THE UNIVERSITY OF ZAMBIA

SCHOOL OF MEDICINE

• HUMAN EMBRYOLOGY

• PHARYNGEAL APPARATUS

• Dr. Mukape Mukape

- UNZA (BSc.HB, MBChB, MSc in Progress)
- ZIDIS (Diplomatic Practice and Public
Relations)
- Senior Resident Medical Officer (SRMO) at
Ministry of Health, Zambia
- Staff Development Fellow (SDF), SOM,
UNZA.

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 Introduction
• The most distinctive feature in development of
the head and neck is the presence of pharyngeal
arches
• The old term for these structures is branchial
arches
• This is because they somewhat resemble the gills
(branchia) of a fish
• These arches appear in the 4th and 5th weeks of
development
• They contribute to the characteristic external
appearance of the embryo
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 Introduction

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 Introduction
• Initially, pharyngeal arches consist of bars of
mesenchymal tissue separated by deep clefts
known as pharyngeal clefts

• Simultaneously, with development of the arches

and clefts, a number of outpocketings called
pharyngeal pouches appear

• These pouches appear along the lateral walls of

the pharynx, the most cranial part of the foregut
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 Introduction

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 Introduction
• The pouches penetrate the surrounding
mesenchyme, but do not establish an open
communication with the external clefts
• Hence, although development of pharyngeal
arches, clefts, and pouches resembles formation
of gills in fishes and amphibians, in the human
embryo, real gills are never formed
• Therefore, the term pharyngeal (arches, clefts,
and pouches) has been adopted for the human
embryo
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 Introduction

• Pharyngeal arches not only contribute to

formation of the neck, but also play an important
role in formation of the face

• At the end of the 4th week, the centre of the face

is formed by the stomodeum, surrounded by the
first pair of pharyngeal arches

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 Pharyngeal Arches
• Each pharyngeal arch consists of a core of
mesenchymal tissue covered on the outside by
surface ectoderm and on the inside by
epithelium of endodermal origin
• In addition to mesenchyme derived from paraxial
and lateral plate mesoderm, the core of each arch
receives substantial numbers of neural crest cells,
which migrate into the arches to contribute to
skeletal components of the face
• The original mesoderm of the arches gives rise to
the musculature of the face and neck
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 Introduction
• Cells from ectodermal placodes, together with
neural crest cells form neurons of the following
cranial nerves:
1. Trigeminal (CN V)
2. Facial (CN VII)
3. Glossopharyngeal (CN IX)
4. Vagus (CN X)

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 Introduction

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 Pharyngeal Arches
• Thus, each pharyngeal arch is characterized by its
own:
1. Muscular component
2. Cartilage component
3. Cranial nerve component
4. Arterial component

• Wherever the muscle cells migrate, they carry

their nerve component with them
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 • I-IV branchial arches
• 1-4 branchial pouches
(inside) and/or
pharyngeal grooves
(outside)
• A=Tuberculum laterale
• B=Tuberculum impar
• C=Foramen cecum
• D=Ductus thyroglossus
• E=Sinus cervicalis

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 Arches

Pouches
Clefts
1

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 Pharyngeal Arches

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 Pharyngeal Arches

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 1st Pharyngeal Arch
• Consists of:
1. Dorsal portion, the maxillary process, which
extends forward beneath the region of the eye
2. Ventral portion, the mandibular process, which
contains Meckel’s cartilage

• During further development, Meckel’s cartilage

disappears except for two small portions at its
dorsal end that persist and form the incus and
malleus
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Cartilages of the Pharyngeal Arches Participating in Formation of Head/Neck

