Introductio to: Splanchnology

1. Introductio to:Splanchnology

2. Composition: • Alimentary system 消化系统 • Respiratory system 呼吸系统 • Urinary system 泌尿系统 • Reproductive system 生殖系统 • Characters of viscera • Most of viscera organs lies in the thoracic, abdominal and pelvis cavities • All of then communicate with external environment through some orifices or channels

3. Reference lines of thorax • Anterior median line • Sternal line • Midclavicular line • Parasternal line • Anterior axillary line • Post axillary line • Midaxillary line • Scapular line • Posterior median line

5. The abdominal regions Nine regions • Left and right hypochondriac region, epigastric region • L . and R. lateral regions of abdomen, umbilical region • L. and R. inguinal region, pubic region

6. Four quadrants • Left and right upper quadrants • Left and right lower quadrants

7. The Respiratory System

8. Composition • Respiratory tract • Nose • Pharynx upper respiratory tract • Larynx • Trachea lower respiratory tract • Bronchi • Lungs-paired organs of respiration Function: supply the body with oxygen and to get rid of excess carbon dioxide resulting from cell metabolism

9. The Nose 鼻 External nose: • Root of nose • Back of nose • Apex of nose • Alae of nasi Nasal cavity –divided into two halves by nasal septum

10. Two parts: • Divided by limen nasi 鼻阈 • Nasal vestibule • Proper nasal cavity Boundaries • Roof－cribriform plate of ethmoid • Floor－hard palate • Medial wall－nasal septum • Lateral wall • Nasal conchae: superior, middle and inferior • Nasal meatus: superor, middle and inferior • Sphenoethmoidal recess

11. Remove the middle nasal conchae • Semilunar hiatus 半月裂孔 • Ethmoidal infundibulum 筛漏斗 • Ethmoidal bulla 筛泡

12. Mucous membrane of nose • Olfactory region嗅区: located upper nasal cavity, above superior，nasal conchae，contains olfactory cells • Respiratory region 呼吸区: its function is to warm, moisten, and clean the inspired air

13. The paranasal sinuses and their site of drainage into the nose

14. Frontal sinus Ethmoidal sinuses Sphenoid sinus Maxillary sinus

15. The Larynx 喉 Position－situated in the anterior part of the neck (below the hyoid bone), and extends from vertebral level of C4 to C6

16. Layngeal cartilages 喉软骨 Thyroid cartilage 甲状软骨 • Shield-shaped cartilage • Laryngeal prominence at base of thyroid notch • Superior thyroid notch, superior and inferior cornua Cricoid cartilage 环状软骨 • Complete ring of cartilage (shaped like a signet ring) • Arch of cricoid cartilage－at level of C6 • Larnina of cricoid cartilage

17. Arytenoid 杓状软骨 • Paired, pyramid shaped, articulate with lamina of cricoid cartilage • Vocal process anteriorly, site of posterior attachment of vocal fold • Muscular process Epiglottic cartilage 会厌软骨leaf-shaped elastic cartilage situated behind the root of the tongue

18. Laryngeal joints • cricothyroid joint • cricoarytenoid joint Laryngeal ligaments and membrane • Thyrohyroid membrane 甲状舌骨膜－extending from hyoid bone to thyroid cartilage

19. Quadrangular membrane 方形膜 • Between epiglottic, thyroid and arytenoid cartilages • Lower free border forms vestibular ligament 前庭韧带 • Conus elasticus 弹性圆锥 • Between arytenoids, thyroid, and cricoid cartilages • Upper free border forms vocal ligament声韧带 • Median cricothyroid ligment环甲正中韧带：may be site of circothyrotomy during acute respiratory obstruction • Cricotracheal ligament 环状软骨气管韧带－between cricoid cartilage and first ring of trachea

20. Muscles of larynx • Increasing tension on the vocal ligament－cricothyroid • Decreasing tension on the vocal ligament－thyroarytenoid • Opening the glottis－posterior cricoarytenoid • Closing the glottis－ cricoarytenoid

21. Laryngeal cavity Aperture of larynx 喉口－bounded by upper border epiglottic cartilage, aryepiglottic folds and interarytenoid notch

22. Structure features • Two pairs of shelf like folds : • Vestibular folds 前庭襞 • Vocal folds 声襞 • Two fissures • Rima vestibulithe 前庭裂 • Fissure of glottis 声门裂 • Inter membranous part膜间部 －anterior 3/5, between vocal-folds • Inter cartilagrnous part 软骨间部 －posterior 2/5, between arytenoids cartilages

