Anatomy of the upper airway Flashcards
label xox
what are the nasal conchae?
aka?
covered in ?
function?
- *nasal conchae:**
- *-** curved folds of bone
- aka nasal turbinates
- covered in ciliated resp. epithelium (aka pseudostratified columnar)
- curve in medially and laterally
- function: rapid warming and humidification of air as it passes to the lungs.
- The superior and middle nasal conchae & inferior nasal conchae are made from which bone?
- why does your nose run when you cry?
Superior and middle nasal conchae are from the ethmoid bone
The inferior nasal conchae is its own bone
nose runs when you cry:
- nasolacrimal duct (the tear duct) drains into the inferior meatus,
- Tear duct from our eye empties next to our inferior conchae, so drainage of this naso-lacrimal duct is what makes the nose run*
how does blood (arterial and venous) supply occur to the nasal cavity?
Arterial supply to the nasal cavities:
- from both the external and internal carotid arteries:
i) branches from the external carotid artery via the maxillary and facial arteries
ii) branches from the internal carotid artery via the ophthalmic artery
venous drainage:
i) branches to the maxillary and facial veins then drains to external jugular vein
ii) branches to the opthalmic vein into the cavernous sinus
what is scientific name for nose bleed?
where do most nose bleeds come from in children / younger people?
- epistaxis
- occur from little’s area: highly vascularised. as get older, come from further back is nasal cavity
what is innervation of nasal cavity like? (3)
CN 1, The olfactory nerve, is a special sensory nerve responsible for smell. These are shown by the yellow branches seen on the diagram.
CN V1, this is the ophthalmic division of trigeminal nerve, is important for general sensory innervation around our forehead and eye area, and the top/middle of the nerve. This is the nasociliary nerve.
CN V2, this is the maxillary division of Trigeminal nerve. Involved in general sensory innervation, mainly the inferior part of the nose. This is the nasopalatine nerve.
which bone is the cribiform plate in?
cribiform plate in the ethmoid bone
what are the paranasal sinuses?
how many are there / what are they called?
what is their function (3) ?
paranasal sinuses: air filled spaces within the facial skeleton, continous with nasal cavity
4 paired sinuses: frontal, ethmoid, sphenoidal and maxillary
- *funtion:**
- *-** humidify air
- reduce weight of skull
- lined with resp. pseudostratified columnar epitheloium with cilia: immunological defence
what can go wrong with paranasal sinuses?
- *sinusitis** (inflammation of sinuses)
- happens most commonly in maxillary sinus: drainage hole is in the superior part of maxillary sinus (compared to others, which drain inferiorly) and becomes blocked quickly with sinusitis. means that rest of maxillary sinus becomes filled with mucous and becomes infected
in photo: left maxillary sinus has become filled with fluid (likely mucous)
what connects the middle ear to the nasopharnyx?
what is the role of ^? (2)
eustachain tube
function:
- equalises pressure
- drains mucous from middle ear
also infection can spread between middle ear and nasopharynx
what is the name for blockage of the eustachian tube ?
what does this cause?
who is it more common in?
otitis media - causes build up of mucous / fluid. can be due to inflammation or infection
common in younger children (ET is more horizontal so gets blocked easier)
whats an example of pathology of posterior oral cavity?
tonisilitis
what are the nasopharynx, oropharynx and laryngopharynx innervated by?
nasopharynx: CN V2
oropharynx: CN IX
laryngopharynx: CN X
what is the musculature like in the pharnyx?
* dont need to know (i think lol) *
just appreciate that there are lots of different muscles in pharynx involved in peristalsis
what level does larynx start / finish level at?
function: (2)?
blood supply from?
layrnx:
- C3 to C6
function:
i) phonation
ii) protection of lower airway
blood supply:
i) Superior laryngeal artery (from external carotid artery)
ii) inferior laryngeal artery (from the thyrocervical trunk).
