resonatory system along with structure and function

ANATOMY & PHYSIOLOGY OF
PHARYNX
 PHARYNX:-
 The pharynx is a wide muscular tube, behind
the nose, the mouth and the larynx.
 Clinically, it is a part of the upper respiratory
passages.
The upper part of the pharynx transmits only
air, the lower part (below the inlet of the
larynx), only food, but the middle part is a
common passage for both air and food, (but
only one at a time.)

DIMENSIONS
 LENGTH: about 12 cm
 WIDTH :
a) Upper part is widest (3.5 cm).
b) Middle part is narrow; and
c) The lower end is the narrowest part of
the alimentary canal.

 It is limited above by the posterior part of
the sphenoid body & the basilar part of
the occipital bone; below, it is continuous
with the oesophagus.
 In front, it opens into the nasal cavity,
mouth & larynx, its anterior wall being
therefore incomplete.

 ON EACH SIDE:
A. The pharynx is attached to:
 The mendible;
 The tongue;
 The hyoid bone;
 The thyroid & cricoid cartilages.
B. It communicates on each side with the
middle ear cavity through the auditory
tube.

PARTS OF THE PHARYNX
 The cavity of the pharynx is divided into:
A. The nasal part [nasopharynx]
B. The oral part [oropharynx]
C. The laryngeal part [laryngopharynx]

NASAL PART OF PHARYNX
(NASOPHARYNX)
This situated is the upper part of the
pharynx situated behind the nose, and
above the lower border of the soft palate.
It resembles the nose structurally as well
as functionally .
a) It is respiratory in function, and no food
ever enters it.
b) It is lined by ciliated columnar
epithelium; and

Cont….
c) Its mucous membrane is supplied by the
trigeminal nerve.
 THE FOLOOWING FACTS MAY BE
NOTED:
1. The wall of the nasopharynx formed by
the pharyngobasilar fascia and the
posterior median pharyngeal ligaments.

Cont….
2.Anteriorly, the nasopharynx
communiates with the nasal cavities
through the posterior nasal apertures.
3. Inferiorly, it communicates with the
oropharynx at the pharyngeal isthmus.
 The isthmus is an opening bounded by
the lower border of the soft palate & the
posterior wall of the pharynx.

Cont….
4.The lateral wall presents the following.
a) The pharyngeal opening of the auditory
tube.
b) The tubal aperture is approximately
triangular in shape, bounded above &
behind by the tubal elevation.
c) Behind the tubal opening, a
salpingopharyngeal fold of mucosa
descends from the tubal elevation.

Cont….
 In front of the antereo-superior angle of the
tubal elevation to the soft palate.
d. The levator veli palatini, as it enters the soft
palate, raises a fold of mucous membrane
just below the tubal opening.
e. In the mucous immediately posterior to the
opening of the pharyngotympanic tube is a
small mass of lymphoid tissue, the bilateral
tonsils.

Cont….
f. Further behind the tubal elevation the lateral
wall has a variable depression, the pharyngeal
recess or fossa of Rosenmuller.
g. The floor of the nasopharynx is formed by
the upper surface of soft palate.
 The nasopharyngeal tonsil is better developed
in children. It is small or absent in adults.A
pathological enlarged pharyngeal tonsil is
given the name adenoids. It is presence may
make nasal breathing impossible.

ORAL PART OFTHE PHARYNX
(OROPHARYNX)
Orophrynx lies behind the oral cavity.
Base of tongue is in the front, tonsil are
present at the sides and soft palate forms the
roof of the oropharynx.
 above, it communicates with the
nasopharynx through the pharyngeal or
nasopharyngeal isthmus.
In front, it communicates with the oral cavity
through the oropharyngeal isthmus or
isthmus.

Cont….
 Below, it opens into the laryngopharynx.
 Posteriorly, it is supported by upper part of the
third cervical vertebra.
 Its lateral wall presents the palatine tonsil which
lies in the tonsillar fossa.
 This fossa bounded anteriorly by the palatoglossal
arch and posteriorly by the palatopharyngeal arch.
 The wall of the oropharynx is formed posteriorly
by the superior, middle and inferior constrictors
of the pharynx.