23. Three parts • Laryngeal vestibule喉前庭 • Extends from the aperture of larynx to the rima vestibuli • Tubercle of epiglottis 会厌结节 • Intermedial cavity of larynx喉中间腔 • Extends from the level of the rima vestibuli to the level of the fissure of glottis • Ventricle of larynx喉室 －a small recess between vestibular and vocal folds on each side • Infraglottic cavity声门下腔 • extends from the level of the vocal folds to the lower border of the cricoid cartilage

24. The Trachea 气管 • Position: extends from the lower border of cricoid cartilage to the level of sternal angle (between T4－T5 vertebrae) where it divides into right and left principal bronchi • Structure features • Consists of about 16－20 C-shaped incomplete tracheal cartilages for patency connected by smooth muscle and connective • Carina of trachea 气管隆嵴 －ridge of cartilage at bifurcation into principal bronchi

25. Bronchi 支气管 Right principal bronchus 右主支气管 • Shorter, wider, and more vertical than the left , is about 2.5cm long, Leaves the extend line of the middle line of trachea at 22～25o angle • Foreign bodies are therefore more likely to lodge in this bronchus or one of its branches Left principal bronchus 左主支气管 • Narrower, longer, and more horizontal than the right is about 5cm long, leaves the extend line of the middle line o trachea at about 35～36o angle

26. The Lungs 肺 Position: located in the thoracic cavity by both sides of mediastinum General features • Cone-shaped, the right lung is shorter and broader, the left one is longer and narrower • Apex of lung－rises 2 ～3 cm above the medial third of clavicle into neck • Base－concave, related to diaphragm, also called diaphragmatic surface • Costal surface－large, convex, related to thoracic wall

27. Medial surface－concave, related to mediastinum and vertebrae • Hilum of lung肺门：area on medial surface where structures in root enter or leave lung • Root of lung 肺根 • Contents • Principal bronchus • Pulmonary artery and vein • Nerves and lymphatics • Surrounded by connective tissue • Order of structures in the root of lung • From before backward: V.A. B. • From above downward: • R.－B. A. V. • L.－A. B. V.

28. Borders • Posterior－blunt • Inferior－ sharp • Anterior－sharp • cardiac notch心切迹 • lingual in left lung 左肺小舌 Lobes and Fissure • Right lung • Two fissures : horizontal an oblique • Three lobes : superior, middle, inferior • Left lung • One fissure : oblique • Two lobes : superior and inferior

29. Bronchial tree支气管树 Each principal bronchus divides into lobar bronchi (two on the left, three on the right), each of which supplies a lobe of lung. Each lobar bronchus then divided into segmental bronchi, which supply specific segments of the lung.

30. Bronchopulmonary segments支气管肺段 • Wedge shaped, with the base lying peripherally and the apex lying towards the root of lungs, ten in each lung • Each with a segmental bronchus and branches of pulmonary artery • The veins lie both in and between segments

31. The Pleura 胸膜 General features • Serous membranes forming closed sacs • Two layers • Visceral pleura－adheres to lung, continuous with parietal pleura at root of lung • Parietal pleura－lines the thoracic cavity

32. Two pleural layers continue with each other at root of lung forming closed potential space－pleural cavity 胸膜腔 • Contains a small amount pleural fluid • Subatmospheric pressure in it

33. Named parts of parietal pleura • Cupula of pleura 胸膜顶 －extends up into the neck, over the apex of lung, 2～3cm above the medial third of clavicle • Costal pleura 肋胸膜 －lines the inner surface of the wall of the chest • Mediastinal pleura 纵隔胸膜 • Lines mediastinum • Pulmonary ligament 肺韧带－redundant pleura at root of lung, which extends downward, allows movement of structures forming root of lung • Diaphragmatic pleura 膈胸膜－Lines diaphragm

34. Pleura recesses 胸膜隐窝－potential spaces of pleural cavity which lungs are not occupied in quiet respiration • Costodiaphragmatic recesse肋膈隐窝－are the slit-like intervals between costal and diaphragmatic pleurae on each side, the lowest point of pleural cavity • Costomediastinal recess 肋纵隔隐窝－on the left side between the mediastinal pleural and costal pleura

35. The surface projection of lower border of lung and pleurae