EAR-NOSE-THROAT

ENT (THT)

A REVIEW
HAMIADJI
 LECTURE OUTLINE
• The nasal cavity (cavum nasi) and
paranasal sinuses (sinus paranasalis)
• The oral cavity (cavum oris) and the
fauces (isthmus faucium)
• The tympanic cavity (cavum tympany)
• The pharynx
• The Larynx
 Humidifying & Warming
FUNCTIONS OF THE NOSE;
Humidifying, Warming, Filtering and Olfaction

Olfaction
Filtering

EXTERNAL NOSE
CAVUM NASI

EXTERNAL NOSE
SEPTUM NASI
1. anterior
ethmoidal
(ophthalmic)
2. posterior
ethmoidal
(opththalmic)
3. sphenopalatine
(maxillary)
4. greater palatine
(maxillary)
5. branch of
superior labial
(facial)

1. anterior
ethmoidal
(V1)
(nasociliary)
2. nasopalatine
(V2)
(maxillary)
 PARANASAL SINUSES
Frontal sinus Maxillary sinus

Ethmoid sinus Sphenoid sinus

sphenoid sinus-->sphenoethmoid recess

frontal sinus-->infundibulum of middle
meatus
The Cavernous anterior ethmoid sinus-->middle meatus
Mucosa of middle ethmoid sinus-->ethmoid bulla of
nasal cavity middle meatus
maxillary sinus-->middle meatus
 THE NASAL CAVITY

1. sphenoid sinus--
>sphenoethmoid recess
2. frontal sinus-->infundibulum of
middle meatus
3. anterior ethmoid sinus--
>middle meatus
4. middle ethmoid sinus--
>ethmoid bulla of middle
meatus
5. maxillary sinus-->middle
meatus THE OSTEO-MEATAL COMPLEX
Development
of the
Sinuses from
Birth to Old
age.
 THE ORAL CAVITY

Oral Cavity: Proper & Vestibule (outside the dental

row)
Roof: Palate ( hard and soft)
Wall: Cheeks + Buccal fat (parotid gland orifice oposit
upper 2nd molar)
Floor: Tongue (mylohyoid, geniohyoid, anterior digastric)
Fauces: Root of tongue, uvula, palatopharyngeal,
palatoglossal arches (palatine tonsil)

Our lips are represented

very large in the Sensory
as well as Motor cortex of
the brain
THE ORAL CAVITY
Adult dentition: 32 (2 incisors,
canine or cuspid, 2 premolars, 3
molars – times 4)

Deciduous-milk teeth: 20 (2
incisors, canine, 2 molars – times 4)

Deciduous teeth be
replaced by secondary
(adult) dentation untill 17
to 23 year of age.

Functions of Oral Cavity:

Analysis of material before swallowing
the bolus
Mechanical processing by teeth
Lubrication by saliva
Digestion of carbohydrate (limited)
THE ORAL CAVITY

STUDY THE ORAL

CAVITY IN MORE
DETAIL
 SALIVARY GLANDS
Parotid – NIX – Otic
ganglion

Sublingual – NVII –
Submandibular – NVII –
Submandibular
Submandibular ganglion
ganglion
 PHARYNX

Pharynx: a common
Nasopharynx
passageway for food
(bolus), liquid, and air!

Oropharynx

1. Pharyngeal constrictors –
movement of bolus
2. Palatopharyngeus and
Stylopharyngeus – elevation
Laryngopharynx
of larynx (closure)
3. Palatal muscles raise the
soft palate >< nasal cavity
PHARYNX

Nasopharynx –
internal nares, Internal nares
adenoid,
pharyngotympanic
tube
Oropharynx – uvula,
paryngeal arches,
palatine tonsil, root of
tongue
Laryngopharynx –
narrow, from hyoid
bone to oesophagus,
resists abrasion Fauces
(stratified squamous
epithelium covering)
THE EXTERNAL EAR

The External Acoustic Meatus

(External Auditory Meatus)
extends from the bottom of the
concha to the tympanic membrane
TYMPANIC MEMBRANE

Outer view – Cone of light

Inner view – Chorda tympany,

Tensor tympany
 The middle The tympanic
ear or cavity consists of
tympanic two parts: the
cavity is an tympanic
irregular, cavity proper,
laterally opposite the
compressed tympanic
space within membrane, and
the temporal the attic or
bone. It is epitympanic
filled with air, recess, above
which is the level of the
conveyed to it membrane.
from the nasal
part of the
pharynx
through the
auditory tube.
 OVAL
WINDOW
MEDIAL WALL

ROUND
WINDOW

The promontory (promontorium) is a rounded hollow prominence,

formed by the projection outward of the first turn of the cochlea; it
is placed between the fenestræ, and is furrowed on its surface by
small grooves, for the lodgement of branches of the tympanic
plexus.
 CONTENTS OF MIDDLE EAR

• Three ear ossicles; Malleus, Incus, Stapes

• Two muscles; Tensor tympany(NV),

Stapedius(NVII)

• Chorda tympany; SVA and GVE (N VII)

• Nerve plexus; Pharyngeal nerve, Lesser petrosal

nerve
 The Cochlea
COCHLEA

COCHLEA-SHAPED LIKE A SNAIL SHELL. AROUND A

CENTRAL PILLAR MODIOLUS-
A HOLLOW BONY TUBE MAKES 2 & 3/4 TURN-
EACH SUCCESSIVE TURN IS OF DECREASING RADIUS-A
CONICAL STRUCTURE WITH APEX ANTERO-LATERAL &
BASE POSTERO-MEDIAL.
 COCHLEA DIVIDED INTO 3 PARTS----
SCALA VESTIBULI SCALA TYMPANI SCALA MEDIA
SCALA VESTIBULI & TYMPANI ARE FILLED WITH PERILYMPH,
VESTIBULAR MEMBRANE SEPARATES SCALA VESTIBULI FROM
COCHLEAR DUCT & BASILAR MEMBRANE SEPARATES SCALA TYMPANI
FROM COCHLEAR DUCT.
•Organ of Corti – cochlear
nerve
•Cochlear nuclei
•Superior olivary nuclei
•Input from both ears –
localisation (detect 400
microsecond difference
•Lateral lemniscus – inferior
colliculus
•Medial geniculate nuclei,
relay binaural, tone and
intensity
•Auditory cortex (Br 41. 42),
bilateral map – sound
awareness!!
THE LARYNX 12

The skeleton of the

larynx is made up of
the hyoid bone and
several cartilages.
THE LARYNX 13
Three singles: Epiglottis, Thyroid, Cricoid

Three pairs: Arythenoids, Corniculates,

Cuneiforms, and “Triticeas”
 THE LARYNX 14
(INTRINSIC MUSCLES)

Posterior
cricoarytenoid
(abducting the
Connective
vocal cord)
tissue
membranes:
Thyrohyoid
membrane,
Quadrangular
membrane, Cricothyroid
Cricothyroid (tensing the
membrane (or vocal cord)
Conus
elasticus)
 THE LARYNX 15
(ACTION OF INTRINSIC MUSCLES)

Cricothyroid
Lateral
cricoarythenoid
Posterior
cricoarythenoid

Transvers
arythenoid

Vocalis

Most of the muscles adduct the vocal cord

EXAMINATION OF GLOTTIS 16

Motor innervations
external laryngeal (X)
recurrent laryngeal (X)
Sensory innervations
internal laryngeal (X)
sensory above the
false vocal cords
recurrent laryngeal (X)
sensory below the
false vocal cords

The glottis is bordered by Ventricular fold

and Vocal fold
EXAMINATION OF GLOTTIS 17