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Neuro > Pharynx/ Larynx > Flashcards

Pharynx/ Larynx Flashcards

1
Q

The laryngeal cough reflex is a NEUROLOGICAL reflex that protects the upper airway from significant aspiration of food or fluid. This is triggered by a noxious stimulus to the ________ - vital function in humans

A

Supraglottic laryngeal mucosa

*Laryngeal cough reflex has a role in neurologic airway protection

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2
Q

Swallowing (deglutition) what are the 3 phases?

A
  1. Oral (mastication)
  2. Oropharyngeal phase (elevation of the floor of the mouth and tongue in order to push the bolos into the oropharynx)
  3. Pharyngo-esophageal phase (The oropharynx is elevated and constricts around the bolus to propel it down the esophagus)
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3
Q

The gutters on each side of the laryngeal adieus are referred to as

A

Pyriform Recess –> empty the food into the esophagus

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4
Q

Newborns are nasal breathers. They can suckle and breathe through their nose at the same time - adults CANNOT. The position of the human larynx changes from a newborn to an adult - describe this change

A

Relationship between the soft glottis and the epiglottis
In the adult the distance between the soft palate and the epiglottis is changed significantly

The reason for this is because the larynx is displaced
Proposed that there is an increase in SID due to the larynx being displaced from the back of the throat to its position in the neck - linear displacement overtime

related to the development of neurological airway protection –> laryngeal cough reflex

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5
Q

What nerve innervates the inferior area of the larynx- specifically the vestibular region of the larynx and is involved with neurological airway protection –> triggers an expiratory cough reflex (expiratory reflex, not a true cough)

A

Internal branch of the superior laryngeal nerve

  • Travels with the Superior Laryngeal A.
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6
Q

What are the 3 divisions of the pharynx?

A

Naso-pharynx
OroPharynx
Laryngopharynx

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7
Q

Boundaries of the pharynx:

What structure is between the nasal cavity and the nasopharynx?

A

Choanae

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8
Q

Boundaries of the pharynx:

What structure is between the nasopharynx and the oropharynx

A

Pharyngeal Isthmus

  • Opening between the soft palate and the posterior pharyngeal wall
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9
Q

Boundaries of the pharynx:

What structure is between the oral cavity and the oral pharynx?

A

Faucial Isthmus
- formed by palatoglossal folds
between the oral cavity and the oral pharynx

  • The uvula sits right in front of it
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10
Q

The nasopharynx is located posterior to the nasal cavity.

It communicates to the nasal cavity via the

A

choanae

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11
Q

The nasopharynx is located posterior to the nasal cavity.

It communicates to the middle ear via the

A

auditory tube (Eustachian tube)

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12
Q

The nasopharynx is located posterior to the nasal cavity.

It communicates to the oropharynx via the

A

pharyngeal isthmus

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13
Q

Anatomically, what is located above the Eustachian tube? (2)

A

Torus Tubarius and the pharyngeal tonsils

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14
Q

The oropharynx communicates with the oral cavity via the

A

faucial isthmus

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15
Q

The faucial isthmus is made up of

A

palatoglossal folds and palatopharyngeal fold

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16
Q

The palatoglossal folds demarcate the

A

anterior 2/3 of the tongue from the posterior 1/3 of the tongue. The glossopharyngeal nerve descends and innervates the posterior 1/3 of the tongue

17
Q

The laryngopharynx communicates with the oropharynx at the level of the

A

hyoid - CV6

- Larynx via the laryngeal aditus and the esophagus via the pyriform recess

18
Q

The _____ fascia is a continuation of the pre tracheal fascia. It covers the

A

outside of the buccinator muscle and the pharynx. The pharyngeal plexus is embedded in the portion of the fascia covering the middle constrictor

19
Q

In between the buccinator fascia and the pre-vertebral fascia is the

A

retropharyngeal space

20
Q

What is the main pharyngeal elevator? What is the origin and insertion and what is it innervated by? What is the function?

A

The Stylopharyngeus muscle arises from the styloid process and inserts on the pharyngeal wall. between the superior and middle constrictors it is innervated by the glossopharyngeal n (IX) *only muscle innervated by this nerve

During the last phase of swallowing (pharyngeoesphogus phase) the pharynx will elevate and constrict. The Stylopharyngeous muscle will elevate the pharynx

21
Q

Pharyngeal constrictors:

A

During the last phase of swallowing (pharyngeoesphogus phase) the pharynx will elevate and constrict. The Stylopharyngeous muscle will elevate the pharynx and the superior, middle and inferior constrictors will constrict.

