Upper Airway Anatomy.pptVIP

Upper Airway Anatomy and Function Pharyngeal Anatomy Posterior and lateral walls are composed of three constrictor, attached to cervical vertibrae posterior. Passavant ridge: when swallowing, soft palate are elevated, forming a fold to seal nasopharyngeal Constrictor Superior constrictor is suspended from the skull base and lateral tongue Anterior attachments of middle constrictor are hyoid and stylohyoid ligament. The inferior constrictor attaches to the thyroid and cricoid cartilages No evidence to support that three constrictors contribute to stability of airway. Negative pressure generated with inspiration is maintained by dilation of the lumen by pulling the tongue base or hyoid bone anteriorly. They are genioglossus, geniohyoid, and anterior belly of the digastric muscle. (Pharyngeal dilating muscles) Pharyngeal Airway Physiology Airway collapse during sleep in all human and obstructive sleep apnea (OSA) is common. OSA is extreme rara in any other animal. Obstructive Sleep Apnea (OSA) The instability seems to be a result of inferior displacement of the larynx during development Pharyngeal dilating muscles are active higher levels during wakefulness with OSA Mueller Maneuver Highly predictive of OSA Generation of negative pressure in the pharynx Cross-sectional area decreases significantly in OSA Snoring Collapsing pressure upstream pressure Collapsing pressure downstream pressure The airway intermittently closes Laryngeal Anatomy The most superior: epiglottis Vallecula: a pouch between tongue base and epiglottis Posterior glottis: 2arytenoid cartilages and the intervening mucosa Skeleton of Larynx Hyoid Thyroid cartilage: Begin to ossify after 20 y/o, accounting for age-related changes in pitch and resonance of the voice Epiglottis Cricoid cartilage: completely rigid diameter through whole airway Arytenoid cartilage: ball-and-socket joint Muscles of Larynx Thyroarytenoid muscle is often considered to be divided into two separate muscles: The medial thyro