Theme 6 Anatomy Flashcards
what is the pharynx
a funnel-shaped fibromuscular tube that is a common area for air and food passages
what are the four basic layers of the pharyngeal wall (same as the rest of the gut)
areolar coat
muscular coar
submucous
mucous
what does the areolar coat cover
the exterior of pharynx
continuous with fascia over buccinator
envelopes sup constrictor
what does the muscular coat cover
semi-circular and longitudinal muscles
what does submucous coat do
anchors the pharynx to the base of the skull at a U-shaped attachment
what does the mucous coat do
coats internal aspect of the pharynx
what are the semicircular muscles
superior/middle/inferior constrictor
what are the longitudinal muscles (internal layer)
stylopharyngeus
palatopharyngeus
salpingopharyngeus
what are they types of fascia
buccopharyngeal
pharyngobasilar
what does the buccopharyngeal fascia do
forms distinct layer up to post part of the buccinator
envelopes sup pharyngeal constrictor
what are pharyngobasilar fasica attachments
pharyngeal tubercle petrous temporal bone cartilaginous part of auditory tube post border of medial ptyergoid int layer lines pharyngeal constrictors
what are the 2 inferior constrictor muscles
thyropharyngeus
cricopharyngeus
what are the 3 functional divisions of the pharynx
nasopharynx
oropharynx
laryngeal pharynx
what is contained in the nasopharynx
opening of auditory tube
salpingopharyngeal fold pharyngeal recess
what is contained in the oropharynx
palatine tonsil
palatopharyngeal fold
palatoglossal fold
what is contained in the laryngeal pharynx
piriform fossa
where may an inhaled incisor tooth lodge
in the piriform fossa, larynx or vallecula
what muscle is the palatopharyngeus joined by when it passes downwards
salpingopharyngeus
which muscle passes downwards between sup and middle constrictors
stylopharyngeus
what are the tonsils in waldeyer’s tonsillar ring
tubal
pharyngeal
palatine
lingual
what is the main innervation for the pharynx
pharyngeal plexus (contains axons from IX, X, XI) except stylopharyngues
what is the motor innervation for stylopharyngeus
CNIX
what is the main sensory supply for pharynx
CNIX
what is the sensory innervation for soft palate and pharyngeal roof
V2
what is the sensory innervation for the area around the laryngeal inlet
CNX
what is the arterial blood supply for the pharynx
inferior thyroid artery
superior thyroid artery
ascending pharyngeal artery
of what larger artery is the inf thyroid artery a branch
thyrocervical trunk
what are the veins involved in venous drainage of the pharynx
int jugular vein
pharyngeal venous plexus
what are the elevators of the soft palate
levator veli palatini
tensor veli palatini
what are the depressors of the soft palate
palatoglossal muscle
palatopharyngeus muscle
what are the function of the soft palate in swallowing
during swallowing sp raised to prevent food/liquid entering nasal cavity
soft palate closure needs to be complete during swallowing
what is the function of soft palate in speech
its position controls degree of nasalisation of sounds
soft palate closure is rare during speech
what is sensory innervation of the soft palate
lesser palatine nerve (br of V2)
what is the sensory innervation of the hard palate
greater palatine nerve
nasopalatine nerve
(br of V2)
what is the sensor innervation of palatal gingivae
1-3 nasopalatine n
4-8 greater palatine n
(br of V2)
what is the motor innervation to muscles of soft palate
pharyngeal plexus except tensor veli palitini
tensor veli is the exception, what is its motor innervation
V3
describe the clinical anatomy of the soft palate
Location of ‘vibrating line’
Importance of rugae (ridges)
Location of incisive fossa (burning mouth syndrome)
Palatal innervation
what bones is the hard palate formed by
palatine process of maxilla
horizontal plate of palatine bone
what are the key anatomical landmarks of the hard and soft palate relevant to the correct fitting of dental prosthesis
incisive fossa
rugae
vibrating line
what is the sensory supply to the hard palate
greater palatine
nasopalatine
(br of V2)
what is the vertebral level of the larynx
C3 to C6
