Anatomy and Physiology of Pharynx MCQs

Inferior concha is an independent bone . Superior and middle concha are parts of ethmoid bone. Uncinate process, lamina papyracea and cribriform plate are also parts of ethmoid bone. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page Number-164.

Middle ear has three parts- epitympanum, mesotympanum and hypotympanum. Mesotympanum is the narrowest part - Epitympanum (Attic) is the deepest part of middle ear Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, pg. no - 6, 13

Aqueduct of cochlea connects the perilymphatic space of the inner ear to the subarachnoid space of the brain. Reference: Scott Brown's Otolaryngology, Head and Neck Surgery, 8th edition - Volume 2 - Page - 545 Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, pg. no - 6, 13

Aphthous ulcers are recurrent and superficial, usually involving movable mucosa, i.e., inner surfaces of lips, buccal mucosa, tongue, floor of mouth and soft palate, while sparing mucosa of the hard palate and gingivae. Ludwig's Angina : Infection of submandibular space(sublingual space + submaxillary spaces) or floor of mouth. It is mainly Cellulitis. Dental Infections account for 80% of the cases. Roots of premolars cause sublingual space infection while roots of the molar teeth cause submaxillary space infection Mixed infections involving aerobes and anaerobes is seen. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingraz, 8 th Edition, pg. no. 255, 31

Plummer vinson syndrome(Paterson-Brown-Kelly syndrome) - Barium swallow shows a web in the postcricoid region and the same can be seen on oesophagoscopy. It is due to subepithelial fibrosis in this region. Predominantly affects females past 40 years. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no. 401

Hypopharynx= laryngopharynx It has 3 parts Pyriform sinus - right and left(=Pyriform Fossa) post cricoid area posterior pharyngeal wall. Anterior pillar, posterior pillar, palatine tonsil, posterior one third tongue, Vallecula , lingual tonsil, soft palate, uvula are parts of oropharynx. So, Vallecula is a part of oropharynx. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Pg. no. 285

Ans. D: XII Nucleus Ambiguus Function: * Motor innervation of ipsilateral muscles of the soft palate, pharynx, larynx and upper esophagus. Pathway: * Axons of motor neurons in the nucleus ambiguus course with three cranial nerves: C.N. IX (glossopharyngeal), C.N. X (vagus), C.N. XI (the rostral or cranial portion of spinal accessory) to innervate striated muscles of the soft palate, pharynx, larynx and upper esophagus. Deficits: * Lesion of nucleus ambiguus results in atrophy (lower motor neuron) and paralysis of innervated muscles, producing nasal speech, dysphagia, dysphonia, and deviation of the uvula toward the opposite side (strong side). * No affection of the Sternocleidomastoid or Trapezius. These muscles are innervated by cells in the rostral spinal cord (caudal portion C.N. XI).

Retropharyngeal abscess Can present as a pediatric emergency . Airway management is the priority. Immediate incision and drainage of abscess should be done. This is usually done without anaesthesia as there is risk of rupture of abscess during intubation. A vertical incision is given in the most fluctuant area of the abscess. Suction should always be available to prevent aspiration of pus. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Pg. no. 313