Session 11 - Pharynx and Larynx Flashcards

1
Q

From where to where does the pharynx extend to, anteriorly and posteriorly?

A

From cranial base to inferior border of cricoid cartilage anteriorly

And Inferior border of C6 posteriorly.

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2
Q

What 3 parts is the pharynx divided into?

A
  1. Nasopharynx
  2. Oropharynx
  3. Laryngopharynx/hypopharynx
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3
Q

What type of epithelium does each part of the pharynx have?

A

Nasopharynx - pseudostratified ciliated with goblet cells

Oropharynx - Stratified squamous non keratinised

Laryngopharynx - Stratified sqmaous non keratinised

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4
Q

From where to where does the nasopharynx extend?

A

top of pharynx to bottom of soft palate/uvula.

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5
Q

Why might an infection lead to blockage of the eustachian tube? What disease does this lead to?

A

Lymphoid tissue forms a Tonsillar ring around the superior part of the pharynx, which aggregates to form the Adenoids. The adenoids may become swollen during infection in children

Leads to otitis media

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6
Q

From where to where does the oropharynx extend?

A

Soft palate to superior border of epiglottis

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7
Q

From where to where does the laryngopharynx extend?

A

superior border of epiglottis to inferior border of cricoid cartilage

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8
Q
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9
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10
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11
Q
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12
Q

what are the two muscular layers of the pharynx?

A

outer circular muscle layer and inner longitudinal mucle layer.

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13
Q

What is the function and action of the outer circular muscle layer of the pharynx?

A

During swallowing the muscle constrict to propel the bolus of food downwards. Muscles overlap each other to achieve this.

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14
Q
A
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15
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16
Q
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17
Q

What are the 3 muscles of the inner longitudinal muscle layer? What is their function?

A
  • Stylopharyngeus
  • Palatopharyngeus
  • Salpingopharyngeus

Act to shorten and widen pharynx

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18
Q

How is the pharynx innervated? and how is this plexus formed?

A

Pharyngeal plexus - formed from vagus, glossopharyngeal, and sympathetic fibres from superior cervical ganglion

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19
Q

What is the motor innervation of the pharynx?

A

Vagus nerve

Except stylopharyngeus muscle which is glossopharyngeal nerve

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20
Q

Describe the voluntary and pharyngeal phase of swallowing

A

Voluntary Phase

  • Tongue moves the bolus back onto the pharynx

Pharyngeal Phase

Pressure receptor in palate triggers:

  1. Inhibition of breathing
  2. Raising of the larynx – Suprahyoid and Longitudinal Muscles
  3. Closure of the glottis
  4. Opening of the upper oesophageal ‘sphincter’
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21
Q
A
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22
Q

What are the arteries that supply the pharynx? Which artery do they originate from?

A

From external carotid:

  • Ascending pharyngeal
  • lingual
  • facial
  • maxillary
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23
Q

What is the venous drainage of the pharynx?

A

Pharyngeal venous plexus –> internal jugular vein

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24
Q

What clinical features can occur in enlarged adenoids?

A
  • Nasal obstruction
  • Mouth breathing, nasal speech
  • Feeding difficulty (especially infants)
  • Snoring / Obstructive Sleep Apnoea
  • Block the opening of the Eustachian Tube
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25
Q

During what ages is the maximal size for adenoids?

A

3-8 then regression

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26
Q

Where does the palatine tonsils lie?

A

lies between palatoglossal arch and palatopharyngeal arch

27
Q

What is the lymphatic drainage of the palatine tonsils?

A

Jugulo-digastric (tonsillar) node

28
Q

What is quinsy? How is it treated?

A

Peritonsillar abscess pushing uvula to other side

Requires drainage

29
Q

Name the 3 regions food is likely to become stuck in the oropharynx

A
  • Vallecula - pouch between tongue and epiglottis
  • Base of tongue
  • Region of palatine tonsil
30
Q

Name the 2 regions food is likely to become stuck in the layngopharynx

A
  • Piriform fossa - recess between central part of larynx and lateral lamina of thyroid cartilage
  • Cricopharyngeus
31
Q

From where to where does the larynx extend?

