mesopharynx

中咽頭

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/10 01:22:30」(JST)

wiki en

[Wiki en表示]

Pharynx
Head and inner neck
Pharynx
Details
Greek	Pharynx
Artery	pharyngeal branches of ascending pharyngeal artery, ascending palatine, descending palatine, pharyngeal branches of inferior thyroid
Vein	pharyngeal plexus
Nerve	pharyngeal plexus, maxillary nerve, mandibular nerve
Identifiers
Gray's	p.1141
MeSH	A03.556.750
Dorlands /Elsevier	12633198
TA	A05.3.01.001
FMA	46688
Anatomical terminology

The pharynx (plural: pharynges) is an organ found in vertebrates and invertebrates, though the structure is not universally the same across the species. In humans the pharynx is part of the digestive system and also of the conducting zone of the respiratory system. (The conducting zone also includes the nose, larynx, trachea, bronchi, and bronchioles, and their function is to filter, warm, and moisten air and conduct it into the lungs.) The pharynx makes up the part of the throat situated immediately posterior to the nasal cavity, posterior to the mouth and superior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx, the oropharynx and the laryngopharynx. It is also important in vocalization.

There are two sets of pharyngeal muscles that act upon the pharynx. These are arranged as an inner layer of longitudinal muscles and an outer circular layer.

Structure

Nasopharynx

The upper portion of the pharynx, the nasopharynx, extends from the base of the skull to the upper surface of the soft palate. It includes the space between the internal nares and the soft palate and lies above the oral cavity. The adenoids, also known as the pharyngeal tonsils, are lymphoid tissue structures located in the posterior wall of the nasopharynx. Waldeyer's tonsillar ring is an annular arrangement of lymphoid tissue in both the nasopharynx and oropharynx.

Upper respiratory system, with nasopharynx, oropharynx and laryngopharynx labeled at right.

Polyps or mucus can obstruct the nasopharynx, as can congestion due to an upper respiratory infection. The eustachian tubes, which connect the middle ear to the pharynx, open into the nasopharynx. The opening and closing of the eustachian tubes serves to equalize the barometric pressure in the middle ear with that of the ambient atmosphere.

The anterior aspect of the nasopharynx communicates through the choanae with the nasal cavities. On its lateral walls are the pharyngeal ostia of the auditory tube, somewhat triangular in shape, and bounded behind by a firm prominence, the torus tubarius or cushion, caused by the medial end of the cartilage of the tube that elevates the mucous membrane. Two folds arise from the cartilaginous opening:

• the salpingopharyngeal fold, a vertical fold of mucous membrane extending from the inferior part of the torus and containing the salpingopharyngeus muscle
• the salpingopalatine fold, a smaller fold extending from the superior part of the torus to the palate and containing the levator veli palatini muscle. The tensor veli palatini is lateral to the levator and does not contribute the fold, since the origin is deep to the cartilaginous opening.

Behind the opening of the auditory tube is a deep recess, the pharyngeal recess (also referred to as the fossa of Rosenmüller). On the posterior wall is a prominence, best marked in childhood, produced by a mass of lymphoid tissue, which is known as the pharyngeal tonsil. Superior to the pharyngeal tonsil, in the midline, an irregular flask-shaped depression of the mucous membrane sometimes extends up as far as the basilar process of the occipital bone, this is known as the pharyngeal bursa.

Oropharynx

The oropharynx lies behind the oral cavity, extending from the uvula to the level of the hyoid bone. It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the palatoglossal arch and the palatopharyngeal arch, is the palatine tonsil. The anterior wall consists of the base of the tongue and the epiglottic vallecula; the lateral wall is made up of the tonsil, tonsillar fossa, and tonsillar (faucial) pillars; the superior wall consists of the inferior surface of the soft palate and the uvula. Because both food and air pass through the pharynx, a flap of connective tissue called the epiglottis closes over the glottis when food is swallowed to prevent aspiration. The oropharynx is lined by non-keratinised squamous stratified epithelium.

The HACEK organisms (Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella) are part of the normal oropharyngeal flora, which grow slowly, prefer a carbon dioxide-enriched atmosphere, and share an enhanced capacity to produce endocardial infections, especially in young children. Fusobacterium is a pathogen.

Laryngopharynx

The laryngopharynx, (Latin: pars laryngea pharyngis), also known as hypopharynx, is the caudal part of the pharynx; it is the part of the throat that connects to the esophagus. It lies inferior to the epiglottis and extends to the location where this common pathway diverges into the respiratory (larynx) and digestive (esophagus) pathways. At that point, the laryngopharynx is continuous with the esophagus posteriorly. The esophagus conducts food and fluids to the stomach; air enters the larynx anteriorly. During swallowing, food has the "right of way", and air passage temporarily stops. Corresponding roughly to the area located between the 4th and 6th cervical vertebrae, the superior boundary of the laryngopharynx is at the level of the hyoid bone. The laryngopharynx includes three major sites: the pyriform sinus, postcricoid area, and the posterior pharyngeal wall. Like the oropharynx above it, the laryngopharynx serves as a passageway for food and air and is lined with a stratified squamous epithelium. It is innervated by the pharyngeal plexus.

