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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
Q

Noncontractile membranes/fascia of pharynx

A

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

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26
Q

Pharyngobasilar fascia

A

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
Q

Buccopharyngeal fascia

A

external fascial lining of pharynx

28
Q

Deglutition (swallowing)

A

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
Q

Innervation of Pharynx

A
  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
Q

Larynx

A
  • 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
Q

Laryngeal skeleton 9 cartilages

A

3 unpaired:

  1. Epiglottis
  2. Thyroid
  3. Cricoid

3 paired

  1. arytenoid
  2. corniculate
  3. cuneiform
32
Q

Thyroid cartilage

A

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
Q

Epiglottic cartilage

A

superior end: free, C3

Inferior end: connected to angle of thyroid cartilage via thyroepiglottic ligament
-Bends to cover airway during swallowing

34
Q

Cricoid cartilage

A

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
Q

Arytenoid cartilages

A

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
Q

Corniculate cartilages

A

articulate with apex of arytenoid cartilages

extend into aryepiglottic fold

37
Q

Cuneiform cartilages

A

Located in aryepiglottic fold and provides stability to the fold

38
Q

Joints of larynx

A

Cricothyroid joints: synovial joints between inferior horn of thyroid cartilage and cricoid cartilage

39
Q

Cricoarytenoid joint

A

Synovial joints between arytenoid and cricoid cartilages

40
Q

Arytenocorniculate joints

A

synovial joint or synchondrosis between arytenoid and corniculate cartilages

41
Q

Extrinsic Membranes and Ligaments

A
  • 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
Q

Cricotracheal ligament

A

Extrinsic

Extends from cricoid cartilage to 1st tracheal cartilage

43
Q

Quadrangular membrane

A

Intrinsic
Drapes downward from epiglottis -> arytenoid cartilage

  • -Aryepiglottic ligament: free superior margin of quadrangular membrane
  • -Vestibular ligament - free inferior margin of quadrangular membrane
44
Q

Cricothyroid ligament

A

intrinsic
Extends from cricoid cartilage to thyroid cartilage and arytenoid cartilage
- Vocal ligament : free superior margin of cricothyroid ligament

45
Q

Intrinsic ligaments covered by mucous membrane

A
  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
Q

Vestibular Fold

A

Vestibular ligament when covered by mucous membrane forms vestibular folds
FALSE vocal cords
RIMA vestibuli: opening between vestibular folds

47
Q

Vocal Fold

A

Vocal ligament, when covered by mucous membrane, forms vocal folds
TRUE vocal cords
Rima GLOTTIDIS: opening between vocal folds

48
Q

Laryngeal inlet

A

opening between larynx and pharynx

49
Q

Piriform recess

A

Depression on either side of laryngeal inlet

50
Q

Laryngeal cavity

A

extends from laryngeal inlet -> continuous with trachea includes:
1. Supraglottic cavity (vestibule): between laryngeal inlet and vestibular folds

  1. 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
  2. Infraglottic cavity: between vocal folds and inferior border of cricoid cartilage (continuous with trachea)
51
Q

Extrinsic laryngeal muscles

A

connect larynx to neighboring structures to move larynx

  • Infrahyoids depress hyoid and larynx (EXCEPT thyrohyoid muscle elevates larynx)
  • Suprahyoid elevate hyoid and larynx
52
Q

Intrinsic laryngeal muscles

A

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
Q

Cricothyroid Muscle

A

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
Q

Posterior cricoarytenoid muscle

A

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
Q

Lateral cricoarytenoid muscle

A

Attachment:

  1. Cricoid arch (lateral)
  2. Muscular process of arytenoid cartilage

Action
1. Close rima glottidis

Innervation - recurrent laryngeal n

56
Q

Transverse and Oblique Arytenoid Muscles and Aryepiglottic Muscle

A

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
Q

Vocalis

A 
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
Q

Thyroarytenoid muscles

A

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
Q

Phonation

A

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
Q

Pitch of one’s voice

A

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
Q

Phonation continued

A

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
Q

Deglutition (protecting airway)

A

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
Q

Nerves of larynx

A

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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