Nose, Larynx & Trachea Flashcards
Bony skeleton of nose consists of
Nasal bones
Frontal process of maxilla
Describe nerve supply of nose.
CN 5
Infratrochlear and external nasal branches from ophthalamic.
Infraorbital from maxillary.
Describe arterial supply of external nose
Ophthalamic artery (dorsal & external nasal)
Lateral nasal and infraorbital from maxillary artery.
Facial artery to skin of ala
Locate the nasal cavity
Between the two orbits, below middle of anterior cranial fossa & above hard palate.
Mention regions of nasal cavity
Nasal vestibule, respiratory region & olfactory region.
Locate the olfactory region
Apex of each nasal cavity
Roof of nasal cavity consists of
Bony part of nose, ciribriform plate of ethmoid, sphenoid bone.
Nasal septum bony part is
Vomer and perpendicular plate of ethmoid bone.
Bones of lateral wall of nasal cavity
Ethmoid, maxilla & perpendicular plate of palatine bone.
Bone forming sup, mid & inf conchae
Sup+ mid = ethmoid
Inf is a seperate bone
Superior meatus recieves
Opening of posterior ethmoidal sinus
Bulla ethmoidalis recieves ….
Middle ethmoidal sinus
Hiatus semi-lunaris receives ….. anteriorly & …..posteriorly.
A: frontal air sinus & anterior ethmoidal air sinus.
P: maxillary air sinus.
Inferior meatus recieves …..
Nasolacrimal duct
Spheno-ethmoidal recess receives ……
Sphenoid air sinus
Areas of nose supplies by greater palantine artery.
Lateral wall: antero-inferior and postero-inferor.
Nasal septum: postero-inferior.
Areas of nose supplied by sphenopalatine
Lateral wall: postero-superior.
Nasal septum: postero-inferior.
Blood supply of anteri-superior aspect of nasal septum
Anterior ethmoidal & superior labial arteries
What is the area with extensive anastomosis in nose, and its clinical appliccation?
Anterior part of medial wall
This is the area where epistaxis occurs the most.
Venous drainage of nose
Facial vein, pharyngeal & pterygoid plexuses
Lymph drainage of nasal cavity
Vestibule to submandibular lymph nodes & remainder to upper deep cervical nodes
Mention regions in nasal cavity supplied by pterygopalatine ganglion
Posterior part of lateral wall & postero-inferior aspect of nasal septum.
When do paranasal sinuses fully develop?
After eruption of permenant teeth.
Nerve supply of maxillary air sinus
Infraorbital and superior alveolar nerves.
Give reason: maxillary sinus is commonly infected.
- Its drainage orifice lies near the roof.
- Infected frontal or anterior ethmoidal sinus can drain to it.
- Spread of infection from teeth.
Nerve supply of frontal air sinus, referred pain and spread of infection.
Supraorbital nerve, pain referred to forehead & infection spreads to the frontal lobe of brain.
Nerve supply and spread of infection related to ethmoidal
Anterior and posterior ethmoidal
Spread to orbit
Nerve supply of sphenoidal air sinus
Posterior ethmoidal nerve
Position of sphenoidal air sinus
Related superiorly to pituitary & optic chiasma
Laterally to cavernous venous sinus
Vertebral level to larynx
C3-C6
Lateral relation of larynx
Carotid sheath and thyroid gland
Muscles attached to oblique line of thyroid lamina
Sternohyoid, sternothyroid & inferior constrictor
Muscles attached to posterior border of thyroid lamina
Salpingo- , stylo- and palatopharyngeus.
Describe position of borders of epiglottis
Upper free broad end and lower narrow end attached to thyroid cartilage by thyro-epiglottic ligament.
Position of cuneiform cartilage
Anterior to corniculate cartilages
Mention extrinsic ligaments of larynx
Thyrohyoid, cricotracheal & glosso-epiglottic ligaments
Structures piercing thyrohyoid ligament
Internal laryngeal nerve
Superior laryngeal artery
Mention free borders of quadrangular membrane
Aryepiglottic fold
Vestibular ligament
Mention ligament forming vocal ligament and its attachement
Cricothyroid ligament
From thyroid angles to vocal process of arytenoids
Describe saccule of larynx
Upper prolongation of laryngeal sinus between vestibular fold & thyroid lamina.
Posterior border of laryngeal inlet
Mucosa covering arytenoids
Extrinsic muscles of larynx
Infra-hyoid muscles, inferior constrictor, stylopharyngeus & palatopharygeus.
Mention the unpaired intrinsic laryngeal muscles
Transverse arytenoid muscle
Mention 3 special features of cricothyroid muscles
Lies externally
Developed from 4th arch
Supplied by external larygeal of superior laryngeal from vagus
Mention muscles controlling laryngeal orifice
Aryepiglottic & interarytenoid, close inlet
Thyro-arytenoid, widens inlet
Muscle stretching vocal cords
Cricothyroid
Muscle relaxing vocal cords
Thyro-arytenoids
Abductor of vocal cords
Posterior crico-arytenoids
Adductors of vocal cords
Transverse arytenoids & lateral crico-arytenoid
Attachment of crico-thyroid joint
Thyroid cartilage (inferior horn) & side of cricoid cartilage
Sensory nerve supply of larynx
Above vocal cords: interal laryngeal
Below: recurrent laryngeal
Level of tracheal bifurcation and level of maximum inspiration.
T4
T6
Tracheal rings covered by thyroid isthmus
2,3&4
Vessels related to cervical trachea
A: inferior thyroid veins
On either side CCA
Brachiocephalic artery on the right
Vessels and nerves related to thoracic trachea
A: cardiac plexus, arch of aorta (bracheocephalic and left common carotid)
R: right vagus, arch of azygos & right bracheocephalic vein and SVC
L: arch of aorta, left common carotid, left subclavian, left recurrent laryngeal nerve.
Compare right and left bronchi (site of division into lobar bronchi)
R: extrapulmonry
L: intrapylmonary
