UNIT–VII

RESPIRATORY
SYSTEM

1
 Pa
rtso
fre
spi
rat
orys
yst
em
 Nos
e(nasa
lca
vit
y)
 Phar
ynx
 Lar
ynx
 Tra
chea
 Bro
nchu
s
 Lun
gs

NOSE

 Thein
teri
orofnosei
scall
ednasalc
avityprop
er.Itp
rese
ntsr
oof,fl
oor
,me d
ialwall(nasa
lsept
um)
andlat
eralwal
l
 Roof:itisl
ine
db yamucousmembranecal
ledol
fact
orymuco
sa,co
nce
rnedwi
ths mellse
nsat
io
n.Iti
s
for
medb yet
hmo i
dbone
,fronta
lb o
ne,n a
salbon
e,sphe
noi
dbonean
dsept
alandlate
ra lc
art
il
age.
 Flo
or:itisformedbyhardpal
ate.

2
 Medi
alwallorNasals
eptum
I
tisformedbynasa
lsept
um.Some d
ialwal
lisca
lle
dnasalse
ptum.
For
ma t
ion
Bone
s:p erp
end
icul
arplat
eofethmoi
dandvomer
,n a
salspi
neoffron
talb
one,c
res
tofn
asa
lbo
ne
an
dr o
stru
mo fspheno
id.
Cart
il
aginou
spart:septa
lcar
til
ageandse
ptalpr
oces
sesofala
rcart
il
ages
.

 Arteri
alsupply:a nt
erio
re t
hmoidalarte
r y
,p ost
erio
ret hmoid
alarte
ry,speno
palat
inea
r t
ery,
great
erp a
lati
near t
eryandsuperio
rlabialartery
.
 Nervesuppl
y:o lfactor
yn er
ves,ante
r i
orethmo i
dalnerve,na
sopal
ati
nenerve
,gr ea
terpalati
nenerv
e
andmax i
ll
arynerve.
 Cli
nica
la na
tomy:
 Lit
tle’
sa re
a:i tisanareaonthea nt
ero-inferi
orpartoft henasa
lseptu
m,whi chishighlyvasc
ular
.
Thisareaofnasalseptu
mi sthecommo ne
sts i
teofepist
a xi
s(noseble
edi
ng).
 Latera
lwa l
l:i tisformedbyb one
sandc arti
lages
.
 Bones:n a
sal,frontalpro
cessofma xi
lla,lacri
mal,conchaeandlabyri
nthofethmoid
,i n
feriorna
sal
co
n c
ha,p er
pendic
u l
arplat
eo fpalat
ineandme dia
lp t
erygoidpla
teofsphenoi
dbone.
 Carti
lages:lateralnas
alcarti
lage,lowern a
salcarti
lagea n
dthreetofourminorala
rc ar
til
age.

3
 Feat
u r
es:i tisdi
videdin
tothreepart
s
1
. Ante
r i
orpartiscalle
dv e
sti
bule
.
2.Middl
ep a
rtisc al
ledatri
umofmi ddl
emeatus
.
3.Post
erio
rp artpresen
tthreeshelfli
keproj
ect
io
nc a
lle
dconc
haean
dspac
ess
eenb
elo
wtheco
ncha
e
cal
le
dme atus.
Therearethreeconchae–superi
or,midd
leandin
feri
or.Ther
efo
rethe
rear
ethr
eemea
tusa
re
pre
sent–sup eri
or,middl
eandinferi
ormeatu
s.

Op
eni
ngsi
nthel
ate
ralwa
llo
fthen
ose
.

Si
tes Open
ings
Sp
heno
ethmoi
dalrec
ess Op
eni
ngo
fthes
pheno
idai
rsin
us.
Su
per
iormeat
us Op
eni
ngo
fthep
ost
eri
orethmoi
dala
irs
inu
s.
Mi
ddl
eme a
tus
a.Onb ull
a Op
eni
ngo
fthemi
ddl
eet
hmo
ida
lai
rsi
nus
b.I nhi
atu
ssemilun
ari
s
1. Ant
erio
rp ar
t Op
eni
ngo
fthefro
ntala
irsi
nus
2.Mi d
dlepart Op
eni
ngo
fthean
teri
oret
hmoid
ala
irs
inu
s
3.Po s
teri
orpart Op
eni
ngo
fthemaxi
ll
aryai
rsin
us

I
nfe
rio
rme
atu
s Op
eni
ngo
fthen
aso
lac
rima
ldu
ct

4
 Arte
ria
lsupply:a n
terioret
hmoida
larter
y,faci
alart
ery,gr
eate
rpalat
inearte
ryand
sp
henopa
lati
nearter
y .
 Nerv
esupply:olfactor
yn erv
e,ante
rio
rethmoi
dalner
ve,maxi
ll
arynerv
ea n
dgr e
aterpa
lat
inenerv
e.
 Cli
ni
calanat
omy:
Rhin
iti
s:itistheinflammati
onofmu c
ousmembran
elini
ngna
salcav
ityduetovi
ruse
s,bact
eriaor
al
ler
gens.Thisisac
c o
mp ani
edbyanexce
ssi
vepro
ducti
onofmuco
sathatresu
ltsi
nn a
salbl
ocage,
sn
eezi
ngandwa terdi
schargefromnose
.
PARANASALAI
RSI
NUSES

