The PharynxThe Pharynx

R. Shane Tubbs, MS, PA-C, PhDR. Shane Tubbs, MS, PA-C, PhD

Four LayersFour Layers

Mucous membraneMucous membrane Pharyngobasilar fasciaPharyngobasilar fascia Muscle layerMuscle layer Buccopharyngeal fasciaBuccopharyngeal fascia

MusclesMuscles Inner longitudinal: Inner longitudinal:

stylopharyngeus, stylopharyngeus, palatopharyngeus, palatopharyngeus, salpingopharyngeussalpingopharyngeus

Outer circular layer: Outer circular layer: pharyngeal pharyngeal constrictorsconstrictors

StylopharyngeusStylopharyngeus

Constrictor AttachmentsConstrictor Attachments

SPC: hamulus, pterygomandibular raphe, SPC: hamulus, pterygomandibular raphe, mylohyoid line, pharyngeal tubercle mylohyoid line, pharyngeal tubercle (insertion)(insertion)

MPC: > and < cornu of hyoid, stylohyoid MPC: > and < cornu of hyoid, stylohyoid ligamentligament

IPC: thyroid cartilage and cricoid cartilage IPC: thyroid cartilage and cricoid cartilage (cricopharyngeus) (cricopharyngeus)

Superior ConstrictorSuperior Constrictor

NervesNerves

Motor IX (stylopharyngeus), XMotor IX (stylopharyngeus), X Sensory: V2 superior to Eustachian tube, IX Sensory: V2 superior to Eustachian tube, IX

between ET and laryngeal inlet, and X between ET and laryngeal inlet, and X inferior to laryngeal inletinferior to laryngeal inlet

Pharyngeal plexus: Ph. Branch of X-SVE, Pharyngeal plexus: Ph. Branch of X-SVE, Ph. Branch of IX-GVA, Ph. Branch of Ph. Branch of IX-GVA, Ph. Branch of Superior cervical sympathetic ganglion Superior cervical sympathetic ganglion (GVE)(GVE)

Arteries, Veins, LymphaticsArteries, Veins, Lymphatics

Ascending pharyngeal, superior and inferior Ascending pharyngeal, superior and inferior thyroid arteriesthyroid arteries

Pharyngeal venous plexus drains into IJPharyngeal venous plexus drains into IJ Lymph into retropharyngeal and superior Lymph into retropharyngeal and superior

deep cervical nodes (jugulodigastric deep cervical nodes (jugulodigastric primarily for palatine tonsil)primarily for palatine tonsil)

Waldeyer’s ring (German anatomist, Waldeyer’s ring (German anatomist, 1836-1921)1836-1921)

NasopharynxNasopharynx

Borders: skull base, Borders: skull base, soft palate, left and soft palate, left and right nasal choana, right nasal choana, C1-C2C1-C2

Nasopharynx (Base-C2)Nasopharynx (Base-C2) Eustachian tubeEustachian tube Torus tubariusTorus tubarius Salpingopalatine foldSalpingopalatine fold Salpingopharyngeal Salpingopharyngeal

foldfold Pharyngeal recessPharyngeal recess Pharyngeal tonsilPharyngeal tonsil Tubal tonsilTubal tonsil Torus levatorius Torus levatorius

Oropharynx Oropharynx

Borders: soft palate, oropharyngeal isthmus, Borders: soft palate, oropharyngeal isthmus, epiglottis, C2-C3epiglottis, C2-C3

OropharynxOropharynx

Palatoglossal archPalatoglossal arch Palatopharyngeal Palatopharyngeal

arch- Passavant’s arch- Passavant’s ridgeridge

Palatine, lingual Palatine, lingual tonsilstonsils

IXIX Stylohyoid ligamentStylohyoid ligament

LaryngopharynxLaryngopharynx

Borders: epiglottis, cricoid cartilage, larynx, Borders: epiglottis, cricoid cartilage, larynx, C3(4) -C6C3(4) -C6

LaryngopharynxLaryngopharynx