Anatomy and Boundaries of the Oropharynx
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Hello everyone.
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My name is Dr. Sidney Levy
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and today I'm here to begin a series
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of vignettes on the anatomy and pathology of
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the oropharynx, in particular the diagnosis and
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staging of squamous cell malignancy in this region.
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But firstly, I'd like to draw
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the boundaries of the oropharynx.
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So the oropharynx consists of multiple components.
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Let's start off on the axial projection.
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We've got pre contrast T1 weighted
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imaging here without fat suppression at
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the line of the circumvallate papillae.
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This is the junction of the anterior two
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thirds of the tongue and the posterior third.
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The posterior third of the tongue is referred
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to as the tongue base and the anterior two
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thirds is referred to as the oral tongue.
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The tongue base is part of the oropharynx, whereas
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the oral tongue is part of the oral cavity.
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From there, we curve around on the axial projection.
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We come to the palatine tonsils and the
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adjacent lateral oropharyngeal wall.
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We then cross over to the other side, the contralateral
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palatine tonsil back towards the base of tongue.
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On the sagittal projection, you can identify
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the junction of the anterior two thirds
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and posterior third of tongue once again.
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So I'll just put a little cross at that site.
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Then from there we head down.
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Don't pay attention to this large lesion here.
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We'll discuss it in a subsequent vignette.
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This is a base of tongue squamous cell carcinoma, but
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for the moment we're just interested in the anatomy.
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The base of tongue reaches down to the
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vollecular, which are cavities on each
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side to which the epiglottis is connected.
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This is the epiglottis here.
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Now the boundary of the oropharynx is
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is between the lingual and the laryngeal
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services of the epiglottis here.
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From there, we cross over to
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the posterior pharyngeal wall.
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And going cranially, we have the posterior
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oropharyngeal wall, as far as the pharyngeal isthmus.
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Now, in this patient, the uvula is touching
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the posterior wall of the oropharynx.
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So The isthmus is actually here.
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Once we reach our next landmark, the soft
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palate, we keep going on the inferior border
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of the soft palate as far as its junction with
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the hard palate, and then we reconnect back.
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So, in summary, the oropharynx
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consists of multiple subunits.
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You have the posterior third of tongue,
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also described as the tongue base, which
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reaches down as far as the epiglottis.
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You then have the soft palate, up here.
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You then have the palatine tonsils, over here.
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Not particularly prominent in this patient in his 60s.
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And then we have the connecting lateral
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and posterior oropharyngeal walls.
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In our next vignette, we're going to
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discuss the contents and relationships of
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the oropharyngeal subsites in relation to
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adjacent subsites within the head and neck.
Sidney Levy, PhD, MBBS
Radiologist and Nuclear Medicine Specialist
I-MED
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