This is Edward from JJM medical college, this presentation for dental students which i have prepared....

1. PHARYNX

2. • Introduction:
• Pharynx is a wide muscular tube situated
behind nose, mouth and larynx.
• Dimensions:
• Length – 12Cms
• Width - Upper part – 3.5Cms
Middle part- Narrow
Lower part - Narrowest 1.5Cms.

3. • Boundaries :
• Superiorly : Base of the skull, the posterior
part of the body of the sphenoid bone and
basilar part of occipital bone, in front of
pharyngeal tubercle.
• Inferiorly : Pharynx is continuous with
eusophagus at the level of 6th
Cervical vertebra.

5. • Anteriorly : It communicates with Nasal cavity,
Oral cavity and the larynx.
• Posteriorly : Pharynx glides freely on the
prevertebral fascia which seperates it from
Cervical spinal.

7. • On each side : Pharynx is attached to
1) Medial pterygoid plate
2 ) Pterygo mandibular raphe
3 ) Mandible
4 ) Tongue
5 ) Hyoid bone
6 ) Thyroid and cricoid cartilages

9. Tongu
e
Mandible

10. Pterygo mandibular raphe
Hyoid bone
Thyroid cartilage
Cricoid cartilage

11. • It communicates on each side with middle ear
through auditory tube.
• Pharynx is related on either side to
STYLOID PROCESS and muscles of it.
COMMON CAROTID ARTERY
EXTERNAL CAROTID ARTERY
INTERNAL CAROTID ARTERY

13. • Parts of pharynx:
The cavity of pharynx is divided into
nasal part 1) Nasopharynx
Oral part 2) Oropharynx
Laryngeal part 3) Laryngeopharynx.

14. Nasopharynx

15. • Its also called as Epipharynx.
• This is the upper part of pharynx situated
behind the nose, and above the lower border
of soft palate and passavant’s muscle.
• It resembles nose structurally and
functionally,

16. 1) Respiratory in function
2) Walls are rigid and non collapsable
3) lined by ciliated columnar
epithelium.
4) Mucous membrane is supplied by
trigeminal nerve.
• Features :
The rigid wall is formed by Pharyngobasilar-
fascia and posterior median Pharyngeal
ligament.

17. • Anteriorly:
It communicates with posterior nasal apertures.
• Posteriorly:
 Roof and Posterior wall form a continuous slope, opposite the
posterior part of body of sphenoid bone, basioccuput, and
anterior arch of atlas.
 Under the mucous membrane, opposite the basiocciput ,
there is a collection of lymphoid tisue beneath the mucous
membrane which projects downwards and forwards, it is
called NASO-PHARYNGEAL TONSIL. It is better developed in
children, small and absent in adult.

20. • Pharyngeal bursa :
It is a small median recess in the mucous
membrane that covers the tonsil. It
corresponds to pouch of Luschka.

22. • Inferiorly:
It communicates with oropharynx at the
pharyngeal isthmus.
Passvants muscle : (Pharyngeal isthmus)
Its an opening bounded by the lower
border of soft palate and the posterior wall of
pharynx.

23. • Lateral wall :
a) Pharyngeal opening of auditory tube, at the
level of inferior nasal concha and 1/2 inch
behind it;
b) Tubal elevation bounds the tubal opening;
c) Salpingopharyngeal fold is a vertial fold of
mucous membrane running downwards from
the posterior margin of tubal elevation and
gradually fading in the sides of pharynx. The
fold is raised by a slip of muscle, the
salpingopharyngeus.

24. • The levator palati, as it enters soft palate, raises
a fold of mucous membrane just below the
tubal opening.
• Behind the tubal elevation and upper part of
the fold there is a narrow vertical slit that leads
into flat pocket of mucous membrane called
Pharyngeal recess or lateral recess or fossa of
rosenmuller, it is present above the superior
constrictor muscle and below foramen lacerum
and petrous part of temporal bone.

