Anatomy of Pharynx
PHARYNX -1
Nasopharynx
Dr Mathew Joseph MBBS,MD(AIIMS),BCC(Palliative Medicine)
Assistant Professor
Department of Anatomy
Al-Azhar Medical College & Super Specialty Hospital
Contents
• Introduction
• Boundaries
• Nasopharynx – Oropharynx - Laryngopharynx
• Location.
• Communications.
• Pharyngeal Isthmus.
• Features.
• Applied Aspects.
Introduction
• Pharynx is a fibromuscular tube.
• It is a common channel for both food and
air.
Location- Behind the cavities of nose, mouth
and the larynx.
Shape - funnel shaped.
Extent- From the base of the skull to the
esophagus.
Dimensions-
• Length- 12-14 cm
• Width:
At base- 3.5 cm
At pharyngo-esophageal
junction- 1.5 cm
Boundaries
Superior-
• Base of skull [ posterior part of body of Sphenoid
& Basilar part of Occipital bone in front of
pharyngeal tubercle.
Inferior-
• Continuous with esophagus at the level of lower
border of cricoid cartilage anteriorly and lower
border of C6 vertebra posteriorly
Posterior-
• Prevertebral fascia.
Anterior-
• Opens into cavities of nose, mouth and larynx.
Lateral-
• Neurovascular bundle of neck.
• Styloid process with its attached muscles and
ligaments
.
Subdivisions
From above downwards:
• Nasopharynx.
• Oropharynx.
• Laryngopharynx.
Nasopharynx
Location-
• Behind choanae (posterior nasal
apertures) and above soft palate.
Communications-
Anteriorly- with nasal cavities.
Inferiorly- with oropharynx.
Pharyngeal Isthmus [Nasopharyngeal Isthmus]
• An opening bounded anteriorly by
the soft palate and posteriorly by
the posterior wall of pharynx (
Passavant’s ridge).
Features:
• Nasopharyngeal (Pharyngeal) Tonsil).
• Orifice of Pharyngo-tympanic tube (Auditory tube or
Eustachian tube).
• Tubal elevation.
• Tubal tonsil.
• Salpingopharyngeal fold.
• Salpingopalatine fold.
• Pharyngeal recess (Fossa of Rosenmüller).
Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]-
• A collection of lymphoid tissue.
Location- At the junction of roof and posterior wall of
nasopharynx.
• Contains nasopharyngeal bursa.
Nasopharyngeal (Pharyngeal) bursa [Pouch of Luschka]-
• A mucous diverticulum which extends upwards into
the substance of pharyngeal tonsil from its apex.
• It is developed due to adhesion of notochord to the
dorsal wall of pharyngeal part of foregut.
Orifice of Pharyngo-tympanic tube
(Auditory tube or Eustachian tube)-
Location-
• On lateral wall of nasopharynx,
approximately 1.25 cm behind inferior
nasal concha.
Tubal elevation-
•Upper and posterior margins of orifice of
eustachian tube are elevated due to
collection of lymphoid tissue.
•These elevated margins are known as tubal
elevation.
Tubal tonsil-
• Collection of lymphoid tissue in tubal
elevation is known as tubal tonsil.
Salpingopharyngeal fold-
•A mucous fold which extends vertically
downwards on the side wall of pharynx
from tubal elevation.
•It contains Salpingopharyngeus muscle.
Salpingopalatine fold-
•A mucous fold which extends downwards
and forwards to the soft palate from tubal
elevation.
•It contains Levator Palati muscle.
Pharyngeal recess (Fossa of
Rosenmüller).
•It is a deep depression behind the tubal
elevation.
Applied Aspects
Adenoids-
•Enlarged nasopharyngeal tonsils due to infection.
•Block the posterior nares.
Clinical Features-
•Nasal obstruction.
•Nasal discharge.
•Mouth breathing.
•Snoring.
•Protrusion of tongue.
•Toneless voice
•Small nose.
•Epistaxis (Nose Bleeding).
Nasopharyngeal tonsils are prominent in children up to
the age of 6 years.
