Introduction to the Respiratory Tract
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Questions and Answers

What is the shape of the external nose?

  • Cuboidal
  • Pyramidal (correct)
  • Spherical
  • Triangular

    • At what age do the frontal and sphenoidal sinuses typically develop?

  • Age 6-7 years (correct)
  • Age 10-12 years
  • At birth
  • Age 3-4 years

    • Which structure forms the floor of the nasal cavity?

  • Frontal bone
  • Maxilla and palatine bone (correct)
  • Ethmoid bone
  • Lateral nasal cartilage

    • What separates the two halves of the nasal cavity?

    <p>Median nasal septum</p> Signup and view all the answers

    What function does the paranasal air sinus NOT perform?

    <p>Aid in digestion</p> Signup and view all the answers

    Which artery supplies blood to the external nose?

    <p>Dorsal nasal branch</p> Signup and view all the answers

    Which of the following sinuses develops during puberty?

    <p>Ethmoid sinus</p> Signup and view all the answers

    Which nerve provides sensory innervation to the external nasal area?

    <p>Infraorbital nerve</p> Signup and view all the answers

    What condition is characterized by inflammation or swelling of the sinus lining?

    <p>Sinusitis</p> Signup and view all the answers

    What is the approximate height of each half of the nasal cavity?

    <p>5 cm</p> Signup and view all the answers

    What can cause the sinuses to become blocked and filled with fluid?

    <p>Common cold</p> Signup and view all the answers

    What is the structure of the roof of the nasal cavity predominantly formed by?

    <p>Cribriform plate of the ethmoid</p> Signup and view all the answers

    Which aspect describes the vestibule of the nasal cavity?

    <p>Lined by skin with hairs and sebaceous glands</p> Signup and view all the answers

    Which anatomical structure opens into the inferior meatus?

    <p>Nasal lacrimal duct</p> Signup and view all the answers

    What structure is associated with the bony bulging known as bulla ethmoidalis?

    <p>Middle ethmoidal air sinuses / Middle meatus</p> Signup and view all the answers

    Which sinus opens into the posterior part of the hiatal semilunaris?

    <p>Maxillary sinus</p> Signup and view all the answers

    Which artery is NOT part of the arterial supply to the lateral wall of the nose?

    <p>Cerebral artery</p> Signup and view all the answers

    What type of nerve provides special sensory supply to the nasal cavity?

    <p>Olfactory nerve</p> Signup and view all the answers

    Where does the sphenoidal sinus open in relation to the nasal cavity structures?

    <p>Sphenoethmoidal recess</p> Signup and view all the answers

    Which of the following indicates a common reason for septal deviation?

    <p>Injury to the nasal region</p> Signup and view all the answers

    Which ganglion is associated with the posterior superior lateral nasal nerve?

    <p>Pterygopalatine ganglion</p> Signup and view all the answers

    What could be a consequence of infection spreading from the nasal region?

    <p>Loss of smell</p> Signup and view all the answers

    Which structure is part of the lateral wall of the nasal cavity but does NOT open into the nasal meatus?

    <p>Sphenoidal sinus</p> Signup and view all the answers

    What is the significance of Kiesselbach's plexus in the nasal cavity?

    <p>It is a major site for nosebleeds (epistaxis).</p> Signup and view all the answers

    Which area of the nose is most commonly associated with nasal fractures?

    <p>The bridge of the nose</p> Signup and view all the answers

    What is the pharynx primarily classified as?

    <p>An elongated muscular tube</p> Signup and view all the answers

    The oropharynx lies in front of which vertebrae?

    <p>C2 and C3</p> Signup and view all the answers

    Which structure is part of the nasopharynx?

    <p>Pharyngeal tonsil (adenoids)</p> Signup and view all the answers

    What anatomical feature is found in the laryngopharynx?

    <p>Inlet of the larynx</p> Signup and view all the answers

    Which term describes the common area where four arteries connect in the nasal septum?

    <p>Kiesselbach's triangle</p> Signup and view all the answers

    What condition is characterized by hypertrophy of the mucosa over the inferior nasal concha?

