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Anatomy

The Layers of the Pharyngeal Wall

  • The pharyngeal wall is composed of 5 layers. From internal to external, they are as follows.
  • Mucous membrane: this lines the pharynx and is continuous with all chambers with which it communicates.
  • Submucosa
  • Pharyngobasilar fascia: this is a fibrous layer that is attached to the skull.
  • Muscular layer: this is composed of inner longitudinal and outer circular parts.
  • Buccopharyngeal fascia: this is a loose connective tissue layer.
  • This fascia is continuous with the fascia covering the buccinator and pharyngeal muscle.
  • It contains the pharyngeal plexus of nerves and veins.

  • Skull 
    Cranium
    o    Superior portion formed by the frontal. parietal, and occipital bones
    o    Lateral portions formed by the temporal and sphenoid bones
    o    Cranial base formed by the temporal. sphenoid, and ethmoid bones
    o    Fontanels-soft spots in which ossification is incomplete at birth

    Frontal bone
    o    Forms the forehead
    o    Contains the frontal sinuses
    o    Forms the roof of the orbits
    o    Union with the parietal bones forms the coronal suture

    Parietal bones
    o    Union with the occipital bone forms the lambdoid suture
    o    Union with the temporal bone forms the squamous suture
    o    Union with the sphenoid bone forms the coronal suture

    Temporal bones
    o    Contains the external auditory meatus and middle and inner ear structures
    o    Squamous portion-above the meatus: zygomatic process-articulates with the zygoma
    o    to form the zygomatic arch 

    •    Petrous portion
    o    Contains organs of hearing and equilibrium 
    o    Prominent elevation on the floor of the cranium

    •    Mastoid portion
    o    Protuberance behind the ear

    o    Mastoid process
    •    Glenoid fossa-articulates with the condyle on the mandible
    •    Styloid process-anterior to the mastoid process; several neck muscles attach here
    •    Stylomastoid foramen-located between the styloid and mastoid processes; facial nerve emerges through this opening
    •    Jugular foramen-located between the petrous portion and the occipital bone: cranial nerves IX. X, and XI exit
     

 

The Soft Palate

  • This is the posterior curtain-like part, and has no bony support. It does, however, contain a membranous aponeurosis.
  • The soft palate, or velum palatinum (L. velum, veil), is a movable, fibromuscular fold that is attached to the posterior edge of the hard palate.
  • It extends posteroinferiorly to a curved free margin from which hangs a conical process, the uvula (L. uva, grape).
  • The soft palate separates the nasopharynx superiorly and the oropharynx inferiorly.
  • During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity.
  • Laterally, the soft palate is continuous with the wall of the pharynx and is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal folds.
  • The soft palate is strengthened by the palatine aponeurosis, formed by the expanded tendon of the tensor veli palatini muscle.
  • This aponeurosis attaches to the posterior margin of the hard palate.

Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

  • Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
  • Inferior attachment: palatine aponeurosis.
  • Innervation: pharyngeal branch of vagus via pharyngeal plexus.
  • This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.
  • It elevates the soft palate, drawing it superiorly and posteriorly.
  • It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

 

The Tensor Veli Palatini (Tensor Palati)

  • Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
  • Inferior attachment: palatine aponeurosis.
  • Innervation: medial pterygoid nerve (a branch of the mandibular nerve).
  • This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
  • It then inserts into the palatine aponeurosis.
  • This muscle tenses the soft palate by using the hamulus as a pulley.
  • It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

 

The Palatoglossus Muscle

  • Superior attachment: palatine aponeurosis.
  • Inferior attachment: side of tongue.
  • Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
  • This muscle, covered by mucous membrane, forms the palatoglossal arch.
  • The palatoglossus elevates the posterior part of the tongue and draws the soft palate inferiorly onto the tongue.

 

  • Superior attachment: hard palatThe Palatopharyngeus Musclee and palatine aponeurosis.
  • Inferior attachment: lateral wall of pharynx.
  • Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
  • This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
  • It passes posteroinferiorly in this arch.
  • This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

 

The Musculus Uvulae

  • Superior attachment: posterior nasal spine and palatine aponeurosis.
  • Inferior attachment: mucosa of uvula.
  • Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.
  • It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
  • When the muscle contracts, it shortens the uvula and pulls it superiorly.

Muscles of the Tongue

  • The tongue is divided into halves by a medial fibrous lingual septum that lies deep to the medial groove.
  • In each half of the tongue there are four extrinsic and four intrinsic muscles.
  • The lingual muscles are all supplied by the hypoglossal nerve (CN XII).
  • The only exception is palatoglossus, which is supplied by the pharyngeal branch of the vagus nerve, via the pharyngeal plexus.

