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Y2 ENT > Throat Anatomy > Flashcards

Throat Anatomy Flashcards

1
Q

what is the posterior boundary of the oral cavity

A

oropharynx

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2
Q

what is the superior border of the oral cavity

A

hard palate and soft palate

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3
Q

what is the anterior border of the oral cavity

A

upper and lower teeth

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4
Q

what is the inferior border of the oral cavity

A

floor of mouth/tongue

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5
Q

what muscles are the muscles of the floor of the mouth

A

mylohyoid, geniohyoid, anterior belly of digastric

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6
Q

what is the anterior surface of the tongue

A

ventral surface; when lifting tongue up

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7
Q

what surface anatomy can be seen on the floor of the mouth

A

sublingual papillae, lingual vein, L/R sublingual folds, frenulum

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8
Q

what are the sublingual papillae

A

opening of submandibular salivary glands ducts

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9
Q

what causes a tongue tie

A

frenulum too short; binds tongue to gingivae of lower incisors

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10
Q

name the major salivary gland pairs

A

parotid, submandibular, sublingual

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11
Q

what type of salivary glands are responsible for basal secretions

A

minor salivary glands

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12
Q

where are the minor salivary glands

A

oral mucosa of lips, cheeks, palate

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13
Q

where is the parotid gland

A

anterior/inferior to ear

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14
Q

is the parotid gland normally palpable

A

no

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15
Q

where is the submandibular gland

A

inferior to mandible

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16
Q

is the submandibular gland normally palpable

A

yes

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17
Q

where is the sublingual gland

A

under floor of mouth

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18
Q

is the sublingual gland normally palpable

A

no

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19
Q

what is the supply to the parotid gland

A

parasympathetic secretomotor CNIX

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20
Q

what is the supply to the submandibular gland

A

chorda tympani parasympathetic secretomotor supply

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21
Q

what is the supply to the sublingual gland

A

chorda tympani CNVII supply

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22
Q

where is the duct of the parotid gland

A

crosses masseter, pierces buccinator to open on parotid papillae of buccal mucosa

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23
Q

where is the duct of the submandibular gland

A

opens on sublingual papillae

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24
Q

where is the duct of the sublingual gland

A

opens on sublingual fold

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25
Q

what type of muscle is the tongue made of

A

skeletal

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26
Q

what is the sensory supply to the anterior 2/3 of the tongue

A

sensory CNV3, special sensory CNVII chorda tympani

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27
Q

what is the sensory supply to the posterior tongue

A

CNIX

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28
Q

what parts of the tongue are located within the oral cavity

A

only anterior 2/3

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29
Q

where is the foramen ceacum

A

midline depression at apex of terminal groove of tongue

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30
Q

what is the embryological significance of the foramen caecum

A

origin of thyroid gland

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31
Q

what type of mucosa are on the tongue

A

lingual mucosa

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32
Q

what is the function of the vallate papillae

A

taste buds

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33
Q

name the papillae of the tongue

A

vallate, foliate, fungiform, filiform

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34
Q

what are the possible embryological abnormalities of the thyroid gland

A

thyroglossal duct cysts or ectopic location

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35
Q

where are thyroglossal duct cysts

A

anywhere on path of descent from foramen caecum to thyroid

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36
Q

how can you tell if a lump in the neck is part of the thyroid

A

thyroid lumps move with the larynx on swallowing

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37
Q

whats the difference between extrinsic and intrinsic tongue muscles

A

intrinsic are within the tongue

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38
Q

what is the function of the extrinsic tongue muscles

A

change tongue position

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39
Q

name the extrinsic tongue muscles and where they originate

A

palatoglossus (palate), styloglossus (styloid process), hyoglossus (hyoid), genioglossus (mandible)

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40
Q

what is the function of the intrinsic tongue muscles

A

change tongue shape

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41
Q

where does CNXII attach to the CNS

A

rootlets at medulla oblongata

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42
Q

what is the intracranial path of CNXII

A

anteriorly towards hypoglossal canal

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43
Q

which bone is the hypoglossal canal a part of

A

occipital bone

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44
Q

what is the extracranial path of CNXII

A

descends lateral to carotid sheath, at hyoid level passed anteriorly to lateral tongue

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45
Q

what is the arterial supply to the tounge

A

lingual artery from external carotid

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46
Q

where is CNXII in relation to the loop of the lingual artery

A

lateral

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47
Q

how to clinically test CNXII

A

ask patient to stick tongue straight out

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48
Q

what will unilateral CNXII damage cause when testing CNXII

A

tip points toward damaged side

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49
Q

where is the palatine tonsil

A

in tonsillar fossa (space between arches of soft palate)