    <p>Allergic rhinitis</p> Signup and view all the answers

    What connects the nasopharynx to the oropharynx?

    <p>Pharyngeal isthmus</p> Signup and view all the answers

    Which area primarily serves as the entrance to the esophagus?

    <p>Laryngopharynx</p> Signup and view all the answers

    Which fascia coats the outside of the muscle wall of the pharynx?

    <p>Buccopharyngeal fascia</p> Signup and view all the answers

    What nerve supplies the stylopharyngeus muscle?

    <p>Glossopharyngeal nerve</p> Signup and view all the answers

    Where does Killian's dehiscence occur in the pharynx?

    <p>Between the thyropharyngeal and cricopharyngeus muscles</p> Signup and view all the answers

    Which of the following arteries is NOT associated with the blood supply to the pharynx?

    <p>Humeral artery</p> Signup and view all the answers

    The paranasal sinuses are lined with which type of epithelium?

    <p>Pseudostratified ciliated columnar epithelium</p> Signup and view all the answers

    What is the main function of the constrictors of the pharynx?

    <p>To constrict the pharynx during swallowing</p> Signup and view all the answers

    Which lymph nodes do lymph vessels draining the pharynx typically enter?

    <p>Cervical lymph nodes</p> Signup and view all the answers

    The communication between the paranasal sinuses and the nasal cavity occurs through what?

    <p>Small apertures</p> Signup and view all the answers

    Which muscle is NOT considered a longitudinal muscle of the pharynx?

    <p>Inferior constrictor</p> Signup and view all the answers

    Which of the following pairs of muscles form the constrictors of the pharynx?

    <p>Superior, middle, and inferior constrictor</p> Signup and view all the answers

    What is the primary nerve supplying the palatopharyngeus muscle?

    <p>Cranial part of accessory nerve</p> Signup and view all the answers

    Which artery is primarily responsible for draining the blood from the pharynx?

    <p>Ascending pharyngeal artery</p> Signup and view all the answers

    Killian's dehiscence is a triangular area in the wall of the pharynx located between which structures?

    <p>Thyropharyngeal and cricopharyngeus muscles</p> Signup and view all the answers

    What type of epithelium lines the paranasal sinuses?

    <p>Pseudostratified ciliated columnar epithelium</p> Signup and view all the answers

    Which structure primarily forms the roof of the nasal cavity?

    <p>Cribriform plate of ethmoid</p> Signup and view all the answers

    What is the approximate width of the nasal cavity near the floor?

    <p>1.5 cm</p> Signup and view all the answers

    Which of the following arteries supplies the nasal cavity?

    <p>Dorsal nasal branch</p> Signup and view all the answers

    What is the primary composition of the lateral wall of each half of the nasal cavity?

    <p>Maxilla</p> Signup and view all the answers

    Which nerve is primarily responsible for sensory innervation of the external nasal area?

    <p>Infraorbital nerve</p> Signup and view all the answers

    In which region does the nasal cavity extend from the nostrils to the choanae?

    <p>Vestibule</p> Signup and view all the answers

    What is the length of the nasal cavity?

    <p>7 cm</p> Signup and view all the answers

    Which portion of the nasal cavity is lined by skin with hairs and sebaceous glands?

    <p>Vestibule</p> Signup and view all the answers

    What components primarily form the bony part of the nasal septum?

    <p>Perpendicular plate of the ethmoid and vomer</p> Signup and view all the answers

    Which of the following correctly identifies the arterial supply to the nasal septum?

    <p>Facial artery and sphenopalatine artery</p> Signup and view all the answers

    What is the primary function of the olfactory nerves in relation to the nasal septum?

    <p>Supplying special sensory input</p> Signup and view all the answers

    What type of tissue is found in the cuticular formation of the nasal septum?

    <p>Fibro-fatty tissue and skin</p> Signup and view all the answers

    Which nerve supplies the mucous membrane of the anterior part of the nasal septum?

    <p>Ant. Ethmoidal nerve</p> Signup and view all the answers

    What component of the nasal cavity is associated with the presence of vibrissae?