The s
earea irfi l
leds paceslin
edb ymuco usme mbraneandcommu n i
catewit
hn asa
lcavit
y.The yred
uce
weightoft hes kull.
1. Ma xi
llar
ya irs inuses:i tisthelargestp ar
an as
alairsinus
.Iti ssitu
a t
edins
idethebodyofma xi
ll
a.
I
ti spyramida li
ns hape.Ap exdir
ectedtowa rdsthez y
goma ti
cb oneandb a
sedire
ctedtowardsthe
nasalcavi
ty.I topensi ntothemi d
d l
eme atusofthela t
eralwallo fnasalcavi
tyatthehiatus
semilu
naris.
2.Et hmo i
dala irsinus:t he yarep l
acedbe twe
e nthelatera
lwa lloft henasalcav
ityandme d
ialwal
lof
theorbit
.The r
ea rethr eegr o
upsofe thmoidalairsinu
ses.
a.An terio
re thmo ida
la irsinuswhicho pensintomiddlemeatus.
b.Mi ddleethmo idalairsinuswhi chopensintomi ddl
eme atu
sa bovetheb ull
a.
c. Posteri
oret hmo i
dala i
rs inuswhicho p
en sin
tos uperi
orme a
tus.
3.Sp he n
oidala irsin
u s:i tisp re
sentintheb odyofs pheno
id.Itop ensi
n t
osphenoe
thmoidalrece
ss.
4.Fr ontalairs inus:i tisp res
entinthefr ontalbone.Itopensintoanteri
orp a
rtofthehi at
us
semilu
narist hroughfr onto–nasa
ld uct
.

5
 App
lie
danat
omy:
I
nfl
amati
onofp
ara
nas
ala
irs
inu
sesa
rec
all
eds
inu
sit
is
.

PHARYNX

I
tisafibro
mu s
cul
art u
be.I
tissi
tua
tedbe
hindt
henose
,mo
utha
ndl
ary
nx.I
tisa
bou
t12t
o14
cml
ong.
I
tissub
divi
dedin
tothreepa
rts.
1
. Naso
pharynx–upperpartl
iesb
ehi
ndthenas
alca
vit
y.
2.Orop
harynx–middl
ep artl
ie
sbehi
ndtheor
alca
vit
y.
3.La
r y
ngopharyn
x–l owerpa
rtli
esbehi
ndt
helar
ynx.

Co
mpa
ris
ono
rdi
ffe
ren
tia
teb
etwe
enn
aso
pha
ryn
x,o
rop
har
ynxa
ndl
ary
ngo
pha
ryn
x.

Fe
atu
res Nas
ophar
ynx Or o
pharynx Laryngopharyn
x
Si
tua
tio
n Be
hindn
ose Behi
ndoralcav
ity Behi
ndlarynx
rd
Ext
ent Bas
eofskul
ltos
oft Softpa
lat
et ouppe
rbor
der Post
eri
or1/3 o fton
gue
pa
lat
e ofepi
glo
ttis tolo
werb o
rderof
cri
coi
dcarti
la
ge
Co
mmu
nic
ati
ons 1
. Ante
rio
rlywi
th 1
. Ante
r i
orl
ywithora
l 1. Anteri
orl
ywi t
h
no
se cav
ity lar
ynx
2.Bel
owwith 2.Abovewithnas
opha
ryn
x 2.Ab ovewit
h
or
opharyn
x 3.Bel
owwi th oro
pharynx
la
ryngophary
nx 3.Be lo
wwi t
h
eso
phagus
Re
lat
ion
s:
An
teri
orwa
ll Pos
ter
iorn
asa
l Orophar
yngealis
thmusand La
ryn
gea
lin
let
ap
ertu
re pharyn
gealpartoftongue.
I
tc o
ntai
nWa ldey
e r
s
lymphat
icri
ng.Itisformed
bynasop
haryngealton
sil
6
 po
s t
er o
su p
eriorl
y,l i
ngual
to
n s
ilan te
riorl
yan dtubal
andpa l
atinetons
illater
ally
.
n
d r
d
Po
ste
rio
rwa
ll Fi
rstcer
vica
l 2t o3 c e
r v
ica
lv ert
ebrae 3rdto6thc ervi
c a
l
ve
rtebr
a ver
tebr a
e
Ro
of Bod
yo fsphen
oidand Softp alat
ea nd Post
er i
or1/3rdof
ba
sio
ccip
ut.Itcon
tai
n naso
p haryngealis
thmu s to
ngu e,vall
eculaan d
na
sophary
ngealto
nsi
l upperb o
rderof
epi
glotti
s
Fl
oor Softp al
ateand Posteri
or1/3rdoft ongue
, Upperb or
dero fc r
icoi
d
nasopharyn
geal va
lleculaa ndupperborderof car
tilagetolowe rborder
th
i
sthmu s ep
iglottis of6 c e
rvic
alv ert
e b
r
La
ter
alwa
ll I
tc onta
in:o pe
nin
go f Tonsi
larfo ssacontai
nin
g Pir
iformfo ssaone ach
audi
torytube,tubal pala
tinet o
nsil si
deo finl
etofl arynx,
el
evation
,t u
bal boundedbya ryepi
glotti
c
to
ns i
l, fol
dme di
all
ya ndthyroid
sa
lp i
ngopharyn
geal car
tilageandt hyrohyoi
d
foldandfo s
saof memb ranelaterall
y
Rosenmulle
r.
Ne
rves
upply Max i
llar
yn e
rve Glo
ssop
haryngealne
rve I
nte
rnalla
ryngea
lnerv
e
Li
ni
ngepi
thel
ium Ci
liatedcol
umnar Str
ati
fiedsq
u a
mo u
s St
rati
fie
dsquamous
non
kerati
ni
sed no
nkerat
ini
se
d
Fu
nct
ion Passageforair Pass
ageforairandfoo
d Pas
sageforfood
Diagr
amofp hary
n x

