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Anatomy of Oral Cavity,
Pharynx and Esophagus Dr. Vishal Sharma BAMS; M.D. (Ayu.)
2020-01-20 Oral Cavity Anatomical regions (Oncological) • Buccal Mucosa – Mucosal surfaces of upper and lower lips , cheeks – Retromolar trigone, upper and lower buccoalveolar sulci • Upper alveolus and gingiva • Lower alveolus and gingiva • Hard Palate • Anterior 2/3 of tongue • Floor of Mouth Floor of mouth Lymphatic Drainage Intrinsic Tongue Muscles • Three groups – Transverse – Longitudinal (Upper and lower) – Vertical • Function – Alter the shape of tongue Extrinsic tongue muscles Alter the position of tongue
Largest muscle of tongue
Action of tongue muscles • Inferior and superior longitudinal : move the tip up and down • Transverse : narrow and lengthen the tongue • Vertical : flatten and depress the tongue • Genioglossus : Prevents tongue from falling back • Styloglossus : Pulls tongue up and back • Palatoglossus : Pulls and raises the tongue • Hyoglossus : Depresses the tongue Nerve Supply of Tongue Anterior 2/3 Posterior 1/3
Sensory Lingual Glossopharyngeal
Motor Genioglossus, Styloglossus and
Hyoglossus supplied by Hypoglossal Palatoglossus supplied by spinal accessory
Taste Chorda tympani Glossopharyngeal
Papillae in tongue
Lingual taste buds lie on lateral borders of papillae
• Fungiform : Tip & sides of tongue
• Circumvallate : Just in front of terminal sulcus
• Foliate : Posterior lateral margins of
tongue
• Filiform : Centre of tongue, have no taste
buds Papillae in tongue Tongue Map Pharynx Divisions Lower Limit of
Nasopharynx Lower border of soft palate or
Junction between hard & soft palate
Oropharynx Tip of epiglottis or
Body of hyoid bone or Base of vallecula
Hypopharynx Lower border of cricoid or
Lower border of C6 vertebra Anterior Relations Nasopharynx Nasopharyngeal Isthmus
• Separates nasopharynx from oropharynx
• Bounded anteriorly by soft palate & posteriorly by
mucosal ridge on nasopharyngeal wall ( Passavant’s
ridge) - due to palatopharyngeus)
• Closure of this isthmus prevents nasal regurgitation
and nasal intonation Parts of Oropharynx Oropharyngeal Isthmus • Separates oral cavity from oropharynx • Boundarie s – Superior: Junction between
hard & soft palate
– Inferior: Circumvallate papillae
– Lateral: Anterior tonsillar pillars (palatoglossus) Waldeyer's tonsillar ring
• Vertically oriented, sub-epithelial lymphoid
tissue
ring located in pharynx
• Thought to function as a barrier to infection in first
few years of life
• Named after nineteenth century German anatomist
Heinrich Wilhelm Gottfried von Waldeyer
Waldeyer’s Tonsillar Ring Parts of Hypopharynx Layers of pharyngeal wall • Mucosa: ciliated columnar in nasopharynx and stratified squamous in other areas
• Pharyngo-basilar fascia
• Longitudinal muscles : stylo-pharyngeus +
salpingo- pharyngeus + palato-pharyngeus
• Constrictor muscles: superior + middle + inferior
• Bucco-pharyngeal fascia Coronal section of Pharynx Muscles Structures Passing
Between Skull Base & Eustachian tube + Levator
Superior Constrictor (Sinus palatini + Tensor palatini + of Morgagni) Ascending palatine artery
Between Superior & Middle Glossopharyngeal nerve &
thyropharyngeus & cricopharyngeus part of inferior constrictor muscle • Mucosa herniates through it to form hypo-pharyngeal pouch (Zenker’s diverticulum) • Perforation occurs here during forceful esophagoscopy (gateway of tears) Oesophagus • Fibromuscular tube
• 23 to 25 cm long in adults
• Extends from crico-pharyngeal sphincter (C6
vertebra) to cardiac orifice of stomach (T11 vertebra)
• Anteroposterior curvature
– Follows antero-posterior curve of vertebral column through neck, thorax (posterior mediastinum) and upper abdomen Lateral curvatures :
Starts in midline → deviates
to left at C7 → returns
to midline at T5 →
deviates to left again at
T7 to reach gastric cardia
Natural Constrictions Natural Constrictions Site Vertebral Level Distance from central incisor Cricopharynx C6 15 cm
Aortic arch T4 23 cm
Lt main T5 28 cm bronchus Esophageal T 10 40 cm hiatus Importance of constrictions
