The Head and Neck

Upper Respiratory Tract

Nose Nostril Nasal Cavity Oral Cavity Pharynx
pg 992

Nose
Nose is the only portion of the RT that is externally visible
CT, bone, hyaline cartilage

Air enters here during breathing

Passes through the external nares (nostrils)

pg 1023

Vestibule
Superior to nostrils Skin lined with:
Sebaceous glands
Greasy secretion Collect dirt Lubricate Kill bacteria

Sweat glands
Acidic Slows growth of bacteria

Hair follicles
Trap small particles of dirt

Vibrissae
pg 1013

Nose hairs Filter large particles (insects)

Nasal Cavity

Functions:
Provides airway for respiration Moistens and warms air Filters inhaled air Resonating chamber for speech Houses olfactory receptors

2 divisions:
External nose Internal nasal cavity

pg 1023

Nasal Cavity
Divided into R and L by nasal septum Continuous with the nasopharynx through the internal nares (choanae)

pg 992

Nasal Cavity
Boundries:
Roof ethmoid bone (cribiform plate) Floor maxilla (palatine process) palatine (horizontal plate) Lateral walls nasal bones, superior and middle nasal conchae of ethmoid bone, inferior nasal conchae, maxilla, palatine bone

Hard palate
Palatine bones and maxillary bone

Soft palate
Skeletal muscle posterior portion End in uvula

Lining of the Nasal Cavity

Respiratory Mucosa
www.mc.vanderbilt.edu/.../Respiratory03.htm

Pseudostratified ciliated columnar epithelium Goblet cells Lamina propria

Mucous and serous cells

Venous plexus Function is to filter and warm inhaled air Highly innervated
Sneeze!

Olfactory Mucosa
Roof of nasal cavity Houses smell receptors No goblet cells Cilia modified for olfaction

Nasal Conchae
Project medially from each lateral wall 3 structures:
Superior of ethmoid bone Middle of ethmoid bone Inferior

Functions:
Create turbulence to increase:
Filters air Heats air Moistens air Reclaim heat and moisture during exhalation

pg 1023

Paranasal Sinuses
Air filled cavities that surround the nasal cavity Lined by mucosa Perform same function as nasal cavity and lightens skull Located in Frontal, Ethmoid, Sphenoid, Maxilla bones

pg 1018

Pharynx
Connects the nasal cavity and mouth to larynx and esophagus Extends from base of skull to level of C6 vertebra Common passage for food and air Lined with skeletal muscle Divided into:
Nasopharynx Oropharynx Laryngopharynx

pg 992

Tonsils
Lymphoid organ
MALT

Swellings of the mucosa lining the pharynx Form ring around the entrance to the pharynx 4 groups: Palatine Lingual Pharyngeal Tubal pg 992 Remove pathogens

Nasopharynx
Location:
Posterior to nasal cavity Inferior to sphenoid bone Superior to level of soft palate

ONLY an air passageway Closed off during swallowing by the soft palates uvula
Giggling!

Ciliated pseudostratified epithelium Contain:

Pharyngeal tonsils (adenoids) Tubal tonsils

pg 992

Oropharynx
Location:
Posterior to the oral cavity Extends inferiorly from level of the soft palate to level of the esophagus

Swallowed food and inhaled air pass through here Stratified squamous epithelium Contain:
Palatine tonsils Lingual tonsils

pg 992

Laryngopharynx
Location:
Lies posterior to larynx Continuous with the esophagus and larynx

Common passageway for food and air

Food esophagus Air - larynx

Stratified squamous epithelium

pg 992

Larynx
Voice box Extends from C4 to C6 Attachments: pg 1001 Hyoid bone superiorly Continuous with trachea inferiorly Functions: Vocalization Provides open airway Switches to route air and food into proper channels Innervation: Vagus Superior part = stratified squamous epithelium Below vocal cords= ciliated pseudostratified columnar

