anats Flashcards
Olfactory nerves
is the first andshortest cranial nerve.
special visceral afferent nerve, which transmits information relating to smell
Paranasal air sinuses
air-filled extensions of the nasal cavity
Name the paranasal air sinuses
What are tehy lined with ?
maxillary, frontal, sphenoid and ethmoid.
lined by a ciliated pseudostratified epithelium, interspersed with mucus-secreting goblet cells
Nasal cavity blood supply
Known as hitters area and is a common site for nose bleeds
Pharynx
Space posterior to the nasal cavity, oral cavity and larynx
Constrictor muscles in posterior wall of pharynx – help with swallowing
Parts of the pharynx
Nasopharynx, oropharynx and laryngopharynx
Neuro supply to the pharynx
pharyngeal plexus glossopharyngeal nerve -sensory; vagus nerve -motor
Venous drainage of pharynx
Internal jugular vein
Arteries to pharynx
branches of the facial, maxillary, laryngeal and lingual arteries
Lymph drainage to pharynx
retro pharyngeal then deep cervical nodes
Laryngeal cartilidges
thyroid, cricoid, epiglottis, arytenoids, cuneiforms and corniculates
Membranes of the larynx
thyrohyoid, cricothyroid and cricotracheal
what are laryngegal folds
protection of the airway, breathing, and phonation.
True vocal cords and false vcal cords
True vocal folds
Under the control of the muscles of phonation, they are abducted, adducted, relaxed and tensed to control the pitch of the sound created.
Vestibular folds
FALSE vocal cords
Superior to true
Fixed folds that provide protection to the larynx
What is the glottis
aperture between vocal folds
Function of larynx
sphincter( closes off larungeal inlet= no food, moves up anteriorly and superiorly ) and phonation(sound production )
Relation to larynx
whats it made from
Communicates with: trachea( inferior), pharynx ( posterior), oral cavity ( superior and anterior)
Suspended from hyoid bone above and attached to trachea below
FIBROCARTILAGENOUS hollow tube
3 sections of the larynx
Supraglottis
Glottis
Subglottis
Supraglottis
From the inferior surface of the epiglottis to the vestibular folds (false vocal cords).
glottis
Contains vocal cords and 1cm below them. The openingbetween the vocal cords is known as rima glottidis, the size of which is altered by the muscles of phonation.
Subglottis
From inferior border of the glottis to the inferior border of the cricoid cartilage.
What is the larynx lined with
pseudostratifiedciliated columnar epithelium
BUT true vocal cords are lined with stratified squamous epithelium
Nerve supply to the larynx
VAGUS
Recurrent laryngeal nerve supplies all intrinsic muscles (except cricothyroid) and mucosa below vocal folds
Superior laryngeal nerve divides into the external branch which supplies cricothyroid muscle and the internal branch which supplies mucosa above vocal folds
What are the types of extrinsic muscles of the larynx and what are they in general
move the larynx superiorly and inferiorly. AS A WHOLE
They are comprisedof the suprahyoid and infra hyoid groups, and the stylopharyngeus (a muscle of the pharynx)
attach to the hyoid bone
What are the suprahyoid group muscles
mylohyoid,diagastric, geniohyoid and stylohyoid – fix and elevate the hyoid bone and larynx
Infrahyoid extrinsic muscles
sternothyroid, sternohyoid, thyrohyoid, omohyoid = lower the hyoid bone and larynx
Role of the intrinsic muscles of the larynx
Pull on vocal cords
Act on the Cricoarytenoid and cricothyroid joints
Adjust tendon, facilitate laryngeal inlet closure, control dimensions of glottis
Name the intrinsic muscles of the larynx
Cricothyroid Posterior cricoartythenoids Lateral cricoarytenoids Thryoarytenoids Oblique and transverse arytenoids
Cricothyoid
Attachments
Actions
Innervation
Attachments: Originates from the anterolateral aspectof the cricoid cartilage, and attaches to the inferior margin and inferior horn of the thyroid cartilage.
Actions: Stretches and tenses the vocal ligament.
Innervation: External laryngeal nerve (branch of superiorlaryngeal).
Thyroarytenoid
Attachments
Actions
Innervation
The thyroarytenoid muscle acts to relax the vocal ligament, allowing for a softer voice.
Attachments: Originates from the inferoposterior aspect of the angle of the thyroid cartilage, and attaches to the anterolateral part of the arytenoid cartilage.
