Anatomy and Physiology of the Larynx, Pharynx, and Tongue, Exams of Nursing

Download Anatomy and Physiology of the Larynx, Pharynx, and Tongue and more Exams Nursing in PDF only on Docsity! CETP Chapter 1 questions well answered already passed What do we call the pressure inside vs outside the lungs? - correct answer ✔✔Pressure within the lungs: alveolar pressure Pressure outside the lungs: atmospheric pressure Describe how differences in alveolar pressure and atmospheric pressure enable breathing - correct answer ✔✔Through contraction of inspiratory muscles, we expand the chest cavity. As the lungs expand, alveolar pressure gets lower than atmospheric pressure. This draws air into the lungs, to equalize pressure. At that point, muscles contract to reduce the volume of the chest cavity. This creates positive pressure within the lungs, pushing air out. How many times per minute does the inhalation-exhalation cycle occur in adults? - correct answer ✔✔12-18 What is the ratio of expiration to inhalation during normal tidal breathing? - correct answer ✔✔60%- 40% What is the ratio of expiration to inhalation during breathing for speech? - correct answer ✔✔90%-10% What % total capacity do the lungs have at rest? - correct answer ✔✔40% Describe the right lung vs left lung - correct answer ✔✔Right: shorter, broader, bigger. Liver underneath forces it up a bit. Three lobes. Left: Smaller, heart takes up space. Two lobes. Describe the relationship between bronchi, bronchioles, and alveolar ducts - correct answer ✔✔In the lungs, bronchi subdivide into bronchioles. Bronchioles repeatedly subdivide until they become very thin. They communicate with alveolar ducts that open into tiny air sacs in the lungs What is the trachea? - correct answer ✔✔A tube about 11 centimeters long formed by approximately 20 rings of cartilage. The rings are incomplete at the back, where the trachea comes into direct contact with the esophagus. The last tracheal ring splits into the left and right primary bronchi at T5 Describe the makeup of the spinal column - correct answer ✔✔32-33 individual vertebrae. 7 cervical vertebrae 12 thoracic vertebrae 5 lumbar vertebrae 5 sacral vertebrae (fused in adults) 3-4 coccygeal vertebrae (fused, called the coccyx) What are the three parts of the sternum? - correct answer ✔✔Manubrium, body, xiphoid process What is the manubrium? - correct answer ✔✔The uppermost part of the sternum. Provides the attachment for the clavicle and first rib What is the body/corpus? - correct answer ✔✔Long and narrow middle of the sternum. Rib cartilages 2- 7 attach to the body. What is the xiphoid process? - correct answer ✔✔Projection of cartilage at the bottom of the sternum Describe the composition of the ribcage - correct answer ✔✔The sternum is the anterior surface 12 thoracic vertebrae in the posterior surface 12 pairs of ribs that connect laterally from the vertebrae to their individual costal cartilages How does the diaphragm move? - correct answer ✔✔Muscle fibers insert into the central tendon of the diaphragm and contract to pull the central tendon down and forward to expand the thoracic cavity What are the intercostal muscles? - correct answer ✔✔11 paired internal intercostals and 11 paired external intercostals What are the biological (non speech) functions of the larynx? - correct answer ✔✔-closure of the trachea so that food and other substances do not enter the lungs -cough reflex to expel foreign substances from the trachea -closure of the vocal folds to build subglottic pressure necessary for physical tasks like excretion and lifting heavy stuff What are the key cartilages of the larynx? - correct answer ✔✔thyroid, cricoid, arytenoid Describe the thyroid cartilage - correct answer ✔✔- largest laryngeal cartilage - forms front and sides of larynx -front is composed of two laminae that meet at the midline to form the thyroid angle -thyroid notch (adam's apple) is the superior point of the thyroid angle -thyroid is open in the back and has two pairs of horns known as cornu -Superior cornua extend up to meet the hyoid bone -Inferior cornua extend down to meet the cricoid cartilage Describe the cricoid cartilage - correct answer ✔✔- ring shaped, completely surrounds the trachea, big in back, narrow in front -linked with thyroid cartilage and arytenoids Describe the arytenoid cartilages - correct answer ✔✔-small and pyramid shaped -connected to the superior posterior cricoid through the cricoarytenoid joint -many intrinsic muscles connect to the arytenoids at two processes: the vocal process and the muscular process -vocal folds attached at the vocal process -ab/adductor muscles attached at the muscular process -proper movement of the arytenoids is essential to voice production Describe the corniculate cartilages - correct answer ✔✔-Sit on the apex of the arytenoids -assist in reducing laryngeal opening when swallowing -tiny cone-shaped cuneiform cartilages located in membrane that covers the aryepiglottic folds, helps stiffen/tense aryepiglottic folds