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Anatomy 2. Semester > 1. Circulatory and Respiratory Organ Systems, Thoracic Cavity > Flashcards

1. Circulatory and Respiratory Organ Systems, Thoracic Cavity Flashcards

1
Q

Red bone marrow - Histology

A
  • reticular network, primary lymphoid tissue
  • located in medullary canals of long bones
    • produce RBCs, platelets
    • destruct old RBCs
    • store iron

4 important structures:

  1. Stroma
    • meshwork of reticular cells and fibres
    • contains:
      • haematopoietic cells
      • macrophages
      • collagen types I + II
      • enzymes
  2. Haematopoietic cords
  3. ​​Sinusoidal capillaries

Haematopoietic stem cells

  • ​​differentiate into RBCs and other cells
  • progenitors to:
    1. Lymphoid cells
      • T-, B-lymphocytes
    2. Myleoid cells
      • granulocytes, monocytes, erythrocytes, megalocytes
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2
Q

Embryonic haematopoiesis

A

→ develop from pluripotential haematopoetic stem cells

  1. 2 weeks after fertilization:
    • from yolk sac mesoderm
  2. until 5th month:
    • Mesenchyme of spleen and liver become haematopoietic
  3. red bone marrow (after birth)

Regulated by hormone Erythropoietin

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3
Q

Erythrocytes - Development

A
  • → from (hematopoietic-) stem cells
    • → myeloid stem cells
  1. Pronormoblasts
  2. early normoblast
  3. intermediate normoblast
  4. late normoblast (nucleus gets ejected)
  5. Reticulocyte
  6. RBC is released
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4
Q

Thrombocytes - Development

A
  1. Megakaryoblasts
  2. Promegakaryocyte
  3. Megakaryocyte
  4. Thrombocytes
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5
Q

Granulocytes - Development

A

→ from myeloblasts to white blood cells

Process:

  1. Myeloblasts
  2. Promyelocytes
  3. Myelocytes
  4. Metamyelocytes
  5. Granulocyte
    • Neutrophils
      • 12-14 micrometer
      • 5000/microliter
      • for phagocytosis
    • Esosinophils
      • 14-16 micrometer
      • 150/microliter
      • for allergic reaction
    • Basophils
      • 13-15 micrometer
      • 30/microliter
      • release histamine
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6
Q

Monocytes

A
  • 15-20 micrometer (largest WBC)
  • function: phagocytosis
  • oval nucleus, kidney shaped
  • azurophilic granules in the cytoplasm

Mononuclear phagocyte system:

  • part of immune system
  • in reticular CT, mainly:
    • monocytes
    • macrophages
  • accumulate in lymph nodes + spleen
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7
Q

Monocytes - Development

A
  • in bone marrow from precursors called monoblasts
  • can give rise to:
    • macrophages
    • dendritic cells
      • antigen presenting cells
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8
Q

Lymphocytes

A

​Structure

  • WBC
    • large nucleus
    • almost no cytoplasm
    • carry many ribosomes for protein synthesis
      • immunoglobulins

3 Types

  • ​natural killer cells
    • cell-mediated response
  • T-cells
    • cell-mediated response
  • B-cells
    • antibody mediated response
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9
Q

Lymphocyte - Development

A

Lymphopoiesis

  1. common lymphoid progenitor
  2. lymphoblast
  3. prolymphocyte
  4. natural killer cell
  5. small lymphocyte
    • B-Cell
    • T-Cell
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10
Q

Lymph nodes - Histology

A
  • organized collection of lymphoid tissue:
    • cortex
      • B-+ T-cells
    • medulla
      • medullary cord
        • B-Cells
        • macrophages
  • lymph passes through it
  • afferent- and efferent lymph vessels are connected
  • contains lymphoid follicles
    • dense collection of lymphocytes
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11
Q

Thoracic Cavity - Topography

A
  • enclosed by thoracic wall and diaphragm
  • divided into 3 mayor parts: right and left pleural cavity + mediastinum​

Mediastinum

  • heart
  • esophagus
  • trachea
  • major nerves + blood vessels

Pleural cavities:

