30
1. Respiratory system an overview 2. Embryonic development of the respiratory system 3. Respiratory passages structure principles 4. Nose: external nose nasal cavity 5. Paranasal sinuses Respiratory system. Nose

Respiratory System Nose - nikolai.lazarov.pronikolai.lazarov.pro/files/histology_eng/Respiratory_System_Nose.pdfcavum nasi proprium Nasal septum, septum nasi: bony part, pars ossea

Embed Size (px)

Citation preview

1. Respiratory system – an overview2. Embryonic development

of the respiratory system3. Respiratory passages – structure principles4. Nose:

� external nose� nasal cavity

5. Paranasal sinuses

Respiratory system. Nose

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Respiratory system

2

� Respiratory system, systema respiratorium

� gas exchange –

negative pressure

breathing

� conducting portion –

respiratory tract

� respiratory portion –

lungs

� voice formation

(phonation) – larynx

� olfaction (sense of smell)

– nasal cavity

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 3

The air passages� Conducting portion – respiratory tract:

� Upper respiratory tract� nasal cavity� pharynx

� Lower respiratory tract� larynx� trachea� bronchi –

external and internal� distributing bronchioles

� Respiratory portion– lungs� respiratory

bronchioles� alveolar ducts� alveolar sacs� alveoli

� Conditioning of the air:� warming� moistening� removal of particulate materials

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 4

Embryonic development

� Embryogenesis of the upper respiratory tract –origin:

� ectoderm of the foregut

� epithelium and nasal glands, nasopharynx

� endoderm of the foregut

� epithelium and glands of oropharynx and hypopharynx

� mesenchyme

� bony and cartilaginous frameworks

o nasal prominences

� Nose:

� frontonasal prominence � root

� two medial nasal prominences

� nasal dorsum and apex

� two lateral nasal prominences

� sidewalls and alae nasi

� nasal (olfactory) placode � nostrils

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 5

� Embryogenesis of the lower respiratory tract –

3rd week of pregnancy:

� respiratory diverticulum (lung bud)

� blind-ended sac

� larynx and trachea

� lung buds

� Larynx:

� epithelium – endoderm of the foregut

� cartilages and muscles – splanchnic mesoderm

Embryonic development

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 6

� Embryogenesis of the lungs:� lung buds �

bronchial buds – Hox genes

� bronchi and bronchioles – 4th mo.

� alveolar ducts and sacs – 6th mo.

� endodermal epithelium� mesenchymal elements� maturation of lungs:

Embryonic development

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Nose

7

� Nose – nasus (Gr. rhis, rhinos):

� both respiratory and olfactory organ

� role in “forming” the timbre of the voice

� Anatomical parts:

� external nose, nasus externus

� nasal cavity, cavitas nasi

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

External nose

8

� External nose, nasus externus:

� side at the middle and upper

parts of the face

� generally pyramidal in shape

� human trait – different types:

� straight, humpy and saddle nose

� Anatomical parts:

� base, basis nasi

� lateral side

� wings, alae nasi

� dorsum, dorsum nasi

� root, radix nasi

� free tip, apex nasi

� nostrils, nares

� columella

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

External nose framework

9

� Bony framework –piriform aperture:

� nasal bones, ossa nasalia

� frontal processes of maxilla

� Cartilaginous framework,cartilagines nasi:

� unpaired� septal cartilage, cartilago nasi septi

� paired:� lateral nasal cartilage,

cartilago nasi lateralis

�major alar cartilage,cartilago alaris major

�minor alar cartilages, cartilagines alares minores

� cartilagines nasales accessoriae

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 10

� Nasal musculature –

rudimentary muscles:

� the procerus, m. procerus

� the nasalis, m. nasalis

� m. depressor septi nasi

� m. apicis nasi – variable

� m. compressor nares

� m. levator labii superioris alaequae nasi

� Connective tissue

� Skin:

� fine hairs

� sweat glands

� numerous large sebaceous glands

External nose sidewall

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

� crooked nose, rhinoscoliosis

� saddle nose, rhinolordosis

� humpy nose, rhinokyphosis

� rhinophyma

� nasal bone trauma and fracture

� squamous cell carcinoma

� nasal anomalies

External nose – clinical relevance

11

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Nasal cavity

12

� Nasal cavity, cavum (cavitas) nasi:� vestibule, vestibulum nasi� nasal cavity proper,

cavum nasi proprium

� Nasal septum,septum nasi:� bony part, pars ossea

� vomer� lamina perpendicularis

ossis ethmoidalis

� pars cartilaginea� cartilago septi nasi� cartilagines alares majores� organum vomeronasale

(Jacobsoni) – pheromones

�Kiesselbach’s area

� membranous part, pars membranacea� nasal septum deviation, deviatio septi nasi

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Vestibule of the nasal cavity

13

� Nasal cavity, cavum (cavitas) nasi:

