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Anatomy

The Pharynx

  • The pharynx is the continuation of the digestive system from the oral cavity.
  • It is a funnel-shaped fibromuscular tube that is the common route for both food and air.
  • The pharynx is located posterior to the nasal and oral cavities, and the larynx.
  • For the convenience of description, the pharynx is divided into three parts: (1) the nasopharynx, posterior to the nose and superior to the soft palate; (2) the oropharynx, posterior to the mouth; and (3) the laryngopharynx, posterior to the larynx.
  • The pharynx is about 15 cm long.
  • It extends from the base of the skull to the inferior border of the cricoid cartilage anteriorly, and to the inferior border of C6 vertebra posteriorly.
  • It is widest (about 5 cm) opposite the hyoid bone and narrowest (about 1.5) at its inferior end, where it is continuous with the oesophagus.
  • The posterior wall of the pharynx lies against the prevertebral fascia, with the potential retropharyngeal space between them.

Classification

Epitheliums can be classified on appearance or on function

Classification based on appearance

- Simple - one layer of cells

- Pseudostratified - looks like more than one layer but is not

- Stratified - more than one layer of cells

Simple epitheliums

Simple squamous epithelium

 Cells are flat with bulging or flat nuclei.  Lines the insides of lung alveoli and certain ducts in the kidney

 Forms serous membranes called mesothelium that line cavities like: pericardial ,  peritoneal,  plural

 Lines blood vessels - known as endothelium

Simple cuboidal epithelium

It appears square in cross section,  Found in: - Ducts of salivary glands,  Follicles of the thyroid gland,  Pigment layer in the eye,  Collecting ducts of the kidney, In the middle ear is ciliated type.

Simple columnar

  • Lines the gastrointestinal tract from the stomach to the anal canal,  Some columnar cells have a  secretory function – stomach, peg cells in the oviduct,  Some columnar cells have microvilli on their free border (striated border) – gall bladder, duodenum
  • Microvilli increase the surface area for absorption
  • Some columnar cells have cilia – oviduct, smaller bronchi
  • Cilia transport particles

Pseudostratified

Appears as stratified epithelium but all cells are in contact with the basement membrane.  Has a thick basement membrane. Different cell types make up this epithelium,  Cells that can be found in this type of epithelium are:

  • Columnar cells with cilia or microvilli.
  • Basal cells that do not reach the surface.
  • Goblet cells that secrete mucous.
  • Found in the trachea, epididymus, ductus deferens and female urethra

Stratified epithelium

Classified according to the shape of the surface cells

Stratified squamous epithelium

Has a basal layer that varies from cuboidal to columnar cells that divide to form new cells. Two types are found:

Keratinized:  Mostly forms a dry covering, The middle layers consists of cells that are forming- and filling up with keratin. The superficial cells form a tough non living layer of keratin,  Keratin is a type of protein,  The skin is of this type has  thick skin - found on the hand palms and soles of the feet,  thin skin - found on the rest of the body

Non-keratinized:  Top layer of cells are living cells with nuclei  Forms a wet covering,  The middle layers are polyhedral,  The surface layer consists of flat squamous cells

  • Is found in:  mouth,  oesophagus,  vagina

Stratified cuboidal epithelium

Found: - in the ducts of sweat glands

Stratified columnar epithelium

Found at the back of the eyelid (conjunctiva)

Transitional epithelium

- Sometimes the surface cells are squamous, sometimes cuboidal and sometimes columnar

- The superficial cells are called umbrella cells because they can open and close like umbrellas, when the epithelium stretch and shrink

- Umbrella cells can have 2 nuclei

- Found in the bladder and ureter

The Skeleton of the Nose

  • The immovable bridge of the nose, the superior bony part of the nose, consists of the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bones.
  • The movable cartilaginous part consists of five main cartilages and a few smaller ones.
  • The U-shaped alar nasal cartilages are free and movable.
  • They dilate and constrict the external nares when the muscles acting on the external nose contract.

 

The Nasal Cavities

  • The nasal cavities are entered through the anterior nares or nostrils.
  • They open into the nasopharynx through the choanae.

 

The Roof and Floor of the Nasal Cavity

  • The roof is curved and narrow, except at the posterior end.
  • The floor is wider than the roof.
  • It is formed from the palatine process of the maxilla and the horizontal plate of the palatine bone.

 

The Walls of the Nasal Cavity

  • The medial wall is formed by the nasal septum; it is usually smooth.
  • The lateral wall is uneven owing to the three longitudinal, scroll-shaped elevations, called the conchae (L. shells) or turbinates (L. shaped like a top).
  • These elevations are called the superior, middle and inferior conchae according to their position.
  • The superior and middle conchae are parts of the ethmoid bone, whereas the inferior conchae are separate bones.
  • The inferior and middle conchae project medially and inferiorly, producing air passageways called the inferior and middle meatus (L. passage). Note: the plural of "meatus" is the same as the singular.
  • The short superior conchae conceal the superior meatus.
  • The space posterosuperior to the superior concha is called the sphenoethmoidal recess.

The Inferior Wall of the Orbit

  • The thin inferior wall of the orbit or the floor is formed mainly by the orbital surface of the maxilla and partly by the zygomatic bone, and orbital process of the palatine bone.
  • The floor of the orbit forms the roof of the maxillary sinus.
  • The floor is partly separated from the lateral wall of the orbit by the inferior orbital fissure.

Gross Features of the Tongue

  • The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
  • The apex of the V is posterior and the two limbs diverge anteriorly.
  • The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.

 

Oral Part of the Tongue

  • This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.
  • On each side of the frenulum is a deep lingual vein, visible as a blue line.
  • It begins at the tip of the tongue and runs posteriorly.
  • All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.
  • On the dorsum of the oral part of the tongue is a median groove.
  • This groove represents the site of fusion of the distal tongue buds during embryonic development.

 

The Lingual Papillae and Taste Buds

  • The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
  • They are arranged in rows parallel to the sulcus terminalis.
  • The fungiform papillae are small and mushroom-shaped.
  • They usually appear are pink or red spots.
  • The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.
  • The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.
  • The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.

 

The Pharyngeal Part of the Tongue

  • This part lies posterior to the sulcus terminalis and palatoglossal arches.
  • Its mucous membrane has no papillae.
  • The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
  • The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.

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

Movements of the Temporomandibular Joint

  • The two movements that occur at this joint are anterior gliding and a hinge-like rotation.
  • When the mandible is depressed during opening of the mouth, the head of the mandible and articular disc move anteriorly on the articular surface until the head lies inferior to the articular tubercle.
  • As this anterior gliding occurs, the head of the mandible rotates on the inferior surface of the articular disc.
  • This permits simple chewing or grinding movements over a small range.
  • Movements that are seen in this joint are: depression, elevation, protrusion, retraction and grinding

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