  • right and left lung, enclosed by 2 pleural layers: parietal and visceral
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12
Q

Mediastinum - Borders

A

Definition: visceral department in the middle of the thoracic cavity, between right and left pleural cavity

Borders:

  • Anterior: Sternum
  • Posterior: Vertebral Column
  • Lateral: Mediastinal pleura (Lungs)
  • Superior: Thoracic inlet (to neck)
  • Inferior: Diaphragm
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13
Q

Mediastinum - Divisions

A

Divisions:

  • superior mediastinum → 6 layers
  • inferior mediastinum (anterior, middle and posterior)

→ dividing plane: “transthorscal plane”, from sternal angle to T4 and T5 vertebral discs

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14
Q

Projection of Thoracic Organs onto Thoracic Wall

A
  • Superior Thoracic Aperture → Root of Neck
    • Cervical pleura + apices of lungs
      *
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15
Q

Female Breast - Anatomy

A

consist of:

  • mammary glands (modified sweat glands)
    • in superficial fascia
    • secretory lobules
    • 15-20 lactiferous ducts → open on nipple
  • associated skin
  • connective tissue
  • fatty tissue

lies on:

  • deep fascia, but seperated from it by retromammary space
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16
Q

Female Breast - Blood supply

A

laterally:

  • axillary artery
    • superior thoracic a.
    • thoracoacromial a.
    • lateral thoracic a.
    • subscapular a.

medially:

  • internal thoracic artery

intercostal:

        1. intercostal arteries → perforate thoracic wall
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17
Q

Female Breast - Lymphatic drainage

A
  • 75% laterally or superiorly into axillary nodes, from there into subclavian trunks
  • remaining: parasternal nodes, which drain into the broncomediastinal trunks
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18
Q

Mammary gland - Histology

A
  • 15 - 20 lobes with each an own lactiferous duct
  • consist of:
    • small tubules
      • lined with simple cuboidal epithelium
      • produce milk
    • interlobar stroma (dense CT)
    • fat cells (contained in milk)
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19
Q

Layers of the superior mediastinum (6x)

A

**Definition: **

lies superior to the horizontal plane between the sternal angle and approximately the T4-T5 intervertebral disc

Layer 1:

  • Thymus (retrosternal adipose body)

Layer 2:

  • Superior vena cava
  • brachiocephalic veins

between: Phrenic + Vagus nerves

**Layer 3: **

  • Aortic arch
  • brachiocephalic trunk
  • left common carotid- + left subclavian artery
  • recurrent Laryngeal nerves

**Layer 4: **

  • Trachea

between: Esophageotracheal groove: recurrent laryngeal nerves

**Layer 5: **

  • Esophagus: Thoracic duct

**Layer 6: **

  • Posterior Thoracic wall: veins, sympathetic trunk
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20
Q

Thymus - Anatomy

A

→ situated in upper part of thorax, behind sternum, in the anterior + superior mediastina

  • primary lymphoid organ
    • matures and differentiates T-lymphocytes
  • right + left lobes, encapsuled
    • connected via CT
  • early life: large
  • degenerates to fat in adult
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21
Q

Thymus - Histology

A
  1. Cortex
    • many T-lymphocytes
    • macrophages
    • epithelial reticulum cells
    • reticular fibres
  2. Medulla
    • ​​many epithelial reticulum cells
      • blood-thymus barrier!
    • Hassal’s corpuscules
      • Eosinophiles, concentrally arranged
    • Neuroendocrine cells
    • Myoid cells
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22
Q

Layers of the posterior mediastinum

PDF 1: slide 16

A

Definition:

lies between the **pericardium anteriorly **and the vertebral column posteriorly and below the transthoracal plane

  • Esophagus (C4-T11)
  • vagus nerves
  • thoracic aorta + parietal and viceral branches
  • azygous + hemiazygous vein w/ tributaries
  • thoracic duct
  • symphathetic trunk
  • thoracic splanchnic nerves
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23
Q

Layers of the anterior mediastinum

A
  • sternopericardiac ligaments
  • internal thoracic vessels
  • parasternal lymph nodes
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24
Q

