Lecture - Resp (Yusuf Upper Airways)

Question 1

Just briefly, what things comprise the upper resp system and what the lower resp system? Like where is the line drawn?

Answer 1

Nose, nasal cavity, paranasal sinuses, pharynx and larynx are upper resp system.

The trachea, bronchi, bronchioles and alveolar units are all the lower resp system

SO the line is drawn sorta in the larynx and trachea

Question 2

In the upper resp system, what do these consist of:

1. Nose
2. Pharynx
3. Larynx

Answer 2

1. Nasal cavities, paranasal sinuses
2. Naso, oro and laryngopharynx

Question 3

NOSE

1. Briefly tell me the functions of the nose and the nasal cavities
2. What is the external nose formed by?

Answer 3

1. So the functions include things like olfaction (which is where there is olfactory aka smell receptros in the mucosa of upper third of media and lateral nasal walls (the bottom 2/3 is respiratory)).

Nose provies an airway for respiration, filters dust, moistens and warms the air, chambers for speech and also reception of the secretions from the sinus or nasolacrimal ducts (so you sniff, I guess)

2. It’s formed by the nasal cartilages (septal and alar - greater and lesser), nasal bone, and fibrous fatty tissue

Question 4

Label this

Answer 4

Question 5

Okay, what are the two nasal cavities separated by?

Answer 5

The median wall of each nasal cavity, which is formed by the nasal septum which has the septal cartilage, vomer and the ethmoidal bone

Question 6

What forms the floor of the nasal cavity?

Answer 6

The maxilla and the palatine bone

Question 7

What is special about the cribriform plate, which is on the roof of the nasal cavity?

Answer 7

It allows the olfactory nerve to pass to the cranium

SO like the ethmoid bone has the cribriform plate on top of it (so it’s part of the ethmoid bone) and that has tiny gaps in it to allow the axons of the olfactory nerve to pass rom upper third of the nasal cavity to get to the bulb and then cranium

Question 8

Label this and then tell me what the roof and floor consist of

-What’s the hard palate?

Answer 8

Hard palate is the maxilla and the palantine bone

Question 9

Now, label the lateral wall

Answer 9

Question 10

Mucosa of the NOSE’s nasal cavities

1. Muscosa of the upper third of the walls of the nasal cavities is concerned with what?
   - what even is it?
2. Where are the olfacory receptor axons located and what do they pass through and where do they connect (where is this specific thing located?).
   - how many olfactory bulbs are there?
3. Okay so what about the mucosa of the lower two thirds of the lateral and medial walls?
   - what is the epithelium of the respiratory part of nasal cavity?
   - do you find cilia in the upper one third of the nasal cavity?
   - what is the purpse of the cilia?
   - what about the purpose of the mucus?
   - how is the inhaled air warmed?

Answer 10

1. Olfaction - it is smell
2. Upper third of the nasal cavities and they pass through the cribiform plate to get to the olfactory bulb which is situation on the upper surface of the cribiform plate and there are two of them (they like sorta sit in the cranium - in the BioDigital thing anyway)

Question 11

Nasal conchae and meatuses

1. So there are nasal conchae that form projections from the lateral wall of the nasal cavity
   - what type of mucosa are they covered by (go back and tell me what the epiithium is)
   - how many bones?
2. What are nasal meatuses?
   - what are the three meatuses and where are they located?
   - what is the exception?
3. Label that

Answer 11

1. They are covered by respiratory type mucosa so like, psccg
   - have two bones really, the superior and middle nasal conchae are parts of the ethmoid bone and the inferior nasal concha is a separate bone
2. Image

Question 12

Label

Answer 12

Question 13

Paranasal sinuses

1. What are they?
2. How many sinuses are there?
3. What are the sinuses lined by? So what’s the epithelium?
4. What’re their two functions?
5. Which wall of the nasal cavity do the sinuses drain into?
6. Where specifically do the paranasal sinuses (in this list) drain into?
7. Which of the paranasal sinus is used as a path in pituitary gland tumor removal surgery? Why?

