The pharynx is a hollow tube that starts behind the nose, goes down the neck, and ends at the top of the trachea and esophagus. The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.
4. PHARYNX -1
Nasopharynx
Dr Mathew Joseph MBBS,MD(AIIMS),BCC(Palliative Medicine)
Assistant Professor
Department of Anatomy
Al-Azhar Medical College & Super Specialty Hospital
6. Introduction
• Pharynx is a fibromuscular tube.
• It is a common channel for both food and
air.
Location- Behind the cavities of nose, mouth
and the larynx.
Shape - funnel shaped.
Extent- From the base of the skull to the
esophagus.
8. Boundaries
Superior-
• Base of skull [ posterior part of body of Sphenoid
& Basilar part of Occipital bone in front of
pharyngeal tubercle.
Inferior-
• Continuous with esophagus at the level of lower
border of cricoid cartilage anteriorly and lower
border of C6 vertebra posteriorly
Posterior-
• Prevertebral fascia.
Anterior-
• Opens into cavities of nose, mouth and larynx.
Lateral-
• Neurovascular bundle of neck.
• Styloid process with its attached muscles and
ligaments
11. Nasopharynx
Location-
• Behind choanae (posterior nasal
apertures) and above soft palate.
Communications-
Anteriorly- with nasal cavities.
Inferiorly- with oropharynx.
12. Pharyngeal Isthmus [Nasopharyngeal Isthmus]
• An opening bounded anteriorly by
the soft palate and posteriorly by
the posterior wall of pharynx (
Passavant’s ridge).
13. Features:
• Nasopharyngeal (Pharyngeal) Tonsil).
• Orifice of Pharyngo-tympanic tube (Auditory tube or
Eustachian tube).
• Tubal elevation.
• Tubal tonsil.
• Salpingopharyngeal fold.
• Salpingopalatine fold.
• Pharyngeal recess (Fossa of Rosenmüller).
Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]-
• A collection of lymphoid tissue.
Location- At the junction of roof and posterior wall of
nasopharynx.
• Contains nasopharyngeal bursa.
Nasopharyngeal (Pharyngeal) bursa [Pouch of Luschka]-
• A mucous diverticulum which extends upwards into
the substance of pharyngeal tonsil from its apex.
• It is developed due to adhesion of notochord to the
dorsal wall of pharyngeal part of foregut.
14. Orifice of Pharyngo-tympanic tube
(Auditory tube or Eustachian tube)-
Location-
• On lateral wall of nasopharynx,
approximately 1.25 cm behind inferior
nasal concha.
Tubal elevation-
•Upper and posterior margins of orifice of
eustachian tube are elevated due to
collection of lymphoid tissue.
•These elevated margins are known as tubal
elevation.
Tubal tonsil-
• Collection of lymphoid tissue in tubal
elevation is known as tubal tonsil.
15. Salpingopharyngeal fold-
•A mucous fold which extends vertically
downwards on the side wall of pharynx
from tubal elevation.
•It contains Salpingopharyngeus muscle.
Salpingopalatine fold-
•A mucous fold which extends downwards
and forwards to the soft palate from tubal
elevation.
•It contains Levator Palati muscle.
Pharyngeal recess (Fossa of
Rosenmüller).
•It is a deep depression behind the tubal
elevation.
16. Applied Aspects
Adenoids-
•Enlarged nasopharyngeal tonsils due to infection.
•Block the posterior nares.
Clinical Features-
•Nasal obstruction.
•Nasal discharge.
•Mouth breathing.
•Snoring.
•Protrusion of tongue.
•Toneless voice
•Small nose.
•Epistaxis (Nose Bleeding).
Nasopharyngeal tonsils are prominent in children up to
the age of 6 years.
They gradually undergo atrophy at puberty.
They completely disappear by the age of 20 years.
17. Adenoid Facies [Long Face Syndrome]
• Long, open-mouthed face of children with
adenoid hypertrophy.
• These children are ‘Obligatory Mouth Breathers’.
• Persistent mouth breathing may be associated
with development of craniofacial anomalies.
• The characteristic facial appearance consists of:
• Underdeveloped thin nostrils
• Short upper lip
• Prominent upper teeth
• Crowded teeth
• Narrow upper alveolus.
• High-arched palate
• Hypoplastic maxilla
21. Pharynx 2
Oropharynx - Laryngopharynx
Dr Mathew Joseph
MBBS,MD(AIIMS),BCC(Palliative Medicine)
Assistant Professor
Department of Anatomy
Al-Azhar Medical College & Super Specialty Hospital
23. Introduction
Extent-
• From lower surface of soft palate to
upper border of epiglottis.
Communications-
Anteriorly- with Oral cavity.
Above- with Nasopharynx.
Inferiorly- with Laryngopharynx.
24. Oropharyngeal Isthmus
• It is a communicating
channel between
oropharynx and oral cavity.
