Mind map
The Pharynx
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The Pharynx
Lymph Drainage
- from tonsil passes through superior constrictor to nodes along inernal jugular vein
- epecially jugulodigastric node at angle of jaw
- in TONSILITIS its the first nodes to enlarge
- TONSILLECTOMY
- lymphoid tissue of tonsil and tonsillar capsule are removed
- usually superior constrictor lies separate from tonsils and its capsule by areolar tissue
- so not damaged during operation
- usually superior constrictor lies separate from tonsils and its capsule by areolar tissue
- lymphoid tissue of tonsil and tonsillar capsule are removed
- infection in peritonsilar tissue secondary to tonsillitis
- abcess so formed can bulge into pharynx
- can compromis swallowing and breathing
- treatment - incising and draining
- can compromis swallowing and breathing
- abcess so formed can bulge into pharynx
- childrens tonsilis are normally larger than adults
- TONSILLECTOMY
- in TONSILITIS its the first nodes to enlarge
- QUINSY
- constrictor muscles constric pharynx involuntarily
- so their action propels food onwards during swallowing
- pharyngeal wall is weakest between constrictors
- important where oesophagus loses support of inferior constrictor
- before it acquires a full longitudinal coat of muscle
- here diverticular of oesophagus can occur
- as pharnyx tapers to oesophagus, carotid cartilage prevents the oesophagus expanding anterioly
- swallowed objects can lodge here
- oesophageal lumen is narrow ant and post, widest from side to side
- = can see stuck objects on x-ray
- oesophageal lumen is narrow ant and post, widest from side to side
- swallowed objects can lodge here
- important where oesophagus loses support of inferior constrictor
- epecially jugulodigastric node at angle of jaw
- from tonsil passes through superior constrictor to nodes along inernal jugular vein
Lateral Relations of Pharyngeal Constrictors
- CN exiting skull via jugular foramen, IX, X and XI pass close to pharyngeal constrictors
- IXth nerve enters neck lying with X, XI and XII between the internal carotid artery and internal jugular vein
- opposite the styloid process it winds around stylopharyngeus and runs along lat side of this to pass into the gap
- between sup and middle constrictor
- supplies innervation to stylopharyngeus as it crosses it
- IX - glossopharyngeal - mainly sensory to tongue and pharynx
- supplies mucosa of posterior 1/3 of tongue with fibres for general sensation and tase
- on the SA of middle constrictor it joins with pharyngeal branch of vagus to form pharyngeal plexus
- thought that his plexus IX supplies tonsils and pharyngeal mucosa
- and with X supplies carotid body and carotid sinus
- thought that his plexus IX supplies tonsils and pharyngeal mucosa
- on the SA of middle constrictor it joins with pharyngeal branch of vagus to form pharyngeal plexus
- supplies mucosa of posterior 1/3 of tongue with fibres for general sensation and tase
- internal and common carotid arteries are, with jugular vein, closely applied to constrictors
- no. of structures lying between the internal and external carotid
- styloid process
- stylopharyngeus
- IX nerve
- pharyngeal branches of vagus
- styloglossus
- parotid gland
- no. of structures lying between the internal and external carotid
- opposite the styloid process it winds around stylopharyngeus and runs along lat side of this to pass into the gap
- IXth nerve enters neck lying with X, XI and XII between the internal carotid artery and internal jugular vein
- CN exiting skull via jugular foramen, IX, X and XI pass close to pharyngeal constrictors
12-14cm long muscular membraneous tube
- from cranial base to lower border of carcoid cartilage at C6 level
- becomes continuous with oesophagus
- 3 regions
- Nasopharynx
- posterior to nose and superior to soft palate
- has pharyngeal tonsil, pharyngotympanic membrane and pharyngeal isthmus
- Oropharynx
- posterior to mouth
- contains palatine tonsils and oropharyngeal isthmus
- Laryngopharynx
- posterior to larynx
- contains epiglottis and laryngeal inlet
- Nasopharynx
- from cranial base to lower border of carcoid cartilage at C6 level
X-Ray
- Retropharyngeal interspace normal -
- C1 - 10mm, C2 - 5mm C3 - 7mm C4 - 7mm C5-7 - 20mm
- inc - neoplasm, post traumatic haematoma, abcesses
- C1 - 10mm, C2 - 5mm C3 - 7mm C4 - 7mm C5-7 - 20mm
- Retropharyngeal interspace normal -
Muscles of Pharynx
- External layer
- 3 constrictor muscles (sup, inf, middle)
