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Gross anatomy > Upper airways, mouth, pharynx and oesophagus > Flashcards

Upper airways, mouth, pharynx and oesophagus Flashcards

1
Q

Where is the upper airways?

A

Part of the respiratory tract above the trachea

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2
Q

What bones form the skull?

A

Frontal bone (forehead)

Parietal and occipital bones (lateral and posterior)

Sphenoid, temporal, occipital make up the floor of skull

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3
Q

What are the three parts to the temporal bone, which is the hardest and what do each form?

A

Squamous (lateral wall of skull), zygomatic (cheek bone), petrous (hardest: auditory and vestibular sensory systems)

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4
Q

Why is the petrous part necessary to be hard?

A

Protect the internal carotid artery and auditory mechanics that runs through/near to it.

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5
Q

What is located in the sphenoid bone?

A

Pituitary fossa

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6
Q

What does greater wing of sphenoid bone form, what is clinically significant about this part?

A

Lateral part of skull called the pterion, most fragile part of the skull

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7
Q

What do lateral pterygoid plates offer attachment for?

A

Jaw muscles

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8
Q

What are the bones (regions) of the facial skeleton?

A

Orbit, nose, upper jaw and lower jaw

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9
Q

What is the orbit and what makes it up

A

The orbit is the bony protective socket for the eye and is formed by the surrounding frontal, sphenoid, maxilla and zygomatic bones. As well as,
Ethmoid bone.
Palatine bone.
Lacrimal bone.

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10
Q

What forms the nose skeleton?

A

Two nasal bones, and the ethmoid bone forms the roof of nose and part of nasal septum. Lateral wall by maxilla

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11
Q

How is zygomatic arch of cheek formed?

A

Zygomatic bone joins maxilla and temporal bone

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12
Q

What forms the upper jaw?

A

Two maxilla bones

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13
Q

What does the lower jaw comprise?

A

Mandible

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14
Q

What does mandible articulate with?

A

Temporal bone (temporomandibular joint)

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15
Q

Two roles of the nose

A

Olfaction

Warming/filtering inspired air

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16
Q

Where does air enter nose?

A

Via nostrils (anteiror nares) passing between anteiror nasal hairs (vibrissae)

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17
Q

How does epithelium lining change after entering the nose?

A

From keratinised to mucous respiratory epithelium (pseudostratified and ciliated)

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18
Q

True or false, mucous membrane often continuous with underlying bone in nasal area

A

True

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19
Q

How does the nose warm air?

A

Rich blood supply warms and moisturises air

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20
Q

Describe the nasal mucosa blood supply

A

Branches of maxillary, facial and opthalmic artery (all from internal/external carotids)

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21
Q

What forms the nasal septum?

A

Bony vomer, septal/perpendicular plate of ethmoid (posteriorly) and septal cartilage (anteriorly)

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22
Q

What do the three conchae do?

A

Increase surface area of nasal
epithelium

Increase turbulence of air flowing through nasal cavity which enhances moistening and warming of passing air and increases change of trapping particles

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23
Q

What are conchae formed by?

A

Bony ridges

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24
Q

What happens to air as it enters the airways and reaches conchae?

A

It is obstructed by conchae hence increased turbulence

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25
Q

What are the superior and middle conchae part of?

A

Ethmoid bone

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26
Q

Describe the two types of mucous membrane lining nasal cavity

A

Respiratory epithelium

Olfactory epithelium

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27
Q

How does nose perform olfaction?

A

Olfactory epithelium found in upper part of nasal cavity above superior conchae and is specialsied for detecting smell

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28
Q

What happens to air as it exits the nose?

A

Exits through posterior openings (right and left choanae i.e. postieror nares) to enter nasopharynx

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29
Q

What are paranasal air sinuses?

A

Hollow air filled bony cavities that surround nasal passage

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30
Q

What are three functions of paranasal air sinuses?

A

Humidfy inspired air
Reduce weight of face
Add resonance to voice

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31
Q

What are the 4 pairs of paranasal sinuses?

A

Frontal, maxillary, ethmoidal, sphenoidal

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32
Q

What are meati?

A

Openings below each concha

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33
Q

What is the opening above the superior concha known as?

A

Spheno ethmoidal recess

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34
Q

What are paranasal sinuses lined by, where do they drain?

A

Respiratory mucosa secreting mucus that drains into nasal cavity behind conchae via meati

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35
Q

What is each sinus drained by?

