Lectures in head and neck anatomy

1. The pharynx
Musculofascial half-
cylinder that links the
oral and nasal cavities
in the head to the larynx
and esophagus in the
neck
From base of the skull
to the level of C6
Nasopharynx:
(choanae) nasal cavities
Oropharynx:
(oropharyngeal isthmus)
oral cavity
Laryngopharynx:
(laryngeal inlet) larynx

2. Attachments
of the pharynx
Base of the
skull: irregular
C-shaped
The open part
of the C faces
the nasal
cavities.
Each arm of
the C begins
at the
posterior
margin of the
medial plate
of the
pterygoid
process of the
sphenoid
bone, just
inferior to the
cartilaginous
part of the
pharyngotymp
anic tube.
The line crosses inferior to the pharyngotympanic tube
and then passes onto the petrous part of the temporal bone
where it is just medial to the roughening for the attachment of
levator veli palatini
From here, the line swings medially onto the occipital bone
and joins the line from the other side at a prominent elevation
of bone in the midline (the pharyngeal tubercle).

3. Anterior vertical line of attachment for the lateral
pharyngeal walls (1st)
Begins superiorly on
the posterior edge of
the medial pterygoid
plate of the sphenoid
bone just inferior to
where the
pharyngotympanic
tube lies against this
plate.
Continues inferiorly
along the edge of the
medial plate of the
pterygoid process and
onto the pterygoid
hamulus.
Descends along the
pterygomandibular
raphe to the mandible
where this part of the
line terminates

4. Anterior vertical line of attachment for the lateral
pharyngeal walls (2nd)
Begins on the
lower aspect of the
stylohyoid
ligament,
The line continues
onto the lesser
horn and then
turns and runs
posteriorly along
the entire upper
surface of the
greater horn of the
hyoid

5. Anterior vertical line of attachment for the lateral
pharyngeal walls (3rd)
Begins superiorly
on the superior
tubercle of the
thyroid cartilage
Descends along
the oblique line to
the inferior
tubercle.
Continues over the
cricothyroid
muscle along a
tendinous
thickening of fascia
to the cricoid
cartilage where it
terminates

6. Muscles of the pharynx
Superior constrictor:
Origin: Pharyngeal
raphe
Insertion:
Pterygomandibular
raphe and adjacent
bone on the
mandible and
pterygoid hamulus
NS: pharyngeal
branch of vagus
Action:
Constriction of
pharynx
- Palatopharyngeal sphincter: A special band of
muscle originates from the anterolateral surface of the
soft palate and circles the inner aspect of the
pharyngeal wall, blending with the inner aspect of the
superior constrictor

7. Muscles of the pharynx
Middle constrictor:
Origin: Pharyngeal
raphe
Insertion: Upper
margin of greater
horn of hyoid bone
and adjacent
margins of lesser
horn and stylohyoid
ligament
NS: pharyngeal
branch of vagus
Action:
Constriction of
pharynx

8. Muscles of the pharynx
Inferior constrictor:
Origin: Pharyngeal
raphe
Insertion: Cricoid
cartilage, oblique
line of thyroid
cartilage, and a
ligament that spans
between these
attachments and
crosses the
cricothyroid muscle
NS: pharyngeal
branch of vagus
Action:
Constriction of
pharynx

9. Pharyngeal raphe:
From the pharyngeal
tubercle on the base of the
skull to the level of C6
where the raphe blends
with connective tissue in
the posterior wall of the
esophagus
- Fascia:
Buccopharyngeal fascia:
thin layer coats the outside
of the muscular part of the
wall (component of the
pretracheal layer of
cervical fascia)
Pharyngobasilar fascia:
a thick layer lines the inner
surface of pharynx

10. Muscles of the pharynx
Stylopharyngeus:
Origin: Medial side
of base of styloid
process
Insertion:
Pharyngeal wall
NS:
Glossopharyngeal
nerve
Action: Elevation
of the pharynx

11. Muscles of the pharynx
Salpingopharyngeus:
Origin: Inferior
aspect of pharyngeal
end of
pharyngotympanic
tube
Insertion:
Pharyngeal wall
NS: Vagus nerve
Action: Elevation of
the pharynx

12. Muscles of the pharynx
Palatopharyngeus:
Origin: Upper
surface of palatine
aponeurosis
Insertion:
Pharyngeal wall
NS: Vagus nerve
Action: Elevation of
the pharynx; closure
of the oropharyngeal
isthmus

13. Gaps in the
pharyngeal wall

14. The nasopharynx
Behind the posterior
apertures (choanae)
of the nasal cavities
Above the level of the
soft palate
Ceiling: base of the
skull and consists of
the posterior part of
the body of the
sphenoid bone and
the basal part of the
occipital bone
Continuous below
with the cavity of the
oropharynx at the
pharyngeal
isthmus. (marked on
the pharyngeal wall
by a mucosal fold
caused by the
underlying
palatopharyngeal
sphincter)
Pharyngeal tonsils: large collection of lymphoid
tissue in the mucosa covering the roof of the
nasopharynx. enlargement of this tonsil, is
known as adenoids

15. The nasopharynx
Opening of the
pharyngotympanic
tube: posterior to and
slightly above the level
of the hard palate, and
lateral to the top of the
soft palate.
Torus tubarius:
posterior rim of the
opening of the
pharyngotympanic tube
(elevation or bulge on
the pharyngeal wall).
Pharyngeal recess:
(deep) Posterior to torus
tubarius
Salpingopharyngeal fold: small vertical, descends from the tubal
elevation and overlies salpingopharyngeus muscle
Torus levatorius: a broad fold or elevation that emerge from just under the
opening of the pharyngotympanic tube, overlies the levator veli palatini
muscle

16. The oropharynx
Posterior to the oral
cavity, Inferior to the
level of the soft palate
Superior to the upper
margin of the epiglottis
Oropharyngeal
isthmus: boundary
between the oral cavity
and the oropharynx
(palatoglossal
muscles)
Palatopharyngeal
arches: posterior and
medial to palatoglossal
arches
The anterior wall of
the oropharynx inferior
to the oropharyngeal
isthmus is posterior
one-third or
pharyngeal part of the
tongue
(lingual tonsils)
The palatine tonsils: large ovoid collection of lymphoid tissue in the
mucosa lining the superior constrictor muscle and between the palatoglossal
and palatopharyngeal arches on the lateral walls of the oropharynx

17. The laryngopharynx
Extends from the
superior margin of
the epiglottis to
the top of the
esophagus at the
level of C6
The laryngeal inlet
opens into the
anterior wall of the
laryngopharynx.
Inferior to the
laryngeal inlet, the
anterior wall
consists of the
posterior aspect
of the larynx
Valleculae: pair
of mucosal
pouches anterior
to the cavity of the
laryngopharynx
(between the
base of the
tongue and
epiglottis).

18. The laryngopharynx
The valleculae are
depressions formed
between a midline
mucosal fold and two
lateral folds that
connect the tongue to
the epiglottis
Piriform fossae: pair
of mucosal recesses
between the central
part of the larynx and
the more lateral
lamina of the thyroid
cartilage.
- Form channels that
direct solids and
liquids from the oral
cavity around the
raised laryngeal inlet
and into the
esophagus

20. Blood supply
of the pharynx
Ascending
pharyngeal
artery
Ascending
palatine and
tonsillar
branches of the
facial artery
Branches of
the maxillary
and the lingual
arteries
Pharyngeal
branches from
the inferior
thyroid artery

21. Pharyngeal plexus
Formed by:
Pharyngeal branch
of the vagus nerve
Branches from the
external
laryngeal nerve
from the superior
laryngeal branch
of the vagus
Pharyngeal
branches of the
glossopharyngeal
nerve
Motor: All muscles of the pharynx are innervated by the vagus nerve [X],
except for the stylopharyngeus, which is innervated by glossopharyngeal nerve
Sensory:
Oropharynx and laryngopharynx: glossopharyngeal nerve
Nasopharynx: pharyngeal branch of maxillary
Nerve supply of the pharynx