Theme 6 Flashcards
Pharynx and Larynx
The Pharyngeal Wall
- Use
- What are the layers of the pharyngeal wall?
- Common passageway for food & air
- There are 4 layers:
Areolar: external fascial containing the pharyngeal plexus (of veins & nerves)
Muscular: 5 paired muscles
- Circular & Longitudinal
- Superior, middle & inferior constrictors - allowing swallowing. Innervated by CNX
- Stylopharyngeus & Palatopharyngeus
Submucous
Muscosa
Semi-Circular Constrictor Muscles of the Pharynx
- Function
- Muscles
- Innvervation
- Swallowing
- All the muscles, posteriorly attach to the Pharyngeal Raphe
(which is attached to the pharyngeal tubercle)
Superior Constrictor:
Anterior attachments: Pterygomandibular Raphe, Post. border of Medial Pterygoid plate & posterior part of the mylohyoid line
Middle Constrictor: Between both horns of hyoid bone - overlapping the S.C muscle above
Inferior Constrictor: has 2 parts. Originate from Thyroid & Circoid
- Thyropharyngeal: from thyroid cartilage oblique line
- Cricopharyngeus: always closed (due to cricopharyngeus sphincter) relaxes during swallowing
- CNX
What are the three regions that compose the Interior of Pharynx?
- Nasopharynx
- Oropharynx
- Laryngopharynx
Nasopharynx
- Where is it located?
- Where is the opening located?
- What structures are located within it?
- Superior portion of the pharynx found above the soft palate
- Opening of auditory tube is located in the lateral wall, posterior & inferior to the inferior nasal concha
3.
Salpingopharyngeal Fold: Small, mucous covered muscle; part of palatopharyngeus a
Pharyngeal Recess: a cleft between the salpingopharyngeal wall & posterior wall of the pharynx
Pharyngeal tonsils
Oropharynx
- Where is it located?
- What does it contain?
- located beneath the soft palate
2.
- Palatopharyngeal arch
- Palatopharyngeal fold
- Palatoglossal fold/arch
- Palatine tonsils - found between the arches
Laryngopharynx
What structures are found within?
What is the function of these structures?
Epiglottis: covers laryngeal inlet
Vallecula: gap between the epiglottis & tongue where things can fall.
- Bounded by Lat. & Median glossoepiglottic folds
Periform Excess: directs food & water from the lateral channels into esophagus
Longitudinal Muscles of the Pharynx
- Function
- Innervation
Palatopharyngeus - CNXI
- From soft palate to pharynx wall, Hyoid & Thyroid cartilages
Stylopharyngeus IX
Function: act to raise Pharynx & Larynx during swallowing (as do the suprahyoids)
Innervation of the Pharynx
Motor:
All by Pharyngeal branch of CNX BUT
Stylopharyngeus is CNIX & Palatopharyngeaus is CNXI travelling with CNX
Sensory:
CNIX: around mucosa
CNV2: soft palate & pharyngeal roof
CNX: around the laryngeal inlet
Blood Supply of the Pharynx
- Ascending Pharyngeal Artery
- Superior Thyroid Artery
- Inferior Thyroid Artery
Venous drainage of the Pharynx
Pharyngeal venous plexus into internal jugular vein
Muscles of the Soft Palate
- What are they?
- What are their functions?
Levator Veli Palatini: Elevates soft palate
- Opening of the pharyngotympanic tube into the palatine aponeurosis (Soft palate)
Tensor Veli Palatini: Elevates soft palate
- via the medial pterygoid & Hamulus
Palatopharyngeus: Raises pharynx & larynx in swallowing
- Longitudinal pharynx muscle
- Forms palatopharyngeal arch after attachment with Hyoid & Thyroid cartilage
Palatoglossus: raises tongue & lowers soft palate
- From palatoglossal fold to the side of the tongue = palatoglossal arch
Innervation of the Soft Palate
Sensory:
Soft palate = Lesser Palatine
Motor:
Muscles = Pharyngeal plexus
Tensor Veli Palatini = CNV3
Laryngeal Cartilages
Unpaired
C3-C4 level: under Adams apple
- Epiglottis
- Cricoid cartilage
- Thyroid cartilage
Paired
- Arytenoid
- Sits on posterior cricoid bt facet on its
- Leans against the posterior wall of thyroid
- Corniculate
- Elastic
- Cuneiform
- Elastic
- Thickenings within the quadrangular membrane
What are the Extrinsic & Intrinsic Laryngeal Membranes?
