Doctor Looby: head and neck, ENT.

LarynxFull stop

The larynx is divided into supraglottic, glottic and subglottic according to whether we are above,
at or below the vocal cords.

False cords contain fat, this is called the paralaryngeal fat.

Larynx has a vestibule and ventricle. True cords mark the point of the glottic larynx

The anterior commissure is the midline meeting point of the vocal cords.

Below this level is the subglottic larynx, at which the structure becomes the trachea.

Hard palate: maxillary and Palatine bone.

maxillary alveolar Ridge contains the teeth

The muscles of the tongue can be considered intrinsic and extrinsic.

The intrinsic muscles are small and serve to shape the tongue the extrinsic muscles form the
main body of the tongue and consist of: Genioglossus, palatoglossus, Hyoglossus,
styloglossus. Genioglossus is the largest of them.

The floor of the mouth is formed from a u-shaped sling of muscle known as the mylohyoid.

The mandible is considered to have a buccal and lingual cortex.

The retromolar trigone is the name given to the mucosa posterior to the last mandibular molar.

Longus, colli and Rectus capitis muscles lie in the prevertebral space.

the oropalatine tonsil is within the pillars, it is not the lingual tonsil.

waldeyer's ring is the name of the ring of lymphoid tissue encircling the aerodigestive tract.
In the neck there are three layers of fat enclosed by layers of fascia.

the superficial layer contains the glands and muscles, while the middle layer contains the
pharynx, oesophagus, larynx and trachea.

the Deep layer contains the vertebral bodies.

Neck spaces are divided into infrahyoid and suprahyoid spaces. The hyoid bone is at level
C2/3

the retropharyngeal, danger space and carotid spaces are full-length spaces.

The retropharyngeal space continues all the way along the anterior aspect of the vertebral
bodies. theoretically and infection can travel all the way down the vertebral column.

The posterior choaena is the name for the posterior entrance into the nasal lumen.

The sinus of morgagni is a space allowing passage of the eustachian tube, levator veli palatini
and the ascending Palatine artery.

the fossa of rosenmuller is adjacent to the torus tubarius.

the tonsils in the lateral oropharynx are called the oropalatine tonsils.

there are anterior and posterior tonsillar pillars. There are lingual and tubal tonsils.

the epiglottis is attached to the thyroid cartilage, the root of the epiglottis is called the petiole.
the epiglottis is also attached to the thyroid cartilage by the median and lateral glossoepiglottic
folds.

the hypopharynx contains the pyriform sinuses and the anterior portion of it is called the post
cricoid ( paradoxically) .

parapharyngeal space is a suprahyoid space and usually contains no lymph nodes. it does
however contain blood vessels and may also contain ectopic rests of salivary gland tissue.

the parotid duct is called stensen's duct and it drains opposite the second upper molar tooth

The submandibular gland duct is called wharton's duct and it drains next to the frenulum.

there are submandibular and sublingual spaces.

 Posterolateral to the parapharyngeal space is the carotid space. this contains the common
carotid, internal jugular and sympathetic plexus, the carotid sheath also contains cranial nerves
9 10 11.

anterior to the styloid is the parapharyngeal space, posterior to the styloid is the carotid space.

the masticator space contains the muscles of mastication and the inferior alveolar nerve.

The alar fascia divides the true retropharyngeal space into an anterior part and a posterior
danger space. While the retropharyngeal space can have lymph nodes in childhood, in
adulthood these are almost always related to tumor and the retropharyngeal space should never
enhance.

The mandible is a single bone fused in the middle of the symphysis menti. The mandible has a
mandibular canal containing the inferior alveolar nerve and artery. It also has a condylar notch ,
a condylar head and neck. The condylar head sits into the glenoid fossa, there is a disc within
the glenoid fossa which is described as having anterior and posterior bands and an intermediate
zone. In profile this disk looks like a bow tie. the disc lies at an oblique angle when the mouth is
closed but becomes flatter when the mouth is opened. The condylar head sits in the glenoid
fossa when the mouth is closed slides anteroinferiorly when the mouth is opened, partially dis
articulating. when the mouth is open the condylar head sits directly below the arcuate
eminence.

the technique for obtaining and MRI of the temporomandibular joints involves: axial T2,
sagittal oblique T1 in open and closed positions.

the field of view for a CT sinuses extends from the upper calvarium to the maxilla. it is a
relatively low dose CT technique. Thin slices are required axially and presenters in axial,
coronal and sagittal reconstructions.

Frontal sinus is highly variable, in particular it may not be aerated in cystic fibrosis patients.
frontal sinus forms a frontal recess which drains into the middle meatus. The largest ethmoid air
cell is the ethmoid Bulla. The agger nasi is the most anterior cell all of the the ethmoid air cells
which are divided into an anterior and posterior group by the basal lamella. The basal lamina is
a part of the middle turbinate.

the posterior Ethmoid air cells cells drain into the superior meatus, the anterior ethmoid air cells
drain into the middle meatus.

the crista Galli contains fat. fovea ethmoidalis joins the orbital plate of the frontal bone.
the sphenoid drains into the superior meatus via the sphenoethmoidal recess.

the ostiomeatal complex consists of the infundibulum, Ostium and uncinate process.

the nasolacrimal duct drains into the inferior meatus.

the turbinates are given the names inferior, middle, superior and supreme.

cone beam CT is occasionally used for dental imaging.

the Keros system is used for measuring the frontal recess

There is an olfactory Groove in the lateral cribriform lamella.

the maxillary sinus is the first to develop. the sphenoid sinus is the last pneumatized.

Haller cells are air cells located lateral to the maxillo ethmoidal suture.

Onodi cells are pneumatized clinoid processes. -4