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132 Cards in this Set

  • Front
  • Back
the pharynx extends from ________ to the level of the ______________ of the larynx and esophagus
the basilar portion of the occipital bone to the cricoid cartilage of the larynx and the esophagus
nasopharynx extends from the _______ to _______ and communicates anteriorly with ____________
base of skull to soft palate; communicates anteriorly with posterior nasal aperture (choane)
structures of the nasopharynx
ostium of the auditory tube
choanae
torus tubarius
salpingopharyngeal fold
pharyngeal tonsisls
pharyngeal recess
oropharynx extends from the _____ to _________, communicates anterior with ______ through the _________________
soft palate to upper border of epiglottis; communicates with oral cavity through the arches of the palate
the area where the oral cavity is continuous with oropharynx
fauces
arches of the palate
palatoglossal arch (fold)
patatopharyngeal arch (fold)
where the palatine tonsils are housed
between the 2 arches of the palate
2 soft tissues of the oropharynx
soft palate and uvula
laryngopharynx extends from ________ to _____ and communicates with this
cranial border of epiglottis to esophagus (C4-C6)

communicates with larynx
components of laryngopharynx
- laryngeal inlet
- epiglottis
- piriform recesses
- vallecula
4 layers of the pharynx
- mucosa
- fibrous later (pharyngobasilar fascia)
- muscular layer
- areolar layer (buccopharyngeal fascia)
where the pharyngobasilar fasica is visible
in the gap between superior constrictor muscle and base of skull
longitudinal (internal) muscles of the pharynx
stylopharyngeus
palatopharyngeus
salpingopharyngeus
contained in the areolar layer of the pharynx
the pharyngeal plexus of nerves and veins
blood supply to the pharynx
- maxillary artery (pharyngeal branch)
- facial artery (ascending palatine and tonsillar arteries)
- lingual artery: dorsal branches
- ascending pharyngeal artery
motor innervation to the stylopharyngeus:

salpingopharyngeus and palatopharyngeus:

constrictor:
CN IX

XI via X

XI via X and efferent autonomics
sensory innervation to nasopharynx

oropharynx

laryngopharynx
primarily maxillary nerve V2

glossopharyngeal IX

vagus nerve X
the gag reflex involves sensory fibers from ______ and ____ motor fibers
CNIX sensory

XI via X motor fibers
cough reflex is a contraction of these muscles

triggered by stiulation of nerves in these organs
- laryngeal muscles, diaphragm and external intercostal muscles

- larynx, trachea, larger bronchii (internal and recurrent laryngeal nerves)
palatine tonsils located on sides of ____________ between ____________
oropharynx

palatine arches/ pillars
pharyngeal tonsils are located in __________ wall of nasopharynx
posterior wall
located on pharyngeal portion of tongue

located adjacent to each auditory tube

adenoids are what tonsils?
lingual tonsils

tubal tonsils

pharyngeal and tubal tonsils
features of the thryoid cartilage
the largest
incomplete
has laryngeal prominence and thryoid notch
characteristics of the cricoid cartilage

shaped like:

has a narrow ______ arch and a wider ______ plate
shaped like a signet ring

has a narrow anterior arch and a wider posterior plate, or lamina
connects laryngeal cartilages to external structures and ligaments
extrinsic: thyrohyoid membrane
connects laryngeal cartilages to each other
cricothyroid ligament (intrinsic)
where the ventricles of the supraglottic cavity are found
laterally between vestibular and vocal folds
3 components of the true vocal folds
- vocal ligament
- vocalis muscle
- mucosal covering
consists of the true vocal folds and the space between them
glottis
abductor of the larynx
posterior cricoarytenoid muscle
tensors of the larynx
cricothyroid muscle

vocalis (minute adjustments for high tones)
external laryngeal nerve gives _________ innervation to
motor to cricothyroid muscle
internal laryngeal nerve gives _______ innervation to:
sensory to larynx above vocal folds
the recurrent laryngeal nerve gives motor innervation to _________ and sensory to ___________
all intrinsic muscles of larynx except cricothyroid

sensory to larynx below vocal folds
terminal branches of the recurrent laryngeal nerve
inferior laryngeal nerves
blood supply to the larynx
- superior laryngeal a. from superior thyroid a.