Extrinsic:
- Cricotracheal
- Thyrohyoid
Intrinsic:
- Conus elasticus (cricothyroid)
- Quadrangular (aryepiglottic)
Cricothyroid Joint
- What type of joint is it?
- Where is it located?
- How does it function?
- Synovial: has a capsule
2.
- Inferior cornu of thyroid cartilage
- Facet on cricoid cartilage
3.
- Rotation about an axis between the two inferior cornuae & some gliding
- Lengthen & shorten vocal folds
Cricoartenoid Joint
- What type of joint is it?
- Where is it located?
- How does it function?
- Synovial
2.
- Facet on base of arytenoid
- Face on shoulder of cricoid
- Oval/concave/convex facet
- Cricoarytenoid ligaments & oblique line is part of this joint
3.
- Rocking & sliding
- Open & close vocal folds (abduction & adduction)
How is the Laryngeal Inlet controlled?
Aryepiglottic: contracts to close the inlet by drawing down the epiglottis
Thyroepiglottic: closes inlet
How are the Vocal Folds controlled?
Posterior cricoarytenoid (abduction)
- Inferiorly attached to post. Aspect of the lamina of the cricoid fossa
- Superiorly attached to the muscular process of the arytenoid cartilage
Lateral cricoarytenoid (adduction)
Interarytenoid (adduction)
How is it lengthened & shortened?
Cricothyroid (lengthen)
- Contained numerous glands that secrete mucous and protect true vocal folds by keeping them moist
Thyroarytenoid (shorten)
Motor Innervation of Larynx
Two nerves, branches of vagus nerve
Recurrent Laryngeal:
- Motor to all intrinsic muscles apart from cricothyroid
External Laryngeal (of superior laryngeal)
- Cricothyroid muscle
Sensory Innervation of Larynx
Important in protective reflexes & voice production
Recurrent laryngeal: - below the vocal fold
To the mucous membrane covered true vocal folds and infraglottic cavity below vocal folds
- Right: turns & passes under the right subclavian artery
- Left: turns & passes under & around the aortic arch and then runs upwards
Internal Laryngeal: - above vocal folds
To the mucous membrane of the cavity of the larynx above the true vocal folds
What are the different cavities found in the larynx?
Vestibule: supraglottic
- Pits at the back of Epiglottis
- Above true & false vocal folds
Ventricle: Laryngeal sinus
- Keeps vocal cords moist
- Sit between ventricular and vocal ligaments
- Lies between true & false vocal folds
Infraglottic:
- A comparement of the larnyx
- Lies below the true vocal folds
Functions of the Larynx
- Ventilatory when fully open - Inspiration & expiration
- Phonatory when Half open
- Voice production
- Articulation
- Sphincteric when fully closed
- Protection from swallowing
- Fixation in thorax
- Regulation of abdominal pressure
- Ingestion of foreign bodies
Phonation
- What is Phonation?
- How does Phonation occur?
- What is the role of Arytenoids?
- Voice Production
2.
- Vocal folds adducted during expiration
- Pressure Rises
- Vocal fold abduct & air is released
- Vocal folds adduct & cycle repeats
3.
Rotation of arytenoids open and closes vocal cord
- Normal breathing: vocal opening is diamond shape
- Forced respiration: vocal opening widens
- Phonation: vocal opening is closed
