The Pharynx and Larynx Flashcards by Blake Aylesworth

Function of Pharynx

-Shared passageway for both air and food
-Provides a resonating chamber for speech sounds
-Houses tonsils, which serve immunological functions

*extends from choanae (internal nares) to C6

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Divisions of Pharynx (3)

Nasopharynx (superior portion)
Oropharynx (middle portion)
Laryngopharynx (inferior portion)

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Nasopharynx Borders

Superior: Choanae
Posterior: Vertebral bodies
Anterior/Inferior: Soft palate and Oropharynx

*Respiratory function

Key features:
-Soft palate
-Openings to eustachian tube
-Adenoid (pharyngeal tonsil)

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Soft Palate

Forms posterior roof of mouth (continuous with hard palate)

-Arch shaped muscular partition b/t nasopharynx and oropharynx

*contracts to close the nasopharynx when swallowing
“Don’t eat and talk”

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Eustachian Tube

-Narrow passage between the nasopharynx and middle ear
-Allows air exchange to equalize pressure between these areas

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Adenoid

-Patch of lymphoid tissue on the superior posterior wall
-Typically atrophies and shrinks significantly by adulthood

‘Pharyngeal tonsil’

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Oropharynx Borders

Superior: Nasopharynx
Inferior: Laryngopharynx
Posterior: Vertebral bodies
Anterior: Fauces (throat)/oral cavity

*Respiratory and digestive functions

Key Features:
-Palatine tonsils
-Lingual tonsils

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Oropharyngeal Tonsils

Patches of lymphoid tissue
-Lingual tonsils
-Palatine tonsils

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Laryngopharynx Borders

Superior: Oropharynx
Inferior: Larynx and esophagus
Posterior: Vertebral bodies

*Respiratory and digestive functions

Key Features:
-Laryngeal inlet
-Piriform fossae (recesses)

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Laryngopharynx Features

Laryngeal inlet: entrance to the larynx

Piriform fossa (recess): groove on either side of the laryngeal inlet

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Pharynx Epithelium

Nasopharynx:
-Pseudostratified ciliated columnar epithelium (respiratory epithelium)

Oropharynx and Laryngopharynx:
-Nonkeratinized stratified squamous epithelium

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Pharyngeal Muscles (3)

Outer Circular Layer:
1. Superior Constrictor (4)
2. Middle Constrictor (2)
3. Inferior Constrictor (2)

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Superior Constrictor

Location: surrounds the oropharynx

Function: constricts the upper portion of the pharynx to facilitate swallowing

*4 fibres/attachments

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Middle Constrictor

Location: surrounds the laryngopharynx

Function: constricts the middle portion of the pharynx to facilitate swallowing

*2 fibres/attachments

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Inferior Constrictor

Location: surrounds the laryngopharynx

Function: constricts the lower portion of the pharynx to facilitate swallowing
-forms the upper esophageal sphincter

*2 fibres/attachments

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Pharyngeal Muscle Attachments

Occipital bone- superior constrictor

Pharyngeal raphe- superior, middle and inferior

‘Raphe’= groove or ridge

Deep View to Superior Constrictor

Deep to superior constrictor, visible in posterior view= nasal conchae and nasal septum

Innervation of Pharyngeal Muscles

Motor: CN X (vagus)
Sensory: CN IX (glossopharyngeal)

Clinical Connection: Obstructive Sleep Apnea

Repetitive collapse/closure of pharynx during sleep, many etiologies including anatomical variations of pharynx

Uvulopalatopharyngoplasty (UPPP)= surgery to fix

Larynx

-Short passageway that connects the laryngopharynx with the trachea
-Anterior to C4-C7

Function:
-Valve to close trachea
-Voice production (via vocal cords)

Structure of Larynx

Consists of cartilage structure: *superior to inferior

Epiglottis (single)
Thyroid cartilage (single)
Arytenoid cartilage (pair)
Cricoid cartilage (single)

Superior= hyoid bone
Inferior= trachea

Epiglottis

-Leaf shaped piece of elastic cartilage
-Covered with epithelium
-“Stalk” is attached to thyroid cartilage
-“Leaf” is unattached

Function:
-Closes off larynx when swallowing (moves down and forms a lid over opening to larynx)

Thyroid Cartilage

-Largest cartilage of larynx
-Form upper and anterior walls
-2 fused plates of hyaline cartilage

Function:
Protect and support the vocal cords

*Laryngeal prominence= Adam’s Apple

Cricoid Cartilage

-Ring of hyaline cartilage
-Forms inferior wall of larynx

Function:
-Maintains airway opening

*Landmark for making an emergency airway

Arytenoid Cartilage

-Triangular pieces of mostly hyaline cartilage -Sit on cricoid cartilage Function: -Influence movement (tension and relaxation) of vocal folds

Laryngeal Ligaments (3)

Support the cartilaginous skeleton of larynx Extrinsic- attach larynx to external structures 1. Thyrohyoid membrane (medial and lateral thyrohyoid ligaments) 2. Cricotracheal ligament Intrinsic- attach cartilages within the larynx 1. Cricothyroid ligament

True and False Vocal Cords

Mucous membrane of larynx forms 2 pairs of folds: Superior= vestibular folds ("false" vocal cords) -Protects the vocal folds Inferior= vocal folds ("true" vocal cords) -Principle structure of voice production

Cavity of Larynx (5 Components)

1. Vestibule- from inlet to vestibular folds ("false cords") 2. Glottis- from vestibular folds to vocal folds ("true cords") 3. Rima glottidis- gap between vocal folds, opening to infraglottic cavity 4. Infraglottic cavity (space)- below vocal folds 5. Trachea

Action of Vocal Cords

Intrinsic laryngeal muscles attach to cartilages and vocal folds During respiration: abduct/open (allows for passage of air) During swallowing: adduct/close (to prevent food/liquid from entering) During phonation: adduct and alter tension of vocal cords

Clinical Connection: Hiccups

Hiccups are caused from the diaphragm spasming, which closes the glottis and decreases air flow

Vocal Resonance

Larynx and pharynx are resonating chambers for speech Reverberation of sound waves from vibrating vocal folds resonate in chambers and produce sound

Intrinsic Laryngeal Muscles

Act on individual components of larynx -Control shape of rima glottidis -Control length and tension of vocal folds 1. Cricothyroid 2. Thyroarytenoid 3. Posterior and lateral cricoarytenoid 4. Transverse and oblique arytenoid

Cricothyroid Muscle

Functions to stretch and tense vocal ligament Known as "singers muscle" as it alters tone of voice

Thyroarytenoid Muscle

Functions to relax vocal ligament

Posterior and Lateral Cricoarytenoid

Posterior: functions as sole ABDUCTOR of vocal folds (widens rima glottidis/pulls apart) Lateral: functions as major ADDUCTOR of vocal folds (narrows rima glottidis/pulls together)

Transverse and Oblique Arytenoid

Functions to adduct arytenoid cartilage, narrows rima glottidis to modulate tone and volume of speech Oblique= crosses Transverse= straight

Innervation of Larynx

1. Superior Laryngeal Nerve: a) Internal laryngeal nerve-> Sensory -> Above vocal cords b) External laryngeal nerve-> Motor-> Cricothyroid 2. Recurrent Laryngeal Nerve a) Sensory= below vocal cords b) Motor= all except cricothyroid