Nasopharynx The upper portion of the pharynx, the nasopharynx, extends from the base of the
skull to the upper surface of the
soft palate. It includes the space between the
internal nares and the soft palate and lies above the oral cavity. The
adenoids, also known as the pharyngeal tonsils, are
lymphoid tissue structures located in the posterior wall of the nasopharynx.
Waldeyer's tonsillar ring is an annular arrangement of lymphoid tissue in both the nasopharynx and oropharynx. The nasopharynx is lined by
respiratory epithelium that is pseudostratified, columnar, and ciliated.
Polyps or
mucus can obstruct the nasopharynx, as can congestion due to an upper respiratory infection. The
auditory tube, which connects the middle ear to the pharynx, opens into the nasopharynx at the pharyngeal opening of the auditory tube. The opening and closing of the auditory tubes serves to equalize the barometric pressure in the middle ear with that of the ambient atmosphere. The anterior aspect of the nasopharynx communicates through the
choanae with the nasal cavities. On its lateral wall is the
pharyngeal opening of the auditory tube, somewhat triangular in shape and bounded behind by a firm prominence, the
torus tubarius or cushion, caused by the medial end of the cartilage of the tube that elevates the
mucous membrane. Two folds arise from the cartilaginous opening: • the
salpingopharyngeal fold, a vertical fold of mucous membrane extending from the inferior part of the torus and containing the
salpingopharyngeus muscle. • the
salpingopalatine fold, a smaller fold, in front of the salpingopharyngeal fold, extending from the superior part of the torus to the palate and containing the
salpingopalatine muscle. The
tensor veli palatini and
levator veli palatini are lateral to the fold and do not contribute.
Oropharynx The oropharynx lies behind the oral cavity, extending from the
uvula to the level of the
hyoid bone. It opens anteriorly, through the
isthmus faucium, into the mouth, while in its lateral wall, between the
palatoglossal arch and the
palatopharyngeal arch, is the
palatine tonsil. The anterior wall consists of the base of the tongue and the
epiglottic vallecula; the lateral wall is made up of the tonsil, tonsillar fossa, and tonsillar (faucial) pillars; the superior wall consists of the inferior surface of the soft palate and the uvula. Because both food and air pass through the pharynx, a flap of connective tissue called the
epiglottis closes over the
glottis when food is swallowed to prevent
aspiration. The oropharynx is lined by non-keratinized squamous stratified epithelium. The
HACEK organisms (
Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella) are part of the normal oropharyngeal flora, which grow slowly, prefer a carbon dioxide-enriched atmosphere, and share an enhanced capacity to produce
endocardial infections, especially in young children.
Fusobacterium is a pathogen.
Laryngopharynx The laryngopharynx, (
Latin:
pars laryngea pharyngis), also known as
hypopharynx, is the
caudal part of the pharynx; it is the part of the throat that connects to the esophagus. It lies inferior to the epiglottis and extends to the location where this common pathway diverges into the respiratory (
laryngeal) and digestive (
esophageal) pathways. At that point, the laryngopharynx is continuous with the esophagus posteriorly. The esophagus conducts food and fluids to the stomach; air enters the larynx anteriorly. During swallowing, food has the "right of way", and air passage temporarily stops. Corresponding roughly to the area located between the 4th and 6th
cervical vertebrae, the superior boundary of the laryngopharynx is at the level of the
hyoid bone. The laryngopharynx includes three major sites: the
pyriform sinus, postcricoid area, and the posterior pharyngeal wall. Like the oropharynx above it, the laryngopharynx serves as a passageway for food and air and is lined with a
stratified squamous epithelium. It is innervated by the
pharyngeal plexus and by the
recurrent laryngeal nerve. The vascular supply to the laryngopharynx includes the
superior thyroid artery, the
lingual artery and the
ascending pharyngeal artery. The primary neural supply is from both the
vagus and
glossopharyngeal nerves. The vagus nerve provides an
auricular branch also termed "Arnold's nerve" which also supplies the external auditory canal, thus laryngopharyngeal cancer can result in referred
ear pain. This nerve is also responsible for the
ear-cough reflex in which stimulation of the ear canal results in a person coughing. == Function ==