25. Levator veli palati

27. Applied aspects
• Adenoids :
Enlarged pharyngeal tonsil is called Adenoids,
nasal breathing impossible.
• Clinically represented-A dimple above the
adenoids
• Reminiscent of buccal mucosal invagination to
form the anterior lobe of pituitary
• Carcinopharyngoima may arise

29. Oropharynx

30. • It is also called as mesopharynx,
• It lies behind the oral cavity, and is supported
dorsally by the bodies of cervical vertebrae C2
and C3, and by the contents of retro
pharyngeal space.

31. Palatoglossalarch
Palatopharyn-
gealarch

32. • Infront
It communicates with the oral cavity through
Oro-pharyngeal isthmus, which is bounded
above by soft palate, below by the dorsal
surface of the tongue, and on each side by
the palate glossal arch containing
corresponding muscle.
• Below
It communicates with laryngopharynx at the
level of the upper border of the epiglottis.

35. • Lateral wall:
Lateral wall of the oropharynx presents on
each side the palatine tonsil which lodges in a
triangular tonsillar fossa.

36. Palatine tonsil
• Infront palatoglossalarch corresponding
muscle;
• Behind palatopharyngeal arch corresponding
muscle;
• Apex by the soft palate where both arches
meet;
• Base, by the dorsal surface of the posterior
1/3rd
of tongue;

37. • Lateral wall or the floor of the fossa, is formed
by the superior constrictor and styloglossus
muscles covered internally by the
Pharyngobasilar fascia.

40. • Blood supply;
Tonsillar branch of facial artery, Additional
branches are Ascending palatine artery, dorsal
lingual branches of lingual; Ascending
pharyngeal brach; and Greater palatine
branch of maxillary.
• Venous drainage
Palatine, pharyngeal or facial vein.
• Lymphatic drainage :
Jugulo gastric nodes.

41. • Nerve supply:
Glossopharyngeal and lesser palatine nerves.
• Applied aspects:
Septic tonsils
Tonsillectomy
Tonsillitis may cause referred pain in the ear.

43. Laryngopharynx
• Laryngopharynx:
• It is also called as Hypopharynx,
• It is the lower part of the pharynx situated
behind the larynx. It extends from upper
border of epiglottis to the lower border of
cricoid cartilage

44. • Anterior wall:
Inlet of larynx and posterior surface of cricoid
and arytenoid cartilages.
• Posterior wall :
It is supported by 4th
and 5th
cervical vertebrae
including the lower part of 3rd
and upper part
of 4th
cervical vertebrae, the posterior
pharyngeal wall is formed by the overlapping
of 3 constrictors upto vocal cords.

46. • Lateral wall:
It consists of piriform fossa one on each side of
the inlet of the larynx. The fossa medially
bounded by the eryepiglottic fold, laterally by
the thyroid cartilage and thyrohyoid
membrane. Beneath the mucosa of the fossa
there lies internal laryngeal nerve,

48. • Removal of foreign bodies from the piriform
fossa may damage the internal laryngeal
nerve, leading to anaesthetia in the supra
epiglottic part of the larynx, this may cause
aspiration pneumonia and death.

49. • The wall of pharynx composed of the following 5 layers
from within outwards
1)Mucosa- Squamous epithelium, nasopharynx –
Ciliated columnar epithelium.
2)Sub mucosa.
3)Pharyngo basilar fascia.
4)Muscular coat-
Outer circular layer formed by 3 Constrictors
Inner longitudinal layer formed by
Stylopharyngeus, salpingopharyngeus and
palatopharyngeus.
5)Buccopharyngeal fascia.

50. Muscles of the pharynx
• Superior constrictor-
It arises at posterior border of medial pterygoid plate
and pterygoid hamulus , and pterygomandibular
raphe and posterior end of mylohyoid line of mandible
and inserts over pharyngeal tubercle supplied by
pharyngeal plexus
• Middle constrictor:-
It arises from lower part of stylohyoid ligament and
lesser cornu of hyoid bone and also upper part of
greater cornu of hyoid bone and inserts to pharyngeal
raphe supplied by pharyngeal plexus of nerves.

