FARYNX

CUPRINSUL PREZENTĂRII

• LIMITS
• FORM
• REPORTS OF THE PHARYNX
• ENDOPHARYNX
• OROPHARYNX
• THE LARYNGOPHARYNX
• STRUCTURE OF THE PHARYNX
• VASCULARIZATION OF THE PHARYNX
SUPRAFAȚĂ EXTERIOARĂ- SUPRAFAȚĂ INTERIOARĂ
EXOFARINGE ENDOFARINGE
RAPORTURI
Posterior face
• CORRESPONDS TO THE CERVICAL SPINE (CAN BE EXPLORED THROUGH THE ORAL
CAVITY.
• The vertebrae at this level are covered by prevertebral muscles and prevertebral
fascia.

• BETWEEN PHARYNX AND PREVERTEBRAL FASCIA—RETROPHARYNGEAL SPACE

• ( COMMUNICATES WITH THE POSTERIOR MEDIASTINUM AND IS CLOSED ABOVE
BY THE ADHERENCE OF THE FASCES AT THE BASE OF THE SKULL.
LATERAL FACES
• Cervical segment-
• It is related to the vasculo-nervous bundle of the neck, covered by the SCM
muscle and the planes of the carotid region (common and internal carotid
arteries, internal jugular vein, vagus nerve, and deep cervical lymph nodes).
• From the external carotid arise the arteries - superior thyroid, lingual and facial
which apply to the pharyngeal wall
LATERAL FACES

• Cephalic segment-
• at which level
• the MANDIBULO SPACE is found
• VERTEBRO –PHARYNGIAN which is
• Divided by the deep blade of the fascia
• Parotids in –
• Glandular space
•
• Subglandular space
SUBGLANDULAR SPACE= LATEROPHARYNGEAL SPACE

Stilian diafragm

LODGE PRESTILIAN LODGE RETROSTILIAN

STILIAN DIAFRAGM
• Of a muscular-fibrous nature placed on the side of the pharynx and arranged in
the frontal plane. It contains the Riolan stylian bouquet and Thoma Ionescu's
stylopharyngeal aponeurosis or pharyngeal fin.
• What does the Riolan style bouquet contain?
• 3 muscles and 2 ligaments
• Stylopharyngeal
• STYLOHYOIDIAN
• STYLOGLOS

• Ligaments- STYLOHYOIDIAN
• STYLOMANDIBULAR
THOMA IONESCU 1860-1926
ANATOMIST
CHIRURG
PROFESOR UNIVERSITAR
POLITICIAN
Întemeietorul școlii românești de chirurgie și de anatomie
topografică
Și astăzi, în vestita
clinică "Mayo" din Rochester (S.U.A.), se află
bustul chirurgului român Thoma Ionescu.
PRESTILIAN LODGE

• LOCATED BETWEEN THE MANDIBULAR BRANCH AND THE PHARYNX.

• CONTAINS THE 2 PTERYGOIDIAN MUSCLES, THE MANDIBULAR NERVE WITH ITS
BRANCHES, THE TRUNK OF THE MAXILLARY ARTERY AND FAT.
• VERY IMPORTANT TO REMEMBER THAT THE PALATINE TONSILS CAN OPEN IN THIS
PLACE
RETROSTILIAN LODGE
• LOCATED BEHIND THE STYLIAN DIAPHRAGM.
• IT CONTAINS THE VASCULO-NERVOUS BUNDLE OF THE NECK, DEEP CERVICAL
LYMPHATIC NODES, THREE CRANIAL NERVES (GLOSSOPHARYNGEAL,
ACCESSORY AND HYPOGLOSSAL) AND THE CERVICAL SYMPATHETIC.
• COMMUNICATES THROUGH THE JUGULAR ORIFICE, CAROTIDAL CANAL AND
HYPOGLOSSAL CANAL WITH THE CRANIAL CAVITY.
ENDOFARINGELE

NAZOFARYNX

OROFARYNX

LARINGOFARYNX
NAZOFARYNX
• BOUNDARIES- FROM THE BASE OF THE SKULL TO THE FREE EDGE OF THE
PALATINE VEIL
• REAR WALL.
• UPPER WALL
• 2 SIDE WALLS.
SIDE WALLS- IMPORTANT DPDVD PRACTICAL

• On each side wall is the pharyngeal opening of the auditory tube. The tympanic
cavity is ventilated by means of the tube. Through the tube, an inflammation in
the pharynx can easily spread to the eardrum (OTITIS)
OROFARYNX (

• IT EXTENDS FROM A PLANE PASSING THROUGH THE FREE EDGE OF THE PALATINE
VEIL, ABOVE, TO A PLANE PASSING THROUGH THE HYOID BONE, BELOW.
• The anterior wall presents a vast opening where the palatine tonsils and the root
of the tongue with the lingual tonsil, the plicae and the glossoepiglottic vallecules
are located.
Between the edges of the epiglottis and the corresponding side wall of the
pharynx, a fold of the mucosa called the PHARYNGOEPIGLOTIC FOLD is formed.
• On the lateral walls of the OROPHARYNGE there are numerous lymphoid
formations that are part of Waldayer's lymphatic ring.
LARINGOFARINGELE/ HIPOFARINGELE
• The anterior wall of the laryngopharynx corresponds to the LARYNX.
• Contain
• EPIGLOTTA, LARYNGIAN ORIFICE AND CRICOID CARTILAGE.
• The lower extremity of the laryngopharynx gradually narrows, like a funnel,
narrower than the lumen of the esophagus.
• In ENDOSCOPY - the mouth of the esophagus (KILIAN) - appears as a transverse
slit or as a crescent.

