Download pharynx

It is a fibro 
muscular tube
that lies behind:
Nose. 
Mouth. 
Larynx. 
It extends from :
Base of the skull
To 
6th cervical 
vertebra.

It is Funnel shaped. 
It has: 
Upper expanded end
that lies under the
skull
and 
A narrow lower end 
that becomes 
continuous with the
Esophagus.

Posterior: 
Prevertebral muscles
and fascia.
Lateral: 
(1) Auditory tube. 
(2) Styloid process 
and its muscles.

(3) Carotid 
sheath and its
contents.
(4) Thyroid 
gland.
It is deficient. 
It is replaced by: 
Posterior nasal 
openings.
Oropharyngeal 
isthmus.
Inlet of the larynx.

1. Mucosa : 
Continuous with that of
the nose ,auditory tube,
oral cavity , larynx and
esophagus.
2. Fascia: Thickened 
Internally: 
Paryngobasilar fascia.
Externally: 
Buccopharynge fascia.
3. Muscles : circular & 
longitudinal.

CONSTRICTORS: 
Superior. 
Middle. 
Inferior. 
They propel the bolus of 
food down into the
esophagus.
They overlap like three 
glasses stacked one inside
the other.
Each one fans out from
its anterior attachment
and passes posteriorly
around the pharynx.
They join each other in
the:
Pharyngeal Raphe 
A fibrous midline raphe
which extends from
the occipital bone to
the esophagus.



It is the lowest fibers of 
the inferior constrictor
muscle.
Action : 
1. A sphincter on the 
lower end of the
pharynx.
2. Prevents the entry of 
air into the esophagus in
between swallowing.
Stylopharyngeus. 
Salpingopharyngeus. 
Palatopharyngeus. 
Origins : 
Styloid process . 
Pharyngotympanic tube.
Soft palate. 

Insertion: 
To the pharyngeal 
wall.
Action: 
1. Elevate the larynx 
and pharynx.
2. Pull the pharynx 
forward during
swallowing and
speaking.
(1) Between: 
Base of the skull
and the superior
constrictor :
Pharyngobasilar
fascia.
Tensor palati. 
Levator palati. 


(2) Between: 
Superior and Middle 
constrictors:
It is a triangular gape . 
It allows : 
A. muscles, vessels & 
nerves to pass between
the tongue and regions
lateral to pharynx.
B. Stylopharyngeus tendon
to slip into the pharynx.
(3) Between: 
Middle & Inferior 
constrictors:
Internal laryngeal 
nerve & superior
laryngeal vessels.
(4) Below: 
Inferior constrictor: 
The recurrent laryngeal
nerve &inferior
laryngeal vessels.

LARYNGO
PHARYNX
NASO
PHARYNX
OROPHARYNX
It has a respiratory 
function.
It is Behind the posterior
nasal openings
(Choanae)
AND 
Above the Soft palate. 

Roof: 
Basilar part of 
occipital bone.
Body of sphenoid. 
It has 
A collection of 
lymphoid tissue
(pharyngeal tonsil)
in its submucosa.

Floor : 
Sloping upper surface
of the soft palate.
Posterior wall: 
Anterior arch of atlas.
Anterior : 
Choanae. 


It is a gap in the floor 
between the free end of
the soft palate and the
posterior wall.
It is closed in 
swallowing by the
elevation of the soft
palate and pulling
forward of the posterior
wall.
Lateral wall : 
1. Pharyngeal opening 
of the auditory tube.
2.Tubal elevation: 
The elevated posterior 
margin of the tube.
Pharyngeal Recess : 
It is a slit like 
depression on each side
behind the tubal
elevation.
3. Salpingo-pharyngeal
fold of mucous
membrane produced by
the salpingopharyngeal
muscle.
4.Tubal tonsil: 
It is a collection of 
lymphoid tissue behind
the opening of the
auditory tube.

