The Pharynx Flashcards
What are the symptoms of obstructed airflow through nasopharynx?
Mouth breathing esp when asleep,
Persistent nasal discharge,
Snoring,
Persistent cough
What are the boundaries of the nasopharynx? What is found here?
Base of skull to soft palate, ant nasal cavity, post C1 C2
Pharyngeal tonsils/adenoids (enlarged) and ET
What are the boundaries of the oropharynx? What is found here?
Soft palate to sup epiglottis, ant oral cavity, post C2 C3
Palatine tonsils
What are the boundaries of the laryngopharynx? What is found here?
Epiglottis to cricoid cartilage at C6 so start of oesophagus, ant larynx, post C4,5,6
Pisiform fossa/recess
In the nasopharynx, what are the three things that the adenoids can cause?
Block nasal airflow if enlarged,
Block ET opening,
Harbour chronic infection (can go to ET/sinuses)- ottitis media, sinusitis
What is the classic theory of ET dysfunction causing ottitis media?
- Cells in middle ear constantly reabsorbing N2/O2
- Blocked ET created -ve pressure in middle ear
- Transudate drawn from mucosa
- Bacteria proliferate leading to ottitis media
What are 4 complications of ottitis media?
Hearing loss (usually temp-effusion)
Mastoiditis
Cholesteatoma
Meningitis and brain abscess
What are the three longitudinal muscles of the pharynx called and what do they do? What is their innervation?
Stylopharyngeus, palatopharyngeus, salpingopharyngeus
Elevate pharynx and larynx during swallowing
All innervated by vagus except stylopharyngeus- glossopharyngeal
Name the 3 constrictors of the pharynx? Are they circular or longitudinal? Which has two parts? What are they innervated by?
Sup, middle, inf constrictors.
Circular
Inf thyroid- thyropharyngeal and cricopharyngeal
Vagus
Where is Killian’s dehiscence/ Zenker’s diverticulum found?
A point of weakness between the two inf constrictors of the pharynx- thyropharyngeal and cricopharyngeal
Where do all three pharyngeal constrictors meet?
Pterygomandibular raphe
How might a pt present with a pharyngeal pouch?
Bad breath, food regurg, occasional choking on fluids, dysphagia
Symptoms related to food collecting/disrupted swallowing
What is a pharyngeal pouch? What direction? What’s its due to?
False diverticulum
Posteromedial
Failure of UOS to relax, abnormal timing of swallowing (higher pressure in laryngopharynx), weak inf constrictor
Where is the pharyngeal plexus located?
Surface of middle constrictor
What is the sensory to naso, oro and laryngopharynx?
5, 9, 10
Maxillary, glossopharyngeal, vagus
Describe the first phase of swallowing? Name? Voluntary/involuntary?
Oral/ preparatory phase, voluntary
Make bolus, transit- compressed against palate and pushed into oropharynx by tongue and soft palate
Describe the second phase of swallowing? Name? Voluntary/involuntary?
Pharyngeal phase, involuntary
- Tongue pushed against hard palate (food cant reenter)
- Soft palate elevates sealing of nasopharynx (tensor and levator palatini), ET open
- suprahyoid and longitudinal muscles shorten- pharynx widens, larynx elevates so sealed off m vocal cords
- Epiglottis closes over larynx
- Bolus moves through pharynx by sequential contraction of constrictors
- UOS relaxed
Describe the third phase of swallowing? Name? Voluntary/involuntary?
Oesophageal, involuntary
Upper oesophagus striated, middle striated and SM, lower SM
LOS relaxes etc
What are 4 causes of dysphagia?
Stroke (aspiration pneumonia),
progression neuro disease e.g PD, MS,
COPD,
dementia
State 5 symptoms of dysphagia?
Drooling (sialorrhea), Coughing and choking, Recurrent pneumonia, Changes in voice/speech- wet voice, Nasal regurg
