Transcript soft tissue neck Chapter_15 online 2 24 2011

Chapter 15
Soft Tissue Neck:
Pharynx, Larynx, Thyroid Gland
2/ 24/ 2011
Anatomy: Neck
Region between skull and
thorax
Radiographically divided
into:
Anterior - soft tissues
Posterior - bony tissues
Anterior Part of Neck
Principal structures:
Upper respiratory parts (trachea)
Upper digestive parts (esophagus)
Thyroid gland
Parathyroid gland
Larger part of submandibular salivary
gland
Thyroid Gland
2 lateral lobes
Connected by narrow median
portion- isthmus
Lobes located on sides of
trachea from lower 3rd of
thyroid cartilage to T1
Controls:
how quickly body burns
energy & makes proteins
how sensitive body should be
to other hormones)
Left Lateral Projection
Parathyroid Glands
(Para: beside; near; alongside)
Small, ovoid structures on
posterior aspect of thyroid
gland lobes
(Adams Apple)
2 on each side
Superior
Inferior
Only function: maintain body’s
calcium level within very narrow
range, so nervous system and
muscular systems function
properly
Left Lateral
Adam’s Apple
Also known as laryngeal prominence
Mosby items and derived items © 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
Women have Adam’s Apples

Not as pronounced as men

Cosmetic surgery to reduce size of a laryngeal
prominence -chondrolaryngoplasty

Surgery may change pt's voice and cause
permanent damage & leave a visible scar

performed in many types of gender reassignment surgery
Pharynx
Musculomembranous, tubular
structure in front of vertebrae,
behind nose, mouth, & larynx
Serves as a passage for both food and
air

Subdivided into 3 parts:

Nasopharynx

Oropharynx

Laryngeal Pharynx
Larynx
Organ of voice
Part of respiratory system
Air passageway between
pharynx and trachea
Vocal Cords
Epiglottis
Situated above larynx
Said to prevent food from
passing into larynx during
swallowing
4 types of Radiographic Exams for
Soft Palate, Pharynx, and Larynx
This exams are largely obsolete, replaced by CT and MRI
Palatography- investigate tumors of soft palate and cleft palate
Nasopharyngography-demonstrates hypertrophy of pharyngeal tonsils
and adenoids
Pharyngography-performed to study the act of deglutition or?
Swallowing
Laryngopharyngography-determine exact site, size and extent of
tumor masses
Example of soft tissue study(Pharyngography)
Thick, creamy barium sulfate
suspension
AP Pharynx
Take AP and lateral images
during swallowing
Fluoroscopy often used due to
rapid motion of swallowing
Lateral Pharynx
Contrasts
Negative - Air
Positive- Barium
or iodinated
Oil
Respiratory and Stress Maneuvers
Quiet inspiration- simply breathe in
-tests abduction of vocal cords
Normal (expiratory) phonation- deep breath in, exhale
making high pitched e-e-e or low pitched a-a-h
-tests adduction of vocal cords
Inspiratory phonation- AKA- aspirant manueverexhale then breath in making e-e-e- sound
-demonstrates laryngeal ventricle
Respiratory and Stress Maneuvers
cont’d
Valsalva’s maneuver- forced expiration against closed
glottis
-tests elasticity and functional integrity of glottis
Modified Valsalva’s maneuver- pinched nose, blow out
and inflate cheeks
-tests elasticity of laryngeal pharynx and piriform
recesses