Hypertrophy and infection 
of the pharyngeal tonsils.
It causes: obstruction of 
the posterior nasal
openings.
The patient: breathes 
through the mouth and
snores loudly at night.
It can cause: deafness 
and recurrent otitis media
due to its close relation to
the auditory tube.
It is behind the mouth 
cavity.
It extends from: 
Soft palate 
TO 
The upper border of the
Epiglottis.

Roof : 
It is the under surface
of the soft palate and
the pharyngeal
isthmus.
It has collection of 
lymphoid tissue.

Floor : 
Posterior 1/3 of the 
tongue & the interval
between the tongue and
the anterior surface of
the epiglottis.
Lingual tonsil : 
A collection of lymphoid
tissue on the posterior
1/3 of the tongue.

Lateral wall : 
Palatoglossal arch 
A mucous fold overlying 
the palatoglossal muscle.
It marks the boundary 
between the oral cavity
and the oropharynx.
The arched opening 
between the two folds is
the Oropharyngeal
isthmus.
Palato-pharyngeal 
arch
A mucous fold behind 
the palatoglossal arch.
It overlies the 
palatopharyngeal
muscle.
Anterior : 
It opens into the 
mouth cavity through
the oropharyngeal
isthmus.
Posterior wall : 
Body of 2nd cervical 
vertebra.
The upper part of the
body of the 3rd
vertebra.

Two oval bodies of lymphoid 
tissue.
They have their maximum 
size in childhood.
They lie on each side in the 
tonsilar sinus in the lateral
wall of the oropharynx
between the palatoglossal
arches (anterior) and
palatppharyngeal arches
(posterior)
They lie on the 
mucosa lining the
Superior Constrictor
muscle.
The capsule is 
separated from the
superior constrictor
muscle by loose
fascia.
This fascia contains: 
The External palatine 
vein.
The Facial artery is 
lateral to the muscle.
The Internal carotid 
artery lies about 1’’ (2.5)
cm behind and lateral to
the tonsil.
Superior: 
Soft palate. 
It is continuous with the
lymphoid tissue on its
undersurface .
Inferior : 
Posterior third of 
tongue.
It is continuous with the
lingual tonsil.


Arterial : 
Tonsillar arteries from : 
Facial. 
Ascending palatine. 
Venous Drainage: 
External palatine vein.
Pharyngeal venous plexus.
Pharyngeal and Facial veins.

Juglodigastric 
nodes:
Below and behind
mandible.

Glossopharyngeal
nerve supplies its
mucosa.

The tonsils are a 
common site of
infection.
Sore throat , Pyrexia 
and Tender Enlarged
juglodigastric lymph
nodes.
After tonsilectomy 
The external palatine 
vein may be the source
of postoperative
bleeding.
It is a Peritonsilar 
abscess.
It is due to the spread
of infection from the
palatine tonsil to the
loose connective
tissue outside the
capsule.

It extends from: 
The upper border of
the epiglottis and
pharyngoepiglottic
fold
TO 
The lower border of
the cricoid
cartilage(C6).


Anterior : 
Inlet of the larynx. 
Posterior wall: 
Bodies of 3rd , 4th ,5th
and 6th cervical
vertebrae.
Lateral wall: 
Thyroid cartilage. 
Thyrhyoid membrane.

Pair of mucosal 
pouches anterior to the
cavity of
laryngopharynx.
They are between: 
The base of the tongue
AND 
The epiglottis. 
One on each side 
between the median
and lateral
glossoepiglottic folds.

Pair of mucosal 
recesses.
Between: 
medially 
The central part of the
larynx from which it is
separated by the
aryepiglottic fold.
laterally 
The thyroid cartilage 
and thyroyhyoid
membrane.

Function: 
It is an important channel
that directs solids and
liquids from the oral
cavity around the raised
laryngeal inlet into the
esophagus.
A foreign body in the 
fossa causes the patient
to gag violently.

Nerves related: 
Branches of internal &
recurrent Laryngeal
nerves lie deep to its
mucous membrane.
Nerve injury: 
They are liable to be 
injured when a foreign
body ( bony fish) is
lodged in the fossa.

The following arteries
supply the pharynx :
1. Ascending 
pharyngeal.
2. Ascending palatine.
3. Facial. 
4. Maxillary. 
5. Lingual. 


