The throat

introduction

The throat (Pharynx) denotes the section between the oral cavity and esophagus (Esophagus) or trachea (Trachea).
It is divided into different floors, serves to transport food and is part of the respiratory system. It is also known colloquially as the upper airway. Due to the upright posture of humans, the throat is more curved than in other mammals. This means that the risk of swallowing is much greater. In addition, the throat contains a lot of lymphatic tissue and is therefore an important part of the immune system.

Anatomy pharynx

The throat (Pharynx) is about 12-15cm long Muscle tube and is through the base of the tongue and the arch of the palate from the Oral cavity delimited. Through the Choanen it is throat connected to the nasal cavity (nasopharyngeal duct).
The throat leads down to the front (ventral) lying larynx (larynx) to which the windpipe (Trachea) connects. Rear (dorsal) the throat goes into the esophagus (esophagus).

The throat itself is divided into three levels:

  • On the one hand the nasopharynx (Pars nasalis pharyngis, nasopharynx or epipharynx) in the area of ​​the transition from the nasal cavity to the oral cavity. As the front opening, the choans establish the connection between the throat and the nasal cavity. On the upper pharynx wall (Fornix pharyngis), which borders the base of the skull, is the unpaired pharyngeal tonsil. It is part of the immune system. The two mouths of the auditory tubes lie to the side of this tonsil. The openings in these tonsils form the connection between the nasopharynx and the tympanic cavity and thus serve to ventilate the middle ear.
  • This is followed by the pharynx (Pars oralis pharyngis, oropharynx or mesopharynx), which is limited by various structures. The two palatal arches represent the anterior transition between the pharynx and the oral cavity. The bottleneck, the Isthmus faucium, educated. The soft palate (Velum palatinum) forms the upper (cranial) Border of the pharynx. The lower (caudal) Border is through the upper edge of the epiglottis (epiglottis) educated.
  • The pharynx closes on the pharynx (Pars laryngea pharyngis, laryngopharynx or hypopharynx) at. This then goes into the larynx or esophagus. The upper limit is the epiglottis (epiglottis). The entrance to the larynx (aditus laryngis) represents the anterior (ventral) Entrance to the larynx and thus the front boundary of the laryngopharynx. The transition into the esophagus (Esophagus) lies at the back (dorsal) in the area of ​​the cricoid cartilage of the larynx (larynx).

Throat layers

The entire throat is with Mucous membrane lined.
Depending on the section of the throat, this mucous membrane has one different structure and different functions. In the area of ​​the nasopharynx, the mucous membrane consists of Ciliated epithelial cells and Goblet cells. These serve to remove smaller dust particles from the air we breathe and to produce mucus. This keeps the mucous membrane moist. It is also located in the part of the pharynx lymphoid tissue. This is known colloquially as "almonds". It consists of different tonsils and is mainly used for immune defense. In its entirety, this lymphatic tissue is called the Waldeyer pharynx ring. The entire mucous membrane lies on the outside Muscle layer (Tunica muscularis). This consists of Skeletal muscles and contains various throat cords with ring-shaped muscles, as well three pharynx lifters (Stylopharyngeus, salpingopharyngeus, and palatopharyngeus muscles) with longitudinal muscle fibers. These muscles are used for coordination during the swallowing process. In addition, the pharyngeal elevators radiate into the side wall of the pharynx and lift the entire intestinal cord.

Blood supply

The pharynx is supplied via various branches from the External carotid artery. The Pharyngeal artery ascendens and the Thyroid artery superior arise directly from the External carotid artery. The Thyroid artery inferior arises from the Subclavian artery. In addition, two pharyngeal arteries supply the Descending palatal artery and ascendens the throat with blood. These arise from the Maxillary artery, or the Facial artery. The venous blood flows over the back (dorsal) lying Pharyngeal plexus directly or indirectly into the Internal jugular vein.

