• Is a wide muscular tube

• 12 cm in length
• Located posterior to the nasal and oral
cavities
• Extends inferiorly, posterior to the larynx
• Extends from the cranial base to the inferior
border of the cricoid cartilage (anteriorly) and
inferior border of C6 (posteriorly) [Extends
from the base of the skull to the level of the
C6 vertebra] where it is continuous with the
oesophagus
• Widest opposite the hyoid bone and narrowest
at the junction where it joins
the oesophagus
• Nasopharynx

• Oropharynx

• Laryngopharynx
• Respiratory function

• Roof and Posterior wall:

Continuous surface that lies

inferior to the body of the

sphenoid bone and the

basilar part of the occipital

bone

• Pharyngeal tonsils:

Found in the mucous membrane

of the roof and the posterior wall

of the nasopharynx
• Digestive function

• Helps in the process of

deglutition

• Borders
Superiorly: Soft Palate

Inferiorly: Base of the Tongue

Laterally: Palatoglossal and

Palatopharyngeal arches and
palatine tonsils
• Palatine tonsils

– Collections of lymphoid tissue on

either side of the Oropharynx

between the arches

• Tonsillar bed

– Superior constrictor of the pharynx

and the pharyngobasilar fascia

form the tonsillar bed

ARTERIAL SUPPLY OF THE
TONSIL
1 Tonsillar A. From facial A.
2 Lingual A.
3Ascending palatine A.
4- Maxillary artery.

Acute follicular tonsillitis

Waldeyer’s Ring

Waldeyer’s ring
A term to describe annular
arrangement of pharyngeal tonsils
 Waldeyer’s
Ring
• Waldeyer's
tonsillar
ring
includes
1. Adenoid
tonsil
2. Two tubal
tonsils
3. Two palatine
tonsils
4. Lingual
tonsil.
Palatine Tonsils
Medial surface
The visible surface
Exposed to the oral cavity
Lined by stratified squamous non-
keratinized epithelium which dips in
crypts
12-15 crypts
One larger crypt near upper end known
as crypta magna
Crypts may be filled with cheesy
material, food particles and bacteria
Palatine tonsils
Palatine Tonsils

Blood supply
by external carotid via 5 arteries:
1.Tonsillar branch of facial artery
(main)
2.Ascending palatine branch of facial
artery
3.Ascending pharyngeal branch of
ECA
4.Dorsal lingual branch of lingual
artery
5.Descending palatine branch of
maxillary artery
Palatine Tonsils
Tonsillar bed
Structures lying in relation to
tonsillar bed:
Styloid process (if tonsil is
enlarged)
Glossopharyngeal nerve
Facial artery
Submandibular gland
Posterior belly of digastric muscle
Medial pterygoid muscle
Angle of mandible
• Extends from the superior
border of the epiglottis and the
pharyngoepiglottic folds to the
inferior border of the cricoid
cartilage

Borders

• Posteriorly: related to the

bodies of the C4- C6

vertebrae.

• Posterior and lateral walls:

Middle and Inferior constrictor

muscles
• Palatopharyngeus and
Stylopharyngeus muscles form the
walls

• Piriform recess, small depression of

the laryngopharyngeal cavity on

either side of the laryngeal inlet

• Separated from the laryngeal inlet

by the aryepiglottic fold
Pharyngeal wall
The wall of the Pharynx consists of five
layers:

1.Mucous membrane

2.Submucosa

3.Pharyngobasilar fascia 4.Pharyngeal

muscles (3 constrictors)

a. Stylopharyngeus
b. Salpingopharyngeus C-
Palatopharyngeus

5.Buccopharyngeal fascia
 muscles of pharynx

Outer constrictor muscles

superior constrictor
Middle constrictor
Inferior constrictor

Inner longitudnal muscles

Stylopharyngeus
Palatopharyngeous
salpingopharyngeous
 2 layers of voluntary
muscle:
• External circular layer

• Internal Longitudinal layer

External circular layer

•Constrictor muscles

•Primarily responsible
for constricting the
pharynx during
swallowing
Both types are
innervated by the
vagus nerve,
except for
the stylopharyngeus,
which is innervated by
the
glossopharyngea l
nerve.
• Internal Longitudinal layer

• Elevate/shorten and widen the

pharynx during swallowing and
speaking

• Palatopharyngeus

• Stylopharyngeus

• Salpingopharyngeus

Palatopharyngeus and

salpingopharyngeus are innervated by the

pharyngeal branch of CNX and the

pharyngeal plexus

• Stylopharyngeus is innervated by CN
IX
Sensory: Each of the three sections of the pharynx have a
different innervation:
The nasopharynx is innervated by the maxillary
nerve (CN V2).
The oropharynx by the glossopharyngeal nerve (CN IX).
The laryngopharynx by the vagus nerve (CN X).

