1、 PharynxLarynx Trachea & EsophagusGeneral arrangement of neckSkeleton Framework of the Pharynx & The Retropharyngeal SpaceWall of pharynxOuter layerpharyngeal constrictors: superior, middle and inferior Inner layerpalatopharyngeus, stylopharyngeus, and salpingopharyngeus palatopharyngeus, stylophary

2、ngeus, and salpingopharyngeus PharynxNasopharynxOropharynxLaryngopharynx Nasopharynx pharyngeal opening of pharyngotympanic (auditory) tube tubal torus pharyngeal recessoropharynx oropharynx Arterial Supply of Pharyngeal tonsilLaryngopharynxRelated nerves Vessels of pharynxLymphoid tissue in tongue

3、and pharynx Muscles, Vessels, NervesMuscles: 2 layersExternal carotid a.: ascending pharyngeal a. facial a. lingual a.Internal jugular v.Pharyngeal plexus: motor & sensory Maxillary n. CN IX, X, XIPositionRelationshipFunction Larynxcartilages connected by membranes and ligaments unpaired: thyroid, c

4、ricoid, epiglottic paired: arytenoid, corniculate, cuneiform Skeleton of larynx: Laryngeal Cartilages thyroid cartilage epiglottic cartilage cricoid cartilage arytenoid cartilagesCartilages of larynx Joints of larynxCricothyroid jointsCrico-arytenoid jointsligaments of larynxThyrohyoid membraneQuadr

5、angular membrane Vestibular foldsCricothyoid membrane vocal ligament, vocal fold, cricothroid ligament thyrohyoid membrane quadrangular membrane cricothyroid membraneVestibular Ligament & FoldVocal Ligament & FoldRima GolttidisRima VestibuliVocal ligaments & rima glottidisLaryngeal Joints & their Mo

6、vementsCricothyroid JointsCrico-arytenoid JointsThe Rima Glottidis under Different Status Extrinsic laryngeal muscles Intrinsic laryngeal muscles adductors abductors sphincters tensors relaxers Muscles of larynxLaryngeal Muscles & Movements of Laryngeal JointsLaryngeal Muscles internal laryngeal mus

7、cles external laryngeal muscles Vocalis MuscleInternal laryngeal cavityVestibule of larynxIntermedial laryngeal cavity (ventricle of the larynx)Infraglottic cavity recurrent laryngeal n.: - motor: all intrinsic mm. except cricothyroid m. - sensory: the laryngeal cavity below the level of the vocal f

8、olds sup. thyroid a. sup. laryngeal a. inf. thyroid a. inf. laryngeal a.Nerves and vesselsInnervation of the LarynxVenous & Lymphatic DrainageHeimlich Maneuver Laryngoscopy Clinical correlationThe Cervical Trachea tracheal ringstrachealis muscle from CV6 to sternal angle 氣管軟骨環(huán)tracheal rings 氣管肌trach

9、ealis muscleTracheostomy & its anatomical relationships Vessels & nerves of the Cervical Esophagus inferior thyroid a. & v.paratracheal & inferior deep cervical lymph nodes recurrent laryngeal n. & cervical sympathetic trunks Tracheoesophageal Fistula Cases 當John完成了第一次解剖學考試后，父親決定帶他去吃牛排以示慶祝。在喝了一點酒后，他

10、注意到父親說話有些含糊不清，進食速度加快。過了一會兒，他發(fā)現(xiàn)父親臉色突然改變，然后突然倒在地板上。開始他懷疑父親可能是休克、心臟病或癲癇發(fā)作。但他還發(fā)現(xiàn)父親脈搏很強，臉色開始發(fā)青。這時他意識到可能是窒息。他將父親的嘴張開，看到一大塊牛排卡在喉的后部。他將示指深入父親口中，試圖取出牛排，但未成功。然后他將父親翻到俯臥位，實施海姆利克操作法。問題：1. 這塊牛排可能會滯留在哪個部位？ 2. 如果海姆利克操作法沒有成功，此時又有一位醫(yī)生來幫助，你認為他還可以采取什么急救措施？ 3. 此類事件可造成所謂“餐館死亡”，試討論之。Cases 一個10歲的男孩因喉痛和耳痛被送到醫(yī)院。伴有高熱、脈搏快、呼吸節(jié)律快。查體發(fā)現(xiàn)咽喉有廣泛紅腫，特別是腭扁桃體紅腫明顯。左側(cè)鼓膜突出。病史發(fā)現(xiàn)該男孩曾經(jīng)有鼻粘膜慢性炎癥癥狀，經(jīng)常用口呼吸，還患過扁桃體周圍膿腫。診斷：扁桃體炎 治療：抗生素治療后炎癥消失。3個月后對其行T和A。問題：1. 扁桃體的定