    <p>Vestibule</p> Signup and view all the answers

    Which part of the nasal cavity contains the conchae?

    <p>Posterior part</p> Signup and view all the answers

    What is the role of Kiesselbach's plexus in the nasal cavity?

    <p>Blood supply regulation</p> Signup and view all the answers

    What type of nerve is predominantly involved in providing sensory innervation to the nasal septum?

    <p>Maxillary nerve</p> Signup and view all the answers

    Which anatomical feature separates the conchae in the lateral wall of the nasal cavity?

    <p>Meatuses</p> Signup and view all the answers

    What is the significance of Kiesselbach's plexus in relation to epistaxis?

    <p>It is a region where multiple arteries anastomose, leading to frequent nosebleeds.</p> Signup and view all the answers

    Which anatomical structures are classified as parts of the pharynx?

    <p>Nasopharynx, Oropharynx, and Laryngopharynx</p> Signup and view all the answers

    What is a common consequence of a nasal fracture?

    <p>Potential spread of infection to the cranial cavity</p> Signup and view all the answers

    What feature is associated with the oropharynx?

    <p>Palatine tonsil</p> Signup and view all the answers

    Which structure lies in front of the C3-C6 vertebrae?

    <p>Laryngopharynx</p> Signup and view all the answers

    What typically indicates hypertrophy of the mucosa over the inferior nasal concha?

    <p>Allergic rhinitis</p> Signup and view all the answers

    What is the function of the pharyngeal isthmus?

    <p>Connects the nasopharynx and oropharynx</p> Signup and view all the answers

    Which arteries form the vascular plexus in Kiesselbach's area?

    <p>Maxillary, facial, and ophthalmic arteries</p> Signup and view all the answers

    Which structure opens into the middle meatus?

    <p>Maxillary sinus</p> Signup and view all the answers

    What connects the auditory tube to the pharynx?

    <p>Tubal elevation</p> Signup and view all the answers

    What is the approximate length of the pharynx?

    <p>12–14 cm</p> Signup and view all the answers

    What is the function of the ethmoidal infundibulum?

    <p>Connecting the anterior and middle ethmoidal cells</p> Signup and view all the answers

    Which nerve is responsible for the special sensory supply to the olfactory region?

    <p>Olfactory nerve</p> Signup and view all the answers

    What is the primary consequence of septal deviation in the nasal cavity?

    <p>Decreased airflow through the nasal passages</p> Signup and view all the answers

    Which artery is NOT part of the arterial supply to the lateral wall of the nose?

    <p>Anterior cerebral artery</p> Signup and view all the answers

    Where do the posterior ethmoidal cells drain?

    <p>Superior meatus</p> Signup and view all the answers

    Which area of the nasal cavity is associated with the opening of the nasolacrimal duct?

    <p>Inferior meatus</p> Signup and view all the answers

    What structure can be found between the superior concha and the roof of the nasal cavity?

    <p>Sphenoethmoidal recess</p> Signup and view all the answers

    Which condition can arise due to infection in the nasal region?

    <p>Cerebral abscess</p> Signup and view all the answers

    Which structure is involved in supplying blood to the nasal cavity?

    <p>Sphenopalatine artery</p> Signup and view all the answers

    Study Notes

    Introduction and Functions of the Respiratory Tract

    • The respiratory tract functions to bring oxygen into the body and remove carbon dioxide.
    • It can be divided into upper and lower respiratory tracts.

    Anatomy of the Respiratory Tract

    • The respiratory tract consists of the nose, pharynx, larynx, trachea, and lungs.

    Nose

    • The nose consists of an external and internal part.
    • External Nose is pyramidal in shape.
      • It includes the tip, root, dorsum, and nostrils.
      • The two nostrils are called nares.
        • They are pear-shaped openings.
        • The nasal septum divides the nostrils.
        • Ala of the nose is the lateral aspect.
    • Nasal Cavity: The cavity is divided in half by the nasal septum.
      • The nasal cavity extends from the nostrils to the choanae openings.
      • Vestibule: is closest to the nostrils and is lined with hair and sebaceous glands.
      • Nasal Cavity Proper: Lined with respiratory epithelium.
        • The respiratory epithelium contains cilia.
        • The cilia help to move mucus toward the nasopharynx.

