Nasal cavities, paranasal sinuses,

nasopharynx, larynx
Summary for dissection room
Csaba Szigeti, MSc, PhD
Department of Anatomy, Histology and Embriology
Szeged, 2014

A. Semilunar hiatus (1), anterior- (2), middle- (3),and posterior (5) ethmoidal air cells
Superior concha (4), sphenoidal sinus (6), ethmoidal bulla (7), opening of maxillary sinus (8)
Perpendicular plate of palatine bone (9), torus tubarius (10), salpingopharyngeal fold (11)
B. Thyrohyoid membrane (1), vestibular fold (2), vestibule (3), ventricle (4), arytenoid m. (5)
thyroid cartilage (6, 10), tracheal ring (7), cricoid cartilage(8), cricothyroid membrane (9)
Piriform recess (11)

The lateral wall of the nasal cavity

Sagittal section

Frontal sinus (1), superior nasal concha (2), nasal bone (3), superior
nasal meatus (4), middle nasal concha (5), inferior nasal concha (6),
sphenoethmoidal recess (7), sphenoidal sinus (8), hypophysis (9),
choana (10), opening of pharyngo-tympanic tube (11),
salpingopharyngeal fold (12) anterior cranial fossa (13)

Conchae partially removed

Frontal sinus(1), nasal bone (2), middle nasal meatus (3), opening of
nasolacrimal duct (4), inferior nasal meatus (5), nasal vestibulum (6),
inferior nasal concha(7), hard palate (8), semilunar hiatus (9),
opening of middle ethmoidal air cells (10), ethmoidal bulla (11),
superior nasal concha (12), Sphenoidal sinus (13),
sphenoethmoidal recess (14), middle nasal concha (15)

OPENINGS OF BONY NASAL CAVITY *

Opening or passage

Where does it lead?

Neurovascular structures :

Piriform aperture

Face

Choana

Epipharynx

Cribriform plate

Anterior cranial fossa

Fila olfactoria (CN.I.); Anterior ethmoidal a. & n.

Sphenopalatine foramen

Pterygopalatine fossa

Sphenopalatine a. & Sup. post. nasal nn.

Semilunar hiatus

Maxillary sinus

Infundibulum (ethmoidale)

Frontal sinus

Opening of sphenoidal sinus

Sphenoid sinus

Nasolacrimal canal

Orbit

Nasolacrimal duct

Incisive canal

Oral cavity

Nasopalatine a. & n. (V/2)

* from Andrea Czigner MD, PhD

Blood supply of the nasal cavity

Kisselbach area

Nasopalatine artery

External carotid artery

anterior-superior part
of the nasal cavity

Internal carotid artery

posterior-inferior part
of nasal cavity

Maxillar artery

ophtalmic artery

sphenopalatine artery
Anterior ethmoidal and Posterior ethmoidal artery
r. septalis post.
Septal rami + nasopalatine artery
(Kisselbach area)

aa.nasales postt
lat.
Greater palatine artery
( incisive canal)

Nerve supply of the nasal cavity

Ophtalmic nerve (V/1)

maxillar nerve (V/2)

PARANASAL SINUSES *

Frontal sinus
Sphenoid sinus
Maxillary sinus
Ethmoidal sinuses

* from Andrea Czigner MD, PhD

F:
A:
P:
Sph:
M:

Frontal sinus
Anterior ethmoidal air cells
Posterior ethmoidal air cells
Sphenoid sinus
Maxillary sinus

NL

Nasolacrimal duct

Nasopharynx

behind the nasal cavity and superior to the soft palate, covered with respiratory epithelia
Elevation of the soft palate separate the nasopharynx from the oropharynx during swallowing
There is a large collection of lymphoid tissue (the pharyngeal tonsil) in the mucosa covering the roof of the nasopharynx
The opening of the pharyngotympanic tube is posterior to and slightly above the level of the hard palate
the vertical salpingopharyngeal fold, which descends from the tubal elevation and overlies salpingopharyngeus muscle
Tubar tonsil: the small follicles around the opening of the pharyngotympanic tube
posterior rim of the opening of the pharyngotympanic tube forms an elevation on the pharyngeal wall torus tubarius

