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CVR anatomy > The Pharynx And Larynx > Flashcards

The Pharynx And Larynx Flashcards

1
Q

What is the pharynx

A

Muscular tube which lies in the neck
Forms part of respiratory and gastrointestinal systems

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2
Q

Structure of walls of pharynx

A

Outer layer of circular muscle and inner layer of longitudinal muscle

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3
Q

Pharynx external circular muscle layer

A

Composed of 3 constrictor muscles- superior, middle and inferior constrictors- that overlap
Contract superior to inferior so that swallowed food moves down pharynx to oesophagus

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4
Q

Process of swallowing

A

Food in oral cavity pushed into oropharynx by tongue
Soft palate rises and closes off Nasopharynx from oropharynx
Food enters laryngopharynx and constriction of muscles of pharyngeal wall move food into oesophagus
Epiglottis closes off laryngeal inlet and prevents food/liquid entering larynx

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5
Q

3 parts of pharynx and locations

A

Nasopharynx- posterior to nasal cavity
Oropharynx- posterior to oral cavity
Laryngopharynx- posterior to larynx

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6
Q

Tonsils

A

Collections of lymphoid tissue in upper parts of pharynx

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7
Q

4 types of tonsils

A

Pharyngeal
Tubal
Palatine
Lingual

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8
Q

Location of pharyngeal tonsil (x1)

A

Lies in roof of Nasopharynx

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9
Q

Location of tubal tonsils (x2)

A

Surrounds opening of the auditory tube which connects Nasopharynx to middle ear

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10
Q

Location of palatine tonsils (x2)

A

Lies next to pharyngeal wall in oropharynx

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11
Q

Location of lingual tonsil (x1)

A

Collection of lymphoid tissue on posterior aspect of tongue

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12
Q

Sensory Innervation of pharynx

A

Glossopharyngeal nerve

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13
Q

Motor Innervation of pharynx

A

Vagus nerve- coordinates contraction of the pharyngeal muscles and soft palate

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14
Q

Which nerves lie close to the posterior pharyngeal wall

A

Cervical part of sympathetic trunk and superior cervical ganglion
Superior laryngeal nerve (passes between inferior and middle constrictors of the pharynx to the larynx)
Hypoglossal nerve
Glossopharyngeal nerve

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15
Q

Number of laryngeal cartilages

A

9
3 paired
3 unpaired

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16
Q

3 unpaired laryngeal cartilages

A

Epiglottis
Thyroid cartilage
Cricoid cartilage

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17
Q

3 paired laryngeal cartilages

A

Arytenoids
Cuneiforms
Corniculate

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18
Q

Thyroid cartilage of larynx

A

Composed of 2 flat cartilages (laminae) that meet in anterior midline to form laryngeal prominence
Laminae form extensions that project superiorly and inferiorly- superior and inferior horns

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19
Q

What does the superior horn attach to

A

Hyoid bone

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20
Q

What do the inferior horns articulate with

A

Cricoid cartilage below

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21
Q

Cricothyroid membrane

A

Connects inferior border of thyroid and superior border of cricoid
Membrane is pierced to create an emergency airway

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22
Q

Epiglottis

A

Attached to superior aspect of thyroid cartilage, where 2 thyroid laminae meet
During swallowing, epiglottis covers entrance to larynx (laryngeal inlet)

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23
Q

Arytenoids

A

Sit on superior surface of cricoid cartilage- articulate at small joints
Small
Movement of Arytenoids move the vocal cords

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24
Q

2 pairs of folds that project into laryngeal cavity

A

Vestibular folds (false vocal cords) superiorly
Vocal folds (true vocal cords) inferiorly
Narrow space separates them

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25
Q

Vestibular folds

A

Folds of mucous membrane that lie superior to vocal folds
Provide protection to larynx

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26
Q

Vocal folds

A

Folds of mucous membrane that cover and protect the vocal ligaments

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27
Q

Vocal ligaments

A

Attached anteriorly to internal aspect of laryngeal prominence and posteriorly to Arytenoid cartilages

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28
Q

Laryngeal prominence

A

Point where 2 thyroid laminae cartilages meet

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29
Q

Rims glottidis

A

Space between true vocal cords

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30
Q

Adduction of true vocal cords

A

Closes the rima glottidis

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31
Q

Abduction of the true vocal cords

A

Opens the rima glottidis

32
Q

Phonation requires

A

Adduction of the cords and closure of the rima glottidis

33
Q

Abduction of the cords opens the rima glottidis when:

