RESPIRATORY SYSTEM I. UPPER RESPIRATORY TRACT, LARYNX NASUS EXTERNUS Radix nasi Dorsum nasi Apex nasi Nares Alae nasi SEPTUM NASI Cartilago alaris major – crus mediale Cartilago septi nasi – processus posterior Lamina perpendicularis ossis ethmoidalis Vomer Cartilago nasi lateralis Cartilago alaris major - crus laterale - crus mediale Cartilagines alares minores Cartilagines nasales accessoriae CAVITAS NASI - vestibulum – limen, vibrisae, recessus apicis nasi - cavitas nasi propria – meatus nasi sup., medius, inf. meatus nasi communis, meatus nasopharyngeus, choanae Septum nasi - pars membranacea - pars cartilaginea - pars ossea Superior wall: cartilago nasi lateralis, os nasale, pars nasalis ossis frontalis, lamina cribrosa ossis ethmoidalis, corpus ossis sphenoidalis Inferior wall: processus palatinus maxillae, lamina horizontalis ossis palatini canalis incisivus NASAL MUCOSA Regio respiratoria plexus cavernosi - epistaxis Regio olfactoria A. sphenopalatina, a. palatina major (a. maxillaris) A. ethmoidalis ant., post. (a. ophthalmica) R. septalis a. labialis sup. (a. facialis) V. sphenopalatina, facialis, vv. ophthalmicae Nll. submandibulares, retropharyngei, parotidei Kiesselbach area N. trigeminus (CN V) - n. ethmoidalis ant. (V1) - rr. nasales posteriores med. et lat. (n. nasopalatinus) (V2) Nn. olfactorii SINUS PARANASALES Sinus maxillaris Sinus frontalis Sinus ethmoidales Sinus sphenoidalis SINUS MAXILLARIS – hiatus sinus maxillaris (Antrum of Highmore) infundibulum ethmoidale hiatus semilunaris Aa. et vv. facialis, palatina major, infraorbitalis Nll. submandibulares Nn. alveolares sup. (V2) SINUS FRONTALIS septum sinuum frontalium A. et v. ophthalmica V1 Nll. submandibulares SINUS ETHMOIDALES (CELLULAE ETHMOIDALES) SINUS SPHENOIDALIS septum sinuum sphenoidalium apertura sinus sphenoidalis A. et v. ethmoidalis ant. et post. A. et v. sphenopalatina V1, V2 Nll. submandibulares, retropharyngei Meatus nasi inf. – ductus nasolacrimalis Meatus nasi medius – hiatus semilunaris – sinus maxillaris, sinus frontalis, cellulae ethmoidales anteriores et mediae Meatus nasi sup. – cellulae ethmoidales posteriores, sinus sphenoidalis PHARYNX NASOPHARYNX Ostium pharyngeum tubae auditivae: Torus tubarius Plica salpingopharyngea Torus levatorius Plica salpingopalatina Cartilago tubae auditivae M. salpingopharyngeus M. levator veli palatini LARYNX ADULT NEONATE Prominentia laryngis CARTILAGINES LARYNGIS: Cartilago thyroidea Cartilago cricoidea Cartilago arytenoidea Cartilago epiglotica Cartilago corniculata Cartilago cuneiformis LARYNX Membrana thyrohyoidea (thyroidea) Cartilago thyroidea -lamina dextra -lamina sinistra -incisura thyroidea sup. -incisura thyroidea inf. -cornua superiora -ligg. thyroidea lateralia -cornua inferiora -facies art. cricoidea -linea obliqua -foramen thyroideum - - CARTILAGO CRICOIDEA -arcus -lamina -facies articularis arytenoidea -facies articularis thyroidea CARTILAGO ARYTENOIDEA - apex - basis - facies art. cricoidea - processus vocalis - processus muscularis - facies anterolateralis - colliculus - crista arcuata - fossa triangularis - fovea oblonga - facies medialis - facies posterior CARTILAGO EPIGLOTTICA -petiolus epiglottidis -lamina - CARTILAGO CORNICULATA CARTILAGO CUNEIFORMIS ARTICULATIO CRICOARYTENOIDEA -lig. cricoarytenoideum post. ARTICULATIO CRICOTHYROIDEA MEMBRANA THYROIDEA lig. thyroideum laterale lig. thyroideum medianum CONUS ELASTICUS -lig. cricothyroideum- coniotomy -lig. vocale – plica vocalis Lig. cricotracheale Lig thyroepiglotticum Lig. hyoepiglotticum Spatium praeepiglotticum MEMBRANA QUADRANGULARIS -lig. ventriculare – plica vestibularis - MEMBRANA FIBROELASTICA LARYNGIS M. thyroepiglotticus M. aryepiglotticus M. cricoarytenoideus post. (posticus) - respiration M. cricoarytenoideus lateralis - phonation M. arytenoideus – phonation M. cricothyroideus M. thyroarytenoideus M. vocalis M. cricothyroideus M. cricoarytenoideus post. M. cricoarytenoideus lateralis M. arytenoideus M. thyroarytenoideus N. laryngeus sup. N. laryngeus inf. – N. laryngeus recurrens A.laryngea sup. - A. thyroidea sup. A. laryngea inf. – A. thyroidea