Anatomy and

Embryology of the
Pharynx
Jared Bradley Turner, MD
January 7, 2005
Embryology
Components of
branchial/pharyngeal
apparatus:
1) Pharyngeal arches
2) Pharyngeal pouches
3) Pharyngeal
clefts/grooves
Pharyngeal (branchial) arches
 Derived from neural crest cells
 Resemble fish gills (branchia)
 Begin to develop early in the 4th week
 By end of 4th week, four pairs of arches are
visible on the surface (not 5th and 6th ) and a
buccopharyngeal membrane ruptures forming
communication between primitive oral cavity and
foregut
Pharyngeal arches (cont.)
 Contribute to the
formation of the neck as
well as the face.
 Visible structures at 42
weeks:
1st arch: mandibular
prominence, maxillary
prominences, and the
frontonasal prominence
Pharyngeal arches (cont.)
 Core of mesenchymal tissue
covered by surface ectoderm
(outside) and by endodermal
epithelium (inside)
 Ectoderm -> skeletal
 Mesoderm -> muscles with
accompanying nerve
 Arterial component (aortic
arches)
 Therefore, each arch carries
nerve, muscle, bone and blood
supply
First pharyngeal arch

 Maxillary process (dorsal)

 Premaxilla, maxilla, zygomatic bone, portion
of temporal bone
 Mandibular process (ventral)
 Contains Meckel’s cartilage which disappears
except for dorsal end (incus & malleus) and
mandible
First pharyngeal arch
 Muscles of mastication, digastric (ant
belly), mylohyoid, tensor tympani and
tensor palatini
 Therefore, the accompanying motor nerve
is the mandibular branch of trigeminal (V2)
and sensory are V1, V2, and V3
 1st aortic arch practically disappears but
forms the maxillary artery
Second pharyngeal arch
 Reichert’s cartilage – stapes, styloid process,
stylohyoid ligament, lesser horn and upper part of the
hyoid
 Muscles include: stapedius, stylohyoid, digastric (post
belly), auricular, and those of facial expression
 Facial nerve (CN VII)
 2nd aortic arch – stapedial & hyoid arteries
Third pharyngeal arch
 Cartilaginous contributions include greater horn
and lower part of hyoid
 Sole muscle: stylopharyngeus
 CN IX (Glossopharyngeal nerve)
 3rd aortic arch (quite large): common carotid, 1st
portion of internal carotid (remainder dorsal
aorta), and external carotid
Fourth & sixth pharyngeal arch
 Cartilaginous contributions to larynx derived from fusion:
thyroid, cricoid, arytenoid, corniculate, and cuneiform
 Muscles of 4th: cricothyroid, levator palatini, and
pharyngeal constrictors are innervated by SLN (CN X)
 Muscles of 6th: intrinsics of larynx are innervated by RLN
(CN X)
 4th aortic arch: L->arch of aorta & R->subclavian
 6th aortic arch: L & R pulmonary with ductus arteriosus on
left
Pharyngeal pouches (5)
 1st:tubotympanic recess->
middle ear & eustacian
tube -> TM
 2nd palatine tonsil/fossa
 3rd: inferior parathyroid
(dorsal), thymus (ventral)
 4th: superior parathyroid
 5th: ultimobranchial body
-> calcitonin producing C
cells (parafollicular)
Pharyngeal clefts/grooves (4)
 1st: external auditory
meatus
 2nd-4th : epicardial ridge
and cervical sinus
(disappears)
Anatomy of the pharynx
Anatomy (cont.)
 Extends from base of skull to inferior
border of cricoid cartilage anteriorly and
inferior border of C6 posteriorly
 Widest portion (5cm) at hyoid
 Narrowest portion (1.5cm) at caudal end
 Divided into 3 parts: nasopharynx,
oropharynx, and laryngo(hypo)pharynx
Nasopharynx
 Respiratory function
 Anterior: choana (posterior nasal aperture)
 Posterior: pharyngobasilar membrane and
superior constrictor muscle
 Superior: basilar portion of occipital bone
 Inferior: soft palate
Oropharynx
 Digestive function
 Anterior: anterior tonsillar pillar
 Posterior: superior constrictor
 Superior: soft palate
 Inferior: base of tongue, superior epiglottis
 Laterally: palatoglossal and palatopharyngeal
arches
Hypopharynx
 Lies posterior to the larynx
 Superior: superior border of epiglottis and
pharyngoepiglottic folds
 Inferior: inferior border of the cricoid
 Posterior/lateral: middle & inferior
constrictors, bodies of C4-C6
 Anterior: laryngeal inlet
Pharyngeal muscles
Pharyngeal muscles
 External circular and internal longitudinal
(opposite in remainder of GI tract)
 External: 3 constrictors (CN XI via X and
ELN/RLN for middle and inferior) function to
constrict wall of pharynx during swallow
 Internal: palatopharyngeus and
salpingopharyngeus (CN XI via X) and
stylopharyngeus (CN IX) act to elevate pharynx
and larynx during speech/swallow
Pharyngeal muscles
 Tensor veli palatini (V3) tenses soft palate
& opens ET during yawn/swallow
 Levator veli palatini (CN XI via X) elevates
palate during swallow/yawn
 Palatoglossus (CN XI via X) approximates
tongue and soft palate
Pharyngeal muscles
Pharyngeal lymphatic drainage
 Oral cavity
 I, II, III
 Oro/hypopharynx
 deep II, III, IV
 Nasopharynx
 II, V, III
Pharyngeal vessels
Afferent innervation of pharynx