WALDEYER’S LYMPHATIC RING
In relation to the oropharyngeal isthmus, there
are several aggregations of lymphoid tissue that
constitute waldeyer’s lymphatic ring.
The most important aggregations are the right &
left palatine tonsils usually referred to simply as
the tonsils.
Posteriorly and above there is the pharyngeal
tonsil, lalerally and above there are the tubal
tonsils, and inferiorly there is a lingual tonsils
(over the posterior part of the dorsom of the
tongue.)

PALATINE TONSIL
SURFACE MARKING:-
It is marked by an oval [almond-shaped]
area over the masseter just anterosuerior
to the angle of the mendiable.
FEATURES:-
The palatine tonsil occupies the tonsiller
sinus or fossa between the palatoglossal
and palatopharyngeal muscle.
It can be seen through the mouth.

Cont….
The tonsil is almond shaped. It has two
surface medial & lateral; two borders
anterior & posterior and two poles, upper
& lower.
The medial surface is covered by
stratified squamous epithelium
continuous with that the mouth.

Cont….
The bed of the tonsil is formed from
within outwards by:
a. The pharangeobasilar fascia.
b. The superior constrictor and
palatopharygeal muscles.
c. The buccopharyngeal fascia.
d. In the lower part the styloglossus.
e. Glossopharyngeal nerve.

Cont….
The anterior border is related to the
palatoglossal arch with its muscle.
The upper pole is related to the soft
palate, and the lower pole, to the tongue.
The posterior border is related to the
palatopharyngeal arch with its muscle.

ARTERIAL SUPPLY OF TONSIL
MAIN SOURCE:-
Tonsillar branch of facial artery.
ADDITIONAL SOURCES:-
a) Ascending palatine branch of facial artery.
b) Dorsal lingual branches of the lingual artery.
c) Ascending pharyngeal branch of the external
caroid artery.
d) The greater palatine branch of the maxillary
artery.

Cont….
VENOUS DRAINAGE
One or more veing leave the lower part
of the deep surface of the tonsil, join the
palatine, pharyngeal or facial veins.

LARYNGEAL PART OF THE PHARYNX
(LARYNGOPHARYNX)
It is also called hypopharynx.
This is the lower part of the pharynx
situated behind the larynx. It extends
from the upper border of the epiglottis to
the lower border of the cricoid cartilage.
The anterior wall presents:
a. The inlet of the larynx &
b. The posterior surface of the cricoid and
arytenoid cartilage.

Cont….
 The posterior wall is supported mainly by the
fourth and fifth cervical vertebrae.
 The lateral wall present a depression called the
piriform fossa, one on each side of the inlet of the
larynx.
 The fossa is bounded medially by the ary.epiglottic
fold, and laterally by the thyroid membrane.
 Beneath the mucosa of the fossa there lies the
internal laryngeal nerve.
 Removal of foreign bodies from the piriform fossa
may damage the internal laryngeal nerve.

Cont….
LYMPHATIC DRAINAGE:-
1> Lymphatics pass to the jugulodiagastric
node.
 NERVE SUPPLY:-
1> Glossopharyngeal and lesser palatine
nerve.

STRUCTURE OF PHARYNX
The wall of the pharynx is composed of
the following 5 layers from within
outwards.
i. Mucosa
ii. Submucosa
iii. Pharyngobasilar fascia or pharyngeal
aponeurosis.This is a fibrous sheet
internal to the pharyngeal muscles.

Cont….
Superiorly, the fascia is attached to the
basiocciput, the petrous temporal bone, the
auditory tube, the posterior border of the
medial pterygoid plate, & the
pterygomandibular raphe.
The muscular coat consists of an outer
circular layer made up of the three
constrictors & an inner longitudinal layer
made up of the stylopharyngeous, the
salpingopharyngeous muscles.

Cont….
The buccopharyngeal fascia covers the
outer surface of the constrictions of the
pharynx.
The buccopharyngeal fascia is best
developed in the upper part of the
pharynx.
Between the buccopharyngeal fascia, &
the muscular coat there are the
pharyngeal plexuses of veins & nerves.

