

It is a conical fibromuscular tube forming

upper part of air and food passage.

12-14 cm long.

Extends from base of skull to lower border
of cricoid cartilage.

Width is 3.5 cm and it becomes narrow at
pharyngo-oesophageal
junction.narrowest part of GIT.
IT CONSIST OF 4 LAYERS:

Mucous membrane

Pharyngeal aponeurosis(pharyngobasilar
fascia)

Muscular coat

Buccopharyngeal fascia

Muscular coat consist of two layers of
muscles with 3 muscles in each layer.

External layer  superior, middle, inferior
constrictor muscle

Internal layer stylopharyngeus,
salpingopharyngeus, palatopharyngeus.
 Inferior constrictor has two parts ;thyropharyngeus with
oblique fibres and cricopharyngeus with transverse fibres.
 Between these two parts exists a potential gap’killian’s
dehiscence’ or “gate way of tears”.
 Perforation can occur during oesophagoscopy.

Scattered throughout the pharynx in its
subepithelial layer is lymphoid tissue which is
aggregated at places to form masses,
collectively called waldeyer’s ring.
The masses are:

Nasopharyngeal tonsil or adenoids.

Palatine tonsils.

Lingual tonsils.

Tubal tonsils.

Lateral pharyngeal bands.

Nodules (in post. Pharyngeal wall)
 Nasopharynx.
 Oropharynx.

 Hypopharynx or laryngopharynx.

NASOPHARYNX:
 Roof, posterior wall, floor, anterior wall and

lateral wall.
 Each lateral wall opening of

eustchaintube.Above and behind is elevation

called torus tubarius . Above and behind tubal
elevation is a recess called “fossa of
Rosenmuller”-> commonest site for carcinoma.

It is a subepithelial collection of lymphoid
tissue at junction of roof and posterior wall
of nasopharynx and causes the overlying
mucous membrane to be thrown into
radiating folds . It increases upto 6 yrs and
gradually atrophies.
ACUTE PHARYNGITIS:

Aetiology

Viral

Bacterial_ grp. A Beta hemolytic
streptococci.

Fungal.
Milder infections:

Discomfort in throat, malaise and low grade
fever.

Pharynx is congested but no lymphadenopathy.

Moderate and severe infections:


Pain in throat, dysphagia, headache, malaise,
high fever.

Pharynx shows erythema exudate ,
enlargement of tonsils and lymphoid follicles.
Very severe cases:

Oedema of soft palate and uvula with
enlargement of cervical lymphnodes.


Viral infections are mild and accompanied
by rhinorrhoea and hoarsness.

DIAGNOSIS:

Culture of throat swab.
General measures:

Bed rest , plenty of fluids, warm saline gargles
and analgesics form main stay of treatment.

Specific treatment:

Streptocoal pharyngitis—penicillin G , for 10
days. benzathine pn.

Erythromycin 20-40 mg/kg daily for 10 days.

For diptheria – antitoxin with pn.
 Fungal pharyngitis: candida infection of oropharynx .
Nystatin is drug of choice.

CHRONIC PHARYNGITIS:
 It is chronic inflammatory condition of pharynx.
 Hypertrophy of mucosa, seromucinous glands,
subepithelial lymphoid follicles and even muscular coat.
Chronic pharyngitis is of two types:
 1)Chronic catarrhal pharyngitis
 2)chronic hypertrophic (granular)pharyngitis.

1) Persistent infection in near by structures.

2) Mouth breathing.

3)Chronic irritants.

4)Environmental pollution.

SYMPTOMS:
 Discomfort or pain in throat.

 Foreign body sensation in throat.

 Tiredness of voice.

 Cough.
SIGNS:

Chronic catarrhal pharyngitis:

Congestion of posterior pharyngeal wall with
engorgement of vessels ; faucial pillars may be
thickened. increased mucus secretion which
may cover pharyngeal mucosa.


Chronic hypertrophic(granular) pharyngitis:

1)Pharyngeal wall appears thick and
oedematous with congested mucosa and
dilated vessels.

2) posterior pharyngeal wall may be studded
with reddish nodules.

3)Lateral pharyngeal bands become
hypertrophied.

4)Uvula may be elongated and oedematous.

TREATMENT:

Causative factor should be eradicated.

Voice rest may be required.

Warm saline gargles

Mandle’s paint (consists of iodine 1.25 grams,
potassium iodine 2.5 grams, water 2.5 ml )may
be applied to pharyngeal mucosa.

Cautery of lymphoid granules by silver nitrate.

THANK YOU !!