Download anatomy_lec22_8_5_2011

This sheet 4 anatomy lecture 22 on sun 8/5 ... enjoyyy 
Pharynx
DR : About the pharynx "7baibii" we said it's a musculomemranous tube
extending from base of the skull to the inferior border of cricoid cartilage ,,
about 15 cm in length ,, located behind 3 cavities :
Behind the nose called nasopharynx
Behind the oral cavity called laryngopharynx
Behind the laryngeal cavity called laryngopharynx
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THE UPPER PART >> NASOPHARYNX
Is bounded anteriorly by choana , posteriorly by C1 vertebrea , superiorly
by body of sphenoid , inferiorly by soft palate , lateral "very important"
by : opening of the auditory tube , tubal elevation , salpingiopharyngeal
fold (covering it's muscle) , pharyngeal recess
NERVE SUPPLY : the maxillary nerve
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THE OROPHARYNX
it's bounded anteriorly by palatoglosses fold which called the
oropharyngeal isthmus , posteriorly by C1 , C2 .............ok ......................
superiorly by soft palate , inferiorly by the upper border of epiglottis ,,
lateral : anterior >> palatoglossal arch , posterior >> palatopharyngeal
arch ... between the 2 arches there R tonsillar sinus which contains the
palatine tonsils
NERVE SUPPLY : IX nerve >> glossopharyngeal nerve & (inferior surface
of epiglottis and valecula) by vagus nerve
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THE LARYNGOPHARYNX
Extending from the upper border of epiglottis to the lower border of
cricoids cartilage ,, bounded anteriorly by laryngeal inlet , posteriorly by
C3+C4+C5+C6 vertebrea , lateral : recess (common site of foreign body
impaction like the fish-bone
NERVE SUPPLY : vagus >> internal laryngeal nerve
*NOTE : 2hm $ii el lateral border rkzoo kteeeer mnii7 3liih CUZ the Dr.
said : 2hm border el lateral border , el lateral border , el lateral border ;)
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MUSCLES OF THE PHARYNX
2 groups of muscles : 3 longitudinal + 3 circular "constrictors"
The constrictors :Superior constrictor .
Middle constrictor .
Inferior constrictor .
Fii 7da rn mobilooo .. ma 3lina >> the constrictors overlap each other like a
telescope thus the superior is the innermost & the inferior is the
outermost ....
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Each is fan-shaped , narrow anterior , wide posterior, meet with the
opposite side by the pharyngeal raphe .
Function :- narrowing the pharynx during swallowing from top 2 bottom in
sequence :]
The longitudinal Ms :
Stylopharyngeus >> from styloid process .
Salpingopharyngeus >> the name indicate that it's like a tube "salpin.." .
Palatopharyngeus .
Function : elevate the pharynx during swallowing "like putting a melon in a
plastic bag & force it to inter" :P :P
*NOTE : All muscles of pharynx R supplied by the pharyngeous plexus
(branches of IX , X & sympathetic) EXEPT stylopharyngeous by
glossopharyngeal nerve "V.important" ........
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THE LARYNX
it's a musculoligamentous tube framed by 9 cartilages :3 single ( thyroid , cricoids , epiglottis ) + 3 paired ( Arytenoid ,
corniculate , cuneiform ) ..... see the slide # 2 (V.important) .....
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1- THYROID CARTILAGE :
The largest 1 formed by 2 laminae joined : superior point of fusion form
laryngeal prominence "Adam's apple" ,, posterior with free posterior
borders .....
It's a hyaline cartilage has an oblique line 4 attachment of extrinsic Ms.
On the lateral surface of lamina , & 2 horns "superior horn + inferior
horn" .......
2- CRICOID CARTILAGE :
The onlyyy complete cartilaginous signet-ring in as a foundation 4 the
larynx .... anterior narrow arch , posterior broad lamina , 4 facets >> 2
lateral "inferior horn of thyroid" & 2 superior "base of Arytenoid :]
3- THE EPIGLOTTIS :It's a leaf-shaped elastic cartilage attached by it's stem to inner angle
of thyroid cartilage & it's broad superior border is FREE , it closes the
laryngeal inlet during swallowing :]
4 – ARYTENOID :A 3-sided pyramid , has an apex superiorly attached to corniculate
cartilage & a base articulate with upper border of cricoids lamina ,
forward projection which is the vocal process 4 vocal cords & lateral one
which is muscular 4 crico-arytenoid Ms. :]
5- CORNICULATE :Small elastic one on posterior part of aryepiglottic fold & attached 2
apex of arytenoid :]
6- CUNEIFORM :Club-shaped one which suspended in the aryepiglottic fold :]
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THE LARYNGEAL CAVITY 
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Devided to 3 regions : supraglottic "vestibule" + glottis "laryngeal sinus /
ventricle" + infraglottic .........