Layers of the middle mediastinum

A
  • heart + pericardium
  • initial parts of great vessels: ascending aorta, pulmonary trunk
  • last parts of great vessels: superior + inferior vena cava, pulmonary + azygos veins
  • phrenic nerves
  • pericardiophrenic vessels
  • root of lung
  • bronchopericardiac membrane
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25
Q

Trachea - Anatomy

A
  • beginning: inferior border of cricoid cartilage (C6)
  • 16-20 incomplete hyaline cartilage
    • prevent trachea from collapsing
    • open posteriorly towards esophagus
  • bifurcates at sternal angle → right and left bronchi
  • last cartilage: carina
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26
Q

Bronchial tree - Anatomy

A
  • thrachea → bronchi → 1°, 2°, 3° bronchi → bronchioles → terminal bronchioles
  1. right bronchus
    • shorter, wider, steeper than left one
    • runs under azygous vein
      • divides into: 3 secondary (lobar) bronchi (superior, middle, inferior)
        • each divide into 10 segmental bronchi
  2. left bronchus​
    • ​​inferior through aortic arch (to left side)
      • divides into: 2 secondary (lobar) bronchi (superior, inferior)
        • each divide into 8-10 segmental bronchi
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27
Q

Trachea - Histology

A
  • divided into 4 different layers:
  1. Tunica mucosa
    • ​​​​Mucous epithelium
      • pseudostratified columnar ciliated epithelium
      • Goblet cells (secretion)
      • Endocrine cells
    • Lamina propria
      • Loose connective tissue
      • Lymphocytes
      • Plasma cells
  2. Tunica submucosa​​
    • ​loose connective tissue
    • mucous glands
  3. Tunica fibro•musculo•cartilaginea
    • ​​hyaline cartilage
    • annular ligaments
  4. Tunica adventitia
    • connective fibres
    • blood vessels
    • nerves
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28
Q

Bronchi - Histology

A

→ can be devided into 4 layers

  • glands and supporting cartilage can be found
  1. Tunica mucosa​​​​
    • ​​​​​pseudostratified columnar ciliated epithelium
    • height decreases towards terminal bronchioles
  2. Tunica muscularis
    • larger bronchi: smooth muscle layer
    • smaller bronchi: smooth muscle cells
  3. **Cartilage plates **
    • decrease in number and size towards terminal bronchioles
  4. Adventitia
    • external layer of bronchi
    • collagen fibres
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29
Q

Bronchioles - Histology

A
  • NO cartilage, NO glands
  • ciliated pseudostratified columnar
    • becomes less ciliated in direction to terminal bronchioles
  • terminal bronchioles also contain “clara cells”
    • have secretory granules which secrete proteins protecting bronchiolar lining against pollution
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30
Q

Lungs - General anatomy

A
  • right lung: 3 lobes
  • left lung: 2 lobes
  • enclosed by pleura
    • visceral + parietal layer → pleural cavity
  • hilum: root of lungs (medial side)
    • contains vessels and nerves

Borders:

  • medial: heart in mediastinum
  • inferior: bases rest on diaphragm
  • superior: thoracic aperture
  • lateral: thoracic wall (enclosed by pleura)
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31
Q

Right lung - Anatomy

A
  • ​​​​larger, heavier
  • usually only 1 bronchial artery
  • 3 lobes (superior, middle, inferior)
    • 3 secondary (lobar) bronchi
    • 10 tertiary (segmental) bronchi
  • devided by
    • oblique fissure: starts at head of 5th rib, runs along 6th rib
    • horizontal fissure​: from upper quarter of oblique fissure to medial side
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32
Q

Left lung - Anatomy

A
  • upper and lower lobes devided by oblique fissure (along 6th rib)
  • usually 2 bronchial arteries
  • cardiac notch: impression on antero-inferior corner of superior lobe
  • 2 secondary (lobar) bronchi
  • 8-10 tertiary (segmental) bronchi
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33
Q