Answer 13

1. They are air filled extensions of the nasal cavities into the adjacent bones
2. You have the frontal sinuses, sphenoid sinuse, ethmoidal sinuses (also called ethmoidal cells - have ant, middle and post) annnnnd maxillary sinuses (largest).
3. Lined by the resp mucosa (psccg)
4. They decrease wieght of the bones and they controbute to voice porduction since they are resonance chambers
5. Lateral
6. They all drain into the middle nasal meatus but the sphenoid sinuses drain into the sphenoethmoidal recess and the posterior ethmoidal cells drain into the superior nasal meatus.
7. Sphenoid

Question 14

Label

Answer 14

Question 15

Answer 15

Question 16

Answer 16

Question 17

Answer 17

Question 18

What is the nasolacrimal duct and where does it open?

Answer 18

So it’s not a paranasal sinus, it’s actually a duct related to the lacrimal gland. Tears will get into this duct and drain into the inferior nasal meatus (so we sniff when we cry)

Question 19

Alright, what’re the 3 parts to the pharynx?

What passes through the pharnyx?

Answer 19

It’s a common pathway for air and food

It’s got nasopharynx (behind nasal cavities)

Orophayrnx (behind the oral cavity)

And Laryngopharnx (behind the larynx)

Question 20

Pharnyx:

1. Extends from behind ___ to ______
2. What is the wall of the pharnynx mainly composed of?
3. The upper part of the pharnynx is lined by what type of epithelium?
4. What is the lower part of the pharynx lined by?

Answer 20

Question 21

Part of the Pharynx: Nasopharynx

1. So this connects the two nasal cavities by what? (what’s the colloquial term for this?)
2. What opens on the lateral wall of the nasopharnyx? How is this useful in planes?
3. What’re the two tonsils? What are they made of? Where are they?
   - which one can be enlarged in children? What’s that called?
   - why is the tubal tonsil called the tubal tonsil?
4. If you get adenoid in kids, what does the kid do to breathe?

Answer 21

2. So the auditory tube is a thing that connects to the middle ear so the pressure between your ear and nose is the same or something - protects the tympanic membrane
3. There is the pharyngeal tonsil and the tubal tonsil- they are lymphoid tissue collections in two different localizations of nasopharnyx
   - Pharngeal can be enlarged in kids and that’s called adenoids
   - tubal tonsil is called that because it’s behind the auditory tube
4. If you get it, then the airflow is closed so you need to open your mouth to breathe

Question 22

Answer 22

Question 23

Part of the pharynx: the oropharynx

1. Why is this crucial when you get adenoids?
2. So this oropharynx connects with the oral cavity through what? (the last word means a narrowing)
3. The oropharnyx location is from where to where?
4. What’re the two tonsils here?
   - where are the tonsils localised?
   - the second tonsils has arches mentioned (and if you know the arches then you’ll know where the second tonsil is), what are they?

Answer 23

1. If you get adenoid then you wil need to open your mouth to breathe and that requires the oropharnyx to at least be open since this connects the oral cavity to the back tube lol

Question 24

Answer 24

Lingual tonsil is at the root of the tongue

And that stick says platoglossal arch

Question 25

Answer 25

Question 26

Part of the pharnynx: Laryngopharynx

1. It’s called the hypopharynx. What does it connect with through the ____ inlet?
2. Just know that it’s behind the larynx

Answer 26

Question 27

Answer 27

Question 28

Answer 28

Question 29

LARYNX FINALLY

1. Okay, where does this extend from and what are the levels of the spinal cord?
2. it is made up of several c____ and fibrous membranes and lined by m_____ membrane
3. Functions of the larynx:
   - major function?
   - most important?
   - most complex?
4. Air enters through the ______ _____, which the food passes through what to the esophagus?