- inferior laryngeal a. from inferior thyroid a.
2 emergency entries to airway
1. cricothyrotomy
2. tracheostomy
area of the larynx that is subject to edema and why?
supraglottic area- the mucous membrane here is loose
3 cartilages of the laryngeal skeleton
1. thyroid
2. cricoid
3. epiglottic
general structure of the nose (5)
root, dorsum, nares, ala, columella
bones/ cartilages that make up the nasal cavity
nasal, forntal, maxillary bones

septal, lateral nasal and alar cartilages
blood supply to exterior nose
facial: lateral nasal and angular arteries

ophthalmic: dorsal nasal artery
innervation to exterior nose
infratrochlear and external nasal nerves (CN V1)

infraorbtial nerve (CN V2)
the nasal cavity is divided into right and left nasal fossae by _______ with each opening anteriorly through the _______ and posteriorly through the ______.
the nasal septum

nares

choane
boundaries of the nasal cavity

roof
floor
median wall
lateral wall
roof: cribriform plate of ethmoid + nasal, frontal, sphenoid bones

floor: hard palate (maxillary + palatine bones)

medial wall: cartilaginous nasal septum, vomer, perpendicular plate of ethmoid (nasal septum)

lateral wall: conchae and meatuses
superior and middle concache are part of what bone(s)?
ethmoid

inferior is its own bone
the superior meatus is the opening of what

opening of sphenoid sinus

opening of naso lacrimal duct

middle meatus opening of what?
sphenoethmoidal recess

inferior meatus

ethmoidal, maxillary and frontal sinuses
structures of the middle meatus
ethmoidal bulla
hiatus semilunaris
blood supply to nasal cavity
ophthalmic artery: anterior ethmoid and posterior ethmoid

maxillary artery: sphenopalatine

facial artery: superior labial
venous drainage from nasal cavity via what veins
ophthalmic v., facial v., pterygoid plexus
innervation of the olfactory area of nose (superior 1/3)
olfactory nerve CNI (specia sense
innervation of the respiratory area of nose

nasal septum:
lateral wall:
anterior ethmoid (V1 branch)

nasopalatine nerve (V2 branch)

lateral wall: later nasal nerves and anterior ethmoid nerve
preganglionic parasympathetic innervation to nasal glands travel this pathway:
CNVII via greater petrosal --> nerve of pterygoid canal --> pterygopalatine ganglion --> nasal branches (postganglionic)
postganglionic sympathetic innervation to nose travels this pathway
superior cervical ganglion --> deep petrosal nerve --> nerve of pteryagoid canal --> pterygopalatine ganglion (just passing through) --> nasal branches
blood supply to nasal sinuses
maxillary sinus: superior alveolar artery

rest: ethmoidal branches of ophthalmic artery
frontal sinus empties via ____ duct into _____ meatus
frontonasal duct into middle meatus
opens into the superior meatus
posterior ethmoidal sinuses
innervation to the nasal cavities

max:
frontal:
ethmoid:
sphenoid:
maxillary: superior alveolar n (V2)
frontal: frontal and nasociliary n (V1)
ethmoid: ethmidal n (V1), orbital and nasal n (V2)
sphenoid: posterior ethmoidal n (V1)
important structures of the pterygopalatine fossa
pterygopalatine ganglion, maxillary n(V2), and maxillary artery
boundaries of pterygopalatine fossa
lateral wall
medial wall
anterior
posterior
roof
floor
lateral wall: opens via pterygomaxillary fissure

