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HNN > Session 9 > Flashcards

Session 9 Flashcards

1
Q

Tongue muscles

A
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2
Q

Parotid gland anatomy

A
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3
Q

Features of salivary gland stones

A

Sialolithiasis

  • Most stones are located in the submandibular glands
  • Dehydration, reduced salivary flow
  • Most stones less than 1cm diameter
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4
Q

Symptoms of salivary gland stones

A

Eating stimulates

Pain in gland, swelling, infection

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5
Q

Diagnosis of salivary gland stones

A

History, X ray, sialogram

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6
Q

Features of tonsillitis

A

Inflammation of palatine tonsils

Fever, sore throat, dysphagia, cervical lymph nodes, bad breath

Viral causes most common
Bacterial up to 40% of cases, e.g Strep pyogenes

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7
Q

Features of peritonsilar abscess

A

Severe throat pain, fever, bad breath, drooling, difficulty opening mouth

Can follow on from untreated or partially treated tonsillitis

Can arise on its own from aerobic and anaerobic bacteria

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8
Q

Nerve innervation of pharynx plexus

A

Pharyngeal plexus

Located mainly on surface of middle constrictor muscle

Vagus, glossopharyngeal, and cervical sympathetic nerves

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9
Q

Nerve innervation of pharynx- motor

A

CN X innervates all muscles

Except stylopharyngeus (glossopharyngeal nerve CN 9)

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10
Q

Nerve innervation of pharynx- sensory

A

Nasopharynx (maxillary nerve CN Vb)
Oropharynx (glossopharyngeal nerve CN 9)
Laryngopharynx (vagus nerve CN X)

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11
Q

Submandibular gland duct

A

Wharton duct

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12
Q

Parotid gland duct

A

Stensens duct

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13
Q

IX and X Cranial nerve problems in mouth area

A

Absent gag, deviated uvula (away from lesion)

Dysphagia, taste impairment posterior tongue, loss of oropharynx sensation

Caused by medullary infarct, jugular foramen issue (fracture)

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14
Q

XII cranial nerve problems in mouth area

A

Wasted tongue
Deviated tongue when stuck out - damage to nerve itself (point to side of lesion)
Muscle wasting
Fasiculations

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15
Q

Oral cavity consists of

A

2 lateral walls, a floor and a roof

Lateral walls- buccinators
Roof- Hard and soft palate
Floor- 2 mylohyoid muscles, tongue

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16
Q

The oral cavity begins anteriorly at the

A

Oral fissure- bounded by the lips

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17
Q

Oral cavity extends posteriorly to the

A

Oropharyngeal isthmus (arch formed by soft palate above and upper surface of tongue below)

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18
Q

Sides of the Oropharyngeal isthmus are formed by the

A

Anterior and posterior pillars of the fauces

Formed by palatoglossus (anterior) and palatopharyngeal (posterior) muscles

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19
Q

What does contraction of palatoglossus and palatopharyngeal muscles cause

A

Pulls soft palate down towards back of tongue, closes Oropharyngeal isthmus, ensures food remains in oral cavity

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20
Q

What lies between the anterior and posterior pillars of fauces

A

Tonsillar fossa, within this the palatine tonsil, making up Waldeyer’s ring

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21
Q

Palatine tonsil is often easily visible and readily noticed when swollen due to inflammation in

A

Tonsillitis

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22
Q
A
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23
Q

Broadly describe the tongue

A

Entirely muscular tissue covered in mucous membrane (squamous epithelium)

Intrinsic and extrinsic muscles

24
Q

Describe the intrinsic muscles of the tongue

A

4

Lie entirely within the tongue and run longitudinally, vertically and transversely

Alter shape of tongue

Blend with extrinsic muscles as have no attachment to bone

25
Q

Describe the extrinsic muscles of tongue

A

Change position of tongue

Protrusion, retraction and side-to-side

Anchor tongue to surrounding structures

26
Q

What do the extrinsic muscles anchor the tongue to

A

Hyoid and mandible below

Styloid process and soft palate above

27
Q

Most important of four extrinsic muscles

A

Genioglossus- one on each half of tongue

Contraction protrudes the tongue (action for determining hypoglossal nerve function)

28
Q

Hypoglossal nerve innervates what part of tongue

A

All muscles of tongue except 1- the palatoglossus (forms shape of anterior arch and soft palate, vagus nerve)

29
Q

Why does the tongue receive afferent innervation from a number of cranial nerves

A

Because of its different embryological origins from several pharyngeal arches

30
Q

Innervation of the tongue posterior 1/3

A

Glossopharyngeal

31
Q

Motor innervation of tongue

A

Hypoglossal except Palatoglossus (vagus)

