Pharynx And Esophagus Flashcards
Define Pharynx
It is a musculomembranous tube which lies behind the nose, mouth and larynx
Extent of the pharynx and length
extends from the base of the skull down to the 6th cervical vertebra
12-14 cm
Nasopharynx extent
extends from the base of the skull down to the level of the soft pala
Name two special features of Nasopharynx
At the junction of it’s roof and posterior wall the mucosa contains:
- nasopharyngeal tonsil
On each lateral wall of the nasopharynx, there are:
Pharyngeal opening of the auditory tube
The Pharyngeal opening of the auditory tube is situated where
1 cm behind the inferior nasal concha
The Pharyngeal opening site
its bounded above and behind by the tubal elevation
the tubal elevation is produced by
by the cartilage of the auditory tube
What is Around the pharyngeal opening
the mucosa contains a collection of lymphoid tissue called the tubal tonsil
The pharyngeal opening is between …… and ……
What’s it’s function
Between midlle ear and nasopharynx
Contains air and maintain pressure
The lower end of the tubal elevation is continuous with a vertical mucous fold called the
salpingopharyngeal fold
What structure is Behind the tubal elevation
pharyngeal recess of Rosenmuller
Oropharynx lateral wall presents
Sinus tonsillar
Also called: tonsillar bed or tonsillar fossa
Sinus tonsillar contains what
Palatine tonsil between the palatoglossal and palatopharyngeal arches
Define palatine tonsils and location
Two masses of lymphoid tissue located in tonsillar fossa between palatoglossal and palatopharyngeal
arches
Each palatine tonsil is covered by what on its medial surface
Mucous membrane on its free medial surface that projects into the pharynx
Each palatine tonsil is covered by what on its lateral surface
By a fibrous capsule that is seperated from superior constrictor muscle by loose areolar tissue
the loose areolar tissue that seperates the fibrous capsule from superior constrictor muscle contains what?
External palatine vein
Also called: paratonsillar vein
External oalatine vein or paratonsillar vein descends from …… to ……
Soft palate to superior constrictor muscle
Paratonsillar vein is between …… and ………
Superior constrictor muscle and palatine tonsil
Blood supply of palatine tonsil
Tonsillar artery branch of facial artery
Veins pierces superior constrictor to join external palatine
Lymphatic drainage: by upper deep cervical l.n
relations to the palatine tonsils
Ant-post-sup-inf-med-lat
Ant: palatoglossal arch
Post: palatopharyngeal arch
Sup: soft palate
Inf: posterior 3rd of the tongue
Med: cavity of the oropharynx
Lat(tonsillar bed): superior const. muscle, paratonsillar vein, tonsillar artery
Laryngopharynx extent
It extends from epiglottis down to the lower border of the cricoid cartilage (C6 vertebra)
What is Anteroinferiorly and inferiorly to the Laryngopharynx
AI: with the larynx via the laryngeal inlet
I: is continuous with the oesophagus
The Muscular Coat of the Pharynx consists of :
- Outer layer formed of 3 constrictors
(superior, middle, inferior) - Inner layer formed of 3 longitudinal muscles
• Stylopharyngeus
• Salpingopharyngeus
• Palatopharyngeus
The 3 constrictors have different origins, but all are inserted?
posteriorly into the pharyngeal raphe
pharyngeal raphe descends from?
the pharyngeal tubercle on the skull base down to the oesophagus
The 3 long. muscles : have different origins, but all are inserted into?
the posterior border of the thyroid cartilage
Mention the Nerve Supply of the Pharynx
all the constrictors and longitudinal muscles of the pharynx are supplied by the cranial accessory nerve through the pharyngeal plexus
all the constrictors and longitudinal muscles of the pharynx are supplied by the cranial accessory nerve through the pharyngeal plexus except
stylopharyngeus, supplied by the glossopharyngeal nerve
What is the action of the constrictors muscles?
have a propulsive swallowing action
What is the action of the long. muscles?
The longitudinal 3 muscles elevate the larynx and pharynx upwards to close the laryngeal inlet
In which stage does the muscles elevate the larynx and pharynx upwards to close the laryngeal inlet?
In the second stage of swallowing
In the thorax, the esophagus passes?
downward and to the left Thoracic part
At what level the esophagus gets pushed back to the midline
At the level of the sternal angle, the aortic arch and L.bronchi pushes the esophagus again to the midline
There is a close relationship between the …… and esophagus
left atrium of the heart
A barium swallow in the esophagus will help the
physician to?
assess the size of the left atrium (dilation) as in case of long standing mitral stenosis or heart failure
In the abdomen The esophagus descends for?
1.3 cm and joins the stomach
At the opening of the diaphragm, the esophagus
is accompanied by:
– The two vagus nerve
– Left gastric vessels
The esophagus has 3 anatomic constrictions where are they?
• The first is at the junction with the pharynx (pharyngeoesophageal junction)
• The second is at the crossing with the aortic arch and the left main bronchus
• The third is at the junction with the stomach
The esophagus 3 anatomic constrictions which have a considerable clinical importance, why?
- They may cause difficulties in passing an esophagoscope
- In case of swallowing of caustic liquids (mostly in
children), this is where strictures develop - The esophageal strictures are a common sites of the development of esophageal carcinoma
- GERG reflex
- Foriegn body won’t pass through it
Arterial supply of the esophagus
• Upper third by the inferior thyroid artery (Branch from subclavian artery)
• The middle third by the thoracic aorta
• The lower third by the left gastric artery (Branch from coelic trunk)
Venous drainage of the esophagus
• The upper third drains in into the inferior thyroid veins
• The middle third into the azygos veins —> S.V.C
• The lower third into the left gastric vein, which is a tributary of the portal vein
What is commonn In the lower part of the esophagus
In general what might occurs (related to veins)
- Columnar metaplasis and carcinoma
- Esophageal varices
Lymphic drainage of the esophagus
• The upper third is drained into the deep cervical nodes
• The middle third is drained into the superior and inferior mediastinal nodes
• The lower third is drained in the celiac lymph nodes in the abdomen
Carcinoma in the uppercpart of the Esop. will drain into?
deep cervical nodes
Nerve supply if tge Esophagus
• It is supplied by sympathetic and parasympathetic
• sympathetic fibers from the sympathetic trunks.
• The parasympathetic supply comes form the vagus nerves