Actions: Relaxes the vocal ligament.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).
Posterior cricoaryenoid
Attachments
Actions
Innervation
sole abductors of the vocal folds, and thus the only muscle capable of widening therima glottidis.
Attachments: Originates from the posterior surface of the cricoid cartilage, and attaches to the muscularprocess of the arytenoid cartilage.
Actions: Abducts vocal folds.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).
Lateral cricoarytenoid
Attachments
Actions
Innervation
major adductors of the vocal folds. This narrows the rima glottidis, modulating the tone and volume of speech.
Attachments: Originates from the arch of the cricoid cartilage, and attaches to the muscularprocess of the arytenoid cartilage.
Actions: Adducts the vocal folds.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).
Transverse adn oblique arytenoids
Attachments
Actions
Innervation
adduct the arytenoid cartilages, closing the posterior portion of rima glottidis. This narrows the laryngeal inlet.
Attachments: Spans from one arytenoid cartilage to the opposite arytenoid.
Actions: Adducts the arytenoid cartilages.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).
Membranes and ligaments examples in the larynx
Thyrohyoid membrane Median thyrohyoid ligament– Anteromedial thickening of the membrane. Lateral thyrohyoid ligaments – Posterolateral thickenings of the membrane. Hyo-epiglotticligament Cricotracheal ligament Median cricothyroid ligament Cricothyroid ligament Quadrangular membrane
Function of ligaments and membranes in the larynx
support the cartilaginous skeleton of the larynx, whilst the folds are involved in airway protection and phonation.
Explain the true vocal cords superficial to deep
Non keratisied stratified squamous epithelium
Reinkes space
Vocal ligament
Vocalis muscle
Reinkes space
TRUE vocal cords
watery, amorphous layer is rich in glycosaminoglycans.
fluidity= the epithelium is able to vibrate freely above it to create sound.
Vocalis muscle
Exceptionally fine muscle fibres that lie lateral to the vocal ligaments.
Vocal folds description
Space between true vocal folds
avascular, and appear white in colour
Rima glottidis
Vestibular folds explained
superiorly to the true vocal cords. vestibular ligament (free lower edge of the quadrangular membrane) covered by a mucous membrane, and are pink in colour. They are fixed folds, which act to provide protection to the larynx
Vocal cavity
Covering
Begins at laryngeal inlet/ends at trachea
Covered by mucosa – epithelial lining with modified salivary glands
What are the laryngeal cartilidges
ninecartilages located within the larynx; three unpaired, and six paired.
form the laryngeal skeleton, which provides rigidity and stability
Unpaired laryngeal cartilidges
Epiglottis
Thyroid
Cricoid
Epiglottis cartilidge
Leaf shaped
Elastic cartilidge
Entrance to larynx
Flattens and moves posteriorly to close off the larynx and prevent aspiration
Thyroid cartilidge
2 sheets which join anteriorly to form the larygeal prominence ( adams apple)
Cricoid cartilidge
Complete ring of hyaline cartilage
Narrower arch anteriorly - signet ring
Encircles airway making inferior border of larynx at c6
Articulates with paried arytenoid cartilidges posteriorly
Pressure can be applied to occlude oesphagus
paired cartilidges
Arytenoid
Corniculate
Cuneiform
Arytenoid cartilidge
PAIRED
Pyramidal shaped sitting on cricoid
Apex, base, vocal process and muscular process
Corniculate cartilidge
Minor cartilaginous structures
Paired
Articulate with arytenoid
Cuneiform cartilidges
Within aryepiglottic folds
STRENGTHEN with no direct attachment
Thoracic cage
12thoracic vertebrae
12 pairs of ribs and coastal cartilages
Sternum
thoracic inlet
Costovertebral joint
Refers to joints between ribs and vertebrae , SYNOVIAL JOINT
Can be:
Between the head of rib and vertebral body
Between tubercule of rib and transverse process of vertebrae ( costotransverse)
Where does rib articulate with verebrae
Corresponding rib articulates with its associated superior demi facet of vertebrae and inferior demi facet of verebrae above
E.g. if you have rib 3 , articulates with 3rd vertebral body below and inferior demi facet of 2nd vertebral body
Intervertebral joint
Synovial joints between articular processes
Symphases between vertebral bodies
Stenocoastal and interchondral joints
Primary cartilaginous joint – 1st sternocastal joint considered a primar…
Synovial joints = remaining sternocoastal joints
Interchondral joints = synovial supported by intercondral ligaments
attach the sternum (sterno-) with the costal cartilages (-chondral) of the thorax.
