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ANATOMY OF
OTORHINOLARYNGOLOGY –
HEAD AND NECK SURGERY
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OBJECTIVES
TO
DISCUSS THE BASIC ANATOMY RELEVANT IN
ORL-HNS
EAR (EXTERNAL, MIDDLE, INNER)
NOSE AND PARANASAL SINUSES
ORAL CAVITY
PHARYNX (NASO/ORO/HYPOPHARYNX)
LARYNX
NECK
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EAR
EXTERNAL EAR
MIDDLE EAR
INNER EAR
EAR CANAL
Lateral 1/3 is cartilaginos (cerumen glands and hair follicles)
Medial 2/3 are bony (no cerumen or hair follicles)
The blood supply for the auricle are the branches of ECA:
superficial temporal artery and posterior auricular
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PROTECTIVE MECHANISMS OF
OUTER EAR
Acidic pH 6.0-6.5
Migratory nature of keratin debris
Normal flora (staph auricularis, staph epidermidis,
corynebacterium, streptococcus, enterococcus, rarely
pseudomonas and fungi)
3 layers of TM:
1. Keratinized squamous epithelium
2. Middle fibrous
3. Middle ear mucosa
EUSTACHIAN TUBE
2/3 CARTILAGINOUS
1/3 BONY
AGING LEADS TO INCREASED SLOPE OF THE
TUBE, AS WELL AS INCREASED LENGTH,
DIAMETER, AND EFFICIENCY OF THE OPENING
Vestibular anatomy and physiology
Semicircular canals (coplanar) – angular accelometers
1. Horizontal canals
2. Left anterior (superior), right posterior
3. Right anterior (superior), left posterior
Otolithic organs (linear accelometers)
Saccule: vertical acceleration
Utricle: horizontal acceleration, head tilt
+ NOSE AND PARANASAL SINUSES
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FUNCTIONS OF THE NOSE:
OLFACTION, VOICE RESONANCE, HUMIDIFICATION, TEMP
CONTROL, CLEANSING
PSEUDOSTRATIFIED CILIATED COLUMNAR EPITHELIUM: ANTERIOR
BORDER BEGINS AT THE LUMEN NASI;
CILIARY ACTIVITY - CAUSES THE TRANSPORT OF MUCUS, AN
ESSENTIAL DEFENSE MECHANISM, AT A FREQUENCY OF 10-15
BEATS/MIN AND MUCOUS BLANKET STREAMS AT A RATE OF 2.5-7.5
ML/MIN
TURBINATES ARE THE LATERAL BONY PROJECTIONS THAT WILL
INCREASE THE SURFACE AREA FOR HUMIDIFICATION, AIR CLEANING,
TEMP CONTROL
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+ Osteomeatal Complex
FINAL COMMON PATHWAY FOR DRAINAGE OF
ANTERIOR SINUSES, UNCIINATE PROCESS,
ETHMOID BULLA, HIATUS SEMILUNARIS,
INFUNDIBULUM, MIDDLE TURBINATE, MAXILLARY
SINUS OSTIUM
PNS: LIGHTENS THE WEIGHT OF THE HEAD, HUMIDIFYING
AND HEATING INHALED AIR, INCREASING THE RESONANCE
OF SPEECH, SERVES AS CRUMPLE ZONES
SINUSES PRESENT AT BIRTH:
MAXILLARY AND ETHMOID SINUSES
FRONTAL SINUS – SIGNIFICANT BY AGE 9
SPHENOID SINUS – SIGNIFICANT BY AGE 10-12
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+ PHARYNX
muscular tube lies behind and communicates with the nasal, oral, and laryngeal
cavities
At the level of C6, the pharynx becomes the esophagus, and anterior to the
pharynx, the larynx becomes the trachea
NASOPHARYNX
Lateral wall: the cartilage of the eustachian tube , the torus tubarius
Anterior: posterior choanae
Posterior: superior pharyngeal constrictor
Superior: posterior body of the sphenoid, basilar component of the occipital bone,
and anterior arch of the atlas
OROPHARYNX
Anterior: base of the tongue, vallecula, glossoepiglootic fold
Posterior: pharyngeal mucosa
Lateral: tonsil, palatopharyngeal and palatoglossal folds
HYPOPHARYNX: 3 PS
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LYMPHATIC
DRAINAGE
•Nasopharynx:
retropharyngeal nodes
•Oropharynx:
jugulodigastric nodal
group (levels II and III)
•Hypopharynx: upper
cervical nodes
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ORAL
CAVITY
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PHARYNX
LARYNX
Unpaired cartilage
1. Epiglottis
2. Thyroid cartilage
3. Cricoid cartilage
Paired cartilages:
1. Arytenoids
2. Corniculate
3. Cuneiforms
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NECK