MUSCLES OF PHARYNX
 The muscular basis of the wall of the pharynx
is formed mainly by the three part of
constrictors:-
i. Superior
ii. Middle
iii. Inferior
 The origins of the constrictors are situated
anteriorly in relation to the posterior
openings of the nose, the mouth & the
larynx.

Cont….
From here their fibres pass into the lateral &
posterior walls of the pharynx, the fibrous of
the two sides meeting in the middle line in a
fibrous raphe
The three constrictors are so arranged that
the inferior overlaps the middle, which in
turn overlaps the superior.
The lower edge of the inferior constrictors
becomes continuous with circular muscle of
two oesophagus.

Muscle Origin Insertion Action
Superior
pharyngeal
constrictor
Mandible, floor
of the mouth,
sides of the
tongue
&occipital
bone.
Median raphe
posterior
pharyngeal wall.
Constricts
pharynx.
Middle
pharyngeal
constrictor
Greater &
lesser horns of
hyoid,
stylohyoid
ligament
Median raphe of
posterior
pharyngeal wall.
Constricts
pharynx.

Cont….
Muscle Origin Insertion Action
Inferior
pharyngeal
constrictor
Thyroid & sides
of cricoid.
Median raphe of
posterior
pharyngeal wall.
Constricts
pharynx.
Stylopharynge
-ous
Styloid process of
temporal bone.
Wall of pharynx. Raises & opens
pharynx.
Salpingophary
-ngeous
Cartilaginous
portion of
Eustachian tube.
Posterior
palatopharyngeous.
Opens
Eustachian tube
& pharynx.

The nose performs two function. It is a
respiratory passage. It is also the organ of
smell.
The receptors for smell are placed in the
upper one-third of the nasal cavity.
This part is lined by olfactory mucosa.
The rest of the nasal cavity is lined by
Respiratory mucosa.

The respiratory mucosa warms the
inspired air.
The secretions of numerous serous
glands make the air moist: while the
secretions of mucous glands trap dust &
other particles.

Thus the nose acts as an air conditioner
where the inspired air is warmed,
moistened & cleansed before it is passed
on to delicate lungs.
The olfactory mucosa lines the upper
one-third of the nasal cavity including the
roof formed by cribriform plate & the
medial & lateral walls.

It is thin than the respiratory mucosa. It
contains receptors called olfactory cells.
The nose is divided in to two main parts:
1.External nose
2. Nasal cavity

EXTERNAL NOSE
Dorsum : prominent ridge separating
right & left halves of nose.
Tip of Nose: lower end of nose.
Root of nose: upper narrow end of nose.
The external nose has a skeletal
framework that is partly bony &
cartilaginous.
The bones are the nasal bones & the
frontal processes of the maxillae.

The bones are the nasal bones & the
frontal processes of the maxillae.
The cartilages are the superior & inferior
nasal cartilages, the septal cartilage &
some small cartilages.
The skin over the external nose is
supplied by the external nasal,
infractrochlear & infraorbital nerves.

NASAL CAVITY
The nasal cavity extends from nostrils to
the posterior nasal apertures & is
subdivided into right & left halves by the
nasal septum.
Each half has a roof, a floor & medial and
lateral walls.

NOSE
Tip of nose divided into two openings :
1. Left nostril
2. Right nostril
They separated by the columella.
It has numerous hair cells called vibrissa.

STRUCTURE OF NASAL CAVITY
1) Roof of Nose:- made up of nasal bone, cribriform
of ethmoid bone, sphenoid bone, frontal bone.
2) Floor of Nose:- made by roof of mouth. It has two
structures: hard & soft palate.
 Hard palate infront & soft palate behind.
 Hard palate contains palatine bones & composed
of maxilla & soft palate has involuntary muscles.
3) Medial wall :- contains septum.
4) Lateral wall :- made up of maxilla, ethmoid bone
& inferior concha.

