Lecture 1kursk state medical university 17 страница

incus. E. Stapes. F. Stapedius tendon. G. Round window

niche.

Fig. 2. Right external auditory meatus.

1. Bony part. 2. Cartilaginous part.

3. Tympanic membrane. 4. Hair follicles and ceruminous glands. 5.

Introitus.

6. Meatal cartilage.

Fig. 4. Vertical coronal diaphragmatic section through right ear.

1. External meatus, cartilaginous part. 2. Middle cranial fossa. 3. Attic.

4. Malleus. 5. Incus. 6. Position of lateral semicircular canal. 7.

Position of posterior semicircular canal. 8. Superior semicircular canal.

9. Vestibule. 10. Facial nerve. 11. Vestibular nerve. 12. Cochlear nerve.

13. Cochlea. 14. Eustachian tube. 15. Stapes. 16. Internal carotid artery.

17. Bony part of external meatus. 18. Cartilage. 19. Parotid gland.

Fig. 5. Left tympanic cavity as seen from the medial aspect.

1. Epitympanic recess. 2. Body of incus. 3. Chorda tympani. 4. Pyramid. 5.

Footplate of stapes. 6. Medial surface of tympanic membrane. 7. Head of

maleus and superior ligament of maleus. 8. Anterior ligament of malleus.

9. Tensor tympany in its canal. 10. Eustachian tube.

Fig. 6. Relations of the left tympanic cavity and the facial nerve.

1. Cerebral cortex. 2. Sub­ara­ch­noid space. 3. Canal for tensor. 4.

Eustachian tube. 5. Internal carotid artery. 6. Jugular bulb. 7. Dura

mater. 8. Aditus. 9. Lateral semicircular canal. 10. Oval

window. 11. Pyramid. 12. Promontory. 13. Mastoid process. 14. Facial

nerve. 15. Round window.

Fig. 7. Membranous labyrinth (right side lateral view).

1. Superior semicircular canal. 2. Utricle. 3. Saccule. 4. Cochlea. 5.

Canalis reuni­ens. 6. Endolymphatic sac. 7. Endolym­phatic duct. 8.

Posterior semicircular canal. 9. La­teral semicircular canal.

10. Crus commune.

Fig. 8. Bony labyrinth (right side lateral view).

1. Superior semicircular canal. 2. Ampulla of superior semicircular canal.

3. Ampulla of lateral semi­circular canal. 4. Oval window. 5.

Cochlea. 6. Round window. 7. Ampulla of posterior semicircular

canal. 8. Lateral semicircular canal. 9. Posterior semicircular canal.

10. Crus commune.

Fig. 9. Bony labyrinth (right side lateral view partly opened).

1. Opening of crus commune into vestibule. 2. El­li­ptical recess (for

saccule). 3. Crista vestibuli. 4. Spherical recess (for saccule). 5.

Helicotrema. 6. Osseous spiral lamina. 7. Opening of perilymphatic

aqueduct. 8. Round win­dow. 9. Opening of endolim­­phatic aqueduct.

Fig. 10. Schematic diagram of semi­circular canal and utricle.

1. Hair cells. 2. Cupula. 3. Ampulla. 4. Temporal bone. 5. Perilymph.

6. Endolymph. 7. Utricle. 8. Otolith organ. 9. Nerve fibers.

Fig. 12. Diagram of a receptor in the semicircular canal:

1. Cupula. 2. Cilia. 3. Sensory cells. 4. Supporting cells. 5.

Crista ampullaris. 6. Afferrent nerve fibers.

Fig. 11. Diagram of an otolith organ:

1. Supporting cells.

2. Sensory cells. 3. Cilia. 4. Otolith membrane. 5. Otoliths. 6.

Afferent nerve fibers.

Fig. 13. Axial cross-section through the cohlea (a) and cohlear duct (b).

1. Modiolus. 2. Spiral ganglion. 3. Nerve fibers. 4. Vestibulococh­learis

ner­ve. 5. Spiral lamina. 6. Perilimphatic space. 7. Apex. 8. Scala media

(ductus coch­learis). 9. Scala vestibuli. 10. Scala tympani. 11. Ba­silar

mem­b­­rane. 12. Organ of Corti. 13. Ligamentum spirale cochleae.

14. Stria vascularis. 15. Reissner`s membrane.

Fig. 14. Scala media with organ of Corti. 1. Osseous spiral lamina. 2.

