Anatomy of Respiratory

System
Presented By:
Dr. Alaa Mohsen Saif Al-Emad
Anatomy and Embryology Department

Faculty of Medicine & Health Science

U.S.T
Course Syllabus
 Classification of Respiratory System

Upper Respiratory Tract

nose and nasal cavity, paranasal sinuses, pharynx

(throat), larynx.

Lower Respiratory Tract

Trachea → carina → main bronchi → lobar bronchi

→ segmental bronchi → terminal bronchioles →
respiratory bronchioles → alveolar duct →
alveolar sac → alveoli
Composed of the nose and nasal cavity, paranasal
sinuses, pharynx (throat), larynx.
Concha or Turbinate
 Nose
 The nose consists of the external nose and the nasal
cavity,
 Both are divided by a septum into right and left halves.
Provides airway
Moistens and warms air
Filters air
Olfactory receptors
 External Nose

 The external nose has two elliptical

orifices called the naris (nostrils),
which are separated from each other
by the nasal septum.

 The lateral margin, the ala nasi, is

rounded and mobile.
 Blood Supply of the External Nose
 The skin of the external nose is supplied by branches of the
ophthalmic arteries.
 The skin of the ala and the lower part of the septum are supplied by
branches from the facial artery.
 Nerve Supply of the External Nose
 The infratrochlear and external nasal branches of the ophthalmic nerve
(CN V) and the infraorbital branch of the maxillary nerve (CN V).
 Nasal Cavity

Palatine process maxilla

Horizontal plate palatine bone

  The nasal cavity has:floor, roof, lateral wall, medial or
septal wall.

 Floor

Palatine process maxilla

Horizontal plate palatine bone

Palatine process maxilla

  ROOF

Narrow 
 It is formed
 Anteriorly the nasal and frontal bones,
 In the middle by the cribriform plate of the ethmoid,
(located beneath the anterior cranial fossa)
 Posteriorly by the downward sloping body of the sphenoid
 The Medial Wall of Nasal Cavity
 The Nasal Septum divides the nasal cavity into right and left
halves, It has osseous and cartilaginous parts
 Nasal septum consists of :
 perpendicular plate of the ethmoid bone (superior),
 vomer (inferior)
 septial cartilage (anterior)

Perpendicul
ar Plate
V
Septalomer(ethmoid)

Cartilage
Vomer
 The Lateral Walls of Nasal Cavity

Marked by 3 projections:
 Superior concha
 Middle concha
 Inferior concha
 The space below each concha is called a meatus.
 Blood Supply to the Nasal Cavity
 From branches of the maxillary artery, one of the terminal branches
of the external carotid artery.

 The most important branch is the sphenopalatine artery.

(artery of Epistaxis)

 The sphenopalatine artery anastomoses with the septal branch of

the superior labial branch of the facial artery in the region of the
vestibule.
OPTHALAMIC ARTERY
OPTHALAMIC ARTERY

(branch of the maxillary artery

Kiesselbach's area or plexus is an anastomosis of five blood

(branch of the maxillary artery vessels in the anterior inferior quadrant of the nasal septum over
the septal cartilage.
 Nerve Supply of the Nasal Cavity
 The olfactory nerves from the olfactory mucous membrane ascend
through the cribriform plate of the ethmoid bone to the olfactory
bulbs.
 The nerves of ordinary sensation are branches of the ophthalmic
division (V1) and the maxillary division (V2) of the trigeminal nerve.
CN I – Olfactory Nerves
Anterior ethmoidal branch
of V1

Posterior nasal
Cut nasopalatine branch branches of V2
of V2 to septum
Paranasal Sinuses
 Paranasal Sinuses
 The paranasal sinuses are cavities found in the interior of the maxilla,
frontal, ethmoid and sphenoid bones .
 They are lined with mucoperiosteum and filled with air.
 They communicate with the nasal cavity through relatively small
apertures.
 Lateral
Anterior

Functions:

1-Decrease skull bone weight

2-Warm, moisten and filter incoming air
3-Add resonance to voice.
4-Communicate with the nasal cavity by ducts
 Openings Into the Nasal Cavity

1. Superior meatus: posterior Ethmoidal Sinuses

2. Middle meatus:
• Anterior & Middle Ethmoidal Sinuses
• Frontal sinus
• Maxillary sinus
3. Inferior meatus: Nasolacrimal duct
4. Sphenoethmoidal recess: sphenoid sinus
 The Pharynx
The pharynx i s a musculofascial half-cylinder that links
the oral and nasal cavities in the head to the larynx and
esophagus in the neck
3 parts: naso-, oro- and laryngo pharynx

laryngo pharynx
 Pharynx

Common space used by both the respiratory and

digestive systems.

