Pharynx And Larynx Flashcards
The ____ and ____ physically close the aditus. The _____ reflex neurological protects the upper airway from significant aspiration of food of fluid. This reflex is triggered by aspiration of food of fluid into the ____.
Epiglottis and laryngeal sphincters
Laryngeal cough reflex (no reflex can cause aspiration based pneumonia)
Larynx
What are the three phases of swallowing and describes what happens in each stage?
What is unique to newborns vs an adult?
Oral: mastication
Oropharyngeal: elevation of floor of mouth and tongue to push bolus into oropharynx
Pharyngo-esophageal: oropharynx elevates and constricts around bolus and propels it down the esophagus
Larynx is more anterior/superior in the infant than adult. Harder for infant to aspirate. Can breath through nasal airway while suckling at the same time; adult larynx drops more inferior (needs more protection through epiglottis and neurological protection through cough reflex)
The internal branch of the _____ nerve is the central nerve for the interior (central region) of larynx and innervates the epiglottis.
Anything that moves into the vestibule is a threat to the airway and triggers an _____ by this nerve.
_____ and ____ go through the thyrohyoid membrane.
Superior laryngeal N
Expiratory reflex
Superior laryngeal A; internal branch of the superior laryngeal N
Inhalation of air passes through the what three cavities/pharynx?
Nasal cavity -> nasopharynx
Oral cavity -> oropharynx
Larynx
What are the three boundaries of the pharynx?
Choanae: opening between the nasal cavity into the nasopharynx
Pharyngeal isthmus: opening between the nasopharynx and oropharynx
Faucial isthmus: opening between the oral cavity and oropharynx (formed by palpoglossal folds)
The nasopharynx communicates with the nasal cavity via the _____; middle ear cavity via the ____; and oropharynx via the _____.
Cartilaginous portion of the auditory tube is ___.
Choanae
Auditory tube
Pharyngeal isthmus
Torus tubarius
The oropharynx communicates with the nasopharynx via the _____; oral cavity via the _____; and laryngopharynx at the level of the _____.
_____ nerve is found in the palatine fossa.
____ separates the anterior 2/3 of tongue from the posterior 1/3.
Pharyngeal isthmus
Faucial isthmus
Hyoid
Glossopharyngeal N
Palatoglossal fold
The laryngopharynx communicates with the oropharynx at the level of the _____; larynx via the ____; and esophagus at the level of _____.
____ are on either side of the esophagus catch food and fluid.
Hyoid
Laryngeal aditus
C6
Piriform recess
What are the three inner elevators of the pharynx?
What are three pharyngeal constrictor muscles? What do they attach to?
Where is the cricopharyngeus muscle?
Stylopharyngeus, salpingopharyngeus, palatopharyngeus
Superior: attached laterally to the pterygomandibular raphe and posteriorly to the pharyngeal raphe
Middle: attached laterally to the hyoid bone and posteriorly to pharyngeal raphe
Inferior: attached laterally to thyroid and cricoid cartilage and posteriorly to pharyngeal raphe; its horizontal fibers comprise the cricopharyngeus muscle used during pharyngeal speech
The _____ covers the outer surface of the buccinator muscle and the pharynx.
The ____ is embedded in the portion of the buccopharyngeal fascia covering the middle constrictor muscle.
The space between the buccopharyngeal fascia and the prevertebral fascia is the ____.
Buccopharyngeal fascia
Pharyngeal plexus: sensory from glossopharyngeal and motor from vagus N
Retropharyngeal space
Stylopharyngeus muscle arises from the ____ and inserts on the ____ between the superior and middle constrictors. It’s innervated by SVE fibers of the ____ nerve.
Fx?
Styloid process
Pharyngeal wall
CN IX
Pharyngeal elevator
Salpingopharyngeus muscle extends from the posterior edge of the ____ to the ____. It forms a mucosal ridge called the _____. Fx?
Torus tubarius
Pharyngeal wall
Salpingopharyngeal fold
Pharyngeal elevator
Where is Killian’s triangle? And what does it cause?
Superior to the cricopharyngeus muscle and inferior to the inferior constrictor muscle -> causes outpouching of the posterior pharyngeal wall just above the esophagus
Where is Zenker’s diverticulum located?
Does it involve the layers of the esophageal wall?
