Download Respiratory System_Nose

Respiratory system. Nose
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Respiratory system – an overview
Embryonic development
of the respiratory system
Respiratory passages – structure principles
Nose:
external nose
nasal cavity
Paranasal sinuses
SPLANCHNOLOGY
Respiratory system
Respiratory system,
systema respiratorium
gas exchange –
negative pressure
breathing
conducting portion –
respiratory tract
respiratory portion –
lungs
voice formation
(phonation) – larynx
olfaction (sense of smell)
– nasal cavity
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
The air passages
Conducting portion – respiratory tract:
Upper respiratory tract
nasal cavity
pharynx
Lower respiratory tract
larynx
trachea
bronchi –
external and internal
distributing bronchioles
Respiratory portion
– lungs
respiratory
bronchioles
alveolar ducts
alveolar sacs
alveoli
Conditioning of the air:
warming
moistening
removal of particulate materials
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Embryonic development
Embryogenesis of the upper respiratory tract –
origin:
ectoderm of the foregut
epithelium and nasal glands, nasopharynx
endoderm of the foregut
epithelium and glands of oropharynx and hypopharynx
mesenchyme
bony and cartilaginous frameworks
o nasal prominences
Nose:
frontonasal prominence root
two medial nasal prominences
nasal dorsum and apex
two lateral nasal prominences
sidewalls and alae nasi
nasal (olfactory) placode nostrils
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Embryonic development
Embryogenesis of the lower respiratory tract –
3rd week of pregnancy:
respiratory diverticulum (lung bud)
blind-ended sac
larynx and trachea
lung buds
Larynx:
epithelium – endoderm of the foregut
cartilages and muscles – splanchnic mesoderm
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Embryonic development
Embryogenesis of the lungs:
lung buds
bronchial buds – Hox genes
bronchi and bronchioles – 4th mo.
alveolar ducts and sacs – 6th mo.
endodermal epithelium
mesenchymal elements
maturation of lungs:
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nose
Nose – nasus (Gr. rhis, rhinos):
both respiratory and olfactory organ
role in “forming” the timbre of the voice
Anatomical parts:
external nose, nasus externus
nasal cavity, cavitas nasi
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
External nose
External nose, nasus externus:
side at the middle and upper
parts of the face
generally pyramidal in shape
human trait – different types:
straight, humpy and saddle nose
Anatomical parts:
base, basis nasi
lateral side
wings, alae nasi
dorsum, dorsum nasi
root, radix nasi
free tip, apex nasi
nostrils, nares
columella
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
External nose framework
Bony framework –
piriform aperture:
nasal bones, ossa nasalia
frontal processes of maxilla
Cartilaginous framework,
cartilagines nasi:
unpaired
septal cartilage, cartilago nasi septi
paired:
lateral nasal cartilage,
cartilago nasi lateralis
major alar cartilage,
cartilago alaris major
minor alar cartilages,
cartilagines alares minores
cartilagines nasales accessoriae
Prof. Dr. Nikolai Lazarov
9
SPLANCHNOLOGY
External nose sidewall
Nasal musculature –
rudimentary muscles:
the procerus, m. procerus
the nasalis, m. nasalis
m. depressor septi nasi
m. apicis nasi – variable
m. compressor nares
m. levator labii superioris alaequae nasi
Connective tissue
Skin:
fine hairs
sweat glands
numerous large sebaceous glands
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
External nose – clinical relevance
crooked nose, rhinoscoliosis
saddle nose, rhinolordosis
humpy nose, rhinokyphosis
rhinophyma
nasal bone trauma and fracture
squamous cell carcinoma
nasal anomalies
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity
Nasal cavity,
cavum (cavitas) nasi:
vestibule, vestibulum nasi
nasal cavity proper,
cavum nasi proprium
Nasal septum,
septum nasi:
bony part, pars ossea
vomer
lamina perpendicularis
ossis ethmoidalis
pars cartilaginea
cartilago septi nasi
cartilagines alares majores
organum vomeronasale
(Jacobsoni) – pheromones
Kiesselbach’s area
membranous part, pars membranacea
nasal septum deviation, deviatio septi nasi
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Vestibule of the nasal cavity
Nasal cavity,
cavum (cavitas) nasi:
entrance – nostrils, nares
shape – racial trait
exit – posterior nasal
apertures, choanae
Nasal vestibule,
vestibulum nasi:
limen nasi
agger nasi
regio cutanea
stiff hairs, vibrissae
sweat and sebaceous glands
transition area
stratified squamous
pseudostratified epithelium
seromucous glands
absent sweat and sebaceous glands
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity proper
Nasal cavity proper,
cavitas nasalis ossea:
bone skeleton – walls
