4/18/2022

The Pharyngeal Apparatus

Embryo at 4 - 5 weeks (Lateral view)

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Pharyngeal Aparatus  During 5th week, the

mesoderm on each side
• During the 4th and 5th weeks, the human embryo shows an anteroposterior
closely resembles a fish embryo.
segmentation into 6
• There are series of parallel ridges seen on the side of the
future head and neck region (in relation to the pharynx) segments called
resemble the developing gill arches of the fish embryo. pharyngeal arches.
• This resemblance made the earlier embryologists to  Each pharyngeal arch
refer to the corresponding arches in the human embryo consists of a core of
as branchial arches, where ‘branchium' means ‘gill'.
mesoderm (derived from
• Up to 4th week of intrauterine life the neck is not yet neural crest cells) and
formed covered on outside by
• Head swelling is followed by cardiac swelling and ectoderm and on inside
separated by depression of stomodium. by endoderm.
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 Initially, they consist of bars of

mesenchymal tissue separated
by deep clefts known as
pharyngeal (branchial)
clefts/groove
 Simultaneously, with
development of the arches and
groove, a number of
outpocketings, the pharyngeal
pouches, appear along the
lateral walls of the pharyngeal
gut, the most cranial part of the
foregut.
 The pouches penetrate the
surrounding mesenchyme, but
do not establish an open
communication with the
5 Sisay A (anatomist) 4/18/2022 6 external clefts.
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PHARYNGEAL MEMBRANES
 The pharyngeal membranes
appear in the floors of the
pharyngeal grooves.
 These membranes form where
the epithelia of the grooves and
pouches approach each other.
 The endoderm of the pouches
and the ectoderm of the
grooves are soon separated by
mesenchyme.
 The pharyngeal apparatus
consists of pharyngeal arches,
pouches, grooves, and
membranes.

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PHARYNGEAL ARCHES  The pharyngeal arches support

 The pharyngeal arches begin to develop early in the fourth week as the lateral walls of the
neural crest cells migrate into the future head and neck regions. primordial pharynx, which is
 The first pair of pharyngeal arches, the primordium of the jaws, derived from the cranial part
appears as surface elevations lateral to the developing pharynx. of the foregut.
 fourth week, four pairs of pharyngeal arches  The stomodeum (primordial
 fifth and sixth arches are rudimentary and are not visible on the mouth) initially appears as a
surface of the embryo. slight depression of the surface
ectoderm.
 It is separated from the cavity
of the primordial pharynx by a
bilaminar membrane-the
oropharyngeal membrane.
 The oropharyngeal membrane
ruptures at approximately 26
days, bringing the pharynx and
foregut into communication
with the amniotic cavity
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Pharyngeal Arch Components Pharyngeal Arch Components

 Each pharyngeal arch consists of a core of mesenchyme • A typical pharyngeal arch contains
1. A pharyngeal arch artery that
(embryonic connective tissue) and is covered externally arises from the truncus arteriosus
by ectoderm and internally by endoderm. of the primordial heart and
passes around the primordial
 Originally, this mesenchyme is derived from mesoderm pharynx to enter the dorsal aorta
in the third week. 2. A cartilaginous rod that forms
the skeleton of the arch
 During the fourth week, most of the mesenchyme is 3. A muscular component that
differentiates into muscles in the
derived from neural crest cells that migrate into the head and neck
pharyngeal arches. 4. Sensory and motor nerves that
supply the mucosa and muscles
 It is the migration of neural crest cells into the arches derived from the arch
and their differentiation into mesenchyme that produces  The nerves that grow into the
arches are derived from
the maxillary and mandibular prominences, in addition neuroectoderm of the primordial
to all connective tissue including the dermis and smooth brain.
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muscle.
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FIRST PHARYNGEAL ARCH

Pharyngeal Arch Arteries
• The first pharyngeal arch consists of a dorsal portion, the maxillary
process, which extends forward beneath the region of the eye, and a As the pharyngeal arches form during the fourth and fifth
ventral portion, the mandibular process, which contains Meckel’s
cartilage weeks, they are supplied by arteries-the pharyngeal arch
 Early in development, small nodules break away from the proximal part arteries-that arise from the aortic sac and terminate in the
of this cartilage and form two of the middle ear bones, the malleus and dorsal aortas.
incus
 The middle part of the cartilage regresses, but its perichondrium forms
the anterior ligament of malleus and the sphenomandibular ligament.

