The pharynx and parapharyngeal spaces Viktria Vereczki M

The pharynx and parapharyngeal spaces Viktória Vereczki M. D. , Ph. D.

Pharynx choana Faucial isthmus C 6 Laryngeal inlet esophagus

Waldeyer’s lymphatic ring:

Blood supply of palatine tonsill:

Muscles of pharynx Raphe pharyngis Musculi constrictores pharyngis n. IX n. X Musculi levatores pharyngis –

Musculi constrictores pharyngis 1.

Musculi constrictores pharyngis 2. m. constrictor pharyngis sup. p. pterygopharyngea p. buccopharyngea p. mylopharyngea p. glossopharyngea

Musculi constrictores pharyngis 3. m. styloglossus m. stylopharyngeus m. constrictor pharyngis medius: p. chondropharyngea p. ceratopharyngea m. constrictor pharyngis inferior m. constrictor pharyngis inf.

Musculi levatores pharyngis M. stylopharyngeus – proc. styloideus (os temporale) M. salpingopharyngeus – cartilage of auditory tube, proc. pterygoideus lamina medialisa M. palatopharyngeus – velum palatinum

Arteries - a. vertebralis -ACI – -ACE: Au – a. auricularis post Oc – a. occipitalis Sty. M – a. stylomastoidea Te – a. temporalis superfic. Ma – a. maxillaris Fa – a. facialis a. Pha – a. pharyngea asc. Ly – a. lingualis Thy – a. thyroid sup.

Blood and nerve supply of the pharynx aa. pharyngea asc. Rami pharyngeales: aa. thyroidea sup. aa. thyroidea inf. vv. pharyngeales Plexus pharyngeus: Nervus glossopharyngeus (N. IX) Nervus vagus (N. X)

The topography of the pharynx

Pharyngeal muscles, posterior view

Connetive tissue spacesnaround the pharynx

Cervical organs in front of the pharynx

Cervical lymph nodes Superficial cervical lymph nodes along external jugular vein. Deep cervical lymph nodes near carotid sheet. Cervical lymph vessels reach the nodes along the blood vessels. Lymph vessels form the jugular trunk. Importance of retropharyngeal space: Between pretracheal and prevertebral layers of cervical fascia, communicates with mediastinum. Inflammation can spread progressively to cause mediastinitis.

1. Fa sci a c erv ica lis lam ina su pe rfic ial is 2. Fascia cervicalis lamina visceralis 3. F. cerv. lamina prevertebralis

SPATIUM PARAPHARYNGEUM (side view) Epipharynx Spatium parapharyngeum A. carotis interna. Tonsillectomia!!

Sp. retropharyngeale • behind pharynx and oesophagus • In front of fascia alaris (danger space) • From base of skull untill T 1 -T 2

Sagital plane

Danger space • Anterior border: fascia alaris Posterior border fascia prevertebralis • Between the base of rthe skull and the diaphragma

Sp. prevertebrale • • art. vertebralis, plexus brachialis, n. phrenicus Scalenus and prevertebral muscles, vertebrae

Pharnx Esophagus Danger space Mediastinum posterius

CT, MRI http: //rad. usuhs. mil/medpix_home. html#top

Cross section of the final exam: C 1 level A. carotis interna. Tonsillectomia!!

Cross section of the final exam: C 3 level

Cross section of the final exam: C 4 level

Cross section of the final exam: C 5 level

Cross section of the final exam: C 5 -6 level

Cross section of the final exam: C 6 -7 level

Pharyngitis <>

Radiographic picture of the esophagus