Chapter 4. PHARYNX DISEASES

Labor recedet, bene factum non abscedet. Difficulty goes by, the good deed remains.

4.1. PHARYNX CLINICAL ANATOMY

Pharynx is the first part of the alimentary tube located between the oral cavity and the esophagus. At the same time, the pharynx is a part of the respiratory tract which conducts the air from the nasal cavity to the larynx.

The pharynx is placed anteriorly to the cervical spine and extends from the skull base to the level of the sixth cervical vertebra, where it narrows down and transformates to the esophagus. Length of the pharynx in adults is 12-14 cm. A distinction is made between the superior, posterior, anterior and lateral pha-ryngeal walls.

► The superior pharyngeal wall, or its vault (fornix pharyngis), is attached to the external surface of the skull base in the region of the basioccipital bone and body of sphenoid bone.

► The posterior pharyngeal wall is adjacent to the prevertebral layer of cervical fascia (lamina prevertebralis) and corresponds to the bodies of the five superior cervical vertebrae.

► The lateral pharyngeal walls are located nearby internal and external carotid arteries, internal jugular vein, vagus, hypoglossal and glossopharyn-geal nerves, sympathetic trunk, greater horns of a hyoid bone and thyroid cartilage.

► The anterior pharyngeal wall in its superior (nasopharyngeal) part communicates with the nasal cavity via choanae, and with the oral cavity in its middle part.

Three parts are distinguished in the pharynx (fig. 4.1):

► upper - the nasal part, or nasopharynx (pars nasalis, epipharynx);

► middle - the oral part, or oropharynx (pars oralis, mesopharynx);

► lower - the laryngeal part, or hypopharynx (pars laryngea).

Fig. 4.1. Parts of the pharynx: 1 - nasopharynx; 2 - oropharynx; 3 - hypopharynx