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Anatomy

Innervation of the Pharynx

  • The motor and most of the sensory supply of the pharynx is derived from the pharyngeal plexus of nerves on the surface of the pharynx.
  • The plexus is formed by pharyngeal branches of the vagus (CN X) and glossopharyngeal (CN IX) nerves, and by sympathetic branches for the superior cervical ganglion.
  • The motor fibres in the pharyngeal plexus are derived from the cranial root of accessory nerve (CN XI), and are carried by the vagus nerve to all muscles of the pharynx and soft palate.
  • The exceptions are stylopharyngeus (supplied by CN IX) and the tensor veli palatini (supplied by CN V3).

The Paranasal Sinuses

  • These sinuses are air-filled extensions of the respiratory part of the nasal cavity.
  • They are in the following bones, frontal, ethmoid, sphenoid and the maxilla.

The Frontal Sinuses

  • These are located between the outer and inner tables of the frontal bone, posterior to the superciliary arches.

The Ethmoidal Sinuses

  • These comprise of several small cavities, called ethmoidal air cells, within the ethmoidal labyrinth (G. labyrinthos, a maze) of the lateral mass of the ethmoid bone.

The Sphenoidal Sinuses

  • These occupy a variable amount in the body of the sphenoid bone and may extend into the wings.

The Maxillary Sinuses

  • These are the largest pair of paranasal sinuses.
  • They are pyramidal-shaped cavities that may occupy the entire bodies of the maxillae.

The skull, the skeleton of the head, is the most complex bony structure in the body because it:

  1. Encloses the brain, which is irregular in shape;
  2. Houses the organs of special senses for seeing, hearing, tasting, and smelling; and
  3. Surrounds the openings in to the digestive and respiratory tracts.

 

  • In the anatomical position, the skull is oriented so that the inferior margin of the orbit (eye socket) and the superior margin of the external acoustic meatus (auditory canal) are horizontal. This is called the orbitomenial plane (Frankfort plane).
  • The term cranium (L. skull) is sometimes used when referring to the skull without the mandible (lower jaw), but the cranium is often used when referring to the part of the skull containing the brain.
  • The superior part is the box-like structure called the calvaria (cranial vault, brain case); the remainder of the cranium, including the maxilla (upper jaw), orbits (eyeball sockets) and nasal cavities, forms the facial skeleton.
  • The term skullcap (calotte) refers to the superior part of the calvaria, which is removed during autopsies and dissections. The inferior aspect of the cranium is called the cranial base.

The Cheeks

  • The cheeks (L. buccae) form the lateral wall of the vestibule of the oral cavity.
  • They have essentially the same structure as the lips with which they are continuous.
  • The principal muscular component of the cheeks is the buccinator muscle.
  • Superficial to the fascia covering this muscle is the buccal fatpad that gives cheeks their rounded contour, especially in infants.
  • The lips and cheeks act as a functional unit (e.g. during sucking, blowing, eating, etc.).
  • They act as an oral sphincter in pushing food from the vestibule to the oral cavity proper.
  • The tongue and buccinator muscle keep the food between the molar teeth during chewing.

Sensory Nerves of the Cheeks

  • These are branches of the maxillary and mandibular nerves.
  • They supply the skin of the cheeks and the mucous membrane lining the cheeks.

  •  Provides a rigid support system
  • Protects delicate structures (e. g., the protection provided by the bones of the vertebral column to the spinal cord)
  • Bones supply calcium to the blood; are involved In the formation of blood cells (hemopoiesis)
  • Bones serve as the basis of attachment of muscles; form levers in the joint areas, aIlowing movement

Internal Muscles of the Pharynx

  • The internal, chiefly longitudinal muscular layer, consists of 3 muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus.
  • They all elevate the larynx and pharynx during swallowing and speaking.

The Stylopharyngeus Muscle

  • This is a long, thin, conical muscles that descends inferiorly between the external and internal carotid arteries.
  • It enters the wall of the pharynx between the superior and middle constrictor muscles.
  • Origin: styloid process of temporal bone.
  • Insertion: posterior and superior borders of thyroid cartilage with palatopharyngeus muscle.
  • Innervation: glossopharyngeal nerve (CN IX).
  • It elevates the pharynx and larynx and expands the sides of the pharynx, thereby aiding in pulling the pharyngeal wall over a bolus of food.

The Palatopharyngeus Muscle

  • This is a thin muscle and the overlying mucosa form the palatopharyngeal arch.

The Salpingopharyngeus Muscle

  • This is a slender muscle that descends in the lateral wall of the pharynx.
  • The over lying mucous membrane forms the salpingopharyngeal fold.
  • Origin: cartilaginous part of the auditory tube.
  • Insertion: blends with palatopharyngeus muscle.
  • Innervation: through the pharyngeal plexus.
  • It elevates the pharynx and larynx and opens the pharyngeal orifice of the auditory tube during swallowing.

Structure of the Nasal Septum

  • This part bony, part cartilaginous septum divides the chamber of the nose into two narrow nasal cavities.
  • The bony part of the septum is usually located in the median plane until age 7; thereafter, it often deviates to one side, usually the right.
  • The nasal septum has three main components: (1) the perpendicular plate of the ethmoid bone; (2) the vomer, and (3) the septal cartilage.
  • The perpendicular plate, which forms the superior part of the septum, is very thin and descends from the cribiform plate of the ethmoid bone.
  • The vomer, which forms the posteroinferior part of the septum, is a thin, flat bone. It articulates with the sphenoid, maxilla and palatine bones.

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