•NASUS EXTERNUS • •Radix nasi •Dorsum nasi •Apex nasi •Nares •Alae nasi • •Cartilago nasi lateralis •Cartilago alaris major • - crus laterale • - crus mediale •Cartilagines alares minores •Cartilagines nasales accessoriae • •SEPTUM NASI • •Cartilago alaris major – crus mediale •Cartilago septi nasi •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 • •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 •SINUS PARANASALES • •Sinus maxillaris •Sinus frontalis •Sinus ethmoidales •Sinus sphenoidalis •SINUS MAXILLARIS •(Antrum of Highmore) Maxillary sinus puncture (Antral washout) •SINUS FRONTALIS • •septum sinuum frontalium • Hiatus semilunaris •SINUS ETHMOIDALES •(CELLULAE ETHMOIDALES) •SINUS SPHENOIDALIS •septum sinuum sphenoidalium •apertura sinus sphenoidalis Hiatus semilunaris •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 • Waters' (Occipitomental) view •PHARYNX •LARYNX •ADULT •NEONATE •Prominentia laryngis •CARTILAGINES LARYNGIS: • •Cartilago thyroidea •Cartilago cricoidea •Cartilago epiglotica • •Cartilago arytenoidea •Cartilago corniculata •Cartilago cuneiformis •LARYNX • •Membrana thyrohyoidea • •Cartilago thyroidea -lamina dextra -lamina sinistra -incisura thyroidea sup. -incisura thyroidea inf. -cornua superiora -cornua inferiora -facies art. cricoidea -linea obliqua • - • • - linea obliqua •CARTILAGO CRICOIDEA • -arcus • -lamina • -facies articularis • arytenoidea • -facies articularis • thyroidea • •CARTILAGO ARYTENOIDEA • - apex • - basis • - facies art. cricoidea • - processus vocalis • - processus muscularis • - facies medialis • - facies posterior • - facies anterolateralis •CARTILAGO EPIGLOTTICA -petiolus epiglottidis -lamina - •CARTILAGO CORNICULATA • •CARTILAGO CUNEIFORMIS •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 • •ARTICULATIO CRICOARYTENOIDEA • •ARTICULATIO CRICOTHYROIDEA • • •MUSCULI LARYNGIS • • •Rima glottidis – pars intermembranacea • – pars intercartilaginea • • •M. thyroarytenoideus - m. vocalis •(m. thyroepiglotticus) • •M. cricothyroideus •M. cricoarytenoideus post. • (posticus) - respiration • • •M. cricoarytenoideus lateralis •M. arytenoideus transversus et obliquus •– phonation •(m. aryepiglotticus) M. thyroepiglotticus M. aryepiglotticus • •M. cricothyroideus •M. cricoarytenoideus • post. • •M. cricoarytenoideus •lateralis •M. arytenoideus • - transversus • - obliquus •M. thyroarytenoideus •N. laryngeus sup. •N. laryngeus inf. – N. laryngeus recurrens • •CAVITAS LARYNGIS • -vestibulum laryngis -plicae vestibulares -rima vestibuli •-ventriculus laryngis -sacculus laryngis -plicae vocales -rima glottidis (glottis) •-cavum infraglotticum •CAVITAS LARYNGIS -aditus laryngis-plicae aryepiglotticae (tuberculum cuneiforme • et corniculatum), plica interarytenoidea, (incisura inter- • arytenoidea) - • • •LARYNGOSCOPY •indirect •direct •RESPIRATION •PHONATION Vocal Cords up close while singing http://www.youtube.com/watch?v=-XGds2GAvGQ TRACHEA -pars cervicalis -pars thoracica -bifurcatio tracheae - carina tracheae -15-20 cartilagines tracheales -ligg. anularia -paries membranaceus (m. trachealis) - glandulae tracheales 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 TRACHEOSTOMIA http://www.jmedicalcasereports.com/content/download/figures/1752-1947-5-381-1.jpeg http://www.medskills.eu/dropbox/enlarge/36.jpg GLANDULA THYROIDEA – lobus dexter - lobus sinister - isthmus - lobus pyramidalis - thyroid hormone - calcitonin 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 MEDIALIS 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 Area interpleuralis sup. (thymica) Area interpleuralis inf. (pericardiaca) Recessus pleurae: r. costodiaphragmaticus r. costomediastinalis r. phrenicomediastinalis Pneumothorax MEDIASTINUM - superius - inferius - anterius - medium - posterius 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 Membrana intercostalis externa 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 EXPIRATION INSPIRATION 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