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Oropharyngeal isthmus (isthmus faucium) – soft palate, palatoglossal and palatopharyngeal arches, the root of the tongue. Approximation of the arches, to shut off the mouth from the oropharynx, is essential to deglutition.
Palatine tonsil (tonsilla palatina) sinus tonsillaris plica triangularis fossa supratonsillaris cryptae tonsillares tonsillitis – tonsillar pegs paratonsillar vein – venous hemorrage tonsillectomy
Muscles of the tongue aponeurosis linguae, septum linguae, hypoglossal nerve (CN XII).
Extrinsic muscles: M. genioglossus M. styloglossus M. palatoglossus M. hyoglossus – (canalis paralingualis contains the lingual artery)
Intrinsic muscles: Superior longitudinal muscle (m. longitudinalis superior) Inferior longitudinal musle (m. longitudinalis inferior) Transverse muscle (m. transversus) Vertical muscle (m. verticalis
Muscles of the soft palate
M. tensor veli palatini - trigeminal nerve (IX., X.) M. levator veli palatini - plexus pharyngeus (IX., X.) Musculus uvulae - plexus pharyngeus (IX., X.) M. palatoglossus - plexus pharyngeus (IX., X.) M. palatopharyngeus plexus pharyngeus (IX., X.)
Movements of the palate are essential to swallowing, blowing and speech; all requires variable degrees of closure of the nasopharynx. In deglutition closure prevents regurgitation into the nasopharynx. During closure levatores veli palatini pull the soft palate up and back towards the posterior pharyngeal wall while simultaneously the palatopharyngeal muscle raises the wall.
PHARYNX
fornix pharyngis pharyngeal recess cavum pharyngis fascia pharyngobasilaris
Pars nasalis pharyngis (nasopharynx)
choanae ostium pharyngeum tubae auditivae - torus tubarius - plica salpingopharyngea, plica salpingopalatina, torus levatorius tonsilla pharyngea - fornix pharyngis tonsilla tubaria Waldeyer’s lympfoepithelial ring
Pars oralis pharyngis (oropharynx)
Pars laryngea pharyngis (laryngopharynx)
- aditus laryngis - epiglottis, aryepiglottic folds
- recessus piriformis
- plica n. laryngei
Muscles of the pharynx
Constrictors - raphe pharyngis M. constrictor pharyngis superior:
- Pars pterygopharyngea –lamina medialis proc. pterygoidei
- Pars buccopharyngea –raphe pterygomandibularis
- Pars mylopharyngea –linea mylohyoidea mandibulae
- Pars glossopharyngea – transverse muscle of the tongue M. constrictor pharyngis medius:
- Pars chondropharyngea –cornu minus ossis hyoidei
- Pars ceratopharyngea - cornu majus ossis hyoidei M. constrictor pharyngis inferior:
- Pars thyropharyngea –linea obliqua of the thyroid cartilage
- Pars cricopharyngea – cricoid cartilage
Levators: M. stylopharyngeus – from the processus styloideus caudally and medially - the fissure between the superior and middle constrictors. M. palatopharyngeus M. salpingopharyngeus – from the cartilaginous part of the auditory tube
The pharynx actively participates in swallowing, respiration and phonation. During swallowing the muscles of the soft palate open the auditory tube to ventilate the tympanic cavity.
Mechanism of the deglutition
The first stage of the swallowing is voluntary: the anterior part of the tonge is raised and pressed against the hard palate. A bolus is pushed dorsaly. The hyoid bone is is moved up and forwards by the suprahyoid muscles. The root of the tonge is drawn up and back and palatoglossal arches are approximated, pushing the bolus through the isthmus of the fauces into the oropharynx. The second stage is involuntary. The soft palate is elevated, tightened and firmly approximated to the posterior pharyngeal wall (by the upper pharyngeal constrictor). Then the
may be seen together at the X-ray picture. Peristalsis serves for the mixing of the content to the pulpy chyme that in small portions is emptied to the duodenum.
Omentum minus – lig. phrenicogastricum, hepatogastricum, hepatoduodenale Omentum majus - lig. gastrocolicum, lig. gastrolienale
INTESTINUM
Intestinum tenue ansae intestinales
Duodenum pars superior - bulbus duodeni flexura duodeni sup. pars descendens duodeni flexura duodeni inf. pars horizontalis pars ascendens flexura duodenojejunalis plicae circulares Kerkringi villi intestinales crypts of Lieberkuhn – glandulae intestinales glandulae duodenales Brunneri plica longitudinalis duodeni - papilla duodeni major Vateri
Jejunum and ileum - jejunoileum
JEJUNUM ILEUM
upper left part of the inframesocolic space
lower right part of the inframesocolic space
wider (3-4 cm) narrower (2-3 cm)
more plicae circulares fewer plicae circulares
1-2 arcades 2-3 arcades
folliculi lymph. solitarii folliculi lymph. aggregati
mesenterium ostium ileocaecale - valva ileocaecalis
