Otolaryngology Anatomy and Physiology - PCC

Medical Language Learning Objectives

Immerse Yourself 1. Identify structures of ears,
nose, and throat (ENT)
THIRD EDITION system

16CHAPTER 2. Describe process of hearing

Otolaryngology 3. Describe common ENT
diseases and conditions,
laboratory and diagnostic
procedures, medical and
surgical procedures

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Otolaryngology Anatomy and Physiology

• Medical specialty that • Ears, nose, and throat (ENT)
studies anatomy and system is
physiology of ears,
nose, mouth, and  contained entirely in head and
throat (ENT) and uses neck
diagnostic tests,
medical and surgical • Head contains:
procedures, and drugs
to treat ENT diseases.  internal and external structures of
ears, nose, and mouth

 internal structures of sinuses

• Neck contains internal
structures of

 pharynx and larynx

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Anatomy and Anatomy of the ENT System
Physiology (cont’d)
• External Ear
• The ENT system:
 known as auricle or
 shares some structures with pinna

• gastrointestinal and respiratory  helix - outer rim of tissue
systems and cartilage
• throat serves as passageway • forms a C and ends at
for both food and air ear-lobe

 contains lymphoid tissue  external auditory meatus
• opening that leads into
• functions as part of immune external auditory canal
response (EAC)

 senses of hearing and smell

• also part of ENT system

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Anatomy of the ENT System
(cont’d)

Figure 16-4 Structures of the middle ear and inner ear • External Ear (cont’d)

 External auditory canal has
glands that secrete cerumen
(waxy, sticky substance)
• traps dirt
• has antibiotic action against
microorganisms that enter the
canal

 At end of canal is tympanic
membrane (TM, eardrum)
• thin dividing wall between
external and middle ear

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Anatomy of the ENT System
(cont’d)

Figure 16-3 Tympanic membrane (ear drum) • External Ear
(cont’d)
Pearson Education/PH College
 Mastoid process

• bony projection
of temporal
bone

• just behind
external ear

• has tiny cavities
filled with air

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Anatomy of the ENT System Anatomy of the ENT System
(cont’d) (cont’d)

• Middle Ear Middle Ear

 hollow area  Eustachian tube
• inside temporal bone of • allows air
skull pressure in
middle ear to
 Contains three tiny bones equalize
• collectively known as • with air pressure
ossicles in throat and
outside of the
• malleus, incus, and stapes body

 Connected to:
• nasopharynx

• by eustachian tube

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Anatomy of the ENT System Anatomy of the ENT System
(cont’d) (cont’d)

• Inner Ear Copyright © 2014, 2011, 2007 by Pearson Education, Inc. • Vestibule Copyright © 2014, 2011, 2007 by Pearson Education, Inc.
All Rights Reserved • entrance area to All Rights Reserved
 Contains 3 inner ear
fluid-filled • one end
becomes three
structures: semicircular
canals
• vestibule • other end
• semicircular becomes coiled
cochlea
canals
• cochlea Medical Language, Third Edition
 all of these Susan M. Turley
structures are
known as the
labyrinth

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Anatomy of the ENT Anatomy of the ENT System
System (cont’d)

• External Nose and Mouth External Nose and Mouth
(cont’d)
 external nose –
• supported by nasal bone,  Lips, cheeks, and chin
forming bridge of nose and • supported by:
dorsum
• maxilla (upper jawbone) and
 at nasal tip • mandible (lower jawbone)
• nasal bone becomes
cartilage  Nasolabial fold - crease in cheek
• from nose to corner of mouth
 nares (nostrils, singular-naris)
–  Philtrum –
• external openings • vertical groove above upper lip

 Mentum - chin

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Anatomy of the ENT System Anatomy of the ENT System
(cont’d) (cont’d)

