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M1 HAE Quiz 4 > Pharynx and Soft Palate > Flashcards

Pharynx and Soft Palate Flashcards

1
Q

Consequently, the pharynx is divided into three regions:

A

• nasopharynx -
• oropharynx -
Laryngopharynx

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2
Q

What are the 4 tissue layers of the pharyngeal wall?

A
  • Mucosa
  • Submucosa (pharyngobasilar fascia)
  • Muscular
  • Exterior Buccopharyngeal fascia
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3
Q

What kind of glands does the mucosa have?

A

pharyngeal glands (mixed salivary glands)

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4
Q

What kind of cells does the…
Nasopharynx have?
Oropharynx and Laryngopharynx have?

A

Nasopharynx: pseudostratified ciliated epithelium (respiratory type)
• Oropharynx and laryngopharynx stratified squamous epithelium

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5
Q

What is the Submucosa (pharyngobasilar fascia of the pharynx?

A

– a strong continuous inner layer of fascia that supports the pharynx (especially where gaps are present between muscles of the pharynx)

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6
Q

What is the orientation of the muscles in the Muscular layer of the pharynx?

A
  • Inner longitudinal
  • Outer circular
  • opposite of the typical GI tract muscular arrangement
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7
Q

What are the 3 elevator muscles of the Inner longitudinal layer?

A
  • palatopharyngeus
  • stylopharyngeus
  • Salpingopharyngeus T585 bottom
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8
Q

What are the 3 muscles of the Outer circular layer?

A
  • superiorconstrictor
  • middleconstrictor
  • inferiorconstrictor T585 top
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9
Q

What is the purpose of the Exterior (buccopharyngeal fascia)?

A

• a layer of loose areolar tissue in which lies the pharyngeal plexus of nerves

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10
Q

The pharyngeal skeleton involves the following bones and cartilage:

A 
base of the skull (pharyngeal tubercle) & medial pterygoid plate of the sphenoid bone
•  The pterygomandibular raphe
•  mandible
•  hyoid bone
•  thyroid cartilage
•  cricoid cartilage
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11
Q

What is the origin and insertion of the superior constrictor?
T584 top

A
  • The pterygoidmandibular raphe, hamulus and the mylohyoid line of the mandible.
  • completed anteriorly by the buccinator and obicularis oris muscles
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12
Q

Where does the middle constrictor originate? T 585

A

•greater horn of hyoid bone

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13
Q

Where does the inferior constrictor originate?

What are the two parts of the Inferior Constrictor?

A
  • thyroid cartilage (oblique line) and cricoid cartilage
  • thyropharyngeal part
  • cricopharyngeal part
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14
Q

What does the thyropharyngeal part of the inferior constrictor do?

A

• fibers overlap the middle constrictor

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15
Q

What does the cricopharyngeal part of the inferior constrictor do?

A

main component of upper esophageal sphincter
• narrowest passage of the entire GI tract
• basal contraction prevents:
• swallowing air during inspiration
• esophageal contents from entering into the trachea

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16
Q

Important structures penetrate the ___(layer)__ _____ filling the pharyngeal gaps to reach the interior of the pharynx:

A

pharyngobasilar fascia (submucosa)

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17
Q

What is in gap between the base of the skull and the superior constrictor? T560

A
  • auditory tube

* levator veli palatini muscle

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18
Q

What is in gap between the superior and middle constrictors? See ppt flaschards pg 15

A
  • stylopharyngeus muscle

* glossopharyngeal nerve (CN IX)

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19
Q

What is in gap between the middle and the inferior constrictors (we have seen these penetrate the thyrohyoid membrane)?

A
  • internal branch of the superior laryngeal nerve (vagus CN X)
  • superior laryngeal artery (branch of the superior thyroid artery)
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20
Q

What is in gap below the inferior constrictor?

ppt flashcards pg 15-16

A
  • recurrent laryngeal nerve

* inferior laryngeal artery (branch of the inferior thyroid artery)

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21
Q

Where do these Incomplete, inner, longitudinal layer muscles insert?