medial wall: palatine bone

anterior: maxilla

posterior: pterygoid process of sphenoid

roof: greater wing of sphenoid

floor: opens via palatine canal
communications of the pterygopalatine fossa

lateral
medial
anterior
posteriorly (3)
inferiorly
lateral: ITF through pterygomaxillary fissure
medial: nasal cavity through sphenopalatine foramen
anterior: orbit through inferior orbital fissure
posterior: middle cranial fossa through foramen rotundum and pterygoid canal. Through pharyngeral canal (palatovaginal canal)
inferiorly: oral cavity through palatine canal
branches of the 3rd part of the maxillary artery
PSA a.,
infraorbital artery --> anterior and middle superior alveolar
descending palatine a. --> greater and lesser palatine
sphenopalatine artery,
pharyngeal a.,
artery of the pterygoid canal
maxillary division of CNV
- zygomatic nerve (zygomaticotemporal and zygomatical facial n)
- PSA nerve
- infraorbital nerve
- greater and lesser palatine nerves
- nasal nerve
- pharyngeal n
the pterygopalatine ganglion is the site of synapse of parasympathetic fibers from facial nerve for innervation to these glands
lacrimal,
nasal,
palatal,
pharyngeal glands
pterygopalatine ganglion is located just inferior to:
maxillary nerve
course of preganglionic parasympathetic fibers in PPF
facial nerve (VII) --> greater petrosal nervethrough hiatus of the facial canal and along groove for greater petrosal n --> nerve of the pterygoid canal (vidian nerve)
course of postganglionic parasympathetic fibers in PPF

to lacrimal:

nasal:

palatal:

pharyngeal:

vasculature and mucosa:
lacrimal: via maxillary n --> zygomatic n --> zygomaticotemporal (V2) --> lacrimal n (V1)

nasal: branches of V2 through sphenopalatine foramen

to palatal glands: branches of V2 through greater and lesser palatine nerves

to pharyngeal glands: V2 through pharyngeal canal

vasculature and mucosa: PSA, MSA, ASA (no parasymp to teeth)
sympathetic postganglionic fibers come from _________ plexus to form the ________ nerve which joints the ________ nerve just superior to the ________ to become this nerve.
internal carotid plexus to form the deep petrosal nerve which joins greater petrosal nerve just superior to foramen lacerum

--> becomes nerve of the pterygoid canal
the hard palate is covered by __________ inferiorly and by ___________ superiorly
mucoperiosteam inferiorly and mucosa of nasal cavity superiorly
mucoperiosteaum presents these 3 things which aid in gripping food against the tongue
median raphe, transverse palatine folds, rugae
the soft palate is suspended from _________ of hard palate; laterally attached to :
posterior edge
laterally attached to walls of pharynx
anterior and posterior arches of the soft palate combine to form passageway between these 2 places
latatoglossal and palatopharyngeal folds

passageway between the oral cavity and oropharynx
framework of soft palate is formed by
the aponeurotisis of tensor veli palatini muscle
function of soft palate
close of nasopharynx from oropharynx in speech and swallowing
foramina of the hard palate
insicive, greater and lesser palatine
blood supply to the palate
greater and lesser palatine arteries (from descending palatine branch of max artery),

ascending palatine artery (branch of facial) & sphenopalatine (branch of max)
palatal muscles
palatoglossus
palatopharyngeus
levator veli palatini
tensor veli palatini
musculus uvulae
motor innervation to the palate and the exception
all by CN XI via X except tensor veli palatini which is innervated by V3
sensory innervation to the palate
all branches of V2
greater palatine (most of hard palate)
lesser palatine (soft palate)
nasopalatine (small portion of anterior hard palate)
palatine tonsil lies within the mucosa in the ________ sinus between ___________ and _________
tonsillar sinus between the palatoglossal and palatopharyngeal folds
blood supplly and innervation to the palatine tonsil
tonsillar artery (facial branch)

tonsillar plexus formed by branch of glossopharyngeal
submandibular region lies between these 2 things
body of the mandible and the hyoid bone
what triangles are included in the submandibular region
submental and submandibular
contents of the submandibular region
submandibular and sublingual glands, suprahyoid muscles, submandibular ganglion, lingual/facial arteires, ligual/hypoglossal nerves
3 parts of the tongue

attached to these 4 things

composed chiefly of _____ muscle; partly covered by _______

important in these 5 things
tip, body, root.

attached to hyoid bone, mandible, styloid process and pharynx

composed of skeletal muscle/ partly covered by mucous membrane.