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Pharyngeal Arch Arteries 4th Pharyngeal Arch Arteries: on the

left side it forms part of final aortic arch
 Each pharyngeal arch has its while on the right side it forms part of
aortic arch. right subclavian artery.
 There are 6 Pharyngeal Arch N.B. Left subclavian artery are formed
Arteries that are connected from the left 7th cervical intersegmental
ventrally to aortic sac and artery.
dorsally to dorsal aorta.
 First arch: degenerates mostly 5th Pharyngeal Arch Arteries:
leaving maxillary artery. Degenerate as the 5th pharyngeal arch.
 Second arch: degenerates 6th Pharyngeal Arch Arteries: Its
mostly leaving stapedial artery. ventral part form pulmonary artery
 Third arch: Its ventral which communicates with pulmonary
(proximal) part gives common trunk.
carotid artery while the dorsal
(distal) part gives internal •The dorsal part of the 6th aortic arch
carotid artery. External carotid remains in the left side as ductus
artery begins as a new branch arteriosus but in the right side it
between proximal and distal degenerates.
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partsSisay
of Athe 3rd arch.
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Fate of the Pharyngeal Arches second pharyngeal arch cartilage

(Reichert cartilage)
 The pharyngeal arches
 related to the developing ear, ossifies to
contribute extensively to the
form the
formation of the face, nasal
 stapes of the middle ear
cavities, mouth, larynx,
 styloid process of the temporal bone
pharynx, and neck.
 its perichondrium forms the stylohyoid
1. Derivatives of the ligament.
Pharyngeal Arch Cartilages  The ventral end of the second arch
 The dorsal end of the first cartilage ossifies to form
pharyngeal arch cartilage  the lesser cornu (Latin, horn) and the
(Meckel cartilage) is closely  superior part of the body of the hyoid
related to the developing bone.
ear. disappears as the third pharyngeal arch cartilage,
mandible develops around it  located in the ventral part of the arch,
by intramembranous ossifies to form the
ossification .  greater cornu and
 the inferior part of the body of the hyoid
bone.
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fourth and sixth pharyngeal Derivatives of Pharyngeal Arch Muscles

arch cartilages  The muscular components of the arches form
various muscles in the head and neck.
 fuse to form the laryngeal
 first pharyngeal arch --muscles of
cartilages, except for the mastication,mylohyoid anterier bely of
epiglottis. digastric,tensor tympani, tensor veli platini
cartilage of the epiglottis  second pharyngeal arch
 develops from mesenchyme in  stapedius
 stylohyoid
the hypopharyngeal eminence
 posterior belly of digastric
,in the floor of the embryonic
 auricular, and muscles of facial expression.
pharynx that is derived from
 third pharyngeal arch --stylopharyngeus.
the third and fourth pharyngeal
 fourth pharyngeal arch --cricothyroid,
arches. levator veli palatini, and constrictors of the
 The fifth pharyngeal arch is pharynx.
rudimentary (if present) and  sixth pharyngeal arch forms the intrinsic
has no derivatives. muscles of the larynx.

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Derivatives of Pharyngeal Arch Muscles Derivatives of the Pharyngeal Arch Nerves

ARCH muscle
 Each arch is supplied by its own cranial nerve (CN).
First (mandibular) Muscles of mastication  The special visceral efferent (branchial) components of
Mylohyoid and anterior belly of digastric the CNs supply muscles derived from the pharyngeal
Tensor tympani
arches.
Tensor veli palati
Second (hyoid) Muscles of facial expression  The facial skin is supplied by the CN V-the trigeminal
Stapedius nerve.
Stylohyoid ARCH NERVE
Posterior belly of digastric
First (mandibular) Trigeminal (CN V)
Third Stylopharyngeus
Second (hyoid) Facial (CN VII)
Fourth and sixth Cricothyroid
Levator veli palatini Third Glossopharyngeal (CN IX)
Constrictors of pharynx Fourth and sixth Superior laryngeal branch of vagus (CN X)
Intrinsic muscles of larynx Recurrent laryngeal branch of vagus (CN X)
Striated muscles of esophagus
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Pharyngeal Pouches
 The primordial pharynx, derived
from the foregut, widens cranially
where it joins the stomodeum , and
narrows caudally where it joins the
esophagus.
 The endoderm of the pharynx lines
the internal aspects of the pharyngeal
arches and passes into diverticula-the
pharyngeal pouches.
 The pouches develop in a
craniocaudal sequence between the
arches.
 The first pair of pouches, for
example, lies between the first and
second pharyngeal arches.
 There are four well-defined pairs of
pharyngeal pouches; the fifth pair is
23 Sisay A (anatomist) 4/18/2022 24 rudimentary or absent.
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Derivatives of the Pharyngeal Pouches