* Similar to the nasal cavity there is a dual arterial supply*
how many cartilages are there in the larynx?
which are the paired (3)
which are the unpaired? (3)
- 9 cartilages
- three unpaired cartilages: epiglottis, thyroid and cricoid cartilage
- three paired cartilages: arytenoid, corniculate and cuneiform
which part of larynx is the adams apple?
which part of larynx is the only complete ring of cartilage?
thyroid cartilage = adams apple
complete ring of cartilage: cricoid cartilage (signet ring)
what happens to the epiglottis when you swallow?
larynx moves up, towards base of tongue and hyoid bone: makes the epiglottis close over the laryngeal inlet to prevent aspiration into trachea
which ligament connects the hyoid bone and thyroid? - what is this covered by?
which ligament connects the cricoid and thyroid cartilage?
where does ithe internal laryngeal nerve and superior laryngeal artery enter larnyx?
Hyoid bone and thyroid are joined by thyrohyoid ligament, covered by a thyrohyoid membrane.
Internal laryngeal nerve and superior laryngeal artery come through this ligament/membrane
Between the cricoid and thyroid cartilages: Crico-thyroid ligament
what are the extrinisic muscles of larynx? (how differentiated?) probs best just to be aware ? might need to know but also effort to learn
differentiated on if below / above the hyoid bone
Suprahyoid
- Mylohyoid
- Geniohyoid
- Stylohyoid
- Digastric (ant. and post.)
Infrahyoid
- Sternohyoid
- Omohyoid
- Sternothyroid
- Thyrohyoid
- The trickiest is the omohyoid (as it is not named according to a location) yet it is key to remember it has two bellies like the digastric. It is a long muscle with a white tendon in the middle
- Sterno-hyoid muscle goes all the way from the sternum to the hyoid
- Sterno-thyroid goes from the sternum from the sternum to the thyroid
- Thyro-hyoid goes from the thyroid to the hyoid
Sterno-hyoid goes the whole length, sterno-thyroid is halfway up and thyro-hyoid above it.
which muscle is this?
omohyoid
what is cricothyroidotomy?
cricothyroidotomy: is a procedure that involves placing a tube through an incision in the cricothyroid membrane (CTM) to establish an airway for oxygenation and ventilation
Vestibular Folds – Mucous membranes encasing vestibular ligaments. Protective function.
Rima Vestibuli – Space between vestibular ligaments
Vocal Folds (Vocal Cords) – Mucous membranes encasing vocal ligaments
Rima Glottidis - Space between vocal ligaments
Glottis – Vocal apparatus of larynx including vocal folds, ligaments and Rima Glottidis
what is the glottis?
Glottis: Vocal apparatus of larynx including vocal folds, ligaments and Rima Glottidis
what is general function of intrinsic muscles of larynx? (3)
which is the main cartilage that move for phonation?
which intrinisc muscle is not involved in movement of cartialge to produce phonation?
- cough
- phonation
- pitch of voice
The main cartilages that move for phonation are the arytenoid cartilages
All of the intrinsic muscles, other than the cricothyroid, are involved in movement of cartilage to produce phonation.
what is the rima glottidis?
rima glottidis: space between vocal ligaments
what happens to the rima glottis during:
- normal respiration?
- forced respiration?
- phonation?
- normal respiration: narrow wedge shape
- forced respiration: wide triangle shape
- phonation: the vocal cords close and the glottis is slit-like, if apparent at all
- whispering: achieved by leaving part of the rima glottidis open throughout the production of the sound.
which nerve controls most of the muscles of larynx? - which muscle does it not innervate?
most motor to muscles controlled by the recurrent laryngeal nerve - PHONATION
sensory innervation to area below vocal cords
doesnt innervate motor control for cricothyroid (comes from superior laryngeal nerve)
what can happen to nerves during thyroid surgery?
Could be caused by surgery to the neck (particularly thyroid), Tumours (often thyroid) leading to compressing nerve, trauma or viral infection, thyroidectomy due to tumour/hyperthyroidism.
Recurrent laryngeal injury will result in paralysis of all intrinsic muscles except cricothyroid which will cause problems with phonation. Vocal cord paralysis means you will be unable to abduct laterally, leading to hoarseness (if this damage only occurs on one side) or aphonia (if the damage is bilateral).
Stridor or respiratory distress can happen if acute due to blockage of the airflow which your body is not able to adapt to. This is due to paralysis of intrinsic muscles.
External laryngeal will lead to paralysis of cricothyroid preventing higher pitched phonation. This leads to Weak voice with low pitch, reduced range so your voice easily tires
