Splanchnology

SHANDONG UNIVERSITY

Liu Zhiyu

Splanchnology

Composition: Alimentary system Respiratory system Urinary system Reproductive system

Characters of viscera Most of viscera organs lies in the thoracic,

abdominal and pelvis cavities All of then communicate with external

environment through some orifices or channels

Reference lines of thorax

Anterior median line

Sternal line

Midclavicular line

Parasternal line

★ Reference lines of thorax

Anteriorlary line

Midaxillary line

Posterior axillary line

Posterior median line

Scapular line

The Respiratory System

The Respiratory System

Composition Respiratory tract

Nose Pharynx Larynx Trachea Bronchi

Lungs : paired organs of respiration 　

Function of respiratory system : supply the body with oxygen and to get rid of excess carbon dioxide resulting from cell metabolism

upper respiratory tract

lower respiratory tract

The Nose

External nose Root of nose Back of nose Apex of nose Alae of nasi

Nasal cavity

Nasal cavity is divided into right and left halves by nasal septum.

The septum is made up of the septal cartilage, the vertical plate of the ethmoid, and the vomer.

Each nasal cavity extends from the nostril in front to the choanae behind.

Nasal septum

Nasal cavityTwo parts: Divided by limen nasi Nasal vestibule Proper nasal cavity

Boundaries of nasal cavity Roof － cribriform plate of ethmoid Floor － hard palate Medial wall － nasal septum Lateral wall ★

Superior, middle and inferior nasal conchae

Superior, middle and inferior nasal meatus

Sphenoethmoidal recess

Nasal cavity

Remove the middle nasal conchae

Ethmoidal bulla Semilunar hiatus Ethmoidal infundibulum

Nasal cavityMucous membrane of nasal cavity The vestibule is lined by modified skin. Olfactory region : the area above superior nasal conchae is lined

with olfactory mucous membrane which contains olfactory cells Respiratory region : the lower part of the nasal cavity is lined with

respiratory mucous membrane. Its function is to warm, moisten, and clean the inspired air.

★The paranasal sinuses

Name of sinus Site of drainage

Frontal sinus Middle meatus via infundibulum

Maxillary sinus Middle meatus through semilunar hiatus

Sphenoid sinus Sphenoethmoidal recess

Ethmoidal sinuses anterior group middle group posterior group

Middle meatusMiddle meatus Superior nasal meatus

Frontal sinus

Ethmoidal sinusesSphenoid sinus

Maxillary sinus

The Larynx

★ Position － situated in the anterior part of the neck (below the hyoid bone), and extends from vertebral level of C3 to C6

The framework of the larynx is made up of cartilages, which connected by membranes and ligaments and moved by muscles. It is lines by mucous membrane.

★ Layngeal cartilages

Thyroid cartilage Shield-shaped cartilage Laryngeal prominence Superior thyroid notch Superior and inferior cornua

Cricoid cartilage Complete ring of cartilage (shaped like

a signet ring) Arch of cricoid cartilage － at level of

C6 Larnina of cricoid cartilage

★ Layngeal cartilages

Arytenoid cartilage Paired, pyramid shaped,

articulate with lamina of cricoid cartilage

Vocal process anteriorly, site of posterior attachment of vocal fold

Muscular process Epiglottic cartilage

Leaf-shaped elastic cartilage Attached by its stalk to the

thyroid cartilage

Laryngeal joints

Cricothyroid joint Cricoarytenoid joint

Membranes and ligaments of larynx

Thyrohyroid membrane － extending from hyoid bone to thyroid cartilage

Membranes and ligaments of larynx

Quadrangular membrane Between epiglottic, thyroid and arytenoid

cartilages Lower free border forms vestibular

ligament Conus elasticus

Between arytenoids, thyroid, and cricoid cartilages

Upper free border forms vocal ligament Median cricothyroid ligment may be site

of circothyrotomy during acute respiratory obstruction

Membranes and ligaments of larynx

Conus elasticus

Vocal ligament

Quadrangular membrane

Vestibular ligament

Membranes and ligaments of larynx

Cricotracheal ligament

－ between cricoid

cartilage and first ring of

trachea

Muscles of larynx

Tensing the vocal ligament － cricothyroid

Cricothyroid

Muscles of larynx

Relaxing the vocal ligament － thyroarytenoid

Thyroarytenoid

Muscles of larynx Opening the glottis － posterior cricoarytenoid

Posterior cricoarytenoid

Muscles of larynx

Closing the glottis － lateral cricoarytenoid

Lateral cricoarytenoid

Laryngeal cavity

★ Aperture of larynx －bounded by upper border epiglottic cartilage, aryepiglottic folds and interarytenoid notch