32
Q

Sensory innervation of anterior 2/3 tongue

A

Lingual branch of V3 from trigeminal

33
Q

Taste innervation of anterior 2/3 tongue

A

Chorda tympani branch of Facial 7, carried by lingual branch

34
Q

Innervation of tongue overview

A
35
Q

Dorsal surface of tongue is covered in

A

Papillae

Location for sensory receptors for tastes ie taste buds

36
Q

Hypoglossal nerve lesion sign and vagus nerve lesion sign

A

Hypoglossal = tongue deviation

vagus nerve = uvula deviation

37
Q

Describe the pharynx

A

Muscular tube that continues as the oesophagus, arising from base of skull extending down to level of C6

38
Q

Narrowest part of oesophagus

A

Inferior end where it becomes continuous with the oesophagus

39
Q

Posterior wall of pharynx is covered with and lies against

A

Buccopharyngeal fascia,

lies against prevertebral layer of deep cervical fascia (where we find retropharyngeal space)

40
Q

Order of 3 parts of pharynx

A

Nasopharynx

Oropharynx

Laryngopharynx

41
Q

Where does the Nasopharynx lie

A

Superior to soft palate

Posterior extension of nasal cavities, open into it through nasal apertures/choanae

C1 vertebrae lies posteriorly

42
Q

What lies within the Nasopharynx

A

Orifice of the Pharyngotympanic/Eustachian tube

Collection of lymphoid tissue- pharyngeal tonsil/adenoids

43
Q

Where is oropharynx

A

Level of soft palate to superior border of epiglottis

C2 and C3 vertebral bodies lie posteriorly

Palatine tonsils lie on either side in interval between palatoglossal and palatopharyngeal arches

44
Q

Where is laryngopharynx

A

Epiglottis to the oesophagus, level of inferior border of cricoid cartilage

Vertebral bodies of C3-6 lie posteriorly

Piriform fossa on each side of laryngeal inlet

45
Q

Walls of the pharynx

A

Externally- circular superior, middle and inferior constrictors

Vagus nerve

46
Q

Posterior common insertion point of pharyngeal constrictors

A

Common midline tendinous insertion called the pharyngeal raphe

47
Q

Inferior pharyngeal constrictor consists of

A

2 muscle bellies, thyropharyngeus and cricopharyngeus

Small area of weakness known as Killian’s dehiscence between the muscle belly components

48
Q

Clinical relevance of Killian’s dehiscence

A

In coordination of pharynx

Pressure rises

Part of pharyngeal mucosa herniated through Killian’s dehiscence, forming pharyngeal pouch or diverticulum

49
Q

Internally, the wall of the pharynx consists of

A

3 longitudinal muscles that act to shorten and widen the pharynx, during swallowing and speaking

50
Q

Majority of the nerve supply to the pharynx is derived from the

A

Pharyngeal plexus of nerves - formed by branches of the vagus, glossopharyngeal and sympathetic branches from the superior cervical ganglion

51
Q

Vagus nerve supplies

A

All muscles of the pharynx and soft palate except the stylopharyngeus (supplied by CN 9)

52
Q

Sensory supply to pharynx

A

Nasopharynx- maxillary branch of trigeminal CN Vb

Oropharynx and Pharyngotympanic tube- glossopharyngeal nerve CN IX

Laryngopharynx- vagus nerve CN X

53
Q

What is Waldeyer’s ring

A

Lymphoid ring formed around Nasopharynx and oropharynx

Pharyngeal tonsils, palatine tonsils and lingual tonsils

54
Q

Features of pharyngeal tonsils/adenoids

A

Prominent in children

Undergo atrophy after puberty

Adenoiditis (chronic inflammation) may obstruct passage of air causing mouth breathing and nasal tone

Can block exit of the Pharyngotympanic tube and lead to middle ear infections (acute otitis media) or otitis media with effusion

55
Q

Pharyngotympanic tube provides a

A

Potential route for infection in the pharynx to spread to the middle ear

Common for URTI to be complicated by middle ear infections

56
Q

Tonsillitis may require

A

Tonsillectomy from tonsillar bed

May result in profuse bleeding from the rich blood supply to the tonsil- via tonsillar branch of facial artery

57
Q

What is clinical relevance of piriform fossa

A

Potential site for foreign bodies entering pharynx to become lodged

Site for pharyngeal cancers

HNN (19 decks)

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