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Department of Anatomy
Respiratory system
MUDr. Marek Joukal, Ph.D.
Cavum nasi
Pharynx
Larynx
Trachea
Bronchi
Lungs
Upper respiratory tract
Lower respiratory tract
Repiratory organ
External nose
Radix nasi
Dorsum nasi
Apex nasi
Nares
Alae nasi
(Pars membranacea
septi nasi)
Cartilago septi nasi
Cartilago nasi lateralis
Cartilago alaris major
Cartilagines alares minores
Cartilagines nasales
accessoriae
Cartilago vomeronasalis
Nasal cartilages
Septal cartilage
os ethmoidale
vomer
Lateral nasal cartilage
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Nasal cavity
1. Vestibulum nasi
Skin with hairs -
vibrissae
2. Cavum nasi proprium
meatus nasi superior
meatus nasi medius
meatus nasi inferior
meatus nasi communis
meatus nasopharyngeus
Proper nasal cavity
Regio olfactoria (2,5 cm2)
Regio respiratoria – plexus cavernosi concharum
Mucous membrane of nasal cavity
locus haemorrhagicus Kiesselbachi
Sinus maxillaris
Sinus frontalis
Sinus ethmoidalis
(cellulae ethmoidales)
Sinus sphenoidalis
Paranasal sinuses
25 ml, recessus (alveolaris, frontalis…)
hiatus sinus maxillaris
hiatus semilunaris (infundibulum ethmoidale)
Maxillary sinus Frontal sinus
15 ml
septum sinuum frontalium
infundibulum ethmoidale
(hiatus semilunaris)
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Ethmoid sinus
Celullae ethmoidales (3-18)
Celullae ethmoidales anteriores
(hiatus semilunaris)
Celullae ethmoidales mediae
(meatus nasi medius)
Celullae ethmoidales posteriores
(meatus nasi superior)
Sphenoid sinus
6 ml
septum sinuum sphenoidalium
recessus sphenoethmoidalis
apertura sinus sphenoidalis
PHARYNX
Pars nasalis, oralis, laryngea
Fornix pharyngis: tonsilla pharyngea
Ostium pharyngeum tubae auditivae:
Torus tubarius
Plica salpingopharyngea
Torus levatorius
Plica salpingopalatina
LARYNX
Adults
C4 – C6
Prominentia laryngea
Newborn
C2 – C4
Cartilago thyroidea
Cartilago cricoidea
Cartilago arytaenoidea
Cartilago epiglotica
Cartilago corniculata
Cartilago cuneiformis
Cartilago sesamoidea (triticea)
Laryngeal cartilages:
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Thyroid cartilage
Lamina dextra et sinistra
Incisura thyroidea superior et inferior
Cornua superiora et inferiora
Facies articulares cricoidea
Linea obliqua
Foramen thyroideum
Cricoid cartilage
Arcus
Lamina
Facies art. thyroidea
Facies art. arytaenoidea
Arytenoid cartilage
Basis (facies art. cricoidea)
Apex (cartilago corniculata)
Processus muscularis
Processus vocalis (lig. vocale)
Facies anterolateralis
Crista arcuata
Colliculus
Fovea triangularis
Fovea oblonga
Facies medialis (rima glottidis)
Facies posterior
Epiglottic cartilage Tritiate cartilage
Corniculate cartilage, cuneiform cartilage
Articulatio cricothyroidea
Facies articularis cricoidea et thyroidea
Oscillating movements
Flat joint
Articulatio cricarytenoidea
Lig. cricoarytenoideum post.
Ball-and-socket
Rotation, sliding movements
Laryngeal joints
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Lig. thyrohyoideum medianum
Lig. thyrohyoideum laterale
Thyrohyoid membrane
Lig. hyoepiglotticum
Lig. thyroepiglotticum
Bursa hyoidea
Spatium praeepiglotticum
Laryngeal syndesmoses Fibroelastic membrane of larynx
1. MEMBRANA QUADRANGULARIS
lig. ventriculare (vestibulare)
2. CONUS ELASTICUS
lig. vocale
lig. cricothyroideum
ConiotomyElastic cone
Cricotracheal ligament Cricopharyngeal ligament
(ligamentum jugale)
MUSCLES OF THE LARYNX
Muscles of the epiglottis
Muscles of the vocal cords (cricoarytenoid j.)
MUSCULUS THYROEPIGLOTTICUS
opens aditus laryngis
MUSCULUS ARYEPIGLOTTICUS
closes aditus laryngis
Muscles of epiglottis:
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Abductors of rima glottidis - respiratory position
MUSCULUS CRICOARYTENOIDEUS POSTERIOR (POSTICUS)
Adductors of rima glottidis – phonatory position
MUSCULUS CRICOARYTENOIDEUS LATERALIS
MUSCULUS ARYTAENOIDEUS (TRANSVERSUS, OBLIQUUS) Tensors of vocal folds
MUSCULUS CRICOTHYROIDEUS
Strain the vocal folds
MUSCULUS THYROARYTAENOIDEUS
MUSCULUS VOCALIS
Innervation of laryngeal muscles
Nervus laryngeus inf.
M. cricothyrodeus –
ramus externus
n. laryngei sup.