• Sinuses • Nasal Cavity

 aka “paranasal sinuses”  Nasal cavity walls have 3 long,
• hollow cavities within bony projections −
bone • superior, middle, and inferior
• lined with mucous turbinates (nasal conchae)
membrane
• divide and slow inhaled air
 Four sets of sinuses • warm air
• frontal • provide moisture
• ethmoid
• sphenoid  Nasal cavity
• maxillary • lined with nasal mucosa
• continuously produces mucus

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Anatomy of the ENT System Anatomy of the ENT System
(cont’d) (cont’d)

Nasal Cavity • Oral Cavity

 Formed by:  Contains:
• ethmoid bone (of cranium) and • tongue
• maxilla of upper jaw • hard palate
• soft palate
 Nasal septum – • uvula
• vertical wall of cartilage • teeth
• divides nasal cavity into right • salivary glands
and left sides
 buccal mucosa - oral
 Cartilage becomes ethmoid bone mucosa in the cheek area
• (of cranium) in posterior nasal
cavity

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Anatomy of the ENT Anatomy of the ENT
System System
(cont’d)
Oral Cavity
• Pharynx (throat)
 Hard palate (roof of mouth)
 Divided into 3 areas:
• divides oral cavity from nasal • nasopharynx,
cavity oropharynx, and
laryngopharynx
 Made of 3 cranial bones:
• Nasopharynx
• maxilla (front of mouth), palatine
bone, and vomer (back of mouth)  becomes oropharynx
(middle portion of throat)
 Submental lymph nodes
 eustachian tubes open into
• under chin nasopharynx

• contain lymphocytes and  roof and walls contain
macrophages lymphoid tissue (adenoids)

• attack bacteria and viruses

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16-1 Anatomy of the ENT System (cont’d)

Anatomy of the ENT System

• Pharynx (pharyngeal tonsil) Pharynx (cont’d) Adenoids
Laryngopharynx
 Oropharynx Copyright © 2014, 2011, 2007 by Pearson Education, Inc.  Tonsils and adenoids
• middle portion of All Rights Reserved • part of lymphatic
the throat system
• contains the • function in immune
palatine tonsils response
• contain lymphocytes
 Laryngopharynx and macrophages
• contains the
lingual tonsils on • attack bacteria and
either side of the viruses in oral cavity
base of the
tongue Medical Language, Third Edition Copyright © 2014, 2011, 2007 by Pearson Education, Inc.
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Anatomy of the ENT System Anatomy of the ENT System
(cont’d)
• Larynx (cont’d)
• Larynx (cont’d)
 Pharynx divides into 2 parts:
• larynx leads to trachea  At superior end of larynx is epiglottis
• esophagus leads to  In middle of larynx are:
stomach
• glottis, ligaments, and vocal cords
 Larynx (voice box)  When you swallow
• short, triangular structure
• surrounded by cartilage • larynx moves up, closes against
epiglottis to keep food from entering
• can be seen at front of neck lungs
as laryngeal prominence
(Adam’s apple)  Remains open during:
• breathing, speaking, or singing
• to allow air to pass over vocal cords

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Anatomy of the ENT System The Human Voice System Video
(cont’d)

• Larynx (cont’d)

 muscles in larynx
• relax or tighten vocal cords
• to lower or raise pitch

 surface layer of each vocal cord
vibrates
• producing sound waves

 men have long vocal cords that
produce a lower-pitched voice than
women

 the volume of air (from lungs)
affects how loud or soft voice is

Copyright ©2011 Eva Lindahl
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Incredible Human Machines – Steven Physiology of the Sense of Hearing
Tyler Vocal Chords

• External ear

 captures sound waves

• Tympanic membranes

 move malleus, incus, and
stapes

• Stapes

 transmits mechanical
motion to oval window

 causing inner ear fluid on
other side of oval window
to move

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Diseases and Conditions (cont’d) 16-3

• Ears (cont’d) Deafness Video

 Cholesteatoma

(epithelial cells and
cholesterol in middle ear or
mastoid )

 Hearing loss

(most common disability in
U.S.)