What are the intrinsic muscles of the larynx? - correct answer ✔✔thyroarytenoid, lateral cricoarytenoid, transverse arytenoid, oblique arytenoid, cricothyroid, and posterior cricoarytenoid Describe the thyroarytenoid muscles - correct answer ✔✔-Paired -attached to the thyroid and arytenoid cartilages and divided into two muscle masses: internal and external -internal portion (vocalis muscle/vocal folds) is the primary part, vibrates and produces sound -external portion aids in adduction What are the adductor muscles? - correct answer ✔✔lateral cricoarytenoid, transverse arytenoid, oblique arytenoid -LCA increases medial compression too Describe the cricothyroid muscle - correct answer ✔✔-Attached to the cricoid and thyroid cartilages -lengthens and tenses the vocal folds, resulting in pitch change Describe the posterior cricoarytenoid muscle - correct answer ✔✔-Inserts into muscular process of arytenoid -is the only muscle responsible for abduction Describe the innervation of the intrinsic laryngeal muscles - correct answer ✔✔-Most innervated by RLN branch of CNX, except cricothyroid, which is innervated by SLN branch What are the suprahyoid muscles? - correct answer ✔✔-digastric, stylohyoid, mylohyoid, geniohyoid, hyoglossus, genioglossus -attach above the hyoid bone -elevate the larynx What are the infrahyoid muscles? - correct answer ✔✔-omohyoid, sternohyoid, sternothyroid, thyrohyoid -attach below the hyoid bone -depress the larynx What are the three layers of the vocal folds? - correct answer ✔✔The epithelium (outer cover), lamina propria (middle layer, subdivides into superficial, immediate and deep), and vocalis muscle(body) What are the aryepiglottic folds? - correct answer ✔✔-Extend from the tips of the arytenoids to the epiglottis. -separate the laryngeal vestibule from the pharynx and help preserve the airway What are the ventricular folds? - correct answer ✔✔-Vibrate only at a very low F0, usually not during normal phonation -Compress during activities such as coughing and lifting heavy things Describe the myoelastic aerodynamic theory - correct answer ✔✔-air flowing out of the lungs is stopped by vocal fold closure. This builds subglottal pressure, which eventually blows the vocal folds apart -Air moves super fast through the glottis, which causes the vocal folds to be sucked together. This is bc of the Bernoulli effect, which says that when the velocity of a gas/fluid increases, its internal pressure decreases. so the vocal folds are sucked together by this lack of pressure in the glottis -once again, subglottal pressure builds below closed vocal folds. This cycle keeps going Describe mucosal wave action - correct answer ✔✔-Critical to vibration of vocal folds -The cover (epithelium and superficial lamina propria, also called Reinke's space) and the transition (intermediate and deep layers of the superficial lamina propria) over the vocalis muscle slide and produce a wave -wave travels across the superior surface of the vocal fold about 2/3s of the way to the lateral edge of the fold -no vibration and no phonation without a mucosal wave! What are the primary cortical areas involved in speech-motor control? - correct answer ✔✔-Primary motor cortex Mandible - correct answer ✔✔lower jaw, houses teeth, forms the floor of the mouth Alveolar arch - correct answer ✔✔part of the mandible that houses the teeth temporomandibular joint - correct answer ✔✔The joint formed where the mandible and temporal bone meet, just in front of the ear Masseter - correct answer ✔✔elevates mandible, most powerful muscle of mastication Temporalis - correct answer ✔✔elevates and retracts mandible medial (internal) pterygoid - correct answer ✔✔elevates mandible, protrudes mandible when contracted with lateral pterygoid anterior belly of digastric - correct answer ✔✔depresses mandible in conjunction with posterior belly of digastric; pulls hyoid forward, retracts mandible posterior belly of digastric - correct answer ✔✔depresses mandible in conjuction with anterior belly of digastric; pulls hyoid back Lateral (external) pterygoid - correct answer ✔✔depresses and protrudes mandible Geniohyoid - correct answer ✔✔depresses mandible, aids in retraction of mandible Mylohyoid - correct answer ✔✔depresses mandible, aids in retraction of mandible Parts of the tongue - correct answer ✔✔tip, blade, dorsum, root + lingual frenulum, connects mandible with the inferior portion of the tongue superior longitudinal muscle - correct answer ✔✔shortens tongue, turns tip upward, assists in turning lateral margins upward (intrinsic) inferior longitudinal muscle - correct answer ✔✔shortens tongue, pulls tip downward, assists in retraction (intrinsic) Transverse muscles - correct answer ✔✔narrow and elongate tongue (intrinsic) Vertical muscles - correct answer ✔✔flatten tongue (intrinsic) Genioglossus - correct answer ✔✔forms the bulk of the tongue and allows it to move freely (extrinsic) Styloglossus - correct answer ✔✔draws tongue up and back (extrinsic) Hyoglossus - correct