The pharynx is drained
through the Pharyngeal
venous plexus.
The plexus drains:
Superiorly: into the
Pterygoid venous plexus.
Inferiorly: into the facial
and internal jugular
veins.
Most of the Motor and
sensory supply of the
pharynx is through
nerves which form the
pharyngeal plexus.

Formed from: 
Pharyngeal branches
of the Vagus.
Branches from 
External laryngeal
nerve (from superior
laryngeal).
Pharyngeal branches
of Glossopharyngeal.
Sympathetic fibers 


The only muscle of the 
pharynx which is
innervated directly by a
branch of the
Glossopharyngeal nerve.

Nasopharynx : 
pharyngeal branch of
Maxillary nerve.
Laryngopharynx: 
pharyngeal plexus
(Vagus nerve).
Oropharynx : 
pharyngeal plexus
(Glossopharyngeal
nerve).
Direct to: 
Deep cervical nodes. 
Indirect to : 
Retropharyngeal. 
Paratracheal nodes. 
The lymphoid tissue of 
the pharynx is generally
enlarged in childhood.






1. The palatine tonsils:
a. Related to the superior constrictor of the
pharynx.
b. Borderd anteriorly by the palatoglossus
muscle.
c. Receives some of its blood supply from the
facial artery.
d. Lies in the oral cavity.
e. The internal carotid artery is at its lateral side.
2. Each of the following is related to the 
walls of the laryngeal part of the pharynx
EXCEPT:
a. Piriform fossa. 
b. Cricoid cartilage. 
c. Thyrohyoid membrane. 
d. Thyroid cartilage. 
e. Palatine tonsil

3. The pharynx: 
a. Extends from the base of the skull to the 4th
cervical vertebra.
b. It is supported externally by the 
pharyngobasilar fascia.
c. It is related posteriorly to the prevertebral 
fascia.
d. It is related anteriorly to the pretracheal 
fascia.
e. Its muscles have motor supply from the 
pharyngeal plexus

4. The inferior constrictor muscle of the
pharynx has nerve supply from:
a. Accessory nerve. 
b. Hypoglossal nerve. 
c. Internal laryngeal nerve. 
d. Pharyngeal plexus. 
e. Ansa cervicalis.


5. The piriform fossa is: 
a. Located above the pharyngeal tonsil. 
b. Located within the pharyngobasilar fascia. 
c. Located on each side of the larynx. 
d. Located posterior to the salpingopharyngeal
fold.
e. Related laterally to the cricoid cartilage. 

6. Structures entering the pharynx between
the superior and middle constrictor muscles
are:
a. Recurrent laryngeal nerve. 
b. Internal laryngeal nerve. 
c. Glossopharyngeal nerve. 
d. Superior laryngeal artery. 
e. Inferior laryngeal artery. 

7. The middle constrictor muscle: 
a. Lies inner to the superior constrictor. 
b. Attached anteriorly to the pharyngeal raphe. 
c. The internal laryngeal nerve is between it and
the inferior constrictor.
d. The stylopharyngeus muscle passes between
it and the superior constrictor.
e. Propels the bolus of food down into the 
esophagus.


8. Palatine tonsil: 
a. Its lymph drainage is to the submandibular
lymph nodes.
b. Lies in the oral cavity. 
c. Lies on the middle constrictor. 
d. The palatopharyngeal arch is anterior to it.
e. Its venous blood drain into the external 
palatine vein.


9. Interior of the pharynx: 
a. Receives a sensory innervation from the 
maxillary nerve.
b. Has the palatine tonsil in the lateral wall. 
c. Has an anterior extension on each side of the
larynx known as the vallecula.
d. Has a ridge formed by the salpingopharyngeus
muscle.
e. The pharyngeal tonsil is a collection of 
lymphoid tissue on its roof.


10. The following arteries supply the
pharynx EXCEPT:
a. Ascending palatine. 
b. Sphenopalatine. 
c. Ascending pharyngeal. 
d. Lingual. 
e. Maxillary. 
