hypopharynx

1. Dr Saheena N

2. PHARYNX
 It is a funnel shaped fibro-muscular tube of about 13 cm . length
 It extends form the base of the skull to the level of the 6th cervical vertebrae.
 Its anterior wall is deficient and lies behind the cavities of the nose, mouth and larynx
 Accordingly it is divided into 3 parts: Nasopharynx , oropharynx & laryngeopharynx .
a)Base of skull
(basioociput and basi
sphenoid) soft palate
b)Plane of hard palate
hyoid bone
c) Hyoid bone lower
border of cricoid
cartilage
Nasopharynx
Oropharynxx
Larygeopharynx

3. Hypopharynx/laryngopharynx
The hypopharynx extend
• from the level of the hyoid boneabove
•to that of the lower borderof the cricoid
cartilage below.
•Lies opposite the 4th 5th
6th cervical vertebrae

4. Subdivisions of hypopharynx
⚫Pyriform sinus
⚫Postcricoid region
⚫Posteriorpharyngeal wall

5. Pyriform fossa
⚫Lies on eithersideof larynx
⚫ Extends from pharyngo epiglottic
fold to the upperend of oesophagus
Boundaries
⚫Superiorly- pharyngoepiglottic fold
⚫Laterally – thyrohyoid membrane & thyroid cartilage
⚫Medially – aryepiglottic fold ,posterolateral sufaceof
arytenoid & cricoid cartilages
⚫Inferiorly – continuesas esophagus

6. ..pyriform fossa

7. ..pyriform fossa
⚫Also knownas smuggler’s fossa
⚫Forms the lateral channel for food
⚫Foreign bodies may lodge in the PF
⚫Internal laryngeal nerve –runs submucosally in the
lateral wall of thesinus- accessible for
local anesthasia
⚫ Referred otalgia in pyriform
fossa malignancy

8. ..pyriform fossa

9. Post cricoid region
⚫Part of anteriorwall of laryngopharynx between the
upperand lower borderof cricoid cartilage
⚫It is thecommon site forca in femaleswith
plummer –vinson syndrome

10. Posterior pharyngeal wall
⚫ Extends from the level of hyoid bone to the
level of cricoarytenoid joint
⚫The posterior hypo pharyngeal
wall continuates the posterior
oropharynx wall;
⚫It is composed of mucosa and
the constrictor muscle.
Smooth bulge of posterior pharyngeal wall
with intact mucosa
due to retropharyngeal malignancy.

11. WALLS OF THE PHARYNX
Sup.constrictor
mid.constrictor
inf.constrictor
Consists of the following from within outwards:
1. Mucous coat lined by stratified squamous epithelium.
2. Inner fibrous coat (pharyngo-basilar fascia).
3. Muscular coat.
4. Outer fibrous coat (buccopharyngeal fascia).
Muscles of the pharynx
 Outer circular layer:
3 constrictors of the pharynx.
 Inner longitudinal layer:
3 longitudinal muscles.
Constrictors of the pharynx.
1- Sup.constrictor
2- mid.constrictor
N.B. All muscles of pharynx take nerve supply from pharyngeal plexus except stylopharyngeus
from glossopharyngeal nerve
3- inf.constrictor
longitudinal muscles.
1 Stylo-pharyngeus
2Salpingo – pharyngeus
3-Palato-pharyngeus:

12. Hypopharyngeal diverticulum
⚫Zenker’sdiverticulum
⚫Failureof cricopharyngeal sphincterrelaxation when
pharyngeal musclesare contracting
⚫Pharyngeal mucosa herniates through killian’s
dehiscence- week area between twoparts of inferior
constrictor muscle
⚫Gatewayof tears- perforation can occurat this site
during oesophagostomy.

13. zenker’s diverticulum

14. Lymphatic drainage
⚫Pyriform sinus- richly supplied by lymphatics
(so nodal metsarecommon in ca pyriform fossa)
- Lymphaticsexit through the thyrohyoid membrane
and drain into the upper jugularchain
⚫Postcricoid region- drain into parapharyngeal
lymph nodes
-Alsodrain intosupraclavicularand para tracheal
nodes
⚫Posteriorpharyngeal wall- lateral orpara pharyngeal
nodesand then todeepcervical nodes

15. ..lymphatic drainage

16. Larynx and laryngopharynx

17. Video laryngoscopy