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Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University

Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan University 1

Dr.Hongqi Zhang (张红旗)Email: [email protected]

Systematic Anatomy

Splanchnology - Part 2

Respiratory system



Respiratory system



Respiratory tractNosePharynxLarynxTracheaBronchi LungsPaired organs of respirationFunction:Inspiring oxygenExpiring carbon dioxideVocalization olfaction Assisting venous return to heart

Upper respiratory tract

Composition

Lower respiratory tract



The Nose

Composition External noseNasal cavityParanasal sinusesFunction Regulate temperature

& moxture. PhonationSmell

The external nose

External nose:1. Root of nose 2. Back of nose 3. Apex of nose 4. Alae of nasi5. Nostril

1

2

34

5

Nasal cavity communicate with the pharynx behind through the choanae.



Two halves by nasal septum

The nasal cavity

Two parts:Boundary:Divided by limen nasi 1 - Nasal vestibule 2 - Proper nasal cavityBoundaries Roof－cribriform plate of ethmoid Floor－hard & soft palate Medial wall－nasal septum Lateral wall

Three nasal conchaeSup.mid.& inf.nasal conchaeThree nasal meatusesSup.mid.& inf.nasal meatuses

Med.wall of nasal cavity(nasal septum)

Medial wall of nasal cavity

12



Three nasal conchae

1-Sup.nasal concha

2-MId.nasal concha

3-Inf.nasal concha

Three nasal meatuses

4-Sup.nasal meatus

5-Mid.nasal meatus

6-Inf.nasal meatus

The structures of lateral wall of nasal cavity

1

3

42 2

35 5

66



Medial wall of nasal cavity (nasal septum)Bone and cartilages

Perpendicular plate of ethmoid

Vomer Septal

cartilage

Sphenoidal sinus

Frontal sinus

Palatine process of maxilla

Horizontal plate of palatine bone



Olfactory region (blue)Located upper nasal cavity,above superior,nasal conchae, contains olfactory cells

Respiratory region: situated out of olfactory region. its function is to warm, moisten, and clean the inspired air

The Mucous membrane of nose

Olfactory region

Olfactory region

Nasal septumLat.wall of nasal cavity



Paranasal sinusesAre the gas cavity in cranium around the nasal cavityMucosa of sinuses is migrating with the mucosa of nasal cavityHave openings pass the nasal cavityThere are four paired sinuses

1 - Frontal sinus - one pair2 - Sphenoidal sinus -one pair3 - Maxillary sinus -one pair4 - Ethmoidal sinus - three groups

(ant.mid. & post. groups)

1

4

1

2

32



The paranasal sinuses and their site of drainage into the nose

Name of sinus Site of drainage

Frontal sinus Mid. meatus via infundibulum

Maxillary sinus Mid. meatus through semilunar hiatus

Sphenoid sinus Sphenoethmoidal recess

Ethmoidal sinusesanterior groupmiddle groupposterior group

Mid. meatusMid. meatusSup. nasal meatus

Frontal sinus

Ethmoidal sinuses

Sphenoidal sinus

Maxillarysinus

Removed anterolateral wall of sinus

Frontal s.

Sphenoidal s.

Ethmoidal s.

Maxillary s.



openings of paranasal sinus

1

2

Lateral wall of nasal cavity (remove nasal concha partially

1. Frontal sinus – open at ant. part of mid. nasal meatus

2. Sphenoidal sinus - open at sphenoethmoid recess.

3. Maxillary sinus – open at mid. part of mid. nasal meatus

3



Location and opening of maxillary sinus

Maxillary sinus－opening in middle meatusMaxillary sinus

The opening of Maxillary sinus



Openings of paranasal sinus

The opening of nasolacraminal duct

Ethmoidal sinus have three groups. Ant.& mid. group of ethmoidal sinus open at mid nasal meatus. Posterior group open at sup.nasal meatus.


