ent anatomy and physiology
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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 - PowerPoint PPT PresentationTRANSCRIPT
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ENT Anatomy and PhysiologyENT Anatomy and Physiology
Dr. ZAID AL-DAHWIConsultant ENT
Head of ENT department
KING SAUD MEDICAL CITY
ENT Undergraduate Lecture
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Ear Anatomy Ear Anatomy External EarExternal Ear
• Auricle (Pinna)– Collects sound– Sound
localization
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Ear Anatomy Ear Anatomy External EarExternal 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)
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Ear Wax (Cerumen)Ear Wax (Cerumen)
1.Keeps skin soft
2. Keeps bugs out
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Mastoid ProcessMastoid Process
• Bony ridge behind the auricle
• Provides support to the external ear and posterior wall of the middle ear cavity
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Middle Ear Anatomy Middle Ear Anatomy Boundaries of Middle Boundaries of Middle
EarEar• Middle ear is Air containing space
in temporal bone.
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Middle Ear Anatomy Middle Ear Anatomy OssiclesOssicles
• 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
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Stapedius MuscleStapedius Muscle
• Connects the stapes to the middle ear wall• Contracts in response to loud sounds; known
as the Acoustic Reflex
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Middle Ear Anatomy Middle Ear Anatomy Tympanic membraneTympanic membrane
• Thin membrane• Forms boundary between outer and middle ear• Vibrates in response to sound• Changes acoustical energy into mechanical
energy
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Middle Ear Anatomy Middle Ear Anatomy Eustachian tube Eustachian tube
• Equalises pressure between middle ear and atmosphere
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Middle Ear Anatomy Middle Ear Anatomy medial wallmedial wall
Oval window Footplate of the
stapes
Round window
Promontory
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Middle Ear Anatomy Middle Ear Anatomy The posterior wallThe posterior wall
Mastoid wall
Tympanic aditus
Pyramidal
eminenceChorda tympani
nerve
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Ear Anatomy Ear Anatomy Inner EarInner Ear
• Cochlea
• Semicircular canal – Angular acceleration
• Vestibule – Linear acceleration
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• 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
Inner Ear Inner Ear CochleaCochlea
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Organ of CortiOrgan of Corti
• The end organ of hearing; contains stereocilia and hair cells.
Hair Cells Frequency-
specificHigh pitch sounds
(base of cochlea)Low pitch sounds
(apex of cochlea)
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Inner Ear Inner Ear Vestibular FunctionVestibular Function
• Macula in saccule and utricle – linear acceleration
• Crista in semi-circular canal – angular acceleration
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RhinologyRhinology
• Anatomy
• Physiology
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Rhinology Rhinology AnatomyAnatomy
• External
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Rhinology Rhinology AnatomyAnatomy
• 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 of these conchae is called nasal meatus.
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Rhinology Rhinology Nasal septumNasal septum
• Above:– perpendicular plate of
the ethmoid.• Below and in front:
– septal cartilage.• Below and behind:
– vomer.
– Little’s area– Epistaxis
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Rhinology Rhinology Roof Roof
• narrow
Formed by :
1.cribriform plate of the ethmoid bone
2.nasal and frontal bones, and posteriorly sphenoid Bone.
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Rhinology Rhinology Paranasal SinusesParanasal Sinuses
– Frontal
– Maxillary
– Ethmoid
– Sphenoid
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Laryngology Laryngology (Mouth - Pharynx-Larynx-)(Mouth - Pharynx-Larynx-)
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Laryngology Laryngology ORAL CAVITYORAL CAVITY
• 1. Lips. • 2. Buccal or cheek
mucosa. • 3. Gums (gingivae). • 4. Hard palate. • 5. Oral tongue. Only
anterior two-thirds
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Laryngology Laryngology PHARYNXPHARYNX
• 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.
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• Structure of Pharyngeal Wall– 1. Mucous
membrane– 2. Pharyngeal
aponeurosis (pharyngobasilar fascia)
– 3. Muscular coat– 4. Buccopharyngeal
fascia
Laryngology Laryngology PHARYNXPHARYNX
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• 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).
Laryngology Laryngology PHARYNXPHARYNX
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palatine (faucial) tonsilspalatine (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.
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palatine (faucial) tonsilspalatine (faucial) tonsils
• Relations of tonsil
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palatine (faucial) tonsilspalatine (faucial) tonsils
• Crypts of tonsil
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Laryngology Laryngology LARYNX AnatomyLARYNX Anatomy
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Laryngology Laryngology Neck AnatomyNeck Anatomy
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Laryngeal CartilagesLaryngeal Cartilages
• Paired
– Arytenoid cartilage– Corniculate
cartilage– Cuneiform
cartilage
• Unpaired:
– Thyroid cartilage– Cricoid cartilage– Epiglottis
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Thyroid CartilageThyroid Cartilage
• Angulation more acute in males
• Its function – Shield larynx from injury and – Provide an attachment to vocal cords
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Cricoid CartilageCricoid Cartilage
• Signet ring shaped• Stronger than thyroid
cartilage.
• Support to arytenoid
• Only cartilagenous part forms continuous 360 degree ring
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EpiglottisEpiglottis
• 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
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ArytenoidsArytenoids• Paired cartilages, pyramidal
in shape
• Base articulated with cricoid cartilage
• Anterior angle elongated into vocal process which receives insertion of vocal ligament
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GlottisGlottis• Consists of
– true vocal cords, – anterior commissure and – posterior commissure
• Anterior 2/3 is membranous
• Posterior 1/3 of cords are called posterior commissure
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Intrinsic musclesIntrinsic muscles
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Cricothyroid MuscleCricothyroid Muscle
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Adductors of the Vocal FoldsAdductors of the Vocal Folds
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Abductor of LarynxAbductor of Larynx
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Nerve Supply: Derived from the Nerve Supply: Derived from the VagusVagus
• 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.
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• Recurrent Recurrent Laryngeal NerveLaryngeal 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.
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THE ENDTHE END
Questions?