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Respiratory 2 > Respiratory Anatomy > Flashcards

Respiratory Anatomy Flashcards

1
Q

What are the three regions of the nasal cavity?

A

Olfactory Respiratory Nasal vestibule

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2
Q

Nasal vestibule aka

A

Nostrils

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3
Q

What bone makes up the superior and middle conchae?

A

Ethmoid bone

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4
Q

What sinus opens up into the sphenoethmoidal recess?

A

Sphenoid sinus

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5
Q

What sinus opens up into the superior meatus?

A

Posterior ethmoid sinuses

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6
Q

What sinuses open up into the middle meatus?

A

Middle ethmoidal sinus and maxillary sinus

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7
Q

What opens up into the inferior meatus?

A

Nasolacrimal duct

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8
Q

What is the function of the conchae?

A

Increases the surface area for inspiration. Warms and humidifies the air. Immunological defence e.g mucous production

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9
Q

What bones make up the medial wall of the nose?

A
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10
Q

Paranasal Sinuses

A

Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity.

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11
Q

What is the function of the paranasal sinuses?

A

Lighten weight of head, humidify and heat inhaled air, increase resonance of speech, protect vital structures in event of facial trauma.

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12
Q

Maxillary Sinusitis

A

Inflammation of the maxillary sinuses.

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13
Q

Why is Maxillary sinusitis common?

A

Maxillary sinusitis is common due to the close anatomic relation of the frontal sinus, anterior ethmoidal sinus and the maxillary teeth, allowing for easy spread of infection.

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14
Q

What is the clinical presentation of sinusitis?

A

Nasal congestion

Discharge from the nose

Pain and tenderness

Fever

Toothache

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15
Q

Secondary sinusitis

A

Inflammation of the sinuses from another source e.g infection from teeth.

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16
Q

What is the treatment for sinusitis?

A

NSAID’s and nasal corticosteroids.

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17
Q

Sinusitis most commonly affects what duct?

A

Maxillary duct

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18
Q

When would you refer sinusitis to secondary care?

A

Referral to secondary care if systemically unwell or signs of periorbital cellulitis / involvement of the CNS.

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19
Q

Periorbital cellulitis

A

Periorbital cellulitis is an infection of your eyelid or the skin around your eyes. It happens when bacteria attack the soft tissue around your eye, including your eyelid.

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20
Q

Explain the innervaiton of the nasal cavity.

A

Olfaction - CNI

Sensation - CNV

Glandular - parasympathetic fibres of CNVII

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21
Q

What are the two large arteries supplying the nose with blood?

A

External and Internal Carotid

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22
Q

Explain the blood supply to the nose via the internal carotid artery.

A

Internal carotid branches:

Anterior ethmoidal artery

Posterior ethmoidal artery

The ethmoidal arteries are branch of the ophthalmic artery. They descend into the nasal cavity through the cribriform plate.

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23
Q

Explain the blood supply to the nose via the external carotid artery.

A

External carotid branches:

Sphenopalatine artery

Greater palatine artery

Superior labial artery

Lateral nasal arteries

In addition to the rich blood supply, these arteries form anastomoses with each other.

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24
Q

Where do the veins of the nose drain into?

A

They drain into the pterygoid plexus, facial vein or cavernous sinus.

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25
Q

How can infection sometimes spread from the nose into the cranial cavity?

A

In some individuals, a few nasal veins join with the sagittal sinus (a dural venous sinus). This represents a potential pathway by which infection can spread from the nose into the cranial cavity.

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26
Q
A
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27
Q

Epistaxis

  • where is epitaxis most likely to occur?
A

Epistaxis is the medical term for a nosebleed. Due to the rich blood supply of the nose, this is a common occurrence. It is most likely to occur in the anterior third of the nasal cavity – this area is known as the Kiesselbach area.

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28
Q

What can cause epistaxis?

A

The cause can be local (such as trauma), or systemic (such as hypertension).

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29
Q

What are the 3 large unpaired cartilages of the larynx?

A

Cricoid

Thyroid

Epiglottis

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30
Q

What are the three smaller paired cartilages of the larynx?

A

Arytenoid

Corniculate

Cuneiform

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31
Q

What is the function of the arytenoid cartilages?

A

Tension, relaxation and approximation of the vocal cords.

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32
Q

What is the function of the cuneiform cartilages?

A

Support of the vocal cords and the epiglottis.

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33
Q

What are the three parts of the cavity of the larynx?

A

Vestibule

Middle chamber

Infraglottic space

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34
Q

The vocal folds (true vocal cords) are located in what part of the larynx?