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversitySinusitis



larynxPosition: Situated in the anterior part of the neck (below the hyoid bone), Composition:Cartilage,muscle & mucosaBoundary: Upper boardline: upper border of epiglottic cartilage: lower boardline : lower border of cricoid cartilageCommunication:to pharynx upwardly,to trachea downwardlyNeighbouring:.skin, fascia, muscle, anteriorly; pharynx posteriorly; blood vessel. nerve and lateral lobe of thyroid are in both side: .Function: “voice box” involved in breathing, sound production (phonation), and protecting the trachea against food aspiration

larynx



Cartilages of the larynx

Epiglottic cartilage (1)

Thyroid cartilage (1)

Cricoid cartilage (1)

Arytenoid cartilage(2)

Ant.view Post.view



Thyroid cartilageShield - shaped cartilage Laryngeal prominence at

base of thyroid notch (Adam’s apple)

Sup.thyroid notch, sup.& inf. cornua

Cricoid cartilageComplete ring of cartilage

(shaped like a single ring)Arch of cricoid cartilage－at

level of C6

Lamina of cricoid cartilage

Cartilage of the larynx

Thyroid cartilage

Ant. Post.

Ant. Post.

Cricoid

cartilage



Arytenoid cartilage(2)Paired,pyramid shaped,

articulate with lamina of cricoid cartilage

Vocal process anteriorly, site of post.attachment of vocal fold

Muscular processEpiglottic cartilage

Spoon-shaped elastic cartilage situated behind the root of the tongue


Epiglotticcartilage

Arytenoid cartilage




Thyroid cartilage

Cricoid

cartilage

Arytenoid

cartilage

Thyroid cartilage

Arytenoid

cartilage

Ant.view

Post.viewPost.view

Post.view

Epiglottic cartilage



Cartilage of the larynx (specimen)

Thyroid cartilage Cricoid cartilage

Arytenoid cartilage

Ant.

Post.


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityAnt.view of the larynx

Thyrocricoid puncture

Learn by yourself


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityPost.view of the larynx

Learn by yourself

Laryngeal jointsCricothyroid jointCricoarytenoid jointLaryngeal lig. and membraneThyrohyroid membrane - extending from hyoid bone to

thyroid cartilage

The important,lig.& membranejoints of larynx

Cricothyroidjoint Cricoarytenoid

joint

Thyrohyroid membrane

Quadrangular membrane Between epiglottic,thyroid & arytenoid cartilages Lower free border forms vestibular lig.which constructs

the frame of vestibular fold. Conus elasticus Situated between arytenoids,thyroid, & cricoid cartilages Upper free border forms vocal lig.Median cricothyroid lig. May be site of circothyrotomy during acute respiratory obstruction

Cricotracheal lig.Between cricoid cartilage & first ring of trachea

Thyroid cartilage

Conus elasticus

Vocal processArytenoid cartilageMuscular process

Fissure of glottis

Median cricothyroid lig.

Sup.viewcricotracheal lig.


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityPosterior view of laryngeal cavity (coronal section)


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityPost.view of muscles of layrnx

Epiglottis

Cuneiform tubercle

Aryepiglottic m.

Post.cricoarytenoid m.

Aryepiglottic fold

Oblique arytenoid m.

Transverse arytenoid m.

Cricoid cartilage

Muscles of larynx


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityIntrinsic muscles of larynx (lateral dissection)

Aryepiglottic m.

Oblique & transverseArytenoid m.

Post.cricoarytenoid m.

Thyroid articular surface

Cricothyroid m.(cut away)

Epiglottis

Thyroepiglottic m.

Thyroarytenoid m.

Lat.cricoarytenoid m.

Conus elasticus.

Muscles of larynx

Muscles of larynx & their functionClose the glottis – Transverse and oblique arytenoid m.Open the glottis – Post. cricoarythenoid m.Tense and lengthen the vocal fold – Cricothyroid & post.

cricoarytenoid m.Relax & shorten the vocal fold – Thyroarytenoid m.



Laryngeal cavityAperture of larynx －bounded by upper border of epiglottic

cartilage,aryepiglottic folds and interarytenoid notch

Epiglottis

Aryepiglottic folds

Interarytenoid notch

Post.view of larynx (post.wall of pharynx is cut)

Three parts Laryngeal vestibule

Extends from the aperture of larynx to vestibular fold Intermedial cavity of larynx Extends from the level of the rima

Vestibuli to the level of the fissure of glottis - the narrowest portionVentricle of larynx a small recess between vestibular & vocal folds on each side

Infraglottic cavityExtends from vocal folds to the lower border of the cricoid cartilage

Laryngeal cavity

Laryngeal vestibule

Intermedial cavity of larynx

Infraglottic cavity

Coronal section(post.view)

Structure featuresTwo pairs of shelf like folds

1 - Vestibular folds & 2 - Vocal folds

Two fissures– Rima vestibuli & fissure of glottis

• Inter membranous part• Ant.3/5, between vocal-folds• Inter cartilagrnous part Post. 2/5, between arytenoids

cartilages

Laryngeal cavity

Thyroid cartilage

Vocal ligment

Conus elasticus

Vocal processArytenoid cartilage

Muscular process

Fissure of glottis

Vocal lig.

