Practical 1 - Upper Respiratory Tract and the Chest Wall Flashcards
What does the upper respiratory tract consist of?
Hint: 2N and 2P
- Nasal cavity
- The paranasal sinuses
- The parts of the pharynx
- Nose
What does the lower respiratory tract consist of?
Hint: 2L and TB
- Larynx (voicebox)
- Trachea
- Bronchi
- Lungs
What are the nasal cavity, pharynx and larynx involved in?
hint: to do with correcting air
the conduction, conditioning and filtering of air passing to the lungs
Explain the term “conditioning”. Why is it necessary? What is the benefit of filtering inspired air?
(hint: to do with warmth and hygiene)
- air is conditioned to the temperature of the body
- filtered to remove bacteria-trapped in mucous and large particles
- prevents damage to delicate tissues that form the respiratory system
What does the nose include?
hint: it is inside and outside
includes an external part sticking out from the face and an internal nasal cavity for the passage of air.
Feel the external portion of your own nose. What tissue(s) do you think it is composed of?
(hint: think tissues types and then subcategories)
- Cartilage:
- Hyaline cartilage - Bone:
- nasal bone
- extension of the maxillary and frontal bone - Dense fibrous connective and adipose tissue
What does the nasal cavity extend from and through? What does it open into?
(hint: Nas-Oro-La and what does air enter in the nose?)
extends from the nostrils, through the facial skeleton
opens into the pharynx
What is the nasal cavity separated into and by what?
left and right compartments by the nasal septum
the posterior border that marks the boundary between the nasal cavity and nasopharynx
Draw out and label the roughly geometrical shape of a sagittally-sectioned specimen the nasal cavity.
see document for drawing roof posterior border floor anterior border
What does the external nose form and what is the name of the boundary between the nasal cavity and nasopharynx?
(hint: positioned borders)
anterior border
posterior border
What structures form the roof and floor of the cavity?
roof - It is divided into three parts; frontal, ethmoidal and sphenoid.
floor - soft and hard palate
How many projections of the lateral wall of the nasal cavity have and what do they extend into?
has 3 projections; the superior, middle and inferior nasal conchae
which extend into the cavity
What are meatuses?
the air passages between the conchae
What is the function of the conchae?
hint: narrow used to make it windy and rainy in the nose
- Important in creating air turbulence
* Covered in mucous layer which is important to moisture, filter and warm air
How is the membrane that lines the nasal cavity adapted for its role in conditioning and filtering inspired air?
(hint: think of 2 things all exchange surfaces require)
surface is lined by mucous membrane
rich blood supply for conditioning of air
Give two other functions of the nasal cavity (think about what happens when your nose is “bunged up” during a cold).
(hint: the nasopharynx is an extension of the soft palate of mouth; smelling danger, stopping eleven’s reaction to her powers and smokers)
- nose has olfactory cells which help with smell sensation
- keeps you from nosebleeds due to dry nose being moisturised from inside
- it also protects lungs via the cilia
What are nasal polyps?
- painless, soft, non-cancerous mass of connective tissue (which may block nose if left untreated)
In addition to the conchae, which openings does the lateral wall of the nasal cavity have?
(hint: No Problem)
those of the paranasal air sinuses
and the nasolacrimal duct.
What are paranasal sinuses and how many are there?
air-filled extensions of the nasal cavity into the surrounding bones of the skull
four on each side
Name the 4 paranasal sinuses.
hint: fems; FEMaleS
frontal sinuses
sphenoidal sinuses
maxillary sinuses
ethmoid sinuses
State which meatuses the following paranasal sinuses drain into:
a) frontal (hint: fever FM)
b) sphenoid (hint: Sphenoid)
c) maxillary (hint: MM)
d) ethmoidal anterior (hint: front and middle)
e) ethmoidal posterior (hint: back and top)
f) nasolacrimal (hint: nasoLacrimal; Less/Lower)
a) middle
b) sphenoidalethmoidal recess
c) middle
d) middle
e) superior
f) inferior
Suggest three possible functions of these air-filled spaces (meatuses)
- Reduce weight
- Humidify air
- Improve voice/speech
Which of the paranasal sinuses is most prone to infection in adults and why?
- maxillary sinus
* Fluid draining from frontal sinus can enter the maxillary sinus = infection can spread
What is the name of the condition that affects paranasal sinuses and why does infection in this sinus commonly give rise to a toothache?
- Infection of sinuses results in inflammation and is called sinusitis
- If more than one is called the paranasal sinus
- Located at a high position which affects its drainage
- Maxillary nerve supply both maxillary sinus and teeth so inflammation of the sinus can lead to toothache
What does the nasolacrimal duct do?
- Drain tears from eyes to nose
- Carry tears
What happens if the nasolacrimal duct is blocked?
- If blocked can result in backflow
What is the pharynx? What are its functions?
hint: same structure as trachea and Pha-La. Functions to do with 2 things that go down the tube
a muscular tube situated behind the nose, mouth and larynx
has both digestive and respiratory functions
What are the 3 parts of the pharynx and which region are each found?
(hint: Nas-Oro-La)
nasopharynx (behind the nose)
oropharynx (behind the mouth)
laryngopharynx (behind the larynx)
What structure separates the oropharynx from the laryngopharynx?