Click on the screenshot to view a video on the topic of deafness.
Back to Directory

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Diseases and Conditions (cont’d) Diseases and Conditions (cont’d)

• Ears (cont’d) • Ears (cont’d)

 Hemotympanum  Motion sickness (better in front of car or
 Labyrinthitis (bacterial or viral inner ear
train, upper deck of boat, wing seats in planes)
infection – vertigo, altered balance, fever,
nausea, vomiting)  Otitis externa (“swimmer’s ear”, bacterial or

 Meniere’s disease fungal infection)

(OVERaccumulation of fluid, loss of hearing)  Otitis media (most common ear infection)

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16-3 Diseases and Conditions (cont’d)

Otitis Media Video • Ears (cont’d)

 Otosclerosis (excess bone)
 Ruptured tympanic

membrane
 Tinnitus (chronic ringing or distressing

noise)

 Vertigo (spinning sensation, loss of balance,

equilibrium)

Click on the screenshot to view a video on the topic of otitis media.
Back to Directory

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Diseases and Conditions (cont’d) Allergic Rhinitis Video

• Sinuses, Nose, and Nasal Cavity

 Allergic rhinitis
 Anosmia loss of smell
 Epistaxis nasal

hemorrhage

Click on the screenshot to view a video on the topic of allergic rhinitis.

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Diseases and Conditions (cont’d) Diseases and Conditions (cont’d)

• Sinuses, Nose, and Nasal Cavity • Sinuses, Nose, and Nasal Cavity
(cont’d) (cont’d)

 Polyp (tumors on a stalk)  Sinusitis
 Rhinophyma (rosacea)
 Septal deviation

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Diseases and Conditions (cont’d) Diseases and Conditions (cont’d)

• Sinuses, Nose, and Nasal Cavity • Mouth, Oral Cavity, Pharynx, and Neck
(cont’d)
 Cancer of the mouth and neck
 Upper respiratory infection (URI) bacterial or viral  Cervical lymphadenopathy
 Cleft lip and palate
infection of nasal passages, pharynx, bronchi

Symptoms of Acute Upper Respiratory Tract Infection

Common/Early Other

• Sore throat • Headache
• Rhinorrhea • Hoarseness
• Watery eyes • Arthralgia
• Nasal congestion • Sinus congestion/pain
• Sneezing • Ear pressure
• Coughing • Nonproductive cough
• Malaise • Fever
• Fatigue • Myalgia

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Diseases and Conditions (cont’d) Diseases and Conditions (cont’d)

• Mouth, Oral Cavity, Pharynx, • Mouth, Oral Cavity,
and Neck (cont’d) Pharynx, and Neck
(cont’d)
 Cold sores (HSV, type 1)
 Glossitis (irritation of tongue; food  Pharyngitis (sore throat)
 Temporomandibular joint
allergy,
infection, Vit B deficiency) (TMJ) syndrome
 Thrush (yeast - Candida albicans)
 Leukoplakia (chronic irritation from

tobacco, thickened white mucous membrane)

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16-3

Diseases and Conditions (cont’d)

• Mouth, Oral Cavity, Pharynx, and Neck
(cont’d)

 Tonsillitis

(bacterial or viral infection,
enlargement)

Figure 16-18 Vocal cord polyp

Childs/CMSP

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Laboratory and Diagnostic Procedures
(cont’d)

• Laboratory and Radiologic
Tests

 Audiometry (tests hearing ability –

frequency in Hz, intensity in dB)

 Culture and sensitivity (C&S)
 Rapid strep test (detects group A

strep within 5 minutes)

Figure 16-20 Rinne test (tests bone and air conduction)

Pearson Education/PH College

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Abbreviations Pronunciation

❏ acoustic neuroma (ah‐KOOS‐tik nyoo‐ROH‐mah)