answer ✔✔retracts and depresses tongue, elevates hyoid bone (extrinsic) Chondroglossus - correct answer ✔✔depresses tongue, elevates hyoid bone (extrinsic) Palatoglossus - correct answer ✔✔sometimes considered a muscle of the velum, helps elevate tongue (but depresses velum) (extrinsic) Mentalis - correct answer ✔✔pulls lower lip out, wrinkles and elevates chin Platysma - correct answer ✔✔depresses mandible Risorius - correct answer ✔✔Retracts lips at corners Buccinator - correct answer ✔✔Constricts oropharynx, moves food onto grinding surfaces of molars depressor labii inferioris - correct answer ✔✔pulls lower lip down and out to dilate orifice depressor anguli oris - correct answer ✔✔helps press lower and upper lips together, depresses corner of mouth zygomatic minor - correct answer ✔✔elevates upper lip, aids in lip protrusion zygomatic major - correct answer ✔✔retracts and elevates angle of mouth orbicularis oris - correct answer ✔✔closes and protrudes lips levator anguli oris - correct answer ✔✔draws corner of mouth up and medially levator labii superioris - correct answer ✔✔elevates upper lip levator labii superioris alaeque nasi - correct answer ✔✔raises upper lip and opens nostril Glial cells - correct answer ✔✔cells in the nervous system that support, nourish, and protect neurons (do not transmit impulses) What are the glial cells of the CNS? - correct answer ✔✔oligodendrocytes, astrocytes, microglia, ependymal cells What are the glial cells of the PNS? - correct answer ✔✔Schwann cells and satellite cells Neurons - correct answer ✔✔a nerve cell; the basic building block of the nervous system Parts of a neuron - correct answer ✔✔cell body, dendrites, axon Dendrites - correct answer ✔✔short fibers that branch out from the cell body and pick up incoming messages CN VIII - correct answer ✔✔Vestibulocochlear Hearing and balance (sensory) CN IX - correct answer ✔✔Glossopharyngeal Tongue and pharynx (sensory), pharynx (motor) CN X - correct answer ✔✔Vagus larynx, respiratory, cardiac, and gastrointestinal systems (sensory and motor) CN XI - correct answer ✔✔spinal accessory Shoulder, arm, throat (motor) CN XII - correct answer ✔✔Hypoglossal Tongue (motor) Sensory fibers of CN V - correct answer ✔✔Composed of three branches: ophthalamic, maxillary, mandibular Ophthalamic branch - correct answer ✔✔Sensory branches from the nose, eyes, forehead Maxillary branch - correct answer ✔✔Sensory branches from the nose, upper lip, maxilla, upper cheek area, upper teeth, maxillary sinus, nasopharynx, and palate Mandibular branch - correct answer ✔✔sensory: lower gums, teeth and lips motor: face and tongue How will unilateral UMN lesions affect CN V? - correct answer ✔✔CN V is bilaterally innervated, so it will minimally affect motor function. How will damage to CN V affect someone? - correct answer ✔✔Unilateral damage will cause the jaw to deviate towards the affected side when the mouth is closed. Bilateral damage may result in an inability to close the mouth and difficulty chewing How will unilateral UMN lesions affect CN VII? - correct answer ✔✔The upper portion of the face is bilaterally innervated, so it will only paralyze the lower face. How will damage to CN VII affect someone? - correct answer ✔✔A person with bilateral damage to the facial nerve will be unable to move their upper and lower face, with minimal to no facial expression. When there is unilateral damage, the smile is drawn to the undamaged side What are the two branches of CN VIII? - correct answer ✔✔vestibular and acoustic/cochlear How will damage to CN VIII affect someone? - correct answer ✔✔Damage results in hearing loss, problems with balance, or both How will damage to CN IX affect someone? - correct answer ✔✔Lesions may create difficulty in swallowing, unilateral loss of the gag reflex, and loss of taste and sensation from the posterior third of the tongue How will damage to CN X affect someone? - correct answer ✔✔Results in a lot of issues, including difficulty swallowing, paralysis of the velum, voice problems How will damage to CN XI affect someone? - correct answer ✔✔May result in neck weakness, paralysis of the sternocleidomastoid, inability to turn the head, inability to shrug shoulders How will damage to CN XII affect someone? - correct answer ✔✔Can result in tongue paralysis, diminished intelligibility, and swallowing problems Spinal nerves of the PNS are closely related to the ______ - correct answer ✔✔ANS. Together, they control various bodily activities that are executed with little conscious effort or knowledge 31 pairs of spinal nerves are attached to the spinal cord through two roots: - correct answer ✔✔Efferent and ventral; afferent and dorsal Spinal nerve segments - correct answer ✔✔8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal What does the ANS do? - correct answer ✔✔regulates body's internal environment What does the sympathetic branch of the ANS do? - correct answer ✔✔mobilizes the body for "fight of flight" situations - accelerates heart rate, dilates