Pharynx and Oesophagus

Question 1

What is the pharynx?

Answer 1

A muscular tube from the base of the skull to oesophagus (approx C6)

Question 2

What does the pharynx conduct?

Answer 2

Air

Question 3

Where do the muscles of the pharynx direct food?

Answer 3

To the oesophagus

Makes sure food travels down the correct way

Question 4

What are the 3 parts of the pharynx?

Answer 4

Nasopharynx, oropharynx, laryngopharynx

Question 5

What is the function of the nasopharynx?

Answer 5

• Respiratory function

Question 6

What is the nasolacrimal duct?

Answer 6

• A duct that carries tears from your eyes to your nose; communication between tear ducts and the nose
• When you cry, liquid also comes out your nose

Question 7

What is the purpose of the auditory tube?

Answer 7

Equalises pressure between the mouth and the inner ear

Question 8

Why are little children more prone to inner ear infections?

Answer 8

Because the auditory tube is very small - they don’t drain as well

Question 9

What are the 3 types of tonsils we have in our body?

Answer 9

1. Pharyngeal tonsils
2. Tubal tonsils
3. Palatine tonsils

Question 10

What is the function of the oropharynx?

Answer 10

Digestive function: food goes in through the oral cavity and passes further down into our oesophagus

Question 11

What are the superior and inferior boundaries of the oropharynx?

Answer 11

Superior = soft palate 
Inferior = base of tongue (epiglottis)

Question 12

What type of cartilage is the epiglottis?

Answer 12

Elastic fibrocartilage - bendy cartilage

Question 13

What is the purpose of the epiglottis?

Answer 13

Makes sure food doesn’t go down the trachea - flaps down when you swallow

Question 14

Which fold is more anterior: palatoglossal fold or palatopharyngeal fold?

Answer 14

Palatoglossal fold is more anterior than the palatopharyngeal fold

Question 15

What is Waldeyer’s ring?

Answer 15

The 3 sets of tonsils: pharyngeal, tubal and palatine tonsils

Question 16

What are the superior and inferior boundaries of the laryngopharynx?

Answer 16

• Superior = epiglottis

- Inferior = level of cricoid cartilage (just below the thyroid cartilage)

Question 17

Which structures is the laryngopharyx continuous with?

Answer 17

Oropharynx (superior) and oesophagus (inferior)

Question 18

Which part of the throat do fishbones get caught in?

Answer 18

Piriform fossa

Question 19

What type of muscles are in the pharynx?

Answer 19

Constrictor muscles

Question 20

Where is the superior constrictor of the pharynx located?

Answer 20

Under the mandible (base of skull and mylohyoid)

Question 21

Which is the only bone in the body not joined on to any other body?

Answer 21

Hyoid

Question 22

What is the hyoid bone useful in?

Answer 22

Forensic identification; >95% of cases of death by strangulation, fractured hyoid bone

Question 23

Where is the inferior constrictor located?

Answer 23

Near thyroid cartilage, where the Adam’s apple is

Question 24

Which cranial nerves innervate the pharynx?

Answer 24

CN IX (glossopharyngeal) and X (vagus)

Question 25

What is otitis media?

Answer 25

Middle ear infection

Question 26

Why are tonsillectomies risky/not routinely performed anymore?

Answer 26

Removing tonsils can be dangerous due to close proximity to: external palatine vein, CN XI, internal carotid artery, tonsillar artery.

Question 27

What is the oesophagus?

Answer 27

A muscular tube from the pharynx to the stomach

Question 28

What are the 2 sphincters in the oesophagus?

Answer 28

- Upper: anatomical sphincter (controlled by muscle) | - Lower: physiological sphincter

Question 29

What type of epithelium is in the oesophagus?

Answer 29

Stratified squamous epithelium

Question 30

What are the types of muscle in each part of the oesophagus?

Answer 30

Upper 1/3 = skeletal Middle 1/3 = mixed Lower 1/3 = smooth

Question 31

Describe the change in epithelium at the gastro-oesophageal junction

Answer 31

Complete change at this point between stratified squamous epithelium to simple columnar epithelium

Question 32

Which sphincter is clinically important for patients who get recurrent indigestion?

Answer 32

Lower oesophageal sphincter

Question 33

What is metaplasia?

Answer 33

Change in one type of tissue to another

Question 34

What is dysplasia?

Answer 34

- Pre-cancer stage - Higher mitotic activity - Cells look different under microscope

Question 35

What are the 2 roles of swallowing/deglutition?

Answer 35

- Food to stomach | - Prevention from entering airway

Question 36

Describe the oral phase of swallowing

Answer 36

- Move food posteriorly - Some can pass onto pharyngeal surface of tongue - Liquid remains in the mouth in front of 'pillars'

Question 37

Describe the pharyngeal phase of swallowing

Answer 37

- Oro to laryngopharynx - Soft palate raises - Depression of the epiglottis - Contraction of vocal folds - Relaxation of the upper oesophageal spinchter (U.O.S)

Question 38

Describe the oesophageal phase of swallowing?

Answer 38

- Upper oesophageal sphincter constricts and bolus passes downwards - Peristalsis drives bolus down the oesophagus. Oesophagus constricts above the bolus and dilates and shortens below it. - Lower oesophageal sphincter relaxes to admit bolus to stomach

Question 39

What is dysphagia?

Answer 39

Difficulty swallowing

Question 40

What can cause dysphagia?

Answer 40

- Neuromuscular disease - Obstruction: strictures, spasm - Oesophageal cancer - Tumours: don't notice symptoms until 30-50% reduction in diameter of oesophagus - Developmental abnormality

Question 41

What is a tracheo-oesophageal fistula?

Answer 41

An abnormal connection between the oesophagus and the trachea. Normally these structures are not connected

Question 42

Describe the 3 types of T.O.F

Answer 42

1. Lower end of the oesophagus joins the trachea. Acid in stomach goes to the trachea. Babies cough a lot and get chest infections. 90% of cases of T.O.F. 2. Oesophagus tube not joined; doesn't feed into stomach or trachea 3. Oesophagus tube is joined but a bit feeds into the trachea. Babies get repeated chest infections.

Question 43

Where is the first point of entry of food/bolus into stomach?

Answer 43

Cardiac orifice

Question 44

Which type of tracheo-oesophageal fistula (T.O.F) is most common (90% of cases)?

Answer 44

The lower end of the oesophagus joins to the trachea. Acid in stomach goes to the trachea.