Pleura - Anatomy

A
  • → pleura constist of
    • mesothelium (single layer of flat cells)
    • supporting connective tissue layer​​
  1. parietal pleura
    • outermost layer, lines thoracic wall
    • innervated by intercostal and phrenic nerves
    • sensitive to pain
  2. visceral pleura
    • ​innermost layer, surrounds the lungs
    • innervated by vagal nerve endings
    • sensitive to stretch
  • ​→ in between: pleural cavity with serous fluid
  • pleural recess:
    • space which is not covered by lungs
    • fluids can collect there
    • costomediastinal vs. costodiaphragmatic recess
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34
Q

Pleura - Innervation

A

Parietal pleura

  • intercostal nerves

Visceral pleura

  • autonomic NS
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35
Q

Lungs - Blood supply

A
  • Lungs contain non respiratory tissues:
    • bronchial veins (→ (hemi-)azygous- and pulmonary vein)
    • ​bronchial arteries (→ thoracic aorta)
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36
Q

Lungs - Innervation

A
  1. Pulmonary Plexus
    • ​​vagus nerve
37
Q

Lungs - Lymphatic drainage

A
  1. Peribronchial network:
    • drains lymph from bronchi & most of lungs
  2. Subpleural network(smaller):
    • borders lungs
    • drains lymph from peripheral lung areas + visceral pleura

⇒ Trachiobroncheal lymph nodes → paratracheal ln → subclavian + internal jugular veins

  • Parietal pleura : drained by intercostal + parasternal l.n
38
Q

Lungs - Histology

A

Inside lungs: Alveoli

  • outpouchings in the wall of bronchioles
  • side of gas exchange:
    • epithelial walls of alveoli are extremely thin
      • Type 1 pneumocytes: gas exchage, flattened
      • Type 2 pneumocytes: surfactant/film production
    • a. might be connected by small pores
    • surrounded by dense CT, which contains anastomosing pulmonary capillary network
  • blood-air barrier:
    • alveolar epithelium + capillary endothelium
39
Q

Pulmonary trunk - Branches

A
  • from right ventricle
  • divides into right + left pulmonary artery
  • carry DEoxygenated blood
40
Q

Heart - Surfaces

A

Apex

  • formed by left ventricle
  • “tip” of the heart

Base of the heart

  • formed by:
  • left atrium, posterior right atrium
  • origin of large vessels​
    • opposite to apex

Terminal sulcus (groove)

  • ​​groove on right atrium
  • extends from front of SVC to front of IVC
  • internal: crista terminalis
    • margin between pectinate muscle and endocardium

Coronary sulcus (groove)

  • division between atria and ventricles on sternal surface

​Interventricular sulcus (groove)

  • separates 2 ventricles

Conus anteriosus

  • pouch on anterior surface of right ventricle
  • continuation: pulmonary trunk
41
Q

Heart - Form

A
  • situated in the middle of the mediastinum
  • pinecone-shape: broad at the base, thin at the apex
  • typically size of the fist
  • mass: 250-300g
42
Q

Heart - Topography

A

Superior view

  • base of the heart
  • large vessels: ant. to post.
    • pulmonary trunk (→ arteries)
    • aorta
    • SVC
    • pulmonary veins (2x each side)

Inferior view

  • apex of the heart
  • inferior margin
  • rests on diaphragm

Lateral view

  • right side:
    • right atrium
    • superior + inferior VC
    • right coronary artery
    • terminal sulcus
  • left side:
    • left ventricle

Anterior view

  • interior interventricular groove
  • great cardiac vein
  • right ventricle

Posterior view

  • right ventricle
  • left atrium
  • “openings” of great vessels
  • coronary sinus (veins)
43
Q

Pericardium - Anatomy

A

→ fibrous sac enclosing the heart and the roots of great vessels

→ oblique + transverse (between aorta and SVC) sinus

**3 layers + wall of heart: **

  1. fibrous pericardium
    • dense CT
  2. serous percardium
    • ​1. + 2. make up parietal layer
  3. pericardiac cavity
    • filled with few drops serous fluid (lubrication)
  4. epicardium (visceral layer)
  5. myocardium
  6. endocardium
44
Q