The vascular supply to the laryngopharynx includes the superior thyroid artery, the lingual artery and the ascending pharyngeal artery. The primary neural supply is from both the vagus and glossopharyngeal nerves. The vagus nerve provides a branch termed "Arnolds Nerve" which also supplies the external auditory canal, thus laryngopharyngeal cancer can result in referred otalgia. This nerve is also responsible for the ear-cough reflex in which stimulation of the ear canal results in a person coughing.

Clinical significance

Inflammation

Main article: Pharyngitis

Pharyngeal cancer

Main article: Pharyngeal cancer

History

Etymology

The word pharynx (pronounced /ˈfærɪŋks/) is derived from the Greek φάρυγξ phárynx, meaning "throat". Its plural form is pharynges /fəˈrɪndʒiːz/ or pharynxes /ˈfærɪŋksəz/, and its adjective form is pharyngeal (/ˌfærɪnˈdʒiːəl/ or /fəˈrɪndʒiəl/).

Other animals

Vertebrates

An illustration of the pharyngeal jaws of a moray eel.

All vertebrates have a pharynx, used in both feeding and respiration. The pharynx arises during development in all vertebrates through a series of six or more outpocketings on the lateral sides of the head. These outpocketings are pharyngeal arches, and they give rise to a number of different structures in the skeletal, muscular and circulatory systems. The structure of the pharynx varies across the vertebrates. It differs in dogs, horses and ruminants. In dogs a single duct connects the nasopharynx to the nasal cavity. The tonsils are a compact mass which point away from the lumen of the pharynx. In the horse the auditory tube opens into the guttural pouch and the tonsils are diffuse and raised slightly. Horses are unable to breathe through the mouth as the free apex of the rostral epiglottis lies dorsal to the soft palate in a normal horse. In ruminants the tonsils are a compact mass which point towards the lumen of the pharynx.

Pharyngeal arches are characteristic features of vertebrates whose origin can be traced back through chordates to basal deuterostomes who also share endodermal outpocketings of the pharyngeal apparatus. Similar patterns of gene expression can be detected in the developing pharynx of amphioxus and hemichordates. However, the vertebrate pharynx is unique in that it gives rise to endoskeletal support through the contribution of neural crest cells.

Pharyngeal jaws are a "second set" of jaws contained within the pharynx of many species of fish, distinct from the primary (oral) jaws. Pharyngeal jaws have been studied in moray eels where their specific action is noted. When the moray bites prey, it first bites normally with its oral jaws, capturing the prey. Immediately thereafter, the pharyngeal jaws are brought forward and bite down on the prey to grip it; they then retract, pulling the prey down the eel's esophagus, allowing it to be swallowed.

Invertebrates

Invertebrates also have a pharynx. Invertebrates with a pharynx include the tardigrades,annelids and arthropods, and the priapulids (which have an eversible pharynx).

The term "pharynx" is used loosely across the animal kingdom for the portion of the digestive tract loosely analogous to the vertebrate pharynx, but this need not imply deep structural or developmental similarities, or that the structures are homologous.

The "pharynx" of the nematode worm is a muscular food pump in the head, triangular in cross-section, that grinds food and transports it directly to the intestines. A one-way valve connects the pharynx to the excretory canal.

• Everted pharynx of Alitta virens (also known as Nereis virens), lateral view

• Pharynx of the flatworm Prorhynchus fontinalis

• Pharynx of the flatworm Platydemus manokwari visible as the worm feeds on a snail.

• Longitudinal section through the roundworm Caenorhabditis elegans showing the position of the pharynx in the animal body.

• Microscopic cross section through the pharynx of a larva from an unknown lamprey species.

Additional images

• Conducting passages

• Organs of the digestive system

• Nose and nasal

• Coronal section of right ear, showing auditory tube and levator veli palatini muscle.

• The entrance to the larynx, viewed from behind

• The position and relation of the esophagus in the cervical region and in the posterior mediastinum. Seen from behind.

• Acute catarrhal pharyngitis. The oropharynx is swollen and red

• Deep dissection of human larynx, pharynx and tongue seen from behind

• The nasopharynx, oropharynx, and laryngopharynx or larynx can be seen clearly in this sagittal section of the head and neck.

See also

This article uses anatomical terminology; for an overview, see anatomical terminology.

• Nasopharyngeal carcinoma
• Pharyngeal consonant
• Pharyngeal (disambiguation)
• Pharyngitis
• Saccopharynx, a genus of deep sea eel-like fishes with large mouths, distensible stomachs and long scaleless bodies
• Tonsil
• Uvula

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

General

• Pharynx, Stedman's Online Medical Dictionary at Lippincott Williams and Wilkins
• Human Anatomy and Physiology Elaine N. Marieb and Katja Hoehn, Seventh Edition.
• TNM Classification of Malignant Tumours Sobin LH & Wittekind Ch (eds)Sixth edition UICC 2002 ISBN 0-471-22288-7

External links

• Anatomy photo:31:st-1401 at the SUNY Downstate Medical Center
• Anatomy photo:31:st-1403 at the SUNY Downstate Medical Center
• Anatomy photo:31:st-1406 at the SUNY Downstate Medical Center

English Journal

• A Phase 1 Study of Everolimus + Weekly Cisplatin + Intensity Modulated Radiation Therapy in Head-and-Neck Cancer.

