The Nose, Mouth and Pharynx. 461 



the posterior surfaces are almost touching one another. 

 In addition to the muscles in contact with the lateral as- 

 pect of the pharynx, are the following structures, viz. : 

 The parotid gland, the ninth, tenth, eleventh and twelfth 

 cranial nerves, the ascending pharyngeal and internal 

 carotid arteries and the internal jugular vein. 



Landmarks, The anterior arch of the atlas is on 

 the same level as the hard palate ; the body of the axis 

 corresponds to the lower edges of the upper teeth, while 

 the lower border of the fifth cervical is opposite the in- 

 ferior end of the pharynx, and is about six inches distant 

 from the incisor teeth. The Eustachian tube opens into 

 the pharynx on a level with the posterior end of the in- 

 ferior turbinated bone, i.e., about half an inch above the 

 level of the floor of the nares. In introducing the Eu- 

 stachian catheter, therefore, it should, after traversing the 

 floor of the nose, be turned, partly outwards, so that the 

 ring on its posterior end shall point to the outer canthus 

 of the eye on the same side as that on which the catheter 

 is being used. 



Diseases of the Pharynx. Retro-pharyngeal abscess 

 generally results from an inflamed lymphatic gland, 

 or from caries of the cervical vertebrae, and tends, very 

 rarely, to spontaneous rupture, hence the need of early in- 

 cision for its evacuation. The pain in retro-pharyngeal 

 abscess is increased by any movements of the head, and, 

 unless evacuated early, there is great danger of spasm of 

 the larynx from reflex action through the pneumogastric, 

 which supplies the larynx as well as the pharynx. There 

 is also danger, in this situation, of the tumor mechanically 

 occluding the windpipe. 



Pharyngeal Tonsil. Near the junction of the 

 posterior wall with the basilar process, and about on a 

 level with the orifices of the Eustachian tubes, is a col- 