Pericardium - Blood supply

A
  • perichardiophrenic artery
  • bronchial artery
  • esophageal artery
45
Q

Pericardium - Innervation

A
  • vasomotor and sensory nerve fibres from phrenic- and **vagus nerves **and the symphathetic trunks
46
Q

Left atrium - Anatomy

A
  • receives oxygenated blood from 4 pulmonary veins
  • smaller than right atrium
  • most posterior of all 4 chambers
  • smooth walls, except for pectinate muscles in auricle
47
Q

Left ventricle - Anatomy

A
  • on back of the heart
  • pumps oxygenated blood into the aorta
  • inferior ventricle + superior aortic vestibule
  • 2 papillary muscles + chordae tendinae
    • hold back the flaps of bicuspid valve​
  • walls with muscular ridges → trabeculae carnae cordis
  • 2-3 thicker than right ventricle (higher pressure)
48
Q

Right atrium - Anatomy

A
  • receives deoxigentated blood from:
    • SVC, IVC
    • Coronary sinus (collection of coronary veins)
    • posterior wall is smooth, anterior wall rough (pectinate muscle ridges)
      • → in between: crista terminalis
  • fossa ovaries, former opening which closed after birth
49
Q

Right ventricle - Anatomy

A
  • on anterior side of heart
  • pumps deoxygenated blood into pulmonary trunk
  • 3 papillary muscles + chordae tendinae
    • hold back the flaps of tricuspid valve
  • walls with muscular ridges → trabeculae carnae cordis

*

50
Q

Heart valves

A

→ 4 valves in total, 2 types

caspital valves

  • prevent backflow from ventricles into atria during systole
  • anchored by chordae tendineae:
    • Tricuspid valve: right AV valve
      • anterior, posterior + septal
    • Bicuspid valve: left AV valve
      • anterior + posterior

semilunar valves

  • 3 half-moon shaped cusps
  • aortic valve
    • left + right + posterior
  • pulmonary valve
    • left + right + anterior
51
Q

Interventricular/-atrial septa - Anatomy

A

Atria:

  • forms during 1st-2nd month of fetal development
  1. septum primum
    • opens when pressure is high in RA
  2. septum secundum
    • has foramen ovale

Ventricles:

  • muscular ventricular septum
  • upper part: membranous VS
    • separates aortic vestibule from
      • upper part of right ventricle
      • lower part of right atrium
52
Q

Blood supply of heart

A

→ coronary arteries, arise from ascending aorta

Right coronary artery

  • SA nodal artery
  • Right marginal artery
  • Posterior interventricular artery
  • AV nodal artery

​Left coronary artery

  • Anterior interventricular artery

Circumflex artery

  • Left marginal artery

Veins into coronary sinus → right atrium

  • small cardiac vein
    • runs with right coronary art.
  • middle cardiac vein
    • posterior surface of heart
  • great cardiac vein
    • runs with interventricular branch of left coronary art.
53
Q

Extrinsic innervation of the heart

A

→ innervate SA- and AV node and coronary vessels of the heart

  • Vagus nerve (right and left)
    • Sensory
    • Parasymphathetic ( - heartbeat)
  • Sympathetic nerve (from symp. ganglion)
    • Sensory
    • Sympathetic ( + heartbeat)
54
Q

Intrinsic pathway of the heart

A
  1. SA node ⇒ cardiac muscle fibers ⇒ atria contract
  2. Myogenic conduction ⇒ to AV node
  3. AV node ⇒ bundle of His ⇒ AV branches
  4. rightandleft branches: in interventricular septum
  5. at apex: Purkinje fibres innervate ventricle muscle right and left
55
Q

Histology of the Heart

A

Cardiomyocytes:

  • one central nucles
  • cross striations: quick signal transduction
  • innervated by autonomic NS → “involuntary striated muscle”
  • between cells: intercalated discs w/ gap junctions
  • at the end of fibres:
    • Fascia adherens
    • Desmosomes
56
Q