A

Infraglottic space

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35
Q

What do the pharyngeus muscles of the larynx do?

A

Elevate the larynx

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36
Q

What do the intrinsic muscles of the larynx do?

A

Tense, relax ab/adduct and approximate the vocal cords which changes the pitch of sound.

37
Q

What is meant by approximate regarding muscles?

A

Approximate means to bring together.

38
Q

Outline sound production.

A

Movement of arytenoid cartilages to move vocal folds.

Intermittent release of expired air between the adducted vocal folds results in vibration, producing sound

39
Q

What does the thyroarytenoid muscle do?

A

Shortens the vocal cords which slows down vibration creating a lower pitch.

40
Q

What does the cricothyroid muscle do?

A

Tenses the vocal cords making them longer and thinner increasing the speed of vibration creating a higher pitch.

41
Q

What are the two nerves that innervate the larynx?

A

Superior laryngeal

Recurrent laryngeal

42
Q

What does the superior laryngeal nerve innervate?

A

Superior laryngeal nerve – the internal branch provides sensory innervation to the supraglottis, and the external branch provides motor innervation to the cricothyroid muscle.

43
Q

What does the internal branch of the superior laryngeal nerve innervate?

A

Sensory innervation to the supraglottis

44
Q

What does the external brnach of the superior laryngeal nerve innervate?

A

Innervation to the cricothyroid muscle.

45
Q

What is clinically significant about the recurrent laryngeal nerve?

A

The long course the recurrent laryngeal nerve takes makes it succeptible to damage this can cause vocal cord paralyis.

46
Q

What is the blood supply to the upper half of the larynx?

A

Upper half larynx: Superior laryngeal branch of superior thyroid

47
Q

What is the blood supply to the lower half of the larynx?

A

Lower half larynx: inferior laryngeal branch of inferior thyroid

48
Q

How can laryngeal lesions occur?

A

Thyroidectomy / Partial thyroidectomy due to close proximity of thyroid vasculature to laryngeal innervation.

Left recurrent laryngeal nerve may be involved with bronchial / oesophageal carcinoma.

Pancoast tumours can also affect the left recurrent laryngeal nerve.

Malignancy of the cervical lymph nodes.

49
Q

Why is the left recurrent laryngeal nerve at high risk of lesions?

A

The left recurrent laryngeal nerve arises from the vagus to the left of the arch of the aorta. It curves inferior to the aortic arch and ascends in the groove between the trachea and the esophagus.

50
Q

How can a unilateral section of a recurrent laryngeal nerve present?

A

The affected vocal cord will be arrested however the other vocal cord can compensate.

May present as a little hoarseness.

51
Q

How can a bilateral section of a recurrent laryngeal nerve present?

A

Both vocal cords arrested so:
Impaired breathing and speech is lost.

52
Q

How are the phases of swallowing broken down?

A

Voluntary phase

Reflexive phase - (pharyngeal and oesophageal phases).

53
Q

What innervates the pressure receptors in the oropharynx that control peristalsis?

A

Glossopharyngeal nerve

Vagus nerve

54
Q

Explain the musculature of the oesophagus.

A

Upper 1/3 is voluntary and skeletal

Lower 2/3 involuntary smooth muscle

55
Q

What region of the brain controls deglutition?

A

Medulla oblongata

56
Q

Define lesion (simply).

A

Area of tissue that has been damaged by injury or disease.

57
Q

Pancoast tumour

A

A Pancoast tumor is a tumor of the pulmonary apex. It is a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung.

58
Q

Describe laryngeal paralysis and explain the causes.

A

Interruption of the motor nerve supply of the larynx is nearly always unilateral and, because of the intrathoracic course of the left recurrent laryngeal nerve, usually left-sided. One or both recurrent laryngeal nerves may be damaged by thyroidectomy, carcinoma of the thyroid or anterior neck injury. Rarely, the vagal trunk itself is involved by tumour, aneurysm or trauma.

59
Q

Sinusitis

A

Inflammation of the paranasal sinuses.

60
Q

Paranasal sinuses

A

The air spaces around the nasal cavity.

61
Q

Name the four paranasal sinuses.

A
62
Q

What are the symptoms of sinusitis?

A

Mainly associated with mucus build up:

Facial pain

Pressure in the face

Headache

Fevers (especially in bacterial sinusitis).

Changes in voice, smell and taste.

Cough (worse at night due to pooling of mucus).

63
Q

How is sinusitis diagnosed?

