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Gross-Session 36

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What are the general funtions of the pharynx?
respiratory
gastrointestinal
immunologic
What is the spatial arrangement of the pharynx?
-airway = anterior
-foodway = posterior
What are the four layers of pharyngeal wall?
1. mucous membrane
2. pharyngobasilar fascia
3. muscular layer
4. buccopharyngeal fascia
What type of epithelium is above the mucous membrane of the pharyngeal wall?

What type of epithelium is below the mucous membrane of the pharyngeal wall?
- respiratory epithelium is above
- stratified squamous is below
What is the pharyngobasilar fascia composed of?
pharyngeal aponeurosis and
dense submucosa
What type of muscle is the muscular layer of the pharyngeal wall composed of?
-outer circular
-inner longitudinal
What three structures pass through gaps on the pharyngeal wall above the superior constrictor?
1. cartilage of the auditory tube
2. levator veli palatini muscle
3. ascending palatine artery
What two structures pass through gaps on the pharyngeal wall between superior and middle constrictors?
1. stylopharyngeus muscle
2. glossopharyngeal nerve
What two structures pass through gaps on the pharyngeal wall between the middle and inferior constrictors?
1. superior laryngeal artery
2. internal branch of the superior laryngeal nerve
What two structures pass through gaps on the pharyngeal wall below the inferior constrictor?
1. inferior laryngeal artery
2. inferior laryngeal nerve
What are the three subdivisions of the pharynx?
1. nasopharynx
2. oropharynx
3. laryngeal pharynx (hypopharynx)
What are the five openings of the pharynx?
1. choanae
2. auditory (pharyngotympanic) tubes
3. isthmus of the fauces
4. superior aperture of the larynx
5. opening into the esophagus
What are the six surface features of the nasopharynx?
1. opening of the auditory tube
2. torus tubarius
3. levator cushion
4. salpingopharyngeal fold
5. pharyngeal recess
6. pharyngeal tonsil
What are the seven surface features of the oropharynx?
1. palatoglossal arch
2. palatine tonsil
3. palatopharyngeal arch
4. lateral glossoepiglottic fold
5. epiglottic vallecula
6. lingual tonsil
What are the three surface features of the laryngeal pharynx?
1. epiglottis
2. aryepiglottic fold
3. piriform recess
What is the lymphatic drainage of the nasopharynx?
to retropharyngeal and superior deep cervical nodes
What is the lymphatic drainage of the soft palate?
to superior deep cervical nodes
What is the lymphatic drainage of the oropharynx?
to superior deep cervical nodes
What is the lymphatic drainage of the laryngeal pharynx?
to superior deep cervical nodes
Should you consider the palate as the anterior wall of the pharynx?
Why?
-yes
-this concept simplifies the understanding of the innervation of the palate
What is the palatine aponeurosis?
the central layer of the soft palate
What is the palatine aponeurosis attached to?
-anteriorly = hard palate
-posteriorly and laterally = muscles
What are the five muscles of the soft palate?
1. tensor veli palatini
2. levator veli palatini
3. uvular muscle
4. palatopharyngeus
5. palatoglossus
What is the course of the tensor veli palatini?
1. it arises from the scaphoid fossa and cartilage of the auditory tube
2. decends vertically
3. tendon passes around the hamulus
4. inserts on the palatine aponeurosis
What is the function of the tensor veli palatini?
pulls upward on the palate
What is the course of the levator veli palatini?
1. arises from the petrous part of the temporal bone
2. slants inferiorly, anteriorly, and medially
3. inserts in upper surface of palatine aponeurosis
What is the course of the uvular muscle?
1. arises from palatine aponeurosis
2. courses posteriorly
3. inserts in the uvula
What is the course of the palatopharyngeus?
1. It arises from the palatine aponeurosis
2. passes behind palatine tonsil
3. spreads out on inner surface of pharyngeal wall
What is the course of the palatoglossus?
1. it arises from the inferior aspect of palatine aponeurosis
2. passes in front of palatine tonsil
3. inserts into the side of the tongue
What does the submucosa of the soft palate contain?
1. loose connective tissue
2. palatine (minor salivary) glands
What does the mucous membrane of the soft palate contain?
1. Non-keratinized epithelium with stratified squamous on the oral side, pseudostratified ciliated columnar on the nasal side
2. abundant blood vessels
What are the movements of the palate and the pharynx?
speech and swallowing
What movement occurs during speech- the closure of the nasopharynx?
1. The side walls of the pharyngeal isthmus are brought inward.
2. soft palate is elevated by levator veli palatini
What movement occurs during swallowing?
1. the palate is tightened and elevated by the tensor veli palatini
2. the palate is drawn downward by the palatopharyngeus
3. the palate is elevated again by the levator veli palatini
4. the posterior pharyngeal wall comes forward to meet the palate- the ridge of passavant and the palate move inferiorly
5. the constrictor muscles contract sequentially.
What is the ridge of passavant?
a contraction of upper fibers of superior constrictor muscles
What are the five cartilages that make up the skeleton of the larynx?
1. thyroid cartilage
2. cricoid cartilage
3. epiglottic cartilage
4. arytenoid cartilages
5. other small cartilages
What are four characteristics of the thyroid cartilage?
1. shield-shaped
2. is open posteriorly
3. suspended from the hyoid
4. articulated below the hyoid with the cricoid
What is a characteristic of the cricoid cartilage?
is the only complete ring in the airway
What are three characteristics of the epiglottic cartilage?
1. petal shaped
2. attached to inside of the "v" of the thyroid
3. elastic
What are three characteristics of the arytenoid cartilages?
1. pyramidal
2. articulate with the top of the cricoid lamina
3. is attached to the back of the vocal ligament
What are the three cavities of the larynx?
1. vestibule
2. ventricles
3. infraglottic cavity
What are the boundaries of the vestibule of the larynx?
- begins at the superior laryngeal aperture
-ends at vestibular folds
What are the boundaries of the ventricles of the larynx?
- lateral expansions of laryngeal cavity below vestibular folds
-ends inferiorly at the vocal cords
What are the boundaries of the infraglottic cavity of the larynx?
-is an expansion of laryngeal cavity below the vocal folds