A

• the pharyngeal wall by blending with each other and the constrictors.

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22
Q

What do the inner longitudinal muscles do?

A

• They elevate and shorten the pharynx during swallowing.

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23
Q

What is the origin, insertion, and function of Salpingopharyngeus?

A

• Origin: auditiory tube cartilage
insertion: pharyngeal wall with the palatopharyngeus
• elevates the pharynx
opens the auditory tube with the tensor veli palitini during swallowing

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24
Q

What is the origin and insertion of the Palatopharyngeus? (also one of the 5 paired muscles of the soft palate)

A
  • Origin: palatine aponeuriosis of the soft palate

* inserts on the interior of the lateral wall of the pharynx and the thyroid cartilage

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25
Q

What is the action and innervation of the Palatopharyngeus?

A 
3 actions
•  lowers the soft palate 17
•  constricts the faucial isthmus
•  shortens the pharynx during swallowing by pulling it up, forward, and medial
•  innervated by the vagus (CN X) nerve
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26
Q

What is the origin and innervation of Stylopharyngeus?

A
  • styloid process

* only muscle of the pharynx innervated by the glossopharyngeal (CN IX) nerve

27
Q

What is the Choana?

A

• the posterior nasal aperture forming the boundary between the nasal cavities and the nasopharynx

28
Q

Where is the nasopharynx?

A

– posterior to the choanae of the nasal cavities and superior to the soft palate

29
Q

What are the contents of the nasopharynx?

A
  • adenoids (nasopharyngeal tonsils)
  • auditory (pharyngotympanic, eustachian) tube
  • torus tubarius (part of the eustacian tube cartilage)
  • tubal tonsils (tonsil next to torus tubarius)
30
Q 
What are the...
•  adenoids (nasopharyngeal tonsils)
•  auditory (pharyngotympanic, eustachian) tube
•  torus tubarius
•  tubal tonsils
A

• adenoids (nasopharyngeal tonsils) - lymphoid tissue within the
pharyngeal fornix (roof)
• auditory (pharyngotympanic, eustachian) tube - equalize pressure on either side of the tympanic membrane by air between the nasopharynx and the tympanic cavity
• torus tubarius - cartilage of the auditory tube
• tubal tonsils - lymphatic tissue around the auditory tube and torus tubaris

31
Q

Where is the Oropharynx?

A

• Posterior to the oral cavity

32
Q

What are the contents of the Oropharynx?

A
  • Fauces/oropharyngeal Isthmus
  • Palatoglossal arch (Palantine arch 1)
  • Palatopharyngeal arch (Palantine arch 2)
  • Palantine tonsils
33
Q

What are the following? Where are they located? Actually… Just look at ppt flashcard page 24
• Fauces/oropharyngealisthmus
• Palatinearches
• Palatoglossal arch (What muscle does this overlie?)
• Palatopharyngeal arch (What muscle does this overlie?)
• Palatinetonsils

A

• Fauces/oropharyngeal isthmus – passageway from the oral cavity to the oropharynx
• bounded by soft palate, palatine arches and dorsum of the tongue
• Palatinearches
• Palatoglossal arch (anterior pillar of the fauces) – mucosa
overlying the palatoglossus muscle
• between the soft palate and the tongue
• Palatopharyngeal arch - (posterior pillar of the fauces) mucosa overlying the palatopharyngeus muscle
• between the soft palate and posterolateral wall of pharynx
• Palatine tonsils – lymphoid tissue lying in the tonsillar fossae between the palatoglossal and palatopharyngeal arches

34
Q

What is the Pharyngeal portion of the tongue?

A

•vertically-oriented posterior 1/3 of the tongue - forms the anterior wall of the
oropharynx below the fauces

35
Q

What is the lingual tonsil?