Boundaries-
Above- Soft Palate
Below- Dorsal surface of
posterior 1/3rd of tongue.
Laterally- Palatoglossal arch.
• Oropharyngeal Isthmus is
closed during deglutition.
25. Features
• Palatine tonsils.
• Anterior faucial pillar ( Palatoglossal arch).
• Posterior faucial pillar (Palatopharyngeal arch).
• Lingual tonsils.
• Upper free end of Epiglottis.
• Median and lateral glossoepiglottic folds.
• Epiglottic valleculae.
26. Features in Lateral Wall
Palatine Tonsil-
Location:
• In the tonsillar fossa.
• Tonsillar fossa is located in the lateral wall of
oropharynx.
• Tonsillar fossa is bounded anteriorly by the anterior
faucial pillar (palatoglossal arch).
• Tonsillar fossa is bounded posteriorly by the
posterior faucial pillar (palatopharyngeal arch).
Posterior 1/3rd of
Tongue
Uvula
27.
28. Anterior faucial pillar ( Palatoglossal arch)-
• Runs downwards and forwards from soft palate to lateral margin of tongue (at
the junction of anterior 2/3rd and posterior 1/3rd ).
• It contains Palatoglossus muscle.
Posterior faucial pillar (Palatopharyngeal arch)-
• Runs downwards and backwards to the pharyngeal wall.
• It contains Palatopharyngeus muscle.
29. Features in Anterior Wall
• Lingual tonsils-
These are the collections of lymphoid tissue underneath the
mucosa of pharyngeal part of tongue.
• Upper free end of Epiglottis.
• Median glossoepiglottic fold-
A mucosal fold connecting anterior surface of epiglottis to
the dorsal surface of posterior 1/3rd of tongue.
• Lateral glossoepiglottic folds-
Mucosal folds connecting edges of epiglottis to the dorsal
surface of posterior 1/3rd of tongue.
• Epiglottic valleculae-
Shallow fossae between median and lateral glossoepiglottic
folds.
30. Applied Aspects
• As oropharynx is a common channel for both food and air,
sometimes food may enter into respiratory tract and cause
choking.
32. Introduction
Vertical Extent-
Anteriorly-
• From upper border of epiglottis to lower
border of lamina of cricoid cartilage.
Posteriorly-
• From C3 vertebra to the lower border of C6
vertebra.
Communications-
Anteriorly- with Laryngeal cavity.
Superiorly- with Oropharynx.
Inferiorly- with Esophagus.
• Laryngopharynx communicates with
laryngeal inlet through Laryngeal Inlet.
33. Features
• Laryngeal Inlet.
• Piriform fossa/recess.
Laryngeal Inlet closes
during deglutition.
Piriform fossa [Smuggler’s
Fossa]-
Location-
• Anterior part of lateral
wall, on each side of
laryngeal inlet.
Piriform
fossa
34. Pharyngeal Wall
Consists of 4 layers (from within outwards)-
1. Mucous membrane.
2. Pharyngobasilar fascia (Pharyngeal
aponeurosis).
3. Muscle layer.
4. Buccopharyngeal fascia.
35. Mucous Membrane
Epithelium- Stratified squamous except nasopharynx.
• Nasopharynx is lined by ciliated columnar
epithelium.
• Epithelium tends to invaginate in sub epithelial
collections of lymphoid tissue in the form of clefts
(crypts).
Waldeyer’s Ring-
• Aggregations of lymphoid tissue underneath the
epithelium of pharyngeal wall in the form of an
interrupted ring.
• Surround the commencement of air and food
passages.
• Lymphoid collections in the Waldeyer’s ring are:
• Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]-
Posteriorly
• Tubal Tonsils- Postero-laterally
• Palatine Tonsils- Antero-laterally
• Lingual Tonsils- Anteriorly.
These lymphoid collections prevent the invasion
of microorganisms in the air and food passages.
37. Pharyngobasilar Fascia
Fibrous thickening of submucosa.
It is thick near the base of skull but thin and indistinct inferiorly.
It is thickest:
• where it fills the gap between upper border of superior constrictor and base of skull.
• where it forms the pharyngeal raphe (posteriorly).
38. Muscle Layer
2 layers of striated muscles.
Outer layer of 3 pairs of
circular muscles (constrictor
muscles):
• Superior constrictor.
• Middle constrictor.
• Inferior constrictor.
Inner layer of 3 pairs of
longitudinal muscles.
• Stylopharyngeus.
• Salpingopharyngeus.
• Palatopharyngeus.
39.
40. Buccopharyngeal Fascia
• It is a layer of loose areolar tissue.
• It covers the outer surface of constrictor
muscles.
• In the upper part, it is prolonged forwards
to cover the Buccinator muscles.
• It blends with the pharyngobasilar fascia,
above the upper border of superior
constrictor muscles.