Karteikarten

anatomy

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1humidifies: increase the level of moisture in (air)ethmoidal bulla;
Bulging of inner wall of the ethmoidal labyrinth in middle meatus of nose, just below middle nasal concha. it is regarded as a rudimentary concha.
2recess; a small, empty space or cavity.sphenoethmoidal recess:
the most superior and posterior part of the nasal cavity, above the superior nasal concha,
into which the sphenoidal sinus opens.
3Openings into the Nasal Cavity: are the sinuses of the nose and their meatuses in which they drain.other structures open into the nasal cavity: The nasolacrimal duct
The auditory tube
4Gateways are different from openings : Gateways: an opening that can be closed by a gate, so it can enter and exit.lamina cribrosa= cribriform plate.
5pterygo: جناحيةforamen:
an opening, hole, or passage, especially in a bone.
fossa:
a shallow depression or hollow.
6Vasculature of the nose; from both the internal and external carotid arteries.The nose has a very rich vascular supply –
role: this allows it to effectively change humidity and temperature of inspired air.
7internal carotid arteries include: ethmoidal arteries .... anterior ......posterior which are branches of the opthalmic artery. They descend into the nasal cavity through the cribriform plateExternal carotid branches include;
1/Sphenopalatine artery
2/Greater palatine artery
3/Superior labial artery
4/Lateral nasal arteries
8In addition these arteries form anastomoses with each other. which is particularly prevalent in the anterior portion of the nose .They drain into the pterygoid plexus, facial vein or cavernous sinus.
9potential pathway by which infection can spread from the nose into the cranial cavity is sagittal sinus where In some individuals, a few nasal veins join with it.innervation of the nose:
special and
general innervation.
10Branches of the olfactory nerve run through the cribriform plate to provide special sensory innervation to the nose. **Special sensory innervation refers to the ability of the nose to smell. This is carried out by the olfactory nerves.The olfactory bulb, part of the brain, lies on the superior surface of the cribriform plate, above the nasal cavity.
11General sensory innervation include: 1/nasopalatine nerve (branch of maxillary nerve) 2/ nasociliary nerve (branch of the ophthalmic nerve). both of them innervate septum and lateral walls. 3/trigeminal nerve= Innervation to the external skin of the nose.The olfactory bulb lies on the cribriform plate.
the damaging of this bulb is irreversible by a fracture. In this case, the patient may present with anosmia (loss of smell).
12—The pharynx is a muscular tube.
role: connects the nasal cavities to the larynx and oesophagus.
13—begins at the base of the skull and ends inferiorly to the cricoid cartilage (C6).
comprised of three parts; the nasopharynx, oropharynx and laryngopharynx.
14two types of muscles that form the walls of the pharynx : longitudinal and circular. Both types are innervated by the vagus nerve, except for the stylopharyngeus, which is innervated by the glossopharyngeal nerve.
15sequentially: بالتعاقب.circular muscles include :
pharyngeal constrictor
Superior, Middle, Inferior(divided into superior and inferior).
all innervated by the vagus nerve (CN X).
16—circular muscles contract sequentially constrict the lumen and propel the bolus of food inferiorly into the oesophagus.
17longitudinal muscles shorten and widen the pharynx, and elevate the larynx during swallowing.longitudinal muscles include:
1/Stylopharyngeus, innervated by the glossopharyngeal nerve (CN IX).
2/Palatopharyngeus.
3/Salpingopharyngeus.
18—Innervation of the majority of the pharynx is achieved by the pharyngeal plexus, divided into:
Sensory & Motor.
which comprises of:
1/Branches of the glossopharyngeal nerve (CN IX)
2/Branches of the vagus nerve (CN X)
3/Sympathetic fibres of the superior cervical ganglion.
19sensory nerves of : nasopharynx: by the maxillary nerve (CN V2). The oropharynx by the glossopharyngeal nerve (CN IX). The laryngopharynx by the vagus nerve (CN X).motor nerve that innervate all of the muscles is vagus nerve (CN X), except for the stylopharyngeus, which is innervated by the glossopharyngeal nerve (CN IX).
