Anatomy Of Pharynx - Pharyngeal Wall

Question 1

What is extent of pharynx ?

Answer 1

Pharynx is a conical fibromuscular tube extending from Base of skull to lower border of cricoid cartilage anteriorly and lower border of C6 vertebra posteriorly

Question 2

What is the narrowest part of digestive tract apart from appendix ?

Answer 2

Pharyngo-oesophageal junction

Question 3

Divisions of pharynx

Answer 3

Nasopharynx - base of skull to soft palate or horizontal plane of hard palate

Oropharynx - from palate to hyoid bone

Hypopharynx - hyoid bone to lower border of cricoid cartilage

Question 4

Structures / layers in pharyngeal wall

Answer 4

Mucous membrane / epithelial lining
Waldeyer’s ring
Pharyngeal aponeurosis / pharyngobasilar fascia
Muscular coat - longitudinal muscle and circular muscles
Buccopharyngeal fascia

Question 5

What is the epithelial lining of pharynx ?

Answer 5

Nasopharynx - pseudostratified ciliated columnar epithelium

Other parts - non- keratinised stratified squamous epithelium

Question 6

What is waldeyer’s ring ?

Answer 6

Lymphoid tissue is scattered throughout the subepithelial layer of pharynx that are aggregated at places to form masses collectively called as waldeyer’s ring

Question 7

What constitutes the waldeyer’s ring ?

Answer 7

Adenoids / nasopharyngeal tonsils/ lushka’s tonsils
Palatine tonsils / faucial tonsils
Lingual tonsils
Tubal tonsils / Gerlach tonsil
Lateral pharyngeal bands
Nodules in posterior pharyngeal wall

Question 8

What are the two types of waldeyer’s ring?

Answer 8

Internal - tonsils ( component of MALT)
External - where the internal waldeyer’s ring drains ( not a component of MALT)

Question 9

External waldeyer’s ring?

Answer 9

Where internal waldeyer’s ring drain
Drains into retropharyngeal lymph nodes and neck nodes

Question 10

what are the longitudinal muscles of pharynx?

Answer 10

Also known as dilators

Stylopharyngeous
Salphingopharyngeous
Palatopharyngeus

All gets inserted into thyroid

Question 11

What are the circular muscles of pharynx ?

Answer 11

Also known as constrictors

Superior , middle , inferior constrictors

Inferior constrictor has two parts - thyropharyngeus(oblique fibre )and cricopharyngeus ( horizontal fibre )

Question 12

What is sinus of Morgagni?

Answer 12

Gap between base of skull and superior constrictor (upper border of superior constrictor muscle is free and is not attached to the base of skull)

Question 13

Structures passing through sinus of morgagni

Answer 13

T - tensor palatini
A - auditory tube
A - ascending palatine artery
L - Levator palatini
A - ascending pharyngeal artery

Question 14

What is Kilian’s dehiscence?

Answer 14

Gap between thyropharyngeus and cricopharyngeus fibre of inferior constrictor muscle

Also known as gateway of tears

M/C site of pharyngeal pouch formation

Question 15

Capsule of palatine/faucial tonsils

Answer 15

Formed by the thickening of the pharyngobasilar fascia on the lateral aspect of the tonsils

Question 16

When does adenoid atrophy?

Answer 16

Prominent in children upto 6 yrs of age
Atrophy till puberty
Completely disappear by the age of 20

Question 17

What is Passavant ridge?

Answer 17

It is a u-shaped mucosal fold formed by the palatopharyngeus muscle in the posterior pharyngeal wall

During swallowing
Soft palate raises and the Passavant ridge comes forward in contact with the soft palate closing the nasopharyngeal isthmus

Question 18

Boundaries of oropharynx

Answer 18

Anterior wall

1.Base of tongue(posterior 1/3)
2.lingual tonsils
3.valleculae

Lateral wall

1.anterior pillar
2.palatine tonsils
3.posterior pillar

Posterior wall

1.C2 and upper part of C3

Roof

1.Same as floor of nasopharynx

Floor

1.hyoid bone

Question 19

Velo pharyngeal insufficiency

Answer 19

Inability of soft palate to meet the Passavant ridge

Feature

Nasal regurgitation
Nasal words pass through nose
Other words also pass through nose producing hyper nasal voice called rhinolalia aperta

Question 20

Boyce sign

Answer 20

On Palpation of zenkers diverticulum , there’s gurgling sounds which is called as boyce sign

Question 21

Where is the opening of Eustachian tube located ?

Answer 21

1.25cm behind the posterior end of inferior turbinate in the lateral wall of nasopharynx

Question 22

What is trotter’s triad ?

Answer 22

Also known as sinus of morgagni syndrome

Features of trotter’s triad

Conductive hearing loss
Ipsilateral immobility of palate
Neuralgic pain

Question 23

Most common site of carcinoma of Plummer Vinson syndrome / Patterson Kelly brown syndrome

Answer 23

Post cricoid region