the pupils, raises the blood pressure, and increases blood flow to the peripheral body structures What does the parasympathetic branch of the ANS do? - correct answer ✔✔Brings the body back to a state of relaxation Midbrain - correct answer ✔✔-Superior peduncles help connect the brainstem and cerebellum -Substantia nigra runs the vertical length of the midbrain -Controls many motor and sensory functions, including postural/visual reflexes, eye movements -Contains nuclei for CN IV and CN III Pons - correct answer ✔✔-With midbrain, connects cerebellum to the brain through the inferior and middle peduncles -Transmits information relative to movement from the cerebral hemispheres to the cerebellum -Houses nuclei for CN V and CN VII supplementary motor cortex - correct answer ✔✔Believed to be involved in the motor planning of speech. It also plays a secondary role in regulating muscle movements. Broca's area - correct answer ✔✔Left inferior frontal gyrus, controls motor movements involved in speech production parietal lobe - correct answer ✔✔primary somatosensory cortex -damage to supramarginal gyrus causes conduction aphasia and agraphia -damage to angular gyrus can cause reading, writing and naming difficulties occipital lobe - correct answer ✔✔primary visual cortex Temporal lobe - correct answer ✔✔primary auditory cortex, auditory association cortex (words and sentences left, music and noise right) -Wernicke's area, critical to comprehension of spoken and written language Hippocampus - correct answer ✔✔Located in the temporal lobe, memory pyramidal system - correct answer ✔✔direct motor activation pathway that is primarily responsible for facilitating voluntary muscle movement -composed of the corticobulbar and corticospinal tracts corticospinal tract - correct answer ✔✔Originates in motor cortex of each hemisphere, passes through internal capsule, decussate in medulla, terminate in spinal cord corticobulbar tract - correct answer ✔✔Control all voluntary muscles of speech Originates in motor cortex, goes through internal capsule, decussates in brainstem, terminates in brainstem lower motor neurons - correct answer ✔✔(Efferent) motor neurons in the spinal and cranial nerves, part of the PNS upper motor neurons - correct answer ✔✔(Efferent) motor neurons within the CNS extrapyramidal system - correct answer ✔✔- Transmits impulses that control the postural support needed by those fine-motor movements - Composed of different subcortical nuclei, including the red nucleus, substantial nigra, sub thalamus, basal ganglia & pathways that connect these structures. - Considered a more indirect activation system that interacts with various motor system in nervous system - Influences lower motor neurons; helps maintain posture and tone and helps regulate movement from LMN. - Damage = involuntary movement disorders projection fibers - correct answer ✔✔create connections between the cortex and subcortical structures like the cerebellum, basal ganglia, brainstem, and spinal cord -internal capsule contains the concentrates projection fibers -as projection fibers move upward toward the upper regions of the brain, fan out into a structure called the corona radiata (afferent + efferent) Association fibers - correct answer ✔✔connect areas within the same hemisphere arcuate fasciculus - correct answer ✔✔connects Wernicke's area and Broca's area; damage can cause conduction aphasia commisural fibers - correct answer ✔✔interhemispheric connectors corpus callosum - correct answer ✔✔a broad band of nerve fibers joining the two hemispheres of the brain. cerebral ventricles - correct answer ✔✔four cavities within the brain that are filled with cerebrospinal fluid Meninges - correct answer ✔✔three protective membranes that surround the brain and spinal cord dura mater - correct answer ✔✔thick, outermost layer of the meninges Arachnoid - correct answer ✔✔delicate middle layer of the meninges Pia mater - correct answer ✔✔thin, delicate inner membrane of the meninges How much of the body's oxygen and blood does the brain use? - correct answer ✔✔25% oxygen, 20% blood external carotid artery - correct answer ✔✔supplies blood to the muscles of the mouth, nose, forehead, and face internal carotid artery - correct answer ✔✔key branches are the middle cerebral artery and anterior cerebral artery Middle cerebral artery - correct answer ✔✔biggest branch of internal carotid which supplies entire lateral surface of cortex including major areas involved with speech, language and hearing Damage to the middle cerebral artery may result in - correct answer ✔✔stroke, aphasia Damage to the anterior cerebral artery may result in - correct answer ✔✔cognitive deficits like impaired judgement, concentration, reasoning anterior cerebral artery - correct answer ✔✔Supplies middle portion of parietal and frontal lobes Circle of willis - correct answer ✔✔A circle of arteries at the base of the brain that supply blood to the brain -if an artery is blocked above the circle, brain damage will occur