Recommended Textbooks The Pharynx Recommended Textbooks Gray’s Anatomy for Students. Authors: Richard Drake, A. Wayne Vogl, & Adam Mitchell. Publisher: Churchill Livingstone Clinical Anatomy by Region. Author: Richard S. Snell. Publisher: Wolters Kluwer/Lippincott Williams & Wilkins Grant’s Atlas of Anatomy Authors: Anne Agur, Arthur Dalley

Pharynx A funnel shaped fibromuscular tube extends from the base of skull & continues below with esophagus at the level of ?? Divided into 3 parts: Nasal: nasopharynx Oral: oropharynx Laryngeal: ?

Muscles of Pharynx (Read your text for origin, insertion, innervation & action of these muscles) 3 constrictors: Sup., mid. & inf. - Run in circular direction & attached post. to pharyngeal raphe - The successive contraction of these muscles produces the action of swallowing Overlap each other in the direction of ???

Killian’s Dehiscence Inferior constrictor m. consists of 2 parts: - Sup.: ?? - Inf.: ?? * A weak area presents between The 2 parts of inf. constrictor m.  m.m. may protrude giving rise to a pharyngeal pouch

Pharyngeal Pouch (Pharyngoesophageal diverticulum) Outpouching of pharyngeal mucosa in the region of Killian dehiscence between ?? & ?? parts of the inf. constrictor m. Manifestation: Mainly affects older adults May be asymptomatic, however: dysphagia regurgitation cough Diagnosis: simple barium meal Rx.: Small, asymptomatic  no Rx. Large, symptomatic  endoscopic stapling

*All of these muscles help elevate the pharynx 3. Stylopharyngeus m.: styloid process  post. Border of ?? pass between?? Innervation? 4. Palatopharyngeus m.: Palatal apon.  ??  Palatopharyngeal fold 5. Salpingopharyngeus m.: Auditory tube (medial end)  Blends with?? *All of these muscles help elevate the pharynx

Nasopharynx Post. To nasal cavity & above ?? Lined by ?? Contains: - auditory tube: opens into ?? - Tubal tonsil: aggregation of lymph nodules around ?? - Tubal elevation & Salpingopharyngeal fold - Pharyngeal tonsil (adenoid): in the submucosa of ??

Oropharynx Post. To oral cavity & opens to it Through ?? between? At the level of ? The floor is made by: post. 1/3 of tongue & ?? Contains: Palatine tonsils: between ? over sup. Constrictor m.  tonsillar bed

Oropharyngeal isthmus & Valleculae

Relations of Palatine Tonsils Ant.: ?? Post.: ?? Sup.: ?? Inf.: ?? Medially: ?? Laterally: ??

Tonsillitis & Tonsillectomy Tonsillitis: inflammation of the tonsils (palatine) Acute (causes?) Vs. Chronic (cause?) Tonsillectomy: removal of palatine tonsils Rationale: * Some argue that tonsilectomy is unnecessary surgery & may be dangerous because: you remove one source of immunity * Others argue that chronically inflamed tonsils are a site of recurrent infection. Inflammation of pharyngeal tonsil ?

Laryngeopharynx From epiglottis to cricoid C. At vertebral level? Lined by ? Contains: - Piriform fossa

Piriform Fossa A small recess (depression) on Each side of laryngeal inlet Bounded: Med.: ? Lat.: ? Fxn.? * Internal laryngeal n. pass In the fossa just beneath the m.m.

Innervation of The Pharynx Sensory: Naso: Oro: Laryngeo: Motor: Pharyngeal plexus to all muscles of pharynx Except?

Gag Reflex Involved both sensory & motor innervations of pharynx working together Sensory stimulation of pharyngeal mucosa (via IX)  Contraction of pharyngeal musculature (from X via pharyngeal plexus)

Waldeyer’s Tonsillar Ring Pharyngeal Tonsil: single, roof of ?? Tubal Tonsils: on lat. Walls of ?? Palatine Tonsils: Lingual Tonsil: single, floor of ??

Esophagus A muscular tube that lies post. to the trachea & extends from the neck (C6) to the stomach ~ 25 – 30 cm long Passes through esophageal opening of the diaphragm at the vertebral level of ?? Fxn: Transport food into the stomach

Histology of Esophagus ?? Submucosa Sk. M. Smooth m. Adventitia Mark Nielsen 4 layers: (in  out) Mucosa: epithelium? Submucosa: A.C.T. Muscularis: sup. 1/3: ?? mid. 1/3: ?? inf. 1/3: ?? Adventitia: