Hyphopharynx

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 bone above
• to that of the lower border of the cricoid
cartilage below.
• Lies opposite the 4th
5th 6th cervical vertebrae

4. Subdivisions of hypopharynx
 Pyriform sinus
 Post cricoid region
 Posterior pharyngeal wall

5. Pyriform fossa
 Lies on either side of larynx
 Extends from pharyngo epiglottic
fold to the upper end of oesophagus
Boundaries
 Superiorly- pharyngo epiglottic fold
 Laterally – thyrohyoid membrane & thyroid cartilage
 Medially – aryepiglottic fold ,posterolateral suface of
arytenoid & cricoid cartilages
 Inferiorly – continues as esophagus

6. ..pyriform fossa

7. ..pyriform fossa
 Also known as 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 the sinus- accessible for
local anesthasia
 Referred otalgia in pyriform
fossa malignancy

8. ..pyriform fossa

9. Post cricoid region
 Part of anterior wall of laryngopharynx between the
upper and lower border of cricoid cartilage
 It is the common site for ca in females with
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
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
Sup.constrictor
mid.constrictor
inf.constrictor
 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’s diverticulum
 Failure of cricopharyngeal sphincter relaxation when
pharyngeal muscles are contracting
 Pharyngeal mucosa herniates through killian’s
dehiscence- week area between two parts of inferior
constrictor muscle
 Gateway of tears- perforation can occur at this site
during oesophagostomy.

13. zenker’s diverticulum

14. Lymphatic drainage
 Pyriform sinus- richly supplied by lymphatics
(so nodal mets are common in ca pyriform fossa)
- Lymphatics exit through the thyrohyoid membrane
and drain into the upper jugular chain
 Post cricoid region- drain into para pharyngeal
lymph nodes
-Also drain into supraclavicular and para tracheal
nodes
 Posterior pharyngeal wall- lateral or para pharyngeal
nodes and then to deep cervical nodes

15. ..lymphatic drainage

16. Larynx and laryngopharynx

17. Video laryngoscopy