Nasal cavity has main three structures:
I. Vestibule
II. Olfactory region
III. Respiratory region

1.) vestibule:
It is located just inside the anterior nasal
opening has numerous hairs inside it.
These hairs filter the air.
2.) olfactory region:
Upper one- third of nasal cavity.
It’s mucous is yellowish & it has olfactory
receptor cells.

3.) Respiratory Region:
Lower two-third of nasal cavity.
It has thick mucous membrane.

NASAL SEPTUM
The nasal septum is medial osseocartilagious
partition between the two halves of the nasal
cavity.
On each side, it is covered by mucous
membrane and forms the medial wall of both
nasal cavities.
The bony part is formed almost entirely by:
1)The mover
2)The perpendicular plate of the
ethmoid.

The cartilaginous part is formed by:
1)The septal cartilage
2) The septal process of the inferior
nasal cartilages.
The cuticular part or lower end is formed
by fibro fatty tissue covered by skin.
The lower margin of the septum is called
the columella.

The septum has:
1)Four borders: superior, inferior,
anterior & posterior.
2)Two surface : right & left.

ANTERIAL SUPPLY
Anterosuperior part is supplied by the
anterior ethmoidal artery.
Posteroinferior part is supplied by the
sphenoplalatine artery.
Anteroinferior part is supplied by the
superior labial branch of basal artery.
Posterosuperior part is supplied by the
posterior ethmoidal artery.

VENOUS DRAINAGE
 The veins form plexus which is more
marked in the lower part of the
septum(little ‘s area).
 The plexus drains anteriorly into the
facial vein posteriorly through the
sphenopalatine vein to pterygoid venous
plexus.

NERVE SUPPLY
General sensory nerves arising from
trigeminal nerve, are distributed to whole
of the septum.
1)the anterosuperior part of the septum
is supplied by the internal nasal branch of
the anterior ethmoidal nerve.
2)the posteroinferior part is supplied by
the nasopalatine branch of the
pterygopalatine ganglion.

LATERAL WALL OF NOSE
 Lateral wall is mainly for respiratory region.
 This wall of the main nasal cavity shows three
elevations: the superior, middle & inferior
nasal concha, inferolateral each being a
corresponding passage or meatus.
 Above the superior concha the triangular
spheno ethmoidal recess bears the opening of
the sphnoidal sinus, sometimes a fourth
concha, the highest nasal concha, appears on
the lateral wall of this recess.

The superior meatus lies along the upper
border of the middle concha.
The middle meatus lies below and lateral to
the middle concha and continues anteriorly
into a shallow fossa above the vestibule
termed the atrium of the middle meatus.
The middle concha must be displaced to
display the lateral wall of middle meatus
fully.

The main features of this wall are a
rounded elevation, the bulla ethmoidalis,
and below it and extending up in front of
it, a curved cleft, the hiatus semilunaris.
The bulla ethmoidalis is formed by the
expansion of the middle ethmoidal
sinuses, which open on or just above it, its
size varying with the contained sinus.

The opening of the maxillary sinus lies
below the bulla, usually hidden by the
flange like lower edge of the hiatus.
The inferior meatus, below and lateral to
the inferior concha, contains the opening
of the nasolacrimal duct.

ARTERIAL SUPPLY OF LATERAL
WALL
1)The anterosuperior quadrant is supplied by
the anterior ethmoidal artery.
2)The anteroinferior quadrant is supplied by
branches from the facial and greater
palatine arteries.
3)The posterosuperior quadrant is supplied
by the sphenopalatine artery.
4)The posteroinferior quadrant is supplied by
branches from the greater palatine artery.

VENOUS DRIANAGE
 The veins form a plexus which drains
anteriorly into the facial vein, posteriorly
into the pharyngeal plexus of veins and
from the middle part, to the pterygoid
plexus of veins.

NERVE SUPPLY
[1] General sensory nerves [derived from
the branches of trigeminal nerve] are
distributed to whole of the lateral wall:
1)The anterosuperior quadrant is supplied
by the anterior ethmoidal nerve (branch
of ophthalmic nerve).
2)The anteroinferior quadrant is supplied
anterior superior alveolar nerve
(branch of maxillary nerve).

