Download Lecture # 08

HEAD AND NECK -1
DR VINIT K ASHOK
ADJUNCT FACULTY
TRIANGLES OF THE
NECK
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POSTERIOR TRIANGLE
BOUNDARIES
ANTERIORLY----STRENOCLEIDOMASTOID
POSTERIORLY---TRAPEZIUS
INFERIORLY--- CLAVICLE
CONTENTS
NERVES- ACCESSORY NERVE, CERVICAL PLEXUS, PHRENIC
NERVE, BRACHIAL PLEXUS
 ARTERIES-SUBCLAVIAN ARTERY
 VEINS-EXTERNAL JUGULAR VEIN
* WOUND TO THE NECK IN THIS REGION CAN LEAD TO
PARALYSIS OF THE TRAPEZIUS AND
STERNOCLEIDOMASTOID
ANTERIOR TRIANGLE
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BOUNDARIES
SUPERIORLY----INFERIOR MARGIN OF THE MANDIBLE
ANTERIORLY----MIDLINE OF THE NECK
POSTERIORLY—STERNOCLEIDOMASTOID
CONTENTS
GLAND---- SUBMANDIBULAR GLAND
MUSCLES----- SUPRAHYOID, INFRAHYOID
VEINS--- UPPER PARTS OF THE JUGULAR VEINS
ARTERIES—UPPER PARTS OF THE CAROTIDS
UPPER RESPIRATORY TRACT
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NOSE
EXTERNAL VISIBLE PART MADE UP
OF CARTILAGE AND BONE
PROVIDES AIRWAY FOR
RESPIRATION
MOISTENS AND WARMS THE AIR
FILTERS INHALED AIR
RESONATING CHAMBER FOR SPEECH
HOUSES THE RECEPTORS FOR SMELL
( OLFACTION)
NASAL CAVITY
• LIES POSTERIOR TO THE NOSE. DIVIDED INTO RT AND LEFT BY
NASAL SEPTUM AIR ENTERS THROUGH THE ANTERIOR NARES.
LINED BY RESPIRATORY MUCOSA/ OLFACTORY MUCOSA
• BOUNDARIES
 ROOF- ETHMOID AND SPHENOID BONES
 FLOOR – PALATE
 ANTERIORLY-ANTERIOR NARES
 POSTERIORLY- INTERNAL NARES ( Choanae). OPENS INTO
NASOPHARYNX
 LATERAL WALLS-NASAL CONCHAE
o PALATE—HARD /SOFT ( SEPERATES THE ORAL AND NASAL
CAVITIES. PALATINE AND MAXILLARY BONES( HARD)
o VESTIBULE-SUPERIOR TO THE NOSTRILS( FLARED)
o VIBRISSAE-NOSE HAIRS
RESPIRATORY MUCOSA
• PSEUDOSTRATIFIED CILIATED COLUMNAR EPITHELIUM WITH
SCATTERED GOBLET CELLS
• GLANDS IN THE CONNECTIVE TISSUE ( SEROUS / MUCOUS)
• SEROUS SECRETIONS ----DIGESTIVE ENZYME( LYSOZYME)
• MUCOUS SECRETIONS---STICKY TRAP DUST,BACTERIA, POLLEN,
DEBRIS FROM AIR. ALSO MOISTENS THE INHALED AIR
• * RHINITIS---INFLAMMATION OF THE NASAL MUCOSA.CAUSED BY
BACTERIA, VIRUSESOR ALLERGENS. RESULTS IN INCREASED
SECRETIONS AND CONGESTION
NASAL CONCHAE
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PROJECTIONS FROM THE LATERAL NASAL WALLS, MUCOSA COVERED
SCROLL LIKE STRUCTURES
• 3 IN NUMBER SUPERIOR, MIDDLE( PART OF THE ETHMOID BONE) AND
INFERIOR ( SEPARATE BONE)
• GROOVE INFERIOR TO THE CONCHA ----MEATUS ( OPENINGS OF MANY
STRUCTURES)
FUNCTIONS OF THE CONCHAE
- CAUSES TURBULANCE OF AIR INHALED
- HEATS THE INHALED AIR
- MOISTENS THE AIR
- HELPS TRAP DUST PARTICLES
- RECLAIMS HEAT AND MOISTURE
PARANASAL SINUSES
• AIR FILLED CAVITIES IN THE BONES SORRUNDING THE NASAL
CAVITY
• FRONTAL, ETHMOID, SPHENOID AND MAXILLARY
• HAVE SAME RESPIRATORY MUCOSA
 FUNCTIONS