The Lymph drainage of the throat occurs via small lymph nodes in the area of ​​the Laryngeal plexus venosus into the larger cervical and deep, lateral lymph nodes. The motor, sensory and vegetative innervation of the nasopharynx and oropharynx takes place through branches of the Glossopharyngeal nerve (IX. Cranial nerve).

The Innervation of the pharynx takes place through branches of the Vagus nerve (X. cranial nerve). At the level of the pharynx, the branches of these two nerves form a network of nerves (Pharyngeal plexus). This contains motor, sensory, secretory and sympathetic fibers. Fibers of this nerve plexus also innervate part of the back wall of the pharynx and thereby loosen it Swallowing or gaggingx off.

Function of the throat

The throat represents the Connection between the oral cavity, nose, food and windpipe. The main function of the throat is to both air as well as Chyme from the mouth further to promote. For this purpose, it has a muscle layer that is able to contract in a ring and thus even transport the chyme against gravity if necessary. After about 12-15 cm the throat divides into the esophagus and trachea. This is where the separation of air and porridge takes place.

The Epiglottis (lat. epiglottis), a cartilaginous plate that sits on the front of the windpipe. When swallowing, it is pressed by the contracting muscles onto the opening of the windpipe and closes it. Then the epiglottis opens again automatically. This ensures that no chyme gets into the windpipe.

The throat is from Mucous membrane coated in some places, especially in the nasopharynx, with tiny Hairs is busy. On the one hand, these serve as filter for the air on the way to the lungs, on the other hand they guarantee one Self cleaningby transporting the collected particles towards the stomach by rhythmically knocking them out.

In addition, there is a lot in the throat lymphoid tissue as the Pharynx), which for Defense against pathogens how bacteria and viruses contribute.

Pharynx

The pharynx (lat. Pharyngeal tonsil) is located on the roof of the throat and is part of the lymphatic ring of the pharynxwhose job it is to catch inhaled pathogens. So you come one immunological protective function to. Like the other tonsils, it consists of lymphoid tissue and is covered with a mucous membrane.

An enlarged pharynx, also colloquially polyp called, does not necessarily have to lead to complaints. In smaller children it is even often enlarged and only forms in the puberty back. However, if the almond grows too much, it can Nasal breathing hinder. This leads to the affected person getting poor breath while sleeping. Breathing through the mouth also increases this when breathing through the nose is difficult Risk of infection for the lung.

If the pharyngeal tonsil grows over the opening of the Eustachian tube (connection between the pharynx and the middle ear), a negative pressure can develop in the tube, which Otitis media favored. If an enlarged tonsil causes discomfort, it is possible to remove it with a small operation.

Diseases

Diseases of the throat

The most important and common disease of the throat is the Sore throat (Pharyngitis). She goes with one red throat and Sore throat and is usually caused by harmless viruses. It occurs mainly in the cold months as part of a cold. The throat can also be inflamed by bacteria. Then the inflammation is accompanied by coatings on the back of the pharynx and the tonsils. There is a much stronger sore throat and a stronger feeling of illness.
In severe cases, these patients also have to use a antibiotic be treated.
The Pharyngeal diptheria is caused by the Corynebacterium diphteriae and can lead to difficulties swallowing, massive Swelling in the area of ​​the neck, Sore throat and fever to lead. In severe cases, the swellings in particular can obstruct the airways and become life-threatening.
Can be very difficult Tumor diseases be in the area of ​​the throat. Depending on the tumor localization Oropharyngeal, nasopharyngeal, and laryngopharyngeal cancers differentiated. Here is the forecast often depends on the location of tumor occurrence and metastasisbecause some tumors are often only recognized late due to their hidden location and low symptoms. Due to its proximity to the brain and numerous important structures, they are then very difficult to treat.

There are different types of cancer that can develop in the throat area. The most common, however, is the Throat cancer (Pharyngeal carcinoma), which resulted from Tobacco and alcohol consumption, cancer-causing substances (Carcinogens) such as nitrosamines or through infection with human Papillomaviruses (HPV) can develop. Throat cancer is often symptom-free for a long time and in most cases only manifests itself when the Lymph nodes (Lymph node metastases) noticeable through swelling in the neck area.