A

Sphenoidal - Sphenoethmoidal recess

Posterior ethmoidal - Superior meatus

Maxillary, frontal and anterior/middle sinuses - Middle meatus

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36
Q

What does nasolacrimal duct do?

A

Drains tears into nasal cavity (to inferior concha, i.e. nose)

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37
Q

Infection and inflammation of Which sinus causes toothache?

A

Maxillary

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38
Q

Where do arteries supplying nose anastomose?

A

Little’s area in anterior nasal septum

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39
Q

What arteries supply roof, anterior and lateral walls of nose?

A

Anterior and posteiror ethmoidal arteries

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40
Q

What supplies meati, septum and conchae?

A

Sphaenopalatine arteries, superior labial artery + branch of greater palatine artery

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41
Q

Describe the sensory innervation to the nose

A

Trigeminal (V) nerve

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42
Q

Describe what innervates the olfactory epithelium

A

Olfactory nerve (I)

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43
Q

What supplies the parasympathetic innervation of the mucosal glands?

A

Pterygopalatine ganglion which is supplied with pre-gang fibres from facial (VII) nerve

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44
Q

What are the lips and oral cavity innervated by?

A

Trigeminal nerve

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45
Q

What is oral cavity formed by?

A

Maxilla, mandible

Soft and hard palate

Buccinator muscle (lateral walls)

Anterior bellies of digastric muscles below mylohyoid muscle (forms floor)

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46
Q

What forms the hard palate (anterior 2/3 of palate)?

A

Palatine process of maxillary bone and horizontal palates of palatine bone

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47
Q

What does the hard palate separate?

A

Oral and nasal cavities

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48
Q

What is soft palate?

A

Fold of mucous membrane containing tensor/levator platini muscles which lift soft palate in swallowing and pronation

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49
Q

Which muscle raises soft palate in swallowing and pronation?

A

Tensor/levator platini muscles

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50
Q

What does oral cavity then lead onto?

A

Leads to pharynx

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51
Q

What innervates hard palate and upper teeth?

A

Trigeminal maxillary branch

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52
Q

What innervates Cheeks, Floor of mouth, lower teeth?

A

Trigeminal mandibular nerve

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53
Q

What causes cleft palate?

A

Failure of fusion of maxilla at midline

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54
Q

What sort of joint is the temporomandibular joint?

A

Synovial hinging/sliding joint allowing opening and closing of mouth

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55
Q

What does the temporomandibular joint contain that makes it unique?

A

Fiborcartilaginous disc

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56
Q

Which three muscles close the jaw?

A

Temporalis
Masseter
Medial pterygoid (including side to side movements)

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57
Q

What muscle opens the jaw?

A

Lateral pterygoid

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58
Q

What are the muscles of mastication innervated by?

A

Mandibular branch of trigeminal nerve

59
Q

What does the mylohyoid do?

A

Depresses the mandible

60
Q

All muscles of tongue apart from palatoglossus are innervated by which nerve?

A

Hypoglossal nerve (XII)

61
Q

Which nerve innervates the palatoglossus?

A

Vagus

62
Q

What do intrinsic muscles of the tongue do?

A

Change the shape of the tongue

63
Q

What do extrinsic muscles of tongue do?

A

Anchor tongue to bones around mouth so move tongue around

64
Q

What are the names of the extrinsic muscles and principle actions?

A

Genioglossus - protrude and lifts up tip tongue

Styloglossus - Elevates and retracts

Hyoglossus - Depresses and retracts

Palatoglossus - elevates posterior tongue

65
Q

Which nerves innervate anterior 2/3 of tongue providing sensation?

A

Trigeminal (general sensation) and facial (taste)

66
Q

Which nerve innervates posterior third of tongue (both taste and general sensory)?

A

Glossopharyngeal (IX)

67
Q

What are the two purposes of saliva?

A

Contains amylase for carbohydrate breakdown

Lubricant

68
Q

What are the three types of salivary glands?

A

Parotid, submandibular, sublingual

69
Q

What is parotid gland controlled by?

A

Otic ganglion (para preganglionic innervation from glossopharyngeal nerve)

70
Q

Where do ducts of parotid, submandibular and sunlingual glands open to?

A

Back of mandible, under and at side of tongue respectively

71
Q

Describe innervation of submandibular and sublingual salivary glands

A

Parasympathetic innervation by postganglionic nerves of submandibular ganglion

Preganglionic innervation of this is from facial nerve (VII)

72
Q

Which vertebral level does pharynx extend to and from?