A

•nodules of lymphoid tissue on the pharyngeal portion of the tongue

36
Q

Where is the epiglottis?

A

• located posterior to the pharyngeal potion of the tongue, it projects superiorly

37
Q

What are the three folds of the epiglotis?

A
  • Two lateral glossoepiglotic fold and the median glosssoepiglottic fold.
  • These are on the lingual side
38
Q

What is the valleculae?

A
  • Depressions the lateral glossoepiglotic folds and the median glosssoepiglottic fold.
  • An important landmark for endotracheal intubation
39
Q

Where is the Laryngopharynx (hypopharynx)?

A

• posterior to the larynx: extends from the tip of the epiglottis to the beginning of the esophagus at C6 (surface anatomy: just above the level of hyoid bone to the lower border of the cricoid cartilage)

40
Q

Internal laryngopharyngeal walls: (don’t memorize specifics; understand them! See next slide.
• posterior – nothing special to note
• lateral – pharyngeal muscles attaching to the hyoid bone and thyroid
cartilage
• anterolaterally (piriform recess) – mucosa overlies the medial (internal) surface of the thyroid cartilage and just superior to this, the thyrohyoid membrane
• anteromedially (from superior to inferior) – epiglottis, aditus to the larynx (laryngeal inlet), posterior wall of the larynx (arytenoid cartilages, lamina of the cricoid cartilage and attached muscles)

A

Internal laryngopharyngeal walls: (don’t memorize specifics; understand them! See next slide.
• posterior – nothing special to note
• lateral – pharyngeal muscles attaching to the hyoid bone and thyroid
cartilage
• anterolaterally (piriform recess) – mucosa overlies the medial (internal) surface of the thyroid cartilage and just superior to this, the thyrohyoid membrane
• anteromedially (from superior to inferior) – epiglottis, aditus to the larynx (laryngeal inlet), posterior wall of the larynx (arytenoid cartilages, lamina of the cricoid cartilage and attached muscles)

41
Q

What is the Piriform recesses (sinuses, fossae)? ppt flashcard 29-30

A

• anterolateral recesses of the pharynx extending forward on either side of the of the larynx

42
Q

What structures are found within the piriform recess?

A

• Superior laryngeal nerves, arteries & veins

43
Q

Why are the valleculae and piriform sinuses relevant clinically (think kids)

A

• Foreign bodies tend to lodge in the valleculae and the piriform sinuses.

44
Q

What is the Zone of Sparse Fibers?

A

An area where the mucosa is unsupported by musculature between the cricopharyngeus and the thyropharyngeus portions of the inferior constrictor.

45
Q

What is the lateropharyngeal space?

A

The retropharyngeal space that extends laterally ppt flashcards pg 35

46
Q

What does the anterior lateropharyngeal space contain?

What does the posterior lateropharyngeal space contain?

A
  • Anterior: pterygoid plexus, the retromandibular vein, and the external carotid artery
  • Posterior: carotid sheath and its contents
47
Q

What is the Retropharyngeal space? Dashed green line on ppt flashcard 36

A

•Between the buccopharyngeal fascia of the pharynx and the prevertebral fascia.

48
Q

What is the function of the retropharyngeal space?

A

• During swallowing, It permits the necessary expansion and movement of the pharynx, larynx, trachea and esophagus.

49
Q

What is the retrovisceral space?

*What is the clinical relevance of the space?

A

• The retropharyngeal space extends from the base of the skull to the infrahyoid area where it changes name to the retrovisceral space.
• The retrovesical space frequently terminates in the superior mediastinum at the level of T3-T4 when the prevertebral fascia obliterates the space by adhering to the esophagus.
Virulent infections in the neck, therefore, can spread into the mediastinum.

50
Q

What is the blood supply to the pharynx? name 3 vessels and what 2 of them branch from.

A
  • ascending pharyngeal artery
  • Tonsillar artery (facial a. branch)
  • ascending palatine (facial a. branch).
51
Q

What is the Venous Drainage of the pharynx…
Posterior drainage?
Superior drainage?
Inferior drainage?