Spiral ganglion. 3. Tectorial membrane. 4. Reissner`s membrane. 5. Stria

vascularis. 6. Cells of Deiters. 7. Cells of Hensen. 8. Cells of Claudius.

9. Spiral ligament. 10. Basilar membrane. 11. Outer hair

cells. 12. Outer pillar of tunnel of Corti. 13. Nerve fibers. 14.

Tunnel of Corti. 15. Inner hair cells.

Fig. 15. The external nose.

1. Nasal bone. 2. Frontal process of maxilla. 3. Upper lateral cartilage.

4. Lower lateral cartilage. 5. Lesser alar cartilage. 6. Fatty tissue of

ala nasi.

Fig. 17. Section through the anterior nose showing the vestibule and the

limen nasi.

1. Bony nasal bridge. 2. Nasal septum. 3. Lateral nasal cartilage. 4.

Nasal cavity. 5. Alar cartilage. 6. Nasal vestibule.

7. Nasal ala. 8. Nasal colcolumella with media crus of the cartilaginous

ala. 9. Filaments of the olfactory nerve. 10. Olfactory bulb. 11. Internal

nasal valve.

Fig. 18. Lateral wall of left nasal cavity, showing the conchae or

turbinate bodies, the meatuses and spheno-ethmoidal recess. 1. Right

sphenoidal sinus. 2. Sphenoidal ostium. 3. Left sphenoidal sinus.

4. Superior meatus. 5. Inferior meatus. 6. Inferior turbinate. 7.

Accessory ostium of maxillary sinus. 8. Middle turbinate. 9. Superior

turbinate. 10. Frontal sinus. 11. Ostium of posterior ethmoidal cells.

12. Sphe-no-ethmoidal recess.

Fig. 16. The external nose.

1. Nasal bone. 2. Frontal process of maxilla. 3. Upper lateral cartilage.

4. Cartilage of septum. 5. Lower lateral cartilage. 6. Lateral crus. 7.

Medial crus.

Fig. 19. Lateral wall of left nasal cavity with the middle turbinate

removed; the lateral wall of the middle meatus is exposed, and the

position of the ostia of the sinuses is indicated by arrows. 1. Right

sphenoidal sinus. 2. Sphenoidal ostium. 3. Left sphenoidal sinus. 4.

Superior meatus. 5. Inferior meatus. 6. Inferior turbinate. 7. Accessory

ostium of maxillary sinus. 8. Uncinate process. 9. Ethmoidal bulla. 10.

Infundibulum or semilunar groove. 11. Nasofrontal duct. 12. Left frontal

sinus. 13. Superior turbinate. 14. Ostium of posterior ethmoidal cells.

15. Spheno-ethmoidal recess.

Fig. 20. Arterial anastomoses on the nasal septum. 1. Anterior ethmoid

artery. 2. Posterior ethmoid artery. 3. Septal branch of the

spheno-palatine. 4. Greater palatine. 5. Branch from superior labial. 6.

Little`s area, from which bleeding commonly occurs in younger patients.

Fig. 21. Normal right middle turbinate

Fig. 22. Nasal sinuses. a. Frontal section. b. Sagittal section. 1.

Frontal sinus. 2. Ethmoid sinus. 3. Maxillary sinus. 4. Sphenoid

cavity.

Fig. 23. Coronal section through the nasal cavities and the ostia of the

sinuses (viewed from behind). 1. Left frontal sinus. 2. Left anterior

ethmoidal cell. 3. General meatus. 4. Right anterior ethmoidal cells. 5.

Right frontal sinus. 6. Ethmoidal bulla. 7. Hiatus semilunaris. 8.

Infundibulum or semilunar groove. 9. Uncinate process. 10. Middle

turbinate cell. 11. Middle meatus. 12. Inferior turbinate. 13.

Maxillary sinus. 14. Inferior meatus.

Fig. 24. Frontal section through the sphenoidal sinus.

1. Optic nerve. 2. Oculomotor nerve. 3. Trochlear nerve. 4. Internal

carotid artery. 5. Cavernous sinus. 6. Abducens nerve. 7. Ophtalmic

nerve. 8. Maxillary nerve. 9. Sphenoid sinus. 10. Pituitary gland.

11. Brain.

Fig. 25. Pharyngeal musculature.

a. Superior constrictor. b. Middle constrictor. c. Inferior constrictor.

