Pharynx + prevertebral region Flashcards
When does pharynx become oesophagus?
At C6
The pharynx is covered in what type of epithelium?
Ciliated columnar epithelium superiorly to stratified squamous inferiorly
Layers of the pharynx?
Epithelium
Fibrous layer under epithelium = connects from base of skull to submucous coat of oesophagus
Muscular layer under fibrous layer = has circular constrictor muscles + longitudinal muscles
Divisions of pharynx?
Nasopharynx = above soft palate (post. to nasal cavities)
Oropharynx = between soft palate and epiglottis (post. to oral cavity)
Laryngopharynx = below epiglottis (post. to larynx to blend with oesophagus)
Nasopharynx found?
Boundaries of the nasopharynx?
You’re at the Nile, with a sphinx, waterslide, sunbed, cat, ichthyosaur
Nasopharynx = posterior to nasal cavities above soft palate
Roof = sphenoid, occipital + pharyngeal tonsil Floor = soft palate + pharyngeal isthmus Anterior = nasal cavities Posterior = roof + C1 level Lateral = eustachian tube + salpingopharyngeal fold
Label
What is indicated by the blue arrow?
Star?
Blue arrow = eustachian tube
Star = salpingopharyngeus (longitudinal muscle of pharynx)
Oropharynx found?
Boundaries of the oropharynx?
Oropharynx = from soft palate to epiglottis
Roof = soft palate Floor = post. 1/3 tongue, lingual tonsil, glossoepiglottic folds Anterior = mouth Posterior = C2/3 level Lateral = palatoglossal + palatopharyngeal folds + palatine tonsil
Which area of the pharynx is labelled here?
Nasopharynx
Which area of the pharynx is labelled here?
Oropharynx
Label
Label
Palatoglossus + palatopharyngeus functions?
Form the arches at the back of the mouth
Contribute to movements of the soft palate, tongue and pharynx
Laryngopharynx found?
Boundaries of laryngopharynx?
Laryngopharynx = behind larynx
Anterior = larynx Posterior = C3-C6 vertebrae Lateral = thyroid cartilage, aryepiglottic fold + thyrohyoid membrane
Which area of the pharynx is labelled here?
Laryngopharynx
What is labelled here?
Superior constrictor
What forms the connection between the lateral wall of the oral cavity and the oropharynx?
The pterygomandibular ligament
Provides attachment for buccinator (lateral wall) anteriorly + superior constrictor posteriorly (oropharynx)
Attachments of superior constrictor muscle?
From medial pterygoid plate, hamulus, pterygomandibular ligament, mandible + side of tongue to
—> pharyngeal tubercle of occipital bone, fibrous raphe + middle constrictor
Function superior constrictor muscle?
Upper fibres pull posterior pharyngeal wall anteriorly to close off nasopharynx
Propel food to middle constrictor
Innervation superior constrictor?
All constrictor muscles = vagus nerve in pharyngeal plexus
Middle constrictor attachments?
From stylohoid ligament to greater + lesser cornua of hyoid bone + raphe (also blend with superior + inferior constrictor)
Label
Middle constrictor
Function middle constrictor?
Innervation?
Propels food towards inferior constrictor
Innervation = vagus nerve from pharyngeal plexus
Label
Inferior constrictor
Attachments inferior constrictor?
From lamina of thyroid cartilage + cricoid cartilage to
—> raphe (blends with middle constrictor + oesopheagus)
Function inferior constrictor?
Innervation?
Propels food to oesophagus
Innervation = vagus from pharyngeal plexus
Label inferior constrictor
Parts of inferior constrictor?
Function?
Innervation?
Thyropharyngeus = fibres pass to midline Cricopharyngeus = more circular
Cricopharyngeus thought to close end of pharynx to stop air passing into oesphagus
All constrictor muscles receive innervation from vagus - EXCEPT cricopharyngeus (external laryngeal nerve from vagus)
Which structure is this?
Inferior constrictor muscle
Longitudinal muscles of pharynx?
Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus
Label
Longitudinal muscles of pharynx
Stylopharyngeus attachments?
Relations?
From base of styloid process to
—> posterior border of thyroid cartilage
It passes across the internal carotid artery
It passes between the superior + middle constrictors
Stylopharyngeus function?
Innervation?
Elevates larynx + pharynx during swallowing
Innervation = glossopharyngeal nerve (odd one out)
Which muscle is this?
Stylopharyngeus
Salpingopharyngeus attachments?
Function?
Innervation?
From cartilage of auditory tube to blend with palatopharyngeus (to attach onto thyroid cartilage)
Function = elevates larynx
Innervation = vagus nerve from pharyngeal plexus
Palatopharyngeus attachments?
Function?
Innervation?
