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Mouth

1- vestibule

2- mouth proper

lined by strat.sq epitheliumand and contains

numerous salivary glands.

Salivary glands divided into:

1-small

2-large:3 pairs; paroted, submandibular and

sublingual



The pharynx is situated behind the nasal

cavities, the mouth, and the larynx



It is divided into nasal, oral, and laryngeal

parts



Its upper part is wider and lies under the skull



Its lower end is narrow and continues with the

esophagus opposite the sixth cervical vertebra

Pharynx

Is a fibro-muscular tube, funnel

shaped being braodest in its

up.part, its lower end

continues with the

esophagus(narrowest part of

the digestive tract).

1- nasopharynx

2- oropharynx

3- laryngopharynx(hypopharynx)

Consists of four layers:

1- Mucous membrane: contains

a- Epithelium

b- Subepith.lymphoid tissues:waldeyers

ring(palatine ,nasopharyngeal, tubal and

lingual tonsils)

2-Apponeurosis (pharyngobasilar fascia)

3- Muscular coat: external and internal layers

a- external : 3 consrictors (sup.,middle and inf.)

b- internal : stylopharyngeuos,palatopharyngeus
and salpingopharyngeus

4- Buccopharyngeal fascia

: External caroted a.

Blood supply

: motor(accesory n.)

Nerve supply

Sensory: by 5

, 9

and 10

cranial

nerves.

: deep jugular nodes.

drainage

Lyphatic



This lies above the soft palate and behind the nasal

cavities



In the submucosa of the roof is a collection of

lymphoid tissue called the nasopharyngeal tonsil



The pharyngeal isthmus is the opening in the floor

between the soft palate and the posterior

pharyngeal wall



On the lateral wall is the opening of the auditory

tube, the elevated ridge of which is called the tubal

elevation

Pharyngeal recess (fossa of Rosen-muller) is a

depression behind the tubal elevation in the
lateral wall of the nasopharynx.

It is the commonest site of a hidden tumor in the

head and neck.

This lies behind the oral cavity

The floor is formed by the posterior one third of

the tongue and the interval between the tongue

and epiglottis

The tongue and epiglottis are connected by 3

mucosal folds, one median and two lateral

glossoepiglottic folds.

The depression on each side of the median
glossoepiglottic fold is called the vallecula

On the lateral wall on each side are the palatoglossal

and the palatopharyngeal arches or folds and the

palatine tonsils between them

The palatoglossal arch is a fold of mucous membrane

covering the palatoglossus muscle

The interval between the two palatoglossal arches is

called the oropharyngeal isthmus

It marks the boundary between the mouth and

pharynx

The palatopharyngeal arch is a fold of mucous

membrane covering the palatopharyngeus
muscle

The recess between the palatoglossal and

palatopharyngeal arches is occupied by the

palatine tonsil

This lies behind the opening into the larynx

The lateral wall is formed by the thyroid cartilage

and the thyrohyoid membrane. It consists of 2

pyrifom sinuses (fossae), postcricoid region

and posterior pharyngeal wall.

The pyriform fossa is a depression in the mucous

membrane on each side of the laryngeal inlet

Nasal pharynx: The maxillary nerve

Oral pharynx: The glossopharyngeal nerve

Laryngeal pharynx: The internal laryngeal branch

of the vagus nerve



Ascending pharyngeal, tonsillar branche of

facial artery, and branches of maxillary and
lingual arteries (branches of external carotid

artery)



Directly into the deep cervical lymph nodes or

indirectly via the retropharyngeal or
paratracheal nodes into the deep cervical nodes

The Larynx

• The larynx is the

portion of the

respiratory tract

containing the vocal

cords

• A

2-inch-long

, tube-shaped organ,

opens into the

laryngeal part of the

pharynx

above and is continuous

with the

trachea

below

The Larynx: Important Relations

• The larynx related to

major critical structures:

 Carotid arteries , jugular

veins, and vagus nerve

 Superior and inferior

thyroid arteries

 Superior and recurrent

laryngeal nerves

Structure

• The larynx consists of

four basic components:

 A cartilaginous

skeleton

 Membranes and

ligaments

 Intrinsic and extrinsic

muscles

 Mucosal lining

The Cartilages

• The cartilaginous

skeleton is comprised

of :

 Single Cartilages

 Thyroid
 Cricoid
 Epiglottis

 Paired Cartilages

 Arytenoid
 Corniculate
 Cuneiform

• All the cartilages,

except the epiglottis,

are of

hyaline

type.

• Epiglottis is formed of

elastic

cartilage

• The cartilages are:



Connected by

joints

membranes

ligaments



Moved by

muscles

Thyroid Cartilage

• Has

two laminae

, which meet in the

midline and form a prominent angle,
called

laryngeal prominence

(

Adam’s

apple

) and the

superior thyroid notch

the rostral margin of the

• The

posterior border

of each lamina

forms

superior & inferior cornu

(horns)

• Outer surface of each lamina shows an

oblique line

which gives attachment to

thyrohyoid

sternothyroid

inferior

constrictor of the pharynx

• The

superior border

gives attachment to

the

thyrohyoid membrane

Oblique
line

superior
cornu

inferior
cornu

Cricoid Cartilage

• Lies below the thyroid

cartilage

• Forms a complete ring
• Has a

narrow anterior arch

& a

broad posterior lamina

• Has an articular facet on its:

• Lateral surface

for

articulation with

inferior

cornu of the thyroid
cartilage

(a synovial joint)

• Upper border

for

articulation with base of

arytenoid cartilage

synovial joint)

Arytenoid Cartilages

• Small,

pyramidal

in shape

• Situated at the back of the larynx
Has:
• A

base

articulating with the upper

border of the cricoid cartilage

• An

apex

supporting the corniculate

cartilage

• A

vocal process

projecting forward,

gives attachment to the vocal
ligament

• A

muscular process

projecting

laterally, gives attachment to
muscles

Corniculate & Cuneiform Cartilages

Corniculate Cartilages

• Small nodules
• Articulate with the apices of

arytenoid cartilages

Cuneiform Cartilages

• Small rod shaped, placed in each

aryepiglottic fold, producing a
small elevation

• Do not articulate with any other

cartilage

Serve as support for the ary-

epiglottic fold

V
F

Epiglottis

• Leaf shaped, situated behind the root

of the tongue

• Connected:



In front to the body of hyoid bone
by the

hyoepiglottic ligament



By its stalk to the back of thyroid
cartilage by the

thyroepiglottic

ligament

• Upper edge is free.

• Laterally

gives attachment to

aryepiglottic fold

• Anteriorly mucosa is reflected onto the

tongue forming three

glossoepiglottic

folds & valleculae

Membranes & Ligaments

• Thyrohoid membrane

median & lateral thyrohoid
ligaments

• Median cricothyroid

ligament

• Cricotracheal membrane
• Hyoepiglottic ligament
• Thyroepiglottic ligament

• Quadrangular membrane:

• Extends between the epiglottis

and the arytenoid cartilages

• Its lower free margin forms the

vestibular ligament

that lies

within the vestibular fold

• Cricothyroid membrane

(conus elasticus):

• Lower margin is attached to upper

border of cricoid cartilage

• Upper free margin forms

vocal

ligament

that is attached

anteriorly

to deep surface of

thyroid cartilage &

posteriorly

the vocal process of arytenoid
cartilage

Laryngeal Cavity

• Extends from laryngeal

inlet to lower border of
the cricoid cartilage

• Narrow in the region of

the vestibular folds
(

rima vestibuli

)

• Narrowest in the

region of the vocal
folds (

rima glottidis

)

Rima
vestibuli

Rima
glottidis

Laryngeal Cavity cont’d

• Divided into

three

parts

A. Supraglottic part

the part above the
true vocal cords

B. Glottis

: The true

vocal cords

C. Subglottic part

, the

part below the true
vocal cords.

Mucous Membrane

• The cavity is lined with

ciliated columnar epithelium

• The surface of

vocal folds

, because of exposure to continuous trauma

during phonation, is covered with

stratified squamous epithelium

• Contains many

mucous glands

, more numerous in the saccule (for

lubrication of vocal folds)

Muscles

Divided into two groups:

• Extrinsic muscles

: divided into two groups

• Elevators

of the larynx

• Depressors

of the larynx

• Intrinsic muscles

: divided into two groups

• Muscles

controlling the laryngeal inlet

• Muscles

controlling the movements of the vocal cords

Elevators of the

Pharynx

• The Suprahyoid Muscles

 Digastric
 Stylohyoid
 Mylohyoid
 Geniohyoid

• The Longitudinal Muscles of the

Pharynx

 Stylopharyngeus
 Salpingopharyngeus
 Palatopharyngeus

Depressors of the Pharynx:

• The Infrahyoid Muscles

 Sternohyoid
 Sternothyroid
 Omohyoid

Muscles Controlling the Laryngeal Inlet

• Oblique arytenoid
• Aryepiglottic muscle

Muscle Increasing the Length & Tension of the

Vocal Cords

• Cricothyroid

: increases the

distance between the

angle of

the thyroid cartilage

& the

vocal

processes of the arytenoid
cartilages,

and results in

increase

in the

length & tension

of the vocal cords

Muscle decreasing the Length & Tension of Vocal

Cords

• Thyroarytenoid

(vocalis)

: pulls the

arytenoid cartilage
forward toward the
thyroid cartilage and
thus

shortens

and

relaxes

the vocal cords

Movements of the Vocal Cords

• Adduction
• Abduction

Folds closed (adducted) Folds open (abducted

)

(View from above)

Glottis (space between folds)

Adductors of the Vocal Cords

• Lateral

cricoarytenoid

• Transverse arytenoid

Abductor of the Vocal Cords

• Posterior

cricoarytenoid

Blood Supply & Lymph Drainage

• Arteries:

 Upper half:

Superior laryngeal

artery

, branch of superior

thyroid artery

 Lower half

Inferior laryngeal

artery

, branch of inferior

thyroid artery

• Veins:

 Accompany the corresponding

arteries

• Lymphatics:

 The lymph vessels drain into

the

deep cervical lymph nodes

Nerve Supply

• Sensory

 Above the vocal cords:

Internal

laryngeal nerve

, branch of the

superior laryngeal branch of

the vagus nerve

 Below the vocal cords:

Recurrent laryngeal nerve

branch of the vagus nerve

• Motor



All intrinsic muscles, except

cricothyroid

, supplied by the

recurrent laryngeal nerve



The

cricothyroid

muscle is

supplied by the

external

laryngeal nerve,

a branch of the

superior laryngeal branch of

vagus nerve

1- protection of lower air passages

2- phonation

3- respiration

4- fixation if the chest

THANX