A

To a small degree in Whispering
Partially in normal breathing
Fully in forced breathing

34
Q

Intrinsic laryngeal muscles

A

Move the laryngeal cartilages and hence the vocal cords

35
Q

Left and right cricothyroid muscles

A

Anteriorly between thyroid and cricoid cartilages
Contraction places tension on vocal chords

36
Q

Left and right posterior cricoarytenoids

A

On posterior surface of cricoid
Each attached to the ipsilateral Arytenoid
Abduct the vocal chords and opens the rima glottidis

37
Q

Transverse Arytenoid

A

Unpaired muscle on posterior aspect of larynx which connects the 2 Arytenoid cartilages
Muscles adduct the vocal folds and close the rima glottidis

38
Q

Extrinsic laryngeal muscles

A

Suprahyoid and infrahyoid muscles
Move larynx as one with speech and swallowing

39
Q

Superior laryngeal nerve

A

Innervates cricothyroid muscles and is sensory to larynx above the vocal folds
Branch of vagus nerve

40
Q

Recurrent laryngeal nerve

A

Innervates all the intrinsic muscles (except the cricothyroid muscle) and is sensory to larynx below the vocal folds
Branch of vagus nerve

41
Q

Surface anatomy of neck

A

• hyoid bone inferior to the mandible
• thyroid cartilage in the midline of the neck (the ‘Adam’s apple’)
• cricoid cartilage in the midline, inferior to the thyroid cartilage
• first tracheal cartilage inferior to the cricoid cartilage
• cricothyroid membrane between the thyroid cartilage and cricoid cartilage – this can be punctured to create an emergency airway
• lobes of the thyroid gland either side of the upper trachea and inferior larynx
• carotid pulse – best palpated just anterior to sternocleidomastoid at the level of the thyroid cartilage.

42
Q

Waldeyer’s ring

A

Ringed arrangement of tonsils

43
Q

Location of pharynx

A

Begins at base of skull and ends at inferior border of cricoid cartilage (C6)

44
Q

Nasopharynx

A

continuous with the nasal cavity and performs a respiratory function by conditioning inspired air and propagating it into the larynx.

This part of the pharynx is lined with respiratory epithelium; ciliated pseudostratified columnar epithelium with goblet cells.

The posterosuperior nasopharynx contains the adenoid tonsils, which enlarge between 3-8 years of age and then regress.

45
Q

Oropharynx

A

involved in the voluntary and involuntary phases of swallowing

It contains the following structures:

Posterior one-third of the tongue.
Lingual tonsils – lymphoid tissue at the base of the tongue.
Palatine tonsils – lymphoid tissue located in the tonsillar fossa (between the palatoglossal and palatopharyngeal arches of the oral cavity).
Superior constrictor muscle

46
Q

Laryngopharynx

A

continuous inferiorly with the oesophagus.

It is found posterior to the larynx and communicates with it via the laryngeal inlet, lateral to which one can find the piriform fossae.

The laryngopharynx contains the middle and inferior pharyngeal constrictors.

47
Q

Pharyngeal plexus

A

Pharyngeal branches from the glossopharyngeal nerve (CN IX).
Pharyngeal branch of the vagus nerve (CN X).
Branches from the external laryngeal nerve.
Sympathetic fibres from the superior cervical ganglion.

48
Q

Arterial supply to pharynx

A

branches of the external carotid artery:

Ascending pharyngeal artery
Branches of the facial artery
Branches of the lingual and maxillary arteries.

49
Q

Venous drainage of pharynx

A

pharyngeal venous plexus, which drains into the internal jugular vein.

50
Q

Location of larynx

A

located in the anterior compartment of the neck, suspended from the hyoid bone, and spanning between C3 and C6.

51
Q

Arterial supply to larynx

A

Superior laryngeal artery – a branch of the superior thyroid artery (derived from the external carotid). It follows the internal branch of the superior laryngeal nerve into the larynx.
Inferior laryngeal artery – a branch of the inferior thyroid artery (derived from the thyrocervical trunk). It follows the recurrent laryngeal nerve into the larynx.

