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Anatomy

The Laryngopharynx

  • The laryngeal part of the pharynx lies posterior to the larynx.
  • It extends from the superior border of the epiglottis to the inferior border of the cricoid cartilage, where it narrows to become continuous with the oesophagus.
  • Posteriorly, the laryngopharynx is related to the bodies of C4 to C6 vertebrae.
  • Its posterior and lateral walls are formed by the middle and inferior constrictor muscles, with the palatopharyngeus and stylopharyngeus internally.
  • The laryngopharynx communicates with the larynx through the aditus or inlet of the larynx.
  • The piriform recess is a small, pear-shaped depression of the laryngopharyngeal cavity on each side of the inlet of the larynx.

First pouch

Auditory tube, which comes in contact

    with epithelial line of first pharyngeal

    cleft, where future external acoustic

    meatus will form.

Distal portion will form tympanic   

    cavity (lining will become eardrum)

Proximal portion will become auditory tube

Second pouch

Forms buds that penetrate surrounding

    mesenchyme, which together form the 

    palatine tonsils

Third pouch

Forms thymus and inferior parathyroid

    glands

Fourth pouch

Forms superior parathyroid glands

Fifth pouch

Forms utlimobranchial body

The Eye and Orbit

  • The orbit (eye socket) appears as a bony recess in the skull when it is viewed from anteriorly.
  • It almost surrounds the eye and their associated muscles, nerves and vessels, together with the lacrimal apparatus.
  • The orbit is shaped somewhat like a four-side pyramid lying on its side, with its apex pointing posteriorly and its base anteriorly.

 

Walls of the Tympanic Cavity or Middle Ear

  • This cavity is shaped like a narrow six-sided box that has convex medial and lateral walls.
  • It has the shape of the biconcave lens in cross-section (like a red blood cell).

 

The Roof or Tegmental Wall

  • This is formed by a thin plate of bone, called the tegmen tympani (L. tegmen, roof).
  • It separates the tympanic cavity from the dura on the floor of middle cranial fossa.
  • The tegmen tympani also covers the aditus ad antrum.

 

The Floor or Jugular Wall

  • This wall is thicker than the roof.
  • It separates the tympanic cavity from the superior bulb of the internal jugular vein. The internal jugular vein and the internal carotid artery diverge at the floor of the tympanic cavity.
  • The tympanic nerve, a branch of the glossopharyngeal nerve (CN IX), passes through an aperture in the floor of the tympanic cavity and its branches form the tympanic plexus.

The Lateral or Membranous Wall

  • This is formed almost entirely by the tympanic membrane.
  • Superiorly it is formed by the lateral bony wall of the epitympanic recess.
  • The handle of the malleus is incorporated in the tympanic membrane, and its head extends into the epitympanic recess.

The Medial or Labyrinthine Wall

  • This separates the middle ear from the membranous labyrinth (semicircular ducts and cochlear duct) encased in the bony labyrinth.
  • The medial wall of the tympanic cavity exhibits several important features.
  • Centrally, opposite the tympanic membrane, there is a rounded promontory (L. eminence) formed by the first turn of the cochlea.
  • The tympanic plexus of nerves, lying on the promontory, is formed by fibres of the facial and glossopharyngeal nerves.
  • The medial wall of the tympanic cavity also has two small apertures or windows.
  • The fenestra vestibuli (oval window) is closed by the base of the stapes, which is bound to its margins by an annular ligament.
  • Through this window, vibrations of the stapes are transmitted to the perilymph window within the bony labyrinth of the inner ear.
  • The fenestra cochleae (round window) is inferior to the fenestra vestibuli.
  • This is closed by a second tympanic membrane.

 

The Posterior or Mastoid Wall

  • This wall has several openings in it.
  • In its superior part is the aditus ad antrum (mastoid antrum), which leads posteriorly from the epitympanic recess to the mastoid cells.
  • Inferiorly is a pinpoint aperture on the apex of a tiny, hollow projection of bone, called the pyramidal eminence (pyramid).
  • This eminence contains the stapedius muscle.
  • Its aperture transmits the tendon of the stapedius, which enters the tympanic cavity and inserts into the stapes.
  • Lateral to the pyramid, there is an aperture through which the chorda tympani nerve, a branch of the facial nerve (CN VII), enters the tympanic cavity.

The Anterior Wall or Carotid Wall

  • This wall is a narrow as the medial and lateral walls converge anteriorly.
  • There are two openings in the anterior wall.
  • The superior opening communicates with a canal occupied by the tensor tympani muscle.
  • Its tendon inserts into the handle of the malleus and keeps the tympanic membrane tense.
  • Inferiorly, the tympanic cavity communicates with the nasopharynx through the auditory tube.

Connective Tissue

Functions of Connective tissue:

→ joins together other tissues

→ supporting framework for the body (bone)

→ fat stores energy

→ blood transports substances

 

Connective tissue is usually characterized by large amounts of extracellular materials that separate cells from each other, whereas epithelial tissue is mostly cells with very little extracellular material. The extracellular substance of connective tissue consists of protein fibers which are embedded in ground substance containing tissue fluid.

Fibers in connective tissue can be divided into three types:

→ Collagen fibers are the most abundant protein fibers in the body.

→ Elastic fibers are made of elastin and have the ability to recoil to original shape.

→ Reticular fibers are very fine collagen fibers that join connective tissues to other tissues.

Connective tissue cells are named according to their functions:

 → Blast cells produce the matrix of connective tissues

→ Cyte cells maintains the matrix of connective tissues

→ Clast cells breaks down the matrix for remodeling (found in bone)

The Layers of the Pharyngeal Wall

  • The pharyngeal wall is composed of 5 layers. From internal to external, they are as follows.
  • Mucous membrane: this lines the pharynx and is continuous with all chambers with which it communicates.
  • Submucosa
  • Pharyngobasilar fascia: this is a fibrous layer that is attached to the skull.
  • Muscular layer: this is composed of inner longitudinal and outer circular parts.
  • Buccopharyngeal fascia: this is a loose connective tissue layer.
  • This fascia is continuous with the fascia covering the buccinator and pharyngeal muscle.
  • It contains the pharyngeal plexus of nerves and veins.

Sternum

o    Forms the medial part of the anterior chest wall
o    Manubrium (upper part)-clavicle and first rib articulate with the manubrium .
o    Body (middle blade)-second and tenth ribs articulate with the body via the costal cartilages
o    Xiphoid (blunt cartilaginous tip)

Ribs (12 pairs)

o    Each rib articulates with both the body and the transverse process of its corresponding
o    thoracic vertebra
o    The second to ninth ribs articulate with the body of the vertebra above'
o    Ribs curve outward, forward, and then downward
o    Anteriorly, each of the first seven ribs joins a costal cartilage that attaches to the sternum
o    Next three ribs (eighth to tenth) join the cartilage of the rib above
o    Eleventh and twelfth ribs do not attach to the sternum; are called "floating ribs"

 

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