The pharynx is a fibromuscular tube that extends from the base of the skull to the lower border of the cricoid cartilage. It consists of three constrictor muscles and has three parts: the nasopharynx, oropharynx, and laryngopharynx. The nasopharynx opens anteriorly to the nose and contains structures like the adenoid, eustachian tube openings, and fossa of Rosenmuller. The adenoid is lymphoid tissue that increases in size until age 6 and decreases by age 20. Adenoid hypertrophy can cause mouth breathing and require adenoidectomy.

1. PHARNYX

3. • Pharynx is a fibromuscular tube that extends from base of skull to level of 6th
cervical vertebra at lower border of cricoid cartilage
• Its Funnel shaped (10cm in length)
• Consists of 3 constrictor muscles namely
1. superior constrictor muscle
2. Middle constrictor muscle
3. Inferior constrictor muscle

4. INFERIOR CONSTRICTOR MUSCLE – 2 parts
a.Oblique fibers- Thyropharyngeus(TP)
b.Circular fibers- Cricopharyngeus(CP)
KILLIAN’S DEHISCENCE(KD)
 It’s a triangular area in between Thyropharyngeus and Cricopharyngeus
 It has no muscle, due to this consider as weaker area- site of ZENKER’S
DIVERTICULUM

5. SINUS OF MORGANI(SOM)
 Space between the skull base and upper border of superior constrictor muscle
 Eustachian tube and Tensor veli palatini or Tensor palati muscle passes through
this SOM

6. PHARYNX – Has 3 parts
 NASOPHARYNX
 OROPHARYNX
 LARYNOPHARYNX
1.NASOPHARYNX
• Opens ANTERIORLY to the nose
• ABOVE: Base of skull
• BELOW: Soft palate

7. LATERALLY:
1. Opening of EUSTACHIAN TUBE
2. TORUS TUBARIUS- Elevated edge of ET opening
3. FOSSA OF ROSENMULLER/ PHARNGEAL RECESS
• Depression in pharyngeal wall behind torus tubarius
• Site of origin Nasopharyngeal carcinoma
• So , if adult smoker patient complaints of nasal obstruction, very important to
examine nasopharynx
4. Adenoid
5.Nasopharyngeal Isthmus

8. ADENOID
• Its also called Nasopharyngeal tonsil (present at birth)
• Its collection of lymphoid tissue in superior aspect of nasopharynx
medial to Eustachian tube orifices
• It don’t have capsule, crypts, definite blood supply
• Increases size upto 6 years of age and start decreasing in size at
puberty, disappear by 20 years of age

9. Adenoid Hypertrophy
• Due to recurrent upper Respiratory infection
Clinical features:
• Mouth Breathing child
• Adenoid Face(open mouth, pinch nose, High arched palate, Malocclusion of
teeth)
• Rhinolalia clausa
• Serous otitis media- CHL (mostly Bilateral)

10. Treatment:
• Surgery- Adenoidectomy

11. ANGIOFIBROMA/ JUVENILE
NASOPHARYNGEAL ANGIOFIBROMA

12. • Clinical feature: present with nasal mass, profuse epistaxis
• Investigation: cect - Hollmann miler sign
• Treatment: surgical