PHARYNX · larynx trachea pharynx esophagus anterior compartment - viscera hyoid bone. say aah!...
Transcript of PHARYNX · larynx trachea pharynx esophagus anterior compartment - viscera hyoid bone. say aah!...
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SAYAAHH!
PHARYNXPharynx
OUTLINE
- LOCATION/ STRUCTURE- MUSCLES -CIRCULAR,LONGITUDINAL- GAPS- DIVISIONS- 'POPCORN'LOCATIONS- NERVES,- BLOOD SUPPLY- LYMPHATICS
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1) Larynx and Esophagus open into pharynx
2) Pharynx - a tube of muscles and fascia that opens to nasal and oral cavities
Nose
Nasal Cavity
Oral cavity
Larynx
Trachea
Pharynx
Esophagus
ANTERIOR COMPARTMENT -VISCERA
HYOIDBONE
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SAY AAH! PALATO-GLOSSALARCH
PALATO-PHARYNGEALARCH
PALATINETONSIL
CLINICAL - PALATOGLOSSAL ARCH = SITE OF THE OROPHARYNGEAL MEMBRANE = BOUNDARY BETWEEN ORAL CAVITY (PRECISE SOMATIC SENSORY) AND PHARYNX (IMPRECISE VISCERAL SENSORY)
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PHARYNX - is continuouswith esophagus, opens to larynx trachea
ESOPHAGUS = TUBE
PHARYNX
LARYNX
HYOID BONE
VIEW: SEPARATE PHARYNX FROMVERTEBRA, POSTERIOR COMPARTMENT
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PHARYNX ACTS TO PROPEL FOOD IN SWALLOWING
Voluntaryphase
Involuntaryphase 1
Involuntaryphases 2,3 =Muscles ofpharynx propelfood down toesophagus
OVERVIEW OF SWALLOWING
= FOOD
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Pharynx is Muscular Tube opens to nasal,oral cavities; continuous below with esophagus; Pharynx has layers like GItract
Disarticulate C1 – occipital bone separate in Retropharyngeal Space
PHARYNX
View Pharynxfrom PosteriorSide
Pharynx is difficult to see;solution: disarticulatehead
CUTHERE
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RETROPHARYNGEAL SPACE
RECALL - neck is compartmentalized
Plane of section
HORIZONTAL SECTION THROUGH NECK
POST.
LAT.
ANT. CAROTID SHEATH
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ORIENT TO PHARYNX PROSECTION
After disarticulateheadVIEW PHARYNX FROM POSTERIORSIDE (RETROPHARYNGEAL SPACE
MUSCLESOF PHARYNX
ESOPHAGUS
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MUSCLESOF PHARYNXCONTENTS OF
CAROTID SHEATH
SYMPATHETIC CHAIN
SUPERIORCERVICALGANGLION
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POST. COMPARTMENT -. Posterior Compartment -Vertebrae and muscleswhich support and move head & neck
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CLINICAL: RETROPHARYNGEAL ABSCESS
Infection in retropharyngealspace can spread unimpededto mediastinum (MIDDLE OF THORACIC CAVITY)
Note: George Washingtonmay have died from this
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LAYERS OF PHARYNX ARE SIMILAR TO GI TRACT
Muscle layers -Inner Layer Circular
Outer LayerLongitudinal
Outer fascia -Bucco-PharyngealFascia (part of PretrachealLayer)
Transverse section of esophagus
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C. Circular Muscles of Pharynx- all insert on midline fibrous raphe posteriorly- all serve to propel food to esophagus during swallowing by constricting pharynx
B. Location1) Extends from Base of skull2) Post. To Nasal and Oral cavities and larynx 3) Ant to vertebrae C1-C64) medial to Carotid sheath and CN IX-XII 5) To level Cricoid Cart.
