Yuan Yulin

Introduction Constituents
Nose pharynx larynx
upper respiratory tract

●Conducting part:

trachea principal bronchi
lower respiratory tract

●Respiratory part: left and right lungs

● External nose ● Nasal cavity ● Paranasal sinuses

Ⅰ.External nose
Root of nose Back of nose Apex of nose Two alea nasi Two nares

1. Nasal vestibule:hairs of
nose, sweat and sebiferous glands

Ⅱ.Nasal cavity

2. Proper nasal cavity:
Superior : cribriform plate Inferior : palate Medial : nasal septum Anterior: limen nasi Posterior : choanae Lateral : nasal conchae and meatuses/Sphenoethmoidal recess
Cribriform plate Limen nasi

choanae choana

Nasal mucous membrane:
olfactory region respiratory region: little region:

Ⅲ. Paranasal sinus
Names Positions Openings

1.Frontal In the frontal Middle nasal bone meatus sinus 2.Ethmoidal Within Superior ,middle and ethmoid sinus
bone possterior nasal meatus Middle nasal meatus
1 nasolacrimal canal


4 2 3

3.Maxillary sinus

In the bodies of maxilla

Within the Sphenoethm4.Sphenoidal body of the oidal recesses sinus sphenoid bone


●Laryngeal cartilages ● Laryngeal joints ● Laryngeal ligaments ● Laryngeal membranes ● Muscles of larynx ● Laryngeal cavities

Ⅰ.Laryngeal cartilages
1.Thyroid cartilage:
Laryngeal prominence Superior thyroid notch Superior cornu /Inferior cornu

2.Cricoid cartilage:
Laminae of cricoid cartilage arch of cricoid cartilage

3.Arytenoid cartilages
Apex Base :muscular process vocal process

4. Epiglottic cartilage:

Ⅱ. The Laryngeal membranes & ligaments
1. Thyrohyoid membrane :
between thyroid cartilage and hyoid bone

2. Conus elasticus :
vocal ligaments /vocal folds/fissure of glottis

3. Quadrangular membrane :
vestibular ligaments / vestibular folds/rima vestibuli Vocal muscle+vocal ligament+vocal fold = vocal cord

Ⅲ. Laryngeal joints
1. Cricothyroid joint
It can be rotated around the coronal axis,so that the length and the tenseness of the vocal fold may be changed.

2. Cricoarytenoid joint
It allow the rotation of arytenoid cartilage on the lamina of cricoid cartilage, so that apposition and abduction of vocal folds can be occured

Ⅳ. Muscles of larynx

1.Posterior cricoarytenoid :
open glottis and tense vocal fold

2.Transverse arytenoid the oblique arytenoid::close


3. Cricothyroid and the posterior cricoarytenoid:
tense and lengthen the vocal fold

2 1

4. Thyroarytenoid:
relax and shorten the vocal fold



Ⅴ. Laryngeal cavity
1.Aperture of larynx Epigottis /Aryepigottic folds / Interarytenoid notch
2.Two pairs of folds ① Vestibular folds ② Vocal folds

3.Two fissures Rima vestibuli Fissure of glottis 4. Three parts
① Laryngeal vestibule

Vocal folds

① ② ③

② Intermedial cavity of larynx: ventricle of larynx ③ Infraglottic cavity

●Position Cricoid cartilage (superior) bronchi (inperior) Esophagus(posterior) ●Structure Wall of trachea: tracheal cartilages smooth muscle connective tiusse Bifurcation of trachea Carina of trachea

Carina of trachea

Bifurcation of trachea

●The right principal bronchus
shorter ,wider and more vertical in position than left

●The left principal bronchus
longer,finer and less vertical in position than the right

● Structure
similar in structure to the trachea

●Bronchial tree
Bronchi →Lobar bronchi →Segmental bronchi→ Bronchioles→Terminal bronchioles


Lungs Ⅰ. External Features
1.Apex of lung :Round and extends to 2-3 cm above the level of the medial one-third of the clavicle 2.Base of lung (Diaphragmatic surface) 3. A costal surface 4. A medial surface (mediastinal surface) :Hilum of lung and root of lung 5. Anterior border: 6.Posterior border 7. Inferior border
①Cardiac notch of left lung ②lingula of left lung ① ②
7 3
5 4 6