taste, mastication, swallowing, oral cleansing and speech
the dorsum of the tongue is divided by the ____________ into anterior 2/3 (oral) and posterior 1/3 (pharyngeal) portions

apex of this structure
sulcus terminalis

apex of sulcus terminalis is foramen cecum
oral part of tongue attached to floor of mouth by:

dorsum of oral part has:

lingual tonsils are located on ______ portion
lingual frenulum. median groove. pharyngeal portion of tongue
types of papillae
circumvallate (just anterior to sulcus terminalis), filiform, fungiform, foliate
intrinsic muscles of the tongue are concerned primarily with the ________ of the tongue

arranged in these planes:
shape of the tongue. longitudinal, transverse, vertical
genioglossus m. arises from: and acts to:
superior genial tubercle and acts to protrude and depress tongue
hyoglossus muscle arises from: and acts to:
body and greater horn of hyoid and acts to flatten and depress the tongue ((not considered a suprahyoid muscle))
styloglossus m. arises from: and acts to:
arises from the styloid process, acts to pull tongue backward and upward
palatoglossus m. arises from: and acts to:
arises from palatine aponeurosis of soft palate and acts to elevate the tongue toward the palate
motor innervation to the tongue muscles and the exception
hypoglossal nerve to all but one muscle of the tongue. palatoglossus is supplied by pharyngeal plexus (XI via X)
general sensation to anterior 2/3 and posterior 1/3 of tongue
anterior: lingual n...

posterior: glossopharyngeal n.
special taste sensation to the anterior 2/3 and posterior 1/3 of the tongue
anterior: chorda tympani// posterior: glossopharyngeal n.
small area of mucosa of the tongue just _______ to epiglottis receives both general and special sensation via this branch of the vagus nerve
anterior to epiglottis- internal laryngeal nerve
parasympathetic secretomotor fibers to the serous glands of the tongue are carried with the (motor/sensory) nerves of the tongue. These postganglionic fibers originate in the __________ ganglion
carried with sensory nerves of the tongue. originate in the submandibular ganglion
blood vessels of the tongue

arteries/ veins- principle vein? where does it drain
lingual artery.
- dorsal lingual, deep lingual and sublingual artery.

lingual veins- 2 accompany the lingual artery. deep lingual vein is principle --> drains into the internal jugular vein
4 routes lymph drains from the tongue

tip:
lateral ant 2/3
medial ant 2/3
posterior 1/3
(some drainage to opposite side)
1. tip of tongue--> submental nodes
2. lateral anterior 2/3 --> submandibular nodes
3. medial anterior 2/3 --> directly to inferior deep cervical nodes
4. posterior 1/3 --> directly to superior deep cervical nodes
superficial part of submandibular gland is located in ________________.

deep part located between these two muscles ____________ & _________.

both parts joined along posterior edge of this muscle:

submandibular duct extends from deep part _________ to ___________ papilla
submandibular triange// deep between mylohyoid and hyoglossal muscles/// joined along the posterior edge of the mylohyoid m. ///extends from deep part anteriorly to sublingual papilla (caruncle)
sublingual gland is located within ______ fold, ______ to the mylohyoid; lies between ________ and _______ muscle.///

has _________ ducts which open separately into oral cavity on ___________ fold. some may unite and open into __________ duct
sublingual fold, superior to mylohyoid, between mandible and genioglossus muscle.//

10-30 ducts. on sublingual fold. some may unite open into the submandibular duct
submandibular and sublingual glands receive parasympathetic & secretomotor fibers from this ganglion: post ganglionic fibers reach the glands by joining this nerve________ sympathetic comes from
submandibular ganglion. postganglionic hitch hike on lingual n.. superior cervical ganglion
vascular supply to sublingual and submandibular glands
adjacent branches of facial and lingual arteries
lingual nerve passes through TIF then across __________ muscle to reach _______ surface of _______ muscle.

crosses submandibular duct these 3 directions:

ascends ________ to duct on surface of this muscle then breaks up into terminal branches.


joined by _______ in ITF
styloglossus mucle to reach lateral surface of hyoglossus.

first laterally, inferiorly, medially.

ascends medially to duct on surface of genioglossus m.

chorda tympani
hypoglossal nerve lies of this muscle, inferior to these two things.

