Pharynx, Soft Palate and Tonsils

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What is the pharynx composed of?
Skeletal Muscle
The pharynx lies anteriorly to what layer of fascia?
Prevertebral
What is the most superior part of the pharynx?
Nasopharynx
Where is the nasopharynx relative to the nasal cavity?
Posterior
What is the inferior border of the nasopharynx?
Soft Palate
What is the choanae (internal nares)?
passageways from the nasopharynx to the nasal cavity
What does the nasopharynx conduct?
Air only
What part of the pharynx connects to the L and R auditory (eustacian/pharyngotympanic) tubes?
Nasopharynx
Which embryonic structure forms the auditory tubes?
1st pharyngeal pouch
What is the function of the auditory tubes?
equalize middle ear pressure (e.g. swallowing)
What are tubal tonsils?
tonsils around the auditory tube that help prevent infection
Where is the pharyngeal tonsil located?
Upper posterior wall of the nasopharynx
What sort of epithelium does the nasopharynx have?
PCCE (Pseudostratified ciliated columnar epithelium)
What is the middle portion of the pharynx?
Oropharynx
Where is the oropharynx located?
from soft palate to hyoid bone posterior to oral cavity
What are fauces?
Archlike openings/passageways between the oral cavity and oropharynx
What does the oropharynx conduct?
both air and food
What tonsils are found in the oropharynx?
Palatine and lingual
Where are the palatine tonsils found?
in the lateral walls near the fauces of the oropharynx
Where are the lingula tonsils found?
Posterior aspect of the tongue
What kind of epithelium does the oropharynx have?
non-keratinized stratified squamous epithelium
What is the most inferior part of the pharynx?
Laryngopharynx
Where is the laryngopharynx located?
from hyoid bone to superior border of the esophagus
What forms the anterior border of the laryngopharynx?
Larynx
What does the laryngopharynx conduct?
Food and Air
What does the laryngopharynx connect to?
both larynx and esophagus
What is the piriform recess and where is it located?
pouch where materials can get stuck on the lateral walls of the laryngopharynx
If the wall by the piriform recess is pierced by material, what neurovascular structure can be damaged?
Recurrent laryngeal nerve
What kind of epithelium does the laryngopharynx have?
Non-keratinized stratified squamous epithelium
If the wall by the piriform recess is pierced by material, what does the piercing thing poke into?
Retropharyngeal space
What kind of contraction do the pharyngeal constrictors have?
Somatic but reflexive
What is the function of the pharyngeal constrictor muscles?
contract sequentially when swallowing so that food is propelled into the esophagus
What do the fibers of the superior pharyngeal constrictor look like and where is it attached?
Arch shaped
Base of cranium
where is the middle pharyngeal constrictor attached?
Hyoid Bone
where is the inferior pharyngeal constrictor attached?
thyorid cartilage of the larynx
What is in between the mucosa of the pharynx and the pharyngeal constrictor muscles?
Pharyngobasilar fascia
What externally covers the pharyngeal constrictor muscles, and what is it continuous with?
Buccopharyngeal fascia
pre-tracheal fascia
What is the general function of the pharyngeal and laryngeal elevators?
short and widen pharynx and larynx when swallowing and speaking
which muscles oppose the actions of the pharyngeal constrictors? (3)
Salpingopharyngeus
Palatopharyngeus
Stylopharyngeus
Where does the salpingopharyngeus muscle run?
from auditory tube to pharynx
What is the function of the salpingopharyngeus muscle?
Attaches to/opens auditory tube (when yawning/swallowing, etc) to equalize air pressure
What muscle forms the posterior wall of the tonsilar fossa?
Palatopharyngeus
Where does the palatopharyngeus muscle run?
from the soft palate to the back of the throat
Where does the stylopharyngeus run?
from styloid process to the pharynx
What innervates the stylopharyngeus muscle?
CNIX
What is the only muscle that CNIX innervates?
Stylopharyngeus
What is the embryonic precursor of the stylopharyngeus muscle?
3rd pharyngeal arch
What innervates all pharyngeal muscles and most soft palate muscles?
Pharyngeal Plexus
Where is the pharyngeal plexus located?
on the posterior pharyngeal wall at the level of the middle pharyngeal constrictor
What are the 2 muscles of the soft palate that are not innervated by the pharyngeal plexus?
