LEARNING TASK

Vignette 1: Kesawa, 32 years old, was seen in the clinic ten days ago, was diagnosed with rhinitis and
sent home with instructions for increased fluids, decongestants, and rest. Kesawa presents today with
worsened symptoms of malaise, low-grade temperature, nasal discharge, night time coughing, mouth
breathing, and early morning pain over sinuses, and congestion. The doctor diagnose he is suffering
sinusitis.

1. Describe the boundaries of the nasal cavity and its blood supply!

- The boundaries of the nasal cavities have a roof, floor, and medial and lateral walls.
• The roof of the nasal cavities is curved and narrow, except at its posterior end, where the
hollow body of the sphenoid forms the roof. It is divided into three parts (frontonasal, ethmoidal,
and sphenoidal) named from the bones forming each part
• The floor of the nasal cavities is wider than the roof and is formed by the palatine processes of
the maxilla and the horizontal plates of the palatine bone.
• The medial wall of the nasal cavities is formed by the nasal septum.
• The lateral walls of the nasal cavities are irregular owing to three bony plates, the nasal
conchae, which project inferiorly, somewhat like louvers
- The blood supply  the arterial supply of the medial and lateral walls of the nasal cavity is
from five sources:
1. Anterior ethmoidal artery (from the ophthalmic artery).
2. Posterior ethmoidal artery (from the ophthalmic artery).
3. Sphenopalatine artery (from the maxillary artery).
4. Greater palatine artery (from the maxillary artery).
5. Septal branch of the superior labial artery (from the facial artery).
2. Describe the paranasal sinuses and its opening at nasal cavity!

The paranasal sinuses are air-filled extensions of the respiratory part of the nasal cavity into the
following cranial bones: frontal, ethmoid, sphenoid, and maxilla. They are named according to
the bones in which they are located. The sinuses continue to invade the surrounding bone, and
marked extensions are common in the crania of older individuals.
 maxillary sinus: middle meatus
 sphenoidal sinus: sphenoidethmoidal recess
  frontal sinus: middle meatus
 ethmoidal sinus:
 anterior and middle ethmoidal cell: middle meatus
 posterior ethmoidal cell: superior meatus
 nasolacrimal duct: inferior meatus

Vignette 2: Gotawa, a singer-18 years old came to clinic with complain a hoarse voice for 3 days. She
also suffers sore throat, nose block, and fever. She was diagnosed laryngitis

1. Describe the structure of larynx and location of vocal cord!

 EXTEND FROM C3-C6 // Location : anterion leher
 CONTINUOUS WITH THE TRACHEA POSTERIORLY
 EXTEND FROM C3-C6
 CARTILAGES (HYALINE) OF THE LARYNX
 SHIELD-SHAPED ANTEROSUPERIOR THYROID CARTILAGE WITH A MIDLINE LARYNGEAL
PROMINENCE (ADAM’S APPLE)
 SIGNET RING–SHAPED ANTEROINFERIOR CRICOID CARTILAGE
 THREE PAIRS OF SMALL ARYTENOID, CUNEIFORM, AND CORNICULATE CARTILAGES
 EPIGLOTTIS – ELASTIC CARTILAGE THAT COVERS THE LARYNGEAL INLET DURING SWALLOWING
2. Describe the intrinsic and extrinsic muscle of larynx!
- EXTRINSIC LARYNGEAL MUSCLES:
a. INFRAHYOID M: DEPRESSORS OF THE HYOID AND LARYNX
b. SUPRAHYOID AND STYLOPHARYNGEUS M: ELEVATORS OF THE HYOID AND LARYNX
- INTRINSIC LARYNGEAL MUSCLES (INFERIOR LARYNGEAL N): khusus pita suara
c. CRICOTHYROID --- EXTERNAL LARYNGEAL N (CN X)
d. THYROARYTENOID
e. POSTERIOR CRICOARYTENOID
f. LATERAL CRICOARYTENOID
g. TRANSVERSE AND OBLIQUE ARYTENOID
h. VOCALIS
Vignette 3: Mande, 30 years old male came to clinic with chief complaint difficulty to breath start from
this morning. He also suffers cough, runny nose and fever. He has history bronchial asthma when he was
2 years old. The doctor diagnose he is suffering bronchial asthma.

1. Describe the structure of trachea!

- flexible and mobile tube extending from the larynx into the mediastinum
- its about 10-11 cm long.
- extend from c6-cv th5 (sternal angle)
- three layers
- organ berbentuk tabung, sifatnya fleksibel dan mobile
- lokasinya setelah laring
2. Describe the different between right and left main bronchus!
Right  lebih lebar, pendek, vertical drpd kiri, dan langsung menjadi radiks pulmonaris, 3 sub
divisi ( seperti conduksi Cuma bawa aja)
Left (kebalikan) dia horizontal, 2 sub divisi.
 3. Describe the principal different between trachea, bronchi, and bronchioles!

Vignette 4: A 57-year-old male is admitted to the hospital with a chief complaint of shortness of breath
for 2 weeks. The radiology examination shows a large left-side pleural effusion.

1. Describe the different between right lung and left lung!

2. Describe the structure of pleura! 

3. Describe the structure of thoracic wall!