Di
agr
amo
fWa
lde
yer
’sl
ymp
hat
icr
ing

7
 Mu
scl
eso
fpha
ryn
x

Pharynxc on
sistsoftwogr oupso fmu scle
s .The yarecons
tri
cto
r sandlon
gidu
nialmuscl
es.
Constri
ctormu scl
esaresuperio
r ,mi dd
lea ndinferior.Longi
tudina
lmu sc
lesaresalpi
ngophar
y n
geus,
pala
topharynge u
sa n
ds t
ylopharynge us.
 Nerves up
p l
yo fmu sc
les:a llthemu sclesa r
es uppli
edbycrani
alrootofacce
ssorythrou
ghv agus
exce
p tstyl
opha r
yngeus,issuppliedbygl ossopharyngea
lnerve.
 Arterialsupply:a s
cendi
ngp hary ngealartery,a sc
endi
ngp a
lat
ineartery
,tonsi
lararte
ry,greater
pala
tineandlingualarter
y.
 Venousd rai
nage:d rain
edintop har y
nge a
lv enousplexu
s.
Appliedanatomy
 Adenoids:nasopharyngealtonsi
lsa repromi n
en tinchi
ldre
nu pto6y ea
rsagethengr a
duall
yatrophy,
afte
ri tenla
rged uetoinfec
t i
ona rekn owna sa de
n o
ids
.
 Thep ir
iformfo ssa
eared an
ge rouss i
tesfo rperforati
onbyanen do
scope
.Itmayc au
seinju
r yt
ot he
i
n t
ernallaryngealner
ve.
 FossaofRo senmull
eristhec ommo nestsiteofc arci
nomaofthep harynx
.

SOFTPALATE

I
tisamo
bil
emu
scu
larfo
ld,s
epa
rat
ena
sop
har
ynxfr
omt
heo
rop
har
ynx
.

Nameofmusc
le Or i
gin I
nse
rti
on Acti
on Ner v
esupply
Te
nsor
vel
ipa
lati
ni Audi
to
r ytubea
nd Ha
rdpal
ate Open
ingof Allthemu sc
les
gre
aterwingof aud
ito
rytubeand aresuppli
edby
sp
henoi
d ti
ghte
nin
go f cran
ialrootof
so
ftpala
te acce
ssory
Le
vato
rvel
i Audi
toryt
ubeand Pal
ati
ne Open
ingof throughvagus,
pa
lat
ine pe
trouspa
rtof apo
neuro
sis aud
ito
rytubeand exce
ptt en
sorvel
i
te
mp o
ralbo
ne el
evat
io
nofs o
ft pala
tinesuppl
ie
d
pal
ate byma ndi
bular
Pos
teri
ornas
al Mu cou
sme mbr
ane Pul
luvul
a nerv
e.
sp
ineandpal
ati
ne ofuvul
a for
wardtosid
e
8
 ap
oneur
osi
s ofact
io
n
Pa
lat
oglo
ssus Pal
ati
ne Si
deofto
ngue Pul
ltheroo
tof
ap
oneur
osi
s to
ngueup
Pa
lat
ophary
ngeu
s Hardpal
atea
nd Thy
roi
dcart
il
age Ele
vat
ethewal
l
pa
lati
ne ofphary
nx
ap
oneur
osi
s

LARYNX

 I
tistheo r
ga nforp roduct
ionofv oi
ceandr e
spirat
ion.
 Si
tuation–i nthea nteri
ormidli
neo fneck.
 Extent–3rdc ervicalver
tebrato6thcervic
alve r
tebra.
 Length–4 4mmi nma leand36mmi nfema l
e.
Skeletonorc arti
lageo flarynx
 I
tisco mposedo fninecarti
lage.Itisdiv
idedintopairedandunpaired
.
 Pai
r e
dc artil
agesa rearyten
oid,cornic
ulateandcuneiform.
 Unpairedcartil
age sarethyroi
d,c ri
coi
da ndepiglo
ttis.
Thyroidc arti
lage
 I
tisqu adri
lateralinshape.Itconsis
tsofr i
ghta ndleftlaminae.Ithasa nt
erio
rb or
der,it
slower
par
tp resentap romi n
encecall
edlaryngealprominenceorAd a
msa pple.Itsupperborde
rpresen
ta
not
chc alledthyroidn o
tch.Po s
terio
rb o
r d
erisfr e
ea ndp r
esentsupwarda nddownwardproj
ecti
on
cal
leds uperi
ora ndinferi
orcornuae.
Cri
c o
idc arti
lage
 I
tisr i
ngs ha pe
d.I thasan arro
wa n
teri
orp artcal
leda rc
ha ndb r
oadp o
steri
orp a
rtcall
edlamin
a.
Epi
gl ott
is
 I
tisal eafs hapedc art
il
age.Itsup pe
rex pan
dedp artisfreeandlowerp artispoi
nted
.Thislower
par
ti sstalklikea ndattac
hedtot heanglebetweent hetwolaminaeoft hyroi
dc a
rti
lage.
Arytenoid
 Thesea retwos mallp y
ramidalshapedcarti
lages.Itha sabase,apexa n
dt wop ro
cess
es.The
pro
c e
ssesa recalledvocalandmu s
cularprocesse
s.
9
 Cor
nic
ulat
eandCu
nei
for
mcart
il
ages
 The
searetwos
mal
lco
nic
aln
odu
lesl
ie
sint
hea
rye
pigl
ott
icfo
ld.