Aorta - Topography

A
  • Ascending aorta
    • lies in middle mediastinum
  1. Aortic arch
    • lies in superior mediastinum
    • arches over right pulmonary art.
    • passes downward on left side T4 vertebra
  2. Thoracic aorta
    • runs on left side of the vertebral column
    • passes through aortic hiatus
  3. Abdominal aorta
    • ​bifurcates on L4 level into left + right common iliac art.
57
Q

Vessels - artery types

A
  1. Aorta: large elastic artery
    1. Tunica intima
    2. Subendothelial layer
    3. Tunica media
      • smooth muscle!
      • collagen fibres
      • elastic laminae
    4. Tunica adventitia
      • collagen fibres
      • blood vessels + nerves
  2. Muscular arteries
    1. Tunica intima
    2. internal elastic membrane
    3. Tunica media
    4. External elastic membrane
    5. Tunica adventitia
58
Q

Vessels - Vein types

A

→ venules, small and large veins

  1. ​Tunica intima
  2. Tunica media
    • thin
  3. Tunica adventitia
    • widest layer
59
Q

Subclavian Artery - Topography

A
  • right: from brachiocephalic trunk, inferiorly to clavicle → axillary artery
  • left: from descending aorta, inferiorly to clavicle → axillary artery
60
Q

Subclavian Artery - Branches

Viny Is Too Cute To Do Anatomy

A
  • Vertebral artery
  • Internal thoracic artery
  • Thyrocervical trunk
  • Costocervial trunk
  • Transverse cervical artery
  • Dorsal Scapular artery
  • Axillary artery
61
Q

Thoracic aorta - Topography

PDF 1: slide 17

A

→ continuation of descending aorta, becomes abdominal aorta after diaphragm

  • begins at lower border of T4 vertebra
  • runs along left side of vertebral column
  • ends at lower border of T12 vertebra (aortic hiatus)
  • posteriorly:
    • azygos vein
  • anteriorly:
    • root of left lung
    • pericardium
    • esophagus
    • diaphragm
  • laterally:
    • right: hemiazygos vein + thoracic duct
    • left: pleura + lung
62
Q

Aorta - Branches

A
  1. Ascending aorta
    • right and left coronary arteries
  2. Aortic arch
    • brachiocephalic trunk
    • left common carotid artery
    • left subclavian artery
  3. Thoracic aorta
    • posterior intercostal arteries
    • pericardial artery
    • bronchial arteries
  4. Abdominal aorta
    • visceral + parietal branches
63
Q

The Tributaries of the SVC

PDF 1: slide 18

A
  • receives blood from all structures superior to diaphragm (exc. heart + lungs)
  • formed by left and right brachiocephalic vein
  • receives:
    • right: azygous vein
    • left: hemiazygous vein
  • enters right atrium
64
Q

The lymphatic drainage of the thoracic cavity

A
  • Lumphatic ducts run on right and left side anterior to vertebral column
  • left lymphatic duct (→ Thoracic duct) drains 75% of body lymph
  • Lymph nodes and vessels from thoracic cavity drain into right and left bronchomediastinal trunk
  • right bronchomediastinal trunk drains directly into right venous angle
  • left bronchomediastinal trunk drains into left thoracic duct
65
Q

Symphathetic trunk in thoracic cavity

A
  • part of the autonomic division of the PNS in posterior mediastinum
  • two parallel cords, 11 - 12 ganglia, connected to thoracic spinal nerves
  • Esophagus:
    • T2-T5→post synaptic axon→esophageal plexus
  • Trachea & bronchial tree:
    • post synaptic thoracic branches→pulmonary plexus (bronchial dilation)
  • Heart:
    1. Cervical ganglion: superior,middle,inferior cervical cardiac nerves
    2. Thoracic ganglia: thoracic cardiac nerves
      • make cardiac plexus together
66
Q

Vagus nerve - Branches

PDF 1: slide 14, 15

A

Recurrent Branches:

  • right recurrent laryngeal nerve
  • left recurrent larnygeal nerve

Branches to the heart:

  • superior + inferior cervical cardiac branches
  • thoracic cardiac branches

Branches to the airways:

  • tracheal branches
  • bronchial branches

Branches to the esophagus:

  • esophageal branches
  • esophageal plexus (ant.+post. vagal trunk)
67
Q

Vagus nerve - Topography

PDF 1: slide 13

A

**Origin: **CN #10, 2x (left + right)

**Thoracic inlet: **

  • right: between right brachiocephalic vein + trunk
  • left: between left brachiocephalic vein + left sublavian artery

(Recurrent laryngeal branches: )

  • right: below right subclavian artery
  • left: below aortic arch

Posterior Mediastinum:

  • behind root of lung → Esophageal plexus

Esophageal hiatus of Diaphragm:

  • anterior + posterior vagal trunk
68
Q

Vagus nerve heart branches

A
  • Superior + Inferior cervical cardiac branches
    • Thoracic cardiac branches
      • cardiac branches → cardiac plexus
69
Q

Phrenic nerve - Topography

PDF 1: slide 11

A

Origin: Cervical plexus, C3-C5, 2x (left + right)

Cervical part:

  • anterior to: anterior scalene muscle

Thoracic inlet:

  • between: subclavian artery and vein
  • anterior to: vagus nerve

Thoracic cavity:

  • anterior to: root of lung
  • between: mediastinal pleura and fibrous pericardium
  • w/ pericardiacophrenic vessels

Sensory terminal branch:

  • right phrenicoabdominal branch: Caval opening
  • left phrenicoabdominal branch: Esophagus hiatus
70
Q

Phrenic nerve - Function

PDF 1: slide 12

A

sensory:

  • fibrous pericardium
  • mediastinal and diaphragmatic pleura
  • diaphragm
  • parietal peritoneum

motor:

  • Diaphragm
71
Q

Nose - Anatomy

A
  • external part of nasal cavity
  • extends nasal c. ventrally, nostrils pointing downwards
  • vestibule: aperture of each nostril
    • covered with hairy skin, sebaceous glands, sweat glands → air “filtering”
  • pyramidal shape, apex in front

→ consist of cartilage:

  • lateral processes of septal cartilage (superiorly)
  • major alar cartilage (antero-inferiorly)
  • septal cartilage (midline)
  • 3 - 4 minor alar cartilage (posterio-inferiorly)
72
Q

Nasal cavity - Anatomy

A
  • divided in the middle by nasal septum
  • opens
    • anteriorly through nostrils → nose
    • posteriorly through choanae → nasopharynx
  • surrounded by facial bones:
    • nasal- + frontal bone
    • ethmoid bone w/ perpendicular plate
    • maxilla w/ palatine processes
    • palatine bone
    • body of sphenoid bone
73
Q

Nasal cavity - Conchae + Meati

A

→ 3 conchae:

Formed by ethmoid bone:

  • superior concha
  • middle concha

Formed by maxilla:

  • inferior concha

→ form 4 air channels:

  • spheno-ethmoidal recess
  • superior meatus
  • middle meatus
  • inferior meatus
74
Q

Paranasal sinuses + Openings

A
  1. Ethmoidal sinus (w/ air cells!)
    • ​​posterior-: → superior nasal meatus
    • middle-: → middle nasal meatus
    • anterior-: → middle nasal meatus
  2. Frontal sinus
    • → middle nasal meatus
  3. Maxillary sinus
    • → middle nasal meatus
  4. Sphenoid sinus
    • → sphenoethmoid recess
  5. Nasolacrimal duct
    • → inferior nasal meatus
75
Q

Nasal Cavity - Histology

A
  • lined by stratified squamous epithelium
  • composed of:
    • olfactory cells
    • ciliated cells → filtering
    • goblet cells → mucus secretion
    • transient immune cells → produce lymphocytes and mast cells
  • tight junctions between cells prevent materials from entering the tissue!
76
Q

Larynx (Kehlkopf)

A
  • organ of voice production
  • part of respiratory tract between pharyx (Rachen) and trachea (Luftröhre)
  • acts as sphincter: prevents swallowed material from entering trachea
  • consists of cartilage, membranes and muslces:
    • 3 large unpaired cartilages
      • Cricoid, Thyroid, Epiglottis
    • 3 pairs of smaller cartilages
      • Artenoids, Corniculate, Cuneiform
77
Q