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 1st Pharyngeal Arch
• Mesenchyme of the maxillary process gives rise to:
1. Premaxilla
2. Maxilla
3. Zygomatic bone
4. Part of the temporal bone through membranous
ossification
• The mandible is also formed by membranous
ossification of mesenchymal tissue surrounding
Meckel’s cartilage
• In addition, the first arch contributes to formation of
the bones of the middle ear
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 1st Pharyngeal Arch
• Musculature of the first pharyngeal arch includes:
1. Muscles of mastication (temporalis, masseter,
and pterygoids)
2. Anterior belly of the digastric
3. Mylohyoid
4. Tensor tympani
5. Tensor palatini
• The nerve supply to the muscles of the first arch
is provided by the mandibular branch of the
trigeminal nerve
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 1st Pharyngeal Arch
• Since mesenchyme from the first arch also
contributes to the dermis of the face, sensory
supply to the skin of the face is provided by
ophthalmic, maxillary, and mandibular branches
of the trigeminal nerve
• Muscles of the arches do not always attach to the
bony or cartilaginous components of their own
arch but sometimes migrate into surrounding
regions
• Nevertheless, the origin of these muscles can
always be traced, since their nerve supply is
derived from the arch of origin
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Various Components of Pharyngeal Arches

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 2nd Pharyngeal Arch
• The cartilage of the second • Muscles of the hyoid arch
or hyoid arch (Reichert’s are:
cartilage) gives rise to: 1. Stapedius
1. Stapes 2. Stylohyoid
2. Styloid process of the 3. Posterior belly of the
temporal bone digastric
3. Stylohyoid ligament 4. Auricular and muscles of
4. Lesser horn and upper facial expression
part of the body of the • The facial nerve is the nerve
hyoid bone of the second arch
• It supplies all of these
muscles

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 3rd Pharyngeal Arch
• The cartilage of the third pharyngeal arch
produces lower part of the body and greater
horn of the hyoid bone
• The musculature is limited to the
stylopharyngeus muscles
• The nerve of the 3rd pharyngeal arch is the
glossopharyngeal nerve
• It supplies the muscles of this arch

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 4th and 6th Pharyngeal Arches
• Cartilaginous components of the 4th and 6th
pharyngeal arches fuse to form the thyroid, cricoid,
arytenoid, corniculate, and cuneiform cartilages of
the larynx
• Muscles of the 4th arch:
- Cricothyroid, levator palatini and constrictors of the
pharynx
- Are innervated by the superior laryngeal branch of
the vagus, the nerve of the 4th arch
• Intrinsic muscles of the larynx are supplied by the
recurrent laryngeal branch of the vagus, the nerve of
the sixth arch
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 Definitive Structures formed by the cartilaginous components of various
Pharyngeal Arches

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Derivatives of Pharyngeal Arches and Their Innervation

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 Derivatives of the Pharyngeal Arteries

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 Pharyngeal Pouches

• The human embryo has four pairs of pharyngeal

pouches; the 5th is rudimentary

• The epithelial endodermal lining of the pouches

gives rise to a number of important organs

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 1st Pharyngeal Pouch
• Forms a stalk-like diverticulum called the
tubotympanic recess
• This diverticulum comes in contact with the epithelial
lining of the 1st pharyngeal cleft, the future external
auditory meatus
• The distal portion of the diverticulum widens into a
sac-like structure called primitive tympanic or middle
ear cavity
• The proximal part remains narrow, forming the
auditory (Eustachian) tube
• The lining of the tympanic cavity later aids in
formation of the tympanic membrane or eardrum
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Development of the Pharyngeal Clefts and Pouches

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 2nd Pharyngeal Pouch
• The epithelial lining of the 2nd pharyngeal pouch
proliferates and forms buds that penetrate into
the surrounding mesenchyme
• The buds are secondarily invaded by mesodermal
tissue, forming the primordium of the palatine
tonsils
• During the 3rd and 5th months, the tonsil is
infiltrated by lymphatic tissue
• Part of the pouch remains and is found in the
adult as the tonsillar fossa
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 3rd Pharyngeal Pouch
• The 3rd and 4th pouches are characterized at their distal
extremity by a dorsal and a ventral wing
• In the 5th week, epithelium of the 3rd pouch differentiates
into:
1. Dorsal region giving the inferior parathyroid gland
2. Ventral region forms the thymus
• Both gland primordia lose their connection with the
pharyngeal wall
• The thymus then migrates in a caudal and a medial
direction, pulling the inferior parathyroid with it
• The main portion of the thymus moves rapidly to its final
position in the anterior part of the thorax, where it fuses
with its counterpart from the opposite side
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 Migration of the Thymus and the Ultimobranchial body