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Laryngeal cavity
VESTIBULUM LARYNGIS
GLOTTIS
CAVUM INFRAGLOTTICUM
(aditus laryngis – rima vestibuli)
(rima vestibuli – rima glottidis)
(rima glottidis - trachea)
Laryngoscopy
directindirect
Laryngoscopic view TRACHEA
C6 (cartilago cricoidea)
Th4-5 (bifurcatio tracheae)
Pars cervicalis
Pars thoracica
(10 – 12 cm)
Tracheal wall
adventicia
cartilago tracheae
paries membranaceus musculus trachealis
Mucous membrane
(pseudostratified
columnar, ciliated )
Submucous tissue
(gl. tracheales)
PARS CERVICALIS TRACHEAE
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thymus, veins, arteries, tr. symphaticus, n.vagus –
n. laryngeus recurrens !!!, oesophagus, lymphatic nodes
PARS THORACICA TRACHEAE
BRONCHUS PRINCIPALIS DEXTER ET SINISTER
70 - 800
dx. sin.
bifurcatio tracheae
Th4
carina tracheae
bronchoscopy
Lungs
apex pulmonis
basis pulmonis
facies costalis
diaphragmatica
medialis
margo anterior
inferior
posterior
fissurae interlobares
PULMO DEXTER
Fissura obliqua
Fissura transversa
Lobus superior
medius
inferior
Th 4
Costa IV.
Costa VI.
PULMO DEXTER HILUS PULMONIS
Bronchus principalis dx.
Arteria pulmonalis dx.
Venae pulmonales dx.
Impressions:
Apex – sulcus a. subclaviae dx.
sulcus costae primae
Impressio cardiaca
Sulcus venae cavae superioris
Sulcus venae azygos
Sulcus oesophageus
Fissura obliqua
Lobus superior
inferior
Incisura cardiaca
Lingula pulmonis
PULMO SINISTER
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PULMO SINISTER HILUS PULMONIS
Arteria pulmonalis sin.
Bronchus principalis sin.
Venae pulmonales sin.
Impressions:
Apex – sulcus a. subclaviae sin.
sulcus v. brachicephalicae
sulcus costae primae
Impressio cardiaca
Sulcus aorticus
Impressio oesophagea
SEGMENTA BRONCHOPULMONALIA
SEGMENTA BRONCHOPULMONALIA DEXTRA
1
2
3
4
6
7
8 9
10
1
2
3
4
5
6
8
910
LOBUS SUPERIOR
(1) seg. apicale
(2) seg. posterius
(3) seg. anterius
LOBUS MEDIUS
(4) seg. laterale
(5) seg. mediale
LOBUS INFERIOR
(6) seg. apicale
(7) seg. basale mediale
(8) seg. basale anterius
(9) seg. basale laterale
(10) seg. basale posterius
SEGMENTA BRONCHOPULMONALIA SINISTRA
LOBUS SUPERIOR
(1+2) seg.
apicoposterius
(3) seg. anterius
(4) seg. lingulare superius
(5) seg. lingulare inferius
LOBUS INFERIOR
(6) seg. apicale
(7) seg. basale mediale
reduced
(8) seg. basale anterius
(9) seg. basale laterale
(10) seg. basale posterius
1 + 2
3 3
44
5
5
6
6
10
109
9
8
7+8
2 + 1
ARBOR BRONCHIALIS
Bronchus principalis dx., sin.
Bronchi lobares (dx. 3, sin. 2)
Bronchi segmentales (dx.10, sin. 8)
6-18 x ramified
Rami bronchiales segmentorum
Bronchioli terminales
(until 1 mm diameter– cartilages)
bronchiolus
terminalis
bronchiolus
respiratorius
ductus
alveolari
s
antrum
saccus
alveolaris
alveolus pulmonis
(300-400 mil)
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Functional blood circulation (pulmonary circulation)
truncus pulmonalis
(a. pulmonalis dx. et sin.)
Venae pulmonalesLUNGS
- O2 + O2
ventriculus dexter
atrium sinistrum
NUTRITIVE BLOOD CIRCULATION
Aorta thoracica → rr. bronchiales Vv. bronchiales →
v. azygos, v. hemiazygos accessoria
PLEURA
pleura parietalis
pleura visceralis
(lig. pulmonale)
cavum pleurae dextrum
cavum pleurae sinistrum
mediastinum
RECESSUS PLEURAE
r. costodiaphragmaticus
r. costomediastinalis
r. phrenicomediastinalis
Projection of pleura
area interpleuralis superior (thymica)
area interpleuralis inferior (pericardiaca)
Recessus retrooesophageus Th4 – Th12
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Projection of lungs MEDIASTINUM
Mediastinum superius
Mediastinum inferius:
anterius
medium
posterius
Mediastinum superius Mediastinum inferius
MECHANISM OF BREATHING
INSPIRATION
Diaphragmatic contraction
(abdominal type)
mm. intercostales externi
(costal type)
Capacity of thoracic cavity is increased:
EXSPIRATION
Capacity of thoracic cavity is decreased:
• Diaphragm and mm. intercostales externi are relaxed
• Contraction of mm. intercostales interni a intimi
• Weight of thorax
• Elasticity of rib cartilages
• Elasticity of lungs
• Pressure of abdominal organs
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References:
Putz, R. (2008):
Atlas of Human Anatomy Sobotta. Elsevier Books.
Keith L. Moore, Arthur F. Dalley (2005):
Clinically Oriented Anatomy. Williams and Wilkins.
Platzer, W., Kahle, W., Leonhardt H. (1992):
Locomotor system. Georg Thieme Verlag, Stuttgart,
New York, 4th edition.
Čihák, R. (1987):
Anatomie 1. Avicenum, Zdravotnické nakladatelství.
Netter, F. H. (1997):
Interactive Atlas of Clinical Anatomy. Novartis, USA.