- epiglottis
Which two structures communicate with each other via the auditory tube?
- upper respiratory tract and middle ear
What is the function of the auditory tube?
hint - if it is linked to an area they must have the same conditions
- to maintain the same atmospheric pressure in the middle ear
What is the pharyngeal/adenoid tonsil?
hint - what form of tissue; immune function
- a mass of lymphoid tissue
Where does the pharyngeal/adenoid tonsil lie in children?
hint - the uppermost area of pharynx and close to ears
- in the roof of the nasopharynx
- superior to the opening of the auditory tube
What happens to the pharyngeal/adenoid tonsil with age?
hint - in evolution if something is used less it becomes…
- becomes much smaller with age
What are tonsils and what is their function?
hint - to do with cleaning out the body of harmful substances
- mass of lymphatic tissue
- first line of defence of body
Lingual tonsils are not always visible in diagrams but where should you be able to see them in real life?
(hint - when someone sticks out their tongue at you)
- on the most posterior part of a protruded tongue
State where each of the tonsils within the pharynx is located?
- Lingual= posteriorly on the tongue
- Pharyngeal/adenoid= roof of the nasopharynx (swelling can obstruct eustachian tube)
- Tubular tonsil = on top of the auditory/eustachian tube
- Palatine tonsil= behind the tongue in the tonsillar fossa
What can swelling of the pharyngeal/adenoid tonsils obstruct?
- the eustachian tube
Which tonsils are you are more likely to be able to identify in a living individual?
- the lingual and palatine tonsils
What condition is evident in the photograph in the figure? Why might this patient develop enlarged lumps in the neck?
- tonsilitis - inflamed tonsils
- strep throat - infection of the throat by streptococcus bacteria
- bacterial or viral infection
What is the larynx?
hint - like the pharynx but Lower
- entrance to the lower respiratory system
- connecting the laryngopharynx to the trachea.
What is the larynx composed of and where do they articulate with one another?
(hint - the tube is made up of…)
- several cartilages (some single and midline, some paired)
- which articulate with each other at tiny joints
Why do the cartilages of the larynx move at their joints?
- due to the action of several small laryngeal muscles
What do soft tissues around the larynx also give rise to?
several important folds/membranes
What are the 2 main functions of the larynx?
hint - near voicebox and oesophagus
- enable the articulation of speech
2. protect food passing in the trachea
What type of cartilage is the epiglottis of the larynx and what does it form?
a midline cartilage that curls up behind the tongue
it forms the anterior boundary of the inlet to the larynx
What are the aryepiglottic folds and why are they named so?
hint - arye-pi-glottic
- 2 folds of the mucous membrane
- that extend from sides of the epiglottis downwards and backwards
- to the paired arytenoid cartilages of the larynx, hence the name aryepiglottic
What do the aryepiglottic folds define and what plane is it?
hint - like the horizon
defining the lateral borders of the laryngeal inlet
plane of the laryngeal inlet is almost vertical
How is narrowing of the laryngeal inlet during swallowing achieved?
- by contraction of laryngeal muscles
- causing the 2 aryepiglottic folds to move towards the midline
How is the laryngeal inlet protected during swallowing while food/fluid passes into the oesophagus?
- tip of the epiglottis is briefly tilted downwards
- like a trapdoor, over the laryngeal inlet protecting it
What do 2 pairs of mucosal folds stretch across and where?
hint - area that contains many areas unto lower areas
- across the cavity of the larynx inferior to the aryepiglottic folds
What are the 2 pairs of mucosal folds?
- the upper pair are vestibular folds
- the lower pair are vocal folds
Like the aryepiglottic folds, what can both pairs of mucosal folds can be approximated as?
- in the midline to close off the airway
Is it possible to breathe and swallow at the same time? Is it possible to breathe in and speak at the same time?
- No
- No
Which regions of the respiratory tract are “closed off” during swallowing?
- Trachea
Which structure closes off the respiratory tract superiorly during swallowing?
- Epiglottis
What is endotracheal intubation?
hint - MLT; My Little Toaster
- the passage of a flexible plastic tube (the ET tube)
- into the mouth, through the larynx (between the vocal folds) and into the trachea below
When is endotracheal intubation performed?
- when a patient cannot breathe for themselves (i.e. during general anaesthesia) and needs to be supported by a ventilator
Which special piece of equipment is used to hold the tongue out of the way so the vocal folds can be visualised and the operator can be sure to see the tube pass between the folds and thus into the larynx?
(hint - think of WE)
- a laryngoscope
- it is easy to mistakenly intubate the oesophagus and this would quickly prove catastrophic if unnoticed
Which pair of folds are involved in phonation?
hint - folds involved in speech-production
- vocal folds
How do vocal folds produce sound?
Tensing the folds in the airstream during expiration causes them to vibrate, producing sound.
How are pitch and amplitude (loudness) of sounds determined by the vocal cords?
- pitch determined by the length and tension of the folds, - - loudness determined by the force of the air expelled from the lungs and passed over them
What is the rima glottidis? Indicate its position in the diagram in the figure.
- Opening between vocal folds are arytenoid cartilage
- Green= rima glottidis
- Black=rima vestibule
(see document for diagram)
