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Year 2 - LCRS - Anatomy of the Head, Neck and Spine > Session 5: Upper Airway > Flashcards

Session 5: Upper Airway Flashcards

1
Q

Nasal cavities

A
  • Upper part of respiratory tract

- Warm and humidify air, help trap pathogens

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2
Q

What are the structural components of the nasal cavities?

A
  • Anterior & posterior regions
  • Contain conchae
  • Meatus (meatuses) in between
  • make up the upper part of the respiratory tract
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3
Q

What are the functions of the larynx?

A
  • Principal: protect the airway from food (valve)

- produce sound (phonation)

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4
Q

What are the functions of the sinuses?

A
  • make the the skull lighter
  • can have clinical implications as they can become infected
  • provide a cruel zone to protect the brain
  • resonant sound production
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5
Q

What are conchae?

A
  • turbinate bones and associated soft tissue that
  • curled shelf of bone that protudrudes into the breathing passage in the nose
  • superior, middle and inferior
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6
Q

What are meatuses in the nose?

A
  • They are the spaces in between conchae
  • superior, middle and inferior
  • inferior meatus is inferior to the inferior conchae
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7
Q

What are the functions of conchae?

A
  • warm and humidify air
  • immune function by catching pathogens
  • drainage routes for sinuses
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8
Q

What are the potential complications of sinus infections?

A
  • some sinuses can drain into the cranial cavity
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9
Q

Innervation of the nasal cavities

A
  • Olfactory nerve (I)
    • > Olfaction
  • Trigeminal nerve (V)
    • V1 – anterior region, V2 – posterior region
  • Facial nerve (VII)
    • > Glands
  • Sympathetic nerves (from T1)
    • > Vascular smooth muscle
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10
Q

Arterial Blood supply of the nasal cavities

A
  • largely from the internal carotid artery
  • also from external carotid artery

Extremely good blood supply -> can lead to Epistaxis (nose bleeds)

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11
Q

Venous drainage of the nasal cavities

A
  • superior parts of the nasal cavities drain into the brainiac cavity
  • this is almost like a flaw in design because pathogens that are filtered in the nose could enter that way
  • e.g. nasal vein passes through foramen caecum
  • some veins drain into the cavernous sinus in cranial cavity
  • inferiorly there is drainage into the facial vein
  • drainage to pterygoid plexus in infra temporal fossa.
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12
Q

What is the sensory innervation of the sinuses?

A

Branches of the trigeminal nerve.

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13
Q

What are the different sinuses? (+ innervation)

A
  • frontal (V1)
  • ethmoid air cells (V1 and V2)
  • maxillary (V2)
  • sphenoid (V1 and V2)
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14
Q

Why do you have a runny nose when you cry?

A
  • the opening of the nasolacrimal duct is in the nose

- when lacrimation occurs, tears drain into the nasal cavity

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15
Q

How do sinuses drain?

A
  • into the nasal cavities (meatuses)

- depending on the place of the sinus opening, it can drain in different positions of the head.

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16
Q

What is the larynx made up of?

A
  • cartilages
  • membrane
  • muscle
17
Q

How does the thyroid cartilage rock on the cricoid cartilage?

A

Due to the cricothyroid joint

18
Q

Where would you insert an instrument to open the airway in an emergency?

A
  • incision through the skin and cricothyroid membrane
  • “cricothyrotomy” or “cric”
  • in between thyroid cartilage and cricoid cartilage
19
Q

Arytenoid cartilages

A
  • pair of small three-sided pyramids which form part of the larynx, to which the vocal folds (vocal cords) are attached. - These allow and aid in the vocal cords’ movement.
20
Q

Rima glottidis

A

hole between the 2 vocal chords (seen through endoscope)

21
Q

Know how to label an endoscopic view of the larynx

A

:)

22
Q

What are the main muscles of the larynx that are important for phonation?

A
  • cricothyroid muscles (straight + oblique): put tension on the vocal chords; rocking of thyroid cartilage on cricoid cartilage with the cricothyroid joint.
  • transverse + oblique arytenoid muscles -> adduction and abduction of vocal chords (opening and closing)
  • lateral arytenoid muscles
  • vocals muscle (antagonist to cricothyroid muscle)
23
Q

Innervation of the larynx

A
  • superior laryngeal N (splits into internal (top) and external (bottom) laryngeal N.
  • recurrent laryngeal N.
24
Q

What do the recurrent laryngeal nerves wind around?

A
  • right: right subclavian A.

- left: ligamentum arteriosum

25
Q

What does a lesion in the vagus nerve cause?

A
  • complete paralysis of muscles of the larynx (on that side)
26
Q

What does a lesion in the internal laryngeal N cause?

A
  • can cause loss of sensation above the vocal folds.
27
Q

What does a lesion in the external laryngeal N cause?

A

Paralysis of cricothyroid

28
Q

What does a lesion in the recurrent laryngeal nerve cause?

A
  • paralysis of all muscles in the larynx except cricothyroid and loss of sensation below vocal folds
29
Q

What do the different nerves that innervate the larynx supply?

A
  • internal laryngeal N: huge involvement in sensation + muscles (does much more than the external laryngeal N.)
    Q: is it only sensory or also motor?
  • external laryngeal N: innervates muscles, supplies the cricothyroid muscle.
  • recurrent laryngeal N: innervates muscles as well
30
Q

Which arteries do the laryngeal nerves travel with?

A
  • superior laryngeal N with the superior thyroid artery

- recurrent laryngeal nerve with the inferior thyroid artery

31
Q

What is the left recurrent laryngeal nerve particularly vulnerable to?

A
  • bronchial or oesophageal tumor/swollen mediastinal lymph nodes (pleural cavity)
32
Q

What are the protective mechanisms for the airway?

A
  • coughing
  • sneezing
  • gag-reflex
  • swallowing
33
Q

Management of the airway

A 
Chin lift/ jaw thrust
Oropharyngeal or nasopharyngeal airway
Endotracheal intubation
Cricothyroidotomy
Tracheostomy
34
Q

What are the differences between sneezing and coughing?

A

Sneezing:

  • soft palate is depressed against the tongue
  • afferent via V2

Coughing:

  • soft palate is raised
  • afferent via X

COMMON:
- Inspiration
Intrathoracic pressure raised
(glottis closed, abdominal muscles contracted
- Sudden abduction of vocal folds to release intrathoracic pressure through nose or mouth

35
Q

Facial Nerve

A
  • Lateral surface of brainstem between pons and medulla
  • passes through internal acoustic meatus
  • Motor (large)
    • > Muscles of facial expression, stapedius, digastric (posterior belly), stylohyoid.
  • Sensory (smaller – intermediate nerve)
    • > Taste (ant 2/3 tongue), parasympathetic (lacrimal glands, mucous glands of nasal cavity, hard and soft palates, sublingual and submandibular glands).
    • > General sensation from external acoustic meatus and deeper parts of auricle.
36
Q

Mastoid air cells

A
  • very tightly packed
  • honeycomb appearance of bone
  • sitting below the middle cranial fossa
  • infections can spread to the cranial cavity by eroding the bone superiorly

Year 2 - LCRS - Anatomy of the Head, Neck and Spine (6 decks)

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