20—
21—
22—The nasopharynx is found between the base of the skull and the soft palate.
*performs a respiratory function by conditioning inspired air and propagating it to the larynx.
is lined with respiratory epithelium: ciliated pseudostratified columnar epithelium with goblet cells.
The postero-superior nasopharynx contains the adenoid tonsils
23—glue ear:
middle ear inflammation with thick mucoid effusion caused by long-standing eustachian( pharyngotympanic) tube obstruction.
This causes deafness which is often unsuspected as the child does not complain.
24The larynx is suspended from the hyoid bone, and spanning between C3 and C6. It is continuous inferiorly with the trachea, and opens superiorly into the laryngeal part of the pharynx.It is covered anteriorly by the infrahyoid muscles, and laterally by the lobes of the thyroid gland. The larynx is also closely related to the major blood vessels of neck.
25Posterior to the larynx is the oesophagus. This is of clinical relevance during emergency intubation – as pressure can be applied to the cricoid cartilage of the larynx to occlude the oesophagus, and thus prevent regurgitation of gastric contents (known as cricoid pressure or Sellick’s manoeuvre).The structure of the larynx is primarily cartilaginous, and is held together by a series of ligaments and membranes.
larynx= (voice box).
26has several important functions, including phonation, the cough reflex, and protection of the lower respiratory tract.The laryngeal muscles act to move the components of the larynx for phonation and breathing.
27—vestibular folds = (false vocal cords).
Glottis – Contains vocal cords and 1cm below them.
The opening between the vocal cords is known as rima glottidis,
the size of this opining could be altered.
28—
29true vocal cords, are lined by a stratified squamous epithelium. while the whole of structure of larynx is lined by a mucous membrane which contains ciliated columnar epithelium.vasculature of the larynx is via:
the superior
and
inferior laryngeal arteries.
30Superior laryngeal artery: branch of the superior thyroid artery (derived from the external carotid). follows the internal branch of the superior laryngeal nerve into the larynx. Inferior laryngeal artery: a branch of the inferior thyroid artery (derived from the thyrocervical trunk). follows the recurrent laryngeal nerve into the larynx.Venous drainage is by the superior and inferior laryngeal veins.
The superior laryngeal vein drains to the internal jugular vein via the superior thyroid,
whereas the inferior laryngeal vein drains to the left brachiocephalic vein via the inferior thyroid vein.
31The larynx receives both motor and sensory innervation via branches of the vagus nerve: 1/ Recurrent laryngeal nerve. 2/ Superior laryngeal nerve.1/ provides sensory innervation to the infraglottis.
motor innervation to all the internal muscles of larynx (except the cricothyroid).
Superior laryngeal nerve – divided into; 1/the internal branch.
2/ the external branch.
internal ones provide sensory innervation to the supraglottis.
the external branch provides motor innervation to the cricothyroid muscle.
32The vocal cords are responsible for the production of speech. cricothyroid muscle; innervated by the external laryngeal nerve.Iatrogenic:
relating to illness caused by medical examination or treatment.
palsy = paralysis.
33vocal cords movement is controlled by the intrinsic muscles of the larynx. In cases of bilateral palsy, both vocal cords are paralysed in a position between adduction and abduction. Breathing is impaired, and phonation cannot occur.In situations where the nerves are only partially damaged, the vocal folds become paralysed in a fully adducted position.
If this occurs bilaterally, the rima glottidis (space between the vocal cords) is completely closed, and emergency surgical intervention is required to restore the airway.
34RLN palsy= paralysis in Recurrent Laryngeal Nerve. which innervate vocal folds.There are nine cartilages located within the larynx; three unpaired, and three paired.
They form the laryngeal skeleton.
importance of cartilage existance:
provides rigidity and stability.
35pharynx= muscle. larynx= cartilage.three unpaired cartilages are:
1/ the epiglottis,(= cartilage)
2/thyroid cartilage.
3/ cricoid cartilage.