 The endodermal epithelial lining of the pharyngeal
pouches gives rise to important organs in the head and
neck.
The First Pharyngeal Pouch
 The first pharyngeal pouch expands into an elongate
tubotympanic recess.
 The expanded distal part of this recess contacts the first
pharyngeal groove, where it later contributes to the
formation of the tympanic membrane (eardrum).

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 The cavity of the tubotympanic recess becomes the • The pouch endoderm forms the surface epithelium and the
tympanic cavity and mastoid antrum. lining of the tonsillar crypts.
 The connection of the tubotympanic recess with the
• At approximately 20 weeks, the mesenchyme around the crypts
pharynx gradually elongates to form the differentiates into lymphoid tissue, which soon organizes into
pharyngotympanic tube (auditory tube). the lymphatic nodules of the palatine tonsil.
The Second Pharyngeal pouch
 is largely obliterated as the palatine tonsil develops and
remains as the tonsillar sinus or fossa .
 The endoderm of the second pouch proliferates and grows
into the underlying mesenchyme.
 The central parts of these buds break down, forming
tonsillar crypts (pitlike depressions).

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The Fourth Pharyngeal Pouch

The Third Pharyngeal Pouch
 The fourth pharyngeal pouch also
 The third pharyngeal pouch
expands and develops a solid, expands into dorsal bulbar and
dorsal bulbar part and a hollow, elongate ventral parts.
elongate ventral part.  Its connection with the pharynx is
 By the sixth week, the epithelium reduced to a narrow duct that soon
of each dorsal bulbar part of the degenerates.
pouch begins to differentiate into
 By the sixth week, each dorsal part
an inferior parathyroid gland.
develops into a superior
 The epithelium of the elongate
ventral parts of the pouch parathyroid gland, which lies on
proliferates, obliterating their the dorsal surface of the thyroid
cavities. gland.
 These come together in the median  Because the parathyroid glands
plane to form the thymus. derived from the third pouches
 The developing thymus and accompany the thymus, they are in
parathyroid glands lose their a more inferior position than the
connections with the pharynx. parathyroid glands derived from
the fourth pouches.

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• The elongated ventral part

of each fourth pouch PHARYNGEAL GROOVES
develops into an  The head and neck regions of the human embryo exhibit
ultimopharyngeal body, four pharyngeal grooves (clefts) on each side during the
which fuses with the thyroid fourth and fifth weeks.
gland.  These grooves separate the pharyngeal arches externally.
• Its cells disseminate within
 Only one pair of grooves contributes to postnatal
the thyroid, giving rise to
structures; the first pair persists as the external acoustic
the parafollicular cells.
meatus or ear canals.
• C cells differentiate from
 The epithelial lining at the bottom of the meatus
neural crest cells that
migrate from the pharyngeal participates in formation of the eardrum
arches into the fourth pair of 
pharyngeal pouches
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 Branchial Cysts Remnants of parts of the cervical sinus

PHARYNGEAL MEMBRANES and/or the second pharyngeal groove may persist and form a
 The pharyngeal membranes appear in the floors of the spherical or elongate cyst
pharyngeal grooves.
 These membranes form where the epithelia of the
grooves and pouches approach each other.
 The endoderm of the pouches and the ectoderm of the
grooves are soon separated by mesenchyme.
 Only one pair of membranes contributes to the formation
of adult structures; the first pharyngeal membrane,
along with the intervening layer of mesenchyme,
becomes the tympanic membrane

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Pharyngeal Arch Nerve Muscles Skeleton

