Hnn - Pharynx, Larynx And Trachea

Front 1

What are the three regions the pharynx is typically divided into?

Back 1

1. Nasopharynx
2. Oropharynx
3. Laryngopharynx

Front 2

What is the nasopharynx?

Back 2

The superior portion of the pharynx lying above the soft palate. The auditory tube enters into this area. The nasopharyngeal tonsils, or adenoids, are also found in this area.

Front 3

Where does the oropharynx lie, what does it communicate with, what happens when the soft palate is at rest and raised, and what is found in this area?

Back 3

The oropharynx lies below the soft palate and communicates anteriorly with the oral cavity. With the soft palate at rest, the nasopharynx communicates with the oropharynx. when the soft palate is raised, it forms a seal against the posterior wall of the pharynx. This occurs during swallowing. The oropharynx is sealed from the oral cavity by the soft palate and dorsum of the tongue coming together. This occurs during sucking. The palatine tonsils are found in this area.

Front 4

Where is the laryngopharynx located and where does it end?

Back 4

The portion of the pharynx adjacent to the larynx is the laryngeal pharynx. The laryngeal pharynx ends inferiorly as it merges into the esophagus.

Front 5

What are the three semicircular constrictor muscles and what do they do?

Back 5

Superior constrictor
Middle constrictor
Inferior constrictor
They work in a peristaltic motion to move the bolus of food down the pharynx.

Front 6

Where does the superior constrictor muscle originate and insert?

Back 6

Originates from the pterygomandibular raphe and inserts on the midline pharyngeal raphe.

Front 7

Where does the middle constrictor muscle originate and insert?

Back 7

Originates from the area of bone between the greater and lesser horns of the hyoid bone and a small portion of the stylohyoid ligament. It inserts on the midline pharyngeal raphe.

Front 8

Where does the inferior constrictor muscle originate and insert?

Back 8

Originates from the lateral aspect of the thyroid and cricoid cartilages. It inserts on the midline pharyngeal raphe.

Front 9

Where does the palatopharyngeus muscle originate and insert?

Back 9

Originates from the palatal aponeurosis to insert into the posterolateral aspect of the pharynx and the posterior aspect of the hyoid bone and thyroid cartilage

Front 10

Where does the stylopharyngeus muscle originate?

Back 10

Originates from the styloid process, travels through gap between superior and middle constrictor muscles to insert with the palatopharyngeus.

Front 11

Where is the first gap of the pharynx located and what passes through it?

Back 11

Between the base of skull and superior constrictor. Passing through are auditory tube, levator palati muscle and ascending palatine branch of the facial artery.

Front 12

Where is the second gap of the pharynx located and what passes through it?

Back 12

Between superior and middle constrictors. Passing through are stylopharyngeus muscle and glossopharyngeal nerve

Front 13

Where is the third gap of the pharynx located and what runs through it?

Back 13

Between middle and inferior constrictor. Internal laryngeal branch of X and superior laryngeal branch of superior thyroid artery pass through.

Front 14

Where is the fourth gap of the pharynx located and what runs through it?

Back 14

Between inferior constrictor and esophagus. Passing through are recurrent laryngeal nerve and inferior laryngeal branch of the inferior thyroid artery.

Front 15

What provides the motor innervation to the pharynx?

Back 15

Glossopharyngeal (IX) Nerve
Accessory (XI) Nerve which travels with the Vagus nerve (X) - PHARYNGEAL PLEXUS

Front 16

1. What provides the motor innervation to the stylopharyngeus?

2. What provides the motor innervation to the remainder of the pharyngeal musculature?

Back 16

1. Glossopharyngeal (IX) Nerve

2. Accessory nerve (XI) travelling with the Vagus nerve (X). These fibers are referred to as the pharyngeal plexus.

Front 17

What provides the sensory innervation to the pharynx?

Back 17

Glossopharyngeal nerve
Maxillary nerve (V2)
Vagus nerve (X)

Front 18

1. What is the main sensory supply for the pharynx?

2. What provides the sensory innervation for the soft palate and the pharyngeal roof?

3. What provides the sensory innervation for the area surrounding the laryngeal inlet?

Back 18

1. Glossopharyngeal (IX) Nerve
2. Maxillary nerve (V2)
3. Vagus nerv (X)

Front 19

What are the main functions of the larynx and how does it differ from the pharynx?

Back 19

The functions of the larynx are:
-Provide an air passage linking the pharynx with the trachea
-Act as a sphincter to prevent food in the pharynx from entering the air passage
-Organ of Phonation

As opposed to the pharynx, which is muscular, the larynx also has a skeleton composed of bones and cartilages.

Front 20

What comprises the laryngeal skeleton?

Back 20

- Three unpaired cartilages (thyroid, epiglottis, cricoid)
- Three smaller paired cartilages (arytenoid, cuneiform and corniculate)
- The hyoid bone is also considered, at least from a functional viewpoint, part of the laryngeal skeleton

Front 21

What are the two types of ligaments that help stabilize the laryngeal complex?

Back 21

Extrinsic (external) and Intrinsic (internal)

Front 22

What are the extrinsic ligaments of the laryngeal complex?

Back 22

- Hyo-epiglottic ligament
- Cricotracheal ligament

Front 23

Where does the hyo-epiglottic ligaments run?

Back 23

Runs from the midline of the epiglottis to the body of the hyoid bone.

Front 24

Where does the cricotracheal ligament run?

Back 24

Attaches to the lower portion of the cricoid cartilage and the upper portion of the first cartilage of the trachea

Front 25

What are the intrinsic muscles of the laryngeal complex?

Back 25

Cricothyroid ligament
Medial cricothyroid ligament
Quadrangular membrane

Front 26

Where does the cricothyroid ligament run and what does it form in part?

