Flashcards in 16 - Head + Neck - Pharynx Deck (34)
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1
The pharynx extends from the base of the skull to which vertebral level?
C6
2
What are the 3 parts of the pharynx, and their associated vertebral levels?
C1 = Nasopharynx
C2-3 = Oropharynx
C3-6 = Laryngopharynx
3
What is the inferior border of the nasopharynx?
Soft palate
4
What are the superior and inferior borders of the oropharynx?
Sup: Soft palate
Inf: Sup. border of the epiglottis
5
What are the superior and inferior borders of the laryngopharynx?
Sup: Sup. border of the epiglottis
Inf: Inf. border of cricoid cartilage
6
What type of epithelium lines the naso-, oro- and laryngo-pharynx?
Naso- Ciliated pseudostratified columnar epithelium + goblet cells
Oro- Stratified squamous epithelium
Laryngo- Stratified squamous epithelium
7
What are the piriform fossae?
Small depressions either side of the laryngeal inlet
- Common site of trapped food and cancers
8
Which muscles elevate the larynx during swallowing?
- Suprahyoids
- Longitudinal pharyngeals
9
What are the main functions of the internal longitudinal muscles of the pharynx?
- Shorten and widen pharynx
- Elevate larynx during phonation + swallowing
10
Name the internal longitudinal muscles of the pharynx:
- Stylopharyngeus
- Palatopharyngeus
- Salpingopharyngeus
11
What is the main function of the outer circular muscles of the pharynx?
Contract sequentially to propel food into oesophagus
12
Name the outer circular muscles of the pharynx:
Superior, Middle and Inferior pharyngeal constrictors
13
Killian's dehiscence is an area of weakness between which pharyngeal muscles?
What is the clinical relevance of this?
- Between the 2 muscle belly's of the inferior pharyngeal constrictor
- Pharyngeal mucosa can herniate through weakness to form a pharyngeal pouch, resulting in dysphagia, regurgitation and halitosis
14
Why is a pharyngeal pouch a 'false' diverticulum?
It does not contain all layers of the pharynx (mucosa only)
15
Which nerve innervates all the pharyngeal muscles except one? What is the exception?
CN X
Exception = Stylopharyngeus = CN IX
16
Which nerves give sensory fibres to the pharynx?
Naso- = CN V2
Oro- = CN IX
Laryngo- = CN X
17
What implications can the adenoids cause if they become chronically inflamed?
- Mouth breathing
- Snoring
- Nasal tone to speech
- Otitis media (block ET)
18
What is the arterial supply to the palatine tonsils?
Facial artery (tonsillar branch)
19
What structures are vulnerable during a tonsillectomy?
- Facial artery (tonsillar branch)
- Internal Carotid artery
- CN IX
20
What are the 3 phases of swallowing?
1) Oral
2) Pharyngeal
3) Oesophageal
21
What is the function of the supra- and infrahyoid muscles during swallowing?
Suprahyoids contract:
- Elevate larynx
- Close epiglottis
- Protect airways
Infrahyoids partially contract to stabilise actions of suprahyoids.
22
Which lymph nodes would you expect to be swollen if a patient had tonsillitis? Describe their location:
Jugulo-digastric
- Posterior and inferior to the angle of the mandible
23
What causes 'glue ear' and why does this predispose to ear infections?
- Eustachian tube dysfunction (^adenoids, tumour, allergens)
- Middle ear cannot equalise with atmospheric P
- Middle ear cells absorb N2 + O2 = negative P
- Causes accumulation of transudate
- Favourable environment for bacteria
24
Which layer of cervical fascia envelops the thyroid gland?
Pre-tracheal fascia
25
The thyroid gland sits at which vertebral levels?
C5 - T1
26
Why does the thyroid gland move during swallowing?
It is connected to the Cricoid cartilage via dense connective tissue
27
The thyroid gland lies deep to which infra-hyoid muscles?
- Sternohyoid
- Sternothyroid
28
Describe the arterial supply of the thyroid:
- Sup. poles = Sup. Thyroid arteries
- Inf. poles = Inf. Thyroid arteries
29
What are the main complications of a Thyroidectomy?
- Bleeding
- Injured recurrent laryngeal nerve
- Injured superior laryngeal nerve
- Hypoparathyroidism
- Hypothyroidism
- Infection
30
What is the function of the suprahyoid muscles?
Elevate hyoid bone = elevates larynx to allow swallowing
31
Is digastric a supra- or infrahyoid muscle? Name the nerve which innervates it:
Suprahyoid muscle
CN V3
32
What are the origins and insertion of the digastric muscle?
Origins:
- Ant. belly = Digastric fossa of mandible
- Post. belly = Mastoid process
Insertion: Hyoid bone
33
What is the origin and insertion of omohyoid?
Origin: Scapula
Insertion: Hyoid
34