 

Extrinsic Muscles of the Tongue

The Genioglossus Muscle

  • This is a bulky, fan-shaped muscle that contributes to most of the bulk of the tongue.
  • It arises from a short tendon from the genial tubercle (mental spine) of the mandible.
  • It fans out as it enters the tongue inferiorly and its fibres attach to the entire dorsum of the tongue.
  • Its most inferior fibres insert into the body of the hyoid bone.
  • The genioglossus muscle depresses the tongue and its posterior part protrudes it.

 

The Hyoglossus Muscle

  • This is a thin, quadrilateral muscle.
  • It arises from the body and greater horn of the hyoid bone and passes superoanteriorly to insert into the side and inferior aspect of the tongue.
  • It depresses the tongue, pulling its sides inferiorly; it also aids in retrusion of the tongue.

 

The Styloglossus Muscle

  • This small, short muscle arises from the anterior border of the styloid process near its tip and from the stylohyoid ligament.
  • It passes inferoanteriorly to insert into the side and inferior aspect of the tongue.
  • The styloglossus retrudes the tongue and curls its sides to create a trough during swallowing. 

 

The Palatopharyngeus Muscle

  • Superior attachment: hard palate and palatine aponeurosis.
  • Inferior attachment: lateral wall of pharynx.
  • Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
  • This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
  • It passes posteroinferiorly in this arch.
  • This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing. 

Intrinsic Muscles of the Tongue

The Superior Longitudinal Muscle of the Tongue

  • The muscle forms a thin layer deep to the mucous membrane on the dorsum of the tongue, running from its tip to its root.
  • It arises from the submucosal fibrous layer and the lingual septum and inserts mainly into the mucous membrane.
  • This muscle curls the tip and sides of the tongue superiorly, making the dorsum of the tongue concave.

 

The Inferior Longitudinal Muscle of the Tongue

  • This muscle consists of a narrow band close to the inferior surface of the tongue.
  • It extends from the tip to the root of the tongue.
  • Some of its fibres attach to the hyoid bone.
  • This muscle curls the tip of the tongue inferiorly, making the dorsum of the tongue convex.

The Transverse Muscle of the Tongue

  • This muscle lies deep to the superior longitudinal muscle.
  • It arises from the fibrous lingual septum and runs lateral to its right and left margins.
  • Its fibres are inserted into the submucosal fibrous tissue.
  • The transverse muscle narrows and increases the height of the tongue.

The Vertical Muscle of the Tongue

  • This muscle runs inferolaterally from the dorsum of the tongue.
  • It flattens and broadens the tongue.
  • Acting with the transverse muscle, it increases the length of the tongue.

Connective Tissue

Functions of Connective tissue:

→ joins together other tissues

→ supporting framework for the body (bone)

→ fat stores energy

→ blood transports substances

 

Connective tissue is usually characterized by large amounts of extracellular materials that separate cells from each other, whereas epithelial tissue is mostly cells with very little extracellular material. The extracellular substance of connective tissue consists of protein fibers which are embedded in ground substance containing tissue fluid.

Fibers in connective tissue can be divided into three types:

→ Collagen fibers are the most abundant protein fibers in the body.

→ Elastic fibers are made of elastin and have the ability to recoil to original shape.

→ Reticular fibers are very fine collagen fibers that join connective tissues to other tissues.

Connective tissue cells are named according to their functions:

 → Blast cells produce the matrix of connective tissues

→ Cyte cells maintains the matrix of connective tissues

→ Clast cells breaks down the matrix for remodeling (found in bone)

Intramembranous ossification

  • Flat bones develop in this way (bones of the skull)
  • This type of bone development takes place in mesenchymal tissue
  • Mesenchymal cells condense to form a primary ossification centre (blastema)
  • Some of the condensed mesenchymal cells change to osteoprogenitor cells
  • Osteoprogenitor cells change into osteoblasts which start to deposit bone
  • As the osteoblasts deposit bone some of them become trapped in lacunae in the bone and then change into osteocytes
  • Osteoblasts lie on the surface of the newly formed bone
  • As more and more bone is deposited more and more osteocytes are formed from mesenchymal cells
  • The bone that is formed is called a spicule
  • This process takes place in many places simultaneously
  • The spicules fuse to form trabeculae
  • Blood vessels grow into the spaces between the trabeculae
  • Mesenchymal cells in the spaces give rise to hemopoetic tissue
  • This type of bone development forms the first phase in endochondral development
  • It is also responsible for the growth of short bones and the thickening of long bones

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