1. Mandibular Trigeminal: maxillay & Mastication; mylohyoid; Premaxilla, maxilla,

(maxillary ,mandibular mandibular divisions anterior belly of digastric, zygomatic bone,part of
processes) tensor palatine, tensor temporal bone, Meckel’s
tympani cartilage, mandible
malleus, incus,anterior
ligament of malleus,
sphenomadibular lig.
2. Hyoid Facial n Facial expression, Stapes, styloid process,
posterior belly of digastric, stylohyoid ligament, lesser
stylohyoid, stapedius horn & upper portion of
body of hyoid

3. Glossopharyngeal Stylopharyngeus Greater horn & lower

portion of body of hyoid
bone
4-6 Vagus Cricothyroid, levator Laryngeal cartilages
Superior laryngeal (n palatine, constrictors of
to 4th arch) pharynx
Recurrent laryngeal (n
to 6 arch) Intrinsic m. of larynx
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PERIOD OF FETUS
The period from the beginning of the 9th week to birth
Fetal period is known as Fetal period.
Tissue and organs mature; become competent to
assume their specialized functions.
Rapid growth of body
By Sisay A.

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LENGTH OF PREGNANCY
 Transformation of embryo to fetus is gradual.
 CRL or CHL
 Growth in length is particularly striking during the 3rd, 4th  280 days or 40 weeks from LNMP
and 5th months  266 days or 38 weeks after fertilization
 While increase in weight is most striking during the last 2
months of gestation.

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MONTHLY CHANGES
 The growth of the head during
 By the beginning of 5th month,
fetal period is slow compared
the size of the head is about
to the rest of body.
1/3rd of crown – heel length
 At the beginning of 3rd month, (CHL)
the head constitutes
approximately ½ of crown –
rump length (CRL).

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 At birth the size of the head is

approximately 1/4th of CHL.

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 During 2nd month size of head

THIRD MONTH (9-12 wks) increases and the limbs, face,
 FACE: More human looking broad ears, nose and eyes form.
 HEAD:  By the beginning of the 5th
Disproportionately large week, forelimbs and hind
Makes up nearly half of the fetus' size limbs appear as paddle shaped
 EYES: buds.
Directed ventrally  The forelimb buds are located
Eyelids fused dorsal to the pericardial
 EARS:
swelling at the level of the C4
 Rise to their definitive position on the side
– T1 somites
of head  Hind limb buds appear at the
level of the lumbar and upper
sacral somites
CRL= 9.8mm; 5th week
45 By Sisay A. 4/18/2022 By Sisay 4/18/2022
A. 46 Forelimbs Paddle shaped

 Terminal portions of buds flatten and

1st circular constriction separates
them from proximal more cylindrical
segments LIMBS: Reach their relative length
 Soon 4 radial grooves separates 5
slightly thicker areas appearing on the PRIMARY OSSIFICATION CENTERS: Are present in
distal portion of buds the long bones and skull by the 12th week.
 These grooves are called rays which
appear in hand region first and
shortly afterwards in foot
 Upper limb is slightly more
advanced in development than
lower limb
 While fingers and toes are formed
2nd constriction divides the proximal
portion of buds into two segments
and 3 characteristic features of adult
extremity are recognizable CRL=13mm; 6th week
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PREUMBLICAL HERNIATION: During the 6th week, intestinal loops

cause a large swelling (physiological herniation) in the umbilical cord.
By the 12th week, loops withdraw into the abdominal cavity. ERYTHROPOIESIS, : At 9th week liver is
the major site, after 12th week activity is
reduced and begins in spleen
 EXTERNAL GENITALIA: Appear well
differentiated
SWALLOWING REFLEX: 10 WEEKS

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4TH AND 5TH MONTHS 6TH AND 7TH MONTHS

 During the 4th and 5th months, the  During the 2nd half of IUL,
fetus lengthens rapidly and at the end weight increases
of first half of intrauterine life, its CRL considerably and
is approximately 15cm, about ½ the particularly during last 2.5
total length of newborn. months, when 50% of the
 Weight is less than 500 gm full term weight (approx.
Fine hair (LANUGO) 3200gms) is added.
Head and eye brow hair are visible  During the 6th month, the
Fetal movements felt by mother skin of the fetus is reddish
(QUICKENING) and has wrinkled appearance
because of the lack of
underlying connective tissue.
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 The respiratory and the central nervous system have not

differentiated sufficiently, and coordination between the two
systems is not yet well developed.
 By 6.5 to 7 months, fetus has length of about 25 cm and weighs
approximately 1100gms.
 If born at this time, the infant has a 90% chance of surviving.
 Sucking movements
 Some sounds can be heard
 Eyes are sensitive to light

