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Pharynx, Larynx & Lung Anatomy A whistle-stop tour By filip & James.

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Presentation on theme: "Pharynx, Larynx & Lung Anatomy A whistle-stop tour By filip & James."— Presentation transcript:

1 Pharynx, Larynx & Lung Anatomy A whistle-stop tour By filip & James

2 Pharynx Nasopharynx Oropharynx Laryngopharynx Middle Ear Muscular region connecting the nasal and oral cavities with larynx and oesophagus

3 Pharynx is formed by 3x pharyngeal constrictors Reduce size of pharynx Squeeze food down pharynx (peristalsis) Pharyngeal Constrictors Superior constrictor Middle constrictor Inferior constrictor Paralysis causes lack of gag reflex, uncoordinated swallowing and increased risk of aspiration

4 Constrictors stack inside each other forming a structurally-sound functional unit Pharyngeal pouch/diverticulum can fill with food causing halitosis or coughing-up of food Pharyngeal Constrictors Midline Raphe (Similar to a long tendon) ‘Weak Spot’ Pharyngeal pouch / diverticulum SC MC IC

5 Pharynx – Internal Muscles Longitudinal (internal) muscles elevate (shorten) & widen pharynx Salpingopharyngeus Stylopharyngeus (CN IX) Tensor veli palatini (CN Vc) Levator veli palatini All pharyngeal muscles Motor innervated by CNX except stylopharyngeaus & tensor veli palatini SC MC IC Palatopharyngeus

6 Pharynx– innervation Motor: CNX (Vagus) Superior laryngeal nerve Damage = Monotonous voice Recurrent (inferior) laryngeal nerve Damage = hoarse/weakened voice Sensory: CN IX

7 Palatoglossal & paltopharyngeal arches Palatine tonsil Lymphoid Tissue - Tonsils Tunstall & Shah 2012 Pocket Tutor: Surface Anatomy

8 Tonsillar (lymphoid) tissue sits in the entrances to the pharynx Pharyngeal (Adenoid) Tubal Palatine Lingual Collectively known as Waldeyer ring of lymphoid tissue

9 Larynx What is the function of the larynx? (4) ◦Prevents entrance of fluid and particles ◦Allows regulation of intrathoracic & intra-abdominal pressure (Valsava manoeuvre) ◦Enables phonation (production of sound) ◦Speech articulation is controlled by the pharynx, tongue & lips

10 Hyoid bone Thyrohyoid membrane Thyroid cartilage Laryngeal prominence Cricoid cartilage Arytenoid cartilage Epiglottis (elastic cartilage) Cricothyroid membrane (emergency airway) Larynx – Bone & Cartilages

11 Cricovocal membrane Thickened free edge = vocal ligament Arytenoid cartilages Articulate with cricoid cartilage via synovial joint that permit pivoting movements Larynx – Arytenoids & Vocal Folds Arytenoids as viewed from above in transverse section Posterior Vocal Process Muscular Process Anterior Joint position

12 Superior Laryngeal Nerve Cricothyroid Pivots thyroid cartilage forward and down on the cricoid & tenses the vocal folds Superior laryngeal nerve (External laryngeal nerve) (Internal laryngeal n.) Anterior Posterior

13 Posterior cricoarytenoid muscleLateral cricoarytenoid muscle Posterior cricoarytenoid muscle (abducts vocal ligaments) Lateral cricoarytenoid muscle (adducts vocal ligaments) Ant. Post. Ant. Post. Recurrent Layrngeal Nerve

14 Thyroarytenoid & vocalis Pull arytenoid cartilage anteriorly & thyroid cartilage posteriorly and superiorly Relaxes vocal fold (or parts of it) and lowers pitch of voice Ant. Post. Recurrent Layrngeal Nerve

15 Vocal Folds Vestibular folds (false vocal folds) Epiglottis Aryepiglotic fold Rima glottidis (gap between vocal folds) Posterior Anterior

16 What makes up the TBT? Trachea Bronchi Bronchioles Terminal bronchioles Alveolar ducts Alveolar sacs Alveoli

17 LUNGS What do structures entering the lung pass through? ◦Hilum What two layers form the pleura of the lungs? ◦Visceral ◦Parietal What holds the pleura together? ◦Surface tension

18 Superior Lobe Inferior Lobe Middle Lobe Superior Lobe Inferior Lobe RIGHTLEFT Oblique fissure Horizontal fissure Oblique fissure Lingula Right lung has 3 lobes and the left has 2 lobes Disease/collapse/atelectasis can affect lobes independently

19 Tunstall & Shah 2012 Pocket Tutor: Surface Anatomy Lung Surface Markings 2cc 6cc 6rib MCL 8 rib MAL Apex sits ~2cm above medial 1/3 of clavicle Horizontal fissure: 4 th cc horizontally back to oblique fissure Oblique Fissure: T3 Spinous Process to 6 th cc anteriorly Lung is soft and compliant so will fill many empty spaces in the thorax Note the tracheal bifurcation at sternal plane or just below T4/T5 Costodiaphragma tic recess The region between the lung and pleura reflection

20 Tunstall & Shah 2012 Pocket Tutor: Surface Anatomy Lung Surface Markings 10 rib PVL - lung Oblique Fissure: T3 Spinous Process to 6 th cc anteriorly Penetrating damage to lung tissue can cause pneumothorax Upper lobe Lower lobe Auscultate lower lobe of lung posteriorly 12 rib PVL - pleura

21 Tunstall & Shah 2012 Pocket Tutor: Surface Anatomy Lung Surface Markings Horizontal fissure: 4 th cc horizontally back to oblique fissure Oblique Fissure: T3 Spinous Process to 6 th cc anteriorly Upper lobe Middle lobe Lower lobe Auscultate middle lobe of lung laterally Mid-axillary line

22 Lymphatic drainage Lymphatic drainage from the lungs follows the tracheobronchial tree Hilar/bronchopulmonary nodes Tracheobronchial nodes Paratracheal nodes Bronchomediastinal duct Thoracic duct/left subclavian vein Left upper lobe Right lymphatic duct /subclavian vein All lymph except left upper lobe


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