Pharynx and Larynx

Innervation to the pharynx

Pharyngeal plexus

Motor: Vagus nerve (CNX) (except stylopharyngeus)

Sensory = Glossopharyngeal nerve (CNIX)

Sympathetic supply from superior cervical ganglion (SCG)

Blood supply to the pharynx

Branches of external carotid artery:

• Ascending pharyngeal branch

• Pharyngeal branches of maxillary artery

• Palatine / tonsillar branches of facial artery

Venous drainage of the pharynx

Pharyngeal venous plexus into the IJV

Branches of external carotid artery (inferior to superior)

1. Superior thyroid
2. Ascending pharyngeal
3. Lingual
4. Facial
5. Occipital
6. Posterior auricular
7. Maxillary
8. Superficial temporal

SALFOPMS

Functions of the different parts of the pharynx

Nasopharynx: resonance and speech

Oropharynx: coordination of swallowing

Hypopharynx (laryngopharynx): airway protection and diversion of food bolus

What is found at C6?

cricoid cartilage

level of oesophageal inlet

***

Name the circular pharyngeal muscles and their function

Superior constrictor

Middle constrictor

Inferior constrictor (cricopharyngeus/ thyrophayngeus)

Function: Enable propulsive movements (peristalsis)

Name the longitudinal pharyngeal muscles and their function

Palatopharyngeus

Stylopharyngeus

Salpingopharyngeus

Function: Elevatory movements

What is a pharyngeal diverticulum and how is it caused?

also called the Zenker's diverticulum

may be caused by a failure of the cricopharyngeus muscle → increase pressure → pouch

Usually found in older adults

Do a barium study to test

Boundaries and function of the larynx

C3-6

Function: protection of the airway, phonation

• Guards the entrance to the tracheobronchial tree

• Vocalisation

• Raises intra-abdominal pressure (valsalva manouvre)

Innervation of the larynx

Branches of vagus nerve (motor and sensory)

Recurrent laryngeal nerve:

• Sensation to subglottis

• Motor supply to all muscles of larynx, except cricothyroid

Superior laryngeal nerve:

• Sensation to supraglottis

• Motor supply to cricothyroid (external branch)

Blood supply to the larynx

Laryngeal branches of superior and inferior thyroid arteries

Name the unpaired thyroid cartilages and their function

epiglottis

thyroid

cricoid

Function: move vocal folds, protect the airway and alter pitch of the voice

Name the paired thyroid cartilages

arytenoids

corniculates

cuneiforms

Function: produce movement of the folds for voice production

Where does the recurrent laryngeal nerve enter the larynx?

Enters immediately posterior to the cricothyroid joint

How do the vocal cords move?

The vocal folds are opened (abducted) and closed (adducted) by movements at the cricoarytenoid joints

What muscles Adduct vocal folds?

** Adjusts volume

Lateral Cricoarytenoids

Thyroarytenoids

Transverse and obliques arytenoids (interarytenoids)

What muscles Tense vocal folds?

** adjust pitch

Cricothyroid (EBSLN)

Vocalis

What muscles abduct vocal folds?

** opens the airway

Posterior Cricoarytenoids

What is this?

Quinsy (peritonsillar abscess)

Treatment: drainage of the abscess, antibiotics