- contract involunarily during swallowing, constricting walls of pharynx
- Superior Pharyngeal Constrictor
- O - pterygoid hamulus, pterygomandibular raphe, post end of myloid line of mandible and side of tongue
- I - pharyngeal tubercle on basilar part of occipital
- I - Pharyngeal branch of vagus and pharyngegal plexus
- Middle
- O - stylohyoid lig and greater and lesser horns of hyoid
- I - Parhyngeal raphe
- Inferior
- O - thyroid cartilage and side of cricoid cartilage
- N- pharyngeal branch of vagus and pharyngeal plexus plus branches of external and recurrent laryngeal nerves of vagus
- 3 constrictor muscles (sup, inf, middle)
- Longitudinal Muscles
- inner layer of pharynx is made of up 3 mucles
- all descend and insert into wall of pharynx
- elevate larynx and shortes pharynx during swallowing and speaking
- Palatopharyngeus
- O - hard palate and palatine aponeurosis
- I - post border of lamina of thyroid cartilage and side of pharynx and oesophagus
- Salpingopharyngeus
- O - cartilaginous part of pharyngotympanic tube
- I - blends with palatopharyngeus
- Stylopharyngeus
- O - styloid process of temporal bone
- I - post and sup borders of thryoid cartilage with palatopharyngeus
- N - glossopharyngeal nerve
- N - Pharyngeal branch of vaus and pharyngeal pleuxs
- all descend and insert into wall of pharynx
- inner layer of pharynx is made of up 3 mucles
- Fascia
- Muscles of pharyngeal wall are between 2 layers of fascia
- THIN BUCCOPHARYNGEAL FASCIA
- coats external layer of pharynx and is continuous post with prevertebral fascia
- anteriorly passes over buccinator
- coats external layer of pharynx and is continuous post with prevertebral fascia
- retropharyngeal space exists between prevertebral and buccopharyngeal fascia
- THIN BUCCOPHARYNGEAL FASCIA
- much thicker pharyngobasilar fascia exists between skull base and sup constrictor which passes inf, and eventually disappears
- Muscles of pharyngeal wall are between 2 layers of fascia
- Holes in the Wall
- Gaps between muscles in pharyngeal wall exist and act as route for muscles and neurovascular tissue to pass
- one large one is between sup and middle constrictors
- allows stylopharyngeus, IX and stylohyoid lig to pass to pharyngeal wall
- one large one is between sup and middle constrictors
- gap between middle and inf constrictors allows internal branch of superior laryngeal nerve and accompanying vessels to enter larynx
- recurrent laryngeal nerve and accompanying vessels enter larynx post to lesser horn of hyoid deep to inferior constrictor
- KILLIAN'S DEHISCENCE
- pathological space - posteiror midline of wall of laryngopharynx within inferior constrictor
- = weakness here
- = food/ liquid escapes, and can collect in a pharyngeal pouch
- KILLIAN'S DEHISCENCE
- recurrent laryngeal nerve and accompanying vessels enter larynx post to lesser horn of hyoid deep to inferior constrictor
- Gaps between muscles in pharyngeal wall exist and act as route for muscles and neurovascular tissue to pass
- External layer
Nerve supply
- motor and most sensory innervation is via branchs of IX and X
- forms pharyngeal plexus
- motor fibres are from vagus nerve and innervate all mscles of pharynx and soft palate except
- STYLOPHARYNGEUS - IX
- TENSOR VELI PALATINI - V3
- motor fibres are from vagus nerve and innervate all mscles of pharynx and soft palate except
- forms pharyngeal plexus
- sensory fibres in plexus are from IX and supply most of mucosa of entire pharynx
- sensory supply for ant and sup. nasopharynx is via V2
- motor and most sensory innervation is via branchs of IX and X
Hard palate
- concave, allowing space for tongue to rest
- formed by palatine processes of maxillae and horizontal plates of palatine bones
- no. of foramen within hard palate allowing transmission of nerves
- formed by palatine processes of maxillae and horizontal plates of palatine bones
- concave, allowing space for tongue to rest
Soft Palate
- forms mobile posterior 2/3 of palate suspended form hard palate
- no skeletal framework but is supported by palatine aponeurosis extending from hard palate
- has a curved free margin from which hangs the uvula
- no skeletal framework but is supported by palatine aponeurosis extending from hard palate
- forms mobile posterior 2/3 of palate suspended form hard palate
Information
- Description
- Mind Map on The Pharynx, created by Harriet Colquhoun on 22/04/2018.
- Created by
- Harriet Colquhoun · Apr 2018
- Updated
- Apr 22, 2018
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