Prof .Saeed Makarem
DEFINATION
It is a muscular tube
that extends from
the base of the skull
to the 6th cervical
vertebra.
It is continuous
below with the
esophagus.
It is funnel shaped with
an upper expanded
end and a narrow
lower end
Prof. Saeed Makarem
SUBDIVISIONS
It lies behind the nose,
mouth and larynx.
It communicates with
each of them.
It is divided into 3 parts:
Nasopharynx.
Oropharynx.
Laryngopharynx.
So, Its anterior wall is deficient
where it is related to nose,
mouth & larynx.
Prof. Saeed Makarem
RELATIONS
Posteriorly:
It lies infront of the
prevertebral muscles and
fascia.
Laterally :
It is related from above
downward to:
1-Auditory tube.
2-Styloid process and its
muscles.
3-Carotid sheath and its
contents.
4-Thyroid gland
Prof .Saeed Makarem
STRUCTURE OF
THE WALL
From inwards outwards
1-Mucous membrane:
It is continuous with that of the
Nose,
Oral cavity,
Auditory tube,
Larynx ,esophagus.
2- Pharyngobasilar fascia.
3- Muscles.
4- Buccopharyngeal fascia
The 2 layers of Fascia:
It is thickened internally to
form the Pharyngobasilar
fascia and externally to
form Buccopharyngeal
MUSCLES OF PHARYNX
NAME
ORIGIN
INSERTION
ACTION
NERVE
Superior constrictor
Medial pterygoid plate,
pterygoid hamulus,
pterygoamndibular raphe,
mylohyoid line
Pharyngeal
tubercle,
pharyngeal raphe
Constricts the
pharynx
Vagus nerve
through the
pharyngeal plexus
Middle constrictor
Greater & lesser horns of
hyoid bone & Stylohyoid
ligament
pharyngeal raphe
Constricts the
pharynx
Vagus nerve
through the
pharyngeal plexus
Inferior constrictor
Arch of cricoid cartilage &
oblique line of thyroid
cartilage
pharyngeal raphe
Constricts the
pharynx
Vagus nerve
through the
pharyngeal plexus
Salpingeopharyngeus
Cartilage of auditory tube
Lateral wall of
pharynx
Elevate the
pharynx in
swallowing
Vagus nerve
through the
pharyngeal plexus
Palatopharyngeus
Posterior border of the hard
palate & palatine
aponeurosis
Thyroid cartilage,
lateral wall of
pharynx
Elevate the
pharynx in
swallowing
Vagus nerve
through the
pharyngeal plexus
Stylopharyngeus
Styloid process
Thyroid cartilage
Elevate the
pharynx in
swallowing
Glossopharyngeal
nerve
Longitudinal
Prof.Saeed Makarem
MUSCLES
Constrictors:
1- Superior.
2- Middle
3- Inferior.
Prof.Saeed Makarem
The three
constrictors
muscles overlap
each others like
segment of an
antenna.
Each one fans out
from its anterior
attachment and
passes
posteriorly
around the
pharynx
horizontally.
Prof.Saeed Makarem
CONSTRICTORS
Each muscle joins its
fellow of the opposite
side in a fibrous
midline
Pharyngeal raphe.
The raphe extends from
the pharyngeal tubercle
of the occipital bone to
the esophagus.
The constrictors propel
the bolus of food down
into the esophagus.
Prof. Saeed Makarem
CONSTRICTORS
The lowest fibers of the
inferior constrictor
forms the
Cricopharyngeus
muscle.
It has a sphincteric
action on the lower
end of the pharynx and
prevents the entry of
the air into the
esophagus in between
swallowing.
Prof.Saeed Makarem
LONGITUDINAL
MUSCLES
1-Stylopharyngeus.
2-Salpingeopharyngeus.
3-Palatopharyngeus.
They are attached to the
styloid process .
Auditory tube.
Soft palate.
They elevate the larynx and
pharynx and pulls the
palatopharyngeal arch
medially during
swallowing
Prof .Saeed Makarem
MOTOR
INNERVATION
All muscles of the 
pharyngeal are
supplied by the
pharyngeal plexus
Except the
Stylopharyngeus
which is supplied by
the glossopharyngeal
nerve.
Prof .Saeed Makarem
SENSORY INNERVATION
Nasopharynx:
5-Maxillary nerve.
Oropharynx:
9-Glossopharyngeal
Laryngopharynx:
10-Vagus nerve
Prof.Saeed Makarem
NASOPHARYNX
It has a respiratory
function.
It extends from skull
base to the soft
palate.
Boundaries:
Roof:
Basilar part of occipital
bone.
Body of sphenoid.
A collection of lymphoid
tissue lies in the
submucosa at the
junction of roof &
posterior wall.
it is called
pharyngeal tonsil
Prof.Saeed Makarem
NASOPHARYNX
Floor :
Sloping upper surface of
the soft palate.
Posterior wall:
Anterior arch of atlas.
Pharyngeal isthmus :
It is a gap in the floor
between the free end of
the soft palate and the
posterior wall of the
pharynx.
Prof. Saeed Makarem
NASOPHARYNX
LATERAL WALL:
it has:
1. Pharyngeal opening of
the auditory tube.