Larynx
All hyaline cartilage except epiglottis Composed of 9 cartilages connected by membranes and ligaments:
1 Thyroid 1 Cricoid 1 Epiglottis 2 Arytenoid 2 Corniculate 2 Cuneiform

pg 1001 pg 1000

Laryngeal Cartilages
Thyroid Cartilage
Large Shield shaped Formed by 2 plates Contains laryngeal prominence
Adams Apple!!

pg 998

Laryngeal Cartilages
Cricoid
Inferior to thyroid cartilage Forms a complete ring Directly superior to trachea

pg 998

Laryngeal Cartilages
Epiglottis
Composed of elastic cartilage Covered by mucosa Projects upward from anterior wall of laryngeal inlet to level of base of tongue Close off larynx during swallowing

pg 999

Vocal Cords
Located in the larynx Mucosal folds formed by vocal ligaments
Composed of elastic fibers Run from arytenoid cartilages (posterior) to the thyroid cartilages (anterior)

Exhaled air passes over them and causes vibration

Force of air = volume Length & tension of folds = pitch

False vocal cords

Vestibular folds (superior to true)
pg 1008

Thyroid Gland
Location:
In anterior neck On trachea, inferior to larynx

2 lateral lobes
Connected by the isthmus Butterfly shape

Largest endocrine gland in body

Produces Thyroid hormone (TH)
Increases metabolic rate

Calcitonin
Depresses excess levels of Ca+ in blood

pg 966

Thyroid Gland
Internally, composed of follicles
Follicular cells
TH

Parafollicular cells
Calcitonin

Blood supply
Superior thyroid arteries
Branches of external carotids

Inferior thyroid arteries

Branches of subclavians

Parathyroid Gland
Two pairs Located on the deep surface of the lateral lobes of the thyroid gland Produce parathyroid hormone
Increases blood calcium levels

pg 966

Hyoid Bone
Location:
Inferior to mandible In anterior neck

Associated with the skull

Only bone in skeleton that does not articulate directly to another bone!!!

Attaches via ligaments to temporal bone, larynx Composed of:

Body 2 pairs of horns

Functions:
Moveable base for tongue Points of attachment for larynx and neck muscles
Sternohyoid, thyrohyoid,
pg 803

Oral Cavity and Associated Organs

Mouth
Tongue Teeth

External Salivary glands

pg 992

Mouth - Oral Cavity

pg 1041

Food enters alimentary canal through here Mucosa-lined

Thick stratified squamous epithelium, with keratinization in some areas

Boundaries:
Lips anteriorly Cheeks laterally Palate superiorly Tongue inferiorly Oropharynx posteriorly

Mouth divided into 2 parts:

Vestibule Oral cavity proper

Mouth
Lips (labia) and Cheeks
Keep food inside mouth during chewing Composed of skeletal muscle surrounded by skin Lips formed by orbicularis oris muscle Cheeks; Muscles of Mastication
Temporalis & Masseter (elevate mandible, close mouth) Buccinator (chewing) Digastric (lower mandible against resistance, opens mouth) Pterygoids (lateral movements)

Palate: forms the roof of the mouth

Soft palate (posterior) rises to close off nasopharynx during swallowing; made of skeletal muscle Hard palate (anterior) provides surface for tongue to force food against during chewing

Tongue
Functions
Grips and moves food between teeth during chewing Mixes food with saliva = BOLUS Moves bolus down pharynx Speech production Houses taste buds (= gustation)

Creates floor of mouth Attachments: hyoid, mandible, styloid process, soft palate Made of Skeletal muscle with a CT septum

pg 1037

Intrinsic muscles (change shape; rolling) Extrinsic muscles (movement; protrude, retract) Motor = Hypoglossal (CN XII) Sensory = Mandibular (CN V3), Facial (CN VII), Glossopharyngeal (CN IX)

Moving Bolus
Swallowing voluntarily initiated (pharynx) Peristalsis = propulsion
Involuntary Alternate waves of contraction and relaxation of muscles in organ walls (e.g. esophagus) Squeezes food from one organ to next Some mixing

www.answers.com

pg 1043

Salivary Glands
Compound tubuloalveolar glands Intrinsic salivary glands
In mucosa of tongue, palate, lips and cheeks Keeps mouth moist at all times