Topography of the larynx

C3-C4
Thyroid gland

External carotid bifurcation

Upper margin of thyroid
cartilage

C6

Arcus of the cricoid

cartilage

Ao r

ta

clavicle
Tendon of the
sternocleidomastoid

Jugular notch

Cartilages of the Larynx

Thyroid cartilage:
Hyaline cartilages:
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilage
Elastic cartilages:
Epiglottis
Corniculate cartilage
Cuneiform cartilage (in aryepiglottic fold)

Cartilages of the Larynx

Cricoid cartilage:

Arytenoid cartilage:

Joints of the larynx

Cricothyroid joint:
Inferior horn
(Thyroid cartilage)

lateral articular facet

(Cricoid cartilage)

hindge joint (movements around the transverse axis)

Cricoarytenoid joint:
Articular facet of arytenoid + superior articular facet of cricoid
pivot joint (movements around the vertical axis )
+ med. et lat. translation (gliding movement)

Outer ligaments of the larynx

(Attach the larynx to the hyoid bone and trachea)

Thyrohyoid membrane,
Median and lateral thyrohyoid lig.
Hyoepiglottic lig.
Thyroepiglottic lig.
cricotracheal lig.
cricopharyngeal lig.

Inner ligaments of the larynx

(Membrana fibroelastica laryngis, stabilize the cartilages of the larynx)

Quadrangular membrane
Vestibular lig.
Conus elasticus (triangular membrane)
Vocal lig.
Median cricothyroid lig. = lig. conicum = pars
libera coni elastici CONICOTOMIA

Muscles of the larynx

superior laryngeal
nerve

Tightens
vocal folds

Vocalis (2)

Tightens
vocal folds

Thyroarytenoid (3)

Adducts vocal
folds

Closes rima glottidis

Arytenoideus
transversus (4)

Adducts
arytenoid
cartilages

Closes rima glottidis

Cricoarytenoideus
posterior (5)

Abducts vocal
folds

Opens rima glottidis

Cricoarytenoideus
lateralis (6)

Adducts vocal
folds

Closes rima glottidis

Arytenoideus
obliquus,
aryepiglotticus
From Andrs Mihly MD. PhD. DSc.

Narrowing the aditus

(epiglottis and
arytenoid cartilages
come closer)

Inferior laryngeal nerve

Cricothyroid (1)

Muscles of the larynx

Superficial layer

Deep layer: cricothyroid m. and the lamina of thyroid

cartilage removed, pharyngeal mucosa reflected

Cavity of larynx

2
3

Laryngeal inlet: aryepiglottic

fold, corniculate and cuneiform
tubercle, interarytenoid notch.
(1) Vestibule, vestibular fold,
rima vestibuli, laryngeal
ventricle (Morgagni), laryngeal
saccule
(2) Glottis: vocal fold, rima
glottidis (pars
intermembranacea, pars
intercartilaginea).
(3) Infraglottic space.

Arterial supply of the layrnx

Superior laryngeal artery

Inferior laryngeal artery

Superior thyroid artery

Inferior thyroid artery

External carotid artery

Thyrocervical trunk

Subclavian artery

Venous drainage of the larynx

Left brachiocephalic vein

Superior laryngeal v.

Superior thyroid v.
Middle thyroid v.

Inferior laryngeal v.

Inferior thyroid v.
Plexus thyroideus impar

Internal jugular v.
Left brachiocephalic v.

Innervation of the larynx

Nodose ganglion
+ superior cervical ggl.

Superior laryngeal nerve

Internal ramus

external ramus

Sensory function:
mucosa above
the vocal fold

motor function:
Cricothyroid m.

recurrent laryngeal nerve

(sin.: arcus aortae, dext.: a. subcl dext.)
sensory: mucosa below the vocal fold
motor: all laryngeal muscles except cricothyroid

n. vagus

Nodose ganglion

Laryngoscopy
Indirect method

Direct method

Laryngoscopy

Open rima glottidis

epiglottis
from Andrs Mihly MD, PhD, DSc.

Reinkes edema of the vocal folds

posterior