� entrance – nostrils, nares

� shape – racial trait

� exit – posterior nasal apertures, choanae

� Nasal vestibule, vestibulum nasi:� limen nasi

� agger nasi

� regio cutanea� stiff hairs, vibrissae

� sweat and sebaceous glands

� transition area

� stratified squamous �pseudostratified epithelium

� seromucous glands

� absent sweat and sebaceous glands

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Nasal cavity proper

14

� Nasal cavity proper, cavitas nasalis ossea:�bone skeleton – walls

�floor, inferior – hard palate

�roof, superior wall:

o nasal bone

o ethmoid bone

o sphenoid bone

�medial wall – nasal septum

� lateral wall:

o maxilla

o lacrimal bone

o ethmoid labyrinth

o palatine bone

o sphenoid bone

o conchae nasales, superior, media et inferior

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 15

Nasal cavity proper

� Nasal mucous membrane:�medial wall

�respiratory segment, regio respiratoria

�olfactory segment,regio olfactoria

� lateral wall�nasal conchae�nasal meatuses:

o meatus nasi superior

o meatus nasi medius

o meatus nasi inferior

o meastus nasi communis

o meatus nasopharyngeus

�openings of the paranasal sinuses:o recessus sphenoethmoidalis

o hiatus semilunaris, infundubulum, plica lacrimalis

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 16

Nasal cavity proper

� Nasal mucous membrane:�medial wall

�respiratory segment, regio respiratoria

�olfactory segment,regio olfactoria

� lateral wall�nasal conchae�nasal meatuses:

o meatus nasi superior

o meatus nasi medius

o meatus nasi inferior

o meastus nasi communis

o meatus nasopharyngeus

�openings of the paranasal sinuses:o recessus sphenoethmoidalis

o hiatus semilunaris, infundubulum, plica lacrimalis

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 17

Nasal cavity proper� Microscopic anatomy:

�olfactory segment –5-10 mm2; yellowish-brown

�olfactory mucosa, tunica mucosa

o olfactory epithelium –

• receptor (olfactory) cells

• supporting cells (sustentacular)

• basal cells – stem cells

• brush cells

o lamina propria

• olfactory(Bowman’s) glands

�absent submucosa, tela submucosa

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 18

� Microscopic anatomy:

� respiratory segment,

regio respiratoria – 1-3 mm

� lamina epithelialis – ciliated,

pseudostratified columnar epithelium

– five cell types:

o ciliated cells

o goblet cells

o brush cells

o small granule cells

o basal cells

� lamina propria

o nasal glands – seromucous, tubular

o venous plexuses, stratum cavernosum

� plexus cavernosi concharum �

epistaxis

o Kiesselbach’s area, locus Kiesselbachi

o broad lymphatic network –

lymphatic nodules

Nasal cavity proper

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov 19

Blood supply of the nose

� External nose:� facial artery� ophthalmic artery

� Nasal cavity:� respiratory segment

� sphenopalatine artery (external carotid artery)

� olfactory segment� anterior and posterior

ethmoidal arteries (internal carotid artery)

� Venous drainage:� facial and ophthalmic veins

� Lymphatic drainage:� deep neck lymph nodes

(internal jugular vein)� retropharyngeal lymph nodes

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Innervation of the nose

20

� Sensory innervation –trigeminal nerve:

� ophthalmic nerve

�nasal nerve

� maxillary nerve

� infraorbital nerve,

infratrochlear nerve (root),

anterior ethmoidal nerve

�posterior nasal nerves

� Autonomic innervation:

� sympathetic

�carotid plexus

� parasympathetic

�pterygopalatine ganglion

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Innervation of the nose

21

� Sensory innervation –trigeminal nerve:

� ophthalmic nerve

�nasal nerve

� maxillary nerve

� infraorbital nerve,

infratrochlear nerve (root),

anterior ethmoidal nerve

�posterior nasal nerves

� Autonomic innervation:

� sympathetic

�carotid plexus

� parasympathetic

�pterygopalatine ganglion

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Paranasal sinuses, sinus paranasales

� sinus maxillaris (antrum Highmori)

� sinus frontalis

� sinus ethmoidalis

� sinus sphenoidalis

22

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Paranasal sinuses, sinus paranasales

� sinus maxillaris – developed in newborns� sinus frontalis – during the 2nd year of life� sinus ethmoidalis – 3-4 years after birth� sinus sphenoidalis� pneumatization – around 20 years

23

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Maxillary sinus, sinus maxillaris

� maxillary sinus (antrum of Highmore):

� the largest air sinuses

� pyramidal cavity in the maxillary body

�hiatus maxillaris �

hiatus semilunaris

�drainage �

meatus nasi medius

24

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Maxillary sinus, sinus maxillaris

� maxillary sinus (antrum of Highmore):

� the largest air sinuses

� pyramidal cavity in the maxillary body

�hiatus maxillaris �

hiatus semilunaris

�drainage �

meatus nasi medius

25

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Frontal sinus, sinus frontalis

� frontal sinus, sinus frontalis:� two sinuses in the frontal bone

�septum sinuum frontalium

�ductus nasofrontalis – 12-16 mm

�drainage � infundibulum of the

meatus nasi medius

26

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Ethmoidal sinus, sinus ethmoidalis

� Cellulae ethmoidales – 10 (5-16):

� cellulae ethmoidales anteriores

�2-3 in number

�drainage � meatus nasi medius

� cellulae ethmoidales medii, incl.

bulla ethmoidalis

�3-4 in number

�drainage � meatus nasi medius

� cellulae ethmoidales posteriores

�4-5 in number

�drainage � meatus nasi superior

(meatus nasi supremus)

27

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Sphenoidal sinus, sinus sphenoidalis

� Sinus sphenoidales:� two sinuses within

the sphenoid bone body�septum sinuum sphenoidalium

�apertura sphenoidalis

�drainage � sphenoethmoidal recess

28

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Clinical significance

29

� sinus infection – sinusitis

� paranasal sinus tumors, cysts

� sinus drainage

� spread to adjacent structures

SPLANCHNOLOGY

Prof. Dr. Nikolai Lazarov

Thank you ...30