UNIT 6: Pharynx + Glossopharyngeal CN

Question 1

the pharynx is a _______ tube, ____ cm long, and extends from _____ to ______

Answer 1

vertical musculo-membranous tube

12 cm long

extends from base of skull @ C6 posteriorly to cricoid cartilage anteriorly

Question 2

pharynx is continuous with

Answer 2

nasal cavity anteriorly
oral cavity anteriorly
larynx anteriorly
esophagus inferiorly

Question 3

musculo-membranous tube is composed of (4 parts - superficial to deep)

Answer 3

mucous membrane

fibrous coat - pharyngobasilar fascia

muscular coat

buccopharyngeal fascia

Question 4

the muscular coat of the pharynx is… (2 parts)…. what do they do?

Answer 4

muscles that run horizontally, wrapping around from front to a midline raphe in the back

in swallowing these construct the pharynx, helping push the food thru its length; also participate in velopharyngeal closure (soft palate to PPW)

AND muscles that run inferiorly from the skull - shorten the length of the pharynx by pulling superiorly

Question 5

3 functions of the pharynx

Answer 5

acts as a resonating chamber for speech; alters spectral characteristics of sound

contracts during swallowing, clearing the food bolus from the pharynx into the esophagus (provides common pathway for food intake and breathing)

forms the upper esophageal sphincter (UES)

Question 6

sensory innervation to the pharynx is provided by

Answer 6

CN IX and pharyngeal branch of CN X

Question 7

pharynx can be divided into 3 parts

Answer 7

nasopharynx
oropharynx
laryngopharynx

Question 8

what are the boundaries of the nasopharynx

Answer 8

superior = skull base (sphenoid)
inferior = level of palate
posterior = pharyngeal protuberance in basioccipital portion of occipital bone

Question 9

_____ keeps the nasopharynx open, and runs from ….

Answer 9

pharyngobasilar fascia (fibrous coat) - runs from base of skull superiorly; inferiorly becomes thinner and disappears

Question 10

the nasopharynx is lined with

Answer 10

ciliated epithelium which have cilia that beat in opp direct to the cilia in trachea

Question 11

______ is the anterior boundary where nasopharynx communicates with nasal cavity

Answer 11

nasal choanae

Question 12

the ____ has its opening into the lateral nasopharynx

Answer 12

eustachian tube

Question 13

superior and posterior edges of ET opening are _____ and covered with ______, and form thickened elevations called the ____, which are formed by _____ and ______

Answer 13

cartilaginous
mucous mem
torsu tubaris
salpinogopharyngeal fold and salpingopalatine fold

Question 14

pharyngeal tonsils are the _____, which is

Answer 14

adenoids
mass lymphoid tissue located on posterior-superior wall of nasopharynx

Question 15

boundaries of the oropharynx

Answer 15

superior = level of the palate
inferior = level of hyoid bone

Question 16

anterior boundary of oropharynx communicates with _____

Answer 16

oral cavity

Question 17

passavant’s pad is

Answer 17

muscular bulge on posterior oropharyngeal wall; contributes to velopharyngeal closure

Question 18

faucial pillars separate the ____ from the oropharynx, space bw them houses the _____

Answer 18

oral cavity
palatine tonsils

Question 19

lingual tonsils are located

Answer 19

on base of tongue

Question 20

boundaries of laryngopharynx

Answer 20

superior = level of hyoid bone (upper edge of epiglottis)
inferior = C6/level of cricoid (pharyngoesophageal junction)
anterior = epiglottis

Question 21

laryngopahrynx communicates with ____and ____, and becomes thinner at ______ end

Answer 21

larynx and esophagus
inferior end

Question 22

3 constrictor muscles of the pharynx

Answer 22

superior, middle, inferior

Question 23

describe the 3 constrictor muscles of the pharynx

Answer 23

stacked like cups
surround the pharynx and contract during swallowing
each muscle has 2 halves
all are open anteriorly, except lower fibres of inferior constrictor m which form a complete ring

Question 24

superior constrictor muscle: O, I, A, Inn

Answer 24

O = ptrygomandibular ligament, spehnoid, medial pterygoud plate, hamular process
I = posterior median pharyngeal raphe, pharyngeal tubercle at base of skull
A = forms sides/back wall of nasopharynx and part of back wall of oropharynx - constricts pharynx (in swallowing and velopharyngeal closure)
Inn = pharyngeal branch of CN X (pharyngeal plexus)

Question 25

middle constrictor muscle: O, I, A, Inn

Answer 25

O = stylohyoid lig, hyoid bone I = posterior median pharyngeal raphe A = constricts pharynx Inn = pharyngeal branch of CN x (pharyngeal plexus)

Question 26

2 parts of inferior constrictor muscle

Answer 26

thyropharyngeus cricopharyngeus

Question 27

inferior constrictor muscle, thyropharyngeus: O, I, A, Inn

Answer 27

O= oblique line of thyroid cartilage I = posterior median pharyngeal raphe A = constricts pharynx Inn = pharyngeal branch of X (pharyngeal plexus)

Question 28

inferior constrictor muscle, cricopharyngeus: O, I, A, Inn

Answer 28

O = cricoid cartilage I = other side of cricoid cartilage A= keeps esophagus closed at UES at rest Inn = pharyngeal branch, eSLN and RLN of X