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50
Q

what are the arches of the soft palate formed of

A

skeletal muscle covered in mucosa

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51
Q

what structure is the uvula a part of

A

soft palate

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52
Q

what is the management of an injury to the vermillion border

A

refer to plastic surgeon

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53
Q

what bones form the hard palate

A

maxillae, palatine and sphenoid

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54
Q

what structure runs in the midline of the hard palate

A

median palatine suture

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55
Q

what parts of the sphenoid contribute to the hard palte

A

lateral & medial pterygoid plates

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56
Q

what foraminae are seen on the hard palate

A

palatine foraminae and incisive foramen

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57
Q

what runs though the palatine foraminae

A

CNV2 branches & vessels

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58
Q

what is seen on surface anatomy of the hard palate

A

palatal rugae and duct openings of the palatine glands

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59
Q

what bone is the pterygoid hamulus a part of

A

sphenoid

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60
Q

what are the 5 muscle pairs of the soft palate

A

levator veli palatine, tensor veli palatini, palatoglottus, palatopharyngeus, musculus uvulae

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61
Q

what is the function of tensor veli palatini

A

tenses soft palate

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62
Q

what is the function of levator veli palatini

A

lifts soft palate towards base of skull

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63
Q

what is the innervation of the soft palate skeletal muscles

A

all CNX except tensor veli palatini (CNV3)

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64
Q

3 functions of the soft palate

A

stops food going in nose when swallowing, directs air in nose, closes orophaynx entrance in gag reflex

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65
Q

how to test the motor function of soft palate

A

ask patient to say ‘ahhh’

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66
Q

what is an normal result when testing the motor function of the soft palate

A

uvula should lift straight up in midline

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67
Q

what is an abnormal result when testing the motor function of the soft palate

A

in unilateral nerve damage uvula pulled away from non-functioning side

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68
Q

describe the external layer of the pharynx

A

circular constrictor voluntary muscles overlapping each other

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69
Q

what is the innervation of the external constrictor muscles of the pharynx

A

CVX pharyngeal plexus

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70
Q

what are the names of the external constrictor muscles of the pharynx

A

superior, middle and inferior constrictor muscles of the pharynx

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71
Q

where do the constrictor muscles of the pharynx insert

A

onto the midline raphe

and onto pharyngeal tubercle of occipital bone

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72
Q

what is cricopharyngeus

A

upper oesophageal sphincter

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73
Q

what vertebral level is circopharyngeus

A

C6

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74
Q

name the longitudinal muscles of the pharynx and where do they originate

A

stylopharyngeus (styloid process), palatopharyngeus (palate), salpinogopharyngeus (pharyngotympanic tube cartilage)

75
Q

where do the longitudinal muscles of the pharynx insert

A

thyroid cartilage posterior border

76
Q

what is the innervation of the longitudinal muscles of the pharynx

A

all CNX except stylopharyngeus (CNIX)

77
Q

what is the function of the longitudinal muscles of the pharynx

A

elevate pharynx & larynx

78
Q

what is a tonsil

A

mucosal site of lymphoid tissue

79
Q

name the tonsil of the nasopharynx and oropharynx

A

palatine tonsil, pharyngeal tonsil, tubal tonsils, lingual tonsil,
(also palate associated lymphoid tissue)

80
Q

where are the tubal tonsils

A

in mucosa of eustachian tube opening

81
Q

where is the pharyngeal tonsil

A

in mucosa of roof of nasopharynx

82
Q

where is the lingual tonsil

A

in mucosa on posterior 1/3 of tongue

83
Q

what is Waldeyer’s ring

A

defensive ring of lymphoid tissue in pharynx

84
Q

define regional node

A

group of LN that 1st receive lymph drained from a given structure

85
Q

where are the retropharyngeal nodes

A

in the retropharyngeal space

86
Q

where are the submental nodes

A

posterior to the mental process of the mandible

87
Q

where are the submandibular nodes

A

superficial to the submandibular gland

88
Q

where are the deep cervical nodes

A

in the carotid sheath

89
Q

what node drains the palatine tonsil

A

jugulo-digastric node

90
Q

what are the region of nodes for the tip of the tongue

A

submental nodes

91
Q

where do all nodes of the head/neck eventually drain to

A

deep cervical LN

92
Q

what is the clinical difference between a lymph node in infection and a lymph node in cancer

A

infection: pain, soft, smooth, not fixed
cancer: no pain, hard, irregular, fixed

93
Q

what is the function of the larynx

A

regulates airflow & protects against aspiration

94
Q

where is the larynx located

A

between pharynx & trachea in the visceral layer of the pretracheal fascia in the neck

95
Q

name the fascia compartments of the neck

A

retropharyngel space, pretrcheal fascia, carotid sheath, investing fascia, prevertebral fascia

96
Q

what are the content of the pretracheal fascia

A

strap muscles, thyroid, trachea, larynx, oesophagus, pharynx, recurrent laryngeal nerves

97
Q

what are the strap muscles

A

infrahyoid muscles (could go into more detail here?)

98
Q

what is the function of the strap muscles

A

accessory muscles of breathing

99
Q

where is the pretrachial fascia in relation to the investing fascia

A

deep

100
Q

what type of fascia are the fascia compartments of the neck

A

deep fascia

101
Q

where is the larynx in relation to the laryngopharynx

A

anterior

102
Q

what is the laryngopharynx

A

region of pharynx from epiglottis to oesophagus

103
Q

what vertebral level is the larynx

A

between C4-C6

104
Q

what vertebral level is the hyoid bone

A

C3

105
Q

what vertebral level are the tracheal cartilages

A

C2-4

106
Q

what are the carotid sheath contents

A

internal jugular vein, common carotid artery, vagus nerve, deep cervical lymph nodes

107
Q

is the spinous process of T1 normally palpable

A

yes

108
Q

is the spinous process of C7 normally palpable

A

yes

109
Q

is the spinous process of C6 normally palpable

A

no

110
Q

are the transverse processes of cervical vertebrae normally palpable

A

yes

111
Q

what parts of the mandible are palpable

A

angle of the mandible, lower border of the mandible, mental process of the mandible

112
Q

is the hyoid bone normally palpable

A

yes

113
Q

what is the laryngeal inlet

A

opening into airway from mouth

114
Q

what direction does the epiglottis move to reduce the risk of aspiration when the laryngeal inlet closes

A

posteriorly

115
Q

where is the thyrohyoid membrane

A

vertical fibres between hyoid bone and superior border of thyroid cartilage

116
Q

what is the adam’s apple

A

Laryngeal prominence of the thyroid cartilage

117
Q

what shape is the 1st tracheal ring

A

C shaped

118
Q

what is the cricothyroid joint

A

joint between cricoid cartilage and inferior horn of the thyroid cartilage

119
Q

what is the epiglottis made of

A

elastic cartilage

120
Q

name the processes of the arytenoid cartilages

A

vocal process and muscular process

121
Q

where and how do the arytenoid cartilages attach

A

to the cricoid cartilage via the cricoarytenoid joint

122
Q

what are the cartilages that make up the laryngeal cartilages

A

thyroid cartilage, cricoid cartilage, arytenoid cartilages

123
Q

what is compressed in cricoid pressure

A

pressing on lamina of cricoid cartilage compresses the oesophagus against the C6 body

124
Q

what is the benefit of cricoid pressure

A

oesophagus closed but airway open to allow ventilation but prevent prevent aspiration

