1. 授課教師:阮春榮 醫師 三軍總醫院 放射診斷部
Head & Neck Imaging
授課教師:阮春榮 醫師
三軍總醫院 放射診斷部

2. Contents Nasopharynx Oropharynx Oral cavity
Ear (external, middle, inner ear)
Orbit
Larynx
Salivary glands
Neck space & vessels

3. Nasopharynx & Oropharynx

5. Nasopharynx

6. Nasopharynx
Nasopharynx
Nasopharynx

8. Nasopharynx Keywords:
-- Rosenmüller fossa, Torus tubarius , Eustachian tube orifice
-- Pterygopalatine fossa (PPF)
-- Parapharyngeal space (PPS)
-- Retropharyngeal space (RPS)
-- Prevertebral musculature
-- Foramen lacerum-ICA (perivascular),
-- Foramen ovale-V3 (perineural)

9. Rosenmüller fossa, Torus tubarius , Eustachian tube orifice

10. 940127
940930

11. Pterygopalatine fossa (PPF)

15. Parapharyngeal space (PPS)
Fat
Branches of cranial nerve V3
Ascending pharyngeal artery
Pharyngeal venous plexus

18. Retropharyngeal space (RPS)
Fat
Lateral retropharyngeal nodes (of Rouviere)
Medial retropharyngeal nodes

20. Prevertebral musculature

21. Foramen lacerum-ICA

22. Foramen ovale-CN V3 Foramen lacerum-ICA

23. Oropharynx (OP) & Oral cavity
Keywords:
-- Hard & Soft palate
-- Tongue
-- Palatine tonsil; Lingual tonsil (tongue base)
-- Posterior OP wall

24. 連連看 ? 1 2 3 4

27. Ear Keywords: -- Tympanic membrane,
-- Ossicular chain (Malleus, Incus, Stapes)
-- Facial nerve
-- Cochlea, Semicircular canal
-- External and internal auditory canals

35. Orbit Keywords: -- Extraconal & Intraconal -- Lacrimal glands
-- Muscles
-- Superior & inferior orbital fissures
-- Optic canal

39. Superior & inferior orbital fissures

40. Larynx
Composed of a mucosal surface and a supporting cartilaginous skeleton.
Mucosal surface: epiglottis, true and false cords, aryepiglottic folds, and pyriform sinuses
Skeleton: Hyoid cartilage, thyroid cartilage, cricoid cartilage, and arytenoid cartilage
Between mucosa and skeleton: paraglottic and preepiglottic spaces (loose areolar tissues, lymphatics, muscular structures)

41. Skeleton Hyoid Bone - attachment to epiglottis and strap muscles.
Thyroid Cartilage - anterior attachment of vocal folds. Posterior articulation with cricoid cartilage.
Cricoid Cartilage - complete ring. Articulates with thyroid and arytenoid cartilages.
Arytenoids - two cartilages which glide along the posterior cricoid and attach to posterior ends of vocal folds.

42. Skeleton
Hyoid Bone
Thyroid Cartilage
Cricoid Cartilage
Arytenoids

43. Larynx

47. Larynx Divisions -- Supraglottis -- Glottis -- Subglottis
-- Paraglottic (Parapharyngeal) space
-- Preepiglottic space

48. Supraglottis
Usually covered with respiratory epithelium containing mucous glands.
Epiglottis - leaf-shaped mucosal-covered cartilage, which projects over larynx.
Aryepiglottic folds (AE folds) - extend from the lateral epiglottis to the arytenoids.
False vocal cords - mucosal folds superior to the true glottis. Separated from true vocal folds by the ventricle.
Ventricle - mucosal-lined sac, variable in size which separates the supraglottis from the glottis.

49. Supraglottis Suprahyoid epiglottis (both lingual and laryngeal aspect)
Infrahyoid epiglottis
False vocal cords (ventricular bands)
Aryepiglottic folds (laryngeal aspects)
Arytenoid cartilages
Ventricles

52. Glottis
The true vocal folds attach to the thyroid cartilage at the anterior commissure. The posterior commissure is mobile, as the vocal folds attach to the arytenoids. Motion of the arytenoids effects abduction or adduction of the larynx. The bulk of the vocal fold is made up of muscle covered by mucosa. The free edge is characterized by stratified squamous epithelium. The vocal folds abduct for inspiration and adduct for phonation, cough, and valsalva.

53. 吸一口氣後出聲

54. Glottis
True vocal cords, including anterior and posterior commissures

57. Subglottis
Area from under surface of the true vocal cords to inferior surface of the cricoid cartilage

58. Salivary glands Parotid glands Submandibular glands Sublingual glands
Minor: tongue, cheeks, lips, palate

59. Parotid glands The largest of the salivary glands
The duct to this gland (also known as Stensen’s duct) empties within the buccal cavity (the inside of the cheek).
The facial nerve (CNVII) runs through this gland

61. Submandibular glands
The Submandibular Gland secretes saliva into ducts called 'Warton's Ducts'. These ducts open on either side of the lingual frenulum.

63. Sublingual glands
Lie anterior to the submandibular glands under the tongue, beneath the mucous membrane of the floor of the mouth. They are drained by 8-20 excretory ducts. The largest duct, the sublingual duct (of Bartholin) joins the submandibular duct to drain through the sublingual caruncle.

65. Neck space & vessels

66. Carotid spaces
Contents: Internal carotid artery Internal jugular vein CN IX, X, XI, XII: nasopharyngeal CS CN X only: oropharyngeal & hypopharyngeal CS Sympathetic plexus Lymph nodes

68. Thanks for your attention