Systemic Anatomy for Respiratory Technology PDF

Systemic anatomy for respiratory Technology Of the Respiratory Therapy Program by Marwa Abdel- Samad Al-Gholam MD Anatomy and Embryology Assistant professor of Anatomy and...

Systemic anatomy for respiratory Technology Of the Respiratory Therapy Program by Marwa Abdel- Samad Al-Gholam MD Anatomy and Embryology Assistant professor of Anatomy and Embryology Menoufia University  Objectives (Ilos) By the end of this lecture, the student should be able to: ❑Describe divisions of the respiratory airway ❑Describe the anatomy of the nose. ❑List arterial supply, venous drainage, nerve supply, and lymphatics of the nose ❑Define the site of the Little's area and enumerate arteries sharing in its formation and describe its clinical importance.  Mediastinum Thoracic wall  Upper respiratory Nose and tract paranasal sinuses Pharynx Larynx above vocal cords Trachea Larynx below vocal cords Bronchi Lung Lower respiratory tract Let's start Anatomy of the nose Anatomy of the Nose ❑ The nose is divided into the external nose and the nasal cavity. ❑ It is located between the two orbits and below the middle part of anterior cranial fossa. Bony part External Nose Cartilaginous part  External Nasal process of frontal bone Nose Nasal bone Frontal process of maxilla ❑ The framework of the external nose is made up above by the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bone. ❑ Below, the framework is formed of plates of hyaline cartilage.  Nasal cavity Anterior nasal The nasal cavity extends from the nostrils (anterior nasal apertures) in front to opening the posterior nasal apertures or choanae behind, where the nose opens into the  Nasal cavity It is divided into right and left halves by a Nasal septum midline nasal septum. Walls of nasal cavity - Each half of the cavity has four walls, 1- Floor 2-Roof 3- Lateral wall 4-Medial wall. The vertical medial wall (septal wall) is common for the two halves.  1- Roof Body of sphenoid ❑ The anterior sloping part is formed by the nasal bones and nasal part of frontal bone. ❑ The middle horizontal part is formed by cribriform plate of ethmoid. ❑ The posterior sloping part is formed by lower surface of body of the sphenoid. Cribriform Cranial plate of cavity ethmoid bone CSF Rhinorrhea ❑ It is important to note that the middle part of the roof separates the nasal cavity from the anterior cranial fossa. Therefore, in fracture of the cribriform plate of ethmoid, the cerebrospinal fluid (CSF) may leak in to the nasal cavity resulting in CSF rhinorrhea (dribbling of clear fluid from the nose on bending or straining). Notice ❑ The roof provides a route for CSF rhinorrhea spread of infection from the nasal cavity into the cranial cavity  2- Floor Horizontal plate of palatine bone Palatine process of maxilla  3- Medial wall Nasal septum Cartilaginous part Bony part The nasal septum is partly bony and partly cartilaginous and is formed by 3 structures: ▪ Perpendicular plate of ethmoid: above ▪ Vomer: below and behind.  Nasal septum (Medial wall of the nose) 3- Medial wall Nasal septum 3- Medial wall Nasal septum Remember  Deviated Nasal Septum It is a common cause of nasal obstruction. ✓ The septum is deviated due to trauma or error in development or unequal growth in the base of skull and palate. ✓ The deviation can be corrected surgically. 4- Lateral wall What ???? Superior concha Middle concha Inferior concha Meatus ❑The lateral wall of the nasal cavity is highly irregular. ❑ It has three shelf – like projections of bone called the superior, middle, and inferior nasal conchae. ❑The space below each concha is called a meatus 4- Lateral wall There are three conchae. i. The superior concha is the smallest and is located in the posterior part of nasal cavity. It is a projection from the ethmoid bone. ii. The middle concha is projection from ethmoid bone. iii. The inferior concha is an independent bone.  Spheno-ethmoidal Superior meatus recess  Sphenopalatine Greater palatine External carotid Arteries that originate from branches of the external carotid artery include the sphenopalatine, greater palatine, superior labial, and lateral nasal arteries.  Anterior ethmoidal Posterior ethmoidal Internal carotid Arteries that originate from branches of the internal carotid artery are the anterior and posterior ethmoidal arteries. Little’s Area and Kiesselbach’s Plexus This is particularly evident in the anterior region of the medial wall  Is the Anterior inferior part of nasal septum Little’s Area and Kiesselbach’s Plexus Def.: Vessels that supply the nasal cavities form extensive anastomoses with each other. Site: This is particularly evident in the anterior region of the medial wall (Little’s area) Arteries sharing: there are anastomoses between branches of the greater palatine, sphenopalatine, superior labial, and anterior ethmoidal arteries form an anastomotic plexus (Kiesselbach’s plexus) and where the vessels are relatively close to the surface. Clinical sig.: This area is the major site of nosebleeds, or epistaxis. Posterior to ptergyoid Anterior to venous plexus facial vein  Upper deep cervical L N Anterior to Submandibular L N  Olfaction “Olfactory N” General sensation “Trigeminal nerve” Parasympathetic “Pterygopalatine ganglion” Sympathetic “T1”