Ep
igl
ott
is

Thyr
oid
c
art
il
age

Cavi
tyorint
erioroflarynx
 Ext
entfrominletoflar
yn xtothelowerborde
ro fc ri
coi
dc a
rti
la
ge.Wi t
hinthecav
ityt
herearetwo
fol
dsofmu c
ousme mbran
ec all
edvesti
bul
arandv ocalfold
s.Thesefol
ddivi
det
hecavi
tyi
ntothree
pa
rts:
1
. Vest
ibul
e–thep artpre
senta bo
vethevest
ibul
a rfo l
d.
2.Vent
ricl
e–thep artpre
sentb e
tweenthevest
ibularandvocalfo
lds.
3.I
nfraglo
tti
cpart–t hepartpresen
tb e
lowthev ocalfol
d.
 Sac
cule–anter
iorpartoft hevent
ricl
eprol
onge dupwardasadiver
tic
ulu
m.Itcon
tai
nsmucousgl
ands
whi
chl u
bric
atesthevoca
lfo lds
.
 Ri
mav es
tib
uli–s p
acebetweentherightandleftv es
tib
ularfol
ds.
 Ri
magl ot
ti
dis–s p
acebetwe e
nrightandle
ftv ocalfolds
.

1
0
 Muscl
esofl a
rynx
 I
tisdiv
idedin
totwoe xtri
nsi
ca n
dintri
nsicmu s
cles
.
 Ext
rins
ic–p al
atopharyngeu
s,salpi
ngopha r
yngeus,styl
ophar
yngeus
,thyr
ohyo
idandste
rnothy
roi
d.
 I
ntri
nsi
c–c ri
cot
hy roi
d,p o
ste
r i
orcri
coaryten
oid,late
ralcri
coa
ryte
noi
d,tr
ans
vers
ea r
yten
oidobl
iq
ue
ar
yteno
idandthyr o
a r
yteno
id.
Blo
odsu p
ply
 Abov
et hevoc
alfo l
d–s uperi
orlary
ngealv es
sel
s.
 Bel
owt hevoc
alfo l
d–i nfer
iorlar
yngealv e
ssel
s.
Nerv
es uppl
y
 Moto
rs uppl
y–a llthemu s
cle
sa r
esuppli
e dbyrecurren
tlaryn
gealner
ve,e
xce
ptcri
cothy
roidby
ex
terna
llaryngealnerve
.
 Sen
sorysuppl
y
Abov
et hevoc
alfo l
d–i nte
rnallar
yngealn e
rve
Bel
owt hevoc
alfo l
d–r ecurr
entlary
ngea lner
ve.
Appl
iedaspect
s
 Lary
ngiti
s–inflamma ti
onoflarynx.
 Los
sofp honat
ion–d amageofb ot
hr e
ccur e
ntlaryngea
lnerve
.
TRACHEA

 I
tist hecontinuat
ionoflary
nx.Itisalsoknownaswindpi
pe.
 Si
tuat i
on–i nthelowerpartofn e
cka ndsupe
rio
rmedias
ti
num.
th th
 Extent–6 c e
rvi
calvert
ebrato4 t hora
cicver
teb
rae.
 Length–1 0t o15cm.
 Parts–i tha scer
vica
landthoraci
cp ar
ts.
 Terminatio
n–i tisdivi
dedi
ntorightandleftpri
nci
palbro
nchia
nde
nte
rst
hehi
lu
mofc
orr
esp
ond
ing
lu
ngs .

1
1
 Rel
ati
onofcerv
icalpart
 Ant
eri
orly–st
erno
thy ro
idmu sc
leandist
hmusoft hyro
idgla
nd
 Pos
teri
orl
y–esop
ha husandr e
curren
tlaryn
gealn e
rve
 Oneac
hs i
de–lob
eo fthy r
oidglandandcar
oti
ds heat
h
Rel
ati
onofthora
cicp ar
t
 Ant
eri
orly–st
erno
thy ro
idmu sc
le,archofaortawithbra
chio
cepha
li
candleftc
ommonc
aro
ti
d
art
erya nddeepcardi
acple
xus
 Pos
teri
orl
y–esop
ha gus
 Ontheri
ghtsi
de–r ightlungandp l
eura
,a zy
go sve
in
 Onthele
ftsi
de–a rchofa ort
awi t
hleftcommo ncar
oti
dandlefts
ubc
lav
ianart
eri
es

1
2
 Mi
cro
scopi
cstruc
ture
1. Mu
cosa:li
nedbyp s
eudos
trat
ifi
edcili
atedcolumnarepi
thel
iumwithgobletcel
ls.
2.Submucos
a:looseconn
ecti
vetis
suewithb l
oodv e
ssel
sandnerve
s,conta
ins
nu
merousela
sti
cfibers
,s erousandmucousglan
ds.
3.Hyali
necar
til
agelaye
r:t hi
slayeriscomposedof“C”s hapedcar
til
ager i
ng,ma d
eupof
hyal
inecarti
lage.Gapb e
tweenpost
eri
orparto fcar
til
agei
s
fil
ledwit
hs mo o
thmu sc
lefiber
scall
edtracheali
s.
4.Advent
it
ia:itismadeupoflooseconn
ectiv
et i
ssuecont
aini
ngela
sti
cfibers.