2.Tubal elevation:
The elevated posterior
margin of the tube.
3-Pharyngeal recess:
It is a slit like depression
behind the tubal
elevation.
Prof.Saeed Makarem
NASOPHARYNX
4.Salpingopharyngeal fold of
mucous membrane
produced by the
salpingopharyngeal
muscle.
5.Tubal tonsil
It is a collection of
lymphoid tissue
behind the opening of
the auditory tube.
Prof.Saeed Makarem
ADENOID
Repeated infection of the
pharyngeal tonsils leads
to its hypertrophy
Now it is called
adenoids.
It causes obstruction of
the posterior nares.
The patient breathes
through his mouth and
snores.
It can cause deafness and
recurrent otitis media
due to its close relation
to the auditory tube.
Prof . Saeed Makarem
OROPHARYNX
It has a digestive function.
It lies behind the mouth
cavity and extends from
the soft palate to the
upper border of the
epiglottis.
Roof :
It is the under surface of
the soft palate and the
pharyngeal isthmus.
Prof. Saeed Makarem
OROPHARYNX
Floor :
It is the posterior one third
of the tongue and the
interval between the
tongue and the anterior
surface of the epiglottis.
Lingual tonsil :
A collection of lymphoid
tissue on the posterior
third of the tongue.
Prof .Saeed Makarem
OROPHARYNX
The tongue is connected
to the epiglottis by one
median and two
lateral
glossoepiglottic
folds.
VALLECULA :
It is a depression on each
side of the of the
median glossoepiglottic
fold.
Prof.Saeed Makarem
OROPHARYNX
Anterior wall :
It opens into the mouth
cavity through the
oropharyngeal isthmus.
Posterior wall :
Body of 2nd cervical
vertebra and the upper
part of the body of the
3rd vertebra.
Prof.Saeed Makarem
OROPHARYNX
Lateral wall :
Palatoglossal arch
It is a mucous fold
overlying the
palatoglossal muscle.
Palatopharyngeal arch
It is a mucous fold
behind the
palatoglossal arch.
The interval between the
two palatopharyngeal
arches is the
Prof .Saeed Makarem

Oropharyngeal isthmus

PALATINE TONSIL
It occupies the
(Tonsillar
Bed).
Which is the
interval
between the
palatoglossal &
palatopharyngeal
Prof.Saeed Makarem
PALATINE TONSIL
Structure :
It is an oval body of
lymphoid tissue.
It has an upper and
lower poles.
Its deep surface is
attached to a fibrous
capsule.
Prof.Saeed Makarem
PALATINE TONSIL
RELATIONS :
Lateral:
superior constrictor muscle and
fascia.
The external palatine vein lies
within this fascia.
The facial artery is more lateral.
Medial :
Oropharyngeal isthmus.
Prof.Saeed Makarem
PALATINE TONSIL
Superior:
Soft palate.
Here the tonsil is
continuous with the
lymphoid tissue on
its undersurface .
Inferior :
Posterior third of
tongue.
It is continuous with
the lingual tonsil.
Prof.Saeed Makarem
PALATINE TONSIL
Arterial Supply :
Tonsillar branch of facial
artery.
Tonsillar branch of ascending
palatine.
The arteries enter its deep
surface.
Venous Drainage:
The veins pierces the superior
constrictor and join the
external palatine, the
pharyngeal and or the facial
veins vein.
PALATINE
TONSIL
Lymph Drainage:
Jugulodigastric
nodes
(which lies below and
behind the angle of
the mandible).
Prof .Saeed Makarem
TONSILITIS
The tonsils have their
maximum size in
childhood.
They are a common site
of infection.
This is manifested by sore
throat ,pyrexia and
tender enlarged
jugulodigastric
lymph
nodes.
After tonsillectomy ,the
external palatine vein
may be the source of
postoperative bleeding.
Prof.Saeed Makarem
PERITONSILAR ABSCESS
QUINSY
It is caused by the
spread of infection
from the palatine
tonsil to the loose
connective tissue
outside the capsule.
Prof. Saeed Makarem
LARYNGOPHARYNX
It extends from the
upper border of the
epiglottis to the
lower border of the
cricoid cartilage (C6).
Anterior wall:
Inlet of the larynx.
Posterior wall:
Bodies of 3rd , 4th ,5th
and 6th cervical
vertebrae.
Prof. Saeed Makarem
LARYNGOPHARYNX
Lateral wall:
Thyroid cartilage.
Thyrohyoid
membrane.
Prof .Saeed Makarem
PIRIFORM FOSSA
It is a small
depression on
either side of
the laryngeal
inlet.
It is separated
from the
laryngeal inlet
by the
Aryepiglottic
fold.
Prof .Saeed Makarem
PIRIFORM FOSSA
It is bounded Laterally
by the thyroid cartilage
and thyrohyoid
membrane.
Branches of the internal
laryngeal and
recurrent Laryngeal
nerves lie deep to its
mucous membrane.
Prof. Saeed Makarem
PIRIFORM
FOSSA
They are liable to be
injured when a foreign
body ( bony fish) is
lodged in the fossa.
A foreign body in the
fossa causes the
patient to gag violently,
and needs a physician’s
assistance
Prof .Saeed Makarem