1
Q
Pharynx
3 regions and links
A
- Nasopharynx
- Oropharynx
- Laryngopharynx
- Links, oral/nasal cavity to larynx/esophagus
2
Q
Pharynx
Location
Relationships
A
- Above base of skull
- C6
- Buccopharyngeal fascia
- Forms part of pharynx wall
- Location of pharyngeal plexus of nerves and veins
- Retropharyngeal space
3
Q
Pharynx is composed of
A
- 3 types of tonsils
- Pharyngeal 1
- Palatine 2
- Lingual 1
- Soft palate
- 3 Constrictor muscles
- 3 longitudinal muscles
- Cartilaginous part of pharyngotympanic (auditory) tube
4
Q
5 layers of Pharynx wall and composition
A
- 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
5
Q
Attachment of pharynx 5
A
- Pterygoid hamulus
- Pterygomandibular raphe
- Pharyngeal tubercle
- Retropharyngeal space
- Pharyngeal raphe
6
Q
Superior Constrictor
O
I
A
N
A
- 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
7
Q
Pterygomandibular raphe
Upper and lower atttachemnets
Point of attachment for
A
- Linear cord like connective tissue ligament
- Upper attachment
- Pterygoid hamulus
- Lower attachment
- Mandible, immediately post to 3rd molar
- Point of attachemnt
- Buccinator
- Superior constrictor
8
Q
Middle Constrictor
O
I
A
N
A
- O: stylohyoid ligament, hyoid
- I: Pharyngral raphe
- A: Constricts middle portion of pharynx
- N: CN X
9
Q
Inferior COnstrictor
O
I
A
N
A
- O: Thyroid cartilage, circoid cartilage
- I: Pharyngeal raphe
- A; Constricts lower pharynx
- N CN X
10
Q
Circopharyngeus
A
- Lower fibers of inferior constrictor
- Constant constriction
- Serves as Upper Esophageal Sphincter
11
Q
Longitudinal muscle and general function
A
- Palatopharyngeous
- Salpinopharyngeus
- Stylopharyngeous
- Pull pharyngeal wall up over bolus
12
Q
Palatopharyngeus
O
I
A
N
A
- O Posterior border of hard palate, palatine aponeurosis
- I: Pharynx
- A: Elevates pharynx and larynx during swallowing, helps close nasopharynx
- CN X
13
Q
Salpinopharyngeus
O
I
A
N
A
- O: Auditory tube
- I: Palatopharyngeus muscle
- A: Elevates nasopharynx, opens auditory tube, equalize pressure between pharynx and auditory canal
- CN X
14
Q
Stylopharyngeus
O
I
A
N
A
- O Styloid process
- I blends with palatopharyngeus
- A Elevates pharynx and larynx, expands sides of pharynx
- CN IX, 12
15
Q
What contributes to the Pharyngeal plexus
A
- CN IX Glossopharyngeal nerve
- Phayngeal branch
- CN X, Vagus
- Paryngeal branch
- CN XI Accessory, cranial part
- Pharyngeal branch
16
Q
First Aperture in Pharyngeal Wall **
A
- Between base of skull and superior constrictor
- Auditory tube
- Levator veli palitini muscle
- Ascending pharyngeal a. from ECA
- Ascending palatine a. from facial a.
17
Q
2nd Aperture in Pharyngeal wall6
A
- 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
18
Q
3rd aperture in pharyngeal wall
A
- Between middle and inferior constrictors
- Internal branch of superior laryngeal n.
- Superior laryngeal a. .and v.
- From superior thyroid a of ECA
19
Q
4th aperture of pharygeal wall
A
- Inferior to inferior constrictor
- Recurrent laryngeal n.
- Inferior laryngeal a. and v.
- From inferior thyroid a. from thyrocervical trunk
20
Q
Sensory Innervation of Pharynx
A
- Nasopharynx
- Pharyngeal branch of V2
- Oropharynx
- CN 9, pharyngeal plexus
- Laryngopharynx
- CN X, pharyngeal plexus
21
Q
Boundaries of Nasopharynx
3
A
- Superior and posterior to soft palate and uvula
- Inferior to sphenoid bone
- Posterior to internal nares (chonae)
22
Q
Contents of Nasopharynx
A
- 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
23
Q
Oropharynx Boundaries
A
- Inferior to soft palate
- Superior to epiglottis
- Posterior to tongue
24
Q
Oropharynx Contents
A
- 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
25
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
26
Palatine Tonsils
Lymphatic tissue
* Contains lymphoid follicles
* MALT
* Covered in crypts
* larege internal surface
27
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.)
28
Palatine Tonsils
Venous drainage
* Peritosilliary plexus to lingual v. and pharyngeal v. to IJV
29
Palatine Tonsils Innervation
* Lesser palatine nerves (V2)
* Tonsilar branches of CN IV
* Most common nerve to be damaged during tonsilectomy
30
Waldeyers Ring
* Ring of lymphoid tissue
* Superior
* Pharyngeal tonsils (adenoid)
* Lateral
* Tubal tonsil (eustachian)
* Palatine tonsil
* Inferior
* Lingual tonsil
31
Laryngopharynx
Boundaries and contents
* Inferior to epiflottis and larynx
* Piriform recess
* On lateral wall
32
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
33
Venous drainage of Pharynx
* Pharyngeal plexus
* Located in buccopharyngeal plexus
* Drains into pterygoid plexus, facial v., and internal jugular v.