 WARMS THE AIR
 LIGHTENS THE SKULL
 GIVES RESONANCE TO THE VOICE
• ALL OPEN INTO THE NASAL CAVITY ( MEATUS)
• BLOWING THE NOSE DRAINS THEM
 MAXILLARY SINUS DOES NOT DRAIN VERY WELL
 SINUSITIS
PHARYNX
• THROAT
• CONNECTS THE NASAL CAVITY AND ORAL CAVITY ABOVE TO THE
LARYNX AND ESOPHAGUS BELOW
• EXTENDS FROM THE BASE OF THE SKULL TO THE C6 VERTEBRA
• MUSCULAR WALLS ( SKELETAL MUSCLE) PRESENT THROUGHOUT
THE LENGTH
• DIVIDED INTO 3 REGIONS
 NASOPHARYNX
 OROPHARYNX
 LARYNGOPHARYNX
INPORTANT CONTENTS IN
THE PHARYNX
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NASOPHARYNX--ACTS ONLY AS AIR PASSAGE
UVULA PREVENTS THE FOOD FROM COMING BACK INTO THE NASOPHARYNX
ADENOIDS( PHARYNGEAL TONSILS) FOUND IN THE ROOF
TUBAL TONSILS FOUND IN THE LATERAL WALL
OROPHARYNX—
COOMON PASSAGE FOR AIR AND FOOD
FAUCES IS THE ARCH LIKE ENTRANCE TO IT
PALATINE TONSILS FOUND IN THE LATERAL WALL OF THE FAUCES
LINGUAL TONSILS COVERS THE POSTERIOR SURFACE OF THE TONGUE
LARYNGOPHARYNXCOMMON PASSAGE FOR BOTH FOOD AND AIR
LIES POSTERIOR TO THE LARYNX
CONTINUOUS WITH BOTH THE LARYNX AND ESOPHAGUS
* TONSILS ARE PART TO THE IMMUNE SYSTEM AND PROTESCT AGAINS INFECTION
LARYNX
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ALSO CALLED THE VOICE BOX
EXTENDS FROM C-4 TO C-6 VERTEBRA
ATTACHMENTS – SUPERIORLY ---HYOID BONE
INFERIORLY ----CONTINOUS WITH THE TRACHEA
FUNCTIONS VOICE PRODUCTION
AIR PASSAGE
- ROUTES FOOD / AIR TO PROPER PATH
FRAMEWORK - NINE CARTILAGES
- MEMBRANES
- LIGAMENTS
CARTILAGES EPIGLOTTIS
THYROID CARTILAGE UNPAIRED
CRICOID CARTILAGE
CORNICULATE
CUNEIFORM
PAIRED
ARYTENOID
LARYNGEAL CARTILAGES
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THYROID
LARGE SHIELD SHAPED
2 CARTILAGE PLATES
ADAMS APPLE( LARYNGEAL PROMINENCE)
EPIGLOTTIS
LEAF SHAPED
ELASTIC CARTILGE COVERED BY MUCOSA
STALK ATTACHED ANTERIORLY TO THE INTERNAL ASPECT OF
THYROID
GAURDIAN OF THE AIRWAYS
CRICOID
LIES INFERIOR TO THE THYROID CARTILAGE
SIGNETRING SHAPED
PERCHED ON TOP OF THE TRACHEA
VOCAL CORDS
• PRESENT IN THE LARYNX
• VOCAL FOLDS( TRUE VOCAL CORDS) ARE AVASCULAR AND
APPEAR PEARLY WHITE
• AIR EXHALED FROM THE LUNGS CAUSES THEM TO
VIBRATE PRODUCING THE BASIC SOUNDS OF SPEECH
THYROID GLAND
• LARGEST PURE ENDOCRINE GLAND
• LOCATED IN THE NECK ON THE TRACHEA INFERIOR TO THE
LARYNX
• PRODUCES HORMONES ---THYROXINE, TRIIODOTHYRONINE AND
CALCITONIN
• MOVES UP WITH SWALLOWING
• BLOOD SUPPLY BY THE SUPERIOR AND INFERIOR THYROID
ARTERIES
HYOID BONE
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LIES INFERIOR TO THE MANDIBLE
BODY AND 2 PAIRS OF HORNS
DOES NOT ARTICULATE WITH ANY OTHER BONE
ATTACHED SUPERIORLY TO THE SKULL BY LIGAMENTS AND ALSO
TO THE LARYNX INFERIORLY BY LIGAMENTS
• ACTS AS A MOVABLE BASE FOR THE TONGUE