prof nabil a hasan - minia
TRANSCRIPT
By
Prof Nabil A Hasan Head of Anatomy Department
Lies in the roof of the oral cavity
Has two parts:
•Hard (bony) palate anteriorly
•Soft (muscular) palate posteriorly
hard
soft palate
Lies in the roof of the oral cavity
Forms the floor of the nasal cavity
Formed by:
•Palatine processes of maxillae in front
•Horizontal plates of palatine bones behind
Bounded by alveolar arches
Posteriorly, continuous with soft palate
Its undersurface covered by mucoperiosteum
Shows transverse ridges in the anterior parts
Attached to the posterior border of the hard palate
Covered on its upper and lower surfaces by mucous membrane
Composed of:
• Muscle fibers
• An aponeurosis
• Lymphoid tissue
• Glands
• Blood vessels
• Nerves
Fibrous sheath Attached to posterior
border of hard palate
Is expanded tendon of tensor velli palatini
Splits to enclose musculus uvulae
Gives origin & insertion to palatine muscles
Tensor veli palatini
• Origin: Scaphoid fossa pterygoid bone & auditory tube
• Insertion: superior surface of palatine aponeurosis
• Action: Tenses soft palate
Levator veli palatini
• Origin:petrous part of the temporal bone & auditory tube
• Insertion: superior surface of palatine aponeurosis
• Action: Raises soft palate to close the posterior pharyngeal wall
Musculus uvulae
Origin: posterior border of hard palate
Insertion: mucosa of uvula
Action: Elevates uvula and contact the posterior pharyngeal wall
Palatoglossus • Origin: inferior surface of
palatine aponeurosis
• Insertion: side of tongue
• Action: pulls root of tongue upward, narrowing oropharyngeal isthmus
Responsible for the rapid downward movement of the
palate during speech
Palatopharyngeus • Origin: inferior surface of
palatine aponeurosis
• Insertion: posterior border of thyroid cartilage
Action: Sphincteric action to pull the lateral pharyngeal walls
medially
Mostly by the maxillary nerve through its branches: • Greater palatine
nerve
• Lesser palatine nerve
• Nasopalatine nerve
Glossopharyngeal nerve supplies the region of the soft palate
All the muscles, except tensor veli palatini, are supplied by the:
• Cranial root of accessory nerve via pharyngeal plexus
Tensor veli palatini supplied by the:
•Nerve to medial pterygoid, a branch of the mandibular nerve
Branches of the maxillary artery
• Greater palatine
• Lesser palatine
• Sphenopalatine
Ascending palatine,
branch of the facial artery
Ascending pharyngeal,
branch of the external carotid artery
The pharynx has a musculomembranous tube, which is deficient anteriorly
Here, it is replaced by the posterior openings into the nose (choana), the opening into the mouth, and the inlet of the larynx
Its upper, wider end lying under the skull (basilar part of occipital bone)
Its lower, narrow end becoming
continuous with the esophagus opposite the sixth cervical vertebra
Laterally, it is related to styloid apparatus , carotid sheath & lobes of thyroid gland
By means of the auditory tube, the mucous membrane is also continuous with that of the tympanic cavity
Its wall is composed of 5 layers 1- lining mucosa 2- sumucosa, aleolar CT 3- pharygobasilar fascia 4- musculosa, longitudinal (smooth ms)
& circular (3 costrictors) 5- buccopharyngeal fascia
Wall of the pharynx consist of the superior , middle inferior
constrictor muscles
Fibers of these muscles run in a somewhat circular direction
Salpingopharyngeus Palatoopharyngeus Stylopharyngeus muscles
Their fibers run in a somewhat
longitudinal direction
1 2 3
4
6 5
1
2 4
3
6
5
The three constrictor muscles extend around the pharyngeal wall to be inserted into a fibrous band or raphe
The raphe extends from the pharyngeal tubercle on the basilar part of the occipital bone of the skull down to the esophagus
The three constrictor muscles overlap each
other Superior Constrictor – Responsible for the medial displacement of
the lateral pharyngeal walls – Narrows the VP port
The lower part of the inferior constrictor, which arises from the cricoid cartilage, is called the cricopharyngeus muscle