    Nasal Cavity – Divisions & Structure

    • The nasal cavity is divided into two halves, and each half is further divided into four sections:
      • Roof
        • 7 cm long and 2 mm wide.
        • Formed by the ethmoid (cribriform plate), frontal bone, nasal bones, nasal cartilages, and sphenoid bone.
      • Floor
        • 5 cm long and 1.5 cm wide.
        • Formed by the palatine process of maxilla and horizontal plate of the palatine bone.
      • Medial Wall - Formed by the nasal septum.
      • Lateral Wall
        • Contains three nasal conchae (superior, middle, inferior).
          • The conchae create turbulence in the air flow, which helps to warm, moisten, and filter the air.
          • They also increase the surface area of the nasal cavity, which improves the sense of smell.
        • Each concha forms a corresponding nasal meatus:
          • Inferior Meatus: Formed by the inferior concha and the floor of the nasal cavity. The nasolacrimal duct opens here.
          • Middle Meatus: Formed by the middle concha. The frontal sinus, maxillary sinus, and anterior/middle ethmoid sinuses drain here.
          • Superior Meatus: Formed by the superior concha. The posterior ethmoid sinuses drain here.
          • Supreme Meatus: Between the superior concha and the roof. The sphenoidal sinus drains here.
          • Sphenoethmoidal Recess: A depression above the superior concha. It is the opening to the sphenoidal sinuses.

    Nasal Cavity - Dimensions

    • Nasal cavity dimensions are:
      • Height: 5 cm
      • Length: 5-7 cm
      • Width: 1.5 cm near the floor and 1-2 mm near the roof.

    Nasal Cavity - Blood Supply and Innervation

    • Arteries:
      • Dorsal nasal branch (ophthalmic)
      • Infraorbital (maxillary)
      • Alar and Septal (facial)
    • Nerves:
      • Sensory:
        • External nasal, Alar, Septal (all branches of the facial nerve)
        • Infratrochlear (ophthalmic)
        • Infraorbital (maxillary)
      • Motor:
        • Facial nerve branches

    Lateral Wall of the Nose

    • Blood Supply:
      • Anterior Ethmoidal
      • Posterior Ethmoidal
      • Sphenopalatine
      • Facial
      • Greater Palatine
    • Nerve Supply:
      • Sensory:
        • Anterior ethmoidal (ophthalmic)
        • Anterior superior alveolar (maxillary)
        • Posterior superior lateral nasal (pterygopalatine ganglion)
        • Anterior palatine (pterygopalatine ganglion)
      • Special Sensory:
        • Olfactory Nerve (responsible for smell)

    Applied Anatomy of the Nose

    • Septal Deviation:
      • A deviated septum is a common condition. It causes congestion and obstruction.
      • Treatment is done by submucosal resection of the nasal septum.
    • Epistaxis (Nosebleeds):
      • A common condition, especially in Kiesselbach's area (aka Little's area). Kiesselbach's area is an area of anastomosis between the four main nasal arteries and is located in the anteroinferior part of the nasal septum.
    • Dangerous Area:
      • Infection in this area can spread to the cranial cavity along the olfactory nerves.
    • Nasal Fracture:
      • A break in the bone or cartilage of the nose. Most often occurs over the bridge of the nose or the nasal septum.
    • Nasal Polyps:
      • Benign, soft, non-cancerous growths in the nasal cavity.
    • Allergic Rhinitis:
      • Inflammation and swelling of the nasal mucosa, especially in the inferior nasal concha. Can block the nasal passages.

    Pharynx

    • The pharynx is a musculomembranous tube that extends from the cranial base to the lower border of the cricoid cartilage.
    • It is located behind and communicates with the nasal, oral, and laryngeal cavities.
    • The pharynx is divided into three regions:
      • Nasopharynx: Connects the nasal cavity to the pharynx.
      • Oropharynx: Connects the oral cavity to the pharynx.
      • Laryngopharynx: Connects the larynx to the pharynx.

