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Y2 LCRS HNS RI > Session 5: The Airway and its Relations > Flashcards

Session 5: The Airway and its Relations Flashcards

1
Q

What are the different laryngeal branches of the vagus nerve and what do these branches do?

A

Superior Laryngeal Nerve – separates into internal and external laryngeal Internal Laryngeal – sensory above the vocal folds External Laryngeal – motor to cricothyroid muscles Recurrent Laryngeal – sensory below the vocal folds + motor to all other muscles of the larynx

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2
Q

Name these structures

A
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3
Q

What membranous outpouching is formed between these two folds?

A

Laryngeal ventricle and laryngeal saccule

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4
Q

What is the name given to the thin plate of bone that forms the roof of the tympanic cavity?

A

Tegmen tympani

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5
Q

What is the function of the nasal cavity?

A

Humidify and warm hair, trap pathogens

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6
Q

Where does the nasolacrimal duct drain and what is its role?

A

To the lateral wall of the inferior meatus It drains tears from the lacrimal sac to the nasal cavity

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7
Q

What name is given to the gaps between conchae?

A

Meati (superior, middle, inferior)

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8
Q

What is the vallecula?

A

Behind the root of the tongue between the folds in the throat – they serve as spit traps, saliva is temporarily held in the valleculae to prevent initiation of the swallowing reflex

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9
Q

Label these structures

A
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10
Q

Which arteries do the superior and recurrent laryngeal nerves run alongside?

A

Superior – Superior thyroid artery Recurrent – Inferior thyroid artery

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11
Q

Which sinus drains into the sphenoethmoidal recess?

A

Sphenoidal Sinus

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12
Q

What type of epithelium lines the conchae?

A

Respiratory Epithelium It increases the surface area for warming and humidifying the inspired air (conchae are also referred to as turbinate bones)

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13
Q

What are the mastoid air cells and describe its connection with the middle ear.

A

They are small sinuses within the mastoid part of the temporal bone The mastoid air cells communicate with the middle ear via the aditus ad antrum and the mastoid antrum This is a possible route for infection of the middle ear

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14
Q

What is the role of the pharyngotympanic tube (Eustachian tube)?

A

Equalises the pressure on either side of the tympanic membrane by allowing a connection between the middle ear and the nasopharynx

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15
Q

What important cartilage is found attached to the top of the cricoid cartilage?

A

Arytenoid cartilage

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16
Q

What are the two parts of the cricoid cartilage?

A

Lamina and Arch

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17
Q

What is the name given to the opening between the vocal folds?

A

Rima glottidis

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18
Q

Where does the sphenoidal sinus drain?

A

Into the sphenoethmoidal recess

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19
Q

Describe what happens in coughing. List the muscles and the nerves mediating this process.

A

Afferents via X

Inspiration

Intrathoracic pressure raised

glottis closed, abdominal muscles contracted

Soft palate raised and tensed against posterior wall of pharynx. (Levator veli palatini (X), tensor veli palatini (V3), sup. Constrictor (X))

Sudden abduction of vocal folds to release intrathoracic pressure through nose or mouth

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20
Q

Which afferents take information from laryngeal receptors totrigger the sneeze reflex?

A

Maxillary branch of the Trigeminal nerve

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21
Q

State some roles of the sinuses in the skull.

A

It makes the skull lighter Acts as a crumple one for the brain Increases projection of the voice

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22
Q

What name is given to the protrusion between the laminae of the thyroid cartilage and what notches are found above and below this point?

A

Laryngeal prominence Superior and inferior thyroid notch

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23
Q

What action does the epiglottis perform to close off the laryngeal inlet?

A

Retroflexion

24
Q

What are the two folds in the mucosa in the laryngeal inlet and how are they arranged?

A

Vestibular Fold (false vocal fold) Vocal Fold (true vocal fold) Vestibular folds are lateral to the vocal folds

25
Q

Why is the left recurrent laryngeal nerve more susceptible to damage by bronchial/oesophageal tumours and swollen mediastinal lymph nodes than the right recurrent laryngeal nerve?

A

Because the left recurrent laryngeal nerve branches off the vagus much more inferiorly than the right so it has more of its length that is near the bronchus, oesophagus and mediastinal lymph nodes

26
Q

The soft palate is raised and tensed against the posterior wall of the pharynx when coughing. Which muscles are involved in this action and which nerves innervate these muscles?

A

Tensor veli palatini (mandibular of trigeminal (V3)) Levator veli palatini (X) Superior constrictor (X)

27
Q

How are the paranasal sinuses innervated?