inf. CAVITAS LARYNGIS -vestibulum laryngis -plicae vestibulares -rima vestibuli -plicae vocales -rima glottidis -glottis -ventriculus laryngis -sacculus laryngis -cavitas infraglottica CAVITAS LARYNGIS -aditus laryngis-plicae aryepiglotticae (tuberculum cuneiforme et corniculatum), plica interarytenoidea,incisura inter- arytenoidea - plicae vestibulares plicae vocales Rima glottidis pars inter- membranacea pars inter- cartilaginea LARYNGOSCOPY indirect direct RESPIRATION PHONATION RESPIRATORY SYSTEM II. LOWER RESPIRATORY TRACT, LUNGS TRACHEA -pars cervicalis -pars thoracica -bifurcatio tracheae - carina tracheae -15-20 cartilagines tracheales -ligg. anularia -paries membranaceus (m. trachealis) - glandulae tracheales M. sternohyoideus M. sternothyroideus Lamina pretrachealis fasciae colli TOPOGRAPHY OF THE TRACHEA -isthmus glandulae thyroideae -vv. thyroideae inferiores -a. carotis communis -v. jugularis int. -n. vagus -oesophagus -n. laryngeus recurrens -truncus brachiocephalicus -v. cava sup. -v. brachiocephalica sinistra -arcus aortae CONIOTOMIA (CRICOTHYROTOMIA) TRACHEOTOMIA SUPERIOR TRACHEOTOMIA INFERIOR INFERIOR TRACHOTOMY -vv. thyroideae inferiores -a. thyroidea ima - v. brachiocephalica sinistra - arcus venosus juguli - pleura - thymus TRACHEOSTOMY Aa. tracheales (aorta, a. thyr.inf.) V. brachiocephalica sin. Nll. tracheales, tracheobronchiales Truncus sympathicus, parasymp. – CN X GLANDULA THYROIDEA – lobus dexter - lobus sinister - isthmus - lobus pyramidalis Capsula propria, folliculi, colloid – thyroid hormone, calcitonin Fascia externa s. perithyroidea A. et v. thyroidea sup. et inf., a. thyroidea ima, nll. cervicales prof., nll. paratracheales GLANDULAE PARATHYROIDEAE –sup. et inf. Parathormone (parathyroid hormone; PTH) BRONCHI -principales -lobares -segmentales Arbor bronchialis PULMO DEXTER lobus superior medius inferior fissura obliqua fissura horizontalis PULMO SINISTER lobus superior inferior fissura obliqua incisura cardiaca lingula pulmonis sinistri apex pulmonis basis pulmonis (facies diaphragmatica) facies costalis margo anterior inferior posterior FACIES MEDIASTINALIS hillum pulmonis radix pulmonis lig. pulmonale sulcus a. subclaviae sulcus costae primae sulcus oesophageus impressio cardiaca sulcus v. cavae sup. sulcus v. azygos sulcus aorticus SEGMENTA BRONCHOPULMONALIA DEXTRA 1.s. apicale 4. s. laterale 6. s. apicale 2.s. posterius 5. s. mediale 7. s. basale mediale 3.s. anterius 8. s. basale anterius 9. s. basale laterale 10. s. basale posterius SEGMENTA BRONCHOPULMONALIA SINISTRA 1+2. s. apicoposterius 6. s. apicale 3. s. anterius (7. s. basale mediale) 4. s. lingulare superius 8. s. basale anterius 5. s. lingulare inferius 9. s. basale laterale 10. s. basale posterius Bronchioli terminales Bronchioli respiratorii Ductuli alveolares Sacculi alveolares Alveoli pulmonis Asthma bronchiale Truncus pulmonalis  a. pulmonalis dx. et sin. Vv. pulmonales  atrium sinistrum Aorta thoracica  aa. bronchiales Vv. bronchiales  v. azygos, v. hemiazygos accessoria > PLEURA - visceralis - parietalis - costalis - diaphragmatica - mediastinalis Cavitas pleuralis Cupula pleurae – lig. scaleno-,vertebro-, costopleurale Recessus pleurae: r. costodiaphragmaticus r. costomediastinalis r. phrenicomediastinalis Pneumothorax Area interpleuralis sup. (thymica) Area interpleuralis inf. (pericardiaca) EXPIRATION INSPIRATION THYMUS MEDIASTINUM - superius - inferius - anterius - medium - posterius T8 MUSCULI THORACIS EXTRINSIC MUSCLES M. pectoralis major M.pectoralis minor M. subclavius M. serratus ant. M. sternalis INTRINSIC MUSCLES M. intercostales externi M. intercostales interni M. intercostales intimi M. subcostales M. transversus thoracis DIAPHRAGM Centrum tendineum - foramen VCI Pars sternalis Pars costalis Pars lumbalis - crus dextrum - crus sinistrum - lig. arcuatum medianum - lig. arcuatum mediale - lig. arcuatum lat. Hiatus esophageus Hiatus aorticus Illustrations and photographs were copied from: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München: Urban & Schwarzenberg, 1993 Netter: Interactive Atlas of Human Anatomy. Windows Version 2.0