    Nasopharynx

    • Structures:
      • Auditory tube opening: Connects the middle ear to the nasopharynx.
      • Tubal elevation: A projection that surrounds the auditory tube opening.
      • Salpingopharyngeal and salpingopalatine folds: Folds of tissue extending from the tube to the pharyngeal wall and palate.
      • Tubal tonsils: Lymphoid tissue located near the auditory tube opening.
      • Pharyngeal tonsils (adenoids): Lymphoid tissue located at the posterior wall of the nasopharynx.

    Oropharynx

    • Structures:
      • Palatopharyngeal folds (arches): Folds extending from the soft palate to the pharynx.
      • Palatine tonsils: Lymphoid tissue in the oropharynx.
      • Tonsillar fossa: A shallow recess between the palatine tonsils.

    Laryngopharynx

    • Structures:
      • The inlet of the larynx.
      • The posterior wall.

    Pharynx - Wall

    • Muscle Wall:
      • Formed by skeletal muscles and fascia.
      • Buccopharyngeal fascia: Lines the outside of the muscle wall.
      • Pharyngobasilar fascia: Lines the inside of the muscle wall.

    Muscles of the Pharynx

    • Constrictors
      • Superior, Middle, and Inferior Constrictors: All originate behind the nasal, oral, and laryngeal cavities.
        • They meet on the midline raphe.
    • Longitudinal Muscles
      • Stylopharyngeus:
      • Palatopharyngeus:
      • Salpingopharyngeus:

    Nerve Supply of Pharynx

    • All constrictors and salpingopharyngeus muscles are supplied by the pharyngeal branch of the vagus nerve.
    • Stylopharyngeus is supplied by the glossopharyngeal.
    • Palatopharyngeus is supplied by the cranial part of the accessory nerve.

    Blood Vessels and Lymphatic System of Pharynx

    • Arteries:
      • Ascending pharyngeal
      • Lingual
      • Facial
      • Maxillary
    • Veins:
      • Venous plexus surrounds the pharynx and drains into the internal jugular and facial veins.
    • Lymphatics:
      • Drain into the deep cervical lymph nodes.

    Nerve Supply of Pharynx

    • Pharyngeal plexus is formed by three nerves
      • Glossopharyngeal
      • Vagus
      • Cranial Accessory

    Killian’s Dehiscence

    • A triangular area in the pharyngeal wall that is a potential weak spot for the development of Zenker's diverticulum.
    • It is found between the thyropharyngeal and cricopharyngeus muscles.

    Paranasal Air Sinuses

    • Air-filled spaces in the bones surrounding the nasal cavity.
    • They are named after the bones in which they are located.
    • The four groups of sinuses:
      • Maxillary: are aerated at birth
      • Ethmoid: develop during puberty
      • Frontal: 6-7 years
      • Sphenoid: 6-7 years
    • The paranasal sinuses are lined with pseudostratified ciliated columnar epithelium and communicate with the nasal cavity through relatively small apertures.

    Functions of the Paranasal Air Sinuses

    • They decrease the weight of the skull.
    • They warm, moisten, and filter incoming air.
    • They serve as resonating chambers for the voice.
    • They act as shock absorbers in trauma.
    • They may help control the immune system.
    • They may change vocal quality when blocked or filled with fluid.

    Applied Anatomy of the Paranasal Air Sinuses

    • Sinusitis: Inflammation or swelling of the sinus tissue.
      • Healthy sinuses are filled with air, but when they become blocked they can become infected.
      • Common cold, allergic rhinitis, nasal polyps, and deviated nasal septum can also cause sinusitis.

    Introduction

    • The respiratory tract is a vital system responsible for gas exchange.
    • It is divided into upper and lower sections.
    • The upper respiratory tract comprises the nose, pharynx, larynx, and trachea.

    Nose

    • The external nose has a pyramidal shape with distinct parts, including: apex, root, dorsum, and nostrils.
    • The nasal cavity is divided into two halves by the nasal septum, a structure composed of bone and cartilage.
    • The vestibule, located near the nostrils, is lined by skin and contains hairs called vibrissae.
    • The nasal cavity itself is lined by mucous membrane for filtration and humidity control.
    • The nasal septum is formed by the perpendicular plate of the ethmoid bone, vomer, septal cartilage, and inferior nasal cartilage.

