Flashcards in H&N 10.1 the pharynx Deck (50):
What are the superior and inferior borders of the pharynx?
From the base of the skull to the inferior border of the cricoid cartilage.
What is found immediately posterior to the pharynx?
The prevertebral fascia.
What are the division of the pharynx?
-The naso pharynx
What are the borders of the nasopharynx?
-superiorly- base of the skull
-inferiorly- upper border of the soft palate.
-posteriorly- C1, 2
What structures can be found within the nasopharynx?
-The opening to the auditary tube.
- The pharyngeal tonsil.
What is another name for 'pharyngeal tonsil'?
When enlarged, how big can the pharyngeal tonsils get?
What could enlarged adenoids cause?
-mouth breathing (due to difficulty nasal breathing due to the obstruction)
-blockage to the eustachian tube
-chronic infection (due to acting as a resivoir for infection)
What is the classic theory of how otitis media with effusion develops?
-the auditory tube is sdysfunctional
-air is not being equilised between the middle ear and the atmosphere.
-air cells of the middle ear absorb air, leading to negative pressure
-a transudate forms, which is drawn from mucosa)
- ideal place for infection to develop
What complications can arise from otitis media?
-hearing loss (often temporary)
-meningitis, brain abscess
What type of hearing loss would be the result of otitis media?
Conductive, due to the effusion inhibiting air waves.
What epithelium lines the nasopharynx?
respiratory epithelium (cilliated, pseudocolumnar epithleium)
What are the superior and inferior borders of the oropharynx?
What lies inferiorly and posteriorly?
-superior- soft palate
-inferior- upper border of the epiglottis, the tongue
-posteriorly- C2,3 vertebrae
What structures are found within the oropharynx?
What are the stages of swallowing?
What happens in the oral phase of swallowing?
The tongue pushes the bolus to the back of the mouth until it touches the oropharynx.
The bolus gets compressed against the palate as it is moved to the oropharynx.
What happens in the oesophageal phase of swallowing?
What nerves cause what to happen?
The bolus touching the oropharynx sets of a reflex which is involuntary and leads to:
-elevation of the soft palate (seal off the nasopharynx) (CN X)
-elevation of the pharynx and larynx (mainly Cn X, CN IX)
-closure of the epiglottis (seal off the larynx)
-tongue being compressed against the palate (prevent bolus going back into oral cavity) (CN XII)
-opening of the UOS.
What happens in the involuntary phase of swallowing?
contractions of the pharyngeal constrictors of the pharynx cause the bolus to move down towards the stomach.
Where do you find the palatine tonsils?
between the anterior and posterior pharyngeal arches.
What epithelium lines the oropharynx?
stratified squamous epithelium
What are the borders of the laryngopharynx?
-inferior- (anteriorly) cricoid cartilage, (posteriorly) C6.
What structure does the laryngopharynx contain?
What is the piriform fossa?
also known as the piriform recess.
A channel, which diverts food, liquid etc around the larynx and into the oesophagus.
If there is loss of co-ordination f swallowing, why can liquids still be swallowed fairly easily?
They run in the piriform fossae, which diverts them around the larynx.
What broad catergories of muscle are found within the pharynx?
-Inner longitudinal muscles
-outer circular muscles.
What is the function of the longitudinal muscles of the pharynx?
To elevate the pharynx and larynx, which opens and shortens the pharynx during swallowing.
What are the names of the longitudinal constrictors of the pharynx?
What are the attachments and innervation of the stylopharyngeus muscles?
-from the styloid process of the tmeporal bone
-to the posterior thyroid cartilage
-innervated by the glossopharyngeal nerve.
What are the attachments and innervation of the palatopharyngeus muscles?
-from the hard palate
-to the posterior border of the thyroid cartilage
What are the attachments and innervation of the salpingopharyngeus muscles?
-from the distal eustachian tube
-to blend with the palatopharyngeus nerve
What are the circular constrictors of the pharynx called?
-superior pharyngeal constrictor
-middle pharyngeal cosntrictor
-inferior pharyngeal constrictor
What is different about the inferior pharyngeal constrictor of the pharynx, with respect to the other constrictors?
It has 2 heads:
(all others only insert into 1 place)
What is Killian's dehiscence?
The area of potential weakness between the thyropharyngeus and the cricopharyngeus muscles, in the inferior pharyngeal constrictors.
What pathology can arise from the inferior pharyngeal constrictor?
Pharyngeal pouch- an outpouching of the pharynx between the 2 heads of the inferior pharyngeal cosntrictor.
This can become a resivoir for food and liquid, leading to bad breath, dysphagia, regurgitation and occaisional choking.
What is thought to be the cause of a pharyngeal pouch?
lack of co-ordination of constriction of the pharyngeal constrictors, leading to increased pressure in the laryngopharynx, which causes the diverticulum to form.
What is the pharyngeal plexus?
A plexus of nerves founs on the middle pharyngeal constrictor.
-sympathetic nerves (cervical)
What provides motor innervation to the pharynx?
-the Vagus nerve
(exception! the glossopharyngeal nerve supplies the stylopharyngeus muscle)
What nerves provide sensory innervation to the pharynx?
-nasopharynx- Maxillary nerve
-oropharynx- glossopharyngeal nerve (gag reflex)
What nerve is resposible for the oral phase of swallowing?
The hypoglossal nerve, it moves the tongue, allowing movement of the bolus.
What causes closure of the epiglottis during swallowing?
-It is connected to the thyroid cartilage, when you elevate the larynx and pharynx, this leads to the epiglottis closing over the larynx.
What are some of the major causes of dysphagia?
-dementia, parkinsons, MS
How could a stroke lead to pneumonia?
The resulting damage from a stroke may cause unco-ordianted swallowing
This increases the risk of aspiration of food
This is likely to be contaminated with lots of bacteria etc, so can cause an infection (pneumonia)
What are some symptoms of dysphagia?
-voice changes (wet voice, fluid coating the vocal cords)
What is the medical term for drooling?
What interventions can you use for someone with dysphagia to help?
-Thinning food (blender)
-modify feeding strategies
-improve oral hygiene
-introduce strategies to reduce fear of choking.
How many suprahyoid muscles are there?
4 pairs (so 8)
What's the innervation of the suprahyoid muscles?
-branches of various cranial nerves.
How many infrahyoid muscles are there?
4 pairs (8)
What's the innervation of the infrahyoid muscles?
-branches from C1-C3 (directly from the cervical plexus)