Pharynx Flashcards
Pharynx
3 regions and links
- Nasopharynx
- Oropharynx
- Laryngopharynx
- Links, oral/nasal cavity to larynx/esophagus
Pharynx
Location
Relationships
- Above base of skull
- C6
- Buccopharyngeal fascia
- Forms part of pharynx wall
- Location of pharyngeal plexus of nerves and veins
- Retropharyngeal space
Pharynx is composed of
- 3 types of tonsils
- Pharyngeal 1
- Palatine 2
- Lingual 1
- Soft palate
- 3 Constrictor muscles
- 3 longitudinal muscles
- Cartilaginous part of pharyngotympanic (auditory) tube
5 layers of Pharynx wall and composition
- Mucous membrane
- Innermost layer
- Submucosa
- Pharyngeal aponeurosis
- aka pharyngobasilar fascia
- Fibrous layer attached to skull
- Muscular
- 3 constrictor
- 3 longitudinal
- Buccopharyngeal fascia
- Loose CT
- Pharyngeal plexus of nerves and veins
Attachment of pharynx 5
- Pterygoid hamulus
- Pterygomandibular raphe
- Pharyngeal tubercle
- Retropharyngeal space
- Pharyngeal raphe
Superior Constrictor
O
I
A
N
- O: Pterygoid hamulus, pterygomandibular raphe, pharyngeal tubercle, mylohyoid line of mandible, side of tongue
- I: Pharyngeal tubercle, pharyngeal raphe
- A: constricts upper pharynx
- N: CNX
Pterygomandibular raphe
Upper and lower atttachemnets
Point of attachment for
- Linear cord like connective tissue ligament
- Upper attachment
- Pterygoid hamulus
- Lower attachment
- Mandible, immediately post to 3rd molar
- Point of attachemnt
- Buccinator
- Superior constrictor
Middle Constrictor
O
I
A
N
- O: stylohyoid ligament, hyoid
- I: Pharyngral raphe
- A: Constricts middle portion of pharynx
- N: CN X
Inferior COnstrictor
O
I
A
N
- O: Thyroid cartilage, circoid cartilage
- I: Pharyngeal raphe
- A; Constricts lower pharynx
- N CN X
Circopharyngeus
- Lower fibers of inferior constrictor
- Constant constriction
- Serves as Upper Esophageal Sphincter
Longitudinal muscle and general function
- Palatopharyngeous
- Salpinopharyngeus
- Stylopharyngeous
- Pull pharyngeal wall up over bolus
Palatopharyngeus
O
I
A
N
- O Posterior border of hard palate, palatine aponeurosis
- I: Pharynx
- A: Elevates pharynx and larynx during swallowing, helps close nasopharynx
- CN X
Salpinopharyngeus
O
I
A
N
- O: Auditory tube
- I: Palatopharyngeus muscle
- A: Elevates nasopharynx, opens auditory tube, equalize pressure between pharynx and auditory canal
- CN X
Stylopharyngeus
O
I
A
N
- O Styloid process
- I blends with palatopharyngeus
- A Elevates pharynx and larynx, expands sides of pharynx
- CN IX, 12
What contributes to the Pharyngeal plexus
- CN IX Glossopharyngeal nerve
- Phayngeal branch
- CN X, Vagus
- Paryngeal branch
- CN XI Accessory, cranial part
- Pharyngeal branch
First Aperture in Pharyngeal Wall **
- Between base of skull and superior constrictor
- Auditory tube
- Levator veli palitini muscle
- Ascending pharyngeal a. from ECA
- Ascending palatine a. from facial a.
2nd Aperture in Pharyngeal wall6
- Btween superior and middle constrictors
- Stylopharyngeus, hyoglossus, styloglossus mm.
- Stylohyoid ligament
- Tonsilar a (from facial a.), Lingual a. and V.
- Nerves: Lingual, glossopharyngeal, hypoglossal
- Lymphatics
- Submandibular gland
3rd aperture in pharyngeal wall
- Between middle and inferior constrictors
- Internal branch of superior laryngeal n.
- Superior laryngeal a. .and v.
- From superior thyroid a of ECA
4th aperture of pharygeal wall
- Inferior to inferior constrictor
- Recurrent laryngeal n.
- Inferior laryngeal a. and v.
- From inferior thyroid a. from thyrocervical trunk
Sensory Innervation of Pharynx
- Nasopharynx
- Pharyngeal branch of V2
- Oropharynx
- CN 9, pharyngeal plexus
- Laryngopharynx
- CN X, pharyngeal plexus
Boundaries of Nasopharynx
3
- Superior and posterior to soft palate and uvula
- Inferior to sphenoid bone
- Posterior to internal nares (chonae)
Contents of Nasopharynx
- Opening (ostium) of pharyngotympanic or eustachian tube
- Allows spread of infection from nasopharynx to middle ear
- Torus tubaris
- Elevation over base of auditory tube
- Salpingopharyngeal fold
- Mucous membrane over salpingopharyngeous muscle
- Pharyngeal recess
- Posterior to salpingopharyngeal fold
- Contains pharyngeal tonsils
- Adenoid of pharyngeal tonsil
- No lymph, sinuses, crypts
- Surrounded in part by CT and part by epithelium
Oropharynx Boundaries
- Inferior to soft palate
- Superior to epiglottis
- Posterior to tongue
Oropharynx Contents
- Soft palate
- Salpingopharyngeal fold
- Palatine tonsils (2)
- Lingual tonsil (1)
- Numerous lymphoid nodules/follicles in post 1/3 tongue. each with single crypt
- Epiglottic vallecula
- Space btw post 1/3 tongue and epiglottis
- Food can get stuck here
Palatine Tonsils
Location
Histology
- Located in isthmus of fauces
- Between palatoglossal arch and palatopharyngeal arch
- Partially covered in epithelium and CT
- Exposed side covered with stratified squamous epithelium
- Attaches to pharynx wall with fibrous CT capsule
Palatine Tonsils
Lymphatic tissue
- Contains lymphoid follicles
- MALT
- Covered in crypts
- larege internal surface
Palatine tonsils
Arterial supply
- Dorsal lingual a. (lingual a.)
- Ascending palatine (facial a.)
- Tonsilar branch a. (facial a.)
- Ascending pharyngeal a (ECA)
- Lesser Palatine a. (descending palatine a.)
Palatine Tonsils
Venous drainage
- Peritosilliary plexus to lingual v. and pharyngeal v. to IJV
Palatine Tonsils Innervation
- Lesser palatine nerves (V2)
- Tonsilar branches of CN IV
- Most common nerve to be damaged during tonsilectomy
Waldeyers Ring
- Ring of lymphoid tissue
- Superior
- Pharyngeal tonsils (adenoid)
- Lateral
- Tubal tonsil (eustachian)
- Palatine tonsil
- Inferior
- Lingual tonsil
Laryngopharynx
Boundaries and contents
- Inferior to epiflottis and larynx
- Piriform recess
- On lateral wall
Arterial supply to pharynx 8
- Ascending pharyngeal a., Superior thyroid a.
- From ECA
- Pharyngeal aa. , Palatine a
- From Ascending pharyngeal
- Ascending palatine a, Tonsilar a.
- from Facial a.
- Pharyngeal a
- From Maxillary
- Inferior thyroid a.
- From thyrocervical trunk
Venous drainage of Pharynx
- Pharyngeal plexus
- Located in buccopharyngeal plexus
- Drains into pterygoid plexus, facial v., and internal jugular v.