They gradually undergo atrophy at puberty.
They completely disappear by the age of 20 years.
Adenoid Facies [Long Face Syndrome]
• Long, open-mouthed face of children with
adenoid hypertrophy.
• These children are ‘Obligatory Mouth Breathers’.
• Persistent mouth breathing may be associated
with development of craniofacial anomalies.
• The characteristic facial appearance consists of:
• Underdeveloped thin nostrils
• Short upper lip
• Prominent upper teeth
• Crowded teeth
• Narrow upper alveolus.
• High-arched palate
• Hypoplastic maxilla
Nasopharyngeal Swab
Thank You
Pharynx 2
Oropharynx - Laryngopharynx
Dr Mathew Joseph
MBBS,MD(AIIMS),BCC(Palliative Medicine)
Assistant Professor
Department of Anatomy
Al-Azhar Medical College & Super Specialty Hospital
Oropharynx
Introduction
Extent-
• From lower surface of soft palate to
upper border of epiglottis.
Communications-
Anteriorly- with Oral cavity.
Above- with Nasopharynx.
Inferiorly- with Laryngopharynx.
Oropharyngeal Isthmus
• It is a communicating
channel between
oropharynx and oral cavity.
Boundaries-
Above- Soft Palate
Below- Dorsal surface of
posterior 1/3rd of tongue.
Laterally- Palatoglossal arch.
• Oropharyngeal Isthmus is
closed during deglutition.
Features
• Palatine tonsils.
• Anterior faucial pillar ( Palatoglossal arch).
• Posterior faucial pillar (Palatopharyngeal arch).
• Lingual tonsils.
• Upper free end of Epiglottis.
• Median and lateral glossoepiglottic folds.
• Epiglottic valleculae.
Features in Lateral Wall
Palatine Tonsil-
Location:
• In the tonsillar fossa.
• Tonsillar fossa is located in the lateral wall of
oropharynx.
• Tonsillar fossa is bounded anteriorly by the anterior
faucial pillar (palatoglossal arch).
• Tonsillar fossa is bounded posteriorly by the
posterior faucial pillar (palatopharyngeal arch).
Posterior 1/3rd of
Tongue
Uvula
Anterior faucial pillar ( Palatoglossal arch)-
• Runs downwards and forwards from soft palate to lateral margin of tongue (at
the junction of anterior 2/3rd and posterior 1/3rd ).
• It contains Palatoglossus muscle.
Posterior faucial pillar (Palatopharyngeal arch)-
• Runs downwards and backwards to the pharyngeal wall.
• It contains Palatopharyngeus muscle.
Features in Anterior Wall
• Lingual tonsils-
These are the collections of lymphoid tissue underneath the
mucosa of pharyngeal part of tongue.
• Upper free end of Epiglottis.
• Median glossoepiglottic fold-
A mucosal fold connecting anterior surface of epiglottis to
the dorsal surface of posterior 1/3rd of tongue.
• Lateral glossoepiglottic folds-
Mucosal folds connecting edges of epiglottis to the dorsal
surface of posterior 1/3rd of tongue.
• Epiglottic valleculae-
Shallow fossae between median and lateral glossoepiglottic
folds.
Applied Aspects
• As oropharynx is a common channel for both food and air,
sometimes food may enter into respiratory tract and cause
choking.
Laryngopharynx
[Hypopharynx]
Introduction
Vertical Extent-
Anteriorly-
• From upper border of epiglottis to lower
border of lamina of cricoid cartilage.
Posteriorly-
• From C3 vertebra to the lower border of C6
vertebra.
Communications-
Anteriorly- with Laryngeal cavity.
Superiorly- with Oropharynx.
Inferiorly- with Esophagus.
• Laryngopharynx communicates with
laryngeal inlet through Laryngeal Inlet.
Features
• Laryngeal Inlet.
• Piriform fossa/recess.
Laryngeal Inlet closes
during deglutition.
Piriform fossa [Smuggler’s
Fossa]-
Location-
• Anterior part of lateral
wall, on each side of
laryngeal inlet.
