1 / 33

The Pharynx

The Pharynx. Fibromuscular tube Extent Base of skull Cricoid cartilage (C6) Open anteriorly. Regions. Nasopharynx Oropharynx Laryngopharyx Systems Respiratory Digestive. Relationships. Anterior: Nasal cavity Oral cavity Larynx Posterior: Retropharyngeal space. Relationships.

faustine-gaynor
Download Presentation

The Pharynx

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Pharynx • Fibromuscular tube • Extent • Base of skull • Cricoid cartilage (C6) • Open anteriorly

  2. Regions • Nasopharynx • Oropharynx • Laryngopharyx • Systems • Respiratory • Digestive

  3. Relationships Anterior: • Nasal cavity • Oral cavity • Larynx Posterior: • Retropharyngeal space

  4. Relationships Lateral: Carotid sheath • Internal carotid a. • Internal jugular v. • Vagus nerve (CN X) CN’s IX, XI, XII Sympathetic trunk Mandible Grant’s Atlas

  5. Layers • Mucosa • Submucosa • Pharyngobasilar membrane/fascia • Muscularis • Adventitia • Buccopharyngeal fascia Netter

  6. Constrictors • Superior • Middle • Inferior • Insertion: Pharyngeal raphe • Action: constrict during swallowing Grant’s Atlas

  7. ConstrictorOrigins • Superior • Pterygo-mandibular raphe • Middle • Hyoid bone • Inferior • Thyroid and cricoid cartilages (Cricopharyngeus) S M I Grant’s Atlas

  8. Longitudinal Muscles • Stylopharyngeus • Palatopharyngeus • Salpingopharyngeus • Action:elevate pharynx (and larynx) during swallowing SaP SC PP StP MC IC

  9. Gaps • Gap 1 • Pharyngobasilar membrane • Gap 2 • Gap 3 • Thyrohyoid membrane • Gap 4

  10. Gap 1 • Auditory (Eustachian, pharyngotympanic) tube • Levator palatini Grant’s Atlas

  11. Gap 2 • Stylopharyngeus • Glossopharyngeal nerve (CN IX)

  12. Gap 3 • Internal laryngeal nerve • Superior laryngeal artery

  13. Gap 4 • Recurrent laryngeal nerve • Inferior laryngeal artery RL

  14. Internal Pharynx • Nasopharynx • Oropharynx • Laryngopharynx

  15. Nasopharynx • Posterior choanae • Auditory (Eustachian, pharyngotympanic) tube opening • Torus tubarius • Salpingopharyngeal fold • Pharyngeal recess • Pharyngeal tonsils (adenoids)

  16. Oropharynx • Soft palate • Posterior tongue • Fauces • Palatoglossal arch • Palatopharyngeal arch • Palatine tonsil • Waldeyer’s ring

  17. Palatine Arches Liebgott 7-79

  18. Laryngo-pharynx • Epiglottis • Laryngeal inlet • Cricoid cartilage • Piriform recess/fossa E P C

  19. Netter

  20. Innervation Pharyngeal plexus • CN IX • CN XI via X • Sympathetics Motor (GSE) • CN IX to Stylopharyngeus • CN XI via X to all other muscles Grant’s Atlas

  21. CN XI via X

  22. General Sensory Innervation • V2 • CN IX • CN X • Gag Reflex Clemente

  23. Blood Supply • Ascending palatine a. (branch of facial a.) • Ascending pharyngeal a. • Superior thyroid a. • Inferior thyroid a.

  24. VenousDrainage • Pharyngeal plexus • Drains to internal jugular vein

  25. VenousDrainage • Pharyngeal plexus of veins • Drains to internal jugular vein • Communication with pterygoid plexus

  26. Swallowing/Deglutition Stage 1 (Voluntary) • Jaws closed • Lips, cheeks compressed • Tongue raised Liebgott

  27. Swallowing/Deglutition Stage 2 (Involuntary) • Nasopharynx closed off by soft palate • Larynx raised • Stylopharyngeus • Palatopharyngeus • Suprahyoids

  28. Swallowing/Deglutition Stage 3 (Involuntary) • Larynx closed • Contraction of the three constrictors • Superior • Middle • Inferior

  29. Swallowing/Deglutition Stage 4 (Involuntary) • Cricopharyngeus relaxes • Bolus enters esophagus • Peristalsis • Airway reopened

  30. Dissection • Identify and separate retropharyngeal space as high as possible

  31. Dissection • Retropharyngeal space • Disarticulate head at atlanto-occipital joint

  32. Dissection • Prevertebral Region • Muscles • Sympathetic trunk

  33. Be careful to • Preserve carotid sheath structures and cranial nerves • Internal jugular vein • Internal carotid a. • CN’s IX, X, XI and XII Grant’s Atlas

More Related