Section 1
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What are the anatomical landmarks that can be used to identify the superior and inferior borders of the laryngopharynx?
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Section 1
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What are the anatomical landmarks that can be used to identify the superior and inferior borders of the laryngopharynx?
The laryngopharynx (hypopharynx) lies posterior to the larynx, extending from the superior border of the epiglottis and the pharyngo-epiglottic folds to the inferior border of the cricoid cartilage, where it narrows and becomes continuous with the esophagus (Fig. 8.16). Posteriorly, the laryngopharynx is related to the bodies of the C4-C6 vertebrae. Its posterior and lateral walls are formed by the middle and inferior pharyngeal constrictor muscles (Fig. 8.18). Internally, the wall is formed by the palatopharyngeus and stylopharyngeus muscles (Fig. 8.17C). The laryngopharynx communicates with the larynx through the laryngeal inlet on its anterior wall (Fig. 8.12B).
Identify how the foramen rotundum communicates with the pterygoidpalatine fossa.
Posterosuperiorly with the middle cranial fossa through the foramen rotundum and pterygoid canal.
Describe the Levator Veli Palatini.
The levator veli palatini (lifter of the soft palate) is a cylindrical muscle that runs infero-anteriorly, spreading out in the soft palate where it attaches to the superior surface of the palatine aponeurosis. The levator veli palatini elevates soft palate during swallowing and yawining. The levator veli palatini muscle is innervated by the Vagus nerve (CN X)
What are the muscles that elevate the pharynx?
The internal, mainly longitudinal, layer of pharyngeal muscles consists of: 1. Palatopharyngeus 2. Stylopharyngeus 3. Salpingopharyngeus. These muscles elevate the larynx and shorten the pharynx during swallowing and speaking.
On the hard palate locate and identify the suture between the maxillae, and between the maxillae and palatine bones.
The suture between the maxillae on the palate is the median palatine suture. The suture between the maxillae and palatine bones is transverse palatine suture.
Identify and locate the three constrictor muscles.
The pharyngeal constrictor muscles form the external layer of the smooth mucles surrounding the alimentary canal. The external layer consist of three pharyngeal constrictors: superior, middle, and inferior.
Briefly describe the venous drainage from the hard and soft palates.
Venous drainage of the palate, corresponding to and accompanying the branches of the maxillary artery, involves tributaries of the pterygoid venous plexus (Fig. 7.44B).
What is the relation and communication of the nasopharynx to the nasal cavity?
The nose opens into the nasopharynx through two choanae (paired openings between the nasal cavity and nasopharynx).
What is the overall action of the constrictor muscles?
The pharyngeal constrictors contract involuntarily so that contraction takes place sequentially from the superior to the inferior end of the pharynx, propelling food into the esophagus. All three constrictors are supplied by the pharyngeal plexus of nerves that lies on the lateral wall of the pharynx, mainly on the middle constrictor (Fig. 8.18).
Identify the three segments of the pharynx.
The pharynx is divided into three parts: 1.Nasopharynx, posterior to the nose and superior to the soft palate. 2.Oropharynx, posterior to the mouth. 3.Laryngopharynx, posterior to the larynx.
Locate and identify the foramina of the palate, and tell what passes through each foramen
Three foramina open on the oral aspect of the hard palate: the incisive fossa and the greater and lesser palatine foramina. The incisive fossa is a slight depression posterior to the central incisor teeth. The nasopalatine nerves pass from the nose through a variable number of incisive canals and foramina that open into the incisive fossa (Fig. 7.54B). Medial to the third molar tooth, the greater palatine foramen pierces the lateral border of the bony palate. The greater palatine vessels and nerve emerge from this foramen and run anteriorly on the palate. The lesser palatine foramina transmit the lesser palatine nerves and vessels to the soft palate and adjacent structures.
Describe the Tensor Veli Palatini.
