Pharynx

Overview and topographic anatomy

General information

  • Pharynx— 5-inch muscular tube from base of the skull (posterior portion of the body of the sphenoid bone and basilar portion of the occipital bone) to the lower border of the cricoid cartilage (C6), where it is continuous with the esophagus

  • Is funnel shaped

  • Posterior portion of the pharynx lies against the prevertebral fascia

  • The retropharyngeal and parapharyngeal spaces surround the pharynx

  • Lies posterior to the nasal and oral cavities and the larynx and thus is divided into 3 parts:

    • Nasopharynx

    • Oropharynx

    • Laryngopharynx

  • Responsible for properly conducting food to the esophagus and air to the lungs

  • Composed of:

    • 3 constrictor muscles

    • 3 longitudinal muscles

    • Cartilaginous part of the pharyngotympanic tube

    • Soft palate

  • The wall of the pharynx has 5 layers:

    • Mucous membrane—the innermost layer

    • Submucosa

    • Pharyngobasilar fascia—the fibrous layer attached to the skull anchoring the pharynx

    • Muscular—3 inner longitudinal and 3 outer circular (constrictor) muscles that overlap such that the superior constrictor is the innermost, whereas the inferior constrictor is the outermost muscle

    • Buccopharyngeal fascia—loose layer of connective tissue continuous with the fascia over the buccinator and pharyngeal muscles, and the location of the pharyngeal plexus of nerves and the pharyngeal plexus of veins

  • Waldeyer’s ring is the anatomic name for the ring of lymphatic tissue in the pharynx and oral cavity:

    • Lingual tonsil (posterior 1/3 of tongue)

    • Palatine tonsil (oropharynx)

    • Tubal tonsil (nasopharynx)

    • Pharyngeal tonsil (nasopharynx)

Figure 15-1

Figure 15-2

Figure 15-3

Parts of the pharynx

Nasopharynx, oropharynx, laryngopharynx

Nasopharynx

Boundaries Major Anatomic Features Comments Vertebral Level
  • Roof —posterior portion of the body of the sphenoid bone and basilar portion of the occipital bone

  • Floor —soft palate (upper surface)

  • Anterior —choanae of the nasal cavity

  • Posterior —mucosa covering superior constrictor

  • Lateral —mucosa covering superior constrictor

  • Ostium of the auditory tube opens into the nasopharynx

  • Torus tubarius is an elevation formed by the base of the cartilaginous portion of the auditory tube, which lies superior to the ostium of the tube

  • Torus levatorius is an elevation of mucous membrane that lies over the levator veli palatini m.

  • Salpingopharyngeal fold is mucous membrane that lies over the salpingopharyngeus m., connecting the torus tubarius to the lateral wall of the pharynx

  • Pharyngeal recess is located posterior to the salpingopharyngeal fold and contains the pharyngeal tonsil (adenoid)

  • Pharyngeal tonsil (adenoid) is mucosa-associated lymphatic tissue (MALT) located along the midline

  • Tubal tonsils are MALT located posterior to the opening of each auditory tube and are considered by some authors to be extensions of the pharyngeal tonsil

  • Nasopharynx epithelium:

  • Anterior —pseudostratified columnar with cilia in anterior portion near nasal cavity

  • Posterior —stratified squamous nonkeratinized in posterior portion

  • Has a respiratory function

  • The auditory tube connects the middle ear with the nasopharynx, which helps equalize air pressure on both sides of the tympanic membrane

  • The cartilaginous portion of the auditory tube is normally closed, except during deglutition and yawning

  • The auditory tube allows spread of infections between the middle ear and the nasopharynx

  • The roof and walls tend to be firm and do not close during muscular contraction of the pharyngeal and palatal muscles

C1 and dens of C2

Oropharynx

Boundaries Major Anatomic Features Comment Vertebral Level
  • Superior —nasopharynx

  • Inferior —superior border of epiglottis

  • Anterior —palatoglossal fold of the oral cavity (oropharyngeal isthmus)

  • Posterior —mucosa covering the superior and middle constrictor mm.

  • Lateral —mucosa covering the superior and middle constrictor mm.

  • Palatine tonsils are located in the oropharynx between the palatoglossal and palatopharyngeal folds (tonsillar sinus)

  • Palatopharyngeal fold is an elevation of mucous membrane that lies over the palatopharyngeal m.

  • Epiglottic valleculae are the depressions immediately posterior to the root of the tongue

  • Oropharynx epithelium is stratified squamous nonkeratinized

Has a respiratory and a digestive function C2–C3

Laryngopharynx

Boundaries Major Anatomic Features Comment Vertebral Level
  • Superior —oropharynx

  • Inferior —inferior border of cricoid cartilage (where it becomes continuous with esophagus)

  • Anterior —larynx

  • Posterior —mucosa covering middle and inferior constrictor mm.

  • Lateral —mucosa covering middle and inferior constrictor mm.

  • Piriform recess is a small depression located on the lateral wall of the laryngopharyngeal cavity on either side of the entrance to the larynx

  • Laryngopharynx epithelium is stratified squamous nonkeratinized

  • Communicates with the larynx

  • The piriform recess is a potential location for objects to become lodged

C4–C6

Figure 15-4

Muscles

Overview

Muscle Origin Insertion Actions Nerve Supply
Superior constrictor
  • Pterygoid hamulus

  • Pterygomandibular raphe

  • Retromolar trigone of mandible

  • Side of tongue

  • Pharyngeal tubercle

  • Pharyngeal raphe

Constricts the upper portion of the pharynx Pharyngeal plexus (the motor portion of this plexus is formed by the pharyngeal branch of the vagus n.)
Middle constrictor
  • Stylohyoid lig.

  • Lesser cornu of hyoid

  • Greater cornu of hyoid

Pharyngeal raphe
  • Constricts the middle portion of the pharynx

  • Inferior constrictor (divided by some authors into:

  • Thyropharyngeus

  • Cricopharyngeus

Oblique line of thyroid cartilage
Side of cricoid cartilage
Constricts the lower portion of the pharynx
  • Pharyngeal plexus (the motor portion of this plexus is formed by the pharyngeal branch of the vagus n.)

  • External laryngeal n. of the vagus (also helps supply the cricopharyngeus portion of the inferior constrictor)

  • Recurrent laryngeal n. of the vagus (also helps supply the cricopharyngeus portion of the inferior constrictor)

Palatopharyngeus
  • Posterior border of hard palate

  • Palatine aponeurosis

Posterior border of the lamina of the thyroid cartilage
  • Elevates pharynx

  • Helps close the nasopharynx

Pharyngeal plexus (the motor portion of this plexus is formed by the pharyngeal branch of the vagus n.)
  • Salpingopharyngeus

  • Cartilage of auditory tube

  • Elevates the upper and lateral portions of the pharynx

Stylopharyngeus Medial aspect of base of styloid process
  • Elevates pharynx

  • Expands the sides of the pharynx

Glossopharyngeal n.
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Feb 15, 2025 | Posted by in General Dentistry | Comments Off on Pharynx

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