52
Q

Venous drainage of larynx

A

superior and inferior laryngeal veins.
The superior laryngeal vein drains to the internal jugular vein via the superior thyroid, whereas the inferior laryngeal vein drains to the left brachiocephalic vein via the inferior thyroid vein.

53
Q

Reinke’s space

A

watery, amorphous layer in vocal folds rich in glycosaminoglycans. Due to its fluidity, the epithelium is able to vibrate freely above it to create sound.

54
Q

Role of hard palate

A

Helps break down food
separating the oral cavity from the nasal and sinus cavities, thus allowing proper phonation and articulation, as well as breathing and chewing

55
Q

Soft palate

A

serves to elevate the nasopharynx, effectively closing the communication from the oropharynx to the nasopharynx. The soft palate is comprised of five muscles that play essential roles in breathing, phonation, and swallowing.

56
Q

Uvula

A

(Dangling bit at back of throat attached to soft palate)
secrete saliva to moisten your mouth and throat. But it also aids in eating and drinking

57
Q

Adenoid tonsils

A

posterosuperior nasopharynx contains the adenoid tonsils, which enlarge between 3-8 years of age and then regress.

58
Q

Waldeyer’s ring

A

ring of lymphoid tissue in the naso- and oropharynx formed by the paired palatine tonsils, the adenoid tonsils and lingual tonsil

59
Q

Causes of abnormal swallowing

A

Stroke
Cerebral palsy
Parkinson’s disease

60
Q

Treatment for difficulty swallowing

A

Speech and language therapy (SALT)
NG tube
Thickeners to food
Advice to chew food more thoroughly, take smaller bites etc

61
Q

Cricothyroid membrane

A

Connects lower border of thyroid cartilage with upper border of cricoid cartilage in midline

62
Q

Laryngoscope

A

a thin tube with a light, lens and a video camera that helps providers look closely at your larynx

63
Q

Vallecula

A

important reference landmark used during intubation of the trachea.

curved laryngoscope tip is placed in the vallecula, exerting upward and forward force on the hyoepiglottic ligament to elevate the epiglottis

epiglottic vallecula is a depression just behind the root of the tongue between the medial and lateral glosso-epiglottic folds in the throat. These depressions serve as “spit traps”; saliva is temporarily held in the valleculae to prevent initiation of the swallowing reflex.

64
Q

posterior cricoarytenoid muscles

A

sole abductors of the vocal folds, and thus the only muscle capable of widening the rima glottidis.

Attachments: Originates from the posterior surface of the cricoid cartilage and attaches to the muscular process of the arytenoid cartilage.
Actions: Abduction of the vocal folds.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).

65
Q

lateral cricoarytenoid muscles

A

major adductors of the vocal folds. They narrow the rima glottidis, modulating the tone and volume of speech.

Attachments: Originates from the arch of the cricoid cartilage and attaches to the muscular process of the arytenoid cartilage.
Actions: Adduction of the vocal folds.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).

66
Q

transverse and oblique arytenoids muscles

A

adduct the arytenoid cartilages, closing the posterior portion of rima glottidis. This narrows the laryngeal inlet.

Attachments: Spans from one arytenoid cartilage to the opposite arytenoid.
Actions: Adduction of the arytenoid cartilages.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).

67
Q

Which muscle abduct the cords and opens the rims glottidis

A

Posterior cricoarytenoids

68
Q

Which muscle adducts the vocal chords and closes the Roma glottidis

A

Transverse arytenoid

69
Q

Contraction of the cricothyroid results in…

A

Contraction of cricothyroid lengthens the cords and places tension on them.

70
Q

Sensory nerve supply to larynx

A

Internal laryngeal nerve = above vocal cords
Recurrent laryngeal nerve = below vocal cords

71
Q

Motor nerve supply to the lungs

A

Superior laryngeal nerve = cricothyroid muscle
Recurrent laryngeal nerve - all other muscles

72
Q

What are the recurrent and superior laryngeal nerves branches from

A

Vagus nerve

73
Q

What is the internal laryngeal nerve a branch from

A

Superior laryngeal nerve

74
Q

Angle of laryngeal prominence in men

A

90 degrees

75
Q

Angle of laryngeal prominence in women

A

120 degrees

76
Q

Which nerve supplies the cricothyroid muscle

A

External branch of superior laryngeal nerve

CVR anatomy (13 decks)

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