Other symptoms that can be triggered by throat cancer include: Sore throat, Ear problems, difficulties swallowing, Nosebleeds or problems breathing through the nose. A throat cancer can be diagnosed by an ear, nose and throat doctor (ENT doctor) through a Mirror examination be recognized. However, if the cancer is deeper, an X-ray is often also Ultrasonic, CT or MRI necessary.

The treatment of throat cancer is usually the surgical removal of the ulcer (tumor) with subsequent radiation or, more rarely, chemotherapy. However, the choice of therapy depends on the spread, size and type of cancer (tumor type).

Swollen throat

A swollen throat is usually the cause of one Sore throat (Pharyngitis), but can also be due to Allergies or Medication to be triggered. When inflamed, the swelling develops through the Inflammatory process Within hours to days, in the case of an acute allergic reaction, the lining of the throat can swell within seconds to minutes, causing a Suffocation threatens. In the event of an acute allergic reaction, you must immediately Ambulance be drawn from the lining of the throat Cortisone can cause swelling. However, if it is a drug side effect, care must be taken, as cortisone is a possible cause of one Swelling can be. In this case, the triggering medication should be exchanged or discontinued. Is the throat due to a cold swollen, the disease that is the trigger for the swelling must be treated, but it is also possible to treat the swelling by active cooling (e.g. ice cubes) and the sucking of throat lozenges in parallel.

Mucous throat

The most common causes of a mucous throat are infections of the throat, the Sinuses or the Bronchi. In the case of a cold, for example, the mucus produced in the paranasal sinuses can flow down through a connection between the nose and throat and thus the feeling of a slimy throat cause. But also with inflammation of the airways (bronchitis), pneumonia (pneumonia) or with inflammatory diseases of the respiratory tract (asthma) or chronic lung disease (COPD) it can lead to mucus build-up and coughing up of mucus.

It is important to post the mucus Quantity, color and toughness (viscosity) to identify possible diseases.

Burning throat

A burning throat is usually an inflammation of the throat (pharyngitis). The causes for this are in most cases various viruses (adeno, rhino, corona, influenza, parainfluenza but also herpes simplex, echo, Coxsackie, Eppstein-Barr, measles or rubella viruses) and more rarely Bacteria (streptococci). These attack the sensitive lining of the throat and cause inflammation there. Many patients describe the pain associated with such inflammation as burning. Often the burning sensation is accompanied by a feeling of dryness in the throat area, as well as fever, hoarseness, runny nose and cough.

As a rule, an acute sore throat heals on its own or, in the case of bacterial infections, with antibiotic therapy. Complications such as tonsillitis (angina tonsillaris), laryngitis (laryngitis) or pus formation with encapsulation (abscess) are possible and require special, intensified therapy.

However, a burning throat can also occur with chronic inflammation of the throat. The most common causes here are not viruses or bacteria, but rather smoking, alcohol, stomach acid, dry room air or dust at the workplace.

Frequent moistening of the throat (drinking, candy, chewing gum) protects the throat from drying out and inflammation.

You can find more on this topic on our website Burning in the throat

Throat pain

Throat pain is a common one Accompanying symptom of a cold, flu or Tonsillitis. Hence, it makes sense to look for the cause of the pain in these diseases. These often subside within a week. However, in rare cases, throat pain can also be due to dangerous diseases such as Diphtheria or Scarlet fever indicate. If the pain does not go away after a few days or additional symptoms such as Shortness of breath or severe fever a doctor should therefore be consulted.

As Home remedies can for example tea or warm milk with honey Provide relief. Also sage, as a candy or as a tea helps against the pain. Most pharmacies and drug stores offer this over-the-counter lozenges that also help against the pain. It can also be with Garbled salt water to disinfect and rinse the throat. In general, it helps to drink plenty of fluids, whether warm or cold. In addition, it is advisable to take it easy on the body for a few days and avoid the cold and great exertion.