From hard palate + palatine aponeurosis to
—> lamina of thryoid cartilage (post)
Function = elevates pharynx
Innervation = vagus nerve from pharyngeal plexus
Folds formed by longitudinal muscles of pharynx?
Salpingopharyngeus forms a fold in the lateral wall of the nasopharynx
Palatopharyngeus forms a fold in the lateral wall of the oropharynx
Label
Label
Recurrent laryngeal nerve between oesophagus and trachea then passes inferior to inferior constrictor of pharynx
Label (posterior view)
What form a ring of protective lymphoid tissue around the openings of nasopharynx + oropharynx?
Pharyngeal tonsil, palatine tonsils + lingual tonsil
Sensory innervation of pharynx?
Nasopharynx = maxillary division of trigeminal Oropharynx = glossopharyngeal Laryngopharynx = vagus
Label (posterior view)
Which nerves contribute to the pharyngeal plexus?
Glossopharyngeal, vagus + sympathetic
Vagus supplies muscles of soft palate except tensor veli palatini (CNV3)
Label
Blood supply to pharynx?
Pharyngeal branches from maxillary artery (nasopharynx)
Ascending pharyngeal artery from external carotid artery
Label veins of pharynx
The pharyngeal veins form a plexus that communicates with the facial and internal jugular veins
Lymph drainage pharynx?
Lymph drains to retropharyngeal + paratracheal nodes then —> to deep cervical nodes
Pre-vertebral (anterior) muscles?
Where are they found?
Longus colli
Longus capitis
Rectus capitis anterior
Rectus capitis lateralis
Lie posterior to the pharynx
Longus capitis attachments?
Function?
Innervation?
From anterior tubercles of transverse processes of C3-C6 to —> base of occipital bone
Function = flexion of head
Innervation = ventral rami of spinal nerves C1-C3
Label
Longus colli attachments?
Parts?
From atlas to T3
Inferior oblique, superior oblique + vertical parts
Inferior oblique = from T3 to anterior tubercle of C5/6
Superior = anterior tubercle C3-5 —> atlantal anterior tubercle
Vertical = T1-3 —> C4-6
Longus colli function?
Innervation?
Flexion of neck
Inferior oblique fibres allow rotation to opposite side
Innervation = ventral rami C2-C6
Label
Rectus capitis anterior and lateralis attachments?
Function?
Anaterior = from root of transverse process of atlas to —> occipital bone (anterior to occipital condyle)
Flexes atlanto-occipital joint
Lateralis = from transverse process of atlas to —> occipital bone (inf surface of jugular process)
Flexes head
(equivalent of suboccipital muscles but flex head instead of extending it)
Rectus capitis anterior and lateralis relations?
Innervation?
Crossed by internal jugular vein
Innervation = ventral rami of cranial nerves C1-C2
(suboccipital equivalent innervated by C1-C2 but posterior rami)
Sympathetic ganglia of neck extend from?
Anatomical relations?
Where is it found in the neck?
Comprised of?
From base of skull to thoracic chain
Medial to vagus nerve
Behind internal + common carotid arteries
Embedded in deep fascia between carotid sheath and fascia over surface of longus capitis + longus coli
In the neck, it is comprised of 3 interconnected ganglia: superior, middle + inferior cervical ganglia
Function of sympathetic ganglia in neck?
Sympathetic innervation to skin, sweat glands, blood vessels
Superior cervical ganglia found?
Course?
Communications?
Large, immediately below skull
Fibres wind around carotid arteries into carotid canal to form internal carotid plexus
Communicates with C1-C4 ventral rami via grey rami communicantes
Branches of superior cervical ganglia?
Internal carotid nerve (travels with internal carotid artery to supply head)
External carotid nerve
Pharyngeal branches join with vagus + glossopharyngeal nerves to form pharyngeal plexus
Nerves to cranial nerves 9, 10, 12
Superior cardiac nerve - plexus in thorax
Label
Superior cervical ganlgion
Middle cervical ganglion found?
Anatomical relations?
Branches?
Small, at level of cricoid cartilage
Anterior to loop of inferior thyroid artery
Grey rami communicantes to C5+6 ventral rami
Thyroid branches travel with thyroid arteries to supply thyroid
Middle cardiac branch - cardiac plexus
Also forms the ansa subclavia!
Loops around subclavian artery (do not confuse with ansa cervicalis that carries C1-3 fibres to strap muscles + overlies carotid sheath)
Label
Inferior cervical ganglion found?
Branches?
Usually fused with 1st thoracic ganglion to form stellate ganglion, lies behind vertebral artery between transverse process of C7 + head of 1st rib
Grey rami communicantes to ventral rami of C7, 8
Branches to subclavian and vertebral arteries
Inferior cardiac branch - cardiac plexus
Label
Inferior cervical ganglion