Pharynx and Larynx Flashcards
pharynx
Common passageway for food/liquid and air
Portions of pharynx
Continuous with the nasal cavity via the nasopharynx, with the oral
cavity via the oropharynx, and divides into dedicated airway and alimentary tract at the laryngopharynx
soft palate
mobile muscular layer in the roof of the oral cavity
where does soft palate attach anteriorly
hard palate (bony roof of the oral cavity).
soft palate function
raised and lowered to seal off different regions of
the pharynx to direct the flow of ingesta or
protect the oral/nasal cavities from regurgitation
Soft palate innervation
CN X
when you swallow what position is your soft palate in?
opens up and seals nasal cavity
when you breath with food in your mouth what position is your soft palate in?
seal food part to open breathing only
Can an infant breathe and suckle simultaneously?
YES
constrictor muscles of pharynx
Superior, middle, and inferior constrictors
constrictor muscle attachment
has points inferiorly in neck then muscles wrap around themselves and attach to themselves at midline
pharyngotympanic tube
opens into the superior pharynx, connects the pharynx to the middle ear.
pharyngotympanic attachment
originates at base of skull
longitudinal muscles of pharynx
Salpingopharyngeus, palatopharyngeus, stylopharyngeus
longitudinal muscle function
Shorten the pharynx, elevate the larynx during swallowing and vocalization
mucosa in regards to pharynx
overlies the structures of the pharynx
mucosa and pharynx creates tube connected with ___
Nasal cavity Oral cavity Middle ear (via the pharyngotympanic tube) Larynx/trachea/airway Esophagus
tonsils
collections of mucosal associated lymphoid tissue (MALT) that are embedded in the mucosa
of the pharynx
how is inflammation of tonsils
inflammation due to infection can be painful and may cause obstruction of
the airway or pharyngotympanic tube
names of tonsils
pharyngeal, palatine*, lingual, and tubal tonsils
what tonsil is commonly taken out?
palatine
motor innervation to muscles
Branches of X
Glossopharyngeal nerve (IX) innervates one muscle
(stylopharyngeus)
sensation innervation from pharynx
V2 – nasopharynx (conscious sensation)
IX – oropharynx (conscious sensation)
X – laryngopharynx (unconscious sensation)
How test test pharyngeal innervation with CN IX and X
Gag reflex: Touching posterior pharyngeal wall or tonsillar arches – sensed by IX
Elevation of soft palate – motor by X
musculus uvulae IM
M: elevates uvula
I: CNX
How to check for damage to CN X
Uvula deviates away from injured side when you look into patient’s mouth
arteries of pharynx
supplied by ascending pharyngeal, lingual, facial and maxillary arteries (all branches of external carotid)
veins of pharynx
drain to pharyngeal venous plexus (drains into the internal jugular vein)
pharyngeal swallow
rapid sequential activity that takes less than one second
functions of pharyngeal swallow
(1) food passage, propelling the food bolus through the pharynx and UES to the esophagus
(2) airway protection,
closing the larynx and trachea from the pharynx to prevent the food from entering the airway
steps of swallowing
Soft palate elevates and contacts the lateral & posterior walls of pharynx, closing nasopharynx
Tongue base retracts, pushing bolus against pharyngeal walls
Pharyngeal constrictor muscles contract from top to bottom, squeezing bolus down
Longitudinal muscles shorten pharynx vertically reducing volume of pharyngeal cavity and raise
larynx.
Elevation of larynx passively closes epiglottis over laryngeal inlet, sealing the airway
muscles underlying hyolaryngeal mechanism
Stretches open inhibited cricopharyngeus forming upper esophageal sphincter.
Suprahyoid muscles comprise ant. group that suspends hyoid bone, and long pharyngeal muscles form post. group that suspends larynx
Thyrohyoid muscle intrinsic to hyolaryngeal complex and approximates larynx and hyoid synergistically with long pharyngeal muscle
Exception to innervation of CN X in pharynx
stylopharyngeus
larynx
specialized structure at the superior end of the airway
Larynx functions
Valve to protect airway from food/liquid passing through pharynx during swallowing
Modifies air for sound production during vocalization
Valve to close the airway to increase intrathoracic pressure during coughing, straining, etc
Skeleton of larynx
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilages
Epiglottic cartilage
Membranes and ligaments
Thyrohyoid membrane
Vocal ligament (vocal folds)
Cricothyroid ligament
Cricotracheal ligament
Joints
Cricothyroid joint
Cricoarytenoid joints
relationship between thyroid cartilage and crico cartilage
thyroid cartilage moves relative to crico cartilage
mucosa in laryngeal structure
gives smooth contour to larynx
laryngeal inlet
entry into airway
piriform recess
entry into esophagus
intrinsic muscles of larynx
cricothyroid, posterior crico-arytenoid, transverse arytenoid, thyro-arytenoid, lateral crico-arytenoid, oblique arytenoid
Cricothyroid IM
M: Only muscle that tenses vocal fold
I: External laryngeal branch of superior laryngeal nerve
thyroarytenoid M
Shorten / relax vocal folds
Vocalis M
Modify tension of fold
Posterior crico-arytenoid M
Abduct (open) vocal folds
Lateral crico-arytenoid M
Adduct (close) vocal folds
Transverse and oblique arytenoids M
Adduct (close) vocal folds
motor innervation of larynx
Entirely via branches of the vagus nerve:
External laryngeal nerve I: cricothyroid muscle
Inferior/recurrent laryngeal nerve I: all other muscles
sensory innervation of larynx
Above the folds: internal laryngeal nerve
Below the folds: inferior/recurrent laryngeal nerve
vasculature of larynx
Via superior and inferior laryngeal arteries
endotracheal intubation
Procedure to maintain airway, Tube is typically passed through the oral cavity (orotracheal intubation) but in some cases may be passed through nasal cavity (nasotracheal intubation).
what is essential in endotracheal intubation
ensure tube passes into the trachea. Balloon is inflated distal to the vocal folds.
