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Walls of the pharynx
Submucosa (pharyngobasilar fascia)
Muscular layer with two layers of muscles (inner longitudinal and outer circular)
Buccopharyngeal fascial layer
Where do the palatine tonsils lie? Function?
In the mucosa.

Produce lymphocytes and have a protective function for bacteria entering the respiratory or GI tract.

Most commonly removed tonsils.
At what level does the pharynx become the esophagus?
At the inferior border of the cricoid cartilage at C6.
Contents of the nasopharynx
Pharyngeal tonsil on the posterior wall.
Ostium of the Eustachian tube.
Opening of the pharygnotympanic/eustachian/auditory tube
What is the torus tubaris?
The swelling produced by the medial portion of the eustachian tube. The salpingopharyngeal fold extends down from the torus tubaris into the nasopharynx.
Where is the pharyngeal recess?
A cleft in the nasopharynx where cancers can form. Lateral to this is the pharyngeal space where infections from teeth, skin, etc. can spread to.
What is the pharyngeal isthmus?
A bridge between the nasopharynx and the oropharynx.
Salpingopharyngeus muscle
Lies deep to the salpingopharyngeal fold.
Levator palatini muscle and tensor palatini muscle
Tensor palatini muscle is aterior and lateral to levator palatini.

Together they elevate and pull the soft palate posteriorly to close the nasopharynx from the oropharynx during the second stage of swallowing.
Palatoglossus muscle
Oropharynx. Deep to the palatoglossal fold. A very short, brief muscle, posterior to which is the palatine tonsillar bed.
Pharyngobasilar fascia
Under mucosa of oropharynx. Lies over tonsil bed. Physicians use it as a lateral boundary in removing the palatine tonsil.
Superior constrictor muscle
Under the submucosa in the oropharynx. Forms bed of the tonsil.

Pierced by arteries and veins.
Lateral borders of the oropharynx
Palatoglossal fold anteriorly and the palatopharyngeal fold posteriorly. With the mucosa removed, you are looking at the palatoglossus and palatopharyngeus muscles.
Paratonsillar vein
In the oropharynx. Bleeding after a tonsillectomy is typically caused by nicking the paratonsillar vein.
What is the only nerve in the tosillar bed?
The glossopharyngeal nerve (IX).
Which nerve supplies taste and general sensation the posterior 1/3 of the tongue?
The glossopharyngeal nerve (IX).
Styloglossus muscle
Lies lateral to the superior constrictor muscle in the oropharynx. Arises from the anterior and lateral surfaces of the styloid process, near its apex, and from the stylomandibular ligament. Passes between the internal and external carotid arteries.

Retrudes and elevates the tongue. Extrinsic muscle of the tongue.

Innervated by hypoglossal nerve (XII).
Which nerve innervates all of the muscles of the tongue except for the palatoglossus?
The hypoglossal nerve (XII).
What innervates the palatoglossus?
The pharyngeal plexus, a plexus which includes motor branches of the vagus nerve (X).
What nerve provides general sensation to the anterior 2/3 of the tongue?
The lingual nerve, a branch of V3.
What nerve provides special taste sensation to the anterior 2/3 of tongue?
The chorda tympani nerve, a branch from the facial nerve (VII). Joins the lingual nerve and runs with it in its sheath.
What nerve provides general and special sensation to the posterior 1/3 of the tongue?
The glossopharyngeal nerve (IX).
How does the vagus nerve supply general and special sensation to the very back of the tongue?
Twigs from the internal laryngeal nerve, a branch from X.

Also carries parasympathetic secretomotor fibers to serous glands in the tongue. Probably synapse in the submandibular ganglion suspended from the lingular nerve.
What muscles arise from the styloid process?
Muscles of the inner layer of the pharynx

The three muscles blend together and attach inferiorly into the wall of the pharynx and the superior and posterior aspects of the thyroid cartilage.
Muscles of the outer layer of the pharynx
Superior, middle and inferior constrictors.
Gap between the superior constrictor muscle and the base of the skull
Pharyngobasilar muscle pierced by auditory tube and the levator of the palate, which lies in the floor of the auditory tube. Both the ascending palatine branch of the facial artery and the ascending pharyngeal artery (second branch of external carotid artery) pass over this gap.
Gap between the superior constrictor muscle and the middle constrictor muscle
Stylohyoid ligament, the stylopharyngeus muscle, and CN IX (the nerve supply to the stylopharyngeus muscle).
Gap between the middle constrictor muscle and the inferior constrictor
Thyrohyoid membrane pierced by the internal laryngeal nerve and the superior laryngeal artery.
Sensory nerves of the pharynx
The pharyngeal branch of V2 - afferent fibers to the upper part of pharynx just superior to the ostium of the auditory tube.

CN IX. Pharyngeal fibers of the glossopharyngeal nerve supply afferent fibers to the area from just superior to the ostium of the auditory tube to the termination of pharynx.

CN X. Internal laryngeal branches of the vagus supply some of the pharynx.
Pharyngeal Plexus
Lies on the posterior aspect of the middle constrictor muscle.

CN X (SVE) are motor to most muscles of the pharynx

CN IX are sensory to most of the pharynx

Sympathetic fibers (pharyngeal branches of sympathetic trunk)

CN IX (SVE) supplies the stylopharyngeus (this is the only motor function of CN IX, the remaining fibers are sensory in nature)
Branches of the external carotid artery
S-uperior thyroid
A-scending pharyngeal
O-cciptal (posterior branch)
P-osterior auricular (posterior branch)
S-uperficial temporal (terminal branch)
M-axillary (terminal branch)
At what level does the common carotid artery bifurcate?
At the superior level of the thyroid cartilage
Superficial lymph node drainage
Submental nodes, posteriorly to the submandibular nodes, parotid nodes, and occipital nodes.5. Superficial lymphatic drainage of the head and neck all drain into deep cervical lymph nodes which in turn drain to a jugular trunk. On the left side it joins with the thoracic duct; on the right it joins with the right lymph duct.

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