HEAD AND NECK -1HEAD AND NECK -1HEAD AND NECK -1HEAD AND NECK -1DR VINIT K ASHOKDR VINIT K ASHOKADJUNCT FACULTY ADJUNCT FACULTY

TRIANGLES OF THE NECK

• POSTERIOR TRIANGLE BOUNDARIES - ANTERIORLY----STRENOCLEIDOMASTOID- POSTERIORLY---TRAPEZIUS- INFERIORLY--- CLAVICLE- CONTENTS NERVES- ACCESSORY NERVE, CERVICAL PLEXUS, PHRENIC

NERVE, BRACHIAL PLEXUS ARTERIES-SUBCLAVIAN ARTERY VEINS-EXTERNAL JUGULAR VEIN* WOUND TO THE NECK IN THIS REGION CAN LEAD TO

PARALYSIS OF THE TRAPEZIUS AND STERNOCLEIDOMASTOID

ANTERIOR TRIANGLE

BOUNDARIES- SUPERIORLY----INFERIOR MARGIN OF THE MANDIBLE- ANTERIORLY----MIDLINE OF THE NECK- POSTERIORLY—STERNOCLEIDOMASTOID

CONTENTS- GLAND---- SUBMANDIBULAR GLAND- MUSCLES----- SUPRAHYOID, INFRAHYOID- VEINS--- UPPER PARTS OF THE JUGULAR VEINS- ARTERIES—UPPER PARTS OF THE CAROTIDS

UPPER RESPIRATORY TRACTUPPER RESPIRATORY TRACT• NOSE- EXTERNAL VISIBLE PART MADE UP OF

CARTILAGE AND BONE- PROVIDES AIRWAY FOR RESPIRATION- MOISTENS AND WARMS THE AIR- FILTERS INHALED AIR- RESONATING CHAMBER FOR SPEECH- HOUSES THE RECEPTORS FOR SMELL

( OLFACTION)

NASAL CAVITYNASAL CAVITY• LIES POSTERIOR TO THE NOSE. DIVIDED INTO RT AND LEFT BY

NASAL SEPTUM AIR ENTERS THROUGH THE ANTERIOR NARES. LINED BY RESPIRATORY MUCOSA/ OLFACTORY MUCOSA

• BOUNDARIES ROOF- ETHMOID AND SPHENOID BONES FLOOR – PALATE ANTERIORLY-ANTERIOR NARES POSTERIORLY- INTERNAL NARES ( Choanae). OPENS INTO

NASOPHARYNX LATERAL WALLS-NASAL CONCHAEo PALATE—HARD /SOFT ( SEPERATES THE ORAL AND NASAL

CAVITIES. PALATINE AND MAXILLARY BONES( HARD)o VESTIBULE-SUPERIOR TO THE NOSTRILS( FLARED)o VIBRISSAE-NOSE HAIRS

RESPIRATORY MUCOSARESPIRATORY MUCOSA• PSEUDOSTRATIFIED CILIATED COLUMNAR EPITHELIUM WITH

SCATTERED GOBLET CELLS• GLANDS IN THE CONNECTIVE TISSUE ( SEROUS / MUCOUS) • SEROUS SECRETIONS ----DIGESTIVE ENZYME( LYSOZYME)• MUCOUS SECRETIONS---STICKY TRAP DUST,BACTERIA, POLLEN,

DEBRIS FROM AIR. ALSO MOISTENS THE INHALED AIR• * RHINITIS---INFLAMMATION OF THE NASAL MUCOSA.CAUSED BY

BACTERIA, VIRUSESOR ALLERGENS. RESULTS IN INCREASED SECRETIONS AND CONGESTION

NASAL CONCHAENASAL CONCHAE• PROJECTIONS FROM THE LATERAL NASAL WALLS, MUCOSA COVERED

SCROLL LIKE STRUCTURES• 3 IN NUMBER SUPERIOR, MIDDLE( PART OF THE ETHMOID BONE) AND

INFERIOR ( SEPARATE BONE)• GROOVE INFERIOR TO THE CONCHA ----MEATUS ( OPENINGS OF MANY

STRUCTURES)FUNCTIONS OF THE CONCHAE- CAUSES TURBULANCE OF AIR INHALED- HEATS THE INHALED AIR- MOISTENS THE AIR- HELPS TRAP DUST PARTICLES- RECLAIMS HEAT AND MOISTURE

