The Pharynx 2

Question 1

Where is the stylohyoid ligament in comparision to the stylohyoid muscle?

Answer 1

It passes deep to this muscle.

Question 2

Where does the stylohyoid ligament attach onto?

Answer 2

It attached onto the lesser horn of the hyoid bone.

The lesser horn also provides some attachment for the middle constrictor muscle at its origin.

Question 3

What is the interior of the pharynx lined with?

Answer 3

Mucous membrane.

Question 4

What is the mucous membrane in the nasopharynx like?

Answer 4

It is respiratory epithelium = pseudostratified ciliated columnar epithelium.

Question 5

What is the rest of the mucous membrane like?

Answer 5

It is stratified squamous epithelium.

Question 6

What are the 3 divisions of the cavity of the pharynx?

Answer 6

• the part behind the nose is the nasopharynx
• the part behind the mouth is the oropharynx
• behind the larynx is the laryngopharynx

We can see the relationship between the 3 divisions clearly on a paramedian section of the head and neck or on a lateral skull radiograph of the region.

Question 7

Where does the nasopharynx lie?

Answer 7

Lies above the level of the palate.

Question 8

How is the nasopharynx continuous of the oral part of the pharynx?

Answer 8

It is continuous through a narrow pharyngeal isthmus.

Question 9

What does the nasopharynx communicate with in front?

Answer 9

It communicates with the nasal cavities.

Question 10

What do the roof and the posterior wall of the nasopharynx consist off?

Answer 10

They consist of mucous membrane covering the bones of the base of the skull.

Question 11

What is found in the submucosa of the posterior wall of the pharynx?

Answer 11

Lymphatics.

Question 12

How is the lymphoid tissue in the nasopharynx found in children?

Answer 12

In children, it is enlarged where aggregations are called adenoids.

Question 13

What happens if the adenoids are grossly enlarged?

Answer 13

They can interfere with breathing and often force a child to breathe through an open mouth and this gives the typical appearance called adenoidal facies.

Question 14

Where is the opening of the auditory tube?

Answer 14

This is on the lateral wall of the pharynx at the level of the floor of the nose.

Question 15

What does the auditory tube do?

Answer 15

It equalises the pressure between the pharynx and the middle ear.

Question 16

When can the auditory tube be blocked?

Answer 16

It can be blocked in upper respiratory tract infections such as a common cold.

Question 17

What is the opening of the auditory tube above and at the back bounded by?

Answer 17

It is bounded by a tubal ridge.

Question 18

What is present in the tubal ridge?

Answer 18

More lymphoid tissue.

Question 19

Form the tubal ridge, what can we see descending down the side wall of the pharynx?

Answer 19

We can see a fold of mucous membrane which contains the delicate salpingopharyngeus muscle that passes down from the auditory tube to the pharyngeal wall. This is a longitudinal muscle.

Question 20

What is the name of the recess behind the tubal ridge?

Answer 20

The pharyngeal recess.

Question 21

What the oropharynx lie behind?

Answer 21

It lies behind the palatoglossal fold.

Question 22

What is the palatoglossal fold formed by?

Answer 22

It is formed by the palatoglossus muscle.

Question 23

What muscle lies behind the oropharynx?

Answer 23

The palatopharyngeus muscle. This also raises a fold.

Question 24

What are the palatoglossal and palatopharyngeus folds sometimes called?

Answer 24

They are sometimes called anterior and posterior pillars of the fauces.

Question 25

What is present between the palatoglossal and palatopharyngeal arches?

Answer 25

The palatine tonsil. There is one tonsil on either side.

Question 26

What are the palatine tonsils?

Answer 26

These are lymphoid masses.

Question 27

How are the tonsilar crypts formed?

Answer 27

The mucous membrane on the surface of the tonsil dips deeply into the substance of the lymphoid tissue to form narrow tonsilar crypts.

Question 28

What is the outer surface of the tonsil covered by?

Answer 28

By a thin capsule which is attached to the pharyngobasilar fascia and to the sheath of the palatoglossal muscle. This helps to keep the tonsil in place.

Question 29

Where is the superior constrictor muscle in relation to the tonsils?

Answer 29

It is outside or lateral to them.

Question 30

What nerve is lateral to the tonsilar beds?

Answer 30

The glossopharyngeal nerve.

Question 31

When the tonsil is removed what does it have to be cut away from?

Answer 31

It has to be cut away from the tonsilar bed.

Question 32

What is important to the tonsil?

Answer 32

The blood supply and venous drainage.

Question 33

What is the chief artery to the tonsil a branch of?

Answer 33

It is a branch of the facial artery.

Question 34

What part of the tonsil does the chief artery to the tonsil enter?

Answer 34

It enters the lower part of the tonsil.

Question 35

Where do veins pierce the superior constrictor muscle?

Answer 35

They pierce the muscle near the chief artery to the tonsil.

Question 36

Where do the veins from the tonsil terminater?

Answer 36

They terminate in the pharyngeal plexus of the veins or they drain into the facial vein.

Question 37

When the pharyngeal plexus of veins or the facial vein bleed badly?

Answer 37

They bleed badly after tonsilectomy.

Question 38

What is the lymphatic drainage of the tonsils like?

Answer 38

These are through lymphatics that pierce the superior constrictor muscle and go to the nearest lymph nodes.

Question 39

When do the lymph nodes near the tonsils become enlarged and painful?

Answer 39

In tonsilitis. One node in particular is affected and this is called the tonsilar node or the jugulodigastric lymph node.

Question 40

What are the 2 pairs of folds of mucous membranes that pass forwards from the epiglottis to the tongue called?

Answer 40

They are called the medial and 2 lateral glossoepiglottic folds.

Question 41

What is the vallecula?

Answer 41

This is a depression on either side of the median fold.

Question 42

Where does the laryngopharyx lie?

Answer 42

It lies behind the larynx.

Question 43

What are the posterior and lateral walls of the laryngopharynx made of?

Answer 43

• They are made of the middle and inferior constrictors
• Lower fibres of the salpingopharyngeus, palatopharyngeus and stylopharyngeus muscles run longitudinally and internally.

Question 44

What is the anterior wall of the laryngopharynx composed off?

Answer 44

It is composed of the inlet of the larynxwith the piriform fossa/ recess on either side.

Question 45

Lower down what is the laryngopharynx made up of?

Answer 45

It is made up of the mucous membrane on the back of the cricoid cartilage.

Question 46

How do the neurones that supply the muscles of the pharynx leave the brain?

Answer 46

They leave the brain through the cranial root of the accessory nerve (11th) and then they enter the vagus nerve (10th). The various branches of the vagus then distribute the neurones to the muscles

Question 47

How is sensory supply to the pharynx like?

Answer 47

It varies with the level of the pharynx.

Question 48

What is the mucous membrane of the nasopharynx supplied by?

Answer 48

It is supplied by the maxillary branch of the trigeminal nerve.

Question 49

How is sensation from the oropharynx transmitted?

Answer 49

It is transmitted through the glossopharyngeal nerve.

Question 50

Apart from transmitted sensation from the oropharynx, where else does the glossopharyngeal nerve supply?

Answer 50

It supplies the mucous membrane of the auditory tube