Pharynx and soft palate

Pharynx and soft palate
• Pharynx — one of the visceral tubes
• — the
th common chamber
h b off the
th
respiratory and digestive tracts
• located behind the nasal and oral
cavities
iti
• funnel-shaped
p in form
• 12 cm in length; its greatest width is
about
b t 5 cm and
d narrowestt 1.5
1 5 cm
1
Pharynx
Nasopharynx
N
h
— extends
t d from
f
the
th base
b
off skull
k ll to
t th
the level
l
l off the
th soft
ft
palate; has a respiratory function
Oropharynx — extends from the soft palate to the hyoid bone
Laryngopharynx — extends from the level of the hyoid bone to the lower
border of the cricoid cartilage, continuous with the esophagus
2
Nasopharynx
Pharyngeal orifice of auditory tube
Pharyngeal recess
Torus of auditory tube
Salpingopharyngeal fold
Pharyngeal tonsil
Torus of auditory tube — the elevation behind the orifice, which is
produced by underlying cartilage of the auditory tube
salpingopharyngeal fold — produced by the salpingopharyngeus, which
extends from the lower part of the torus to palatopharyngeus
pharyngeal recess — a slit-like recess behind the salpingopharyngeal fold
pharyngeal tonsil — a collection of lymphatic tissue lying on the roof of
3
the pharynx
Nasopharynx
Levator veli palatini m.
Salpingopharyngeus m.
Tensor veli palatini m.
Ascending palatini a.
4
Oropharynx
Palatopharyngeal arch
Palatoglossal arch
Palatine tonsil
Oropharynx — extends from the soft palate to the hyoid bone
palatine tonsil — the mass of lymphatic tissue between the two folds
5
Oropharynx
6
Oropharynx
Sup. constrictor m.
P l t h
Palatopharyngeal
l m.
Palatoglossal m.
Styloglossal m.
Stylopharyngeal m.
m
Glossopharyngeal n.
Hyoglossal m.
Mid. constrictor m.
Stylohyoid ligament
7
Laryngopharynx
Piriform recess
Laryngopharynx — extends
from the level of the
hyoid bone to the lower
border of the cricoid
cartilage, continuous
with the esophagus
piriform recess — lies between the hyoid bone, thyrohyoid membrane and
thyroid cartilage laterally, and the aryepiglottic fold and the arytenoid
and cricoid cartilages medially
8
Blood supply of pharynx
a) ascending pharyngeal branch of
external carotid a.
c) tonsil branch of facial a.
b) ascending palatine branch of facial a.
d) descending palatine a. from
maxillary a.
9
Nerve supply of pharynx
1) motor: glossopharyngeal n
n.. (IX) innervate the stylopharyngeus m
m.;;
mandibular n. (V3) innervate the tensor veli palatini m; the remaining
10
muscles by the pharyngeal branch of the vagus (or accessory n.)
Nerve supply of pharynx
2) sensory: nasopharynx
h
b
by maxillary
ill
n..; oropharynx
h
by
b
glossopharyngeal n; larygopharynx by vagus n.
11
Wall of pharynx
Pharyngobasilar fascia
Pharyngobasilar fascia — a strong fibrous submucosal layer
exposing in the interval between the superior constrictor
muscle and the base of the skull
Circular coat: sup. constrictor, mid. constrictor, and inf. constrictor
12
Wall of pharynx
Longitudinal
g
coat: stylopharyngeus,
y p
y g
,
palatopharygeus, and
salpingopharyngeus
salpingopharyngeus — from lower part of
auditory tube to joins fibers of
palatopharyngeus muscle
Palatopharyngeus — from posterior border
of hard p
palate and p
palatine aponeurosis
p
to side of pharynx
Stylopharyngeus — from styloid process to
posterior border of thyroid cartilage and
wall of pharynx
nerve supply — glossopharyngeal n
13
Structures of the pharyngeal wall
superior constrictor — from medial pterygoid plate, pterygoid hamulus,
pterygomandibular raphe, mylohyoid line, side of tongue to median raphe
of pharynx
14
Structures of the pharyngeal wall
middle constrictor: — from lesser and greater horns of hyoid bone;
stylohyoid ligament to median raphe of pharynx
inferior constrictor : — from the oblique line of thyroid cartilage; side of
15
cricoid cartilage to median raphe of pharynx
Structures passing through intervals between
Auditory tube
Skull and superior constrictor — levator veli palatine,
ascending palatine a., auditory tube
16
Structures passing through intervals between
Sup.
p constrictor
Skull and superior constrictor —
levator veli palatine m.,
ascending palatine a.,
auditory
di
tube
b
Mid. constrictor
Inf constrictor
Inf.
Superior constrictor and middle
constrictor — styolpharyngeus
y p
y g
m.,,
glossopharyngeal n.; and stylohyoid lig
Middle constrictor and inferior constrictor — internal laryngeal n., superior
l
laryngeal
l a.
Inferior constrictor and esophagus — recurrent laryngeal n.., inferior laryngeal a.
