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Nasopharynx

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The nasopharynx refers to the air-containing cavity that occupies the uppermost extent of the aerodigestive tract.

 

The nasopharynx is the  upper portion of the pharynx,and it 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. 

 

It is a fibromuscular sling suspended from the skull base. 

 

The roof and posterior wall of the nasopharynx are formed by the sphenoid sinus, the clivus, and anterior aspect of the first two cervical vertebrae. 

Waldeyer’s tonsillar ring is an annular arrangement of lymphoid tissue in both the nasopharynx and oropharynx. 

The nasopharynx is lined by respiratory epithelium that is pseudostratified, columnar, and ciliated.

The inferior aspect of the nasopharynx is formed by the hard palate, the soft palate, and the ridge of pharyngeal musculature that opposes the soft palate when it is elevated.

 

The lateral nasopharyngeal walls are formed by the margins of the superior constrictor muscle. 

 

Anteriorly, the nasopharynx is in direct continuity with the nasal cavity through the posterior choanae. 

 

 

The nasopharynx is bounded anteriorly by the posterior nasal cavity at the level of the choana; superiorly by the sphenoid sinus; posterosuperiorly by the clivus, upper cervical spine, and prevertebral muscles; and inferiorly by the soft palate. 

 

 

It is in direct communication with the middle ear cavity through the Eustachian tubes.

The auditory tube, which connects the middle ear to the pharynx, opens into the nasopharynx at the pharyngeal opening of the auditory tube. 

The opening and closing of the auditory tubes serves to equalize the barometric pressure in the middle ear with that of the ambient atmosphere.

 

 

 

The nasopharynx is superior to the other two subdivisions of the pharynx, the oropharynx and hypopharynx. 

 

 

The nasopharynx is a cavity formed by muscle and fascia with an epithelial mucosal covering.

 

Polyps or mucus can obstruct the nasopharynx, as can congestion due to an upper respiratory infection. 

 

 

The roof of the soft palate forms the inferior border of the nasopharynx and creates the junction between the nasopharynx and the oropharynx. 

 

 

The nasopharynx is bound anteriorly by the posterior end of the nasal septum and the choanae; posteriorly by the vertebral bodies, the atlas, and the axis; and superiorly by the sphenoid sinus and the basisphenoid.

 

 

The nasopharyngeal muscular component is the superior pharyngeal constrictor, which emanates from the pharyngeal tubercle. 

 

 

Lateral to the nasopharynx are the parapharyngeal space and the masticator space.

 

 

The eustachian tubes descend medially to enter the lateral nasopharynx. 

 

 

The posterior aspect of the Eustachian tube orifice creates a protrusion called the torus tubarius.

 

 

Posterior to the torus is the lateral recess known as the pharyngeal recess, or Rosenmüller’s fossa. 

 

 

The walls and the roof of the nasopharynx are covered by mucosa.

 

 

It contains squamous mucosa, lymphoid tissue as adenoids, pharyngeal constrictor muscles, the levator palatini muscle, and the torus tubarius.

 

 

The presence of a nasopharyngeal mass can  obstruct the eustachian tube, causing dysfunction and serous otitis. 

 

 

The Rosenmüller fossa represents the uppermost aspect of the lateral recess of the nasopharynx and is a common site of origin of nasopharyngeal cancers.

 

 

The  retropharyngeal space and prevertebral space are between the vertebral bodies.

 

 

Within the retropharyngeal space are the lateral retropharyngeal nodes of Rouviere, which are the first-echelon nodes in the lymphatic drainage of the nasopharynx.

 

 

The foramen lacerum and foramen ovale are  pathways for nasopharyngeal tumor extension into the intracranial cavity. 

 

 

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