Pharnyx and Larynx

Anatomy and Physiology

 Pharnyx
Tubular,
fibromuscular space
extending from the
skull base to upper
esophagus
Function
Swallowing
Immune response
Resonance chamber
 Nasopharnyx
Oropharnyx
Hypopharnyx
 Nasopharnyx
Posterior
apaerature -Soft
palate
Pharngeal
isthmus
Soft palate
contraction:men
utup jalan.
(palatopharngea
l spinchter)
Pharngeal tonsil:
membesar
 Nasophanyx
Pharngygotymoanic tube:
menghubughan phanyx denga
middle ear.
Salpingipharngeal muscle
 Oropharnyx
Batas inferior
of soft palate-
upper epglotis.
Palatoglossal
arch
Palatine tonsil
1/3 posterior
lidah: lingual
tonsil
 Hypopharnyx
Laryngopharnyx:
batasnya dari
superior larnyx-
esophagus level
c7
 Muscle
Constrictor muscle
Longituidnal muscle
Constrictor Muscle
Longitudinal Muscle
 Vessels of pharnyx
Ascending phrangeal
artery
Facial artery: the
ascending and
tonsillar branches
Branches of maxilaary
artery and linguinal
artery
Origins from external
carotid artery
Veins and lymphatic
 Vessels of phranyx
Lower part of phranyx supplied by
inferior thyroid artery, origin from
thyrocervical trunk of subclavian
artery
Veins: drains into prethygroid plexus
in infratemporal fossa and inferiorly
into the facial and internal jugalar
veins
Lymphatic: Retropharngeal ,
parathracheal and infrahyoid nodes
 Nerves
Vagus nerveL: Pharngeal
branch of the vagus
nerve X all muscle
except stylopharyngeus
that innervated
glossopharngeal nerve IX
Sensory:Nasopharnyx
(maxilarry nerve V2),
Oropharnyx IX(gag
reflex), laryngopharnyx X
Tonsils
 Physiology of phanyx
Swallowing
Oral phase: food is broken down and moistened to
form a bolus, moved to oropharnyx. Pressing the food
agains hard palate with the toounge
Pharyngeal phase: bolus comes contact with receptor
in the thorat, eliciting an involutary swallowing
reflex. Afferent impules travel through
glossopharngeal and vagus nerve. So involuntary
swallowing reflex is triggered.
Velum close of the nasophanyx.
Larnyx is also sealed of by elevation of the epilgotis.
 Physiology of phanyx
Esophangeal: food swallowing by
peristaltic wave. Within 7-10 second
 Larnyx
Function
Respiration
Phonation
Effort closure
Swallowing
 larnyx
Three large unpaired
cartilages(cricoid,
thyroid and epiglottis)
Smaller cartilage
(arytenoid, corniculate
and cuneiform
Fibroelastic membrane
and numerous intrinsic
muscle
Innervation motory and
sensory of nerve x
 Ligaments of Larnyx
Extrinsic ligament(thyrohyoid
membrane,hypoepiglotic membrane
and cricotracheal ligament
Intrinsic ligament (Fibro-elastic
membrane, cricothyroid ligmanent,
quadrogranular membrane)
 Cavity of larnyx
Vestibule:larngeal
inlet and vestibular
folds
Middle larngeal :
vestibalr folds and
vocal folds
Infraglotis: vocal
folds and inferior
the opening of the
larynx
 Cavity of Larnyx
Ventricles: mucus gland. Menuju
saccule untuk lubrikasi vocal folds
 Intrinsic Muscle
Adjust the vocal ligament
Open and close the roma glottidis
Control the inner dimesnion of the
vestibule
closing larngeal inlet
 Cricothyroid muscle
Forward and
downward
rotation of the
thyroid
cartilage or
cricothyroid
joint
 Posterior crico artyneoid
muscle, primary abductor of
the vocal folds. The primary
openers of the rima glottida
Lateraltcrico arytenoid
muscles: adduction vocal
folds
Transverve arytenoid
muscle adduction of
arytenoid cartilage
Obelique arytenoid muscles:
spincther of laryngeal inlet
Thyro-arytenoid: spinchter
of vestibule and of laryngeal
inlet
Vocalis muscle: laryngeal
inlet
 Intrinsic muscle
Tightening of the vocal cords:
posterior cricoarytenoid muscle
closing the glottis:lateral crico
arytedoid ,transverve and obelique
intrarytenoid muscle,thyroarytenoid
muscle
opening glottis: cricothyroid muscle,
thyroarytenoid muscle, vocalis
muscle
 Vessels
Superior laryngeal
artery
Inferior laryngeal
artery
 Veins
Superior
larngeal
vein,drain into
jugular vein
Inferio larngeal
vein, left
brachiocephalic
vein
 Nerve
Superior larngeal nerve
Inferor laryngeal nerve:
sensory laringeal avity
down to the level of
the vocal folds
Reccurent larengal
nerve:Sensory below
the vocal cords, motor:
all the intrinsic muslce
expect for cricothyroid.
 Physiology larnyx
Protective mechanism:Reflex closure
of the vocal cords in response
phrangeal swallowing.
Contraction of suprahyoid and
infrayoid muscle elevates larnyngeal
skeleton 2-3cm.
While tongue bulges and press
epilgotis downward, direct the food
bolus pas and behind the larnyx io
esophangeal inlet.
 Physiology larnyx
Cough reflex: protect the lower
airway. Glottis closes tightly, allowing
a rise intrathoraic pressure. Rapidly
to allow forceful explusion of the
aspirated material.
 Reference
Grays anatomy anatomy for students
thrid edition
Basic otolaryngology: a step by step
learning guide: Thieme