A

Laryngeal inlet to inferior border of cricoid cartilage

32
Q

What is the function of the larynx?

A

Guards air passage during swallowing. Larynx rises and epiglottis closes to allow the bolus to slide down it and into the oesophagus

33
Q
A
34
Q

What cervical vertebrae does the upper surface of the thyroid cartilage mark? What can be found here?

A

c4 - bifurcation of common carotid and level of carotid body

35
Q

How does the thyroid cartilage articulate with the hyoid bone nad the cricoid cartilage

A

via superior and inferior horns

36
Q

What cervical level does the cricoid cartilage mark?

A

c6

37
Q

What is the function of the arytenoid cartilage?

A

vocal cord movement

38
Q

What is the conus elasticus? What is the upper free border of the cricovocal ligament?

A

lateral cricothyroid ligament. Upper free border is the vocal ligament.

39
Q
A
40
Q

What is found in the supraglottic space?

A

vestiblar folds (false vocal cords)

41
Q

What is found in the glottis?

A

vocal cords and rima glottis (space between vocal cords)

42
Q

What is found in the subglottic space?

A

Lower border of cricoid cartilage

43
Q

What is the function of the infrahyoid and suprahyoid muscles?

A

Elevates or depresses larynx

44
Q

What is the function of the vocal folds of the larynx?

A

Open and close glottis

45
Q

What is the function of the aryepiglottic folds of the larnx?

A

Help close laryngeal inlet

46
Q

What structures do the intrinsic muscles of the larynx act upon?

A

Vocal and aryepiglotic folds

47
Q

What is the nervous supply of the intrinsic muscles of the larynx?

A

The Recurrent Laryngeal Nerve supplies the intrinsic muscles. The exception is the Cricothyroid Muscle, which is supplied by the External Laryngeal Nerve.

48
Q

What are the 3 layers of the vocal cords?

A
  • Stratified Squamous Epithelium
  • Vocal Ligament
  • Vocalis Muscle
49
Q

Which muscles are responsible for the abduction and adduction og the vocal cords?

A

Abduction – Posterior Cricoarytenoid

Adduction – Lateral Cricoarytenoid and cricothyroid

50
Q

What is the laryngeal nerves a subsidiary of?

A

Branches of vagus nerve

51
Q

What nerves supply the sensation above and below the true vocal cords?

A

Above - superior laryngeal

Below - Recurrent laryngeal

52
Q

What vertebrae does the left and right recurrent laryngeal descend to? Where does each nerve curve under?

A

Left - T4, under arch of aorta

Right - T2, under right subclavian

53
Q

How does palsy of the recurrent laryngeal nerve present clinically?

A

hoarseness of the voice. Longer than 3 weeks is red flag

54
Q

Give 3 possible causes of recurrent laryngeal palsy

A

Infection, GORD, apical lung tumour

55
Q
A
56
Q

What is the blood supply to the larynx and what are they branches of?

A

Superior and inferior laryngeal arteries which are branches of superior and inferior thyroid arteries.

57
Q

What is the venous drainage of the larynx?

A

Superior and inferior laryngeal veins

superior Laryngeal –> superior thyroid –> internal jugular

Inferior laryngeal –> inferior thyroid –> left brachiocephalic

58
Q

What 2 things can cause a laryngeal obstruction?

A

Inhalation of foreign body and tumour

59
Q

In an emergency, where would you open an airway into the trachea?

A

Through the cricothyroid membrane, aka cricothyroidotomy

60
Q

What is the afferent and efferent limb of the gag reflex?

A

Afferent - glossopharyngeal

Efferent - Vagus

61
Q

In a patient with tonsillitis, which lymph node would you expect to be enlarged?

A

Tonsillar (jugulo-digastric)

62
Q

What is a pharyngeal pouch?

A

Weakening between cricopharyngeus and thyropharyngeus muscles leading to diverticulum of pharyngeal mucosa between them

63
Q
A