The superior constrictor is attached laterally to the pterygomandibular raphe and attaches posteriorly to the midline by the pharyngeal raphe.

The middle constrictor attaches to the hyoid bone laterally and it is attached posteriorly to the middle of the pharyngeal raphe

The inferior constrictor *** –> attached laterally to the oblique line of the thyroid cartilage and cricoid cartilage. **This is attached posteriorly to the pharyngeal raphe and its fibers will change from oblique to horizon to comprise the cricopharyngeous muscle - this is the muscle used during pharyngeal speech

22
Q

What are the three branches off he vagus nerve

A
  1. Pharyngeal N. –> pharynx
  2. Internal branch of the superior laryngeal nerve goes to the inferior larynx
  3. external branch of the superior laryngeal nerve goes to the cricothyroid muscle
23
Q

The ___ constrictor is the largest constrictor. What is special about this constrictor? What is the clinical relevance?

A

inferior constrictor - this constrictor has oblique fibers that posteriorly turn into horizontal fibers that comprise the cricopharyngeous muscle. This is the area you can get the zener’s diverticulum –> frequently at the junction of the cricopharyngeous and esophageal musculature. This is an area of constriction.

Most result from abnormal intraluminal pressure due to a stricture, esophageal spasm or abnormal lower esophageal sphincter function.

24
Q

What is the blood supply to the pharynx?

A

Ascending Pharyngeal A.

and the Inferior Thyroid A

25
Q

How is the pharynx innervated?

sensory and motor

A

The pharynx is innervated by the pharyngeal plexus which is embedded in the buccopharyngeous fascia.

SENSORY: GVA fibers from the pharyngeal branch of the glossopharyngeal n. (ectoderm)

MOTOR: SVE fibers from the pharyngeal branch of the vagus nerve. All pharyngeal muscles are innervated by the vagus nerve except the stylopharyngeous m.

26
Q

Branches of IX

A
  1. Pharyngeal nerve to pharyngeal plexus
  2. Sensory GVA to the mucosa of the posterior 1/3 of the tongue and pharynx and SVA to taste buds.
  3. Motor to stylopharyngeous M. (SVE)
27
Q

Gag Reflex:

In by ___ out by ___

A

IX out by X

28
Q

What are the contents of the carotid sheath?

A
  1. Vagus Neve
  2. Common Carotid
  3. Internal Jugular Vein
29
Q

The main supporting element of the laryngeal airway is the

A

Cricoid cartilage CV6

30
Q

What is the valleculae epiglottic?

A

cup-shaped recesses between the tongue and epiglottis, they are separated from each other by the median epiglottic fold and bounded laterally by the lateral glossoepiglottic fold

31
Q

What nerve courses posterior to the cricothryoid joint?

A

The recurrent laryngeal nerve

32
Q

In an emergency cricothyrotomy what ligament do you go through?

A

The median cricothryoid ligament

33
Q

What is the function of the posterior cricoarytenoid muscle?

A

Brings the cricoarytenoid together and ABDUCTS the vocal cords - only abductor of the vocal cords

34
Q

What is the function of the cricothyroid muscle?

What is this muscle innervated by?

A

On the anterior surface of the cricoid and thyroid cartilages. When it contracts - moves the cricoid forward, There is an increase in the tension of the vocal cords- HIGH PITCH

Innervated by the external branch of the superior laryngeal nerve

CN: the cricothryoid membrane can be tested by having the person say e-e-e in a high-pitched voice. Under these conditions, the examiner can palpate the decrease in width of the cricothryoid membrane

35
Q

What is the function of the vocalis muscle?

A

Decreases tension on the vocal cords, lies immediately adjacent and parallel to the vocal ligament
- when it contracts, it decreases the tension on the vocal ligament

36
Q

What nerve supplies the laryngeal muscles except the cricothryoid muscle?

A

Recurrent Laryngeal N. (off of vagus)

37
Q

Describe the laryngeal expiration reflex

A

Stimulus: Aspiration of material into the laryngeal vestibule stimulates receptors in the mucosa

Afferent component: the internal branch of the superior laryngeal nerve –> innervates these receptors and afferents enter the medulla with the vagus nerve and terminate in the vicinity of the nucleus tractus solitarus (CN VII, IX, X)

Efferent component: the recurrent laryngeal, intercostal and abdominal nerves control the laryngeal, intercostal and abdominal muscles, respectively

Effect: abrupt, involuntary, expiratory cough

Neuro (6 decks)

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