Bro
nchia
ltre
e
 Tr
achea→ ri
ghtandle
ftpri
nci
palbr
onc
hi→ segmen
talbro
nchi
→t er
tia
rybro
nchi
ol
e→ t
ermi
nal
br
onchi
ole→ re
spi
rat
oryb
ronc
hiol
e→ resp
ira
toryb
ronchi
ol
e→ alv
eol
ioflu
ng

1
3
 Di
ffe
ren
ceb
etwe
enr
ighta
ndl
eftp
rin
cip
alb
ron
chi

Ri
ghtp
rin
cip
alb
ron
chu
s Le
ftp
rin
cip
alb
ron
chu
s

Sho
rta
nd2c
mlo
ng Lo
nga
nd5c
mlo
ng

Wi
de Na
rro
w
I
tli
esmo
rev
ert
ic
al I
tde
fle
cte
dtot
hel
efts
ide

Angl
eo fdev
iat
io
nfr o
ml o
ngaxi
softr
ache
a Angleofde
viat
ionfro
mlongax
iso
ftr
ache
a
i
s25° i
s4 5°
Us
u a
llydi
vi
desbefo
reent
eri
ngi
ntot
hel
ung Us
u al
lydi
vi
desaftere
nte
rin
gin
tot
hel
ung

 Bl
oodsuppl
y–inferi
orthyr
oidandbro
n c
hialve
ssel
s.
 Ne
rvesuppl
y
 Sy
mp a
thet
ic–cervi
cals
ympathet
icgangl
ion
 Pa
rasympat
heti
c–vagus&r e
c u
rren
tlaryngeal
Appl
ie
danatomy
 Tr
acheos
tomy:i ti
sal i
fesavingsur
gicalproc
edureinwhi
cha
nop
eni
ngi
sma
dei
nthet
rac
heat
o
i
nse
rttrac
heost
omytubeinca
seofr e
spir
atoryobs
truct
ion
.

1
4
 PLEURA

 Itisas e rousme mb r
an elin
est helungs .Itconsi
stsoftwol ayersouterpari
etallay
era ndinn
erv i
scer
al
la
ye r
.Thes p acebetwe entwol ayersarec a
lledpleura
lc avi
ty.
Visceralp le
u ra
 Itc omp letel
yc overst hes urfa c
eo fl unge xceptatt hehi l
um.I tisfi r
mlya dherenttot he lung
surfacea ndc annotbes epara
te dfromi t.
Parietalp le
ur a
 Itist hi
c kert hanv i
sceralpleuraa ndline
st hewa l
lsoft hepu l
mo n
aryc a
vit
y.
Subdivi
s i
o ns
 Itisd iv
id edintofo u
rp arts
1. Costalple ur
a
2.Di aphragma ticp l
eura
3.Me d i
asti
n alpleura
4.Ce rvica
lp l
eura
 Co stalp leura:i tli
nest heinners urfaceoft horac
icwa llandcosta
ls u
rfaceofl u
ng.
 Di aphragma ti
cp leura:i tc overst hesuperi
o rsurfaceo fdiaphragma nddiaphragmaticsurfaceof
lu
ng.
 Me d i
astinalp le
u ra:i tlin
est hecor re
spondin
gs urfaceo ftheme di
asti
numa ndme d
iasti
nalsurfaceof
lu
ng.
 Ce rvicalp le
u ra:i tex ten
dsin tother ootoft henecka boutoneincha bo
vetheme dialendofc la
vic
le
andlinet heap exoft hel u
ng.
Recesseso ft hep l
eura
 Thee xpan de
dr egionso fpleuralcavityarec a
lledpleu
ra lreces
ses.Thesearet wotypes
1. Costodi
a phragma t
icr eces
s:i tisloc a
tedinferio
rlybetwe e
nc ost
alandd i
aphragmaticpleur
ae.
2.Co stome dias
tinalr e
cess:i tisl oc
ateda nte
roi
n feri
orl
yb etweenthec os
talandme d
iasti
nalple
u ra
e.

Ne
rves
upp
ly,b
loo
dsu
ppl
yan
dly
mpha
ticd
rai
nage
1
5
 Vi
sce
ralp
leu
ra Pa
rie
talp
leu
ra

Ne
rves
upp
ly Sy
mpathe
ti
c–T2toT5 I
nte
rco
sta
lan
dphr
eni
cne
rve
s
Pa
ras
ympathe
ti
c–va
gus

Bl
oods
upp
ly Br
onc
hia
lve
sse
ls I
nte
rco
sta
l a n
d p
eri
car
dio
-
p
hreni
cves
sel
s

Ly
mpha
tic
s Tr
achi
obr
onc
hia
lly
mphn
ode
s I
nte
rco
sta
lly
mphn
ode
s

App
lie
da na
tomy
 Pl
euri
sy–thisi
sthein
flamat
io
no fpleu
ra.
 Pn
eumothora
x-p re
senceofa
irinthepleu
ralca
vit
y.
 Ha
emothorax-pres
enceofbl
oodintheple
uralc
avi
ty.
 Hy
dropneu
motho
rax-p res
enc
eofb othai
randflui
dinthep
leu
ralc
avi
ty.