-beginning of the lower airway
-continues into trachea at lower border of cricoid
What are the three membranes and ligaments of the larynx?
1. quadrangular membrane
2. elastic cone
3. thyrohyoid membrane
What are the boundaries of the quadrangular membrane of the larynx?
-begins within the aryepiglottic fold
-ends inferiorly in the vestibular ligament
What are the vocal ligaments of the elastic cone?
-the upper free borders of the elastic cone
Where do the vocal ligaments of the elastic cone attach to the elastic cone?
-inside the "v" of the thyroid cartilage
- in the vocal process of the arytenoid cartilage
What is the median cricothyroid ligament of the elastic cone?

What does the median cricothyroid ligament attach?
- the anterior thickening of the elastic cone

- attaches cricoid and thyroid cartilages
What is the innervation of the larynx?
1. superior laryngeal nerve
2. inferior laryngeal nerve
What is the function of the internal branch and the external branch of the superior laryngeal nerve?
-internal= supplies sensory innervation above vocal folds

-external= supplies motor to cricothyroid muscle
What is the function of the inferior laryngeal nerve?
- supplies sensory innervation below vocal folds

- supplies all intrinsic muscles except cricothyroid
What are the two arteries of the larynx?
1. superior laryngeal artery
2. inferior laryngeal artery
Where is the superior laryngeal artery from?
What area of the larynz does it supply?
-from the superior thyroid artery
-supplies the larynx above the vocal cords
Where is the inferior laryngeal artery from?
What area of the larynx does it supply?
- from the inferior thyroid artery
-supplies the larynx below the vocal cords
What are the veins of the larynx?
1. superior laryngeal vein
2. inferior laryngeal vein
What are the three functions of the larynx?
1. vocalization
2. "closure" of the superior laryngeal aperture (it guards the airway
3. the valsalva maneuver (the closure of vestibular folds)
What is "vocalization"
1. vibrations set up in exhaled air by slight opening of the glottis
2. selective closure of the glottis modulates vibrations
When does closure of the superior laryngeal aperture occur?

What does the superior laryngeal aperture guard?
-during swallowing and during vomiting
-the airway
When does the valsalva maneuver occur?

What is the valsalva maneuver?
- during coughing, sneezing, lifting, pushing, urination, defecation, parturition, vomiting

-the closure of vestibular folds

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