STRUCTURE OF THE PHARYNX

•TUNIC FIBROUS – THE SUBMUCOS LAYER

•MUSCULAR TUNIC
STRATUL SUBMUCOS

• The submucosal layer has the same shape as the pharynx (INCOMPLETE CONE -
MISSING ANTERIOR WALL)
• It has an upper extremity, a lower extremity, two surfaces and two edges.
• The upper extremity or the base is inserted on the skull.
• The lower end or tip is continuous with the submucous tunic of the esophagus.
• It presents two edges (a right edge and a left edge) that insert along the entire extent of the
pharynx, from the base of the skull to the cricoid cartilage.
• They attach to all the bony formations arranged from the base of the skull to the cricoid
cartilage—
• Medial blade of the pterygoid process
• The pterygomandibular raphe
• Mylohyoid line
• The stylohyoid ligament
• The hyoid bone - the greater horn and the lesser horn
• Thyrohyoid ligament
• Thyroid cartilage - posterior border
• The cricoid cartilage
MUSCULAR TUNIC
• It is made up of circularly oriented muscles -
constrictors and
• longitudinal muscles
• lifters
 CONSTRICTORS – 3!!!
superior, midlle and inferior
• The superior constrictor- also called the cephalopharyngeal muscle.
• It presents four portions that bear each name
• according to the anatomical formations on which it is attached –
• a- Pterygopharyngeal - post border. of the medial blade of Fr. Pterygoid
• b- Buccopharyngeal- on the pterygomandibular raphe
• c- Mylopharingian - on the mylohyoid line
• d- Glossopharyngeal- brings the fibers from the edges of the root of the
tongue.
CONSTRICTORUL midlle
CONSTRICT INFERIOR

ALSO CALLED LARINGOPHARYNGEAL.

At the origin, it attaches to the two large cartilages of the larynx - THYROID AND
CRICOID.
The thyropharyngeal portion starts from the posterior edge of the lamina and the
oblique line of the thyroid cartilage.
The cricopharyngeal portion starts from the lateral face of the cricoid cartilage.
The recurrent laryngeal nerve passes under the inferior constrictor
ELEVATOR MUSCLES

Palatopharyngeal- constrictor of the

nasopharyngeal isthmus, lifter of the
pharynx and dilator of the tube.
It participates in the separation of the
nasal pharynx from the oral pharynx, thus
preventing food from returning to the
nasal passages.
Through the tubal bundle, the muscle
dilates the auditory tube.
It has a major role in swallowing- Raises
the larynx and pharynx (through its
terminal fascicles- thyroid and pharyngeal)
THE STYLOPHARYNGEAL MUSCLE

It extends from the styloid process to the pharynx.

The posterior fibers attach to the submucosal layer
of the pharynx.
The anterior fibers attach to the larynx.
Action- levator of the larynx and pharynx.
MUCOASA FARINGELUI
• It is the innermost tunic of the pharynx. Its appearance varies according to the
different regions.
• In the nasopharynx, the mucosa resembles the pituitary (reddish, thick, adherent
and very rich in small mixed seromucous glands). It consists of the lamina propria
and a non-keratinized stratified squamous epithelium.

• In the oropharynx, it resembles the oral mucosa. Thin, regular, red-whitish color,
formed by non-keratinized stratified squamous epithelium.

• In the laryngopharynx it is red, thick and very irregular. Consisting of the lamina
propria and a squamous epithelium.
• There are three formations on the roof of the pharynx

• PHARYNGEAL TONSIL - lymphoid organ, located on the middle part of the vault of
the pharynx, consists of 6-8 lobules, separated from each other by grooves.
• The surface of the pharyngeal tonsil is dotted with a series of small depressions,
at the level of which the tonsil crypts open.
• The pharyngeal tonsil is present in the newborn, it progresses until the age of 14,
after which it involutes.
• Adenoid vegetations are soft, irregular formations due to hypertrophy of the
pharyngeal tonsil
• PHARYNGEAL BURSA - inconstant depression of the mucous membrane. When
present, it is located at the level of the median sulcus or recess.

• PHARYNGEAL PITUITARY - rudimentary formation with the same structure as the

cerebral pituitary. It is located in front of the pharyngeal tonsil.
VASCULARISATION

• ARTERIES originate mostly from the ascending pharyngeal artery – branch of the
external carotid.
• Smaller branches arise from the ascending palatine and the pterygoid (vidian)
canal artery.
• The lower portion of the pharynx receives branches from the superior and
inferior thyroid arteries.
• VEINS - depart from two plexuses, one superficial and the other deep, and flow
into the internal jugular vein.

• Lymphatics- The superior and posterior drain to the retropharyngeal nodes, and
the lateral, anterior and inferior to the deep cervical nodes

• Nerves- The glossopharyngeus innervates the stylopharyngeus and superior

constrictor muscles. All other muscles are innervated by the vagus nerve.

• The inferior constrictor also receives several threads from the recurrent laryngeal
nerve.
BIBLIOGRAFIE
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