•NASUS EXTERNUS •Radix nasi •Dorsum nasi •Apex nasi •Nares •Alae nasi • •Cartilago nasi lateralis •Cartilago septi nasi •Cartilago alaris major • - crus laterale • - crus mediale •Cartilagines alares minores • •Septum nasi • - pars membranacea • - pars cartilaginea • - pars ossea •SEPTUM NASI •Cartilagines alares majores – crura medialia •Cartilago septi nasi – processus posterior •Lamina perpendicularis ossis ethmoidalis •Vomer •CAVITAS NASI • - vestibulum – limen, vibrisae, recessus apicis nasi • - cavitas nasi propria – meatus nasi sup., medius, inf. • meatus nasi communis, meatus nasopharyngeus, choanae • •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) Maxillary sinus puncture (Antral washout) •SINUS FRONTALIS • •Septum sinuum frontalium •Hiatus semilunaris • •CELLULAE ETHMOIDALES •SINUS SPHENOIDALIS •Septum sinuum sphenoidalium •Apertura sinus sphenoidalis •Meatus nasi inf. – ductus nasolacrimalis •Meatus nasi medius – hiatus semilunaris – sinus maxillaris, • sinus frontalis, cellulae ethmoidales anteriores •Meatus nasi sup. – cellulae ethmoidales posteriores, sinus • sphenoidalis • https://upload.wikimedia.org/wikipedia/commons/thumb/6/6e/Waters%27_view.svg/1920px-Waters%27_view. svg.png Waters' (Occipitomental) view •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 epiglottica •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 - • - • • •CARTILAGO CRICOIDEA • -arcus • -lamina • -facies articularis • arytenoidea • -facies articularis • thyroidea • •CARTILAGO ARYTENOIDEA • - apex • - basis • - facies art. cricoidea • - processus vocalis • - processus • muscularis • - facies anterolateralis • - facies medialis • - facies posterior • •CARTILAGO EPIGLOTTICA -petiolus epiglottidis -lamina - •CARTILAGO CORNICULATA • •CARTILAGO CUNEIFORMIS • •ARTICULATIO CRICOARYTENOIDEA •-lig. cricoarytaenoideum 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 = conus elasticus + •membrana quadrangularis •MUSCULI LARYNGIS • •M. thyroarytenoideus •(thyroepiglotticus) •M. vocalis • •Rima glottidis – pars intermembranacea • – pars intercartilaginea • •M. cricoarytenoideus post. • - respiration • • •M. cricoarytenoideus lateralis •M. arytenoideus transversus •M. arytenoideus obliquus (aryepiglotticus) • •M. cricothyroideus • •M. cricothyroideus •M. cricoarytenoideus • post. • •M. cricoarytenoideus •lateralis •M. arytenoideus trans. et obliq. •M. thyroarytenoideus •N. laryngeus sup. (CN X) •N. laryngeus inf. – N. laryngeus recurrens (CN X) • •CAVITAS LARYNGIS -vestibulum laryngis -plicae vestibulares -rima vestibuli -plicae vocales -rima glottidis •-glottis •-ventriculus laryngis -cavitas infraglottica •CAVITAS LARYNGIS -aditus laryngis-plicae aryepiglotticae (tuberculum cuneiforme • et corniculatum), plica interarytenoidea,incisura inter- • arytenoidea - • •plicae vestibulares •plicae vocales • •LARYNGOSCOPY •indirect •direct •RESPIRATION •PHONATION Vocal Cords up close while singing YouTube video 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 -truncus brachiocephalicus -arcus aortae -v. brachiocephalica sinistra -v. cava sup. -a. carotis communis -v. jugularis int. -n. vagus -oesophagus -n. laryngeus recurrens -nodi lymph. paratracheales CONIOTOMIA (CRICOTHYROTOMIA) TRACHEOTOMIA SUPERIOR TRACHEOTOMIA INFERIOR INFERIOR TRACHEOTOMY -vv. thyroideae inferiores -a. thyroidea ima - v. brachiocephalica sinistra - arcus venosus juguli - pleura - thymus TRACHEOSTOMY BRONCHI - principales - lobares - segmentales - BRONCHIOLI ALVEOLI Arbor bronchialis PULMO DEXTER Lobus superior, medius et inferior Fissura obliqua et horizontalis PULMO SINISTER Lobus superior et inferior Fissura obliqua Incisura cardiaca Lingula Apex pulmonis Basis pulmonis (facies diaphragmatica) Facies costalis Facies mediastinalis Margo anterior inferior posterior FACIES MEDIASTINALIS hillum pulmonis radix pulmonis lig. pulmonale impressio cardiaca 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 PLEURA - visceralis - parietalis - costalis - diaphragmatica - mediastinalis Cavitas pleuralis Cupula pleurae Recessus pleurae: r. costodiaphragmaticus r. costomediastinalis r. phrenicomediastinalis Pneumothorax Area interpleuralis sup. (thymica) Area interpleuralis inf. (pericardiaca) EXPIRATION INSPIRATION 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) THYMUS MEDIASTINUM - superius - inferius - anterius - medium - posterius T8 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