Answer 29

Question 30

Skeleton of the larynx:

Okay so it’s composed of:

1. 3 large unpaired cartilages - what are their names?
2. 3 PAIRS of smaller cartialges - what are their names?
3. And a _____-_____ membrane and numerous what?
4. The inferior horn of the thyroid cartialge articulates with the cricoid cartilage through what sort of basic joint?
   - Each of the ______ cartialges articulate with the cricoid cartialge by a synoival joint too.
5. Are there acually any bones in the larynx?
6. So you have these synovial joints between certain cartialges (bw inferior thyroid + cricoid and arytenoid + cricoid) - why are they synovial?

Answer 30

5. Nope, no bones, only cartialges
6. You have synovial joints so you can move easily - need to move because production and modulation to voice and sometimes need more airflow to the respiratory system

Question 31

Larynx: cartialges

1. Okay, so the thyroid cartialg is the largest layrngeal cartialge and it is made of two _____ which meet in an anterior prominence called what? (what’s the colloquial term for this?)
2. What cartialge is attachec to the laryngeal prominence?
3. The cricoid cartialge is located below the ____ cartilage, what sits on the shoulders of it?
4. The corniculate and cuneiform cartialge are embedded into the _______ fold (what is a fold?)

Answer 31

4. A fold is like mucosal or something

Question 32

Answer 32

Question 33

External membranes of the larynx

1. Where is the thyroid membrane attached?
   - what nerve and what artery pierces this membrane from the lateral aspect?
2. There is also a cricothyroid membrane (anterior portion). It also is known as the median cricothyroid ________
   - where is it attached?
   - how does this cricothyroid membrane (anterior portion) relate to emergency situations?

Answer 33

Question 34

Answer 34

Question 35

Internal Membranes of the Larynx:

1. So there is the quadrangular membrane; where is it attached
   - superiorly
   - inferiorly
   - anteriorly
   - posteriorly
2. There is also the cricothyroud membrane (lateral portion); where is it attached to
   - superiorly (upper border)
   - inferiory
   - anteriorly
   - posteriorly
3. What’s the difference between a fold and a cord?
4. Which cord is the true vocal cord and which one is the false?

Answer 35

3. Cord (ligament) with mucosa = fold
4. Vocal is true and vestibular is false

Question 36

Answer 36

Question 37

Vocal folds (vocal cords)

1. What are vocal folds formed by?
2. Where do the vocal cords extend from?
3. The positions and tensions in the vocal folds can be varied by what?
4. Abduction of adduction of the vocal folds alters the size of the interval between the vocal folds, known as the ______ ______

Answer 37

Question 38

Vocal cords - respirtation

1. Which muscles absuct the vocal cords and opens the rima glottidis, which allows the airflow in respiration?

Vocal cords - airway protection

1. Which muscles adduct the vocal cords for full closure (with some other muscles) in airways protection reflexes to block foreign objects entering the trachea?
2. Full closure of the rima glottidis also occurs in the need of what?
3. Which membrane senses foreign objects so it closes the vocal cords and then you can cough etc?

VESTIBULAR LIGAMENTS ARE NOT VOCAL CORDS (but they still open too)

Answer 38

Question 39

Vocal folds - phonation

1. Sound is produced how?
2. What variable controls the pitch (frequency) of voice and what determines the quality (whispering, hoarness)?
3. The ______ ______ tilts the thyroid cartialge over cricoid and modulates what?

Answer 39

Question 40

Cavity of the larynx

1. It’s divised into 3 parts - what are they
   - where does each extend from?

Answer 40

Question 41

Answer 41

Question 42

Innervation of the larynx:

Sensory innervation

1. What branch supples the sensation above the laryngeal ventricle?
2. What about below the laryngeal ventricle?
3. Which big nerve are tey branches of?

Motor innervation

1. All the muscles of the larynx are innervated by what nerve? What muscle is the exception to this?

Other ish:

1. If you injure the recurrent bilaterally, what won’t you be able to do?
2. What happens if you damage the external branch?

Answer 42

1. Above = internal branch of superior laryngeal nerve
2. Below = recurrent laryngeal nerve
3. Vagus

-

1. All are by the recurrernt branch except the cricothyroid muscle (which is for pitch of sound)