Piriform
fossa
Pharyngeal Wall
Consists of 4 layers (from within outwards)-
1. Mucous membrane.
2. Pharyngobasilar fascia (Pharyngeal
aponeurosis).
3. Muscle layer.
4. Buccopharyngeal fascia.
Mucous Membrane
Epithelium- Stratified squamous except nasopharynx.
• Nasopharynx is lined by ciliated columnar
epithelium.
• Epithelium tends to invaginate in sub epithelial
collections of lymphoid tissue in the form of clefts
(crypts).
Waldeyer’s Ring-
• Aggregations of lymphoid tissue underneath the
epithelium of pharyngeal wall in the form of an
interrupted ring.
• Surround the commencement of air and food
passages.
• Lymphoid collections in the Waldeyer’s ring are:
• Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]-
Posteriorly
• Tubal Tonsils- Postero-laterally
• Palatine Tonsils- Antero-laterally
• Lingual Tonsils- Anteriorly.
These lymphoid collections prevent the invasion
of microorganisms in the air and food passages.
Waldeyer’s Ring
Pharyngobasilar Fascia
Fibrous thickening of submucosa.
It is thick near the base of skull but thin and indistinct inferiorly.
It is thickest:
• where it fills the gap between upper border of superior constrictor and base of skull.
• where it forms the pharyngeal raphe (posteriorly).
Muscle Layer
2 layers of striated muscles.
Outer layer of 3 pairs of
circular muscles (constrictor
muscles):
• Superior constrictor.
• Middle constrictor.
• Inferior constrictor.
Inner layer of 3 pairs of
longitudinal muscles.
• Stylopharyngeus.
• Salpingopharyngeus.
• Palatopharyngeus.
Buccopharyngeal Fascia
• It is a layer of loose areolar tissue.
• It covers the outer surface of constrictor
muscles.
• In the upper part, it is prolonged forwards
to cover the Buccinator muscles.
• It blends with the pharyngobasilar fascia,
above the upper border of superior
constrictor muscles.
Thank You

Anatomy of Pharynx

  • 1.
  • 4.
    PHARYNX -1 Nasopharynx Dr MathewJoseph MBBS,MD(AIIMS),BCC(Palliative Medicine) Assistant Professor Department of Anatomy Al-Azhar Medical College & Super Specialty Hospital
  • 5.
    Contents • Introduction • Boundaries •Nasopharynx – Oropharynx - Laryngopharynx • Location. • Communications. • Pharyngeal Isthmus. • Features. • Applied Aspects.
  • 6.
    Introduction • Pharynx isa fibromuscular tube. • It is a common channel for both food and air. Location- Behind the cavities of nose, mouth and the larynx. Shape - funnel shaped. Extent- From the base of the skull to the esophagus.
  • 7.
    Dimensions- • Length- 12-14cm • Width: At base- 3.5 cm At pharyngo-esophageal junction- 1.5 cm
  • 8.
    Boundaries Superior- • Base ofskull [ posterior part of body of Sphenoid & Basilar part of Occipital bone in front of pharyngeal tubercle. Inferior- • Continuous with esophagus at the level of lower border of cricoid cartilage anteriorly and lower border of C6 vertebra posteriorly Posterior- • Prevertebral fascia. Anterior- • Opens into cavities of nose, mouth and larynx. Lateral- • Neurovascular bundle of neck. • Styloid process with its attached muscles and ligaments
  • 9.
  • 10.
    Subdivisions From above downwards: •Nasopharynx. • Oropharynx. • Laryngopharynx.
  • 11.
    Nasopharynx Location- • Behind choanae(posterior nasal apertures) and above soft palate. Communications- Anteriorly- with nasal cavities. Inferiorly- with oropharynx.
  • 12.
    Pharyngeal Isthmus [NasopharyngealIsthmus] • An opening bounded anteriorly by the soft palate and posteriorly by the posterior wall of pharynx ( Passavant’s ridge).
  • 13.