Larynx - Thyroid cartilage

A
  • hyaline cartilage
  • right and left lamina
  • anterior part of larynx (great part)
  • in men: laryngeal prominence (90°)
  • superior horn
    • lateral thyroid ligament - sesamoid cartilage - hyoid bone
  • inferior horn
    • cricoid cartilage attached
78
Q

Larynx - Epiglottis

A
  • elastic cartilage
  • spoon-shaped, on inferior side
  • attached to back of thyroid cartilage by thyro•epiglottic ligament
79
Q

Larynx - Cricoid cartilage

A
  • hyaline cartilage ring
  • anterior: arch
  • posterior: lamina
  • lowest part of larynx

IMPORTANT: crico•thyroid ligament → Cricothyrotomy

80
Q

Larynx - Arytenoid cartilage

A
  • elastic + hyaline cartilage
  • pyramide shape:
  1. Apex
    • cuneiform cartilage
    • corniculate cartilage
  2. Vocal process - anterior
    • vocal ligament
    • vocalis muscle
  3. Muscular process - posterior
    • thyro•arytenoid muscle
    • crico•artenoid muscles
81
Q

Larynx - Ligaments

A

→ attach larynx to the hyoid bone and trachea!

  1. Thyro•hyoid membrane,
  2. Thyro•hyoid ligament
  3. Hyo•epiglottic ligament
  4. Thyro•epiglottic ligament
  5. Crico•tracheal ligament
  6. Crico•thyroid ligament (!)
  7. Crico•pharyngeal ligament
82
Q

Larynx - Cavity

frontal section for end semester exam!

P. 26 Thieme

A

→ Divided into 3 parts by vestibular- and vocal folds

  1. Vestibule
    • laryngeal inlet to vestibular folds
  2. Glottis/Rima Glottidis
    • vestibular folds to vocal fold
  3. Infraglottic cavity
    • part inferior to the vocal fold
83
Q

Hyoid bone - Anatomy

A
  • horseshoe-shaped bone
  • lies in neck on height of C3 vertebrae
  • consists of body and 2 pairs of greater + lesser horn
  • attached to thyroid cartilage by thyro•hyoid membrane
84
Q

Laryngoscopic image

A
  • indirect: using a mirror, looking down the pharynx
  • direct: head tilted backwards, patient must lie down. Using laryngoscope
85
Q

Larynx - Muscles

inferior laryngeal nerve

A
  1. Crico•thyroid muscle - superior laryngeal n.
    • tightens vocal folds
    • opens rima glottidis
  2. Vocal muscle
    • tightens vocal folds
    • closes rima glottidis
  3. Thyro•arytenoid muscle
    • adducts arytenoid cartilages
    • closes rima glottidis
  4. posterior Crico•arytenoideus muscle
    • adducts vocal folds
    • opens rima glottidis
  5. lateral Crico•arytenoideus muscle
    • adducts vocal folds
    • closes rima glottidis
  6. oblique Arytenoideus muscle
86
Q

27.1 Larynx - Blood supply

A
  1. from: Subclavian artery →
    • Thyrocervical trunk →
    • Inferior thyroid artery →
    • Inferior laryngeal artery
  2. from: External carotid artery →
    • Superior thyroid artery →
    • Superior laryngeal artery
87
Q

Larynx - Blood drainage

A
  1. from: superior laryngeal vein →
    • superior/middle thyroid vein →​
    • internal jugular vein
  2. from: inferior laryngeal vein →​
    • inferior thyroid vein →​
    • left brachiocephalic vein
88
Q

Larynx - Innervation

A
  • Nodose-ganglion → Superior laryngeal nerve
    • internal ramus
      • sensory function
    • external ramus
      • motor function - cricothyroid muscle
    • recurrent laryngeal nerves
      • sensory and motor - all muscles
        • left: under aortic arch
        • right: under right subclavian artery
89
Q

Larynx - Histology

A
  • Hyaline cartilge vs. Elastic cartilage (check last semester)
  • Covering epithilia:
    • stratified squamous epithelium without papillae

Anatomy 2. Semester (3 decks)

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