A

1) frontal - V1
2) ethmoid - V1, V2
3) sphenoidal - V1, V2
4) maxillary - V2

28
Q

What significant structure is found inferior to the middle nasal concha?

A

Semilunar Hiatus

29
Q

Which muscles are involved in abducting and adducting the vocal folds?

A

Posterior cricoarytenoid muscle – abduction Lateral cricoarytenoid muscle – adduction

30
Q

What main arteries supplying the nasal cavity?

A

Internal and external carotid

31
Q

What is the difference in the oropharyngeal isthmus in coughing compared to sneezing?

A

In coughing, the oropharyngeal isthmus is open When sneezing, it is closed

32
Q

Where does the maxillary sinus drain?

A

To the bottom of the semilunar hiatus

33
Q

What is the name of the space superior to the superior concha?

A

Sphenoethmoidal Recess

34
Q

Where are the ethmoidal cells found?

A

Medial to the orbit

35
Q

The soft palate is depressed against the tongue when sneezing toprevent the release of the pressure through the mouth. Which nerve and muscles are involved in this?

A

Vagus – palatoglossus/palatopharyngeus

36
Q

Which nerve provides sensory and motor control of the larynx?

A

Vagus Nerve

37
Q

What two things do the cricoid cartilage articulate with?

A

Arytenoid cartilage Inferior horns of the thyroid cartilage

38
Q

Where does the nasal cavity’s blood drain?

A

1) superiorly - cavernous sinus
2) posterioinferiorly - pterygoid plexus
3) anterioinferiorly - facial vein

39
Q

How is the nasal cavity innervated?

A

• Olfactory nerve (I) – Olfaction • Trigeminal nerve (V) – V1 – anterior region, V2 – posterior region • Facial nerve (VII) – Glands • Sympathetic nerves (from T1) – Vascular smooth muscle

40
Q

Where do the posterior ethmoidal air cells drain?

A

Lateral wall of the superior meatus

41
Q

What happens to the vocal folds when sneezing and coughing?

A

They abduct

42
Q

Which muscles are attached only to the arytenoids?

A

Transverse and Oblique Arytenoid muscles

43
Q

Name these structures

A
44
Q

Which afferents take information from laryngeal receptors totrigger the cough reflex?

A

Vagus

45
Q

Through which membrane is a cricothyroidotomy performed?

A

Cricothyroid ligament

46
Q

What effect does tilting the thyroid cartilage forwards have on the vocal folds? Which muscles perform this action?

A

Puts tension on the vocal folds Cricothyroid muscles

47
Q

Name the labelled structures

A
48
Q

What is the clinical relevance of the sphenoid sinus in relation to the pituitary gland?

A

It is penetrated in transphenoidal hypophysectomy

49
Q

How is the movement of the soft palate different in cough reflexcompared to a sneeze?

A

Cough – soft palate is raised and tensed against the posterior wall of the pharynx Sneeze – soft palate is depressed against the tongue

50
Q

What is the name of the joint that the thyoid bone pivots on?

A

Cricothyroid joint.

51
Q

Describe what happens in sneezing. List the muscles and the nerves mediating this process.

A

Afferents via V2

Inspiration

Intrathoracic pressure raised

glottis closed, abdominal muscles contracted

Soft palate depressed against tongue palatopharyngeus/palatoglossus (X)

Sudden abduction of vocal folds to release intrathoracic pressure through nose or mouth

52
Q

What two bits of cartilage are found on top of the arytenoid cartilage?

A

Corniculate and Cuneiform Cartilage

53
Q

What are the three parts of the ethmoidal air cells and where do each of them drain?

A

Anterior, middle and posterior ethmoidal air cells Posterior – lateral wall of superior meatus Middle – ethmoidal bulla Anterior – top of the semilunar hiatus via the frontonasal duct with the drainage of the frontal sinus

54
Q

Where does the vagus nerve exit the skull?

A

stylomastoid foramen

55
Q

What are the motor funtions of the facial nerve?

A

•Muscles of facial expression, stapedius, digastric (posterior belly), stylohyoid.

56
Q

What are the sensory funtions of the facial nerve?

A

•Taste (ant 2/3 tongue),

parasympathetic (lacrimal glands, mucous glands of nasal cavity, hard and soft palates, sublingual and submandibular glands).

•General sensation from external acoustic meatus and deeper parts of auricle.

57
Q

Name these components of the ear

A

Y2 LCRS HNS RI (6 decks)

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