64 SURGICAL ANATOMY OF 



SURGICAL ANATOMY OF THE PHARYNX. 



The pharynx presents for examination four walls, an 

 anterior, a posterior, and two lateral. 



The anterior, very oblique behind and below, contains 

 from above downwards, the posterior nares, the velum 

 pendulum palati, the posterior pillars of the fauces, base 

 of tongue, epiglottis, the glosso-epiglottic folds, and 

 larynx. 



The posterior wall is in relation with the cervical ver- 

 tebrae, being separated from them by the recti antici and 

 longi colli muscles. Between the muscular coat of the 

 pharynx, which is formed by the constrictors, is a quan- 

 tity of loose cellular tissue, in which retro-pharyngeal 

 abscesses form, frequently from disease of the cervical 

 vertebrae. These abscesses push the pharynx forward 

 against the posterior nares if high up, and if lower down, 

 by pressing upon the larynx interfere with respiration 

 and speech. Occasionally these abscesses point at the 

 side of the neck in front of the sterno-cleido-mastoid (vide 

 Fasciae of Neck). 



The lateral walls, also formed by the constrictors, are 

 in relation with the sympathetic, glosso-pharyngeal, 

 spinal accessory, vagus, hypo-glossal nerves, internal 

 carotid artery, and internal jugular vein. In front of 

 the vessels and nerves, the pterygo-maxillary region, 

 pterygoid plates of the sphenoid, deep portion of the 

 parotid, and the lateral portion of the submaxillary 

 region are in immediate relation with them. This close 

 relation to the parotid and internal maxillary regions, 

 explains the pointing of abscesses forming in these spaces 

 at the sides of the pharynx. 



It is hardly necessary to remind the student that in 