Sore throat

As Sore throat(lat. Pharyngitis) is a term that occurs very frequently, especially in winter Inflammation of the lining of the throatwhich is often associated with a flu-like infection occurs. Typical symptoms are a sore throat or sore throat, burning and scratching in the throat, as well as difficulty swallowing and speaking. Often those affected also have a reddened palate and the feeling that something is stuck in the throat. Occasionally, there is also a slight fever. Children are generally more affected than adults, and they can also experience nausea.

One through Viruses The sore throat that is caused cannot be treated causally, but it usually heals on its own within a week. The symptoms can still be treated: Against the sore throat and swelling are recommended Lozenges or possibly pain centerYour family doctor can prescribe medication for a high fever.

As a home remedy it helps a lot to drink, ideally warm tea. That too Gargle with salt water or eucalyptus provides relief and supports the mucous membrane in regeneration. It is also advisable to take care of the body for a few days and avoid cold and exertion. A lack of sleep, as well as smoking and alcohol consumption, can delay healing. The inflammation should not be cooled with ice, since the strong cooling hinders the blood circulation and thus the fight against the inflammation by the immune system.

One through bacteria caused pharyngitis usually shows in stronger symptoms and higher fever. In this case, a doctor should be consulted, as the bacterial throat inflammation is a serious secondary disease rheumatic fever, and therefore with Antibiotics should be treated.

Is the throat of one mushroom infested, one speaks of a thrush. This is characterized by a white coating and a furry feeling and should also be shown to a doctor. Thrush is very rare in people with a functioning immune system.

Throat cancer

As Throat cancer one calls one tumor in the area of ​​the throat. Very often there is one Degeneration of the mucous membrane in front (Squamous cell carcinoma) seldom others too. Throat cancer occurs in Europe with a frequency of around 2-5 per thousand inhabitants, most frequently in men between the ages of 50 and 70. The exact causes have not yet been clarified. However, the greatest risk factors are considered to be Smoke and regular alcohol consumption and, according to recent studies, an infection with the human papilloma virus (HPV).

Throat cancer itself often causes little or no symptoms for a long time. If symptoms occur, these are rather unspecific and include, depending on the localization Nosebleeds, difficulties swallowing, Hotness or a "lump in the throat". However, throat cancer tends to metastasize to other parts of the body at an early stage. Usually first in the lymph nodes on the neck, which then swell and can be felt with the hand.

If the tumor is detected early, it can often be completely removed by surgery. In later stages a radiotherapy or one chemotherapy become necessary. The aim of therapy is to ensure the patient's quality of life as much as possible by maintaining bodily functions such as speaking, swallowing and breathing. Since the course of the disease depends heavily on the location and the stage at which it is discovered, it is not possible to make a general prognosis for the course.

Summary

The pharynx is the connection between the mouth or nose and the trachea or esophagus. It is a 12-15cm long muscle tube that is used to transport air and food.
The soft palate and epiglottis serve as important auxiliary structures for coordinating the path from the mouth to the lungs or stomach.
The pharynx is divided into three sections and divided into a nasopharynx, a pharynx and a pharynx according to its location.
These individual parts are supplied by various nerves and vessels and are all reinforced by a layer of muscles. This serves to coordinate the act of swallowing. In addition to these functions, the throat has the task of immune defense. For this purpose, there are numerous immune defense cells in the entire mucous membrane of the throat. These are bundled in the area of ​​the various almonds (Tonsils) and should make the pathogens harmless, especially from the air we breathe. If the pathogens from the breath are too strong or the immune system is too weak, the throat can become inflamed and then typically lead to a sore throat and red throat. In some cases, bacteria can colonize the throat, causing plaque and a serious feeling of illness. Cancers can also occur in the throat area, often as a result of longstanding alcohol or nicotine abuse. In most cases, these cancers are difficult to cure.