The Oral Cavity and Pharynx
Principle function of the above are the followings:
‰Mastication- Grinding the food.
‰Deglutition- Movement of bolus of food to the Pharynx
‰Swallowing- Movement of bolus of food down Pharynx and Esophagus
Walid Bermani M.D.,Ph.D.
Associate Professor of Clinical Anatomy
origin
Nasopharynx
Oropharynx
Superior constrictor m.
Middle constrictor m.
Laryngeal Pharynx
Inferior constrictor m.
Esophagus
Insertion
Raphe
1
Super.&inf. Genicular tubercles
Incisive foramen
Angle of the Mandible
Hard palate
Maxillary plate
Palatine bone
(Horizontal)
InfraTemporal
Fossa
Pharyngeal
tubercle
Form. Magnus
Mastoid Process
Styloid Process
&Stylomastoid
Foramen CN VII
Jugular Foramen
Oral Cavity
Vestibule
Buccinator m.
Geniohyoid m.
Genioglossus m.
Submandibular duct and
Lingual n.
Myelohyoid m.
‰
Mastication- Grinding the food.
Temporalis, Masseter, Pterygoids,
Mylohyoid, Ant. Belly of Diagastric,
Parotid duct
Tensor Velli Palatini, & Tensor Tympani
CN V 3 /
Orbicularis Oris m.
accessory ms Buccinator & O. Oris-CN VII
2
Posterior wall
Of pharynx
Soft palate and Uvula
PalatoGlossal arch
Ant. Pillar of fauces
Palatopharyngeal
arch
Tonsilar Fossa
( palatine)
Anterior Pillar of Fauces are
the marker that
Separate the Oral cavity
From the Pharynx
Diphtheria (pseudomembrane)
Tonsilitis (exudative)
Pharyngitis
3
Maxillary vestibule
Parotid papilla
Maxillary tuberosity
Retromolar pad
Pterygomandibular
fold (ligament)
Buccal mucosa
Mandibular Vestibule
Interdental gingiva
Marginal gingiva
Incisive Papilla
Attached gingiva
Palatine rugae
Median Palatine
raphe
Hard Palate
4
Primary Palate
Nasopalatine n.&a.
Via incisive canal
Greater Palatine a&n
Of V2
Horzontal
Plate of Max.
Secondary
palate
Lesser Palatine n.&a.
Horizontal
Plate of
Palatine bone
Hamulus of Medial Pterygoid plate
With tendon of Tensor Velli Palatine m.
Soft Palate
Formed by intrinsic muscles
And two extrinsic muscles
Tensor veli Palatini (V3)
Levator Veli Palatini m. X
Origin of
Superior Constrictor m.
Hamulus
Pterygo-mandibular
Ligament or Raphae
Palatopharyngeaus m.
Buccinator m.
Palatoglossus m.
5
Tuberosity of Maxilla
Pterygomandibular fold
Retromolar pad
Anterior pillar fauces
Sup. Constrict. M.
Buccinator m.
Lingual n
Submandibular duct
Stylohyoid Lig.
Hyoid bone,
origin of Middle Constrictor M,
Floor of the Oral Cavity
Myelohyoid muscle
Myelohoid line
Hyoid bone
Submandibular
Salivary gland
Facial artery
Lingual nerve (V3)
Submandibular duct
?
Digastrics tendon
Stylohyoid ligament
Innervated by Myelohyoid branch of Inferior Alveolar n. of V3
6
Myelohyoid line
Genioglossus m.
Geniohyoir m.
Myelohyoid n
Posterior free edge of Myelohyoid m.
Hyoglossus m.
Epiglottis
Vallecular Fossa
Frenulum
Abscess of Premolar teeth/ above Mylohyoid line
(Sublingual space)
Lingual n.
Myelohyoid line
Abscess of 2nd and 3rd Molar teeth
below L.Mylohoid (Submaxillary space)
7
Sublingual v.&a.
Frenulum of tongue
Sublingual gland
Submandibular
caruncle
Mucus-gingival line
Labial mucosa
Stone in Submandibular duct
Sailogram of Parotid
Salivary gland
Sailogram of Submandibular
Salivary gland
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Palatoglossus m.
Styloglossus m.
Stylopharyngeus m.
Lingual n.
Deep Lingual a.
Dosrsal lingual a.
Genioglossus
Lingual artery
Submandibular duct
Hyoglossus m.
Sublingual a.
Hypoglossal n. CN XII &
Lingual vein
Paralysis of CN XII on
one side causes the tongue
to deviate to Ipsilateral side
?
Submandibular duct
?
Lingual vein
?
Submandibular gland
a. superficial
b. deep
c. accessory lobes
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Trigeminal Nerve, Mandibular V3
TMJ
Myelohyoid n.
Inferior Alveolar n.
Lingual n.
Petrygomandibular raphe
Chorda tympani
Joining lingual n.
Pterygomandibular
raphe
Lingual N.
Submandibular duct
Submandibular ganglion
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Occipital artery
Stylogossus m.
Tongue movement
Genio-glossus m.
Geniohyoid m.
Myelohyoid m.
Hyoglossus m. separates between
Hypoglossal n. and Lingual a.
Palatopharyngeus m
Palatoglossus m.( vagus n.)