The tensor veli palatini (tensor of the soft palate) is a muscle with a triangular belly that passes inferiorly; the tendon formed at its apex hooks around the pterygoid hamulus—the hook-shaped inferior projection of the medial pterygoid plate—before spreading out as the palatine aponeurosis. The tensor veli palatini tenses the soft palate and opens the mouth of pharyngotympanic tube (auditory tube) during swallowing and yawning. It is innvervated by the Mandibular division of the Trigeminal Nerve (CN V3).
What action does the salpingopharyngeous muscle exert on the pharynx as a whole?
The salpingopharyngeus is known to raise the pharynx and larynx during deglutition (swallowing) and laterally draws the pharyngeal walls up. In addition, it opens the pharyngeal orifice of the pharyngotympanic tube during swallowing. This allows for the equalization of pressure between the auditory canal and the pharynx. The salpingopharyngeus is innervated by the vagus nerve (CN X) via the pharyngeal plexus.
Locate the salpingopharyngeal fold and its underlying muscle. What effect does the salpingopharyngeus muscle have on the auditory tube?
Extending inferiorly from the medial end of the pharyngotympanic tube (auditory tube) is a vertical fold of mucous membrane, the salpingopharyngeal fold. It covers the salpingopharyngeus muscle, which opens the pharyngeal orifice of the pharyngotympanic tube during swallowing.
What are the structures that pass through the gap between the superior and middle pharyngeal constrictors?
It is through this gap that several structures pass through the pharynx to enter the posterolateral aspect of the oropharynx and oral cavity (GD Fig 7.83). These structures are: 1. Glossopharyngeal nerve 2. Stylopharyngeus muscle 3. Stylohyoid ligament
What is the tubal tonsil, where is it located, and what is its purpose?
The collection of lymphoid tissue in the submucosa of the pharynx near the pharyngeal orifice of the pharyngotympanic tube is the tubal tonsil. The tonsils may have the following functions. •It produces lymphocytes (white blood cells) which play an important role in fighting infections as part of the body's immune defenses. •It traps and neutralizes invading pathogens that may enter through the mouth and nose. •It plays a role in allergic mechanisms (immune mediated hypersensititvity). •It monitors the air, food and fluids that enter through the nose and mouth and may trigger localized and even systemic reactions in response to certain compounds.
What does the lesser palatine nerve provide sensory to?
The lesser palatine nerves supply the soft palate.
What ganglion the sensory nerves of the palate pass through before entering the palate?
The sensory nerves of the palate (greater palatine nerve, nasopalatine nerve, and lesser palatine nerve) pass through the pterygopalatine ganglion and are considered branches of the maxillary nerve.
What structures form the "bed" of the tonsil?
The tonsillar bed is formed by the superior constrictor of the pharynx and the thin sheet of pharyngobasilar fascia (Fig. 8.18A). This fascia blends with the periosteum of the cranial base and defines the limits of the pharyngeal wall in its superior part.
Describe the soft palate.
A mobile fibromuscular structure that is attached to the posterior edge of the hard palate. The soft palate is continuous with the lateral wall of the pharynx and is connected to the tongue and pharynx by the palatoglossal and palatopharyngeal arches, respectively. The soft palate is involved in swallowing and speech.
What are the anatomical landmarks that can be used to identify the superior and inferior borders of the nasopharynx?
The nasopharynx has a respiratory function. It lies superior to the soft palate and is the posterior extension of the nasal cavities (Fig. 8.16A). The nose opens into the nasopharynx through two choanae (paired openings between the nasal cavity and nasopharynx). The roof and posterior wall of the nasopharynx form a continuous surface that lies inferior to the body of the sphenoid bone and the basilar part of the occipital bone.
What drains the Pterygoid Plexus, Superior and Inferior Thyroid veins?
The Pharyngeal Venous Plexous drains the Pterygoid Plexus, Superior, and Inferior Thyroid Veins. The Pharyngeal Venous Plexous drains into the Internal Jugular Vein.
Identify how the pterygoid maxillary fissure communicates with the pterygoidpalatine fossa.
