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Anatomy Head and Neck PHM > Pharynx and Larynx > Flashcards

Pharynx and Larynx Flashcards

1
Q

The pharynx opens into the

A

Esophagus

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2
Q

Extent of pharynx

A

base of skull to level of C6 vertebra (lower border of cricoid cartilage)

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3
Q

Pharynx subdivisions

A

nasopharynx
oropharynx
laryngopharynx

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4
Q

Extents of pharynx subdivisions

A

Nasopharynx (from base of skull to soft palate)

Oropharynx (from soft palate to tip of epiglottis)

Laryngopharynx (from tip of epiglottis to lower border of cricoid level of C6 vertebra)

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5
Q

Communications of nasopharynx

A

Anterior: communicates with nasal cavity via nasal choanae

Inferior: communicates with oropharynx via pharyngeal isthmus

Laterally: communicates with middle ear via auditory tube (at tubal orifice)

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6
Q

The pharyngotympanic tube is the

A

Eustachian tube

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7
Q

Boundaries of tubal orifice

A

tubal elevation superiorly and posteriorly

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8
Q

Location of tubal tonsil

A

in the tubal orifice

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9
Q

Structure containing salpingopharyngeus muscle

A

salpingopharyngeal fold

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10
Q

Which fold holds the levator palatini muscle?

A

Salpingopalatine fold

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11
Q

Features of nasopharynx

A

Salpingopharyngeal and Palatopharyngeal folds
Tubal orifice
Tubal tonsil
Pharyngeal tonsils at junction of its superior and posterior wall

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12
Q

Communications of oropharynx

A

Anteriorly: with oral cavity via oropharyngeal isthmus

Superiorly: with nasopharynx through pharyngeal isthmus

Inferiorly: with laryngopharynx

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13
Q

Boundaries of tonsillar fossa. State which part of oropharynx it is found and its contents.

A

Anteriorly: Palatoglossal fold
Posteriorly: Palatopharyngeal fold

contains palatine tonsil

located on lateral wall of oropharynx

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14
Q

Communications of laryngopharynx

A

Anteriorly: larynx via laryngeal inlet

Inferiorly: with esophagus

Superiorly: with oropharynx

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15
Q

Location of piriform fossa

A

Lateral wall of laryngopharynx

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16
Q

Boundaries of piriform fossa

A

Superomedial: aryepiglottic fold
Laterally: Thyroid cartilage + mucous membrane covering thyrohyoid membrane

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17
Q

Clinical signifiance of piriform fossa.

A

Internal laryngeal nerve (together with superior laryngeal vessels) travel across its floor from lateral to medial. When food gets impacted and attempts to remove it cause damage to the internal laryngeal nerve, there is loss of cough reflex due to sensory loss

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18
Q

Name layers of pharyngeal wall from inside out

A

*MNEMONIC: Medical Students Pay Millions of Bucks!

Mucosa 
Submucosa 
Pharyngobasillar fascia 
Muscularis (inner longitudinal outer circular)
Buccopharyngeal fascia
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19
Q

The only external muscle of pharynx that does not get supply from vago-accessory pharyngeal plexus complex is the

A

Stylopharyngeus which gets Glossopharyngeal nerve

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20
Q

Describe sensory innervation to subdivisions of pharynx

A

Pterygopalatine ganglion pharyngeal branch –> nasopharynx

Glossopharyngeal nerve –> oropharynx

Internal laryngeal nerve –> laryngopharynx

*MNEMONIC: Please Give In love!

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21
Q

Name structures passing above superior constrictor

A

Auditory tube
Tensor veli palatini muscle
Ascending palatine artery
Palatine branch of ascending pharyngeal artery

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22
Q

Structure passing below inferior constrictor

A

Recurrent laryngeal nerve

Inferior laryngeal vessels

23
Q

Enumerate structures passing between the constrictors.

A

Between superior and middle constrictor: Glossopharyngeal nerve + Stylopharyngeus muscle

Between middle and inferior constrictor
Internal laryngeal nerve + Superior laryngeal vessels

24
Q

Pasavant’s ridge composition.

A

Horizontal fibers of palatopharyngeus that blend with superior constrictor

25
Q

Pasavant’s ridge formed during

A

During swallowing when the soft palate is elevated

26
Q

Significance of pasavant’s ridge

A

Together with the soft palate, it shuts off the nasopharynx from the oropharynx so that food is not regurgitated back into nasopharynx during swallowing

27
Q

Killian Dehiscence formation and its clinical relevance.

A

Is a gap between the cricopharyngeal and thyropharyngeal muscle fibers of the inferior constrictor. The thyropharyngeal fibers run obliquely while cricopharyngeal fibers run horizontally resulting in a gap on posterior aspect of pharynx. This is a weak area and there is potential for diverticulum (outpouching of mucosa or submucosa)

28
Q

Efferent and afferent fibers of the GAG reflex.