3)The posterosuperior quadrant is
supplied by the posterior superior lateral
nasal branches from the pterygopalatine
ganglion.
4)The posteroinferior quadrant is supplied
by the anterior palatine branch from the
pterygopalatine ganglion.

[2] Special sensory nerves (olfactory) are
distributed to the upper part of the
lateral wall just below the cribriform plate
of the ethmoidal up to the superior
concha.

LYMPHATIC DRIANAGE
 Lymphatic from the anterior half of the
lateral wall pass to the submendibular
nodes, & from the posterior half, to the
retropharyngeal and upper deep cervical
nodes.

PARANASAL SINUSES
 Paranasal sinuses are air filled spaces
present within some bones around the
nasal cavities.
The sinuses are frontal, maxillary, sphenoid
& ethmoidal.
All of them open into the nasal cavity
through its lateral wall.
The function of the sinuses is to make the
skull lighter and add resonance to the vaice.

In infections of the sinuses (sinusitis) the
voice is altered.
The sinuses are rudimentary, or even
absent at birth.They enlarge rapidly
during the ages of 6 to 7 years ,(time of
eruption of permanent teeth) and then
after puberty.

PRENASAL SINUSES
Description
(1)Frontal sinus:
It lies in the frontal bone, posterior to the
superciliary arches.
It extends upwards above the medial end
of the eyebrow, and backwards into the
medial part of the roof of the orbit.

It opens into the middle meatus of nose
at the anterior end of the hiatus
semilunaris either through the
infundibulum or through the frontonasal
duct.
The right and left sinuses are usually
unequal in size, and rarely one or both
may be absent.

Their average height, width and
antereoposterior depth are each about
2.5 cm. the sinuses are better developed
in males than in females.
They are rudimentary or absent at birth.
They are well developed between 7 and 8
years of age, but reach full size only after
puberty.

Arterial supply:-
Supraorbital artery.
Nerve supply:-
Supraorbital nerve.

MAXILLARY SINUS
 SURFACE MARKING:
The roof is formed by the floor of orbit,
the floor by the alveolar process of the
maxilla, the base by the lateral wall of the
nose.

FEATURES:
(1)The maxillary sinus lies in the body of
the maxilla, and is the largest of all the
paranasal sinuses.
It is pyramidal in shape, with its base
directed medially towards the lateral wall
of the nose, & the apex directed laterally
in the zygomatic process of the maxilla.

(2)It opens into the middle meatus of the
nose in the lower part of the hiatus
semilonaris.
A second opening is often present at the
posterior end of the hiatus.
Both opening are nearer the roof than
the floor of the sinus.

SPHENOIDAL SINUS
FEATURES:
(1)The right and left sphenoidal sinuses lie
within the body of the sphenoidal bone.
They are separated by a septum.
The two sinuses are usually unequal in
size.
Each sinus opens into the
sphenoethmoidal recess.

(2)Each sinus is related superiorly to the
optic chaisma and the hypophysis cerebral
and laterally to the internal carotid artery.

Arterial supply:-
 Posterior ethmoidal & internal carotid
arteries.
Nerve supply:-
 Posterior ethmoidal nerve and orbital
branches of the pterygopalatine ganglion.

ETHMOIDAL SINUSES
FEATURES:
Ethmoidal sinuses are numerous small
inter communicating spaces which lie
within the labyrinth of the ethmoid bone.
The sinuses are divided into:
1. anterior
2. middle &
3. posterior groups.

(1)The anterior ethmoidal sinus is made up
of 1 to 11 air cells. It opens into the
anterior part of the hiatus semilunaris of
the nose.
It is supplied by the anterior ethmoidal
nerve and vessels.

(2)The middle ethmoidal sinus consisting of
1 to 7 air cells open into the superior
meatus of the nose.
It is supplied by the posterior ethmoidal
nerve and vessels and the orbital

(3)the posterior ethmoidal sinus consisting
of 1 to 7 air cells opens into the superior
meatus of the nose.
It is supplied by the posterior ethmoidal
nerve and vessels and the orbital

resonatory system along with structure and function

resonatory system along with structure and function

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