The fibers of Cricopharyngeus pass horizontally around the lowest and narrowest part of the pharynx and act as a sphincter
First gap between base of the head & Sup. Constrictor for: Tensor & levator palati muscles and Eustachian tube
Second gap between Sup. & middle Constrictors for:Stylopharyngeus muscle, stylohyoid ligament & glossopharyngeal nerve
Third gap between middle & inferior Constrictors for: internal laryngeal nerve
This lies above the soft palate and behind the nasal cavities
In the submucosa of the roof is a collection of lymphoid tissue called the pharyngeal tonsil
The pharyngeal isthmus is the opening in the floor between the soft palate and the posterior pharyngeal wall
On the lateral wall is the opening of
the auditory tube, the elevated ridge of which is called the tubal elevation
The pharyngeal recess is a depression in the pharyngeal wall behind the tubal elevation
The salpingopharyngeal fold is a
vertical fold of mucous membrane covering the salpingopharyngeus muscle
This lies behind the oral cavity
The floor is formed by the posterior one third of the tongue and the interval between the tongue and epiglottis
In the midline is the median glossoepiglottic fold
on each side the lateral glossoepiglottic fold
The depression on each side of the median
glossoepiglottic fold is called the vallecula
On the lateral wall on each side are the palatoglossal and the palatopharyngeal arches or folds and the palatine tonsils between them
The palatoglossal arch is a fold of mucous membrane covering the palatoglossus muscle
The interval between the two palatoglossal arches is called the oropharyngeal isthmus
It marks the boundary between the mouth
and pharynx
The palatopharyngeal arch is a fold of mucous membrane covering the palatopharyngeus muscle
The recess between the palatoglossal
and palatopharyngeal arches is occupied by the palatine tonsil
At the junction of the mouth with the oral part of the pharynx, and the nose with the nasal part of the pharynx, are collections of lymphoid tissue
The palatine tonsils and the nasopharyngeal tonsils are the most important
This lies behind the opening into the larynx
The lateral wall is formed by the thyroid cartilage and the thyrohyoid membrane
The piriform fossa is a depression in
the mucous membrane on each side of the laryngeal inlet
Nasopharynx: The maxillary nerve
Oropharynx: The glossopharyngeal nerve
Laryngeal pharynx: The internal
laryngeal branch of the vagus nerve
All Muscles of the pharynx are supplied by cranial root of accessory nerve via pharyngeal plexus which situated on the middle constrictor muscle of the pharynx EXCEPT stylopharyngeus that is supplied by glossophryngeal nerve
Ascending pharyngeal, tonsillar branches of facial arteries, and branches of maxillary and lingual arteries
Directly into the deep cervical lymph nodes or indirectly via the retropharyngeal or paratracheal nodes into the deep cervical nodes
The lymphoid tissue that surrounds the opening into the respiratory and digestive systems forms a ring
The lateral part of the ring is formed by the palatine tonsils and tubal tonsils
The pharyngeal tonsil in the roof of the
nasopharynx forms the upper part, and the lingual tonsil on the posterior third of the tongue forms the lower part
• Velum is at rest and low while breathing
• Velum is elevated and stretched during speech production of oral sounds
• Velum is pulled down during production of nasal sounds • VP function differs for speech and
non‐speech activities
• Resonance: Refers to the acoustic
phenomenon that –occurs when sound vibrates in the nasal or oral cavity
– The velopharyngeal valve does not adequately close during speech
– Velopharyngeal Incompetence = adequate structure, but inadequate function – Velopharyngeal Insufficiency = inadequate
structure – Velopharyngeal Mislearning = inadequate
closure due to faulty learning – Hypernasality: occurs when the oral and nasal
cavities are abnormally coupled – Hyponasality: occurs typically due to a blockage
in the nasal cavity
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