PARANASAL SINUSESPARANASAL SINUSES• AIR FILLED CAVITIES IN THE BONES SORRUNDING THE NASAL

CAVITY• FRONTAL, ETHMOID, SPHENOID AND MAXILLARY• HAVE SAME RESPIRATORY MUCOSA FUNCTIONS WARMS THE AIR LIGHTENS THE SKULL GIVES RESONANCE TO THE VOICE• ALL OPEN INTO THE NASAL CAVITY ( MEATUS)• BLOWING THE NOSE DRAINS THEM MAXILLARY SINUS DOES NOT DRAIN VERY WELL SINUSITIS

PHARYNXPHARYNX• THROAT• CONNECTS THE NASAL CAVITY AND ORAL CAVITY ABOVE TO THE

LARYNX AND ESOPHAGUS BELOW• EXTENDS FROM THE BASE OF THE SKULL TO THE C6 VERTEBRA• MUSCULAR WALLS ( SKELETAL MUSCLE) PRESENT THROUGHOUT

THE LENGTH• DIVIDED INTO 3 REGIONS NASOPHARYNX OROPHARYNX LARYNGOPHARYNX

INPORTANT CONTENTS IN INPORTANT CONTENTS IN THE PHARYNXTHE PHARYNX

• NASOPHARYNX--- • ACTS ONLY AS AIR PASSAGE• UVULA PREVENTS THE FOOD FROM COMING BACK INTO THE NASOPHARYNX• ADENOIDS( PHARYNGEAL TONSILS) FOUND IN THE ROOF• TUBAL TONSILS FOUND IN THE LATERAL WALL • OROPHARYNX—• COOMON PASSAGE FOR AIR AND FOOD• FAUCES IS THE ARCH LIKE ENTRANCE TO IT• PALATINE TONSILS FOUND IN THE LATERAL WALL OF THE FAUCES• LINGUAL TONSILS COVERS THE POSTERIOR SURFACE OF THE TONGUE• LARYNGOPHARYNX-• COMMON PASSAGE FOR BOTH FOOD AND AIR• LIES POSTERIOR TO THE LARYNX• CONTINUOUS WITH BOTH THE LARYNX AND ESOPHAGUS• * TONSILS ARE PART TO THE IMMUNE SYSTEM AND PROTESCT AGAINS INFECTION

LARYNXLARYNX• ALSO CALLED THE VOICE BOX• EXTENDS FROM C-4 TO C-6 VERTEBRA• ATTACHMENTS – SUPERIORLY ---HYOID BONE• INFERIORLY ----CONTINOUS WITH THE TRACHEA• FUNCTIONS - VOICE PRODUCTION• - AIR PASSAGE• - ROUTES FOOD / AIR TO PROPER PATH• FRAMEWORK - NINE CARTILAGES• - MEMBRANES• - LIGAMENTS CARTILAGES EPIGLOTTIS THYROID CARTILAGE UNPAIRED CRICOID CARTILAGE CORNICULATE CUNEIFORM PAIRED ARYTENOID

LARYNGEAL CARTILAGESLARYNGEAL CARTILAGES• THYROID LARGE SHIELD SHAPED 2 CARTILAGE PLATES ADAMS APPLE( LARYNGEAL PROMINENCE)• EPIGLOTTIS LEAF SHAPED ELASTIC CARTILGE COVERED BY MUCOSA STALK ATTACHED ANTERIORLY TO THE INTERNAL ASPECT OF

THYROID GAURDIAN OF THE AIRWAYS• CRICOID LIES INFERIOR TO THE THYROID CARTILAGE SIGNETRING SHAPED PERCHED ON TOP OF THE TRACHEA

VOCAL CORDSVOCAL CORDS• PRESENT IN THE LARYNX• VOCAL FOLDS( TRUE VOCAL CORDS) ARE AVASCULAR AND

APPEAR PEARLY WHITE• AIR EXHALED FROM THE LUNGS CAUSES THEM TO VIBRATE

PRODUCING THE BASIC SOUNDS OF SPEECH

THYROID GLANDTHYROID GLAND• LARGEST PURE ENDOCRINE GLAND• LOCATED IN THE NECK ON THE TRACHEA INFERIOR TO THE

LARYNX• PRODUCES HORMONES ---THYROXINE, TRIIODOTHYRONINE AND

CALCITONIN• MOVES UP WITH SWALLOWING• BLOOD SUPPLY BY THE SUPERIOR AND INFERIOR THYROID

ARTERIES

HYOID BONEHYOID BONE• LIES INFERIOR TO THE MANDIBLE• BODY AND 2 PAIRS OF HORNS• DOES NOT ARTICULATE WITH ANY OTHER BONE• ATTACHED SUPERIORLY TO THE SKULL BY LIGAMENTS AND ALSO

TO THE LARYNX INFERIORLY BY LIGAMENTS• ACTS AS A MOVABLE BASE FOR THE TONGUE