Ⅱ. Lobes ﹠Segments of lungs
1.Two fissures: oblique fissure horizontal fissure 2.Lobes: Left lung : superior and inferior lobes Right lung : Superior, middle and inferior lobes 3.Segments (bronchopulmonary Segments)


Cupula of Pleura Costal Pleura

Mediastinal Pleura

The pleura is a thin, glistening, slippery serous membrane.Some of them lines the inner surface of the thoracic wall(parietal pleura) and some of them covers with the surfaces of lungs and extends into the pulmonary fissures(visceral pleura) Costal Pleura/ Diaphragmatic Pleura/Cupula of Pleura/Mediastinal Pleura

Ⅰ. Parietal Pleura (PP)

Diaphragmatic Pleura

Ⅱ.Visceral Pleura (VP)
The pleura is reflected from the mediastinum to the surface of lung, where it is called visceral pleura covering the lungs and extending into the fissures of lung .Below the root of lung the mediastinal pleura extends as a double layer to the mediastinal surface of lung.This double layer is called the pulmonary ligament

Ⅲ. Pleural Cavity and ecesses
1.Pleural cavity (PC):Only a potential and sealed space between the parietal and visceral pleurae / containing little serous fluid in health/ separated from each other by the mediastium/present a negtive pressure. 2.Pleural recess: parts of PC/ in deep breathing inferior border of lung no completely reaching reflexion of PP with inserting slit/containing serous fluid, such as ①costodiaphragmatic recess(between costal and diaphragmatic pleura) and ②costomediastinal recess.
② ①



Ⅳ. Projection of the Inferior Margins of Lungs ﹠Pleurae
On the surface of the body, the projections of the inferior margins of the lungs and PP lines of reflection are shown in the images.

Posterior median line

1o 12

1.Surface projection of the inferior margins of lung is
located in the junctions of 6th rib and Midclavicular line, 8th rib and midaxillary line, and 10th thoracic spinal process and posterior median line.

Midclavicular line Midaxillary line

2. Surface projection of PP ines of reflection is located in the junctions of 8th
and midclavicular line, 10th rib and midaxillary line, and 12th thoracic spinal process and posterior median line.

6 8 8 1o

● Difinition: It is generally
defined as the interval between the right and left pleural sacs

● Boundaries:
sternum and costal cartilages(in front) thoracic vertebrae (behind) mediastinal pleura (on both sides ) thoracic inlet (above) diaphragm (below)

● Division
Superior mediastinum Inferier mediastinum: anterior mediastinum middle mediastinum posterior mediastinum

superior mediastinum
anterior mediastinum middle mediastinum posterior mediastinum

inferior mediastinum

Important concepts
Upper respiratory tract and lower respiratory tract Costomediastinal recess, mediastinum pleural cavity Paranasal sinus, carina of trachea, bronchial tree bronchopulmonary segments, hilum of lung, root of lung, pulmonary lingament, vocal folds Important contents 1. Positions and openings of paranasal sinuses 2. Divisions of laryngeal cavity 3. Features of left and right principal bronchi 4.External features of lung and lobes of lungs
5.Divisions of parietal pleura

What to observe in the practice ?
/ superior, middle and inferior conchae and corresponding the meatus / nasal septum /choanae /alae nasi / paranasal sinuses

1.Nose: Limen nasi

2. Larynx: thyroid cartilage- laryngeal prominence ,inferior
and superior cornu,superior thyroid notch / arytenoid cartilage– apex and base (vocal process and muscular process) / epigottic cartilage/ cricoid cartilage –lamina and arch/ laryngeal cavityaperture of larynx(epigottis, aryepiglottic folds, interarytenoid notch)vocal folds, vestibular folds, ventricle of larynx

3.Lungs: apex of lung / base of lung / anterior ,posterior and
inferior borders/ costal surface / medial surface-pulmonary ligament and hilum of lung, root of lung (pulmonary artery, vein, bronchi)

4.Trachea and bronchi: posterior wall of trachea /
bifurcation of trachea/ carina of trachea / bronchial tree

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