1. Digastric muscle.

2. Stylohyoid muscle.

3. Stylopharyngeus muscle.

4. Killian`s triangle. 5. Inferior part of the cricopharyngeus muscle. 6.

Eso­pha­gus.

Fig. 26. Pharynx posteriorly. Posterior wall of the pharynx is opened.

1. Choana. 2. Nasal septum.

3. Tubal tonsil. 4. Styloid process. 5. Stylopharyngeus muscle. 6.

Tubopharyngeal plicae. 7. Anterior palatine pillar.

8. Palatine tonsil. 9. Epiglottis. 10. Piriform sinus. 11. Esophagus. 12.

Thyroid gland.

13. Arytenoid cartilage. 14. Laryn­geal inlet. 15. Aryepiglottic fold. 16.

Base of the tongue. 17. Uvula. 18. Soft palate.

Fig. 27. Examination of the oropharynx. 1. Palatine tonsil. 2.

Palatoglossal fold. 3. Uvula. 4. Palatopharyngeal fold. 5. Soft palate. 6.

Posterior wall of the pharynx.

Fig. 28. The nasopharyngeal image on posterior rhinoscopy.

1. Choana. 2. Septum. 3. Inferior nasal turbinate. 4. Middle turbinate. 5.

Superior turbinate.

6. Adenoid. 7. Tubal tonsil.

8. Osteum of Eustahian tube.

Fig. 30. Thyroid cartilage.

Fig. 29. Cricoid cartilage.

Fig. 31. Laryngeal sceleton posteriorly

Fig. 32. Anterior aspect of cartilages and ligaments of larynx. 1.

Epiglottic cartilage. 2. Thyrohyoid membrane. 3. Su­perior thyroid notch.

4. Cri­cothyroid ligament. 5. Cricoid cartilage. 6. Inferior horn of

thyroid cartilage. 7. Thyroid prominence. 8. Superior horn of thyroid

cartilage. 9. Hyoid bone. 10. Cricotracheal membrane.

Fig. 33. Lateral aspect of laryngeal muscles.

1. Epiglottis. 2. Thyroepiglottic muscle. 3. Aryepiglottic muscle. 4.

Transverse arytenoid muscle. 5. Lateral cricoarytenoid muscle. 6.

Posterior cricoarytenoid muscle. 7. Thyroarytenoid muscle. 8. Trachea.

9. Cricoid cartilage. 10. Cricothyroid muscle. 11. Cricothyroid membrane.

12. Thyroid cartilage. 13. Hyoid bone.

Fig. 35. Larynx, vertical median section, seen from left side.

1. Epiglottis. 2. Adipose tissue. 3. Thyroid cartilage. 4. Ventricle. 5.

Vocal cord or fold. 6. Cricothyroid membrane. 7,8. Cricoid

cartilage. 9. Respiratory glottis, showing submucous position of arytenoid

cartilage. 10. Arytenoideus muscle. 11. Vestibular fold or false vocal

cord. 12. Corniculate cartilage. 13. Cuneiform cartilage.

Fig. 34. Larynx posteriorly. 1. Base of the tongue. 2. Epiglottis. 3.

Hyoid bone. 4. Thyrohyoid membrane. 5. Aryepiglottic muscle. 6. Transverse

arytenoid muscle. 7. Cricoid cartilage. 8,9 Trachea. 10. Posterior

cricoarytenoid muscle. 11. Oblique arytenoid muscle.

Fig. 36. The laryngeal image of indirect laryngoscopy. 1. Dor­sum of

tongue. 2. Vallecula. 3. Epi­glottis. 4. Vestibular fold. 5. Vo­cal fold

(cord). 6. Pyriform fossa. 7. Ary-epiglottic fold. 8. Arytenoid cartilage.

9. Glottis. 10. Inter­arytenoid fold.

Fig. 37. The compartments of the larynx. 1. Epiglottis. 2. Hyoid bone.

3. Ventricle of larynx. 4. Thyroid cartilage. 5. Cricoid cartilage. 6.

Thyro-arytenoid muscle. 7. Vocal fold. 8. Vestibular cord. 9.

Aryepiglottic fold. 10. Piriform sinus.

Fig. 38. Telescopic photograph of a normal larynx.

Fig. 39. Normal larynx.

Fig. 40. Glottis on inspiration.

Fig. 41. Glottis on phonation.

Fig. 42. Bilateral intubation granulomas.

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