125
Q

what is the other name for the laryngeal inlet

A

aditus

126
Q

where is the false vocal cord in relation to the true vocal fold

A

superior

127
Q

what structure separates the true and false vocal fold

A

laryngeal ventricle

128
Q

what part of the larynx is inferior to the true vocal cord

A

infra-glottic cavity

129
Q

what part of the larynx is superior to the false vocal cord

A

laryngeal vestibule

130
Q

what is the difference between a vocal cord and a vocal fold

A

become cords when covered in connective tissue

131
Q

where do the false vocal cords attach

A

arytenoid cartilage to epiglottis

132
Q

where do the true vocal cords attach

A

arytenoid cartilage to thyroid cartilage

133
Q

what is the difference in the function of the true and false vocal cords

A

only the movement of the true vocal cords impacts sound

134
Q

where is the quadrangular membrane

A

between vestibular ligament and epiglottis

135
Q

where is the conus elasticus

A

between cricoid and vocal ligament

136
Q

where is the vestibular ligament

A

free lower border of quadrangular membrane

137
Q

where is the vocal ligament

A

free upper border of conus elasticus

138
Q

where is a laryngoscope placed

A

vallecula

139
Q

where is the vallecula

A

space between epiglottis and tongue

140
Q

what is the rima glottidis

A

space between the true vocal cords

141
Q

what is the aryepiglottic fold

A

superior border of quadrangular membrane

142
Q

what type of muscles are the intrinsic muscles of the larynx

A

skeletal muscle

143
Q

what is the function of the intrinsic muscles of the larynx

A

movement of the vocal cords

144
Q

how will tension of the vocal cords affect voice

A

increase pitch

145
Q

how will relaxation of the vocal cords affect voice

A

decrease pitch

146
Q

how will adduction of the vocal cords affect voice

A

quieter

147
Q

how will abduction of the vocal cords affect voice

A

louder

148
Q

what is the innervation to the intrinsic muscles of the larynx

A

all CNX

149
Q

what intrinsic muscle of the larynx tenses the vocal cords

A

cricothyroid muscles

150
Q

what ixtrinsic muscle of the larynx relaxes the vocal ligament

A

thyroarytenoid muscles

151
Q

what are the attachments of the cricothyroid muscles

A

anterolateral cricoid cartilage to inferior horn of thyroid cartilage

152
Q

action of the cricothyroid muscles

A

‘nod’ thyroid cartilage

153
Q

what are the attachments of the thyroarytenoid muscles

A

posterior thyroid to anterior arytenoid cartilage

154
Q

what intrinsic muscles of the larynx adducts the vocal ligaments

A

lateral crico-arytenoid muscles and arytenoid muscles

155
Q

what intrinsic muscle of the larynx abducts the vocal ligaments

A

posterior crico-arytenoid muscles

156
Q

what are the attachments of the lateral crico-arytenoid muscles

A

muscular process of the arytenoid to anterior cricoid cartilage

157
Q

what are the attachments of the arytenoid muscles

A

1 arytenoid cartilage to another cricoid cartilage

158
Q

what are the components of the arytenoid muscles

A

oblique band and transverse band

159
Q

what is the action of the arytenoid muscles

A

close rima glottidis

160
Q

what are the attachments of the posterior crico-arytenoid muscles

A

posterior cricoid cartilage to muscular process of arytenoid cartilage

161
Q

what is the action of the posterior crico-arytenoid muscles

A

open rima glottidis

162
Q

what happens to the intrinsic muscles of the larynx when whispering

A

Lateral crico-arytenoids

contract

163
Q

what happens to the intrinsic muscles of the larynx in phonation

A

Arytenoids contract and lateral crico-arytenoids assist

164
Q

what happens to the intrinsic muscles of the larynx in forced respiration

A

Posterior crico-arytenoids contract

165
Q

what happens to the intrinsic muscles of the larynx at rest

A

Laryngeal muscles relaxed

166
Q

which LN do supra-glottic tumours spread to

A

deep cervical nodes

167
Q

where do glottic tumours spread do

A

95% stay on the cords

168
Q

which LN to sub-glottic tumours spread do

A

paratracheal nodes

169
Q

what is subglottal pressure

A

pressure in respiratory tree inferior to larynx

170
Q

what happens in the larynx during phonation

A

when subglottal pressure threshold is reached then air crosses vocal cords causing vibration

171
Q

role of the pharynx, oral &nasal cavities in phonation

A

amplify laryngeal buzz

172
Q

nasal sounds

A

“m”, “n” or “ing”

173
Q

what is tracheo-oesophageal puncture

A

Air flow directed through oesophagus below cricopharyngeus muscle

174
Q

innervation of intrinsic muscles of the pharynx

A

all inferior laryngeal nerve apart from cricothyroid (external laryngeal)

175
Q

innervation of mucosa above the folds

A

internal laryngeal nerve

176
Q

innervation of mucosa below the folds

A

inferior laryngeal nerve

177
Q

where does left recurrent laryngeal become inferior laryngeal nerve

A

at the level of cricothyroid joint

178
Q

what are the ENT relevant branches of the vagus nerve

A

left recurrent laryngeal and superior laryngeal nerve

179
Q

what does the superior laryngeal nerve branch into

A

internal laryngeal nerve and external laryngeal nerve

180
Q

what is galen’s anastomosis

A

anastomosis between internal laryngeal nerve & inferior laryngeal nerve

181
Q

where does the recurrent laryngeal nerve branch off CNX

A

in mediastinum (left under arch of aorta)

182
Q

how to clinically test the CNX supply of the pharynx

A

get patient to swallow small sip of water and watch the larynx move

183
Q

how to clinically test the CNX supply of the larynx

A

listen for voice hoarseness and listen/watch the power of their cough

Y2 ENT (12 decks)

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