Pharynx and Oesophagus Flashcards
how many cervical vertebrae are there
seven
what are the viscera
internal organs
where is the pharynx located
at the base of the skull just below the sphenoid air sinus, and stretches from here to C6
what are the cervical vertebrae
the bones of the neck
what are the functions of the oropharynx
conduct air
muscles to direct food to the oesophagus for digestion and passage toward the stomach
what is the sphenoid air sinus
one of the paranasal sinuses which help to lighten the skull, add vocal resonance and pneumatise the head
what are the three parts of the pharynx
nasopharynx
oropharynx
laryngopharynx
where is the nasopharynx
sits behind the nose
where is the oropharynx
sits behind the oral cavity
where is the laryngopharynx
the last part of the pharynx before the oesophagus or larynx
what is the pharynx
a muscular tube that stretches from the base of the skull to the oesophagus
where does the nasolarimal duct open
into the lower aspect of the nose, specifically under the inferior nasal concha
what is the function of the nasopharynx
respiratory function; it is the opening of the auditory tube.
what are adenoids
pharyngeal tonsils
what is the nasolacrimal duct
the tear duct that carries tears away from the lacrimal sac into the nasal cavity
where is the lacrimal sac located
it sits laterally at the orbit
when is there potential communication between the oral cavity and the nose
if there is irregular movement of the uvula or soft palate
where are tubal tonsils located
around the eustachian tube or auditory tube
what are tubal tonsils responsible for
equalising air pressure between the middle ear and the external via the throat or pharynx
what are tonsils
a collection of lymphoid tissue and chronic inflammatory cells
which tonsils are removed due to tonsilitis
adenoids, and possibly palatine tonsils
what are the functions of the oropharynx
respiratory and digestive
how does the soft palate aid the oropharynx
provides a potential way for food and fluid to pass into the nasal cavity from the oral cavity if the uvula does not function properly
why are some people able to “cry” milk
they can force the milk through their mouth and bypass the soft palates uvula
what is waldeyer’s ring
a collection of four types of tonsils
what are the four types of tonsils
- pharyngeal tonsils
- tubal tonsils
- palatine tonsils
- lingual tonsils
which tonsils are found in the nasopharynx
pharyngeal and tubal
which tonsils are foud in the oropharynx
the palatine tonsils
which tonsils are found in the posterior one third of the tongue
lingual tonsils
what is the epiglottis
elastic cartilage which functions to help close off the trachea partly when swallowing
where is the epiglottis located
the superior laryngopharynx
what is cricoid cartilage
one of the laryngeal cartilages. only one of the cartilages of the larynx that forms a complete ring all the way round this area
what forms a complete ring around the larynx
cricoid cartilage
what is the piriform fossa
an area where things like fish bones can become trapped. lies on either side of the laryngeal opening or orifice. if something is stuck there it can give the feeling of something being stuck in the throat
what is the piriform
area involved in speech. piriform means pair shaped
what is continuous with the oesophagus
the laryngopharynx
what are the two groups of the pharyngeal constricers
longitudinal and circular
what are the three pharyngeal constrictors
superior, middle and inferior.
how do the pharyngeal constrictors constrict
sequentially from superior to inferior
which bone is between the middle and inferior constrictors
hyoid bone
where is the superior constrictor found
at the base of the skull and mylohyoid
which constrictor forms the floor of the mouth
superior
where does the superior constrictor run to
the mylohyoid
where does the middle constrictor run to
hyoid bone
what is the hyoid bone
the only bone of the body to not be attached to any other bones. can also be fractured during manual strangulation - an applicated in forensic medicine
where does the inferior constrictor run to
the largest of all laryngeal cartilages (thyroid cartilage)
where is the adams apple
within the thyroid cartilage. elongates during puberty - vocal folds are attached here
where do the pharyngeael constrictors join
at the back or posterior aspect of the pharynx at the median raphe
which cranial nerve innervates the pharyngeal constrictors
vagus nerve
where is the olfactory nerve found
the nose - for smell
what is the function of optic nerve
vision
function of the oculomotor nerve
supplies all extra ocular muscles apart from those supplied by trochlear and abducens nerve
function of trochlear nerve
the superior oblique - muscle that moves eyes down and out
function of trigeminal nerve
sensory to the face and has three branches - motor innervation to the muscles of mastication
function of abducens
supplies the lateral rectus
function of facial nerve
supply the muscles of facial expression
function of vestibulocochlear
hearing and balance
function of glosspharyngeal nerve
supplies the pharyngeal muscles. supplies taste and general sensation to the back one third of the tongue
function of the vagus nerve
has parasympathetic fibres, slows heart rate and breathing. increases gut motility - rest and digest nerve
function of spinal accessory nerve
supplies two muscles. the sternocliedomastoid which moves the neck and trapezius, which helps raise the shoulders
function of hypoglossal
innervate the muscles of the tongue
what do motor nerves supply
muscle
what do sensory nerves supply
sensation
what does the carotid artety do
supply the brain with blood internally, as well as externally supply the face and neck
what does the jugular do
a vein - carries blood back
what is the pharyngeal plexus
the glossopharyngeal and vagus nerves.
