Equalizes pressure; opened during swallowing by tensor veli palatini (V3) + levator veli palatini (X)
Torus tubarius
Raised bulge of tissue over the tube’s cartilage
Landmark curving around the tube opening
Salpingopharyngeal fold
Mucosa over salpingopharyngeus, running inferiorly from the torus
Salpingopharyngeus = longitudinal muscle (CN X)
Pharyngeal recess
Pocket posterior to the torus tubarius
Nasopharyngeal carcinoma → serous otitis media + neck mass
Pharyngeal tonsil
Lymphoid tissue on the roof / posterior wall (“adenoids”)
Adenoid hypertrophy → blocks airflow
“Salpinx” = tube → salpingopharyngeus runs from the tube to the pharynx.
4 · Oropharynx
The “tonsil sandwich,” anterior → posterior.
Palatoglossal fold marks the transition from the oral cavity to the oropharynx.
Epiglottic vallecula = space between the epiglottis and the posterior 1/3 of the tongue — the laryngoscope blade goes here during intubation.
All palate muscles are CN X (pharyngeal plexus) except tensor veli palatini (CN V3).
Tonsillectomy
Removing the palatine tonsil risks CN IX, which lies deep to the tonsillar bed → temporary loss of taste and sensation on the posterior 1/3 of the tongue.
5 · Laryngopharynx (Hypopharynx)
Structures
Epiglottis — leaf-shaped; flips down over the laryngeal inlet in the pharyngeal phase
Laryngeal inlet (aditus) — opening into the larynx; epiglottis forms its anterior boundary
Piriform recesses — “gutters” on each side of the inlet that funnel food into the esophagus
Continues inferiorly as the esophagus
Wall
Mainly the inferior and middle constrictors, plus stylopharyngeus and palatopharyngeus.
Under the piriform mucosa: the internal branch of the superior laryngeal nerve (sensory above the vocal folds). A lodged foreign body (e.g., fish bone) can injure it → lost cough reflex, aspiration risk.
Trachea
C-shaped cartilage rings, open posteriorly so the esophagus behind it can expand when a bolus passes.
Esophagus
Posterior to the trachea. Its upper esophageal sphincter = cricopharyngeus (lowest part of the inferior constrictor).
6 · Pharyngeal Muscles
Posterior-view schematic of the constrictors and the structures passing through their gaps.
Group
Muscles
Nerve
Action
Circular (constrictors)
Superior · middle · inferior (thyropharyngeus + cricopharyngeus)
Soft palate (levator + tensor veli palatini); longitudinal muscles
Pharyngeal
Peristalsis by the constrictors; epiglottis flips down; piriform recesses guide food; cricopharyngeus relaxes
Superior → middle → inferior constrictors
Esophageal
Peristalsis moves food to the stomach
Esophageal muscle
If the cricopharyngeus fails to relax, pressure builds on Killian’s triangle above it → Zenker’s diverticulum (food trapped in a sac, dysphagia, bad breath).
8 · Retropharyngeal Space
The space posterior to the pharynx. In the bisected head, look here for:
Schematic of where each nerve leaves the retropharyngeal region. “IX dives in, XI turns back, XII loops forward, X keeps going.”
Structure
Key function
Lesion / high-yield
Superior cervical ganglion
Sympathetic → dilator pupillae, superior tarsal muscle, facial sweat glands
Adult with unilateral ear fullness / fluid + neck lump
Pharyngeal recess
Nasopharyngeal carcinoma blocking the pharyngotympanic tube → serous otitis media
Child mouth-breathing, snoring, nasal obstruction
Pharyngeal tonsil
Adenoid hypertrophy
Newborn with nasal obstruction
Choanae
Choanal atresia
Loss of taste on the posterior tongue after tonsillectomy
CN IX
Injured deep to the tonsillar bed
Food regurgitation, halitosis, neck pouch in an older adult
Killian’s triangle
Zenker’s diverticulum
Fish bone in the throat → lost cough reflex / aspiration
Piriform recess
Internal branch of the superior laryngeal nerve
Intubation: where does the laryngoscope blade go?
Epiglottic vallecula
Lifts the tongue base and epiglottis
Ptosis, miosis, anhidrosis after a high neck lesion
Superior cervical ganglion
Horner syndrome
Beyond lecture (enrichment): tumors at each level threaten a different nerve — nasopharynx → skull-base group (superior cervical ganglion, CN XII); oropharynx / tonsil → CN IX (referred ear pain); laryngopharynx / piriform recess → CN X (hoarseness, aspiration). Going down the pharynx, the CN numbers go up.
10 · Self-Check Questions
Answer first, then open each one to check.
1. Name the lateral-wall structures of the nasopharynx, anterior → posterior.
Choana → opening of the pharyngotympanic tube → torus tubarius (salpingopharyngeal fold inferiorly) → pharyngeal recess.
2. What does the pharyngotympanic tube connect, and which muscles open it?
Middle ear ↔ nasopharynx; tensor veli palatini (CN V3) and levator veli palatini (CN X).
3. What are the boundaries of the oropharynx?
Soft palate to the superior border of the epiglottis.
4. What lies between the palatoglossal and palatopharyngeal folds?
The tonsillar fossa containing the palatine tonsil (CN IX deep to its bed).
5. What is the function of the piriform recesses?
Gutters that direct food/drink into the esophagus, away from the larynx.
6. Which pharyngeal muscle is not supplied by CN X?
Stylopharyngeus — CN IX.
7. Name the two parts of the inferior constrictor and the weak area between them.
Thyropharyngeus and cricopharyngeus; Killian’s triangle (→ Zenker’s diverticulum).
8. What passes through the gap between the middle and inferior constrictors?
Internal branch of the superior laryngeal nerve + superior laryngeal artery (through the thyrohyoid membrane).
9. What happens in the oropharyngeal phase of swallowing?