Tensor veli palatini
Stylopharyngeus
What innervates the tensor veli palatini muscle?
CNV3
Where does the motor innervation for the pharyngeal muscles and most soft palate muscles come from?
pharyngeal branches of CNX
What provides sensory innervation to most of the pharynx?
CNIX
what receives sensory information from the laryngopharynx?
CNX
Sensory innervation via the pharyngeal plexus is primarily through which nerves?
CNIX and CNX
where does the sympathetic innervation via the pharyngeal plexus come from?
superior cervical ganglion
What occurs in vasomotor constriction from the pharyngeal plexus?
constriction of smooth muscle of blood vessels of the pharynx
What makes up the hard palate, and where is it located?
maxilla and palatine bones
anterior 2/3 of palate
What kind of muscle makes up the soft palate and where is it located?
Skeletal muscle
posterior 1/3 of palate
What is unique about the muscle that makes up the soft palate?
it is skeletal muscle that contracts involuntarily
Where is the uvula located?
the midline of the soft palate
What are the muscles of the soft palate innervated by (generally)?
pharyngeal plexus
which of the soft palate muscles is not innervated by the pharyngeal plexus? what innervates it?
Tensor vali palatini
V3
What is the general function of the muscles of the soft palate?
tense or elevate the soft palate and uvula to close off the opening to the nasopharynx when you swallow
If palate muscles are paralyzed, which way will the uvula deviate?
away from the paralyzed side (towards the working muscles)
What supplies the sensory innervation to the soft palate?
greater and lesser palatine nerves
What are the greater and lesser palatine nerves branches of?
CNV2
Where does lymph drain from the pharynx, soft palate and tonsils?
deep cervical lymph nodes in the neck
Where doe the pharynx and palatine tonsils drain?
Jugulodigastric node
What do the deep cervical LNs cluster around in the neck?
internal jugular vein
The deep cervical lymph node that is enlarged in strep throat drains what structures? (2)
pharynx
palatine tonsils
What are tonsils?
aggregations of lymphatic tissue partially surrounded by a CT capsule
What is the function of tonsils?
provide a first line of defense against pathogens in food and air
The 4 basic types of tonsils in the pharynx form what?
(Waldeyer) Tonsillar Ring
What are the 4 basic types of tonsils in the pharynx?
Pharyngeal
Tubular
Palatine
Lingual
Which basic types of tonsils in the pharynx are paired?
Tubular
Palatine
why do tonsils become enlarged when exposed to a pathogen?
proliferating lymphocytes
where are the palatine tonsils located?
lateral wall of oropharynx
What is adenoids?
enlarged pharyngeal tonsil
The enlargement of the pharyngeal tonsil (adenoids) can interfere with what other processes? (2)
obstruct nasal airflow
auditory tube opening/closing
What is an adenoidectomy?
removal of enlarged pharyngeal tonsil
What is the embryonic derivative of the palatine tonsils?
2nd pharyngeal pouch
What is the tonsillar fossa?
depression with palatine tonsils in it
Where is the palatoglossal arch?
anterior border of the tonsillar fossa
What is the palatoglossal arch?
palatoglossus muscle covered by mucosa
What are the anterior and posterior borders of the tonsillar fossa?
Anterior - palatoglossal arch
Posterior - Palatopharyngeal arch
What structures are found in the tonsillar fossa? (3)
External palatine vein
tonsillar arteries
CNIX
These neurovacular structures are at risk of damage during a tonsillectomy (2)
External palatine vein
CNIX
What is tonsillitis?
inflamed/infected palatine tonsils
What is a peritonsillar abscess (PTA/Quincy)?
bacterial infection that invades soft tissue around tonsil and creates a pocket of pus
What are two possible causes of Quincy (peritonsillar abscess/PTA)?
Dental work
severe tonsillitis
What is a tonsillectomy?
removal of (usually palatine) tonsils
What symptoms would a person have if CNIX was damaged in a tonsillectomy? (2)
loss of sensation at posterior part of tongue, nasopharynx and oropharynx
loss of taste in posterior 1/3 of tongue
What are the two palate muscles and what innervates them?
Levator veli palatini - CNX
Tensor veli palatini - CNV3