Motor: All the muscles of the pharynx are innervated by the

vagus nerve (CN X), except for the stylopharyngeus, which
is innervated by the glossopharyngeal nerve (CN IX).
Blood Supply of the
pharynx:

Arterial supply
is via branches of the
external carotid artery:

• Ascending
pharyngeal artery
• Ascending
palatine artery
• Tonsillar branches of the facial
artery
• Branches of the maxillary and
lingual arteries
• Pharyngeal branches of the
inferior thyroid artery

Venous drainage is achieved by the

pharyngeal venous plexus,
which drains into the internal jugular
vein.
Clinical Relevance: Pharyngeal Diverticulum (Pouch)

Inferior pharyngeal constrictor is found in the laryngopharynx and has

two components. The superior component (cartilage and the inferior
component (cricopharyngeus) has horizontal fibres that attach to the
cricoid cartilage This area between the two is a weak area in the muscosa.

Normally during swallowing, the thryopharyngeus contracts as the

cricopharyngeus relaxes, allowing the bolus of food to be propelled into
the oesophagus and preventing the intrapharyngeal pressure form rising.

If this coordinated relaxation of the cricopharyngeus does not occur,

the intrapharyngeal pressure tends to rise and pharyngeal mucosa
forms a midline diverticulum in the area between the thyropharyngeus
and cricopharyngeus.

It is possible for food to accumulate here, leading to dysphagia.

Barium swallow X-ray
Nasopharyngeal tonsil

•Adenoids is the
hypertrophied mass of
lymphoid tissue situated at
the junction of roof & post.
wall of nasopharynx.

•The mass of lymphoid tissue

is termed as Adenoids only
when it is hypertrophied.

•It usually undergoes

atrophy by puberty (13- 14
yrs)
 Oropharynx
Deglutition
(Swallowing)
Complex process that transfers a food bolus from the mouth through the
pharynx and esophagus into the stomach.
Solid food is masticated (chewed) and mixed with saliva to form a soft bolus
(mass) that is easier to swallow.
Deglutition occurs in 3 stages:
Stage 1: voluntary; the bolus is compressed against the palate and pushed
from the mouth into the oropharynx, mainly by movements of the muscles
of the tongue and soft palate.
Stage 2: involuntary and rapid; the soft palate is elevated, sealing off the
nasopharynx from the oropharynx and laryngopharynx. The pharynx
widens and shortens to receive the bolus of food as the suprahyoid muscles
and longitudinal pharyngeal muscles contract, elevating the larynx.
Stage 3: involuntary; sequential contraction of all three pharyngeal
constrictor muscles creates a peristaltic ridge that forces the food bolus
inferiorly into the esophagus.
 Oropharynx
Deglutition (Swallowing)

1st stage 2nd stage 3rd stage

 LARYNX
• Is the upper ,
expanded part of
the windpipe
which is modified
for phonation

• Supported by a
number of
cartilages
• Complex organ of voice
production

• Composed of 9 cartilages
connected by membranes
and ligaments
• Contains the vocal folds
• Located anteriorly in the
neck
• Vertebral levels C3-C6
• Connects the inferior part of
the Oropharynx to the trachea
• Lies anterior to the
Laryngopharnx
• Secondary function is to
guard the air passages
• Main divisions of the
Laryngeal Cavity

1 Laryngeal Vestibule

2 Laryngeal cavity

3- Infraglottic cavity
Muscle Origin Insertion Innervation Action
Cricothyroid Antero-lateral part Inferior margin and External Stretches and tenses
of cricoid cartilage inferior horn of thyroid laryngeal nerve vocal ligament
cartilage

Thyro-arytenoid Lower ½ of Anterolateral arytenoid Relaxes valocal

posterior aspect of surface ligament
angle of thyroid
laminae and
cricothyroid
ligament

Posterior Crico- Posterior surface of Abducts vocal folds

arytenoid lamina of cricoid
cartilage Inferior
Vocal process of laryngeal nerve
arytenoid cartilage (terminal part of
Lateral crico- Arch of arytenoid recurrent Adducts vocal folds
arytenoid cartilage laryngeal nerve
from vagus)

Transverse & One arytenoid Contra-lateral arytenoid Adducts arytenoid

Oblique arytenoids cartilage cartilage cartilages

Vocalis Lateral surface of Ipsilateral vocal ligament Relaxes posterior vocal

vocal process of ligament while
arytenoid maintaining tension of
cartilages anterior part
• Superior Laryngeal artery

Supplies the internal surface of the larynx

• Cricothyroid artery

Supplies the cricothyroid muscle

• Inferior Laryngeal artery

Supplies the mucous membrane and the muscles of the inferior part of the larynx