floor, inferior – hard palate
roof, superior wall:
o nasal bone
o ethmoid bone
o sphenoid bone
medial wall – nasal septum
lateral wall:
o
o
o
o
o
o
maxilla
lacrimal bone
ethmoid labyrinth
palatine bone
sphenoid bone
conchae nasales, superior, media et inferior
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity proper
Nasal mucous membrane:
medial wall
respiratory segment,
regio respiratoria
olfactory segment,
regio olfactoria
Lateral wall
nasal conchae
nasal meatuses:
o
o
o
o
o
meatus nasi superior
meatus nasi medius
meatus nasi inferior
meastus nasi communis
meatus nasopharyngeus
openings of the paranasal sinuses:
o recessus sphenoethmoidalis
o hiatus semilunaris, infundubulum, plica lacrimalis
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity proper
Nasal mucous membrane:
medial wall
respiratory segment,
regio respiratoria
olfactory segment,
regio olfactoria
Lateral wall
nasal conchae
nasal meatuses:
o
o
o
o
o
meatus nasi superior
meatus nasi medius
meatus nasi inferior
meastus nasi communis
meatus nasopharyngeus
openings of the paranasal sinuses:
o recessus sphenoethmoidalis
o hiatus semilunaris, infundubulum, plica lacrimalis
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity proper
Microscopic anatomy:
olfactory segment –
5-10 mm2; yellowish-brown
olfactory mucosa,
tunica mucosa
o olfactory epithelium –
• receptor (olfactory)
cells
• supporting cells
(sustentacular)
• basal cells – stem cells
• brush cells
o lamina propria
• olfactory
(Bowman’s) glands
absent submucosa,
tela submucosa
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Nasal cavity proper
Microscopic anatomy:
respiratory segment,
regio respiratoria – 1-3 mm
lamina epithelialis – ciliated,
pseudostratified columnar epithelium
– five cell types:
o
o
o
o
o
ciliated cells
goblet cells
brush cells
small granule cells
basal cells
lamina propria
o nasal glands – seromucous, tubular
o venous plexuses, stratum cavernosum
plexus cavernosi concharum
epistaxis
o Kiesselbach’s area, locus Kiesselbachi
o broad lymphatic network –
lymphatic nodules
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Blood supply of the nose
External nose:
facial artery
ophthalmic artery
Nasal cavity:
respiratory segment
sphenopalatine artery
(external carotid artery)
olfactory segment
anterior and posterior
ethmoidal arteries
(internal carotid artery)
Venous drainage:
facial and ophthalmic veins
Lymphatic drainage:
deep neck lymph nodes
(internal jugular vein)
retropharyngeal lymph nodes
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Innervation of the nose
Sensory innervation –
trigeminal nerve:
ophthalmic nerve
nasal nerve
maxillary nerve
infraorbital nerve,
infratrochlear nerve (root),
anterior ethmoidal nerve
posterior nasal nerves
Autonomic innervation:
sympathetic
carotid plexus
parasympathetic
pterygopalatine ganglion
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Paranasal sinuses,
sinus paranasales
sinus
sinus
sinus
sinus
maxillaris (antrum Highmori)
frontalis
ethmoidalis
sphenoidalis
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Paranasal sinuses,
sinus paranasales
sinus maxillaris – developed in newborns
sinus frontalis – during the 2nd year of life
sinus ethmoidalis – 3-4 years after birth
sinus sphenoidalis
pneumatization – around 20 years
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Maxillary sinus,
sinus maxillaris
maxillary sinus (antrum of Highmore):
the largest air sinuses
pyramidal cavity in the maxillary body
hiatus maxillaris
hiatus semilunaris
drainage
meatus nasi medius
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Frontal sinus,
sinus frontalis
frontal sinus, sinus frontalis:
two sinuses in the frontal bone
septum sinuum frontalium
ductus nasofrontalis – 12-16 mm
drainage infundibulum of the
meatus nasi medius
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Ethmoidal sinus,
sinus ethmoidalis
Cellulae ethmoidales – 10 (5-16):
cellulae ethmoidales anteriores
2-3 in number
drainage
meatus nasi medius
cellulae ethmoidales medii, incl.
bulla ethmoidalis
3-4 in number
drainage
meatus nasi medius
cellulae ethmoidales posteriores
4-5 in number
drainage
meatus nasi superior
(meatus nasi supremus)
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Sphenoidal sinus,
sinus sphenoidalis
Sinus sphenoidales:
two sinuses within
the sphenoid bone body
septum sinuum sphenoidalium
apertura sphenoidalis
drainage sphenoethmoidal recess
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
Clinical significance
sinus infection – sinusitis
paranasal sinus tumors, cysts
sinus drainage
spread to
adjacent structures
Prof. Dr. Nikolai Lazarov
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SPLANCHNOLOGY
rhinencephalon
(nose-brain)
Thank you ...
Prof. Dr. Nikolai Lazarov
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