Head: Pharynx Flashcards
Pharynx is part of
- The alimentary system
- Shared with respiratory system
Pharynx extends from
- Extends from cranial base to the level of the cricoid cartilage (C6 level)
Pharynx is narrowest where
- Narrowest where it is continuous with the esophagus
Pharynx is located immediately
- Immediately anterior to cervical vertebrae
3 parts of the Pharynx
- Nasopharynx
- Oropharynx
- Laryngopharynx
Nasopharynx location
- Posterior to nasal cavity
- Superior to soft palate
Oropharynx location
- Posterior to oral cavity
Laryngopharynx location
- Posterior to larynx
Cervical Esophagus
- Begins at pharyngo-esophageal jxn (location of criopharyngeus)
- Vertebral level C6
Nasopharynx
- Respiratory function
- C1 vertebral level
- Continuous with the nasal cavity anteriorly through the choanae
Nasopharynx boundaries
- Soft palate inferiorly and sphenoid bone and occipital bone (roof and posterior wall)
Nasopharynx content
- Pharyngeal tonsils (adenoids)
- Torus tubarius
- Opening of pharyngotympanic tube
- Tubal tonsils
- Salpingopharyngeal fold
- Pharyngeal recess
- Pharyngeal isthmus
Pharyngeal tonsils (adenoids)
- Lymphatic tissue
- Part of the immune system
Torus tubarius (torus of the pharyngotympanic tube)
- Mucosal elevation
- Formed by the pharyngeal end of the pharyngotympanic tube
Opening of pharyngotympanic tube communicates with
- Communicates with middle ear
Salpingopharyngeal fold
- Lies over the salpingopharyngeus muscle
Pharyngeal recess is located
- Located posterior to pharyngotympanic tube
Pharyngeal isthmus provides communication between
- Naso and oropharynx
Oropharynx
- Digestive function
- Shared pathway with respiratory system
- C2,3 vertebral levels
Oropharynx boundaries
- Soft palate superiorly
- Epiglottis inferiorly
- Oropharyngeal isthmus (anteriorly)
Oropharyngeal isthmus (anterior boundary of oropharynx) contains
- Palatoglossal/palatopharyngeal arches
- Pharyngeal tongue (tongue base)
Oropharynx content
- Tonsillar fossa
- Palatine tonsils
Tonsillar fossa is located
- Between palatoglossal and palatopharyngeal folds (arches)
Palatine tonsils are located
- In tonsillar bed between arches
Laryngopharynx
- Posterior to the larynx
- Continuous with the esophagus
- C4-6 vertebral levels
Laryngopharynx boundaries
- From level of epiglottis to cricoid cartilage
Laryngopharynx content
- Piriform recess (fossa)
Piriform recess (fossa)
- On the sides of laryngeal inlet
- Objects/food can become lodged here
- Internal laryngeal and recurrent laryngeal nerves deep to the mucosa
External layer of pharyngeal muscles
- Superior pharyngeal constrictor
- Middle pharyngeal constrictor
- Inferior pharyngeal constrictor
Superior pharyngeal constrictor anterior attachment
- Pterygoid Hamulus
- Pterygomandibular raphe
Superior pharyngeal constrictor posterior attachment
- Pharyngeal tubercle
- Pharyngeal raphe
Middle pharyngeal constrictor anterior attachment
- Stylohyoid ligament
- Greater and lesser horns of hyoid
Middle pharyngeal constrictor posterior attachment
- Pharyngeal raphe
Two parts of the inferior pharyngeal constrictor
- Thyropharyngeal part
- Cricopharyngeal part
Inferior pharyngeal constrictor anterior attachments
- Thyroid cartilage (thyropharyngeal part)
- Cricoid cartilage (cricopharyngeal part; cricopharyngeus)
- Pharyngo-esophageal jxn (upper esophageal sphincter
Inferior pharyngeal constrictor posterior attachments
- Pharyngeal raphe
- Except for the cricopharyngeal part (forms a complete loop)
- Muscles blend with opposite side
Constrictor muscles (superior, middle, inferior) function
- All constrict the pharynx during swallowing
Internal layer of pharyngeal muscles include
- Palatopharyngeus
- Salpingopharyngeus
- Stylopharyngeus
Palatopharyngeus attachments
- Hard palate and palatine aponeurosis
- Pharynx
Salpingopharyngeus attachments
- Cartilage of pharyngotympanic tube
- Blends with palatopharyngeus into the pharyngeal muscles
Stylopharyngeus attachments
- Styloid process of temporal bone
- Passes between superior and middle constrictors
- Blends with other pharyngeal muscles
Internal layer of pharyngeal muscles function
- Elevate pharynx and larynx during swallowing
Salpingopharyngeus (internal layer) function
- Salpingopharyngeus helps open cartilage of the pharyngotympanic tube during swallowing
Pharyngeal muscles innervation (all)
Pharyngeal plexus
Pharyngeal muscles motor innervation
- Vagus (CN X), except for stylopharyngeus (CN IX)
Pharyngeal muscles sensory innervation
- Glossopharyngeal, except for nasopharynx (CN V2)
- Branches from superior cervical sympathetic ganglion
Blood supply of pharynx (branches of external carotid)
- Ascending pharyngeal artery
- Tonsillar and ascending palatine arteries (branches of facial artery)
- Thyroid arteries
- Descending palatine arteries
Pharyngeal lymphatics (tonsillar ring) pathway
- Tubal tonsils
- Pharyngeal tonsil
- Palatine tonsils
- Lingual tonsils
Pharyngeal lymphatics (tonsillar ring) all end up in
- Jugulodigastric node
- Other deep cervical nodes
Two responses of gag reflex
- Pharyngeal response (pharyngeal reflex)
- Palatal response (palatal reflex)
Gag reflex involves sensory stimulation of
- Pharyngeal wall
- Posterior tongue
- Tonsils
- Arches
- Soft palate
Gag reflex is examined by
- Touching posterior pharynx
- Watching for pharyngeal contraction and soft palate elevation
Gag reflex nerve stimulation order
- Glossopharyngeal or trigeminal nerves (afferent)
- Medulla
- Vagus nerve (efferent)
- Palate and pharyngeal muscles
Loss of gag reflex may result from lesion of
- CN IX
- CN X
CN IX lesion (regarding gag reflex)
- Gag reflex not elicited when bad side is stimulated
CN X lesion (regarding gag reflex)
- Uvula deviates away from bad side (towards intact side)
Deglutition (swallowing)
- Part voluntary, part involuntary
- Programmed motor behavior
- Swallowing disorders can drastically impact quality of life
Oral phase of deglutition (swallowing)
- Chewing
- Formation of food bolus
Oral transit phase of deglutition (swallowing)
- Food bolus is compressed against palate and transferred to oropharynx
Pharyngeal phase (involuntary) of deglutition (swallowing)
- Soft palate seals off nasopharynx
- Pharynx shortens and widens
- Larynx and hyoid are pulled ant & sup by suprahyoid muscles
- Glottis closes and epiglottis retroflexes over laryngeal inlet
- Laryngeal inlet muscles contract
- Pharyngeal contraction moves food toward esophagus
Esophageal phase of deglutition (swallowing)
- Relaxation of upper esophageal sphincter (cricopharyngeus)
- Sequential waves of esophageal muscle contraction
