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ENT Anatomy and Physiology

ENT Undergraduate Lecture. ENT Anatomy and Physiology. Dr. ZAID AL-DAHWI Consultant ENT Head of ENT department KING SAUD MEDICAL CITY. Ear Anatomy External Ear. Auricle (Pinna) Collects sound Sound localization. Ear Anatomy External Ear. External audiotary meatus

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ENT Anatomy and Physiology

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  1. ENT Undergraduate Lecture ENT Anatomy and Physiology Dr. ZAID AL-DAHWI Consultant ENT Head of ENT department KING SAUD MEDICAL CITY

  2. Ear Anatomy External Ear • Auricle (Pinna) • Collects sound • Sound localization

  3. Ear Anatomy External Ear • External audiotary meatus • Approximately 24mm in length, “S” shaped • Lateral/Outer 1/3 • in cartilages • wax (cerumen) • hair • Medial 2/3 • bone • wax free • Skin migration Increases sound pressure at the tympanic membrane by as much as 5-6 dB (due to acoustic resonance)

  4. Ear Wax (Cerumen) 1.Keeps skin soft 2. Keeps bugs out

  5. Mastoid Process • Bony ridge behind the auricle • Provides support to the external ear and posterior wall of the middle ear cavity

  6. Middle Ear Anatomy Boundaries of Middle Ear • Middle ear is Air containing space in temporal bone.

  7. Middle Ear Anatomy Ossicles • Three ossicles • Mallus, • incus • stapes • Ossicles are smallest bones in the body • Act as a lever system • transfer sound from air to inner ear fluids

  8. Stapedius Muscle • Connects the stapes to the middle ear wall • Contracts in response to loud sounds; known as the Acoustic Reflex

  9. Middle Ear Anatomy Tympanic membrane • Thin membrane • Forms boundary between outer and middle ear • Vibrates in response to sound • Changes acoustical energy into mechanical energy

  10. Middle Ear Anatomy Eustachian tube • Equalises pressure between middle ear and atmosphere

  11. Middle Ear Anatomy medial wall • Oval window • Footplate of the stapes • Round window • Promontory

  12. Middle Ear Anatomy The posterior wall • Mastoid wall • Tympanic aditus • Pyramidal eminence • Chorda tympani nerve

  13. Ear Anatomy Inner Ear • Cochlea • Semicircular canal • Angular acceleration • Vestibule • Linear acceleration

  14. Inner Ear Cochlea • Sound transmission through middle ear • Oval Window – • located at the footplate of the stapes; when the footplate vibrates, the cochlear fluid is set into motion • Round Window – • functions as the pressure relief port for the fluid set into motion initially by the movement of the stapes in the oval window • Cochlea : organ of corti • Snail-shaped organ with a series of fluid-filled tunnels; converts mechanical energy into electrical energy

  15. The end organ of hearing; contains stereocilia and hair cells. Organ of Corti • Hair Cells • Frequency-specific • High pitch sounds (base of cochlea) • Low pitch sounds (apex of cochlea)

  16. Inner Ear Vestibular Function • Macula in saccule and utricle • linear acceleration • Crista in semi-circular canal • angular acceleration

  17. Rhinology • Anatomy • Physiology

  18. Rhinology Anatomy • External

  19. Rhinology Anatomy • LATERAL WALL OF NASAL CAVITY It has 3 curved long projections called nasal conchae: 1) Superior turbinate. 2) Middle turbinate. 3) Inferior turbinate. * The space below each ofthese conchae is called nasal meatus.

  20. Rhinology Nasal septum • Above: • perpendicular plate of the ethmoid. • Below and in front: • septal cartilage. • Below and behind: • vomer. • Little’s area • Epistaxis

  21. Rhinology Roof • narrow Formed by : • cribriform plate of the ethmoid bone • nasal and frontal bones, and posteriorly sphenoid Bone.