• Fury MG, Lee NY, Sherman E, Ho AL, Rao S, Heguy A, Shen R, Korte S, Lisa D, Ganly I, Patel S, Wong RJ, Shaha A, Shah J, Haque S, Katabi N, Pfister DG.SourceDepartment of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
• International journal of radiation oncology, biology, physics.Int J Radiat Oncol Biol Phys.2013 Nov 1;87(3):479-86. doi: 10.1016/j.ijrobp.2013.06.2043.
• PURPOSE: Elevated expression of eukaryotic protein synthesis initiation factor 4E (eIF4E) in histologically cancer-free margins of resected head and neck squamous cell carcinomas (HNSCCs) is mediated by mammalian target of rapamycin complex 1 (mTORC1) and has been associated with increased risk of d
• PMID 24074921

• Anisotropic margin expansions in 6 anatomic directions for oropharyngeal image guided radiation therapy.

• Yock AD, Garden AS, Court LE, Beadle BM, Zhang L, Dong L.SourceDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas; Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas.
• International journal of radiation oncology, biology, physics.Int J Radiat Oncol Biol Phys.2013 Nov 1;87(3):596-601. doi: 10.1016/j.ijrobp.2013.06.2036. Epub 2013 Jul 29.
• PURPOSE: The purpose of this work was to determine the expansions in 6 anatomic directions that produced optimal margins considering nonrigid setup errors and tissue deformation for patients receiving image-guided radiation therapy (IGRT) of the oropharynx.METHODS AND MATERIALS: For 20 patients who
• PMID 23906931

• Features of lateral cephalograms associated with difficult laryngoscopy in Japanese children undergoing oral and maxillofacial surgery.

• Kohjitani A, Miyawaki T, Miyawaki S, Nakamura N, Iwase Y, Nishihara K, Ohno S, Shimada M, Sugiyama K.SourceDepartment of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
• Paediatric anaesthesia.Paediatr Anaesth.2013 Nov;23(11):994-1001. doi: 10.1111/pan.12178. Epub 2013 Apr 25.
• BACKGROUND: Difficult laryngoscopy and tracheal intubation are occasionally encountered in children with congenital anomalies or micrognathia. However, no study has elucidated anatomical etiology in relation to craniofacial development.METHODS: Two hundred ten patients aged 8 months-18 years were
• PMID 23617361

Japanese Journal

• 中咽頭上側壁切除後の再建術

• 櫻庭 実,宮本 慎平,永松 将吾,茅野 修史,大島 梓,林 隆一
• 口腔・咽頭科 = Stomato-pharyngology 26(1), 27-32, 2013-03-31
• 中咽頭癌上側壁切除例においては, 適切な再建術を行わないと, 鼻咽腔閉鎖不全や嚥下障害を引き起こす場合がある. 2002年から2011年までの10年間に国立がん研究センター東病院および中央病院において, 中咽頭上側壁の切除後に再建を行った症例109例のうち, 術後嚥下障害により経口摂取が不可能であった10例を対象に, 嚥下障害の要因について検討を加え報告した.中咽頭癌上側壁がん切除後の再建術におい …
• NAID 10031163000

• 経口腔ロボット支援手術を行った中咽頭癌2症例

• 清水 顕,伊藤 博之,船戸 宣利,吉田 知之,鈴木 衞
• 頭頸部外科 = Journal of Japan Society for Head and Neck Surgery 22(3), 297-302, 2013-02-28
• da Vinci® surgical systemによる頭頸部腫瘍に対する手術は経口腔咽喉頭手術の支援として中咽頭早期癌から臨床応用され，現在，喉頭癌，下咽頭癌と進行癌に対する再建手術にも応用されるようになってきた。今回，われわれは2011年8月本邦で初めて中咽頭癌2症例に対し経口腔ロボット支援手術の臨床応用を行い，良好な結果を得たので報告する。症例1は中咽頭前壁癌T1N0M0，症例2は中咽頭後壁 …
• NAID 10031170511

• 血清SCC抗原測定の頭頸部扁平上皮癌診療における有用性の再評価

• 平賀 幸弘,黄 淳一
• 頭頸部癌 39(4), 477-483, 2013
• 当科で一次治療した頭頸部扁平上皮癌346例の血清SCC抗原測定値をレトロスペクティブに統計的再検討を行い，腫瘍マーカーとしての有用性を明らかにした。至適基準値は，統計的に2.0ng/mlが適切と判断した。初診時測定での有用性の検討では，346症例における2.0ng/ml以上と未満の2群での平均値は強く有意に前者で高値であり，一方2群の3年生存率は有意に前者で低かった。Stage別では，進行度に応じ …
• NAID 130004510199

Related Pictures

---

★リンクテーブル★

リンク元

「口部咽頭」

「口部咽頭」

　　[★]

英

oropharynx

関

中咽頭 mesopharynx