Bbbbbbbbbbbbbbbbbbbآناتومی بینی و حلق.pdf

Naso pharynx anatomy

1. Nose and Pharynx
Dr. Sama ul Haque

2. Objectives
Discuss the anatomical structure of nose.
Define Paranasal sinuses.
Describe the anatomical structure of pharynx.
Enlist the extrinsic and intrinsic muscles of the
pharynx with their nerve supply and actions.

3. Organization and Functions of the Respiratory
System
Consists of an upper respiratory tract (nose to
larynx) and a lower respiratory tract
(trachea onwards).
Conducting portiontransports air.
-includes the nose, nasal cavity, pharynx,
larynx, trachea, bronchi and bronchioles.
Respiratory portioncarries out gas exchange.
-composed of small airways called respiratory
bronchioles and alveolar ducts as well as air
sacs called alveoli.

5. Upper Respiratory Tract
Nose
Nasal cavity
Paranasal sinuses
Pharynx (throat)
Larynx

6. Upper Respiratory Tract

7. Structure of the Nose
Nose,is the only visible part of
the respiratory system and
serves as the entrance to the
respiratory tract
The nose has two cavities,
separated from one another by
a wall called the septum.
The external openings, known
as external (anterior) nares or
nostrils,lead to the nasal
cavities.

9. Nasal Cavity
Extends from the
external (anterior)
nares to the posterior
nares (choanae).
Divided into right &
left halves by the
nasal septum.
Each half has a:
Roof
Lateral wall
Medial wall
(septum)
Floor

10. Roof
Narrow & formed
(anteroposteriorly)
by the:
1.Nasal bone &
cartilage
2.Frontal bone.
3.Cribriformplate
of ethmoidbone
4.Body of
sphenoid.
Floor
•Formed by the hard (bony) palate.
•Separates it from the oral cavity.
4
3
2
1
Oral cavity

11. Medial Wall
(Nasal Septum)
Osteo-
cartilaginous
partition
between the two
nasal cavities.
Formed by:
1.Septalcartilage.
2.Perpendicular
plate of ethmoid
bone.
3.Vomer.

12. Lateral Wall
Shows three horizontal
bony projections, the
superior,middle&
inferiorconchae.
The cavity below each
conchais called a
meatusand are named
as superior, middle&
inferiorcorresponding
to the conchae.
The small space above
the superior conchais
the sphenoethmoidal
(suprameatal) recess.
The conchaeare covered by
respiratory epithelium and thus
increase the surface area of the
nasal cavity.
Sphenoethmoidal
recess
Meati

13. Sphenoethmoidal
recess
sphenoidalsinus
Superior meatus posterior ethmoidalsinus
Middle meatus middle ethmoidal, maxillary, frontal & the
anterior ethmoidalsinuses
Inferior meatus nasolacrimalduct.
The recess & meati receive the openings of the paranasal
sinuses & naso-lacrimal duct.

14. Nose
Olfactory mucosa:
Mucous membranes that contain smell
receptors.
Respiratory mucosa:
Pseudostratified ciliated columnar
epithelium containing goblet cells that
secrete mucus which traps inhaled
particles.

15. Nerve Supply
Olfactory
mucosasupplied
by olfactory
nerves.
Nerves of
general
sensation are
derived from
ophthalmic&
maxillary nerves.
Autonomic
fibers.
LymphaticDrainage:
To the submandibular
and the upper deep
cervicallymph nodes.

17. Paranasal sinuses

18. Anatomy
Maxillary Sinus
first to develop at day 65 of gestation
seen on plain films at 4-5 months
slow expansion until 18 years
Ethmoid Sinus
develop in third month of gestation
ethmoids seen on radiographs at one year
enlarges to reach adult size at age 12
Sphenoid Sinus
originates in fourth gestational month from posterior part of nasal cavity
pneumatization begins at age 3
rapid growth to reach sella by age 7 and adult size at age 18
Frontal Sinus
begins in fourth month of gestation from superior ethmoid cells
seen on radiographs at age 5-6
grows slowly to adult size by adolescence

19. 21
Normal Water’s and Towne’ s Views of
the Sinuses

20. 22
Lateral View Showing Normal
Sphenoid Sinus

21. Paranasal Sinuses
Air filled cavities located in the
bones around the nasal cavity
Frontal, ethmoidal, sphenoidal,
maxillary.
Lined by respiratory mucosa
which is continuous with the
mucosa of the nasal cavity
Decrease skull bone weight.
Warm, moisten and filter incoming
air.
Add resonance to voice.
Communicate with the nasal cavity
by ducts for drainage