LUNGS

 Lu n
gsa reap airofre s
pirato
ryor gans
.Situat
edint hethoraci
ccavit
y.Itissoft,ela
sti
ca n
ds p
ongy.
Co l
o ur
 Ne wb orn–r osyp i
nk
 Childr en–gr ey
 Ad ults–b lack
Sha pe–c onical
We ight: -Ri ght–625gma ndLe ft–565gm
Ex t
e rnalfeatur e
s
1. Ape x: -itisextendedint
ot herootofnecka n
dc o
ver edbycervi
calpl
eura.
2.Ba s
e: -itisrestont heuppersurfaceofthed i
aphra gma n
dc o
veredbydiaphragmati
cpleura.
3.Bo r
d ers
a.An teriorborder: -itisverythina n
dshort.
Rights i
de:-a nt
erio
rb o
rderisv ert
ica
l.
Leftside:- a nteri
orborderp res
entadeepnotchcall
e dcar
dia
cn ot
chand
bel
owt he
reisat on
gueshapedproje
cti
o ncall
edli
ngula
.
b.Po s
t eri
orb order:-itist hi
cka ndrounded
.
c.Inferiorb orde
r: -its e
p e
r a
tesbasefromt hecos
tala ndmedia
lsurface.
4.Su rfaces
a.Co s
t alsurface: -itisrelate
dtot hora
cicwall
.Thi ss ur
facepres
entsimpressio
nsofribsandcos
tal
cartilages.Itiscoveredbyc os
talp l
eur
a.

b
.Media
lsur
face:-thi
ssur
facei
sdi
vid
edi
ntot
wo,
i
) An
ter
iorp
art:-itisc
all
edmed
ias
ina
lpa
rtbec
aus
eiti
sre
lat
edt
otheme
dia
sti
numa
ndp
res
ent
s
1
6
 hi
lu
ma ndcardi
acimpres
sio
ns.
i
i)Po
ster
iorpart:-iscal
ledverte
bralp
artbe
cau
sei
tisr
elat
edtothethorac
icve
rte
braan
d
i
nte
rver
tebraldi
scs
.
Lo
besandFissur
es
 Ri
ghtlungisdi
vide
dintothreelo
bebytwofi
ss
ure
s.Thelo
besareupper,mid
dlea
ndlo
werby
ho
riz
ontalan
do bl
iqu
efissur
es.
 Le
ftlungisdiv
ide
dintotwolobebyonefi
ss
ure
.Thelo
besareup
p e
ra n
dl o
werbyanob
liq
uefi
ss
ure
.

Rootoflun
g
 I
tconnec
tshil
umtomedi
ast
inu
ma n
ditcon
tai
nspri
nci
palb
ronchus
,pul
monar
yarte
ry,sup
eri
ora
nd
i
nferi
orpulmon
aryv
ein
s,bronc
hia
lves
sel
s,ant
eri
orandpos
teri
orpu
lmon
aryne
rveple
xus,
sy
mp a
theti
c,ly
mphnode
sandareo
lart
iss
ue.

Hil
umofl u
ng
 Thi
sistheareathrou
ghwhic
hthest
ruct
ure
sente
rore
merge
sfr
omt
hel
ung.I
tco
nsi
st
sof
1
. Apairo
fp ulmon
a r
yv e
in
2.Onepul
monaryarter
y
3.Twobronc
hionrightsid
ean
donebr
onchu
sonthele
fts
ide

Di
ffe
ren
ceb
etwe
eni
mpr
ess
ion
sont
heme
dia
sti
nals
urfa
ceo
fri
ghta
ndl
eftl
ungs

Me
dia
sti
nals
urfa
ceo
fri
ghtl
ung Me
dia
sti
nals
urfa
ceo
fle
ftl
ung
1
7
 Ri
ghtatri
um Le
ftvent
r i
cl
e
Su
peri
orandinferi
orve
nacav
a As
cend
ingaorta
Azy
gosvein Ar
chofa ort
aanddesce
ndin
gt horac
icaor
ta
Ri
ghtbrachi
ocepha
licv
ein Le
ftsubcl
avia
na n
dcommonc a
r o
ti
da rt
eri
es
Es
ophagusandtrac
hea Es
opgagusandthor
aci
cd u
ct
Ri
ghtphreni
cn e
rve Le
ftphreni
cn e
rve
Ri
ghtvagusnerve Le
ftvagusandrecur
rentla
ryngealner
ves

Bronc
hopul
monar
ysegme nt
s
 I
tisthest
ruct
urala
n dfunct
io
nalbasi
cunio
flungs.Bron
chopu
lmonarysegment
sarewel
ldefine
d
pyr
amida
lshape
dindepen
dentuni
tsoflun
gswhichareae
rate
db yter
tia
ryo rse
gmenta
lbro
nchiwith
se
parat
ebranc
hofp ulmona
ryarter
yanddrai
nedbyadj
acen
tvei
n s
.Ap e
xisd i
rec
tedt
oward
st heroo
t
ofthelu
ng.Eachsegmentisse
perat
edfromtheot
herbycon
necti
veti
ssue