Extrinsic salivary glands

Lie external to mouth Connected by ducts Secrete only during eating or prior to (mouth watering) 3 paired glands:
Parotid Submandibular sublingual

pg 863

Salivary Glands
Produce saliva
Mixture of water, ions, mucus and enzymes Moistens mouth Dissolves food for taste Binds food into a bolus Enzymes digest starch Bicarbonate buffer neutralizes acids Kill microorganisms Contains proteins to promote growth of beneficial bacteria

pg 1046

Teeth From Eruption to Edentate

Function:
Ingestion and mechanical breakdown of food

Have 2 sets of teeth (dentitions)

Primary dentition / deciduous (milk) teeth Permanent dentition
Incisors: rip, cut Canines: tear and pierce Premolars: grinding Molars: grinding
pg 1056

Teeth
Gomphosis
Synarthrosis Peg in socket with ligament

The sockets (alveoli) are in gum-covered margins in mandible and maxilla Periodontal ligaments (collagen fibers) anchor tooth in bony socket
Continous with gingiva (gum)

Teeth Substances
Enamel
Made of calcium salts Avascular, acellular Not renewed or replaced HARDEST substance in body!!!!

Dentin
Underlines enamel Forms bulk of tooth Made of minerals and collagen Maintained during life Harder than bone

Cementum
Calcified external surface Attaches tooth to periodontal ligament

Teeth
Regions:
Crown
Covered with enamel Projecting into oral cavity

Neck (gumline) Root

Area beyond neck in alveolus

Pulp cavity
Center of tooth Loose CT with vessels and nerves Supplies nutrients to hard tissues

Teeth
Root Canal
Portion of the pulp cavity in the root

Apical foramen
Opening into the root canal at the tip of each root

Blood supply
Superior/Inferior Alveolar artery, branches of External Carotid artery

Innervation
Maxilla = Superior Alveolar Nerves Mandible = Inferior Alveolar Nerves

Teeth at Birth
Number of erupted teeth = 0 Jaws covered by gingiva (gums)
Lots of drooling!!!

First Teeth 6 Months

Lower central incisors first to appear
8 Incisors = 6-10 months 4 Canines = 16-20 months 4 1st Molars = 12-16 months 4 2nd Molars = 20-24 months

pg 1056

20 deciduous teeth emerge by age 2 Dental formula

Describes the number and position of classes of teeth (half of the mouth) 2I, 1C, 2M 2I, 1C, 2M

X 2 = 20

Deciduous teeth dental formula:

****No premolars!

Adolescence Adult
Permanent teeth enlarge and develop
Roots of deciduous teeth reabsorbed Teeth loosen and fall out Begin to erupt from 7-13 years of age Third molars (wisdom teeth) emerge from 17-25 years
May be absent!!

Adult dental formula: 2I, 1C, 2P, 3M 2I, 1C, 2P, 3M

pg 1056

X 2 = 32

Tooth Troubles
Cavities (caries)
Demineralization of enamel by bacteria In severe cases, erodes the dentin of tooth Most severe cases erosion penetrates pulp cavity

Tooth Troubles
Gingivitis
Inflammation of the gingiva caused by plaque accumulation Leads to.

Periodontitis
Infection of periodontal ligament leading to its destruction along with the bone around the teeth Leads to toothlessness!

Triangles of the Neck

Neck subdivided into two triangles Separated by the sternocleidomastoid muscle Anterior triangle Posterior triangle

Triangles of the Neck: Posterior

Boundries:
Anterior - sternocleidomastoid Posterior - trapezius Inferior clavicle

Contents:
Nerves: accessory nerve, phrenic nerve, brachial plexus Artery: Subclavian Vein: External jugular
pg 948

Triangles of the Neck: Anterior

Boundries:
Anterior - midline Posterior - sternocleidomastoid Superior inferior margin of the mandible

Contents:
Glands: Submandibular Muscles: Suprahyoid and infrahyoid muscles Artery: Common carotid Vein: Internal jugular, External jugular Nerve: Accessory
pg 954