★ Laryngeal cavity

Two pairs of shelf like folds : Vestibular folds

Fixed fold on each side of the larynx Formed by mucous membrane covering

the vestibular ligament and is pink in color

Vocal folds Mobile fold on each side of the larynx. Formed by mucous membrane covering

the vocal ligament and is white in color

★ Laryngeal cavity

Two fissures Rima vestibuli Fissure of glottis

The narrowest part of the laryngeal cavity

Inter membranous part － anterior 3/5, between vocal-folds

Intercartilaginous part －posterior 2/5, between arytenoids cartilages

★ Laryngeal cavityThree parts Laryngeal vestibule

Extends from the aperture of larynx to the rima vestibuli

Tubercle of epiglottis Intermedial cavity of larynx

Extends from the level of the rima vestibuli to the level of the fissure of glottis

Ventricle of larynx a small recess between vestibular and vocal folds on each side

Infraglottic cavity extends from the level of the vocal folds to the lower border of the cricoid cartilage

★ The Trachea Position Extends from the lower border of

cricoid cartilage to the level of sternal angle (between T4 － T5 vertebrae) where it divides into right and left principal bronchi

Structure features Consists of about 14 － 17 C-

shaped incomplete tracheal cartilages

Bifurcation of trachea Carina of trachea — ridge of

cartilage at bifurcation

★ Bronchi Right principal bronchus Shorter, wider, and more vertical than the

left About 2.5cm long, Leaves the extend line

of the middle line of trachea at 22 ～ 25o angle

Foreign bodies are therefore more likely to lodge in this bronchus or one of its branches

Left principal bronchus Narrower, longer, and more horizontal

than the right About 5cm long, leaves the extend line of

the middle line o trachea at about 35 ～36o angle

★ The Lungs Position: Located in the thoracic cavity by

both sides of mediastinum

General features Cone-shaped, the right lung is

shorter and broader, the left one is longer and narrower

Apex of lung － projects upward into the neck for approximately 2.5 cm above the medial third of clavicle into neck

Base － concave, sits on the diaphragm, also called diaphragmatic surface

Costal surface － large, convex, related to thoracic wall

★ The Lungs Medial surface － concave, related to medias

tinum Hilum of lung middle of medial surface, wh

ich is a depression where the bronchi, vessels, and nerves enter the lung to form the root

Root of lung Contents

Principal bronchus Pulmonary artery and vein Nerves and lymphatic vessels

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

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

L. － A. B. V. R. － B. A. V.

★ The Lungs

Borders Anterior － sharp

Cardiac notch Lingual in left lung

Posterior － blunt Inferior － sharp

★ The Lungs Lobes and Fissure

Right lung Two fissures : horizontal and

oblique Three lobes : superior,

middle, inferior Left lung

One fissure : oblique Two lobes : superior and

inferior

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.

Bronchopulmonary segments

Bronchopulmonary segments are the anatomic, functional, and surgical units of the lungs.

It is pyramidal in shape, with its apex toward the lung root, ten in each lung

It has a segmental bronchus, a segmental artery, lymph vessels, and nerves.

The segmental veins lie in the connective tissue between bronchopulmonary segments

Because it is a structural unit, a diseased segment can be removed surgically.

Bronchopulmonary segments

Bronchogram showing the branching pattern of the trachea and bronchi of the right lung, in a slightly oblique anteroposterior view. In this procedure, a radiopaque contrast medium has been introduced into the respiratory tract to coat the walls of the respiratory passages

★ The Pleura

General features Serous membranes forming

closed sacs Two layers

Visceral pleura －covers the outer surfaces of the lungs, and extends into the interlober fissures

Parietal pleura － lines the thoracic wall and coves the diaphragm and the lateral surface of the mediastinum

The Pleura

Two pleural layers continue with each other at root of lung forming closed potential space －pleural cavity Contains a small amount

of pleural fluid Subatmospheric

pressure in it

★ Named parts of parietal pleura Cupula of pleura －

extends up into the neck, over the apex of lung, 2.5cm above the medial third of clavicle

Costal pleura － lines the inner surface of the wall of the chest

Mediastinal pleura Lines mediastinum Pulmonary ligament －

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

Diaphragmatic pleura －Lines diaphragm

Pleura recesses Potential spaces of pleural

cavity which lungs are not occupied in quiet respiration

Costodiaphragmatic recesse － are the slit-like space between costal and diaphragmatic pleurae on each side, the lowest area of pleural cavity into which the lungs expand during deep inspiration.

Costomediastinal recess － on the left side between the mediastinal pleural and costal pleura

★ Surface markings of lower border of the lung and pleura

Lower border

Midclavicular lines

Midaxillary lines

Scapular line

Sides of the vertebral column

Lungs 6th rib 8th rib 10th rib T11

Pleura 8th rib 10th rib 11th rib T12

Thoracentesis