i6oa 



HTM AN ANATOMY. 



FIG. 1358. 



Pharyngcal tonsil of child one year 

 old. (Schwabach.) 



Lymph-nodule 



is nothing more than the fold around the end of a transverse linear cleft. The whole 

 lateral aspect is covered by a thick layer of areolar tissue, continuous with that 

 of the carotid sheath. It is most convenient to give the relations of the lateral wall 

 from below upward, excepting the nerves. The upper 

 part of the lobes of the thyroid gland comes very close 

 to the lower part of the pharynx, and may even touch 

 it without undue enlargement. They separate the 

 common carotid from the pharynx. A little higher 

 this vessel is on the outer side of the great wing of 

 the thyroid cartilage, but if the head be turned to 

 one side the vessel of the other side will rest on the 

 pharynx. The common carotid artery is very close 

 to the pharynx just before its division. The inter- 

 nal carotid lies against it until it reaches the skull. 

 The beginning of the external carotid with its lingual and facial branches is also 

 against it. The ascending pharyngeal artery runs along it, the middle meningeal 

 lying against its upper part. The internal jugular vein is, probably, nowhere in 

 direct contact with the pharynx unless just below the skull. The submaxillary 

 gland touches it at the angle of the jaw. 



The sympathetic nerve comes in contact with the back or side of the pharynx. 

 The vagus lies against the pharynx behind the internal carotid ; on reaching the 



common carotid, however, 



FIG- 359- it is in less direct contact. 



Its superior laryngeal branch 

 crosses the pharynx to reach 

 the thyro-hyoid membrane. 

 The spinal accessory and the 

 glosso-pharyngeal nerves lie 

 against the upper part of the 

 pharynx. 



The faucial tonsil lies 

 about 2. 5 cm. above the angle 

 and opposite a vertical line di- 

 viding the ramus of the jaw 

 into a front and a back half. It 

 lies between the pillars of the 

 fauces, and is separated from 

 the mucous membrane by a 

 thin layer of muscular fibres. 

 The lower end reaches the 

 tongue, the adenoid tissue 

 being at times continuous 

 between them. The tonsil is 

 covered by the superior con- 

 strictor. External to this is a 

 yielding mass of areolar tis- 

 sue, continuous with that of 

 the carotid sheath, into which 

 the tonsil may force its way 

 if enlarged. This areolar tis- 

 sue is bounded in front by 

 tin- internal pterygoid muscle, 

 and is pierced by the stylo- 

 ; s,-, ,,,,, P..S,,.,,,,, u.,11.,1 ,,h.,M, 1X ,, t .i.n.i .showing part of Rl ssu s and the stylo-pha- 

 ptenratw! tOMiL ryngrus, which subdivide it, 



leaving a small part of it be- 

 tween them and the tonsil. At this level both carotids are at a considerable dis- 

 tance from the tonsil. The internal is posterior and external, about 2 cm. distant. 

 According to Zuckcrkandl, a transverse line through the posterior pillar will pass 



Bundles of 

 muscular tis- 

 sue of constric- 

 tors 



-I'h.uviiKeal 

 aponeurosts 



MO* 

 iu in 



