NEET MDS Lessons
Anatomy
The Laryngopharynx
- The laryngeal part of the pharynx lies posterior to the larynx.
- It extends from the superior border of the epiglottis to the inferior border of the cricoid cartilage, where it narrows to become continuous with the oesophagus.
- Posteriorly, the laryngopharynx is related to the bodies of C4 to C6 vertebrae.
- Its posterior and lateral walls are formed by the middle and inferior constrictor muscles, with the palatopharyngeus and stylopharyngeus internally.
- The laryngopharynx communicates with the larynx through the aditus or inlet of the larynx.
- The piriform recess is a small, pear-shaped depression of the laryngopharyngeal cavity on each side of the inlet of the larynx.
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First pouch |
Auditory tube, which comes in contact with epithelial line of first pharyngeal cleft, where future external acoustic meatus will form. Distal portion will form tympanic cavity (lining will become eardrum) Proximal portion will become auditory tube |
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Second pouch |
Forms buds that penetrate surrounding mesenchyme, which together form the palatine tonsils |
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Third pouch |
Forms thymus and inferior parathyroid glands |
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Fourth pouch |
Forms superior parathyroid glands |
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Fifth pouch |
Forms utlimobranchial body |
Initially, four clefts exist; however, only one gives rise to a definite structure in adults.
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1st pharyngeal cleft |
Penetrates underlying mesenchyme and forms EAM. The bottom of EAM forms lateral aspect of tympanic cavity. |
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2nd pharyngeal cleft |
Undergoes active proliferation and overlaps remaining clefts. It merges with ectoderm of lower neck such that the remaining clefts lose contact with outside. Temporarily, the clefts form an ectodermally lined cavity, the cervical sinus, but this disappears during development. |
o English: all speech sounds produced by making exhaled air audible
o Two ways of producing sound
at larynx
further up in vocal tract (tongue, lips)
o How to produce sound at larynx
changes in breathing: regulate airstream from lungs to atmosphere by changing movements of vocal folds, pharynx, soft-palate, tongue, lips and jaws
• inhalation: take in greater volume more quickly, abduct folds
• expiration: variable force; use muscles of inhalation to control rate of expiration, adduct
How to vibrate vocal cords
• NOT rhythmic contraction of laryngeal muscles: would be impossible b/c frequenceies of virbration
• Changes in air pressure cause vibrations
o Adduct folds increase in subglottal pressure force folds apart folds sucked back together (Bernouilli effect)
• The vibration of vocal cords disturbs airareas of low pressure (rarefaction) alternating with areas of high pressure (compression)
• Changes in pressure sound at ears
• Sine waves
o Changes in amplitudes: loudness
o Changes in frequency: pitch
o Normal sounds have fundamental frequency, overtones or harmonics
o Mass of folds: critical in voice
Low pitch of lion’s roar: due to massive fibrous pad that forms part of vocal cords
Men: more massive vocal cords
Larger foldsslow vibrationdeeper voice
o Producing vowels and constants
Most vowels are “voiced”: vocal folds produce sounds
Consonants: can be “voiced” (Z) or “non-voiced” (S)
• Use higher regions of vocal tract to control by stopping, restricting airflow from vocal folds; use lips, teethaperiodic sound
o Vocal folds and resonators emphasize and deemphasize certain frequencies
Never hear sounds produced at vocal foldsevery sound changed by passage thru vocal tract: sinuses/resonating chambers
Howling monkeys: large hyoid bonepowerful resonator
o Age-related changes in voice
Infant larynx is smaller, different proportions
• Arytenoids are proportionately larger
• Smaller vocal apparatushigher pitch
• Larynx sits higher easier to breathe thru nose
Abrupt change in larynx at pubertycan’t control voice
Older adult: normal degenerative changes in lamina propria, ossification of thyroid cartilagechanges in fundamental frequency
Lose your voice vocal fold are irritated
• Can’t adduct foldsair escapes
o Singing v. speaking
Singing: greater thoracic pressure and uneven breathing with changes in resonators
o Whispering
Intercartilaginous portions of vocal folds: open to allow air to escapelesser subglottal pressureslittle vibration of foldslittle tonal quality, low volume
o Falsetto
Allowing only part of vocal folds to vibrate
Increase range by training which part of vocal folds to vibrate
o Colds
Mucus secretions add mass to folds—decrease in pitch, can’t adduct folds as well
o Surgeryscars, fibrotic changes can interfere with voice
The Lateral Wall of the Orbit
- This wall is thick, particularly its posterior part, which separates the orbit from the middle cranial fossa.
- The lateral wall is formed by the frontal process of the zygomatic bone and the greater wing of the sphenoid bone.
- Anteriorly, the lateral wall lies between the orbit and the temporal fossa.
- The lateral wall is partially separated from the roof by the superior orbital fissure.
The Muscles of Facial Expression
- These lie in the subcutaneous tissue and are attached to the skin of the face.
- They enable us to move our skin and change our facial expression. They produce their effects by pulling on the skin but do not move the facial skeleton.
- These muscles surround the facial orifices and act as sphincters and dilators.
- All facial muscles receive their innervation from the branches of the facial nerve (CN VII)-temporal, zygomatic, buccal, marginal mandibular, cervical.
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Mesodermal Origin |
Muscles |
Innervation |
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Somitomeres 1, 2 |
Superior, medial and ventral recti |
Oculomotor (III) |
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Somitomere 3 |
Superior oblique |
Trochlear (IV) |
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Somitomere 4 |
Jaw-closing muscles |
Trigeminal (V) |
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Somitomere 5 |
Lateral rectus |
Abducens (VI) |
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Somitomere 6 |
Jaw-opening and other 2nd arch muscles |
Facial (VII) |
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Somitomere 7 |
Stylopharyngeus |
Glossopharyngeal (IX) |
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Somites 1, 2 |
Intrinsic laryngeals |
Vagus (X) |
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Somites 2-5 |
Tongue muscles |
Hypoglossal (XII) |