    Features: • Nasopharyngeal (Pharyngeal)Tonsil). • Orifice of Pharyngo-tympanic tube (Auditory tube or Eustachian tube). • Tubal elevation. • Tubal tonsil. • Salpingopharyngeal fold. • Salpingopalatine fold. • Pharyngeal recess (Fossa of Rosenmüller). Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]- • A collection of lymphoid tissue. Location- At the junction of roof and posterior wall of nasopharynx. • Contains nasopharyngeal bursa. Nasopharyngeal (Pharyngeal) bursa [Pouch of Luschka]- • A mucous diverticulum which extends upwards into the substance of pharyngeal tonsil from its apex. • It is developed due to adhesion of notochord to the dorsal wall of pharyngeal part of foregut.
  • 14.
    Orifice of Pharyngo-tympanictube (Auditory tube or Eustachian tube)- Location- • On lateral wall of nasopharynx, approximately 1.25 cm behind inferior nasal concha. Tubal elevation- •Upper and posterior margins of orifice of eustachian tube are elevated due to collection of lymphoid tissue. •These elevated margins are known as tubal elevation. Tubal tonsil- • Collection of lymphoid tissue in tubal elevation is known as tubal tonsil.
  • 15.
    Salpingopharyngeal fold- •A mucousfold which extends vertically downwards on the side wall of pharynx from tubal elevation. •It contains Salpingopharyngeus muscle. Salpingopalatine fold- •A mucous fold which extends downwards and forwards to the soft palate from tubal elevation. •It contains Levator Palati muscle. Pharyngeal recess (Fossa of Rosenmüller). •It is a deep depression behind the tubal elevation.
  • 16.
    Applied Aspects Adenoids- •Enlarged nasopharyngealtonsils due to infection. •Block the posterior nares. Clinical Features- •Nasal obstruction. •Nasal discharge. •Mouth breathing. •Snoring. •Protrusion of tongue. •Toneless voice •Small nose. •Epistaxis (Nose Bleeding). Nasopharyngeal tonsils are prominent in children up to the age of 6 years. They gradually undergo atrophy at puberty. They completely disappear by the age of 20 years.
  • 17.
    Adenoid Facies [LongFace Syndrome] • Long, open-mouthed face of children with adenoid hypertrophy. • These children are ‘Obligatory Mouth Breathers’. • Persistent mouth breathing may be associated with development of craniofacial anomalies. • The characteristic facial appearance consists of: • Underdeveloped thin nostrils • Short upper lip • Prominent upper teeth • Crowded teeth • Narrow upper alveolus. • High-arched palate • Hypoplastic maxilla
  • 19.
  • 20.
  • 21.
    Pharynx 2 Oropharynx -Laryngopharynx Dr Mathew Joseph MBBS,MD(AIIMS),BCC(Palliative Medicine) Assistant Professor Department of Anatomy Al-Azhar Medical College & Super Specialty Hospital
  • 22.
  • 23.
    Introduction Extent- • From lowersurface of soft palate to upper border of epiglottis. Communications- Anteriorly- with Oral cavity. Above- with Nasopharynx. Inferiorly- with Laryngopharynx.
  • 24.
    Oropharyngeal Isthmus • Itis a communicating channel between oropharynx and oral cavity. Boundaries- Above- Soft Palate Below- Dorsal surface of posterior 1/3rd of tongue. Laterally- Palatoglossal arch. • Oropharyngeal Isthmus is closed during deglutition.
  • 25.
    Features • Palatine tonsils. •Anterior faucial pillar ( Palatoglossal arch). • Posterior faucial pillar (Palatopharyngeal arch). • Lingual tonsils. • Upper free end of Epiglottis. • Median and lateral glossoepiglottic folds. • Epiglottic valleculae.
  • 26.
    Features in LateralWall Palatine Tonsil- Location: • In the tonsillar fossa. • Tonsillar fossa is located in the lateral wall of oropharynx. • Tonsillar fossa is bounded anteriorly by the anterior faucial pillar (palatoglossal arch). • Tonsillar fossa is bounded posteriorly by the posterior faucial pillar (palatopharyngeal arch). Posterior 1/3rd of Tongue Uvula
  • 28.
