, , (102),

The Nasal Region & Larynx

, ( ( ) ( ) ), 4

Upper Respiratory Tract

Lower Respiratory Tract


1. 2/3 (respiratory epithelium) vestibule 1/3 (olfactory

without goblet cell

epithelium) pseudostratified ciliated columnar

pseudostratified ciliated columnar with goblet cell stratified squamous epithelium 2. 3.

4.

5. 6. duct

nasolacrimal

paranasal sinus

Conducting Portion ( 4

1. Conduct 2. Warming 3. Humidifying 4. Cleansing

frontal

nasal mucosa sphenoid

frontal sinus sphenoidal sinus ethmoidal sinus maxillary sinus

ethmoid maxillary

vestibule acrimal duct) numatic

(inferior meatus) 1 cm. (nasol

External Nose :

Nasal bone 2

) (nostrils) anterior

nares Nasal bone 2 Cartilage 5 1. lateral nasal cartilage( 2. alar cartilage ( 3. septal cartilage 1 ) 2

) 2

1. lateral nasal branch facial artery**

2. nasal branch infraorbital artery 3. external nasal branch anterior ethmoidal artery *** Anterior ethmoidal a. Ophthalmic a.

1. infraorbital nerve 2. infratrochear nerve**

3. external nasal branches anterior ethmoidal nerve ***** nerve artery infraorbital nerve/artery 2

external nasal branch anterior ethmoidal nerve/artery

Buccal branch of facial nerve

1. Procerus

Frontalis m. 2 1. Pars

2. Nasalis m. Procerus transversalis 2. Pars alaris

3. Depressor septi nasi m.

Procerus

v.

: facial v.

retromandibular

Lymph nodes : facial node

submandibular node

Nasal Cavity ( )
Nostrils nasopharynx Anterior nares Choanae

Posterior nares

Stratified Vestibule 4

Squamous Epithelium

Vestibule 1. Roof

1/3 1/3

1/3 Sphenoid 2. Floor ( Palate) Hard Palate 2 maxilla ) (Soft Ethmoid

(Hard Palate)

 3/4 Hard Palate( ) (palatine process of the maxilla)

 1/4

Horizontal

process of Palatine bone 3. Medial Wall ( )

 Septal cartilage  Vomer Perpendicular plate of ethmoid 

4. Lateral wall ( ) 3 Conchae

(Turbinate)    Inferior Concha Meatus

Superior Concha Middle Concha

Conchae

 Superior concha  Middle concha  Inferior concha

Superior meatus Middle meatus Inferior meatus Pituitary Gland

Superior Concha

Sphenoethmoidal recess

Perpendicular plate of Ethmoid, Vomer, Septal cartilage

- Frontal bone Frontal spine - Sphenoid bone Sphenoidal crest - Palatine bone Palatine crest - Maxilla Maxillary crest ***Ethmoid bone crest

Paranasal Sinus Duct

Nasolacrimal

1. Sphenoethmoidal recess sphenoidal sinus 2. Inferior meatus nasolacrimal duct 3. Superior meatus superior meatus 1 cm.

posterior ethmoidal air cells 4. Middle meatus middle concha

middle meatus middle ethmoidal air cells ethmoidal ethmoidal bulla(bulla ethmoidalis)

bulla middle ethmoidal air cells ethmoidal bulla uncinate process ethmoid uncinate process ethmoidal bulla

hiatus semilunaris

ethmoidal bulla

 maxillary sinus anterior ethmoidal air cells

frontonasal duct frontal sinus middle meatus

1. Infraorbital nerve 2. External nasal branch of anterior ethmoidal nerve 3. Infratrochlear nerve 1/3 nasal septum lateral wall epithelium olfactory 1/3

1. Anterior ethmoidal nerve 2 1.1Lateral internal nasal branch of anterior ethmoidal nerve nerve lateral internal . 1.2Medial internal nasal branch of anterior ethmoidal nerve 1 2. Pterygopalatine ganglion (internal) lateral

2.1Nasopalatine nerve

medial wall

2.2Superior posterior lateral nasal branch of pterygopalatine ganglion ( )

