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ANATOMY OF PHARYNX pptx presentation ppt
- 1.
- 2. • Pharynx isa fibro muscular tube extends from skull base to 6th cervical vertebra. • It lies behind and divided into : • NOSE……Nasopharynx ( C 1 ) • MOUTH…….Oropharynx ( C 2- C 3 ) • LARYNX ……. Hypopharynx ( C 4 – C 6 )
- 4. THE NASOPHARYNX • Extendsfrom skull base to the palate . Behind the nose ( choana ). FEATURES : • ROOF = contain sub –epithelial lymphoid tissues ( When hypertrophy called ADENOID ). • LATERAL WALL = • Opining of Eustachian tube ( 1 CM behind inferior turbinate ) .
- 5. • Tubal elevationor torus tubarius ( caused by ET ). FORMING THE EUSTACHIAN CUSHION • Pharyngeal recess or fossa of Rosen muller (above and behind ET opining ).
- 7. THE OROPHARYNX • Extendsfrom the palate to the tip of Epiglottis . • Behind the oral cavity . FEATURES : • The palatine tonsils present on each side of oropharynx between pillar of fauces .
- 8. THE HYPOPHARYNX • Extendsfrom tip of epiglottis to the lower border of cricoid cartilage . • Behind the larynx . • Consists of 3 parts : 1 - PYRIFORM FOSSA = on both sides of larynx. • Laterally : Thyroid Cartilage and thyroid membrane . • Medially : Cricoid cartilage and Aryepiglottic fold .
- 9. 2 - POSTCRICOIDALAREA : v imp cuz its forming the beginng of esophagus, any widening in this area means theres some pathology n usually it’s a tumor. When we examine we have to move larynx from ryt to left n u will feel laryngeal cryptus which is normal n shud be there due to friction of cricoid cartilage over the vertebra . Extends from the Arytenoid cartilage above to the lower border of cricoid cartilage below . 3 – POSTERIOR PHARYNREAL WALL .
- 10. • PHARYNGEAL WALLIS FORMED OF : 1 – MUCOSAL LAYER = Stratified squamous epith Exept the nasopharynx ( respiratory epithelium > stratified columnar ciliated epi.). 2 - SUBEPITHELIAL CONNECTIVE TISSUE .
- 11. 3 - MUSCULARLAYER : # Main pharyngeal muscles = sup. , mid , and inf constrictors . # Accessory pharyngeal muscles = stylo – salpingo and palatopharyngeus muscles .4 – BUCCOPHARYNGEAL FASCIA : Covers the pharynx from outside , separated from prevertebral fascia by retropharyngeal space .
- 12. BLOOD SUPPLY • 1– Ascending pharyngeal artery from ECA . • 2 - Ascending palatine artery from Facial artery . • 3 - Descending palatine artery from maxillary artery . • 4 – Dorsalis lingual artery from lingual artery . • 5 -Tonsillar artery from facial artery .
- 14. Venous drainage • Pharyngealplexus = IJV ( Jugular vein ) .
- 15. NERVE SUPPLAY • MOTOR= all pharyngeal muscles are supplied from pharyngeal plexus ( from vagus ) except 2 muscles : • 1- tensor palati ( by trigeminal nerve) 2- stylopharyngeous ( by glossopharyngeal nerve ). SENSORY = from pharyngeal plexus ( from glossopharyngeal ) except the hypopharynx from glossopharyngeal and vagus .
- 16. • NOTE = •Pharyngeal plexus of nerve = • Motor = vagus • Sensory =glossopharyngeal . • LYMPHATIC DRAINAGE : • Retropharyngeal L.Ns to the deep cervical L.Ns
- 17. Waldeyer’s ring It isaring of lymphoid tissues present in the subepithelial connective tissues in the upper part of aerodigestive tract . It has no afferent lymphatic vesseles . SO plays v imp role in first line of defense against microorganisms Only efferent lymphatics ( direct contact with the organism). It is drained in retropharyngeal LNs then to the upper deep cervical LNs.
- 18. • It consistsof : 1 – nasopharyngeal lymphoid tissue . 2 – tubal tonsil ( around the ET ) . 3 – palatine tonsils ( in the oropharynx ) . 4 – lingual tonsils ( at the base of the tongue ). 5 – lymphoid follicles in the posterior pharyngeal wall .
Editor's Notes
- #2 C6 IS THE BEGINNING OF THE ESOPHAGUS , CRIOID CARTILAGE AT C6 , BUFURCATION OF. CAROTID ARTERY AR C6, ENDING OF PHARYNX AT C6.
- #3 ORIGIN OF MOST CA OF NASOPHARYNX IS AT FOSSA OF ROSEMULLER. TONSIL DEVELOPS AT THE AGE OF 6 MONTHS. SO IMMUNITY OF BABY IS DEPENDING ON THE ADENOID. UNTIL AGE OF 2 YR THE ADENOID IS SHRINKED IN SIZE AND THEN WILL DISAPPEAR. SO 20 YR OLD WITH SNORING > DON’T SAY ADENOID (IT MIGHT BE BUT NOT COMMON).
- #4 OPENGN OF NASOPHARYNX TO NASAL CAVITY > POST. CHOANA
- #7 Pharyngeal folds are pillars.
- #8 Cricoid cartilage is at the level of c6.
- #12 2A 2D T So mainly supplied by external carotid ARTERY.
- #15 SO WHENEVER TEHRES ABSENCE OF GAG REFLEX THETES EITHER : 1- SENSORY EMPAIRMENT OF GLOSSOPHARYNGEAL NERVE 2- OER MOTOR THRU VAGUS NERVE OR MAYBE BOTH
- #17 ITS NOT AVISBILE RING.
- #18 So when u advice for tonsilictomy > tonsils r not the only organ responsible for first line of immu nity which are the weldyer ring .