    Anterior faucial pillar( Palatoglossal arch)- • Runs downwards and forwards from soft palate to lateral margin of tongue (at the junction of anterior 2/3rd and posterior 1/3rd ). • It contains Palatoglossus muscle. Posterior faucial pillar (Palatopharyngeal arch)- • Runs downwards and backwards to the pharyngeal wall. • It contains Palatopharyngeus muscle.
  • 29.
    Features in AnteriorWall • Lingual tonsils- These are the collections of lymphoid tissue underneath the mucosa of pharyngeal part of tongue. • Upper free end of Epiglottis. • Median glossoepiglottic fold- A mucosal fold connecting anterior surface of epiglottis to the dorsal surface of posterior 1/3rd of tongue. • Lateral glossoepiglottic folds- Mucosal folds connecting edges of epiglottis to the dorsal surface of posterior 1/3rd of tongue. • Epiglottic valleculae- Shallow fossae between median and lateral glossoepiglottic folds.
  • 30.
    Applied Aspects • Asoropharynx is a common channel for both food and air, sometimes food may enter into respiratory tract and cause choking.
  • 31.
  • 32.
    Introduction Vertical Extent- Anteriorly- • Fromupper border of epiglottis to lower border of lamina of cricoid cartilage. Posteriorly- • From C3 vertebra to the lower border of C6 vertebra. Communications- Anteriorly- with Laryngeal cavity. Superiorly- with Oropharynx. Inferiorly- with Esophagus. • Laryngopharynx communicates with laryngeal inlet through Laryngeal Inlet.
  • 33.
    Features • Laryngeal Inlet. •Piriform fossa/recess. Laryngeal Inlet closes during deglutition. Piriform fossa [Smuggler’s Fossa]- Location- • Anterior part of lateral wall, on each side of laryngeal inlet. Piriform fossa
  • 34.
    Pharyngeal Wall Consists of4 layers (from within outwards)- 1. Mucous membrane. 2. Pharyngobasilar fascia (Pharyngeal aponeurosis). 3. Muscle layer. 4. Buccopharyngeal fascia.
  • 35.
    Mucous Membrane Epithelium- Stratifiedsquamous except nasopharynx. • Nasopharynx is lined by ciliated columnar epithelium. • Epithelium tends to invaginate in sub epithelial collections of lymphoid tissue in the form of clefts (crypts). Waldeyer’s Ring- • Aggregations of lymphoid tissue underneath the epithelium of pharyngeal wall in the form of an interrupted ring. • Surround the commencement of air and food passages. • Lymphoid collections in the Waldeyer’s ring are: • Nasopharyngeal (Pharyngeal) Tonsil [Adenoids]- Posteriorly • Tubal Tonsils- Postero-laterally • Palatine Tonsils- Antero-laterally • Lingual Tonsils- Anteriorly. These lymphoid collections prevent the invasion of microorganisms in the air and food passages.
  • 36.
  • 37.
    Pharyngobasilar Fascia Fibrous thickeningof submucosa. It is thick near the base of skull but thin and indistinct inferiorly. It is thickest: • where it fills the gap between upper border of superior constrictor and base of skull. • where it forms the pharyngeal raphe (posteriorly).
  • 38.
    Muscle Layer 2 layersof striated muscles. Outer layer of 3 pairs of circular muscles (constrictor muscles): • Superior constrictor. • Middle constrictor. • Inferior constrictor. Inner layer of 3 pairs of longitudinal muscles. • Stylopharyngeus. • Salpingopharyngeus. • Palatopharyngeus.
  • 40.
    Buccopharyngeal Fascia • Itis a layer of loose areolar tissue. • It covers the outer surface of constrictor muscles. • In the upper part, it is prolonged forwards to cover the Buccinator muscles. • It blends with the pharyngobasilar fascia, above the upper border of superior constrictor muscles.
  • 41.