Throat anatomy Flashcards
how does the posterior cricoarytenoid cause vocal cord adduction
lateral rotation of the arytenoid cartilages to cause rima glottidis closure
how does the lateral cricoarytenoid cause vocal cord abduction
medial rotation of the arytenoid cartilages to cause rima glottidis closure
describe phonation
subglottal pressure increases to cross the vocal cords and causes vibration
vocal cord tension causes
higher pitch
vocal cord relation causes
lower pitch
vocal cord adduction causes
quieter sound
vocal cord abduction causes
louder sound
innervation to intrinsic muscles of the larynx
inferior laryngeal branch of CN X
describe the route of the vagus nerve
leaves medulla as rootlets
passes htrough jugular foramen and through carotid sheath
branch to superior/inferior laryngeal nerve
gives recurrent laryngeal by passing under arch of aorta/ R subclavian
passes post to hila and becomes vagus trunk and plexus around oesophagus
what does the superior laryngeal branch of vagus supply
external is innervation to cricothyroid
internal is sensory innervation to internal larynx
what is galens anastomosis
connection between superior and inferior laryngeal nerves
what is the sensory supply to the larynx
mucosa above cords is by internal superior laryngeal
mucosa below is by inferior laryngeal
what muscle of the larynx is NOT supplied by inferior laryngeal nerve
cricothyroid, innervated by superior laryngeal
describe the involuntary cough reflex
sensory innervation detects something in larynx
conveyed to brainstem and glottic closure by lateral cricothyroid and arytenoid
increase in body cavity pressure by thoracic muscles and release of high pressure air
clinical test of the pharynx
ask pt to sip water
clinical test of the larynx
ask pt to speak
clinical test of cough
ask pt to cough and assess power and function
what lymph nodes would a supra glottic tumour drain to
superior deep cervical
what lymph nodes would a glottic tumour spread to
stays on cords
what lymph nodes would a sub-glottic tumour drain to
paratracheal
what affects speech resonance?
pharynx, oral and nasal cavities
paranasal sinuses
what causes articulation
soft palate tenses by V3 and elevates by X ro direct air through oral cavity
sound interrupted by tongue and teeth
function on nasal cavities in speech
making M, N, -ing
depending on position of tongue, teeth and lips
course of CN IX
leaves CNS at upper medulla and passes through jugular foramen
enters paraphaeyngeal space and lays on stylophaeyngeus
somatic motor to stylopharyngeus and enters mouth laterally
following mouth innervation, CN IX has parasympathetic innervation. describe the course
passes through jugular foramen and gives off tympanic branch to reenter temporal bone
supplies tympanic plexus and exits as lesser petrosal nerve via foramen ovale to synapse with otic ganglion with auriculotemporal nerve of CN V3
chemo and barorecepts of carotid body travel via
CN IX
glossopharyngeal supply to the tongue?
vallate papillae and post 1/3 tongue
3 phases of swallow
oral phase
pharyngeal phase
oesophageal phase
what occurs during the oral phase of swallow
mastication of food and mix with saliva
intrinsic/extrinsic muscles malipulate food bolus and align with dentition/push against palate
soft palate depresses to crease oropharyngeal seal and tongue ripples bolus posterior
sensory/secretomotor innervation to the hard palate?
CN V2 and facial
greater palatine nerve
incisive branch of nasopalatine for hard palate on ant 4 incisors
sensory supply to the soft palate
lesser palatine nerve
also motor to tensor veli palatini
describe the course of CN XII and its innervation
extends from medulla and passes through hypoglossal canal
descends close to carotid shealth and courses lateral to hyoglossus into floor of mouth
supplies all muscles of tondue except palatoglossus
describe the pharyngeal phas eof swallow q
soft palate elevates
posterior pressure from tongue seals off laryngeal aditus by forcing epiglottis
hyolaryngeal elevation by suprahyoid and langitudinal muscles
sequential constriction of constrictors
relaxation of cricopharyngeus
describe the oesophageal phase of swallow
involuntary peristalsis moving food bolus to stomach
what is the retropharyngeal space and why is it clinically relevant
space posterior to pharynx that descends into mediastinum
any infection in the space could spread to mediastinum
what is the parapharyngeal. space and why is it clinically relevanr
space to either side of pharynx
tumour formation and growth in these spaces can lead to dysfunction
what is the pharyngeal plexus and what is its innervation
plexus formed by CN IX and X
sensory via CN IX and motor via X except laryngopharync just above cords where it is vagal
glossopharyngeal innervates stylopharyngeus
what nerve stimulates a response in the gag reflex
IX
what is locatred in the gap between superior and inferior pharyngeal constrictor muscle
IX
Lingual artery
stylopharyngeus muscle
muscles opening jaw
lateral pterygoid
muscles closing jaw
medial pterygoid
temporalis
masseter
function of buccinator
aligns food bolus between dentition
what is the TMJ formed by
mandibular condyle
glenoid fossa
function of intrinsic muscles of the tongue and fibre directions
modify shape of tongue in speech and swallow
horizontal, vertical, inferior and superior longitudinal
extrinsic muslces of tongue and their innervation?
genioglossus styloglossus palatoglossus hyoglossus all innervated by XII except palatoglossus, by X
innervation to the muscles of the soft palate
all X except tensor veli palatini, innervated by CN V3
muscles of the soft palate
palatoglossus musculus uvulae tensor veli palatini levator veli palatini palatopharyngeus
components of waldeyer’s tonsillar ring and function?
pharyngeal tonsil lingual tonsil tubal tonsil palatine tonsils immunologic protection
functions of salivary glands
moisten oral mucosa
aid carb digestion
moisten food
medium for food to dissolve to be tasted
control bacterial flora by lysozyme and IgA
where does parotid gland drain
buckle of 2nd molar
where does submandubular gland drain
sublingual caruncle
where does sublingual gland drain
several ducts in floor of mouth
muscles of the pharynx?
superior, middle and inferior pharyngeal constrictors
stylopharyngeus
palatopharyngeus
salpingopharyngeus
function and attachments of cricothyroid
anterolateral cricoid to inf horn thyroid
tenses vocal ligament
function and attachments of thyroarytenoid
relaxes vocal ligament
posterior thyroid to anterior arytenoid
function and attachments of lateral arytenoid
adducts vocal cords
muscular process arytenoid to anterior cricoid
pulls arytenoid medially
function and attachments of posterior arytenoid
abducts vocal cords
muscular process arytenoid to posterior cricoid
pulls arytenoid medially
function and attachments of arytenoid muscle
adducts vocal cords
oblique and transverse band
attaches from one arytenoid to another cricoid cartilage
suprahyoid muscles?
anterior/posterior body digastric
stylohyoid
geniohyoid
mylohyoid
infrahyoid muscles?
sternohyoid
sternothyroid
omohyoid
thyrohyoid