2.3Inferior posterior lateral nasal branch of greater palatine nerve ( ) block

2.4Greater palatine nerve 2.5Lesser palatine nerve

block nerve

superior alveolar nerve

Artery

1. Sphenopalatine artery maxillary artery sphenopalatine a. ganglion wall ( 2 medial nasopalatine nerve) pterygopalatine

1.1 Posterior septal branches 1.2 Posterior lateral nasal anterior ethmoidal arteries

posterior

ethmoidal arteries ophthalmic artery

Vein
sinus Cavernous sinus cavernous

Lymnode
node JD

submandibular node

node (jugulodigastric node)

The Paranasal sinuses

Sinus :

Frontal sinus

hiatus semilunaris

middle meatus

Maxillary sinus ethmoidal bulla hiatus semilunaris

Sphenoidal sinus sphenoethmoidal recess Ethmoidal sinus 3 3 cells 18 cells

Anterior ethmoidal air cells hiatus semilunaris Middle ethmoidal air cells ethmoidal bulla Posterior ethmoidal air cells superior meatus Sinus 4

maxillary sinus sphenoidal sinus 6-7

frontal sinus ethmoidal sinus

Paranasal

maxillary

 paranasal sinus

4 5 6

1. thyroid cartilage - lamina

notch

superior thyroid notch

superior horn superior horn thyroid greater horn hyoid - hyoid bone membrane thyroid cartilage

Lateral thyrohyoid ligament

membrane

thyrohyoid membrane internal laryngeal N.

superior laryngeal N.

-inferior horn thyroid cartilage cricoid cartilage hinge joint - joint) cricothyroid joint

cricoidthyroid (cricothyroid

ligament cricothyroid ligament 1

2. cricoid cartilage -

- cricoid cartilage articulation

cricoarytenoid

cricoid cartilage joint

3. epiglottis - ligament -

thyroid thyroepiglottic

thyrohyoid ligament

4. arythenoid cartilage 2 - larynx - vocal cord) - 3

muscular process

vocal process

( true

corniculate 2 2

5. corniculate cartilage 6. cuneiform cartilage -

(false vocal cord)

Cricothyroid muscle external laryngeal N.

Posterior arytenoid m.

Conus elasticus elastic membrane medial

vocal ligament(true vocal fold)

Vestibular ligament (false vacal fold) cartilage quadrangular membrane corniculate

false vocal cord true vocal cord false true vocal cord ventricle

rima glottidis

true vocal cord

1.intrinsic muscle

2.extrinsic muscle

Intrinsic muscle
1. Posterior cricoarytenoid muscle : abduct vocal cord

2. lateral cricoarytenoid muscle : adduct vocal cord cricoid muscular process arytenoid 3. transverse arytenoid muscle : adduct vocal cord

4. oblique arytenoid muscle : adductor vocal cord

5. thyroarytenoid muscle :

thyroid

muscular process arytenoid 6. vocalis muscle :

vocalis m.

vocal ligament

7. cricothyroid muscle : 8. aryepiglotticus muscle : 9. thyroepiglotticus muscle :

epiglottis thyroid epiglottis thyrohyoid

lateral thyrohyoid ligament cricothyroid joint

membrane lamina thyroid cricothyroid muscle (lateral dissection)

thyroepigltticus m., lateralcricoarytenoid m., thyroarytenoid m.

Anterior view superior view

intrinsic muscle larynx

2 recurrent laryngeal n.(inferior

vagus n.

superior laryngeal n. laryngeal n.) Superior laryngeal n.

-internal laryngeal n.

thyrohyoid membrane

-external laryngeal n. m.

cricothyroid

Recurrent laryngeal n. intrinsic cricothyroid m.

2 superior laryngeal a. (

superior thyroid a.) inferior laryngeal a.( inferior thyroid a.)

Vein

superior laryngeal v. inferior laryngeal v. ( middle thyroid vein

superior thyroid v. inferior thyroid v.)

Lymph node
trachea pretracheal node( infrahyoid node ( ) cervical node )

inferior deep