A
  • Posterior: pharyngeal venous plexus
    • Superior: pterygoid plexus located in the infratemporal fossa
    • Inferior: internal jugular vein
52
Q

Where is the pharyngeal nerve plexus?

A

external surface of the pharynx within the buccopharyngeal fascia.

53
Q

What nerves form the pharyngeal nerve plexus?

A

sensory branches of the glossopharyngeal nerve (CN IX)

sensory and motor branches from the vagus nerve (CN X).

54
Q

Explain the Motor innervation of the pharyngeal plexus

A

• all muscles of the pharynx ==> vagus nerve (CN X)

with the exception of the stylopharyngeus muscle ==> glossopharyngeal nerve (CN IX).

55
Q

Explain the Sensory innervation of the pharyngeal plexus…
Nasopharynx?
Oropharynx?
Laryngopharynx?

A
  • Nasopharynx: pharyngeal branch of the maxillary nerve (CN V2)
  • Oropharynx: glossopharyngealnerve (CN IX)
  • Laryngopharynx: vagus - (CN X)
  • Note: the nasopharynx is above the level of the auditory tube. The oro and laryngo is below.
56
Q

What is Wadeyer’s ring?

A

•circumpharyngeal ring of mucosa-associated lymphoid tissue (MALT) “guards” the entrance into the respiratory and digestive tracts.

57
Q

What are the tonsils that compose Waldeyer’s ring?

A
  • nasopharyngeal tonsils
  • palatine tonsils
  • tubal tonsils
  • lingual tonsils
58
Q

What does the hard palate consist of? What does it do?

A

anterior 2/3 - composed of the palatine processes of the maxillary bones and the horizontal plate of the palatine bones
• mucosa is thick, adherent and contains numerous minor salivary glands
• serves as a partition between the oral and nasal cavities

59
Q

What does the soft palate consist of? What does it do?

A

posterior 1/3
• serves to close off the oropharnx from the nasopharynx during deglutition
• thick fold of mucosa suspended from the posterior border of the hard palate
• hangs down as a mobile projection in front of the posterior pharyngeal wall.
• forms the anterior border of the nasopharynx

60
Q

What are the Five paired muscles of the soft palate?

A 
•  Tensor veli palatini
•  Levator veli palatini
•  Palatoglossus
•  Palatopharyngeus
*  Uvular
61
Q 
What are the actions of the...
•  Tensor veli palatini
•  Levator veli palatini
•  Palatoglossus
•  Palatopharyngeus
•  Uvular
A

• Tensor veli palatini - tenses soft palate prior to elevation
•Levator veli palatini – elevates soft palate
• Palatoglossus - elevates posterior tongue; closes oropharyngeal isthmus
• Palatopharyngeus - elevates pharynx and larynx
• Uvular- stiffens the soft palate

62
Q

Every muscle of the soft palate is innervated by CN ? (except the tensor veli palatini CN ?

A

Vagus (except for V3)

63
Q

What are the contents of the soft palate?

A
  • five paired muscles, mucous glands, vessels, nerves and lymphatics
  • two arches (anterior and posterior) on each side of the soft palate
  • uvula projects downward from the posterior margin
64
Q

Explain the general principles of the PALATINE TONSILS

A
  • largest accumulation of lymphoid tissue in Waldeyer’s ring
  • tonsillar fossa – depression between the palatoglossal and palatopharyngeal arches
  • thin capsule covers the deep surface of the tonsil separating it from the pharyngobasilar fascia and the superior constrictor muscle
  • tonsillar branch of the facial artery is the largest of many vessels nourishing the palatine tonsil (most vessels enter via the deep surface of the inferior pole)
  • paratonsillar vein drains into the facial vein
  • lymphatic drainage is, in particular, to the jugulodiagastic node

M1 HAE Quiz 4 (7 decks)

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