36Thyroid Cartilage: composed of two sheets (laminae), which join together anteriorly to form the laryngeal prominence (Adam’s apple). posterior border of each sheet project superiorly and inferiorly to form the superior and inferior horns (also known as cornu). The superior horns are connected to the hyoid bone via the lateral thyrohyoid ligament, while the inferior horns articulate with the cricoid cartilage.cricoid cartilage:
is a complete ring of hyaline cartilage, consisting of a broad sheet posteriorly and a much narrower arch anteriorly.
The cricoid is the only complete circle of cartilage in the larynx or trachea.
37The cartilage completely encircles the airway, marking the inferior border of the larynx at the level of C6. It articulates with the paired arytenoid cartilages posteriorly, as well as providing an attachment for the inferior horns of the thyroid cartilage.Epiglottis= elastic cartilage.
Cricoid Cartilage= hyaline cartilage.
38During swallowing, the epiglottis flattens and moves posteriorly to close off the larynx and prevent aspiration. The epiglottis is a leaf shaped plate of elastic cartilage which marks the entrance to the larynx. Its ‘stalk’ is attached to the back of the anterior aspect of the thyroid cartilage. stalk:ساق.– Structure of the (a) thyroid cartilage and (b) cricoid cartilage.
39three paired cartilages – the arytenoid, corniculate and cuneiform.The arytenoid cartilages are pyramidal shaped structures that sit on the cricoid cartilage.
They consist of an apex, base, three sides and two processes, (=Vocal,Muscular process).
provides an attachment point for various key structures in the larynx.
40—Vocal process of Arytenoid Cartilages– provides attachment for the vocal ligament.
Muscular process of Arytenoid Cartilages – provides attachment for the posterior and lateral cricoarytenoid muscles.
41Apex of Arytenoid Cartilages – articulates with the corniculate cartilage. Base – articulates with the superior border of the cricoid cartilage.apices: قمم.
The corniculate cartilages are minor cartilaginous structures.
They articulate with the apices of the arytenoid cartilages.
42The cuneiform cartilages are located within the ary-epiglottic folds. They have no direct attachment, but act to strengthen the folds.larynx contains:
numerous ligaments and folds;
the ligaments support the cartilaginous skeleton of the larynx,
whilst the folds are involved in airway protection and phonation.
43—
44—aryepiglottic fold:
a fold of mucous membrane extending on each side between the lateral border of the epiglottis and the summit of the arytenoid cartilage.
fold=plica(طية):
a thin margin curved back on itself, or doubling.
45we have 2 ligaments in larynx: extrinsic & ligaments intrinsicThe extrinsic ligaments are situated on the outer aspect of the larynx,
while the intrinsic ligaments are located internally.
46Extrinsic:include 1/Thyrohyoid membrane, include: Median thyrohyoid ligament – Anteromedial thickening of the membrane. Lateral thyrohyoid ligaments – Posterolateral thickenings of the membrane. 2/Hyo-epiglottic ligament. 3/Cricotracheal ligament. 4/Median cricothyroid ligament.Thyrohyoid membrane – Spans between the superior aspect of the thyroid cartilage and the hyoid bone.
It is pierced laterally by the superior laryngeal vessels and internal laryngeal nerve (branch of the superior laryngeal nerve).
pierced: مثقوب.
47Hyo-epiglottic ligament – Connects the hyoid bone to the anterior aspect of the epiglottis. Cricotracheal ligament – Connects the cricoid cartilage to the trachea. Median cricothyroid ligament – Anteromedial thickening of the cricothyroid ligament , connecting the thyroid and cricoid cartilages.Intrinsic:
Cricothyroid ligament – Originates from the cricoid cartilage and extends superiorly, where it terminates with an free (unattached) upper margin – which forms the vocal ligament.
It is additionally attached anteriorly to the thyroid cartilage, and posteriorly to the arytenoid cartilage.
Quadrangular membrane – Spans between the anterolateral arytenoid cartilage and the lateral aspect of the epiglottis.
(It has a free upper margin and lower margin). The lower margin is thickened to become the vestibular ligament.