17
Structures passing through intervals between
Superior constrictor and middle constrictor — styolpharyngeus
m., glossopharyngeal n.; and stylohyoid lig
18
Soft palate
19
Soft palate
tensor veli palatini — from sphenoid bone, lateral surface of the auditory
tube,, pass
p
around the hamulus of the medial p
pterygoid
yg
plate
p
to aponeurosis
p
of the soft palate
nerve supply: mandibular n..
levator veli palatini — from petrous portion of temporal bone , medial surface
20
of the auditory tube to aponeurosis of the soft palate
Soft palate
21
Soft palate
Musculus uvular — from posterior nasal spine of hard palate to connective
tissue of uvula
22
Soft palate
Palatopharyngeal m.
Palatoglossal m.
palatopharyngeus — from posterior border of hard palate and
palatine aponeurosis to side of pharynx
palatoglossus — from the side of the tongue to inferior surface of
the soft palate
23
Borders of the infratemporal fossa
Lat. pterygoid m.
Med. pterygoid m.
24
Borders of the infratemporal fossa
25
Borders of the infratemporal fossa
26
Removal of head
Cut along the ant. border of the foramen magnum
Cut tectorial membrane, sup. band of cruciate ligament, alar ligament,
apical ligament and ant. atlantoocipital menbrane
27
Removal of head
sup band of cruciate lig
sup.
lig.
alar lig.
Cut tectorial membrane, sup. band of cruciate ligament, alar
ligament, apical ligament and ant. atlantoocipital menbrane
28
Removal of head
Identify the sympathetic trunk and the large superior cervical
sympathetic
th ti ganglion,
li
cutt one side
id off it just
j t superior
i to
t
29
SCG, and leave it to the prevertebral region
Removal of head
Hold the cervical viscera forward
30
Removal of head
Cut rectus capitis lateralis, rectus capitis anterior, and longus capitis
31
Orientation of the cranial nerves
S f
Safeguard
d cranial
i l nerves IX,
IX X,
X XI and
d XII
32
Orientation of the cranial nerves
A
CN IX
CN XII
L
E.A
CN X
down
I.A
Int.V
SCG
CN XI
33
Orientation of the cranial nerves
34
Orientation of the cranial nerves
35
Subdivisons of pharynx:
nasopharynx,
h
oropharynx,
h
llaryngopharynx
h
Nasopharynx: salpingopharyngeus, pharyngeal tonsil,
tensor veli palatini m., levator veli palatine m.
Oropharynx: palatoglossal m., palatopharyngeal m.;
palatine tonsil
Larygopharynx: piriform recess
Blood supply of pharynx: ascending pharyngeal a., facial
a., maxillary a., lingual a.
Nerve innervation of pharynx
Motor: pharyngeal plexus, glossopharyngeal n., mandibular
n.
Sensory: nasopharynx (maxillary n.), oropharynx
(glossopharyngeal
(g
p y g
n.),
), laryngopharynx
y g p y ((vagus
g n.))
36
Structure of the pharynx wall
Mucous membrane
Muscular layer
Circular coat: superior, middle, inferior constrictor m.
Longitudinal coat: stylopharyngeus,
stylopharyngeus
salpingopharyngeus, palatopharyngeus m.
Buccopharyngeal fascia
Structure passing through intervals between
Skull and superior constrictor: levator veli palatine
palatine,
ascending palatine a., auditory tube
Superior and middle constrictor: stylopharyngeus m.,
glossopharyngeal n., stylohyoid lig.
Middle and inferior constrictor: internal laryngeal n., superior
laryngeal a.
a
Inferior constrictor and esophagus: recurrent laryngeal n.,
inferior laryngeal a
Muscules off the soft
f palate: tensor veli palatini, levator veli
palatini, palatoglossus, palatopharyngeus, musculus uvular
37
Pharynx and Soft Palate
Dr. Lue, Grossanatomy
Pharynx — one of the visceral tubes
— the common chamber of the respiratory and digestive tracts
— located behind the nasal and oral cavities
— funnel-shaped in form
— 12 cm in length; its greatest breath is about 5 cm and narrowest 1.5 cm
Subdivisions
— without anterior wall, the pharynx communicates directly with the nasal, oral,
and laryngeal cavities; posterior wall lies against the prevertebral layer of
deep cervical fascia; it is subdivided accordingly
A. Nasopharynx:
—extends from the base of skull to the level of the soft palate; has a respiratory
function
—Anteriorly, choanae (two posterior nasal apertures), nasal septum
Wall of the pharynx
Pharyngeal orifice of the auditory tube:
Torus of auditory tube: the elevation behind the orifice, which is produced by
underlying cartilage of the auditory tube
salpingopharyngeal fold: produced by the salpingopharyngeus, which extends
from the lower part of the torus to palatopharyngeus
pharyngeal recess: a slit-like recess behind the salpingopharyngeal fold
pharyngeal tonsil: a collection of lymphatic tissue lying on the roof of the
pharynx; enlarged→ adenoids
tensor veli palatini m.
levator veli palatini m.