A

C1-C6

73
Q

Where does the pharynx extent to and from?

A

Base of skull to oesophagus

74
Q

What does pharynx do?

A

Provide path for food from oral cavity to oesophagus and air from nasal cavity to trachea

75
Q

What is pharynx formed from?

A

3 constrictor muscles (superior, middle and inferor) which are fused posteriorly as raphe)

76
Q

What is superior constrictor of pharynx attached to?

A

Medial pterygoid plate (sphenoid)

77
Q

What is middle constrictor of pharynx attached to?

A

Hyoid bone

78
Q

What is inferior constrictor of pharynx attached to?

A

Thyroid cartilage and cricoid cartilage

79
Q

What is the sphincter between the pharynx and oesophagus?

A

Cricopharyngeus

80
Q

What do muscles of pharynx receive innervation from and what do they do?

A 
Pharyngeal plexus (vagus)
Peristaltic contractions in response to receptors in upper part of oropharynx
81
Q

How is nasopharynx protected from regurgitation of food in swallowing?

A

Soft palate rises upwards, closing it off from rest of nasopharynx from rest of pharynx

82
Q

Where is oropharynx found?

A

Behind the mouth, between soft palate and hyoid bone

83
Q

What does oropharynx do upon receiving food?

A

Involuntarily contracts, squeezing bolus into laryngopharynx and into oesophagus

84
Q

What does oropharynx contain between palatoglossal and palatopharyngeal arches at back of throat?

A

Palatine tonsils

85
Q

Where does laryngopharynx extend to?

A

Epiglottis to C5 (terminating at start of oesophagus)

86
Q

Describe arterial blood supply to pharynx

A

Branches from external carotid and superior thyroid

87
Q

Describe venous drainage of pharynx

A

Pharyngeal venous plexus drains into internal jugular vein

88
Q

Describe the sensory innervation of the pharynx

A

Glossopharngeal to oropharynx
Trigeminal (maxillary division) to nasopharynx
Vagus to laryngopharynx

89
Q

Describe the motor innervation of the pharynx

A

Vagus

90
Q

What are the roles of the larynx

A

Produces speech and sound, protects trachea and bronchial tree in swallowing

91
Q

What is larynx compromised of?

A

9 cartilages bound by ligaments and muscles and contains vocal cords

92
Q

What is the importance of U shaped hyoid bone?

A

Framework by which larynx attaches to other structures in neck e.g. pharynx, mandible, tongue

93
Q

What level is the hyoid bone?

A

C3-C4

94
Q

What is the epiglottis

A

Elastic flap of cartilage that forms entrance to the larynx

95
Q

What is opening of larynx formed by?

A

Aryepiglottic folds

96
Q

Which cartilage forms the Adams apple?

A

Thyroid cartilage

97
Q

What shape is the thyroid cartilage?

A

V shape

98
Q

Which cartilage is the only complete ring of cartilage in the respiratory system?

A

Cricoid

99
Q

Describe the innervation of the larynx

A

Laryngeal structures above vocal cord (supraglottic): superior/interior laryngeal nerve (sensory innervation)

Below vocal cord (subglottic) recurrent laryngeal nerve

100
Q

Describe blood supply to larynx

A

Superior laryngeal branch from superior thyroid artery (above cord structures)

Inferior laryngeal branch from inferior thyroid artery (below cord)

101
Q

What is the name for the opening between the true vocal cords and the arytenoid cartilages of the larynx?

A

Rima glottides

102
Q

Why is the rima glottides significant?

A

Its area is constantly changing in vocalisation

103
Q

What is the false vocal cord, what forms it?

A

Superior vestibular fold forms it

Protective role (closes glottis in swallowing)

104
Q

What forms true vocal cord, what is it for?

A

Inferior vestibular fold

Important for vocalisation (air flows between vocal cords and vibrates them)

105
Q

Describe three divsions of the larynx

A

Supraglottic

Glottic (between 2 types of vocal cords)

Subglottic

106
Q

What determines loudness of voice?

A

Force of air passing between vocal cords and separation of vocal cords

Intrinsic laryngeal muscles move/rotate arytenoid cartilages) and thus affect separation of vocal cords

107
Q

Which nerve supplies muscles that abduct/adduct (motor) vocal cord/glottis?