  22. RhinologyParanasal Sinuses • Frontal • Maxillary • Ethmoid • Sphenoid

  23. Laryngology(Mouth - Pharynx-Larynx-)

  24. Laryngology ORAL CAVITY • 1. Lips. • 2. Buccal or cheek mucosa. • 3. Gums (gingivae). • 4. Hard palate. • 5. Oral tongue. Only anterior two-thirds

  25. LaryngologyPHARYNX • 1. NasophcHynx • extends from the base of skull to the soft palate • 2. Oropharynx • extends from the base of skull to the soft palate includes (Base of tongue, Lingual and Palatinc tonsils, Valleculae) • 3. Hypopharynx or Laryngopharynx • extends from hyoid bone to lower border of cricoid cartilage • continuous with oesophagus. • opposite the 3rd, 4th, 5th, 6th cervical vertebrae. • pyriform sinus, post-cricoid region and the posterior pharyngeal wall.

  26. LaryngologyPHARYNX • Structure of Pharyngeal Wall • 1. Mucous membrane • 2. Pharyngeal aponeurosis (pharyngobasilar fascia) • 3. Muscular coat • 4. Buccopharyngeal fascia

  27. LaryngologyPHARYNX • Waldeyer's Ring • Masses of Scattered lymphoid tissue in the pharynx • l. Nasopharyngeal tonsil or the adenoids • 2. Palatine tonsils or simply the tonsils • 3. Lingual tonsil • 4. Tubal tonsils (in fossa of Rosenmuller) • 5. Lateral pharyngeal bands • 6. Nodules (in posterior pharyngeal wall).

  28. palatine (faucial) tonsils • Blood Supply of tonsils • l. Tonsillar branch of fac ial artery. • 2. Ascending pharyngeal artery from external carotid. • 3. Ascending palatine, a branch of facial artery. • 4. Dorsal linguae, branches of lingual artery. • 5. Descending palatine branch of maxillary artery.

  29. palatine (faucial) tonsils • Relations of tonsil

  30. palatine (faucial) tonsils • Crypts of tonsil

  31. Laryngology LARYNX Anatomy

  32. Laryngology Neck Anatomy

  33. Laryngeal Cartilages • Paired • Arytenoid cartilage • Corniculate cartilage • Cuneiform cartilage • Unpaired: • Thyroid cartilage • Cricoid cartilage • Epiglottis

  34. Thyroid Cartilage • Angulation more acute in males • Its function • Shield larynx from injury and • Provide an attachment to vocal cords

  35. Cricoid Cartilage • Signet ring shaped • Stronger than thyroid cartilage. • Support to arytenoid • Only cartilagenous part forms continuous 360 degree ring

  36. Epiglottis • Thin leaf shaped fibro-cartilage, situated in midline • Upper free projects up behind base of tongue • Epiglottic cartilage contains many pits filled with mucous glands

  37. Arytenoids • Paired cartilages, pyramidal in shape • Base articulated with cricoid cartilage • Anterior angle elongated into vocal process which receives insertion of vocal ligament

  38. Glottis • Consists of • true vocal cords, • anterior commissure and • posterior commissure • Anterior 2/3 is membranous • Posterior 1/3 of cords are called posterior commissure

  39. Intrinsic muscles

  40. Cricothyroid Muscle

  41. Adductors of the Vocal Folds

  42. Abductor of Larynx

  43. Nerve Supply: Derived from the Vagus • Superior Laryngeal Nerve • Internal -It provides sensation of the glottis and supraglottis, • External -It supplies motor function to the cricothyroid muscle which tenses the vocal cords • Recurrent Laryngeal Nerve • sensation to the subglottic • motor function to the intrinsic muscles of the larynx.

  44. Recurrent Laryngeal Nerve • It branches from the vagus in mediastinum and turns back up into the neck. • On the right, it travels inferior to the subclavian and loops up • on the left it travel inferior to the aorta and loops up.

  45. THE END Questions?

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