HNNS Anatomy - Pharynx Flashcards
Define the borders of the 3 parts of pharynx.
Nasopharynx = Base of skull > C1 Oropharynx = Soft palate at C1 to Epiglottis at C3 Laryngopahrynx = C3 to C6 @ oepning to trachea ad esophagus
Compare the epithelium lining at 3 parts of the pharynx?
Naso = Respiratory epithelium
Oro- and Laryngo- = Stratified Squamous epithelium
Define the location of the tonsils in the pharynx? Drainage?
Pharyngeal tonsils = roof of nasopharynx
Lingual tonsils = behind sulcus terminalis of tongue at orophraynx
Palatine tonsils = Between palatoglossal and palatopharyngeal arches in oropharynx
All drain to deep cervical LN
Route of spread of infection to middle ear?
Auditory tube at lateral wall of nasal cavity»_space; middle ear»_space; otitis media
Common location for NPC?
Behind elevated part/ Tubal elevation of auditory tube = Pharyngeal recess
Sensory supply of nasopharynx?
V2
Explain how nasopharynx infection can reach the mastoid antrum?
Nasopharynx > auditory tube > middle ear > mastoid antrum
List the soft palate muscles?
Tensor veli palatini Levator veli palatini Palatoglossus Palatopharyngeus Musculus uvulae
All supplied by Pharyngeal plexus EXCEPT TENSOR VELI PALATITNI BY V3
Which nerves form the pharyngeal plexus?
CN 9,10,11 + sympathetic branches from superior cervical ganglion C1
Motor = cranial root of CN 9 carried by CN 10 Sensory = CN 9
Define the circular muscles of the oropharynx and nasopharynx.
Superior constrictor = from floor of mouth, interdigitate with buccinator at pterygomandibular raphe
Middle constrictor = from hyoid bone
Inferior constrictor: 2 parts:
1) Upper = Thyropharyngeus (attach to thyroid cartilage)
2) Lower = Cricopharyngeus (attach to cricoid arch)
Overall function of the constrictor muscles of the pharynx?
All push food into esophagus except cricopharyngeus
Cricopharyngeus = sphincter for esophagus, prevent swallowing
Define the internal and external lining of the pharyngeal constrictor muscles?
Internal = Pharyngobasilar fascia (thick) External = Bucopharyngeal fascia
Define the parts of the prevertebral fascia?
Alar part and Prevertebral part
Define the location of the retropharyngeal space and clinical significance?
Between Alar part of prevertebral fascia and Bucopharyngeal fascia down to level of esophagus
= Danger space, communicate with posterior mediastinum, route for spread of infections
Where does pharyngeal diverticulum ocur?
Region between thyropharyngeus and cricopharyngeus muscles
only region where constricotrs dont overlap
List the muscles that lift up the larynx during swallowing.
Salpingopharyngeus (attached to cartilage of auditory tube)
Palatopharyngeus (arise from soft palate)
Stylopharyngeus (arise from styloid process)
Thyrohyoid
All attach to thyroid cartilage
What structure sets the boundary between oral cavity and oropharynx?
Palatoglossal arch
Describe the connection between palatine tonsils and neck LN?
Palatine tonsils drain to Upper cervical lymph nodes - Jugulodiagastric LN
Blood supply of palatine tonsils?
Facial artery and Ascending palatine artery
List the structures lateral to the palatine tonsils?
Fibrous capsule
CN9
ICA
Paratonsillar vein*
profuse bleeding if breached in tonsillectomy
All structures vulnerable to damage if fibrous capsule is breached
Nerve supply of all pharyngeal muscles and soft palate?
Pharyngeal plexus
EXCEPT: stylopharyngeus (CN9) + Cricopharyngeus (CN 10) + Tensor veli palatini (V3)
General blood supply and drainage of pharynx?
Supply = Ascending pharyngeal artery + branches of Facial and Maxillary arteries (all ECA)
Drain = Pharyngeal venous plexus»_space; IJV and Pterygoid venous plexus
LN drainage of Pharynx?
Retropharyngeal LN > Jugulodiagastric LN > IJV
What is the recess found on both sides of the laryngopharynx
Piriform fossa
Deep to mucosa = internal laryngeal nerve (irritated by food stuck in the fossa)
Sensory nerve supply of the pharynx?
CN 9 + internal laryngeal branch of CN 10
Location of pharyngeal plexus?
Lateral side of middle constrictor
