fuse Angle of thyroid cartilage: angle (internal surface) resulting from fusion of 2 laminae Posteriorly, extending from each lamina = 2 processes, superior horn and inferior horn - -- inferior horn has articular facet for cricoid cartilage - -C4-C5 vertebral level
33
Epiglottic cartilage
superior end: free, C3 Inferior end: connected to angle of thyroid cartilage via thyroepiglottic ligament -Bends to cover airway during swallowing
34
Cricoid cartilage
Most inferior of laryngeal cartilages (C6) - Shaped like a signet ring, broad lamina positioned posteriorly and narrow arch positioned anteriorly - Completely encircles airway - Has articular surfaces for inferior horn of thyroid and arytenoid cartilages
35
Arytenoid cartilages
Pyramidal-shaped Apex- articulates with corniculate cartilage Base - articulates with lamina of cricoid cartilage -Vocal process - projects anteriorly; attachment site for a ligament (vocal ligament) and muscle (vocals) -Muscular process - projects laterally; attachment site for several muscles
36
Corniculate cartilages
articulate with apex of arytenoid cartilages | extend into aryepiglottic fold
37
Cuneiform cartilages
Located in aryepiglottic fold and provides stability to the fold
38
Joints of larynx
Cricothyroid joints: synovial joints between inferior horn of thyroid cartilage and cricoid cartilage
39
Cricoarytenoid joint
Synovial joints between arytenoid and cricoid cartilages
40
Arytenocorniculate joints
synovial joint or synchondrosis between arytenoid and corniculate cartilages
41
Extrinsic Membranes and Ligaments
- Thyrohyoid membrane: extends from thyroid cartilage to hyoid bone - --Median thyrohyoid ligament: thick median aspect of thyrohyoid membrane - ---Lateral thyrohyoid ligament: thick posterior portion of thyrohyoid membrane
42
Cricotracheal ligament
Extrinsic | Extends from cricoid cartilage to 1st tracheal cartilage
43
Quadrangular membrane
Intrinsic Drapes downward from epiglottis -> arytenoid cartilage - -Aryepiglottic ligament: free superior margin of quadrangular membrane - -Vestibular ligament - free inferior margin of quadrangular membrane
44
Cricothyroid ligament
intrinsic Extends from cricoid cartilage to thyroid cartilage and arytenoid cartilage - Vocal ligament : free superior margin of cricothyroid ligament
45
Intrinsic ligaments covered by mucous membrane
1. Aryepiglottic fold - aryepiglottic ligament, when covered by mucous membrane, forms aryepiglottic fold NOTE: corniculate and cuneiform cartilages located in aryepiglotic fold - vestibular fold, vocal fold
46
Vestibular Fold
Vestibular ligament when covered by mucous membrane forms vestibular folds FALSE vocal cords RIMA vestibuli: opening between vestibular folds
47
Vocal Fold
Vocal ligament, when covered by mucous membrane, forms vocal folds TRUE vocal cords Rima GLOTTIDIS: opening between vocal folds
48
Laryngeal inlet
opening between larynx and pharynx
49
Piriform recess
Depression on either side of laryngeal inlet
50
Laryngeal cavity
extends from laryngeal inlet -> continuous with trachea includes: 1. Supraglottic cavity (vestibule): between laryngeal inlet and vestibular folds 2. Middle laryngeal cavity: region between vestibular folds and vocal folds - --Laryngeal ventricle: extends laterally from middle laryngeal cavity - --Laryngeal saccule: elongated tubular extension of ventricle; numerous mucous glands, which assist in lubricating vocal folds 3. Infraglottic cavity: between vocal folds and inferior border of cricoid cartilage (continuous with trachea)
51
Extrinsic laryngeal muscles
connect larynx to neighboring structures to move larynx - Infrahyoids depress hyoid and larynx (EXCEPT thyrohyoid muscle elevates larynx) - Suprahyoid elevate hyoid and larynx
52
Intrinsic laryngeal muscles