Vestibular folds

Vocalfolds



Epiglottis

Vestibular foldsLaryngeal ventricle

Infraglotticcavity

Laryngeal vestibule

Vocal folds

Laryngeal vestibule

Thyroid cartilage

Fissure of glottis

Cricoid cartilage

Laryngeal cavity (coronal section, posterior view)



Aperture of larynx (sup. aspect) & the change of vocal cord in sounding or smooth respiration

Epiglottis

Vocal foldMed.border

Trachea

Vestibular foldMed.border

Epiglottis

Aryepiglottic folds

Interarytenoidnotch

Learn by yourself

Glottis is open(breathing)

Glottis is close(sounding)

Glottis is open (sounding)



Larynx specimen

Ant.viewof larynx Post.view

of larynxPost.view of larynx

(trachea is cut)Lat.viewof larynx



Description:Is the passage for air. divides into left & right principal branchi at the level of sternal angle.

Boundary: C6～T4 lower borderLength: about 10cmPortions: Cervical part & thoracic partConstitution:14-20 C-shaped cartilages

Consitution: C-shape cartilage, smooth muscle. mucosa

Carina of trachea: Ridge of cartilage at bifurcation into principal bronchi.

Carina of trachea

Connectivetissue

Trachea



Tracheostomy(usuaslly 3-5 tracheal cartilage are cut)



The principal Bronchi

Right principal bronchus Shorter,wider,& more vertical in

position than left one,is about 2-3cmin length.

Left principal bronchus Finer,longer & less vertical than right

one is about 4-5cm in length. Usually, foreign bodies are therefore

more likely to lodge in right bronchus or one of its branches.

Trachae usually divides into right and left principal bronchi at the level of sternal angle (between T4-T5 vertebrae)

Foreign particles are easily to enter right bronchus.



Bronchial tree

Each principal bronchus divides into lobar bronchi (two on the left, three on the right), each of which supplies a lobe of lung. Each lobar bronchus then divided into segmental bronchi, which supply specific segments of the lung.

Bronchi looks like up down tree



General description of the Lung

Position:Located in the thoracic cavity by both sides of

mediastinum

Color: Related with age,occupation, health station

Weight:800～1300g more in male than female

Air content:5000～6500ml, more in male than female

Function: air interchange (both O2 and CO2)

Lung in newborn don’t float in water(not breath)Respired lung can float in water. (contain air)



Lung-general descriptionGeneral features Cone-shaped, the right lung is

shorter and broader, the left one is longer and narrower

Left lung have two lobes (oblique fissure); it is longer, lighter and thinner than right lung.

Right lung Lobes : it have three lobes(oblique fissure & horizental fissure) , right lung is shorter,heavier and broader,

Forensic medicine:Density of fetus lung is more than 1,not floating after the birth, it is less than 1 in density. floating on the water



The Lungs - shape featuresGeneral features Cone-shaped, the right lung

is shorter and broader, the left one is longer and narrower

Apex of lung－rises 2～3 cm above the medial third of clavicle into neck

Base－concave, related to diaphragm, also called diaphragmatic surface

Costal surface－large, convex, related to thoracic wall



The position of Lungs

Position:Located in the thoracic cavity by both sides of mediastinum

Lungs in sity(ant. view) Topography of lungs(post.view)



External feature of the lungs

Apex: Rises 2～3 cm above the medial 1/3 of clavicle into neck.Base: Concave,close to diaphragm (diaphragmatic surface).Two surfaces: Mediastinal surface and sternocostal surface.Three borders: Ant. post. & inf. border.

Apex

Base

Mediastinal surface

Sternocostalsurface

Sternocostalsurface

Medial surface of right lung

Ant.borderPost.border

Inf.border

Ant.border

Medial surface－concave,related to mediastinum and vertebrae– Hilum of lung:area on medial

surface where structures in root enter or leave lung

– Root of lung Contents

– Principal bronchus– Pulmonary artery and vein– Nerves and lymphatics

Surrounded by connective tissue Order of structures in the root of lung

– From before backward: V.A. B.– From above downward:

» R.－B. A. V. » L.－A. B. V.