The pterygopalatine fossa communicates (Fig. 7.62B): Laterally with the infratemporal fossa through the pterygomaxillary fissure.
Locate the pharyngeal tonsil ("adenoids").
The lymphoid tissue in the pharynx forms an incomplete tonsillar ring around the superior part of the pharynx. The lymphoid tissue is aggregated in certain regions to form masses called tonsils. The pharyngeal tonsils (commonly called adenoids when enlarged) are in the mucous membrane of the roof and posterior wall of the nasopharynx.
What does greater palatine nerve provide sensory to?
The greater palatine nerve supplies the gingivae, mucous membrane, and glands of most of the hard palate (Fig. 7.54B).
What are the dual functions of the pharynx?
The functions of the pharynx are 1. Conduct air to the larynx, trachea, and lungs 2. Direct food to the esophagus
List the five layers of the pharynx.
1. Mucosa. There are lymph nodules (not nodes!) that form a lymphatic ring (of Waldeyer) in the mucosa of the pharynx. 2. Submucosa - There is an extensive venous plexus located in this layer. 3. Pharyngobasilar fascia 4. Muscular layer - organized into two layers. a. A circular layer of constrictor muscles that is more external (Table 8.6). b. A longitudinal layer of muscles that act as elevators of the pharynx. (Table 8.6) 5. Buccopharyngeal fascia (which forms the anterior boundary of the retropharyngeal space.
Describe the Palatoglossus muscle.
The palatoglossus is a slender slip of muscle that is covered with a mucous membrane; it forms the palatoglossal arch. Unlike the other muscles ending in -glossus, the palatoglossus is a palatine muscle (in function and innervation) rather than a tongue muscle.The Palatoglossus muscle elevates posterior part of tongue and draws soft palate onto tongue. The Palatoglossus muscle is innervated by the Vagus nerve (CN X).
Describe the Palatine Aponeurosis.
The palatine aponeuorsis is derived from the tensor veli palatini; forms a connective tissue "skeleton" for the soft palate and provides attachment for other muscles.
What are the anatomical landmarks that can be used to identify the superior and inferior borders of the oropharynx?
The oropharynx has a digestive function. It is bounded by the soft palate superiorly, the base of the tongue inferiorly, and the palatoglossal and palatopharyngeal arches laterally (Figs. 8.16 and 8.17). It extends from the soft palate to the superior border of the epiglottis.
Where does the pharynx begin and end?
The pharynx extends from the cranial base to the inferior border of the cricoid cartilage anteriorly and the inferior border of C6 vertebra posteriorly. The pharynx is widest opposite the hyoid and narrowest at its inferior end, where it is continuous with the esophagus. The flat posterior wall of the pharynx lies against the prevertebral layer of deep cervical fascia.
Identify how the inferior orbital fissure communicates with the pterygoidpalatine fossa.
Anterosuperiorly with the orbit through the inferior orbital fissure.
By what actions do the muscles elevate the pharynx?
By shortening and widening
Name the innervation of the Palatopharyngeus and Salpingopharyngeus msucles.
The innervation to the Salpingopharyngeus and Palatopharyngeus muscle is pharyngeal branch of the Vagus nerve (CN X).
Name the innervation to the three Constrictor muscles?
All three pharyngeal constrictor muscles are innervated by Vagus nerve (CN X) and pharyngeal plexus however, the middle and inferior are also innervated by the branches of external and recurrent laryngeal nerves of vagus.
What is the innervation of the glossopharyngeal nerve to the pharynx?
Sensory fibers in the plexus are derived from the Glossopharyngelal nerve (CN IX). They supply most of the mucosa of all three parts of the pharynx.
Define the tonsillar sinus.
Between the plica triangularis and the surface of the palatine tonsils is a space known as the tonsillar sinus; in many cases, however, this sinus is obliterated by its walls becoming adherent.
Locate the palatoglossal and palatopharyngeal arches, their underlying muscles, and the palatine tonsil.
