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Clinical anatomy and topography of the pharynx. Pharyngeal and periopharyngeal spaces

The pharynx (pharynx) is the initial section of the digestive tract and respiratory tract.

In the throat, there are three departments:

1. Upper - nasopharynx,

2. Medium - oropharynx.

3. The lower is the larynx.

The nasopharynx performs a respiratory function. At the top, the nasopharynx arch is fixed to the base of the skull, behind the nasopharynx it borders the cervical vertebrae I and II, choanas are located in front, pharyngeal openings of the auditory tubes are located on the side walls. There is a pharyngeal pocket posterior to the mouth of the auditory tube, in which there is a tube tonsil (V and VI tonsils of the pharynx). At the border of the upper and posterior walls of the nasopharynx is the pharyngeal (III or nasopharyngeal) tonsil.

Oropharynx .. Here is the intersection of the respiratory and digestive tract. In front, the oropharynx through the pharynx opens into the oral cavity, behind it borders on the III cervical vertebra. The pharynx is bounded by the edge of the soft palate, the anterior and posterior palatine arches, and the root of the tongue. Between the palatine arches are the tonsils (1 and II). At the root of the tongue is the lingual (IV) tonsil of the pharynx.

Larynx The border between the oropharynx and larynxopharynx is the upper edge of the epiglottis and the root of the tongue. Down the larynx, the pharynx narrows like a funnel and passes into the esophagus. The larynx is located in front of the IV, V and VI cervical vertebrae. The front and bottom of the larynxopharynx opens the entrance to the larynx. On the sides of the entrance to the larynx there are pear-shaped sinuses.

Pharyngeal structure

The wall of the pharynx consists of four layers: its base is the fibrous membrane, which is covered by the mucous membrane from the inside of the pharyngeal cavity and by the muscular layer from the outside. The muscles are covered with connective tissue - adventitia.

The mucous membrane of the pharynx in the upper part is covered with a multi-row ciliated epithelium, and in the middle and lower parts - a multi-row flat epithelium.
There are many mucous glands in the mucous membrane. Lymphadenoid tissue, including tonsils, is localized in the submucosal layer.

The fibrous membrane at the top is attached to the bones of the base of the skull, below - to the hyoid bone and thyroid cartilage.

The muscle layer is represented by circular and longitudinal muscles.

Three constrictors compress the pharynx - upper, middle and lower. The longitudinal muscles raise the throat. These include m.stylopharyngeus, m.palatopharyngeus. Between the posterior pharyngeal wall and the prevertebral fascia there is a pharyngeal space in the form of a flat sheli filled with loose connective tissue. From the sides, the pharyngeal space is limited by fascial bags that go to the pharyngeal wall from the pre-vertebral fascia. Starting from the base of the skull, this space passes down behind the pharynx to the esophagus, where its tissue passes into the post-esophageal tissue, then into the tissue of the posterior mediastinum. The median septum the pharyngeal space is divided sagittally into two symmetrical halves.

But on the sides of the pharynx there is a periopharyngeal space made by fiber, in which the neurovascular bundle passes and the main lymph nodes of the neck are located.

Pharyngeal blood supply - from a.pharyngea ascendens, a.palatina ascendens, aa. palatinae descendens, a.thyreoidea inferior.

Lymphatic drainage occurs in the deep and posterior cervical lymph nodes.

nodes.

Pharyngeal innervation originates from plexus pharyngeus, which is formed by the branches of n.glossopharyngeus, n. vagus, n.sympathicus. Innervation also involved the II branch of n.trigeminus.
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Clinical anatomy and topography of the pharynx. Pharyngeal and periopharyngeal spaces

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