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 3rd Pharyngeal Pouch
• The thymus tail portion sometimes persists either
embedded in the thyroid gland or as isolated thymic
nests
• Growth and development of the thymus continue
until puberty
• In the young child, the thymus occupies considerable
space in the thorax and lies behind the sternum and
anterior to the pericardium and great vessels
• In older persons, it is difficult to recognize, since it is
atrophied and replaced by fatty tissue.
• The parathyroid tissue of the 3rd pouch finally comes
to rest on the dorsal surface of the thyroid gland and
forms the inferior parathyroid gland (parathyroid III)

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 4th Pharyngeal Pouch
• Epithelium of the dorsal region of the fourth
pharyngeal pouch forms the superior parathyroid
gland(parathyroid IV)

• When the parathyroid gland loses contact with

the wall of the pharynx, it attaches itself to the
dorsal surface of the caudally migrating thyroid as
the superior parathyroid gland

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 4th Pharyngeal Pouch
• The ventral region of the 4th pouch gives rise to
the ultimobranchial body, which is later
incorporated into the thyroid gland

• Cells of the ultimobranchial body give rise to the

parafollicular, or C cells of the thyroid gland

• These cells secrete calcitonin, a hormone involved

in regulation of the calcium level in the blood

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Derivatives of the Pharyngeal Pouches

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 Pharyngeal Clefts
• The 5-week embryo is characterized by the
presence of 4 pharyngeal clefts
• Out of 4, only one contributes to the definitive
structure of the embryo
• The dorsal part of the 1st cleft penetrates the
underlying mesenchyme and gives rise to the
external auditory meatus
• The epithelial lining at the bottom of the meatus
participates in formation of the eardrum

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 Pharyngeal Clefts
• Active proliferation of mesenchymal tissue in the
second arch causes it to overlap the third and
fourth arches
• Finally, it merges with the epicardial ridge in the
lower part of the neck, and the second, third, and
fourth clefts lose contact with the outside
• The clefts form a cavity lined with ectodermal
epithelium, the cervical sinus, but with further
development, this sinus disappears

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 Clinical Correlates
Birth Defects Involving the Pharyngeal Region

Ectopic Thymic and Parathyroid Tissue

• Since glandular tissue derived from the pouches
undergoes migration, it is not unusual for accessory
glands or remnants of tissue to persist along the
pathway
• This is true particularly for thymic tissue, which may
remain in the neck, and for the parathyroid glands
• The inferior parathyroids are more variable in
position than the superior ones and are sometimes
found at the bifurcation of the common carotid
artery
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 Clinical Correlates
Branchial Fistulas
• Branchial fistulas occur when the 2nd pharyngeal
arch fails to grow caudally over the 3rd and 4th
arches
• This leaves remnants of the 2nd, 3rd, and 4th clefts in
contact with the surface by a narrow canal
• Such a fistula, found on the lateral aspect of the
neck directly anterior to the sternocleidomastoid
muscle, usually provides drainage for a lateral
cervical cyst
• These cysts are remnants of the cervical sinus
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 Lateral Cervical Cyst/fistula

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 Patient With a Lateral Cervical Cyst

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 Clinical Correlates
• They are most often found just below the angle of the
jaw, although they may be found anywhere along the
anterior border of the sternocleidomastoid muscle
• Frequently a lateral cervical cyst is not visible at birth
but becomes evident as it enlarges during childhood
• Internal branchial fistulas are rare
• They occur when the cervical sinus is connected to
the lumen of the pharynx by a small canal, which
usually opens in the tonsillar region
• Such a fistula results from a rupture of the membrane
between the second pharyngeal cleft and pouch at
some time during development
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 The End!

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