A

Recurrent laryngeal nerves

108
Q

What determines pitch?

A

Tension in vocal cords

109
Q

What happens when we swallow?

A

The tip of the tongue is elevated against the hard palate and the posterior part of the tongue depressed, bolus moves to the oro-pharynx.

The sensory receptors on the posterior part of the tongue (glossopharyngeal) initiate a swallowing reflex.

The soft palate is tensed and elevated, sealing the nasal part of the pharynx. The hyoid bone is elevated (epiglottis to cover larynx opening) as the bolus passes to the pharynx, where the pharyngeal constrictors force the bolus down toward the oesophagus.

Once past the cricopharyngeus muscle, the hyoid descends and the epiglottis flips back to reopen the airway.

110
Q

The sensory component of the gag reflex is given by which nerve?

A

Glossopharyngeal nerve

111
Q

The margins of the inlet to the larynx …

A

Epiglottis and ary-epiglottic folds

112
Q

The sensory innervation of the vestibule of the larynx…

A

Superior/Internal laryngeal branch of the vagus nerve

113
Q

The nasal cavity has a prominent submucous venous plexus…

A

True

114
Q

The pharynx is mainly lined by a non-keratinised stratified squamous epithelium…

A

True

115
Q

What do olfactory sensory nerves pass through?

A

Cribiform plate

116
Q

What cranial nerve allows protrusion of the tongue?

A

Hypoglossal

117
Q

What tongue muscle is not innervated by the hypoglossal nerve?

A

Palatoglossus (Vagus)

118
Q

Where does the naso lacrimal duct enter the nasal passage ?

A

Beneath the inferior concha

119
Q

Where is the maxillary sinus in close proximity to?

A

The roots of the teeth of the upper jaw

120
Q

What is the role of the pharyngo tympanic tube?

A

Allows pressure equalisation across the tympanic membrane

121
Q

T/F the nasal conchae increase the surface area of the nasal passage to enhance the sense of olfaction

A

False

122
Q

Cranial nerve controlling lacrimation

A

Facial

123
Q

Ganglion supplying post ganglionic fibres to the nasal mucosa

A

Pterygopalatine

124
Q

Where is the parotid duct?

A

Through the buccinator muscle

125
Q

What muscle controls the pitch?

A

Cricothyroid

126
Q

Muscle which opens the vocal folds?

A

Posterior cricoarytenoid

127
Q

All intrinsic laryngeal muscles except posterior cricoarytenoid …

A

Close the vocal folds

128
Q

Floor of mouth muscles and innervation

A

Superficial digastric, the mylohyoid innervated by V3, geniohyoid (hypoglossal)

129
Q

Genioglossus shape

A

Fan shaped

130
Q

Sensory innervation of the upper palate

A

V2 hard, glossopharyngeal soft

131
Q

Arches at the back of mouth and relative position

A

Lateral anterior palatoglossal arch, medial palatopharyngeal

132
Q

What is found around the parotid gland?

A

Facial nerve, division / termination of external carotid, retromandibular vein

133
Q

What artery passes over the submandibular gland?

A

Facial

134
Q

Processes on mandible

A

Coronal and condylar

135
Q

Temporomandibular joint consists of

A

Head of mandible, glenoid fossa, intra-articular disc

136
Q

Opening of mouth muscles

A

Lateral pterygoid, digastric depresses

137
Q

Oropharynx between

A

Soft palate and the epiglottis

138
Q

What is the retropharyngeal space?

A

Posterior to pharnyx and oesophageal posterior walls extends from skull base to thoracic spine contains areolar fat and lymph nodes

139
Q

What is the Danger space?

A

Posterior to the retropharyngeal space extending from skull base to posterior mediastinum

140
Q

Why is danger space called danger space?

A

Direct communication with posterior mediastinum and free L/R communication - sepsis and infection risk

141
Q

Involuntary rapid swallowing phase

A

Soft palate muscles contract to seal off the nasopharynx, pharynx widens while the larynx is elevated by suprahoid muscles, larynx shuts and epiglottis covers, then contraction of the pharyngeal constrictors pushes food into oesophagus

142
Q

Voluntary phase of swallowing

A

Muscles of mastication and extrinsic / intrinsic tongue muscles create bolus and push into oropharynx

143
Q

Soft palate muscles and innervation

A

Tensor veli palatini (trigeminal v3) Levator veli palaitini (vagus)

Gross anatomy (17 decks)

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