 Br
onc
hop
ulmo
nar
yse
gme
nts

Ri
ghtl
ung Le
ftlu
ng
Up
perl
obe–Ap
ica
l(1) Up
perl
obe-Ap
ica
l(1)
1
8
 Po
ste
rio
r(2) Pos
teri
or(2)
An
teri
or(3) Ant
eri
or(3)
Sup
eri
orli
ngul
ar(4)
Mi
ddl
elobe–La
ter
al(4) I
nferi
orli
ngu
lar(5)
Medialal(5)
Lo
werlo
be–Super
ior(6) Lo
werl
obe–Su
p e
rio
r(6)
Medialb a
sal(7) Medi
alb a
sal(7)
Anteri
o rbasal(8) Ante
riorbasal(8)
Late
ra lbasal(9) Lat
eralbasal(9)
Post
er i
orb a
sa l(1
0) Pos
teri
orb a
sa l(1
0)

 Art
eria
ls u
pply–b ronc
hialandpulmona
rya r
terie
s.
 Ven
ousdrainage–rightsidedrai
nsint
oaz y
gosv e
inandle
ftsid
edrain
sinto
leftsuperi
orin
tercos
taloracce
sso
ryhemiazy
gosvein
s.
 Ne
rvesupply-Sy mp at
hetic–T2t oT5
Parasympathet
ic–vagus
 Ly
mp hat
icsdrain
age-Su per
fici
alvess
elsdr
ainsin
tobron
chopul
monaryly
mp hno
des
.
Deeplymphvessel
sdrai
nsint
opulmona
ryandb ro
nchop
ulmo
nar
y
lymphn o
des.Bothfinal
lydrai
nsint
otrac
heobro
nchi
ally
mphnode
s.
 Appli
eda n
atomy
 Pn
eumonia:-infect
ionorinfl
amma ti
onoflung.
 Tu
bercul
osis
 Ca
rci
n o
ma

MUSCLESOFRESPI
RATI
ON

1
9
1
.In
ter
cos
talmu
scl
es

Muscl
e Ori
gin Insert
ion Actions Ner v
esupp
ly
1
. Ext
ern
al Lowe
rborde
rof Ou t
erlipofu p
per I
nter
cost
a l Allthe
i
nte
rco
sta
l ri
babov
e borderoft heri
b musc
lesisto i
nterco
sta
l
below pre
vent muscle
sare
1
.Inte
rna
l Flooro fthe I
n ne
rl i
po fupper i
nter
cost
a l su
p p
liedb
y
i
nte
rco
sta
l costalgr o
oveo fborderoft heri
b sp
acesbein
g i
nterco
sta
l
riba bov
e below dr
awnind uri
ng ne
r v
e.
2.Tr an
svers
us I
n nersurfa ceofI
n ne
rs urfaceo
f i
nspi
rati
onand
tho
raci
s ther i
bn eart hetwoort hreeri
bs bul
ging
3(a)
.subcos
tal
is angle below ou
twardsdurin
g
3(b)
.Inte
rcos
tal
is Mid dl
et wo- I
n ne
rl i
po fthe ex
pirat
io
n .
in
timi fourtho ft he upperbor d
erof
ridgea bovethe ribbelo
w
costalgr o
ove
3(
c)
.st
ern
oco
sta
li
s Posteriorsurfa c
e Cos
talc
ar t
il
age
n
d
oft heb odya nd o fthe2 to6th
xiphoidp r
oc e
ssof ri
bs
sternuma ndl ower
3o r4t ruer ibs

DI
APHRAGM

Ori
gin I
nse
rti
on Ac
tio
ns Ne
rves
upp
ly
St
ern
alpa
rt– I
ntot
hecent
ralt
end
on  Mus
cle
sof Ri
ghta
ndle
ftphr
eni
c
20
 poster
iors urfac
eof o fd i
aphra
gm.Itis i
nsp
irati
on n
erves
,lowerfiv
e
xiphoi
dp rocess t
rifo
li
atesha
pe.  I
thelp
sinweight i
nte
rcos
talner
veand
Costalp art–inner -
li
ftin
g s
ubcos
talne
rve.
surfaceo flowersix  I
tactasa
ribneart heirco
stal s
phinc
terof
carti
lages. e
sophagus
Ve rt
ebralp art–ri
ght
andleftc ruraandfive
arcuateligaments
.
Rightc rura–a ri
ses
fromr ightu ppe
r
threelumb ar
verteb
r aean d
i
n te
rvertebraldis
c.
Leftcr ura–a ri
ses
fromt hel eftuppe
r
twolumb arv ert
ebra
e
andintervertebr
al
disc.