what are the 3 function of the larynx
air passage (links pharynx to trachea sphincter (prevent food in pharynx enter air passage ) organ of phonation
is the larynx open or closed when air passes through
open
is the larynx open or closed when it acts a sphincter
closed
is the larynx open or closed when it acts as an organ of phonation
half open
what are the paired laryngeal cartilages of larynx
thyroid
epiglottis
cricoid
what are the unpaired cartilages of larynx
arytenoid
corniculate
cuneiform
what are the features of the thyroid cartilage
thyroid prominence (adams apple)
thyroid notch
sup & inf horns
oblique line
at what vertebral level is the cricoid cartilage found
C6
what features are found on the cricoid cartilage
lamina
arch
cricoid lumen
features of arytenoid cartilage
apex
vocal process
muscular process
what is the function of corniculate cartilages
extend length of apical processes
what are the extrinsic laryngeal membranes
thyrohyoid - hyoid bone to thyroid cartilage
cricotracheal- cricoid cart to 1st tracheal ring
what are the intrinsic laryngeal membranes
cricothyroid (conus elasticus)
aryepiglottic (quadrangular membrane)
what are the laryngeal cavities
supraglottic (vestibule)
ventricle
infraglottic
(correct order shown)
what are the joints formed in the larynx
cricothyroid joint
cricoarytenoid joint
what type of joints of these joints in the larynx
synovial
explain the movement and function at the cricothyroid joint
rotation and some gliding
lengthen and shorten vocal folds
explain the movement and function at the cricoarytenoid joint
rocking and sliding
open & close vocal folds
(abduct/addcut)
what does the incisive fossa/fo. transmit
nasopalatine nerve
what does the greater palatine fo. transmit
greater palatine nerve and vessels
what does the lesser palatine fo. transmit
lesser palatine nerve and vessels
what are the muscles controlling the laryngeal inlet
aryepiglottic
thyroepiglottic
what are the muscles cause adduction of the vocal folds
lateral cricoarytenoid
interarytenoid
what muscles causes abduction of the vocal folds
posterior cricoarytenoid
what muscle causes the vocal folds to lengthen
cricothyroid
what muscles cause the vocal folds to shorten
thyroarytenoid
which 2 nerves provide motor innervation to the larynx
recurrent laryngeal
external laryngeal branch of sup laryngeal
the recurrent laryngeal n is motor to all but one intrinsic muscle of the larynx, which muscle is this? what is its innervation?
cricothyroid muscle
ext laryngeal nerve
what is the sensory innervation for the vocal folds and above
internal laryngeal n
what is the sensory innervation below the vocal folds
recurrent laryngeal n
what is the true vocal fold
laryngeal landmark that separates the internal laryngeal branch of superior laryngeal nerve & the recurrent laryngeal nerve
explain the spincteric role of the larynx
ingestion of foreign bodies protective during swallowing role in protective reflexes fixation of thorax regulation of abdominal pressure (micturition, defaecation, parturition)
explain what happens in voice production- phonation
vocal folds adducted during expiration pressure rises vocal folds abduct and air is released vocal folds adduct and cycle repeats pitch and loudness can be varied
what nerve is superior laryngeal a branch of
vagus
what br does the superior laryngeal n give rise to?
internal laryngeal
external laryngeal
is the internal laryngeal n sensory or motor
sensory
is the ext laryngeal muscle sensory or motor
motor (innervates the cricothyroid)
outline the steps in the cough release after the presence of a foreign body entering the supraglottic cavity
detection by sensory receptor which is relayed to the brain
deep inspiration & vocal fold adduct (close)
increase in thoracic pressure by forceful expiration against closed vocal folds
pressure below vocal folds rises & eventually vocal folds abducted (opened)
this will dislodge the foreign body by rapid rise in air pressure
outline the events of swallowing
oral voluntary stage- bolus formed and passed to oropharynx
pharyngeal involuntary stage- bolus passes over epiglottis and through piriform fossa, while the airways are closed.