    Nasal Cavity Structure

    • The roof of the nasal cavity is 7cm long and 2mm wide, sloping downwards both in front and behind.
    • The roof is formed by the cribriform plate of the ethmoid bone, the nasal part of the frontal bone, nasal bones, nasal cartilages and the inferior surface of the body of the sphenoid bone.
    • The floor is 5cm long and 1.5cm wide, formed by the palatine process of the maxilla and the horizontal plate of the palatine bone.
    • The lateral wall of the nasal cavity is composed of the concha and meatuses.

    Concha and Meatuses

    • The inferior, middle, and superior concha are three bony structures that project into the nasal cavity.
    • They divide the nasal cavity into spaces called meatuses, each associated with specific openings or spaces.
    • Each meatus has both an inner and outer wall. The inner wall is formed by the concha themselves (and is comprised of the bone). The outer wall is made from the specific bones that each meatus sits within.

    Lateral Wall of the Nose

    • The lateral wall of the nose is subdivided into the vestibule, atrium of the middle meatus, and the concha.
    • The spaces between the concha are called meatuses, which are important for airflow and drainage.

    Blood Supply and Innervation

    • The nose is supplied by branches of the ophthalmic, maxillary, and facial arteries.
    • Innervation is provided by branches of the ophthalmic and maxillary nerves, with sensory and motor components.

    Pharynx

    • The pharynx is a 12-14 cm long musculomembranous tube extending from the cranial base to the level of the sixth cervical vertebra.
    • It is divided into nasopharynx, oropharynx, and laryngopharynx.
    • The pharynx lies behind and communicates with the nasal, oral and laryngeal cavities.
    • The oropharyngeal isthmus connects the oral cavity and pharynx.

    Muscles of the Pharynx

    • Three constrictors (superior, middle, inferior) along with three longitudinal muscles (stylopharyngeus, palatopharyngeus, salpingopharyngeus) comprise the muscles of the pharynx.
    • The constrictors originate posterior to the nasal, oral, and laryngeal cavities, meeting at midline raphe.
    • The longitudinal muscles play a role in swallowing and speech.

    Nerve Supply

    • The pharynx is innervated by the pharyngeal plexus, formed by branches of the glossopharyngeal, vagus, and cranial accessory nerves.
    • The pharyngeal branch of the vagus nerve supplies the constrictors and salpingopharyngeus, while the glossopharyngeal nerve supplies the stylopharyngeus, and the cranial part of the accessory nerve supplies the palatopharyngeus.

    Paranasal Sinuses

    • These are air-filled cavities found in the bones surrounding the nasal cavity.
    • The four main groups are: maxillary sinuses (Antrum of Highmore), ethmoid sinuses, frontal sinus, and sphenoid sinus.
    • They are lined with mucoperiosteum and filled with air, communicating with the nasal cavity through small apertures.
    • The sinuses are lined by pseudostratified ciliated columnar epithelium.

    Killian's Dehiscence

    • This is a triangular area in the wall of the pharynx between the thyropharyngeal and cricopharyngeus muscles.
    • It represents a potentially weak spot where a pharyngoesophageal diverticulum (Zenker's diverticulum) may occur.

    Applied Anatomy

    • Septal deviation of the nasal septum can cause congestion and obstruction, often requiring corrective surgery.
    • Epistaxis, bleeding from the nose, can be a concern, especially in Kiesselbach's plexus, a common site of bleeding in the anteroinferior part of the nasal septum.
    • Fractures of the nasal bones, often referred to as a broken nose, are common injuries.
    • Nasal polyps are benign growths in the nasal cavity.
    • Allergic rhinitis can lead to hypertrophy of the mucosa over the inferior nasal concha.
    • Infections can spread from the nasal cavity to the middle cranial fossa through the cribriform plate, or to the lacrimal apparatus via the nasolacrimal duct.

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