52. • Inferior constrictor:-
It arises from oblique line of thyroid cartilage and
tendinous band across the cricothyroid muscle
and inserts as pharyngeal raphe, supplied by
Pharyngeal plexus, external laryngealnerve and
recurrent laryngeal nerve.
• Stylopharyngeus:-
It arises from medial surface of styloid process
and enters in pharynx between superior and
middle constrictors, and is inserted on the
posterior border of the lamina of thyroid
cartilage and lateral aspects of epiglottis ,
supplied by Glossopharyngeal nerve.

53. • Palatopharyngeus:-
It arises from posterior border of hard palate
and forms an arch called palate pharyngeal
arch and runs downwards on the dorsum of
tongue and some fibres runs downwards to
the lamina of thyroid cartilage, supplied b
pharyngeal plexus.
• Salpingopharyngeus:-
It arises at anterior end of the cartilage of
auditory tube and insertion is it blends with
palatopharyngeus, supplied by pharyngeal
plexus.

55. • Blood supply :
• Ascending pharyngeal branch of External
carotid artery
• Ascending palatine and tonsillar branches of
facial artery
• Dorsal lingual branches of lingual; and Greater
palatine, pharyngeal and pterygoid branches
of maxillary artery

57. Venous drainage:
Veins form plexus on the posterolateral aspect of
the pharynx, it receives blood from pharynx, soft
palate and prevertebral region. It communicates
with plexus above and drains into IJV and Facial
vein.
Lymphatic drainage:
Retro pharyngeal group of lymph nodes and deep
cervical lymph nodes.

59. Nerve supply:
• Pharynx is supplied by Pharyngeal plexus of
nerves which chiefly on the middle
constrictor,
Plexus formed by Pharyngeal branch of Vagus
(motor )nerve, pharyngeal branch of 9th
(Sensory) and superior cervical sympathetic
ganglion

60. Auditory tube
• Its also called as pharyngo tympanic tube or
Eustachian tube,
• It is trumpet shaped channel which connects
the middle ear with the nasopharynx,

61. • Length and direction:
• It is about 1 ½ inches long, and is directed
downwards, forwards and medially.
• Parts:
• Posterior 1/3rd
part is bony and anterior 2/3rd
part is cartilaginous

62. • Bony part:
• It is half inch long, and lies in the petrous part of
temporal bone near tympanic plate.
• Lateral end is wider and opens in the anterior
wall of middle ear cavity, the medial end is
narrow and jagged for the attachment of
cartilaginous part,
• Relations:
• Superior : canal for tensor tympani
• Medial: Carotid canal
• Lateral: Chorda tympani, spine of sphenoid and
jaw joint
• Lumen is oblong, being widest from side to side.

64. • Cartilagenous part:
• One inch long lies in the sulcus tubae,
• It is made up of a triangular plate of cartilage
which is curled to form the superior and medial
walls of tubae.The lateral wall and floor are
completed by fibrous membrane.
• Relations:
• Anterolaterally: tensor palate, mandibular nerve
and its branches, otic ganglion,chorda
tympani,middle meningeal artery and medial
pterygoid plate.
• Posteromedially: Petrous part of temporal bone
and levator palaiti

65. Blood supply:
• Ascending pharyngeal, middle meningeal and
artery of pterygoid canal.
• Venous drainage:
Pharyngeal and pterygoid venous plexus.
• Lymphatic drainage:
Retropharyngeal group of lymphnodes.

66. • Nerve supply:
• Pharyngeal branch of pterygopalatine
ganglion;
• Cartilagenous part by nervous spinosus
• Bony part by 9th
cranial nerve

67. • Function:
• It maintains atmospheric pressure in the
middle ear cavity thus the air pressures on the
twosides of the tympanic membrane are
equalized, the tube is usually closed when
relaxed. It opens during swallowing, yawning
and sneezing by the action of tensor and
levator veli palatine muscles.

68. Applied aspects:
• Inflammation of auditory tube.