Move specific laryngeal cartilage, altering length and position of vocal ligaments and size/shape of rima glottidis 1. Crycothyroid 2. Posterior cricoarytenoid 3. Lateral cricoarytenoid 4. Transverse and oblique arytenoids 5. Aryepiglotticus 6. Vocalis 7. Thyroarytenoids 8. Thyroepiglotticus
53
Cricothyroid Muscle
Attachments: - Cricoid arch - Thyroid cartilage Action - Tilts thyroid cartilage anteriorly and inferiorly on cricoid, thereby lengthening vocal ligaments Innervation: external branch of superior laryngeal nerve
54
Posterior cricoarytenoid muscle
Attachments: 1. Cricoid lamina (posterior) 2. Muscular process of arytenoid cartilage Action: ABducts vocal folds/open rima glottidis note: only muscle to OPEN rima glottidis Pull arytenoids posteriorly, assisting cricothyroid muscles in tensing vocal cords Innervation: recurrent laryngeal nerve
55
Lateral cricoarytenoid muscle
Attachment: 1. Cricoid arch (lateral) 2. Muscular process of arytenoid cartilage Action 1. Close rima glottidis Innervation - recurrent laryngeal n
56
Transverse and Oblique Arytenoid Muscles and Aryepiglottic Muscle
Attachments 1. Arytenoid muscle: from one arytenoid cartilage to contralateral arytenoid cartilage 2. Aryepiglottic Muscle: formed by oblique arytenoid fibers that continue into aryepiglottic fold Action: adduct arytenoid cartilages, closing posterior rima glottidis Innervation: recurrent laryngeal n
57
Vocalis
``` Intrinsic Attachments: artyenoid cartilage (vocal process) angle of thyroid cartilage and along vocal ligament (thyroarytenoid internus muscle) ``` Action: produces minute adjustments of vocal ligaments; contraction produces localized relaxation of vocal ligament Inn: recurrent laryngeal n
58
Thyroarytenoid muscles
Attachments: - Arytenoid cartilage - Angle of thyroid cartilage and along cricothyroid ligament Action: -Draw arytenoid cartilages toward thyroid cartilage, thereby relaxing vocal ligaments Inn: recurrent laryngeal n
59
Phonation
Males have longer/thicker vocal ligaments Inhalation-> vocal folds aBduct prior to speaking -> vocal folds approximate --> increased pressure from below (subglottic pressure) -Air from subglottic space moves through glottidis, causes vibration of vocal folds -> frequency of vibration related to sounds we hear
60
Pitch of one's voice
Determined by length/tension relationship of vocal ligaments - Increase tension in vocal ligaments-> increase vibration of vocal ligaments as air passes through larynx -> high pitch - Decrease tension in vocal ligaments -> decrease vibration of vocal ligaments as air passes larynx -> low pitch
61
Phonation continued
Volume of sound depends upon force of air passing through vocal folds - lot of air forced through rima glottidis -> loud - little-soft whispering= only posterior part of rima glottidis open, vocal folds DO NOT VIBRATE. all whispers have same pitch -although vocal folds produce sound, pharynx, oral cavity, tongue and lips that use sounds to produce words
62
Deglutition (protecting airway)
larynx ELEVATEs, moves anteriorly As movement occurs, epiglottis approximates the base of tongue, causing epiglottis to bend posteriorly, covering laryngeal inlet (aryepiglottic muscles may also assist in closing laryngeal inlet) --bolus slips over anterior surface of epiglottis before passing laterally into piriform recess (lateral food passageway) before entering esophagus Brief closure of rima glottidis required to protect airway from fluid or food particles entering the lungs
63
Nerves of larynx
Sensory: all sensation above vocal fold level = internal branch of superior laryngeal n below vocal fold = recurrent laryngeal n Motor innervation: ALL intrinsic except cricothryoid by recurrent laryngeal.

Gross Anatomy Module 4 (7 decks)

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