Commonly called the throat.

Originates posterior to the nasal and oral cavities

and extends inferiorly near the level of the bifurcation
of the larynx and esophagus.

Common pathway for both air and food

* Longitudinal pharyngeal muscles consists of the palatopharyngeus,
salpingopharyngeus, and stylopharyngeus muscles. The pharyngeal muscles
receive innervation from the vagus and glossopharyngeal nerve to work in sync to
propel food from the oral cavity into the esophagus.
 Clinical Relevance:
Pharyngeal Diverticulum (Pouch)
The inferior pharyngeal constrictor is split into two parts; the
thyropharyngeus and the cricopharyngeus. This area between
the two is a weak area in the mucosa.

Normally during swallowing, the thyropharyngeus contracts as

the cricopharyngeus relaxes, allowing the bolus of food to be
propelled into the oesophagus and preventing the
intrapharyngeal pressure from rising.
If this coordinated relaxation of the cricopharyngeus does not
occur, the intrapharyngeal pressure tends to rise and
pharyngeal mucosa forms a midline diverticulum in the area
between the thyropharyngeus and cricopharyngeus. It is
possible for food to accumulate here, leading to dysphagia.
Parts of inferior constrictor muscle
 Nasopharynx
Located directly posterior to the nasal cavity and superior to the soft
palate, which separates the oral cavity.

Normally, only air passes through.

Material from the oral cavity and oropharynx is typically blocked

from entering the nasopharynx by the uvula of soft palate, which
elevates when we swallow.

In the lateral walls of the nasopharynx, paired auditory/eustachian

tubes connect the nasopharynx to the middle ear.

Posterior nasopharynx wall also houses a single pharyngeal tonsil

(commonly called the adenoids.
Palatine tonsils
 Oropharynx
The middle pharyngeal region.
Immediately posterior to the oral cavity.
Common respiratory and digestive pathway through which both air
and swallowed food and drink pass.

Lymphatic organs here provide the first line of defense against

ingested or inhaled foreign materials.

 Palatine tonsils are on the lateral wall between the arches, and the
lingual tonsils are at the base of the tongue.
 Laryngopharynx

• The most distal part of the pharynx.

• Located between the superior border of the epiglottis and
inferior border of the cricoid cartilage (C6). It is continuous
inferiorly with the oesophagus.
• It is found posterior to the larynx and communicates with it
via the laryngeal inlet, lateral to which one can find
the piriform fossae.
• The laryngopharynx contains the middle and
inferior pharyngeal constrictors.

• The recess between the tongue & epiglottis is called the

Vallecula
 Vasculature
Arterial supply to the pharynx is via branches of the external carotid artery:
• Ascending pharyngeal artery
• Branches of the facial artery
• Branches of the lingual and maxillary arteries.

Venous drainage is achieved by the pharyngeal venous plexus, which drains into
the internal jugular vein.
 Larynx
Anatomical Position and Relations
The larynx is located in the anterior compartment of the neck,
suspended from the hyoid bone, and spanning between C3 and
C6. It is continuous inferiorly with the trachea, and opens
superiorly into the laryngeal part of the pharynx.
It is covered anteriorly by the infrahyoid muscles, and laterally by
the lobes of the thyroid gland. The larynx is also closely related
to the major blood vessels of neck, which ascend laterally to it.
Posterior to the larynx is the oesophagus.
This is of clinical relevance during emergency intubation – as
pressure can be applied to the cricoid cartilage of the larynx to
occlude the oesophagus, and thus prevent regurgitation of
gastric contents (known as cricoid pressure or Sellick’s
manoeuvre).
Cricothyroidotomy
???????????

Cricothyroid membrane?

Epiglottis – elastic cartilage that covers the laryngeal inlet

during swallowing
Vestibule: between the laryngeal inlet and the vestibular folds
Middle part: between the vestibular folds above and vocal folds below
Infraglottic cavity: between the vocal fold and the trachea
N.B: white because avascular
Vocal Cords
 Vasculature

The arterial supply to the larynx is via the superior and

inferior laryngeal arteries:
Superior laryngeal artery – a branch of the superior
thyroid artery (derived from the external carotid). It follows
the internal branch of the superior laryngeal nerve into the
larynx.
Inferior laryngeal artery – a branch of the inferior thyroid
artery (derived from the thyrocervical trunk). It follows the
recurrent laryngeal nerve into the larynx.
Nerve supply of the larynx