The palatoglossal arch (glossopalatine arch, anterior pillar of fauces) on either side runs downward, lateralward, and forward to the side of the base of the tongue, and is formed by the projection of the Glossopalatinus with its covering mucous membrane. The palatopharyngeal arch (pharyngopalatine arch, posterior pillar of fauces) is larger and projects farther toward the middle line than the anterior; it runs downward, lateralward, and backward to the side of the pharynx, and is formed by the projection of the Pharyngopalatinus, covered by mucous membrane.
Describe the role of the greater palatine and lesser palatine arteries in the vascular supply to this region. What is the origin of these two arteries? The ascending palatine artery, a branch of the facial artery, also contributes to the vascular supply in this region.
The palate has a rich blood supply, chiefly from the right and left greater palatine arteries, branches of the descending palatine arteries (Fig. 7.54B). The lesser palatine artery, a smaller branch of the descending palatine artery, enters the palate through the lesser palatine foramen and anastomoses with the ascending palatine artery, a branch of the facial artery.
What is within the mucous membrane covering the hard palate?
The hard palate is covered by mucous membrane that firmly adheres to the periosteum. The mucous membrane contains numerous palatine glands.
The pharynx receives blood supply from which arteries?
The pharynx receives blood from whatever arteries "are in the neighborhood." a. Ascending Pharyngeal b. Superior Thyroid c. Inferior Thyroid d. Twigs from the Facial and Lingual arteries.
Describe the Uvular muscular (Musculus Uvulae).
The musculus uvulae inserts into the mucosa of the uvula. The musclus uvulae shortens the uvula and pulls it. The musculus uvulae is innervated by the Vagus nerve (CN X).
C. Locate the opening and torus of the pharyngotympanic tube (auditory tube).
The pharyngotympanic tube extends from the anterior wall of the middle ear to the lateral wall of the nasopharynx, approximately at the level of the inferior nasal concha. A portion of the tube (~1/3) proximal to the middle ear is made of bone; the rest is composed of cartilage[3] and raises a tubal elevation, the torus tubarius, in the nasopharynx where it opens.
Describe the Palate.
Forms the roof of the oral cavity proper. Consists of the hard (bony) and soft (muscular) portions.
Describe the Palatopharyngeus muscle.
The palatopharyngeus is a thin, flat muscle also covered with a mucous membrane; it forms the palatopharyngeal arch and blends inferiorly with the longitudinal muscle of the pharynx. The palatopharyngeus muscle tenses the soft palate and pulls walls of pharynx superiorly, anteriorly, and medially during swallowing. The palatopharyngeus muscle is innervated by the Vagus nerve (CN X).
Locate the pterygopalatine fossa.
The pterygopalatine fossa is a small pyramidal space inferior to the apex of the orbit. It lies between the pterygoid process of the sphenoid and the posterior aspect of the maxilla anteriorly (Fig. 7.62A). The fragile perpendicular plate of the palatine bone forms its medial wall. The incomplete roof of the pterygopalatine fossa is formed by the greater wing of the sphenoid. The floor of the pterygopalatine fossa is formed by the pyramidal process of the palatine bone. Its superior, larger end opens into the inferior orbital fissure; its inferior end is closed except for the palatine foramina.
What does the nasopalatine nerve provide sensory to?
The nasopalatine nerve supplies the mucous membrane of the anterior part of the hard palate.
Describe the Hard Palate.
The hard palate is the anterior vaulted (concave) part; this space is filled with the tongue when it is at rest. The hard palate (covered by a mucous membrane) is formed by the palatine processes of the maxillae and the horizontal plates of the palatine bones (Fig. 7.54A).
What nerve supplies sensory to the anterosuperior portion of the nasopharynx?
The sensory nerve supply of the mucous membrane of the anterior and superior nasopharynx is mainly from the maxillary nerve (CN V2).
Name the innervation of the Stylopharyngeus muscle.
The innervation to the Stylopharyngeus muscle is the Glosspharyngeal nerve (CN IX).
Section 2
(11 cards)