1- SUPRAGLOTTIC :From laryngeal inlet 2 vestibular folds , covered by low stratified
squamous Epi. ..... Quadrangular membrane between epiglottis &
aarytenoid C. which is a fibro-elastic one , has 2 free margins : upper >>
aryepiglottic & lower thickens to form vestibular ligament :]
*NOTE : vestibular fold : enclosing vestibular ligament ,fixed 4 false
vocal cords , highly vascular ..
*NOTE : rima vestibule :P the triangular space between both of folds
which covered by thick stratified squamous Epi.
2-GLOTTIC :Between vestibular fold superiorly , & vocal fold inferiorlyyy
3 things :- vocal folds + rima glottis (not sure) :P + ventricular of larynx
- VOCAL folds/cords :- true mobile cords 4 controlling sound
production , white in color because of the avascular thick stratified
squamous Epi. .. note that the vocal ligament is the upper free thickened
part of cricothyroid ligament 
- Rima glottidis : triangular space between true vocal folds . The
narrowest part of larynx .
- Ventricle of larynx : A small recess between 2 folds :]
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3- THE Infraglottic Region :From vocal folds to lower border of cricoids ,, Carpeted by the fibroelastic cricothyroid ligament ,, Lined with columnar ciliated epithelium :@
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Muscles of larynx
They move laryngeal cartilages relative to one another , affecting the
tension of the vocal folds .
1- Cricothyroid : >>>> Tenses vocal cords & a Muscle of emergency like
shouting :D
2- Posterior cricoarytenoid : >>>> it's the Most Important muscle in the
body which Abducts vocal cords .
3- Lateral cricoarytenoid :>>>> adducts vocal cords .
4- Thyroarytenoid : >>>> Relax vocal cords .
5- Vocalis : >>>> Relax vocal cords like in whispering "b7ebk :P bmoot
fiiik :P 3la el drj "  .... At the Medial part of thyroarytenoid muscle .
** the Nerve supply of laryngeal muscles :All supplied by the recurrent laryngeal nerve except cricothyroid by
external laryngeal nerve :]
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N.B :- The vocal folds bisect the larynx into upper halve and lower
halve regarding , arterial , venous, lymphatic & sensory never supply.
1- THE Upper halve of larynx ( Larynx above vocal folds ) :* Artery :
Superior laryngeal from superior thyroid artery which ccompanied the
external laryngeal never ^-^
* Veins : Accompanies the artery >>> To internal jugular vein .
*Lymph : Deep cervical lymph nodes .
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*Sensory : Internal laryngeal nerve .
2- THE Lower halve of larynx ( larynx below vocal folds ) :*Artery :
Inferior laryngeal A . from inferior thyroid artery which Accompanies
the recurrent laryngeal nerve .
*Veins : Mainly to left brachiocephalic vein .
* Lymph : Deep cervical lymph nodes
* Sensory : Recurrent laryngeal nerve .
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BEST WISHES 4 ALL OF U IN THE COMING FINALS
DONE BY : HADEEL 7mmodeh 2bo-sla7 
DEDICATED 2 :*My great , best of the best Dr. Sofian Z. 2bo-$. "really appreciate that
u r in my world & gd luck in ur exams 2 " <3
* secret characters :P
* The supportive Bro. Lord 2mjd , 2bdallah , maldiniiii :P, 9la7& 5aled ..
thnx all 
*Best friends : Ala'a , R3'd , Esra'a brmawiii , Rai7ana , Mjdoliin , Slam ,
Do3a2 & sjood ;)
* l kol dof3etnaaa specially ll ljneh .. thnx
"" 2 everyone I made a mistake or hurt his feelings ... I didn't mean that
4 sure & sooo sryyy .... sam7oniiii ""
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