❏ adenoidectomy (AD‐eh‐noy‐DEK‐toh‐mee)

❏ ala (AA‐lah)

❏ alae (AA‐lee)

❏ anosmia (an‐AWZ‐mee‐ah)

❏ audiometry (AW‐dee‐AWM‐eh‐tree)

❏ auditory (AW‐dih‐TOH‐ree)

❏ buccal mucosa (BUK‐al myoo‐KOH‐sah)

❏ candidiasis (KAN‐dih‐DY‐ah‐sis)

❏ cervical lymphadenopathy (SER‐vih‐kal lim‐FAD‐eh‐ NAWP‐eh‐thee)

❏ cheiloplasty (KY‐loh‐PLAS‐tee)

❏ cholesteatoma (koh‐LES‐tee‐ah‐TOH‐mah)

❏ cochlea (KOH‐klee‐ah)

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Pronunciation Pronunciation

❏ concha (CON‐kah) ❏ leukoplakia (LOO‐koh‐PLAY‐kee‐ah)
❏ endoscopy (en‐DAWS‐koh‐pee) ❏ malleus (MAL‐ee‐us)
❏ epistaxis (EP‐ih‐STAK‐sis) ❏ maxillofacial surgeon (MAK‐sil‐oh‐FAY‐shal SER‐jun)
❏ eustachian (yoo‐STAY‐shun) ❏ Meniere’s disease (MEN‐eh‐AIRZ dih‐ZEEZ)
❏ external auditory meatus (eks‐TER‐nal AW‐dih‐TOH‐ree mee‐AA‐tus) ❏ mucosal hypertrophy (myoo‐KOH‐sal hy‐PER‐troh‐fee)
❏ helix (HEE‐liks) ❏ myringitis (MEER‐in‐JY‐tis)
❏ impedance (im‐PEE‐dans) ❏ myringotomy (MEER‐ing‐GAWT‐oh‐mee)
❏ incudal (IN‐kyoo‐dal) ❏ nasolabial (NAY‐zoh‐LAY‐bee‐al)
❏ incudes (in‐KYOO‐deez) ❏ otalgia (oh‐TAL‐jee‐ah)
❏ labyrinthitis (LAB‐ih‐rin‐THY‐tis) ❏ otitis externa (oh‐TY‐tis eks‐TER‐nah)
❏ laryngeal (lah‐RIN‐jee‐al) ❏ otitis media (oh‐TY‐tis MEE‐dee‐ah)
❏ laryngopharynx (lah‐RING‐goh‐FAIR‐inks) ❏ otorhinolaryngologist (OH‐toh‐RY‐noh‐LAIR‐ing‐ GAWL‐oh‐jist)
❏ larynx (LAIR‐ingks) ❏ otosclerosis (OH‐toh‐skleh‐ROH‐sis)

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Pronunciation Summary

❏ otoscopy (oh‐TAWS‐koh‐pee)
❏ palatine tonsil (PAL‐ah‐teen TAWN‐sil)
❏ pharyngeal (fah‐RIN‐jee‐al)
❏ pharyngitis (FAIR‐in‐JY‐tis)
❏ rhinophyma (RY‐noh‐FY‐mah)
❏ rhinorrhea (RY‐noh‐REE‐ah)
❏ stapedectomy (STAY‐pee‐DEK‐toh‐mee)
❏ stapedial (stay‐PEE‐dee‐al)
❏ temporomandibular joint (TEM‐poh‐roh‐man‐DIB‐yoo‐lar JOYNT)
❏ tympanic membrane (tim‐PAN‐ik MEM‐brayn)
❏ tympanoplasty (TIM‐pah‐noh‐PLAS‐tee) (TIM‐pah‐noh‐PLAS‐tee)
❏ vestibulocochlear nerve (ves‐TIB‐yoo‐loh‐KOH‐klee‐ar NERV)
❏ vestibule (VES‐tih‐byool)

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11