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Flashcards in Pharynx and Larynx Deck (40):

what are the 3 phases of swallowing

1) oral phase: mastication
2) oropharyngeal phase: elevation floor of mouth and tongue to push bolus into oropharnx
3) pharyngeo-esophageal phase: bolus propolled down esophagus


divisions of pharynx



nasopharynx location and communication

posterior to the nasal cavity
communicates with nasal cavity via choanae
communicates with middle ear cavity via auditory tube
communicates with oropharynx via PHARYNGEAL ISTHMUS


oropharynx location and communication

posterior to oral cavity
communicates with oral cavity via faucial isthmus
communicates with nasopharynx via pharyngeal isthmus


laryngeopharynx located ___
communicates with oropharynx at the level of what
communicates with larynx via what

posterior to larynx
laryngeal aditus


what is the piriform recess
innervated by what?

posterior and lateral to arytenoid cartilages in laryngeopharynx
-epithelium innervated by internal branch of superior laryngeal nerve


stylopharyngeus muscle is a ___ of the pharynx
-location and innervation?

arises from the styloid process and inserts on wall btwn superior and middle constrictors
innervated by SVE of the glossophargyngeal n


superior constrictor muscle location

attached laterally to pterygomandibular raphe near third molar


middle constrictor location

attached laterally to hyoid and posteriorly to the midline pharyngeal raphe


inferior constrictor location

laterally to oblique line of thyroid and cricoid cartilage
-horizontal fibers comprise cricopharyngeus muscle used during pharngeal speach


what is killums triangle

transition between inferior constrictor mucsle and cricopharyngeus muscle


zenker's diverticulum

herniation of the mucosal lining of the esophagus between cricopharyngeal m and inferior constrictor muscle
-may be weakened area due to transition from skeletal to smooth m


buccopharyngeal fascia

subdivision of pretracheal fascia, covers outer surface of buccinator muscle and pharynx
-part that covers middle constrictor contains pharyngeal plexus


retropharyngeal space location and relevance

between buccopharyngeal fascia and prevertebral fascia
-continuous from the base of the skull to the mediastinum
-infections can spread through regions here
-in cervical fusion of vertebrae, anterior bodies of cervical vertebra are approached here


innervation of the pharynx

sensory: GVA from the pharyngeal branch of glossopharyngeal n, convey afferent info for GAG reflex

motor: SVE from the pharyngeal branch of the vagus nerve


branches of nerve IX in pharynx and what they do (3)

1) pharyngeal branch to the pharyngeal plexus
2) sensory GVA to mucosa of post 1/3 tongue and pharynx, SVA to taste buds of post 1/3 tongue
3) motor (SVE) to stylopharyngeus muscle


Gag relex nerves involved

IX send afferents in
X send efferents to cause reflex
-assisted by intercostal, phrenic, and abdominal nerves


superior laryngeal nerve is a branch off of what nerve

the vagus nerve


the thyroid laminae form the ___ anteriorly
superior horn continous with ___ and forms ___
inferior horn articulates with ___ ___ and makes ___ __

laryngeal prominence
hyoid bone, thyrohyoid ligament
cricoid cartilage, cricothyroid joint


arytenoid cartilages location, vocal and muscular process

pyramidal shaped on superior edge of cricoid cartilage
-vocal process attached to vocal ligament of vocal cord
-muscular process attached to posteior and lateral cricoarytenoids


arytenoid cartilages and phonateion and respiration

phonation: tension of vocal folds
respiration: slide laterally to open rima glottidis


piriform recesses ______ if the patient says "a-a-a" in a low voice. secretions may gather here but should disappear on swallowing. if they do not then patient has ___ sign which suggests ___

slightly dilate
obstruction or paralysis of upper esophagus


valleculae epiglottica location
seperated by
bound laterally by

recess between tongue and epiglottis
-separated from each other by median glossoepidglottic fold
-bound laterally by lateral glossoepiglottic folds


where is the blade often placed during intubation
opens what?

in the valleculae epiglottica, moved forward and theis moves tongue and epiglottis forward too
-opens laryngeal aditus


the thyrohyoid membrane is piereced by what

internal branch of the superior laryngeal nerve
superior laryngeal artery


what muscle of the larynx is the only abductor of the vocal cords

posterior cricoarytenoid muscle


what muscles of the larynx are adductors of the vocal cords

lateral cricoarytenoid m


how to test cricothyroid muscle and what happens to width of membrane

have patient say eeee in a high pitched voice
causes contraction and decrease in the cricothyroid membrane


what innervates the cricothyroid muscle

external branch of the superior laryngeal nerve


after the RLN corsses the ___ and enters the ___ it is called the ____. conveys ___ fibers to laryngeal muscles except ____

cricothyroid joint, inferior laryngeal nerve
SVE cricothyroid muscle


at what level does the oropharynx communicate with the laryngeopharynx



layers of the pharyngeal wall from in to out

1) muccosa layer
2) pseudostratified and stratified non keratinized epithelia
3) submucosa layer
4) pharyngeobasilar fascia: forms inner layer of muscular fascia
5) inner elevators of pharynx
6) pharyngeal constrictor muscles
7) Buccopharyngeal fascia


what is the chief sensory nerve to the interior of the larynx
-what kind of fibers

the internal branch of the superior laryngeal nerve
GVA fibers


what can someone get if the laryngeal cough reflex is not working

aspiration pneumonia


what nerve inervates the cricothyroid muscle

external branch of the superior laryngeal nerve


after the recurrent laryngeal nerve crosses the _____ joint and enters the larynx it is called _____
-supplies what fibers

cricothyroid joint, inferior laryngeal nerve
-supplies laryngeal muscles except cricothyroid muscle


what does paralysis of the recurrent laryngeal nerve cause

hoarseness and dysphagia


the superior laryngeal nerve is the chief sensory nerve to what?

interior of the larynx and piriform recess


laryngeal expiration reflex afferent component

internal branch of superior laryngeal nerve innervates receptors, afferents enter medulla with vagus nerve and terminate at NTS


laryngeal expiration reflex efferent component

recurrent laryngeal, intercostal and abdominal nerves activate muscles and cause expiratory coughing