A

In subacut / chronic cases CT scan and rhinoscopy.

64
Q

Function of the extrinsic larynx muscles vs intrinsic.

A

Extrinsic laryngeal muscles move the larynx as a whole.

Intrinsic laryngeal muscles move the laryngeal components, altering the length and tension of the vocal folds and the size and shape of the rima glottidis.

65
Q

What is the rima glottidis?

A

The rima glottidis is the opening between the true vocal cords and the arytenoid cartilages of the larynx.

66
Q

What are the extrinsic laryngeal muscles and what do they do?

A

The infrahyoid muscles are depressors of the hyoid and larynx.

The suprahyoid muscles and the stylopharyngeus are elevators of the hyoid and larynx.

67
Q

Explain the cricothyroids innervation and function.

A

Innervation: External laryngeal nerve (branch of vagus).

Function: Stretches and tenses vocal ligament.

68
Q

What is the innervation of the intrinsic muscles of the larnyx?

A

Innervation: Inferior laryngeal nerve (branch of the recurrent laryngeal nerve).

(To all intrinsic muscles of the larynx excluding cricothyroid).

69
Q

How is the larynx involved in swallowing?

A

When you swallow, a flap called the epiglottis moves to block the entrance of food particles into your larynx and lungs. The muscles of the larynx pull upward to assist with this movement. They also tightly close during swallowing. That prevents food from entering your lungs.

70
Q

Recurrent laryngeal nerve innervates what?

A

The internal muscles of the larynx that control the vocal cords.

71
Q

Unilateral lesion of the recurrent laryngeal nerve leads to what?

A

Hoarseness

72
Q

Bilateral palsy of the recurrent laryngeal nerve leads to what symptom?

A

Whispering

73
Q

What does the internal laryngeal nerve innervate?

A

Sensory sensation to the larynx - stimulates the cough reflex.

74
Q

What does a palsy of the internal superior laryngeal nerve do?

A

Unable to cough of feel food trapped in the throat.

Trapped food in the throat can thus begin to rot causing halitosis.

75
Q

Cricothyroid muscle

Function

Innervation

A

Stretches the vocal cords - controls pitch (higher pitch).

Innervated by the external superior laryngeal nerve.

76
Q

What are the laryngeal muscles involved with swallowing?

A

Suprahyoid and Infrahyoid

77
Q

Explain the role of the suprahyoid and infrahyoid in swallowing.

A
78
Q

Define cough.

A

Forced expulsion of air against a semi-closed glottis.

79
Q

What stimulates the cough reflex?

A

Irritation in the bronchial tree / Blockage obstructing airway.

80
Q

Explain the process of the cough reflex.

A
  1. Inhalation of irriatant / blockage stimulates pulmonary irritant receptors in the epithelium of the respiratory tract are sensitive to both mechanical and chemical stimuli.
  2. Nerve transmission through the vagus to the medulla (cough centre).
  3. Motor impulse sent down vagus, phrenic and motor spinal nerves.
  4. Diaphragm contracts and internal intercostal muscles relax - big inhalation.
  5. Diaphragm relaxes internal intercostals contract = big quick exhalation.
81
Q

Function of the posterior cricoarytenoid muscle

A

Abducts the vocal folds

82
Q

Nasopalatine nerve function.

A

Sensory innervation to the nose, controls sneezing.

83
Q

Origin of the nasopalatine nerve.

A

Maxillary branch of the trigeminal nerve.

84
Q

What bones form the hard palate?

A
  • Horizontal plate of the palatine bone.
  • Palatine process of maxilla.
85
Q

What are the posterior and anterior ethmoidal arteries a branch of?

A

The opthalmic artery.

86
Q

What is the sphenopalatine artery a branch of?

A

Maxillary artery, branch of the external carotid.

87
Q

What is the name of the chemoreceptors involved in coughing, and what do they respond to?

A

Type 1 Vanilloid receptor aka Capsaicin - Chemoreceptor sensitive to acid, heat, and capsaicin like compounds - chilli pepper and related plants.

88
Q

Cervical ribs

A

A cervical rib in humans is an extra rib which arises from the seventh cervical vertebra. Their presence is a congenital abnormality located above the normal first rib.

89
Q

What problems can arise due to the presence of cervical ribs?

A

A cervical rib is an abnormality that’s present from birth. It doesn’t usually cause problems, but if it presses on nearby nerves and blood vessels, it can cause neck pain, numbness in the arm and other symptoms, which collectively are known as thoracic outlet syndrome.

Respiratory 2 (22 decks)

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