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NINTH MONTH (33-36 wks) VERNIX CASEOSA: By the end of IUL, the skin is covered by a
SKIN: whitish fatty substance
Dull redness of the skin fades
Wrinkles smooth out
Lanugo begins to disappear

BODY AND LIMBS:

Become rounded
Deposition of subcutaneous fat

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GROWTH IN LENGTH & WEIGHT DURING

 At the end of 9th month, the FETAL PERIOD
skull has the largest Age (weeks) CRL (cm) Weight (g)
circumference of all parts of 9 -12 5-8 10 - 45
the body. 13 - 16 9 - 14 60 - 200
 At the time of birth, the
17 - 20 15 - 19 250 - 450
weight of a normal fetus is
3000 to 3400gms, its CRL is 21 - 24 20 - 23 500 - 820
about 36cms, and its CHL is 25 - 28 24 - 27 900 - 1300
about 50cms. 29 - 32 28 - 30 1400 - 2100
 Testes should be in the
33 - 36 31 - 34 2200 - 2900
scrotum (end of 9th month)
57 By Sisay A. 4/18/2022 58 37 - 38
By Sisay A. 35 - 36 3000 - 3400
4/18/2022

DEVELOPMENTAL HORIZONS DURING FETAL LIFE MEASUREMENTS AND CHARACTERISTICS

OF FETUSES
EVENTS AGE (weeks)
 Various measurements and external characteristics are
Taste buds appear 7
useful for estimating fetal age.
Swallowing 10  Until the end of first trimester, CRL is the method of
choice.
Respiratory movements 14 – 16
 In the second and third trimesters, several structures can
Sucking movements 24 be identified and measured ultrasonographically
 Gestational sac appear on transabdominal sonography at
Some sounds can be heard 24 – 26
5th week and approx a week earlier by TVS .
Eyes sensitive to light 28
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CROWN RUMP LENGTH

ULTRASONOGRAPHY MEASUREMENTS
 BPD
 Head circumference
 Abdominal circumference
 Femur length
 Foot length
 Fetal weight

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BI-PARIETAL DIAMETER CIRCUMFERENE

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FEMUR LENGTH FOOT LENGTH

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FACTORS INFLUENCING FETAL GROWTH

Following factors stimulate fetal growth:
 Glucose
 Aminoacids
 Insulin (secreted by fetal pancreas)
 Insulin like growth factors
 Human growth hormone

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FOOT L FETAL
AGE CRL 7 WEIGHT
(wks) (mm) (mm) (g) MAIN EXTERNAL CHARACTERISTICS
Previable Fetuses
9 50 7 8 Eyelids closing or closed. Head large and more rounded.
External genitalia still not distinguishable as male or female.
Intestines in proximal part of umbilical cord.
Ears are low-set.
10 61 9 14 Intestines in abdomen. Early fingernail development.
12 87 14 45 Sex distinguishable externally. Well-defined neck.
14 120 20 110 Head erect. Eyes face anteriorly. Ears are close to their definitive position.
Lower limbs well developed. Early toenail development.
16 140 27 200 External ears stand out from head.
18 160 33 320 Vernix caseosa covers skin. Quickening (first movements) felt by mother.
20 190 39 460 Head and body hair (lanugo) visible.
Viable Fetuses
22 210 45 630 Skin wrinkled, translucent, and pink to red.
24 230 50 820 Fingernails present. Lean body.
26 250 55 1000 Eyelids partially open. Eyelashes present.
28 270 59 1300 Eyes wide open. Good head of hair often present. Skin slightly wrinkled.
30 280 63 1700 Toenails present. Body filling out. Testes descending.
32 300 68 2100 Fingernails reach fingertips. Skin smooth.
36 340 79 2900 Body usually plump. Lanugo (hairs) almost absent. Toenails reach toe-tips.
Flexed limbs; firm grasp.
38 360 83 3400 Prominent chest; breasts protrude.
69 Sisay A (anatomist) Testes in scrotum or palpable in inguinal canals. 4/18/2022 70 By Sisay A. 4/18/2022
Fingernails extend beyond fingertips.

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