XIPHISTERNAL and manubriosternal joints
Manu= symphysis, formed by the inferior border of the manubrium and the superior border of the sternal bod
Xiph=sympysis, near the bottom of the sternum, where the body of the sternum and the xiphoid process meet
Costochondral joints
10 pairs
between each rib and its coastal cartilidge
Hyaline cartilidge
Primary cartilaginous
Sternoclavicular junction
Saddle shaped synovial joint
Arteries to thoracic wall
Internal thoracic artery and the anterior & posterior intercostal arteries and veins
Veins from thoracic wall
Anteriorly the thoracic veins drain into brachiocephallic vein
Posteriorly the azygous veins drain into the superior vena cava
Nervous supply of throacic wall
Ventral primary rami of thoracic spinal nerves form intercostal nerves, and receive rami communicants from the sympathetic trunk
The diaphragm
2 main functions
double-domed musculotendinous sheet, located at the inferior-most aspect of the rib cage. It serves two main functions:
Separates the thoracic cavity from the abdominal cavity Undergoes contraction and relaxation, altering the volume of the thoracic cavity and the lungs, producing inspiration and expiration.
Peripheral attachments of diagram
Lumbar vertebrae and arcuate ligaments.
Costal cartilages of ribs 7-10 (attach directly to ribs 11-12).
Xiphoid process of the sternum.
Left crus of diaphragm
Arises from L1-L2 and their intervertebral discs.
Right crus of diaphragm
Arises from L1-L3 and their intervertebral discs.Some fibres from the right crus surround the oesophageal opening, acting as a physiological sphincter to prevent reflux of gastric contents into the oesophagus.
Central tendon of the diaphragm and the domes
The muscle fibres of the diaphragm combine to form a central tendon. tendon ascends to fuse with the inferior surface of the fibrous pericardium. Either side of the pericardium, the diaphragm ascendsto form left and right domes.
What are the crus of diaphragm
The parts of the diaphragm that arise from the vertebrae( tendinous in structure)
Right dome vs left dome placement
the right dome lies slightly higher than the left – this is thought to be due to the presence of the liver.
Pathways through the diagram
T8 – inferior vena cava and terminal branches of right phrenic nerve
T10- oesphagus, right and left vagus nerves, esophageal branches of left astric artery/vein
T12- aorta, thoracic duct, azygous vein
Innervation from diaphragm
motor innervation from thephrenic nerve.The left half of the diaphragm (known as a hemidiaphragm) is innervated by the left phrenic nerve, and vice versa. Each phrenic nerve is formed in the neck within the cervical plexusand contains fibres from spinal roots C3-C5.
Arterial supply to the diaphragm
inferior phrenic arteries, which arise directly from the abdominal aorta.
Trachea - posterior anterior and lateral
Anteriorly –thyroid isthmus at 2ndand 3rdtracheal cartilage; left brachiocephalic vein
Posteriorly –oesophagus
Laterally –the lobes of the thyroid gland and the carotid sheath, containing the common carotid artery, the internal jugular vein and the vagus nerve
Bifurcation ( carina)
t4/t5
trachea
occurs between the division of the two main bronchi
Lobes of lung
Right has 3, left has 2
Where do vessels and bronchi enter the lung
at the root;on medial surface of lung, this is knownas the hilum
Lung tissue and visceral pleura is supplied by..
drained by
vasculature
bronchial arteries, branches of desc. Aorta
Corresponding bronchial veins drain into azygos and hemiazygos veins
Nervous innervation to lung tissue and visceral pleura
Lungs and visceral pleura are supplied with autonomic innervation from sympathetic trunks and vagus nerves, via pulmonary plexi;
Parasympathetic stimulation constricts bronchioles
Sympathetic dilates bronchioles
Lymphatics - lung tissue and visceral pleura
Lymph from the lungs drains to bronchopulmonary nodes at the hilum, to tracheobronchial nodes in the mediastinum, then drains up to nodes along the tracheato the root of the neck
What are pleura
mesothelial membranes that line the thoracic cavity and enclose the pleural space
Contain thin film of pleural fluid
Visceral pleura
adherent to the surface of lung (innervated by autonomic nerves)
Parietal plerua
has costal, diaphragmatic and mediastinal parts (somatic innervation by intercostal andphrenic nerves