how do you test the function of the pharyngeal plexus
asking the patient to say ahh - the uvual should raise in the midline only. deviation indicates lesions of one or both of the nerves
what is the auditory tube
related to the ascending infection causing middle ear infection. the tube is shorter in children
what is tonsillitis
inflammation of the tonsils
which tonsils are most commonly affecte by tonsillitis
palatine and tubal tonsils
why is a tonsilectomy dangerous
the external palatine vein, tonsillar artery and internal carotid artery are responsible for 80% of brain blood supply. if cut off, there is a big issue
what is ectomy
the cutting of a structure and surgical removal of it
approx how long is the esophagus
20-25 cm
what is the oesophagus
muscular tube from the pharynx to the stomach
where does the esophagus lie
the neck, thorax and abdomen
what is the esophagus posterior to
the trachea and the heart
what must the esophagus pass through
the diaphragm
what is the diaphragm
skeletal muscle responsible for breathing that moves downward on inhale
what is the esophagus surrounded by
muscular rings
what are oesophageal sphincters
muscular rings that surround the esophagus at the top and bottom ends
what are the two oesphageal sphincters
upper and lower oesophageal sphincters
do sphincters remain open all the time
no - they shut when food is not being swallowed
describe the upper oesphageal sphincter
an anatomical sphincter comprised of the lower fibres of the inferior pharyngeal constrictor. it is comprised of skeletal muscle, and is not under voluntary control. it is influenced under the swallowing reflex
describe the lower oesophageal sphincter
a gastro oesphageal sphincter or cardiac sphincter found between the oesophagus and the stomach. physiological, or functional. due to the angle that it enters into the stomach, its sphincter like function is aided.
what causes gastro oesophageal reflux disease
dysfunction of the lower oesophageal sphincter
how does the type of muscle change as you go down the oesophagus
top third has skeletal
middle is both
lower is smooth muscle
explain the epithelium of the oesophagus
stratified squamous non keratinising epithelium. there are submucosal glands to secrete mucous within the cell too
what is the epithelium of the muscle layers
muscularis mucosae - the inner is circular and the outer is longitudinal
what is the submucosa
the dense irregular connective tissue with large blood vessels, lymphatics and nerves
which sphincter acts as a physiological sphincter
the lower oesophageal sphincter
what is metaplasia
change in epithelium from one type to another which is not typical of that site
what is dysplasia
abnormal growth or development of cells and organs
what can gastro oesophageal reflux disease lead to
metaplasia
how does GORD lead to metaplasia
in the oesophagus, if the acid comes back up from the stomach then there is a change in the epithelium from the usual stratified squamous to that of the stomach. this would mean it would change to simple columnar, and there would be metaplasia
what are the roles of swallowing
taking food to the stomach and preventing food from entering the airway
what does swallowing do
move food posteriorly
where does liquid remain in the mouth
in front of the pillars
how does the tongue ensure food is swallowed
it passes upward to squash the food toward the pharynx, and the uvual moves up to preven the food going up into the nasal cavity
what is misdirection of food prevented by
tongue blocking th eoral cavity, the soft palate blocking the nasal cavity, and the epiglottis blocking the larynx
where do the vocal folds move when food is swallowed
forward in order to make more room for the food
how does food pass down the throat
upper esophageal sphincter constricts and the food passes downward. peristalsis drives the food down the oesophagus. the oesophagus then constricts above the food and dilates to shorten below it
how does food get into the stomach from the esophagus
the lower esophageal sphincter relaxes to admit the food to the stomach
what is dysphagia
difficult swallowing, can be caused by neuromuscular diseases or by obstructions, like strictures, spasms, tumours or developmental abnormalities.
how long does it take for patients to notive the obstruction from a tumour in their oesophagus
takes until the tumour has led to a 30%-50% reduction in oesophagus diameter
what methods can be used to identify the causes of dysphagia
biopsies or endoscopies
what is tracheooesophageal fistula
a developmental abnormality in which the oesophagus is not completely attached to itelf. there are three types. type A is when it ends and the other part of the oesophagus has attached itself to the trachea. type B is when it just isnt attached and there is a gap, and the final one is where a part of the oesphoagus is fused onto the trachea.
what is a fistula
an abnormal connection between 2 epithelial lined hollow organs or spaces like in blood vessels, organs and intestines.
what is the risk with the type C of tracheooesophageal fistula
fluid passing into the oesophagus can go straight into the trachea, leading to choking and coughing when feeding. symptoms are a swollen abdonmen, cyanosis when feeding and frothy bubbles in the mouth
what is the lateral rectus
one of the eye muscles
what is the thyroid cartilage
large prominent structure easily seen in adult males composed of two sheets which join to form the adams apple
what is the anatomical name for the adams apple
laryngeal prominence
what are laminae
sheets
what is cricoid cartilage
a complete ring of hyaline cartilage that completely circles the airway to mark the inferior border of the larynx.
what is the only complete circle of cartilage in the larynx or trachea
the cricoid cartilage
what kind of cartilage is the epiglottis
elastic
