Anatomy Of Pharynx - Pharyngeal Wall Flashcards
What is extent of pharynx ?
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
What is the narrowest part of digestive tract apart from appendix ?
Pharyngo-oesophageal junction
Divisions of pharynx
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
Structures / layers in pharyngeal wall
Mucous membrane / epithelial lining
Waldeyer’s ring
Pharyngeal aponeurosis / pharyngobasilar fascia
Muscular coat - longitudinal muscle and circular muscles
Buccopharyngeal fascia
What is the epithelial lining of pharynx ?
Nasopharynx - pseudostratified ciliated columnar epithelium
Other parts - non- keratinised stratified squamous epithelium
What is waldeyer’s ring ?
Lymphoid tissue is scattered throughout the subepithelial layer of pharynx that are aggregated at places to form masses collectively called as waldeyer’s ring
What constitutes the waldeyer’s ring ?
Adenoids / nasopharyngeal tonsils/ lushka’s tonsils
Palatine tonsils / faucial tonsils
Lingual tonsils
Tubal tonsils / Gerlach tonsil
Lateral pharyngeal bands
Nodules in posterior pharyngeal wall
What are the two types of waldeyer’s ring?
Internal - tonsils ( component of MALT)
External - where the internal waldeyer’s ring drains ( not a component of MALT)
External waldeyer’s ring?
Where internal waldeyer’s ring drain
Drains into retropharyngeal lymph nodes and neck nodes
what are the longitudinal muscles of pharynx?
Also known as dilators
Stylopharyngeous
Salphingopharyngeous
Palatopharyngeus
All gets inserted into thyroid
What are the circular muscles of pharynx ?
Also known as constrictors
Superior , middle , inferior constrictors
Inferior constrictor has two parts - thyropharyngeus(oblique fibre )and cricopharyngeus ( horizontal fibre )
What is sinus of Morgagni?
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)
Structures passing through sinus of morgagni
T - tensor palatini
A - auditory tube
A - ascending palatine artery
L - Levator palatini
A - ascending pharyngeal artery
What is Kilian’s dehiscence?
Gap between thyropharyngeus and cricopharyngeus fibre of inferior constrictor muscle
Also known as gateway of tears
M/C site of pharyngeal pouch formation
Capsule of palatine/faucial tonsils
Formed by the thickening of the pharyngobasilar fascia on the lateral aspect of the tonsils
When does adenoid atrophy?
Prominent in children upto 6 yrs of age
Atrophy till puberty
Completely disappear by the age of 20
What is Passavant ridge?
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
Boundaries of oropharynx
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
Velo pharyngeal insufficiency
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
Boyce sign
On Palpation of zenkers diverticulum , there’s gurgling sounds which is called as boyce sign
Where is the opening of Eustachian tube located ?
1.25cm behind the posterior end of inferior turbinate in the lateral wall of nasopharynx
What is trotter’s triad ?
Also known as sinus of morgagni syndrome
Features of trotter’s triad
Conductive hearing loss
Ipsilateral immobility of palate
Neuralgic pain
Most common site of carcinoma of Plummer Vinson syndrome / Patterson Kelly brown syndrome
Post cricoid region