in the oesophageal stage- bolus passes through the oesophagus
what are the muscles involved in the oral phase of swallowing
intrinsic and extrinsic muscles of tongue
elevators and depressors od palate
suprahyoid muscles
what are the muscles involved in the pharyngeal phase of swallowing
pharyngeal constrictors
pharyngeal elevators
soft palate elevators
muscles of laryngeal inlet
what are the other protective reflexes (apart from coughing) during ingestion of foreign bodies or swallowing
larynx raised (supra/infra hyoid muscles) epiglottis lowered passively laryngeal inlet closed vocal folds adducted ventilation suspended
what is the basi-occiput
bone in the base of the skull immediately in front of the foramen magnum
of which bone is the basi-occiput apart of
the occipital bone
what structures are attached to the pharyngeal tubercle
pharyngeal raphe
superior constrictor
pharyngobasilar fascia
what is attached to the posterior edge of the medial pterygoid plate
superior fibres of sup constrictor inferiorly
pharyngobasilar fascia superiorly
what structure is attached to the tip of the hamulus
pterygomandibular raphe
what structure lies in the opening of the auditory tube
pharyngotympanic tube
where does the pharyngotympanic tube open in the neck
nasopharynx
what the functions of the constrictor muscles in the neck
control calibre (diameter) of the pharynx and the muscle tension in its walls are active during swallowing and speech
what is the function of the palatoglossus and palatopharyngeus
lower the soft palate
what is the function of the cricopharyngeal sphincter (part of the cricopharyngeus)
usually closed to prevent the ingestion of air into the stomach. during swallowing the sphincter opens to allow food and water to pass into the oesophagus
what lies in the margin surrounding the opening of the auditory tube
tonsillar tissue
tubular tonsil
what is the function of the salpingopharyngeal fold
it overlies the salpingopharyngeal muscle, a muscle that opens the auditory tube
what structures bound the piriform fossa
thyrohyoid membrane
thyroid cartilages
quadrangular membrane arytenoid cartilages
of what bone is the palatine process of maxilla apart of
maxilla
name the suture joining the palatine process of maxilla & horizontal plate of palatine bone
palatomaxillary suture
what are the functions of the tensor veli palitini and the levator veli palitini
palatal elevation
tensor- lifts soft palate
levator- raises the soft palate
what structures bound the vallecula
the lateral and median glossoepiglottic folds
importance of vibrating line in denture fittings
aligning the denture with vibrating line means they will not be displaced by movements of the soft palate
importance of rugae in denture fittings
complying with the rugae helps to ensure a good fit
importance of incisive fossa in denture fittings
taking care not to enroach on incisive fossa when taking impression will reduce the risk of pressure on the incisive nerve and consequent pain
at what vertebral level is thyroid cartilage found
C3-C4
of which joint is thyroid cartilage apart of
cricothyroid joint
name the muscles that attach to the oblique line
thyrohyoid
sternothyroid
thyropharyngeus
of what joint is the arytenoid cartilage apart of
cricoarytenoid joint
why is the piriform fossa important
it directs food and water from the lateral food channels into the oesophagus
foreign bodies can lodge here
what spaces does the piriform fossa communicate with superiorly and inferiorly
sup- lateral food channels
inf- with lower part of laryngopharynx and oesophagus
what features of the larynx divide the larynx into cavities
false & true vocal folds
vestibule above false vf
infraglottic below true vf
ventricle between false and true)
which vocal fold divides the larynx into territories for internal laryngeal branch of superior laryngeal nerve & the recurrent laryngeal nerve
true
what is the int laryngeal nerve sensory to
mucous membrane of cavity above the true vocal folds
what is the recurrent laryngeal sensory to
mucous membrane covering the true vocal folds and lining the infraglottic cavity below
what cartilages is the true vocal fold attached
arytenoid and thyroid
what does the true vocal fold consist of
vocal ligament and thyroarytenoid muscles centrally and a covering of the mucous membrane
what is the function of the false vocal fold
contains numerous glands that secrete mucous that protects the true vocal folds keeping them moist
what muscle opposes the action of the cricothyroid muscle
thyroarytenoid
what muscles oppose the action of the posterior cricoarytenoid muscle
lateral cricoarytenoid
oblique and transverse interarytenoid muscles
which muscle is located in the aryepiglottic fold
aryepiglottic muscle (closes the laryngeal inlet)
how does the innervation of the left and right recurrent laryngeal nerve differ
left- loops round the aorta in the thorax
right- loops around the subclavian artery in the neck
which sensory nerves might trigger a cough reflex by detecting irritation of the mucous membrane lining the appropriate parts of the airway
internal laryngeal br of vagus
recurrent laryngeal
glossopharyngeal
what is the function of the epiglottis
cover laryngeal inlet
protects larynx from foreign bodies
what are the valleculae
spaces that lie anterior to the epiglottis separating it from the base of the tongue
what is the functional role of valleculae
main site of accumulation of food/liquid immediately prior to the initiation of a swallow
high density of sensory nerve endings here triggering the onset of a swallow
how can you tell the difference between tensor veli palitini and levator veli palitini on a specimen
the one more anterior and deeper is tensor veli palitini
