prof nabil a hasan - minia

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

THANK YOU