Oral cavity
Lingual n.
Glossopharyngeal n.
Ant. 2/3 of Tongue
Internal laryngeal n.
Hypoglossal n. motor
Paralysis of CN XII result in
Ipsilateral deviation of tongue
11
‰
Deglutition is pushing the bolus of food into the Pharynx
•Hyoid must be fixed
•The tongue rolled up against the hard palate
by Longitudinal intrinsic muscles
•Posterior of tongue depressed by Hyoglossus
and pull base anteriorly by Genioglossus
•Lateral sides will be elevated by Palatoglossus m.
•Soft palate contracts and harden against the
pharyngeal walls
‰
Swallowing- Movement of bolus of food
down Pharynx and Esophagus
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Pterygomandibular Raphe- origin of
Superior Constrictor muscle
Hyoid bone- origin of
Middle constrictor muscle
Thyroid and Cricoid's cartilages- origin of
Inferior Constrictor m.
(lowest fibers called Cricopharyngeaus m.)
All the muscle join in Raphe posteriorly to attach ( insert)
To the base of the skull ( Pharyngeal tubercle)
( anterior to foramina Magnum)
All three muscles are innervated by
Pharyngeal plexus of CN X
exception
Cricopharyngeus (inferior part of Inf. Constrictor)
is innervated by external laryngeal n.
Additional muscle are
Salpingopharyngeus m.
Palatopharyngeus m.
Stylopharyngeus m. (exception
muscle-innervated by CN IX)
Posterior view of Pharynx
Retropharyngeal lymph nodes
Internal Jugular v.
Vagus n.CN X
Carotid arteries
Superior Sympathetic Ganglion
13
Pharyngobasilar membrane
Jugular Foramen
Internal Jugular vein&
CN-IX,X,XI
Stylopharyngus m.
& CN IX
CN XI
CN XII
Salpingopharyngus m.
Superior Cervical
Sympathetic Ganglion
Epiglottis
Post. Tongue
oropharynx
Pharyngeal
Plexus from
IX &X
Vagus nerve
Piriform Fossa
Paralysis of one side of soft palate result in deviation of uvula to Contralateral side
Torus tuberous &
Tubal lymphoid
Pharyngeal Tonsil
( Adenoid)
Pharyngotympanic tube
Tensor veli palatini
Levator veli palatini
Salpingopharyngeus ms.
Palatine Tonsil
CN IX
Stylohyoid lig.
Valicular fossa
Lingual tonsil
Piriform fossa
Epiglottis
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*
GAP 1
*The area above the Superior Constrictor is
filled by Pharyngo-Basilar membrane.
•Muscles (2) Levator and Tensor Veli Palati
•Tube(Eustachian) and
•Artery the Ascending Pharyngeal a.
** The area between Superior and Middle Const
**
***
• Muscles ( 3
GAP 2
GAP 3
) Stylopharyngeus, Styloglossus ,
Hyoglossus
• Ligament the Stylohyoid ligament
• Artery (2) lingual artery, Tonsilar branch of Facia
• Nerve (1) Glassopharyngeal IX
*** The area middle and Inferior Constrictor
ms
• Thyrohyoid membrane
• Nerve the Internal Laryngeal of Sup. Laryg - X
•Artery the Sup. Laryng of Sup. Thyroid a.
GAP 4
**** Below Inf. Constrictor
Nerve - Recurrent laryngeal n -X
Artery- Inferior Laryng. A.
S.Ph.C.
M.Ph.C.
I.Ph.C.
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?
Submandibular
Lymph nodes
Submental Lymph nodes
Lymph drainage from Upper &Lower lips
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Tongue Lymphatics
Superior Deep Cervical
Lymph nodes
Superior Deep Cervical
Lymph nodes
Inferior Deep Cervical
nodes
Inferior Deep Cervical
nodes
Submandibular
nodes
Submandibular
nodes
Submental
nodes
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General schema for lymphatic drainage of Oral Cavity and pharynx
Middle of tongue crosses
To both sides
Retropharyngeal
nodes
Submandibular
Lymph nodes
Submandibular nodes
JuguloDiagastric
node
SDC nodes
Submental
Inferior Deep Cervical
nodes
Superior Deep
Cervical nodes
Lateral lip cross over
Tip of tongue cross over
IDC nodes
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Pathology of Oro-pharynx
1. Pharyngitis
2. Tonsilitis
3. Peritonsillar cellulities & abcess
4. Lemierre’s Sundrome
5. Parapharyngeal absceas
6. Velophyrangeal Insufficiency
7. Tornwaldt’s Cyst
8. Nasopharyngeal squamous cell carcinoma
9. Squamous cell Carcinoma of the Tonsil
Lemierre’s Syndrome: suppurative lateral pharyngeal space with septic Jugular thrombophlebitis, after 1 week after phyrangutis diagnosis by ultasound or MRI of neck.
Tornwaldt’s Cyst: rare cyst midline of Nasopharynx infect superficial to superior
constrictor covered by mucous membrane . Persistant purulent drainage with
foul taste and odor.
Velopharyngeal Insufficiency: Incomplete between oro-naso pharynx impaired speech,
deglution regurgitation of solid food
Cleft Palate
Incisor Abscess
Squamous cell Papilloma
Fracture mandible
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