48—
49hyo= hyoid. the thyroid cartilage is palpated in the neck. palpated:متلمس. examine (a part of the body) by touch, especially for medical purposes.
50—**cricothyroidotomy:
is an emergency procedure to provide a temporary airway.
It is typically used in situations where there is an obstruction at or above the larynx (e.g foreign body, angioedema or facial trauma),
and intubation has been unsuccessful.
51To perform the technique, below the thyroid cartilage there is a depression representing the cricothyroid ligament. A small incision is made in the midline of this ligament, and an endotracheal tube is inserted to secure the airway.Membranes = Ligaments.
but they're different than folds.
phonation;
the production or utterance of speech sounds.
utterance =a spoken word, statement, or vocal sound.(كلام)
52There are two important soft tissue folds located within the larynx – the vestibular folds and vocal folds. They play an crucial role in protection of the airway, breathing, and phonation.abducted, adducted, relaxed and tensed muscles control the pitch of the sound created.
The vocal folds are relatively avascular, and appear white in colour.
53Histologically, vocal folds are structured as follows (superficial to deep): Non-keratinised stratified squamous epithelium – Stratified layer provides extensive protection against foreign bodies which may accidentally enter the larynx. [Non-keratinised so it can move]. Reinke’s space – This watery, amorphous layer is rich in glycosaminoglycans. Due to its fluidity, the epithelium is able to vibrate freely above it to create sound. Vocal ligament – Lies at the free upper edge of the cricothryoid ligament. Vocalis muscle – Exceptionally fine muscle fibres that lie lateral to the vocal ligaments.vocal folds =(true vocal cords).
vestibular folds= (false vocal cords) .
54vestibular folds: lie superiorly to the true vocal cords. They consist of the vestibular ligament. (free lower edge of the quadrangular membrane) covered by a mucous membrane,they are pink in colour= means they're vascularised. They are fixed folds, which act to provide protection to the larynx.
55The muscles of the larynx can be divided into two groups; the external muscles and the internal muscles.The external muscles act to elevate or depress the larynx during swallowing.
In contrast, the internal muscles act to move the individual components of the larynx,
– playing a vital role in breathing and phonation.
56The extrinsic muscles act to move the larynx superiorly and inferiorly. They are comprised of: the suprahyoid infrahyoid groups, and the stylopharyngeus (a muscle of the pharynx).the suprahyoid muscles and the stylopharyngeus elevate the larynx,
whilst the infrahyoid muscles depress the larynx.
57—The intrinsic laryngeal muscles control the shape of the rima glottidis,
and the length and tension of the vocal folds.
58The cricothyroid is innervated by the external branch of the superior laryngeal nerve – again derived from the vagus nerve.All the intrinsic muscles of the larynx (except the cricothyroid) are innervated by the inferior laryngeal nerve – the terminal branch of the recurrent laryngeal nerve, itself a branch of the vagus nerve.
59The cricothyroid muscle: stretches and tenses the vocal ligaments, and so is important for the creation of forceful speech.intrinsic laryngeal muscles are;
1/ Cricothyroid.
2/Thyroarytenoid.
3/Posterior cricoarytenoid.
4/Lateral cricoarytenoid.
5/Transverse and Oblique Arytenoids.
60The thyroarytenoid muscle acts to relax the vocal ligament, allowing for a softer voice. The posterior cricoarytenoid muscles are the sole abductors of the vocal folds, and thus the only muscle capable of widening the rima glottidis. sole : one and only.The lateral cricoarytenoid muscles:
are the major adductors of the vocal folds. This narrows the rima glottidis, modulating the tone and volume of speech.
The transverse and oblique arytenoids muscles:
adduct the arytenoid cartilages, closing the posterior portion of rima glottidis. This narrows the laryngeal inlet.
Attachments: Spans from one arytenoid cartilage to the opposite arytenoid.
61—
62decibel: a unit used to measure the intensity of a sound or the power level of an electrical signal by comparing it with a given level on a logarithmic scale.