Question 29

3 muscles that elevate the pharynx during swallowing

Answer 29

salpingopharyngeus palatopharyngeus stylopharyngeus

Question 30

salpingopharyngeus: O, I, A, Inn

Answer 30

O = eustachian tube, posterior lip of torus tubaris (salpinogopharyngeal fold) I = lateral wall of pharynx (w palatopharyngeus m) A = elevates pharynx, shortens pharynx Inn = Pharyngeal branch of CN X (pharyngeal plexus)

Question 31

palatopharyngeus m: O, I, A, Inn

Answer 31

O = palatine raphe (aponeurosis) I = posterior border of thyroid cartilage, inferior portion of pharynx A = lifts the pharynx and larynx, directs the bolus into pharynx during swallowing Inn = pharyngeal branch of CN X (pharyngeal plexus)

Question 32

palatopharyngeus muscle forms

Answer 32

the palatopharyngeal arch

Question 33

stylopharyngeus: O, I, A, Inn

Answer 33

O = temporal bone, styloid process I = (internal) lateral wall of pharynx, thyroid cartilage of larynx A = elevates larynx and pharynx, shortens pharynx Inn = CN XI

Question 34

3 tendons/ligaments of the pharynx

Answer 34

posterior median pharyngeal raphe pterygomandibular ligament stylohyoid ligament

Question 35

posterior median pharyngeal raphe

Answer 35

midline tendon of a pharyngeal aponeurosis originates at occipital bone and descends along posterior wall of pharynx site insertion for pharyngeal constrictor muscles

Question 36

pterygomandibular ligament

Answer 36

extends from hamular process of medial pterygoid plate (of sphenoid) to the mylohyoid line of mandible

Question 37

stylohyoid ligament

Answer 37

extends from styloid process to lesser cornu of hyoid bone

Question 38

5 fibre types in CN IX

Answer 38

SVE GVE GSA GVA SVA

Question 39

SVE of CN IX supply

Answer 39

the stylopharyngeus muscle (3rd branchial arch)

Question 40

GVE of CN IX supplies

Answer 40

secretomotor innervation to the parotid gland

Question 41

GSA of CN IX supplies

Answer 41

posterior 1/3 of tongue, faucial pillars, palatine tonsils, pharyngeal walls, skin of external ear, tympanic membrane (internal surface)

Question 42

GVA of CN IX supplies

Answer 42

baroreceptors (blood pressure) in the carotid sinus

Question 43

SVA of CN IX supplies

Answer 43

chemoreceptors (oxygenation) in carotid bodies taste from posterior 1/3 of tongue

Question 44

SVE of IX: Intracranial pathway

Answer 44

cell bodies of LMN in nucleus ambiguus (motor nucleus of IX and X) in medilla axons exits skill via jugular foramen (along w X)

Question 45

SVE of IX: extracranial pathway

Answer 45

descends w/i neck deep to styloid process and then innervates stylopharyngeus

Question 46

GVE of IX: Intracranial pathway

Answer 46

Cell bodies in inferior salivatory nucleus of medulla axons exit skull via jugular foramen w other fibres of IX

Question 47

GVE of IX: extracranial pathway

Answer 47

supplies secretomotor fibres to parotid gland

Question 48

GSA of IX are important for

Answer 48

gag reflex and swallowing Xph and SLN of X also participate in triggering swallowing

Question 49

GSA of IX: pathway

Answer 49

cell bodies of 1st order sensory nerves are in the inferior glossopharyngeal ganglion some nerves synapse in spinal tract nucleus (V), some synapse in the nucleus tractus solitarius

Question 50

______ and _______ are thought to be the most effective sites for triggering the pharyngeal stage of swallowing

Answer 50

anterior and posterior faucial arches

Question 51

posterior faucial arch, lateral and posterior pharyngeal walls, receive inn from both ____ and ____ and are very densely innervated

Answer 51

IX and X

Question 52

GVA of IX: pathway

Answer 52

sensations are relayed from the carotid sinus, cell bodies in the inferior glossopharyngeal ganglion synapse in the nucleus tractus solitariys connections made w hypothalamus for control of respiration, blood pressure, and cardiac output

Question 53

SVA of IX: Pathway

Answer 53

cell bodies of 1st order neurons are in the inferior glossopharyngeal ganglion enter medulla and synapse in nucleus tractus solitarius including the gustatory nucleus

Question 54

to test the integrity of IX and X, test the _____

Answer 54

gag reflex

Question 55

how to test the gag reflex of IX and X

Answer 55

mechanical stimulus to the 1/3 of the tongue, palate, palatal arch, posterior pharyngeal wall see musculature contract when elicited if no reaction question integrity

Question 56

to further test the integrity of X observe the

Answer 56

soft palate at rest and on phonation If a X LMNL, on phonation, will see elevation on intact side of soft palate only, w the deviation of uvula toward the intact side

Question 57

the pharynx is a multi-purpose musculomembranous tube that ....

Answer 57

in speech acts as a resonating chamber in swallowing transports the bolus from the oral cavity to the esophagus

Question 58

the glossopharyngeal nerve holds great importance for respiration bc

Answer 58

it can override motor output based on oxygen needs

Question 59

the glosspharyngeal nerve is v important for swallowing bc

Answer 59

saliva flow during mastication sensory input to faciliatate the pharyngeal phase of swallowing taste from posterior 1/3 of tongue pharyngeal and laryngeal elevation