1) Superior Constrictor2) Middle Constrictor3) Inferior Constrictor
All Insert toMidline Pharyngeal RapheEsophagusPost Side
III. PHARYNX
mastoidprocess
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Tell Constrictors Apart by level of insertion: Inf. to Thyroid, Cricoid; Middle to Hyoid; Superior - region superior to Hyoid bone
Superior Constrictor
Middle Constrictor
Inferior Constrictor
SUPERIOR CONSTRICTOR O - Pterygo-mandibular Raphe(Connective tissue 'ligament' from Medial Pterygoid plate to Mandible) CONTINUOUS ANT. WITH BUCCINATOR)MIDDLE CONSTRICTORO - HYOID
INFERIOR CONSTRICTORO - THYROID & CRICOIDCartilage
PHARYNX CONSTRICTOR MUSCLES
PTERYGO-MANDIBULAR RAPHE
BUCCINATOR
KNOW ORIGINS
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PHARYNX - LONGITUDINAL MUSCLES - to be continued in next block
O - Styloid processof Temporal boneI - Thyroid CartilageA - Raise pharynxand pull walls laterallyInn - IX (BRANCHIO-MOTOR)
1. Stylopharyngeus
SEE ON PROSECTION 314
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D. Structures Through Gaps In Constrictors
PHARYNX
1) Between Sup. Constrictorand SkullLevator Veli Palatini M.Auditory Tube
2) Between Sup. and Mid.ConstrictorGlossopharyngeal N. (IX)Stylopharyngeus M.
3) Between Mid. and Inf.ConstrictorSuperior Laryngeal A.Internal Laryngeal N.
Sup. Const.
Mid. Const.
Inf. Const.
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SAY AAH! PALATO-GLOSSALARCH
PALATO-PHARYNGEALARCH
PALATINETONSIL
CLINICAL - PALATOGLOSSAL ARCH = SITE OF THE OROPHARYNGEAL MEMBRANE = BOUNDARY BETWEEN ORAL CAVITY (PRECISE SOMATIC SENSORY) AND PHARYNX (IMPRECISE VISCERAL SENSORY)
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LOOKS LIKE BACK WALL:SUPERIOR CONSTRICTOR
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F. DIVISIONS OF PHARYNX
1)NasopharynxInf. To SphenoidAnt. To Occip. BonePost to nasal cav.Sup to soft palate
2) OropharynxInf. to soft pal.; Sup to upper border of Epiglottis; Post.to palatoglossal arch
3) LaryngopharynxInf. To upper border of epiglottisSup to lower border cricoid cart. Communicates with esophagus - infLarynx - ant.
Soft Palate
Upper Border Epiglottis
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CONTENTS OF PHARYNX
in Nasopharynx- Pharyngeal Tonsil (Adenoids)- opening of Auditory Tube
in Oropharynx-Palatine Tonsils (Tonsillitis)posterior to Palatoglossal Arch(boundary between Oral Cavityand Oropharynx)
Soft Palate
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in Oropharynx- Valleculae =depressions (2)Between Med & LatGlossoepiglotticFolds; Food/objectsLodge in Valleculae
Vallecula
Medial Glossoepiglottic fold Lateral
Glosso-Epiglottic
CONTENTS OF PHARYNX
Clinical: Valleculae =Popcorn 1
TONGUE!***
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Inlet of Larynx
PiriformRecess
in LaryngoPharynx-Piriform Recesses –LateralTo InletOfLarynx
foreignobjectslodge inRecesses
CONTENTS OF PHARYNX
Clinical: PiriformRecess = Popcorn 2
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PHARYNX: INNERVATION, BLOOD SUPPLY
G. INNERVATION
1) Motor- Branchio-motor (SVE)All Vagus (X)except Stylopharyngeus(IX)
2) Sensory - Visceral Sensory (GVA)VII - NasopharynxIX - OropharynxX - Laryngopharynx
H. Blood Supply
Ascending PharyngealFacialLingualMaxillary
VeinsPharyngeal plexusto Int. Jugular
LymphaticsDeep Cervical Nodes
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POPCORN QUESTIONS - Food stuck when trying to swallow - not localize because innervation is Visceral Sensory
POPCORN 1) Posterior tongue - food caught in Valleculae between Medial and Lateral Glossoepiglottic folds
POPCORN 2) 'Throat'- food caught in Piriform recesses, lateral to opening of larynx