R. Shane Tubbs, MS, PA-C, PhD

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R. Shane Tubbs, MS, PA-C, PhD The Pharynx R. Shane Tubbs, MS, PA-C, PhD

Four Layers Mucous membrane Pharyngobasilar fascia Muscle layer Buccopharyngeal fascia

Muscles Inner longitudinal: stylopharyngeus, palatopharyngeus, salpingopharyngeus Outer circular layer: pharyngeal constrictors

Stylopharyngeus

Constrictor Attachments SPC: hamulus, pterygomandibular raphe, mylohyoid line, pharyngeal tubercle (insertion) MPC: > and < cornu of hyoid, stylohyoid ligament IPC: thyroid cartilage and cricoid cartilage (cricopharyngeus)

Superior Constrictor

Nerves Motor IX (stylopharyngeus), X Sensory: V2 superior to Eustachian tube, IX between ET and laryngeal inlet, and X inferior to laryngeal inlet Pharyngeal plexus: Ph. Branch of X-SVE, Ph. Branch of IX-GVA, Ph. Branch of Superior cervical sympathetic ganglion (GVE)

Arteries, Veins, Lymphatics Ascending pharyngeal, superior and inferior thyroid arteries Pharyngeal venous plexus drains into IJ Lymph into retropharyngeal and superior deep cervical nodes (jugulodigastric primarily for palatine tonsil)

Waldeyer’s ring (German anatomist, 1836-1921)

Nasopharynx Borders: skull base, soft palate, left and right nasal choana, C1-C2

Nasopharynx (Base-C2) Eustachian tube Torus tubarius Salpingopalatine fold Salpingopharyngeal fold Pharyngeal recess Pharyngeal tonsil Tubal tonsil Torus levatorius

Oropharynx Borders: soft palate, oropharyngeal isthmus, epiglottis, C2-C3

Oropharynx Palatoglossal arch Palatopharyngeal arch- Passavant’s ridge Palatine, lingual tonsils IX Stylohyoid ligament

Laryngopharynx Borders: epiglottis, cricoid cartilage, larynx, C3(4) -C6

Laryngopharynx