Arcu
ateli
gamen t
s
1
. Medi
anarcuat
el i
gament:-i
tisaa r
chedfi
brousbandstre
tchi
ngbe
twee
ntwocr
ura.
2.Medi
alarcu
ateligament:-i
tisthethi
cken
ingofpsoasshee
thande
xten
tsfr
ombodyof“L2”
ve
rteb
ratothet r
a n
sve
rsepr
ocesso
f“L1”v e
rte
b r
a.
3.Lat
eralarc
uateligament
:-i
tisthethi
ckeni
ngoffasciacov
eri
ngqua
drat
usl
umbor
um.Itext
end
s
t
h
fro
mt ra
nsve
rsep roce
ssof“L1”ver
teb
r at
o12r i
b.
 Open
igsofdiaphragm
1
. Ma jo
ro pe
n i
ngs

Op
eni
ngs Lo
cat
ion Sha
pe Vert
ebral St ruct
urespa s
singthrou
gh
l
evel
Vena
cava
l Centr
alten
don Qua
dran
gul
ar T8 I
n feri
orvena
ca v
aa ndri
ght
op
eni
ng phreni
cn e
rve
Eso
phagea
l Leftofthemedi
an Ov
al T10 Es o
phagus,rightandleft
op
eni
ng pl
a n
e vagaltrun
ksa ndesopha
geal
branchofleftga st
rica
r t
ery
Aort
ic Behin
dthemedi
an Circu
lar T12 Ao r
ta,azygosveinand
op
eni
ng ar
c ua
tel
igame
nt thoraci
cduct

2.Mi
noro
pen
ings

Lo
cat
io
n St
ruc
ture
spass
ingthr
ough
th
Be
twee
nxi
pho
idp
roc
essa
nd7 co
sta
lca
rti
la
ge Su
per
iorepi
gas
tri
cves
sel
s
21
 t
h
Be
tween7 a
n d8thribs Musc
ulo
p hreni
carter
y
t
h t
h
Be
tween7 t o1 1r ibs Lo
werfi vein
terc
osta
lnerv
eandves
sel
s
La
teralarcuateli
ga ment Su
bcost
a lnerv
eandvess
els
Med
ialarcuateli
ga ment Sy
mp a
the t
icchai
n
Ri
ghtc r
uso fd i
aphr a
gm Ri
ghtgr eat
er,les
serandl
easts
pla
nchni
cne
rve
s
Le
ftcr u
so fdiaphragm Le
ftgre ate
r,less
erandle
astsp
lan
chni
cner
ves
,
he
miazygosvein

Di
ffe
ren
ceb
etwe
en

Ri
ghtl
ung Leftlu
ng
Shorte
ran dwide Lon
gerandn arr
owe r
We i
ght–625gm Weight–565gm
Threelo
be sandtwofis
sure
s Twolobe
sa ndonefiss
u r
e
Abse
n c
eofc ardi
acnotc
h Pre
senc
eo fcardi
a cno
t c
h
Abse
n c
eofl in
gula Pre
senc
eo flin
gu l
a
Hil
umc on
t ai
n–e pa
rter
ialb
ron
chu
s,pul
mon
ary Hi
lum–p ulmonaryart
e r
y,bro
nchu
san
din
fer
ior
art
ery,hy pa
rteri
albron
chusa
ndi
nfe
rio
r pul
monaryvein
pul
mo n
aryv ei
n
Onebronchia
la r
tery Twob
ron
chi
ala
rte
rie
s

Tr
ache
a Br
onc
hus

22
Alargememb r
aneou
stuberein
formedbyri
ngs Anyoft
hemaj
orairp
ass
ageo
fthel
ungswhi
ch
ofcart
il
age,exten
dingfro
mt helar
y n
xtothe di
ver
gefro
mtrac
hea
bro
nchia
ltubeco
nvei
ngairtoandfromthel
u n
gs.
Air
wa y
swhi c
hc o
nnec
tlary
n xtobro
nchi Air
wa yswhic
hc o
nnec
ttracheatolu
n gs
Therei
so n
lyonetra
chea Therearetwobron
chi,whichbranc
hfu rt
her
Wa l
listhi
n Thi
ckwa llduet
oincr
easi
nga moun
to fsmoot
h
musc
les
Co
nta
in“C”s
hap
edc
art
il
age
nou
sri
ngs Cont
ainirre
gula
rlyarra
ngedc a
rti
lagepla
tes

Phar
ynx Lary
nx
Mus
cul
artu
be Musc
uloc
arti
la
gin
oustub
e
Co
mmonchan
nelfo
rfoo
dandai
r Uppe
rp a
rtofres
pira
tor
ytrac
tandvoi
ce
pr
oduct
ion
Ext
endsfromba
seofsku
llt
othet
hir
dce
rvi
cal Ext
endsfromthi
rdtosi
thce
rvi
calv
erte
bra
ve
rte
bra
I
tcont
inuo
usase
sop
hagus I
tcont
inuo
usastr
achea

Questi
ons
1. Drawan eatlabel
leddiagramso fresp
irator
ys y
stem.Br
iefl
yde
scr
ibet
hep
art
san
dri
ght
andleftlu ngs.
2.No se
3.Pa ranasalairsinus
e s
4.Pl eura
5.Tr achea
6.Pha rynx
7.So ftp al
ate
8.La rynx
9.Di aphragm
10.I
ntercost
a lmu s
cles
Differenceb et
we e
n
11.Tracheaa ndb r
onchi
12.Righta ndleftprinci
palb ron
chi
13.Righta ndleftlungs
14.Mediasti
nals ur
facesofr ightandleftlungs
15.Pharynxa ndl a
rynx
16.Nasopharynx ,orophary
n xandlaryngopharynx
17.Bronchopulmo n
arys e
gme ntsogr i
ghtandleftlungs
Li
s t
18.Partsofr espir
atorysystem
19.Openingso flate
ralwa l
lo fnose
20. Ma jorandminoro pe
ningsofdiaphragm

23