Left lungMed.surface

Right lung(med.surface)

Medial surface of the the lungs

A-arteryV-veinB-bronchus



Lung specimen

Lat.surfaceof right lung

Ant.surfaceof left lung

Med.surfaceof left lungMed.surface

of right lung

Oblique fissure

Oblique fissure

horizental fissure



The PleuraGeneral features

Serous membranes forming closed sacs

Two layers

Visceral pleura－adheres to lung, continuous

with parietal pleura at root of lung

Parietal pleura－lines the thoracic cavity

Two pleural layers continue with each

other at root of lung forming closed

potential space－pleural cavity

Contains a small amount fluid

Subatmospheric pressure



lungVisceral pleura

Mediastnalpleura

Diaphragmatic pleura

Costal pleura

Cupula of pleura

Pleural cavity

Costaldiaphreg-matic recess

Division of pleura



Named parts of parietal pleura Cupula of pleura

Extends up into the neck, over the apex of lung, 2-3cm above the medial third of clavicle

Costal pleura Lines the inner surface of the wall of the chest

Mediastinal pleura– Lines mediastinum – Pulmonary lig. －redundant

pleura at root of lung, which extends downward, allows movement of structures forming root of lung

Diaphragmatic pleuraLines diaphragm



potential spaces of pleural cavity which lungs are not occupied in quiet respiration

Costodiaphragmatic recesse are the slit-like intervals between costal and diaphragmatic pleurae on each side, the lowest point of pleural cavity

Costomediastinal recess

on the left side between the mediastinal pleural and costal pleura

Pleural reesses

lung

Costaldiaphreg-matic recess

Costomedias-tinal recess



Pleural cavity1. It is a closed cavity

2. Each one on both sides

3. Left & right side don’t communicate each other

4. Pressure of cavity is subatomospheric pressure

5. Contain a little lubricating liquid

6. Costaldiaphrematic recess (lowest)

7. Clinic –puncture.Pneumothorax (Thoracic wall is open.lung injury)

Collapsedlung

Inflated lung



The lower boundary of lungs and pleura

T6 T8T10



The surface projection of lower border of lung and pleurae

Lower border

Midclavicular lines

Midaxillary lines

Sides of the vertebral column

Lungs 6th rib 8th rib 10th rib

Pleura 8th rib 10th rib 12th rib


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityAsthma


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityCilial dysfunction


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityBronchitis


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityLung cancer



肺的X-ray 支气管造影


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityEmphysema



MediastinumConcept The mediastinum is the full term of all structures between the two mediastinal pleurae.

Inf.mediastinum

Ant.mediastinum

Mid.mediastinum

Post mediastinum

Sup.mediastinumIt contains all the thoracic viscera except the lungsBoundary line:At the plane from the sternal angle to the disc of T4-T5Sup.mediastinum-above the upper level of the pericardium, Inf.mediastinum:below the upper level of the pericardium. three parts, Ant. mediastinum - in front of the pericardium, the; Mid. mediastinum -containing the pericardium and its contents, Post.mediastinum- that behind the pericardium

Disease:Tumor,inflammation,pneumomediastinum, a widened mediastinum (aortic unfolding,traumatic aortic rupture, thoracic aortic aneurysm)


Copy Right- Hongqi ZHANG-Department of Anatomy-Fudan UniversityLateral view (left) Lateral view (right)

Mediastinum-lateral view (from left & right side)



Healthy lung lung tumor



The contents you have to master today

1. The constitution and function of respiratory system.2. The concept of upper and lower respiratory tract.3. The position and openings of paranasal sinuses.4. The cartilage of larynx, laryngeal cavity and change

of apeature of larynx while both deep breathing and quiet respiration.

5. The constitution, length and function of trachea.6. The feature of left and right principal bronchi.7. The morphological feature of lungs (apex,base,

surface. border, lobes, fissure etc)8. Concept and division of pleura and pleural cavity.9. Concept and division of mediastinum.



Good luck to you!



肺段,每侧肺10个

肺段－切除

Bronchopulmonary segmentsIt is the whole name for every

segmental bronchi & all the lung

tissues in its branching area.

There are usually ten pulmonary

segments eachlung. Wedge

shaped, with the base lying

peripherally & the apex lying

towards the root of lungs. Every

segment has its name.

The bronchopulmonary

segments could regards as the

reference of partially pulmonary

resection. Learn by yourself



Bronchopulmonary segments

Learn by yourself

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