goes deep to _________ to reach rest of tongue muscles
lies of hyoglossus, inferior to submandibular duct and lingual nerve

sublingual gland
ganglion for parasympathetic secretomotor innervation of submandibular/sublingual glands as well as minor salivary glands. located on ________ muscle suspended from ________ nerve
submandibular ganglion. on hyoglossus muscle suspended from lingual nerve (CNV3)
course of parasmapthetic fibers of submandibular ganglion to submandibular: to sublingual
pre- chorda tympani (CNVII)
post: submandibular gland by direct glandular branches and to sublingual by joining the lingual nerve
portions of the submandibular ganglion may be found within:
the submandibular gland
lingual artery arises from ________ artery at level of __________. passes deep to _______ muscle. 3 major branches:
external carotid at hyoid bone. hyoglossus muscle.
Dorsal lingual, sublingual, and deep lingual arteries
dorsal lingual a. supplies:
sublingual a supplies:

deep lingual a. supplies:
base of the tongue, the anterior floor of the mouth, anterior portion of the tongue
facial artery arises from _______ just above _______

passes through ________ before crossing the mandible to reach the face. major branches in submandibular region:
external carotid just above lingual a. passes through submandibular gland.

glandular and submental branches major
all veins on one side of tongue form ______ vein which drains into either of these 2 veins
lingual vein drains into --> facial or internal jugular vein
the retromolar fossa is bound medially and laterally by:. at the apex, posteriorly, attaches the:
crests of the postmolar alveolar process

attaches to pterygomandibular raphe
defines the anterior boundary of the oropharynx
pterygomandibular raphe and palatoglossus muscle
retromolar region boundaries- lateral: posterior: medial: inferior:
lateral: buccinator m.,
posterior: superior constrictor m. even deeper is medial pterygoidm
medial: palatoglossal arch,
inferior: styloglossus muscle, lingual nerve and submandibular gland
the external auditory meatus is a canal bounded _________ by the tympanic membrane (eardrum)
medially
tympanic membrane faces slightly:

composed of these two laters and what is in between them?
inferiorly and posteriorly

2 epithelial layers (skin externally/ mucosa internally) w/ fibrous tissue in between
external tympanic membrane is innervated by:

external meatus is innervated by these three things:

internal tympanic membrane and middle ear mucosa innervated by:
auriculotemporal

auriculotemporal, facial, and vagus

glossopharyngeal
boundaries of the tympanic cavity

roof

floor

anterior (carotid) wall

posterior wall

lateral wall

medial wall
roof: tegmen tympani (in middle cranial fossa)

floor: jugular wall

anterior: opening of auditory tube, tensor tympani, internal carotid artery

posterior wall: aditus to mastoid air cells, stapedius m., facial canal

lateral wall: tympanic membrane

medial wall: oval window (fenestra vestibuli), round iwndow (fenestra chochleae), and promontory (site of the tympanic plexus)
contents of tympanic cavity
ossicles: malleus, incus, stapes

muscles: tensor tympani, stapedius

chorda tympani
tensor tympani is attached to:
innervated by:

stapes is attached to:
innervated by:
malleus, CNV3

attached to stapes, innervated by CNVII
chorda tympani runs across ___________ and _______ to the malleus
tympanic membrane and medial to the malleus
the cochlea is _______, responsible for _______, _______ window opens from it
anterior, responsible for audition, round window opens from it
the semicircular canals are _______ to vestibule, responsible for _________
posterior to vestibule, responsible for balance
vestibulocochlear nerve (CNVIII) branches
cochlear n. (hearing) and vestibular n. (equilibrium)
facial nerve branches in the ear
- geniculate ganglion
- greater petrosal n.
- nerve to stapedius
- chorda tympani
clinical correlates for the ear
middle ear infection (otitis media), fractures of meatus, TMJ disease, referred sensation involving V3, IX, or X
parasympathetics for the ciliary (III) ganglion arise from this nucleus:

for the submandibular (VII) ganglion arise from:

for the pterygopalatine (VII) ganglion arise from:

for the otic ganglion (IX) arise from:
edinger-westphal

superior salivatory nucleus

lacrimal

inferior salivatory nucleus
innervation to the tympanic cavity
glossopharyngeal n (IX)

tympanic plexus (CN IX and sympathetics)
blood supply to tympanic cavity
maxillary a (anterior tympanic branches)
malleus is attached to this:
tympanic membrane (umbo)