Back 26

Runs from the arch of the cricoid cartilage to the upper free margin on the inner aspect of the thyroid cartilage.

A portion of this forms the vocal ligament which participates in phonation.

Front 27

Where does the median cricothyroid ligament run and what is it a portion of?

Back 27

A thickening of a portion of the cricothyroid ligament which runs between the arch of the cricoid cartilage and the inferior aspect of the thyroid cartilage.

Front 28

What does the quadrangular membrane attache to and what does the free lower margin of the ligament form?

Back 28

Attaches to the lateral margin of the epiglottis and the anterolateral aspect of the impsilateral arytenoid cartilage. It also attaches to the croniculate cartilage.

The free lower margin of the ligament forms the vestibular ligament which is found under the vestibular fold. The vestibular fold is also known as the false vocal cord of the larynx.

Front 29

What is the vestibular fold also known as?

Back 29

The false vocal cord of the larynx

Front 30

What is the superior border of the internal aspect of the larynx?

Back 30

Entry into the pharynx just below and posterior to the tongue

Front 31

What is the anterior border of the internal aspect of the larynx?

Back 31

Mucosa covering the superior aspect of the epiglottis

Front 32

What is the lateral border of the internal aspect of the larynx?

Back 32

Folds of mucosa (aryepiglottic folds) that enclose the superior aspect of the quadrangular membranes, cuneiform and corniculate cartilages

Front 33

What is the posterior border of the internal aspect of the larynx?

Back 33

Midline mucosal fold between the two corniculate cartilages and their tubercles.

Front 34

What is the inferior border of the internal aspect of the larynx?

Back 34

Continuous with the lumen of the trachea

Front 35

What are the names of the muscles associated with the larynx?

Back 35

Cricothyroid
Transverse arytenoid
Posterior cricoarytenoid
Lateral cricoarytenoid muscle
Vocalis

Front 36

What is the origin, insertion and function of the cricothyroid muscle?

Back 36

Origin: Anterior portion of the cricoid cartilage
Inserts: Posteroinferior aspect of the thyroid
Function: tilts the thyroid cartilage forward over the cricoid cartilage they act to stretch the vocal folds

Front 37

What is the origin, insertion and function of the transverse arytenoid muscle?

Back 37

Origin: Lateral aspect of one arytenoid
Inserts: Lateral aspect of the other arytenoid
Function: fibers contract to approximate the right and left arytenoid cartilages (ie pull them closer to each other)

Front 38

What is the origin, insertion and function of the posterior cricoarytenoid muscle?

Back 38

Origin: Posterior aspect of the cricoid cartilage
Insertion: arytenoid
Functon: The right and left muscles contract to spin the arytenoid cartilages about vertical axes as the cricothyroid joints. This causes the vocal processes and attached vocal fold to abduct, opening the rima glottidis.

Front 39

What is the origin, insertion and function of the lateral cricoarytenoid muscle?

Back 39

Origin: Lateral aspecto of the cricoid cartilage
Insert: Arytenoid
Function: Muscles bilaterally contract to turn the arytenoids about vertical axes at the cricoarytenoid joints. This causes the vocal processes to adduct to close the rima glottidis.

Front 40

What is the origin, insertion and function of the vocalis?

Back 40

Origin: Part of the thyroarytenoid muscle which arises from the internal aspect of the thyroid
Inserts: Lateral aspect of the arytenoid
Function: Fibers contract to approximate the thyroid cartilage and arytenoid cartilages, shortening the vocal ligaments.

Front 41

What are the four actions of the Larynx?

Back 41

1. Control of vestibular opening
2. Abduction of vocal folds
3. Adduction of vocal folds
4. Control tension of vocal folds

Front 42

What muscles are involved in the control of the vestibular opening of the larynx?

Back 42

During swallowing, the vestibule is close by the sphincteric action of the aryepiglotticus, thyroepiglotticus and thyroarytenoid muscles.

Front 43

What are the muscles involved with the abduction of the vocal folds?

Back 43

Right and left posterior cricoarytenoid muscles

Front 44

What are the muscles involved with the adduction of the vocal folds?

Back 44

Lateral cricoarytenoids aided by the thyroarytenoids and transverse arytenoids

Front 45

What are the muscles involved with the control of tension of the vocal folds?

Back 45

Cricothyroid and vocalis

Front 46

What provides the motor innervation for the larynx?

Back 46

Intrinsic muscles of the larynx - CN XI via CN X
Cricothryoid muscle - external laryngeal branch
Remainder of muscles - inferior larygneal branch of the recurrent laryngeal branch

Front 47

What provides the sensory innervation for the larynx?

Back 47

VAGUS NERVE

The vagus nerve is the sensory nerve of the larynx via the internal laryngeal and recurrent laryngea nerves. These are true vagal branches.

Front 48

What is the trachea composed of and where is it located?

Back 48

The trachea tube is composed of 20 "U" shaped cartilages and the tissue that binds them together.

It begins in the neck and continues down into the thorax.

Front 49

At what vertebral level does the trachea divide into the right and left primary bronchi and what is this location called?

Back 49

T5, Sternal Angle

Front 50

With respect to the ribs where is the sternal angle located?

Back 50

At the level of the junction of the 2nd ribs to the sternum

Front 51

When is a cricothyrotomy performed and where is it performed?

Back 51

Normally performed as an emergency procedure

Midline of the cricothyroid ligament - median cricothyroid ligament, a portion of the cricoid cartilage can also be incised

Front 52

When is a tracheotomy performed and where is it performed?

Back 52

Performed under more leisurely conditions

A hole is made between the 1st and 2nd, or 2nd and 3rd tracheal cartilages

Front 53

If a long term insertion of a tube into the trachea is performed what is it called?

Back 53

A tracheostomy