A

Afferent from Glossopharyngeal nerve

Efferent from Vagus nerve

29
Q

Adenoids

A

hypertrophy of pharyngeal tonsils

30
Q

Functions of larynx

A 
Voice box (phonation) 
Allow passage of air into respiratory tract as it is part of it
31
Q

Extent of larynx

A

Epiglottis upper border to lower border of cricoid cartilage

(C3 to C6 levels)

32
Q

Difference between male and female thyroid cartilage

A

Larger in males
Angle is more prominent in males
Angle between the laminae at the angle of the thyroid cartilage is 90 degrees in males but 120 in females

33
Q

Name the paired and unpaired cartilages of larynx.

A

3 paired:
Arytenoid
Corniculate
Cuneiform

3 unpaired:
Cricoid
Thyroid
Epiglottis

34
Q

Thyroid cartilage lies at which level

A

C4 - C5

35
Q

Structures attaching to thyroid cartilage superior and inferior borders of lamina.

A

Superior border: Thyrohyoid ligament and membrane

Inferior border: Cricothyroid ligament

36
Q

The only unpaired ligament attaching to the internal surface of thyroid cartilage is the

A

Thyroepiglottic ligament

37
Q

connections of epiglottis from above downwards

A

To tongue via the glossoepiglottic ligament
To hyoid bone via the hyoepiglottic ligament
To thyroid cartilage via the thyroepiglottic ligament

38
Q

Name the intrinsic and extrinsic ligaments/membranes of the pharynx

A

intrinsic

  • Vocal ligament
  • Quadrangular membrane
  • Vestibular ligament
  • Cricovocal ligament

Extrinsic

  • Thyroepiglottic ligaments
  • Thyrohyoid ligaments
  • Thyrohyoid membrane
  • Cricothyroid ligament
  • Cricotracheal ligament
39
Q

Structures that form the true and false vocal cords, as well as their attachments.

A

True vocal cords; Cricovocal ligament upper thickened margin
Attaches to cricoid arch

False vocal cords; lower margin of Quadrangular membrane
Attaches to aryepiglottic fold

40
Q

3 parts of the laryngeal cavity and their extent.

A

Vestibule/Supraglottic part; from laryngeal inlet to vestibular fold below

Ventricle/Sinus; between vestibular and vocal folds

Infraglottic part; from vocal fold to lower border of cricoid cartilage

41
Q

The “oil can of the larynx” refers to which structure?

A

Hilton’s pouch/Saccule, a soft tissue mass or appendix rich in mucous glands whose secretions keep the vocal cords moist

42
Q

Compare and contrast the false and true vocal cords.

*Hint: Include type of epithelium lining

A

False vocal cords

  • do not take part in phonation
  • gap between them is called rima vestibule
  • lined by pseudostratified columnar epithelium
  • do not contain muscles within the folds, but has the vestibular ligament
  • rich in blood capillaries in their submucosa so appear pink

True vocal cords

  • take part in phonation
  • gap between hem is called rima glottis
  • lined by stratified non-keratinized squamous epithelium
  • contain vocalis muscles within the folds and also has vocal ligament
  • lack capillaries in submucosa so appear white
43
Q

The most narrow part of larynx and state its boundaries.

A

Rima glottis

  • bounded laterally by vocal folds (anterior 3/5th) and vocal processes of arytenoid cartilages (posterior 2/5th)
  • anteriorly by thyroid cartilage
  • posteriorly by interarytenoid fold
44
Q

True or false: The anterior 2/5th of the rima glottis is inter-cartilaginous.

A

False: It’s the anterior 3/5th of the rima glottis that is actually inter-membranous (between vocal folds)

45
Q

The cricotracheal ligament attaches the cricoid to which tracheal ring?

A

1st

46
Q

Structures piercing the thyrohyoid membrane.

A

Superior laryngeal vessels
Internal laryngeal nerve

*THINK: Structures passing between inferior and middle constrictor.

47
Q

Name the depressors of the larynx.

A

Sternohyoid
Sternothyroid
Omohyoid

48
Q

The primary elevators attach to the ____ while the secondary elelvators of larynx attach to the ____>

A

Primary elevators attach to tyroid cartilage

Secondary elevators attach to hyoid

49
Q

Larynx mucous membrane supplied by

A

Vagus nerve

50
Q

Sensory supply to larynx above vocal folds and below vocal folds.

A

Above is by the internal laryngeal nerve

Below is by the recurrent laryngeal nerve

51
Q

Effect of injury on phonation to external laryngeal nerve? recurrent laryngeal nerve? both nerves?

A

If external laryngeal is damaged, the cricothyroid which it supplies is not able to tense the vocal cord resulting in weakness of phonation because the vocalis is still able to tense one part of the folds as it is innervated by recurrent laryngeal nerve

If recurrent laryngeal nerve damaged, the vocal cords are held in between adduction and abduction.. Unilateral damage results in a hoarse voice as the other half of the muscles on the other side are working. Bilateral damage affects phonation and breathing.

If both nerves are injured, the vocal cords are abducted more and there is no phonation, although breathing is possible.

52
Q

Rima glottidis refers to

A

Abduction of vocal cords caused by damage to both external and recurrent laryngeal nerves = paralysis of intrinsic muscles

53
Q

The sinus of Morgagni refers to

A

Ventricle/sinus of larynx

Anatomy Head and Neck PHM (14 decks)

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