B. Oropharynx
— extends from the soft palate to the hyoid bone
palatoglossal arch: produced by the palatoglossal m.
palatopharyngeal arch: produced by palatopharyngeal m.
palatine tonsil: the mass of lymphatic tissue between the two folds.
Five tonsillar arteries to the palatine tonsil:
a) descending palatine a. from maxillary a.
7
b) ascending pharyngeal branch of external carotid a.
c) ascending palatine branch of facial a.
d) tonsil branch of facial a.
e) dorsal lingual branches of the lingual a.
C. Laryngopharynx
— extends from the level of the hyoid bone to the lower border of the cricoid
cartilage, continuous with the esophagus.
piriform recess: lies between the hyoid bone, thyrohyoid membrane and thyroid
cartilage laterally, and the aryepiglottic fold and the arytenoid and cricoid
cartilages medially; Foreign bodies such as fish bones may lodge in this
recess.
Blood supply of pharynx:
arteries
a) ascending pharyngeal branch of external carotid a.
b) ascending palatine branch of facial a.
c) tonsil branch of facial a.
d) descending palatine a. from maxillary a.
veins: pharyngeal venous plexus via pterygoid plexus internal jugular v.
Nerve supply of pharynx:
1) motor: glossopharyngeal n. (IX) innervate the stylopharyngeus m.;
mandibular n. (V3) innervate the tensor veli palatini m; the remaining
muscles by the pharyngeal branch of the vagus (or accessory n.)
2) sensory: nasopharynx aid by maxillary n.; oropharynx supply from
glossopharyngeal n; laryngpharynx supply from vagus n
Structure of the pharyngeal wall:
Mucous membrane — is continuous with the lining of the adjacent chambers
Pharyngobasilar fascia — a strong fibrous submucosal layer exposing in the
interval between the superior constrictor muscle and the base of the skull
Muscular layer — divided into two groups:
Circular coat — consists of the three constrictor muscles
superior constrictor: from medial pterygoid plate, pterygoid hamulus,
pterygomandibular raphe, mylohyoid line, side of tongue to median
raphe of pharynx
8
middle constrictor: from lesser and greater horns of hyoid bone; stylohyoid
ligament to median raphe of pharynx
inferior constrictor : from the oblique line of thyroid cartilage; side of
cricoid cartilage to median raphe of pharynx
—each muscle meets its fellow in the posterior median plane at the fibrous
pharyngeal raphe which extends up to attach to the pharyngeal tubercle of
the occipital bone
action — participate in act of swallowing
nerve supply — from pharyngeal plexus
— the inferior constrictor muscle is also supplied by the external
branch of superior laryngeal nerve
Longitudinal coat— also consists of three muscles which originate separately
and blend at their insertions
Stylopharyngeus: from styloid process to posterior border of thyroid
cartilage and wall of pharynx
action— elevates larynx and pharynx
nerve supply — glossopharyngeal n.
Palatopharyngeus: from posterior border of hard palate and palatine
aponeurosis to side of pharynx
action — approximates palatopharyngeal folds
nerve supply — pharyngeal plexus
salpingopharyngeus: from lower part of auditory tube to joins fibers of
palatopharyngeus muscle
action — same as that of the palatopharyngeus m.
nerve supply - pharyngeal plexus
Buccopharyngeal fascia - the areolar coat covers the muscles, is continuous with
the buccinator fascia, and contains pharyngeal venous and nerve plexuses
Structures passing through intervals between:
A. Skull and superior constrictor
levator veli palatini— palate
ascending palatine artery— palate
auditory tube— nasopharynx
B. Superior constrictor and middle constrictor
stylopharyngeus m., glossopharyngeal n.; and stylohyoid lig.
9
C. Middle constrictor and inferior constrictor
internal laryngeal n.— larynx
superior laryngeal a.
D. Inferior constrictor and esophagus
recurrent laryngeal n.— larynx
inferior laryngeal a.
Soft Palate
Muscles of the soft palate
tensor veli palatini: from sphenoid bone, lateral surface of the auditory tube,
pass around the hamulus of the medial pterygoid plate to aponeurosis of
the soft palate
action: tenses the plate, opens the auditory tube
nerve supply: mandibular n.
levator veli palatini: from petrous portion of temporal bone, medial surface
of the ausitory tube to aponeurosis of the soft palate
action: lifts the soft plate
nerve supply: pharyngeal plexus.
palatoglossus: from the side of the tongue to inferior surface of the soft
palate
action: pulls the tongue superiorly, tenses the plate
nerve supply: pharyngeal plexus
palatopharyngeus: from posterior border of hard palate and palatine
aponeurosis to posterior border of thyroid cartilage and side of pharynx
action: lifts the larynx, tense the plate
nerve supply: pharyngeal plexus
musculus uvular: from posterior nasal spine of hard palate to connective
tissue of uvula
action: elevate and retract uvula; thickens central region of soft plate
nerve supply: pharyngeal plexus
10