24. Drainage of the Paranasal Sinuses
Sphenoethmoidalrecess:
Sphenoidalair sinus
Superior meatus:
Posterior ethmoidalair sinus
Middle meatus :
Bulla ethmoidalis:
Middle ethmoidalair sinus
Hiatus semilunaris:
Frontal air sinus
Maxillary air sinus
Anterior ethmoidal
Inferior meatus:
Nasolacrimal duct

25. Physiologic Importance of
Sinuses
Provide mucus to upper airways
–Lubrication
–Vehicle for trapping viruses, bacteria,
foreign material for
removal
• Give characteristics to voice
• Lessen skull weight
• Involved with olfaction

26. Blood supply of the nasal cavity:-

27. Functions of the Nose
Provides an airway for respiration
Moistens and warms entering air
Filters and cleans inspired air
Resonating chamber for speech
Detects odors in the air stream

28. Pharynx
Common space used by both the respiratory
and digestive systems.
Commonly called the throat.
Walls are lined by a mucosa and contain
skeletal muscles that are primarily used for
swallowing.
Partitioned into three adjoining regions:
Nasopharynx
Oropharynx
Laryngopharynx

29. 31
Divisions of the Pharynx
Divided into three parts:
Nasopharynx:
Superior part,
communicates with the
nasal cavity through
posterior nasal apertures
Oropharynx:
Middle part, communicates
with the oral cavity through
theoro-pharyngeal
isthmus
Laryngopharynx:
Inferior part, communicates
with the larynx through the
laryngeal inlet

30. Nasopharynx
Located directly posterior
to the nasal cavity and
superior to the soft palate,
which separates the oral
cavity.
Normally, only air passes
through.
In the lateral walls of the
nasopharynx, paired
auditory/eustachian tubes
connect the nasopharynx to
the middle ear.

31. Oropharynx
Middle pharyngeal region.
Lies immediately posterior to
the oral cavity.
Common respiratoryand
digestivepathway through
which both air and swallowed
food and drink pass.
Lymphatic organs here
provide the first line of
defense against ingested or
inhaled foreign materials.
Palatine tonsilsare on the
lateral wall between the
arches, and the lingual tonsils
are at the base of the tongue.

33. Laryngopharynx
Inferior, narrowed
region of the
pharynx.
Terminates at the
superior border of
the esophagus and
the epiglottis of the
larynx.
Permits passage of
both food and air.

34. Piriformfossa
A small depression
situated on either side of
the laryngeal inlet
It is a common site for the
lodging of foreign bodies.
Branches of internal
laryngeal& recurrent
laryngeal nerves lie deep
to the mucous membrane
of the fossaand are
vulnerable to injury during
removal of a foreign
body.

36. Muscles of Pharynx
M
S
I
The muscles of the pharynx are
arranged in circularand
longitudinal layers
Circular (Constrictor)
Three muscles, overlap each other:
Superior, Middle& Inferior
Propel the bolus of food down into
the esophagus
Longitudinal Muscles
Three muscles:
Stylopharyngeus
Salpingopharyngeus
Palatpharyngeous
Elevate the larynx & pharynx
during swallowing

37. Sensory Nerve Supply
•Nasopharynx: Maxillary nerve
•Oropharynx: Glossopharyngealnerve
•Laryngopharynx: Vagusnerve
MotorNerve Supply :
•All the muscles of pharynx, except the stylopharyngeus, are supplied
by the pharyngeal plexus.
•Stylopharyngeusis supplied by the glossopharyngealnerve
Pharyngeal plexus
A network of nerves (sensory, motor & sympathetic) located on the surface
of the middle pharyngeal constrictor muscle, is formed by the:
•Pharyngeal branches of glossopharyngeal nerve (sensory)
•Pharyngeal branch of vagus nerve (motor)
•Sympathetic fibers from superior cervical ganglion (vasomotor)

38. Arterial supply: From branches of:
Ascending pharyngeal artery
Ascending palatine artery
Facial artery
Maxillary artery
Lingual artery
TheVeinsdrain into pharyngeal venous plexus, which
drains into the internal jugular vein
TheLymphaticsdrain into the:
Deep cervical
Retropharyngeal &
Paratracheallymph nodes

43. Functions of the Pharynx
Provides a passageway for Air & Food
Moistens and warms entering air
Taste
Protection
Speech