Just above the cricopharyngeal muscle (above UES)
No
What is the second branch off the external carotid A that gives blood supply to the pharynx?
Ascending pharyngeal A
The pharynx is innervated by the ____ which is embedded in the ____ fascia.
This plexus receives sensory (GVA) from the pharyngeal branch of the ____ nerve. These GVA fibers in the plexus covey afferent info for the ___ reflex.
This plexus receives motor (SVE) fibers from the pharyngeal branch of the ____ nerve.
Pharyngeal plexus; buccopharyngeal
Glossopharyngeal N; gag reflex
Vagus N (innervates all pharynx muscles except stylopharyngeus m)
What does the CN IX innervate?
Pharyngeal N to pharyngeal plexus
Sensory (GVA) to mucosa of posterior 1/3 of tongue and pharynx; sensory (SVA) to taste buts of posterior 1/3 tongue
Motor to stylopharyngeus muscle
The sensory afferent fibers of the gag reflex are conveyed by the ____ nerve. The efferent component is mediated by the ____ nerve assisted by intercostal, phrenic, and abdominal nerves.
Glossopharyngeal CN IX
Vagus CN X
During deglutition, the tongue moves backwards in the mouth and pushes the ____ posteriorly to cover the laryngeal aditus. The bolus of food cascades over the lateral edges of the epiglottis and flows through the ____ adjacent to the larynx in the laryngopharynx.
____ is where the blade is inserted during intubation to bring the tongue forward.
Epiglottis
Piriform recess
Valleculae epiglottica
What are the three laryngeal membranes?
Cartilage?
Joint? What is the relationship of this joint and the vocal cords? What nerve does it have a relationship with?
____ has a turn style affect that brings the vocal cords apart for respiration and brings them together for vocalization. ____ sits on top of this cartilage.
Thyrohyoid membrane Quadrangular membrane (structural reinforcement for laryngeal wall) Cricothyroid membrane (cricothyrotomy)
Cricoid cartilage
Cricothyroid joint; thyroid cartilage slides forward on cricoid cartilage, stretching vocal cords and increasing pitch caused by cricothryoid m; recurrent laryngeal N
Posterior cricoarytenoid m attaching from cricoid cartilage to the arytenoid cartilage; corniculate cartilage
What are three muscles of the larynx?
What are their innervations?
Posterior cricoarytenoid m, vocalis m, thyroepiglottic m
Vagus N
Superior laryngeal n
External branch of superior laryngeal N: cricothryoid m; causes thyroid cartilage to slide forward on cricoid cartilage, stretching vocal cords and increasing pitch
Recurrent laryngeal n
____ muscle increase vocal fold tension by tilting the thyroid cartilage forward, stretching the vocal cords. What’s its innervation?
It is opposed by the ____ muscle.
Cricothyroid muscle
External branch of the superior laryngeal N
Vocalis muscle
Branches off the Vagus N:
The internal branch of the ____ nerve is the chief sensory nerve to the interior of the larynx and supplies GVA sensory fibers to the interior of the larynx. It’s involved in the ___ reflex. Also supplies parasympathetic fibers (GVE) to the ____.
____ innervates the intrinsic muscles of the larynx.
____ innervates the cricothyroid m.
Superior laryngeal N
Cough
Saccule glands
Recurrent laryngeal N
External branch of the superior laryngeal N
After the recurrent laryngeal N crosses the cricothyroid joint and enters the larynx, it becomes the ____ and coveys fibers to all the laryngeal muscles, except the cricothyroid muscle. These fibers originate in the _____.
Inferior laryngeal N
Nucleus ambiguus
____ is stimulated when there is aspiration of material into the laryngeal vestibule, stimulating receptors in the mucosa.
These afferent receptors are innervated by the ____. Afferent fibers enter the medulla with the vagus N and terminate in the _____.
The efferent component is through the ____ that controls the laryngeal, intercostal, and abdominal muscles, carrying out the reflex.
Laryngeal expiration reflex (cough reflex)
Internal branch of the superior laryngeal N; nucleus tractus solitarius
Recurrent laryngeal, intercostal, abdominal nerves
The interior larynx contains what three parts?
Vestibule: laryngeal aditus, vestibular folds, rima vestibularis (perimeter of vestibular folds)
Ventricle: saccule, glottis, vocal cords, rima glottidis (perimeter of formed by the vocal folds)
Infraglottic region
