The pharynx Flashcards

1
Q

State the location, relations and extents of the pharynx

A

Length: 5 inches
Location: in front of upper 6 cervical vertebrae
Extent: from base of skull to C6( lower border of the cricoid cartilage to continue as the esophagus)

Relations
1. Anterior: nasal cavity, oral cavity and larynx.
2. Posterior: upper 6 cervical vertebrae
3. Sides:
a. Styloid process and structures attached to it; stylopharyngeus, styloglossus, stylohyoid muscles and stylomandibular and stylohyoid ligaments
b. Vessels: carotid arteries ( ECA, CCA & ICA) and internal jugular vein.
c. Nerves:- last 4 cranial nerves and sympathetic chain

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2
Q

Name the parts of the pharynx.

A
  1. Nasopharynx- behind the nasal cavities
  2. Oropharynx - behind the oral cavity
  3. Laryngopharynx- behind the larynx
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3
Q

Discuss the boundaries and features of the nasopharynx

A

Boundaries:
1. Roof & posterior wall- adenoid (pharyngeal tonsil)
2. Floor- soft palate
3. Anterior - posterior nasal orifice
4. Lateral wall: contains
- opening of auditory tube/ eustatian tube
- tubal elevation
- salpingopharyngeal fold- formed by salpingopharyngeal muscle
- pharyngeal recess

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4
Q

Name the features of the oropharynx

A
  1. Palatine tonsil- in tonsillar fossa
  2. Anterior - palatoglossal arch
  3. Posterior - palatopharyngeal arch
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5
Q

Discuss the location and boundaries of the palatine tonsil.

A

Site: tonsillar fossa bounded by:
1. Anterior: palatoglossal arch
2. Posterior: palatopharyngeal arch
3. Floor: superior constrictor muscle

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6
Q

State the blood supply of the palatine tonsils

A
  1. Facial artery: tonsillar branch- main supply
  2. Facial artery: ascending palatine branch
  3. Ascending pharyngeal: from ECA
  4. Lingual artery: through dorsal lingual artery
  5. Lesser palatine: from greater palatine artery
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7
Q

State the features of the laryngopharynx and their boundaries.

A
  1. Laryngeal inlet: bounded by
    • anterior: epiglottis
      _ posterior: arytenoid cartilage and interarytenoid fold.
    • sides: aryepiglottic fold
  2. Pyriform fossa: lateral to aryepiglottic fold.
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8
Q

Name the layers of the pharyngeal wall.

A
  1. Buccopharyngeal fascia - loose areolar sheath
  2. Muscle layer
  3. Pharyngobasilar fascia- pharyngeal aponeurosis
  4. Mucous membrane
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9
Q

Name the muscles of the pharynx

A

Constrictor
1. Superior constrictor
2. Middle constrictor
3. Inferior constrictor

Longitudinal
1. Stylopharyngeus
2. Palatopharyngeus
3. Salpingopharyngeus

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10
Q

State the origins, insertions and actions of the three constrictor muscles

A
  1. Superior constrictor
    • pterygoid hamulus
    • pterygomandibular ligament
    • mylohyoid line of mandible
  2. Middle constrictor:
    • stylohyoid ligament
    • hyoid bone
  3. Inferior constrictor:
    • thyroid cartilage
    • cricoid cartilage
    • arch over cricothyroid muscles

Insertion:
• all insert to median raphe extending from the pharyngeal tubercle to the cricoid cartilage

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11
Q

State the origins, insertion and action of the three longitudinal muscles.

A

Origins
3. Salpingopharyngeus- from the eustachian (auditory) tube
2. Palatopharyngeus - from the palatine aponeurosis
1. Stylopharyngeus - from the styloid process.

Insertion
Posterior border of the lamina of the thyroid cartilage.
** Action**
Elevation of pharynx and larynx during swallowing.

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12
Q

Discuss the gaps in the lateral wall and state their contents

A
    • Above the superior constrictor*
      • auditory tube: cartilaginous part
      • 2 muscles: tensor and levator palati.
      • 2 arteries: ascending palatine & pharyngeal branch of ascending pharyngeal artery
    • Between Superior and middle constrictors*
      • glossopharyngeal nerve
      • stylohyoid muscles
      • stylohyoid ligament
    • Between the middle and inferior constrictors*
      -Thyroid membrane which is pierced by:
      • internal laryngeal nerve
      • superior laryngeal artery
  1. Below the inferior constrictor
    • recurrent laryngeal nerve
    • inferior laryngeal artery
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13
Q

State the arterial supply of the pharynx

A

1. 2 pharyngeal arteries
• ascending pharyngeal artery- from ECA
• pharyngeal branch - from maxillary artery

2. 2 from facial artery:
• tonsillar artery
• ascending Palatine artery

3.2 Palatine arteries: from maxillary
• greater palatine
• lesser palatine

4.2 dorsal lingual arteries: from lingual artery

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14
Q

State the Venous drainage of the pharynx

A

• Largely drained into pharyngeal Venous plexus located on the posterolateral aspect of the pharynx over the middle constrictor.
• drains into IJV

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15
Q

State the motor, sensory and sympathetic nerve supply of the pharynx.

A

motor
- all the muscles are supplied by the pharyngeal branch of the vagus( from the cranial root of accessory nerve) except the stylopharyngeus by the glossopharyngeal

Sensory:
1. Nasopharynx: maxillary
• pharyngeal branch of the pterygopalatine ganglion
2. Oropharynx: glossopharyngeal
• pharyngeal branch of IX nerve
3. Laryngopharynx: vagus
• internal laryngeal nerve of vagus

Sympathetic
Superior cervical sympathetic ganglion through pharyngeal plexus

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16
Q

Discuss the pharyngeal plexus stating the roots and distribution.

A
  1. Motor root(vagus)- to muscles of the pharynx except stylopharyngeus (glossopharyngeal)and muscles of the palate except tensor palati(mandibular)
  2. Sensory root(IX)- mucous membrane of the oropharynx
  3. Sympathetic root- blood vessels
17
Q

Discuss the lymph drainage of of the pharynx.

A
  1. Retropharyngeal lymph nodes
  2. Upper and lower deep cervical lymph nodes

Surrounded by ring of lymphoid tissues called waldeyer’s ring

18
Q

State the components of waldeyer’s ring

A
  1. Adenoid (pharyngeal) tonsil- in the roof of the nasopharynx.
  2. Tubal tonsil - around the opening of the auditory tube.
  3. Palatine tonsil- on each side of the oropharynx.
  4. Lingual tonsil- in posterior 1/3 of the tongue
19
Q

State the functions and clinical anatomy of waldeyer’s ring.

A
  1. Prevent invasion of microorganisms from air and food passages
  2. This helps in the defense mechanics of the respiratory and alimentary systems