Home Prosthetics and implantation Features of the structure of the pharynx of a newborn. Features of the structure and functions of the pharynx

Prosthetics and implantation

Features of the structure of the pharynx of a newborn. Features of the structure and functions of the pharynx

The throat is the main component in the human body. It has a complex structure and has a wide range of functions. Thanks to him, people live, breathe and eat. In medicine there is no term “throat”. But this word has long been entrenched in our vocabulary. Its meaning refers to the complex anatomical structure of the larynx.

Anatomical structure of the throat

The structure of the throat consists of several parts: pharynx, larynx, trachea. To correctly diagnose the disease, it is necessary to carefully study the anatomy of the throat and analyze all its components in detail. Pathology can form in any area. Therefore, knowledge of the anatomy of the throat is one of the most important areas in otolaryngology.

Structure and sections of the throat

If we talk about how the throat works, then in its structure it looks like an inverted cone, located near the 4th and 6th vertebrae. It originates from the hyoid bone, descends and passes into the trachea.

The diagram of the human throat is complex and is divided into several parts:

The pharynx, which includes the nasopharynx, oropharynx, and swallowing department.
The larynx, which is lined with tissue structures, blood and lymph vessels, nerves, glands, cartilage and muscles.

Detailed anatomy of the throat can be seen in the photo.

It is worth noting! The structure of the throat of a child and an adult has no obvious differences. The only thing that can be highlighted is that in children the size of the cavities is smaller.

What functions does the throat perform?

If we summarize the work performed by all components of the throat, we can identify several functions without which human existence is unimaginable.

The functions of the throat are divided into:

voice-forming;
protective;
respiratory;
esophageal

Violation of one of the listed actions can cause the development of serious pathology.

Diseases affecting the throat

Frequent ENT diseases of the throat include laryngitis. The disease may be acute or chronic course. The pathology is manifested by hoarseness of voice, barking dry cough, pain during swallowing.

The causes of the disease may be:

previous whooping cough;
overstrain of the vocal cords;
long exposure to the cold;
inhalation of vapors, gases, dust;
poor nutrition;
presence of bad habits.

One of the common pathologies affecting the throat can also be pharyngitis.

The disease usually occurs during/after:

talking in the cold;
prolonged inhalation of cold air through the mouth.

Signs of the disease include sore throat and sore throat. The patient complains of weakness, persistent and frequent cough, fever, muscle pain and headache.

Tonsillitis occurs when there is an inflammatory process in the palatine tonsils. The disease is quite dangerous, as it can be transmitted through common household items and by airborne droplets. Only those pathologies that arise against the background of an allergic reaction are safe for others.

Possible injuries

You can hurt your throat different ways. Internal and external factors can provoke injury.

External ones include:

firearms;
cut;
chopped;
bruised wounds.

The resulting external injuries damage not only the throat, but also the face, neck, and mucous membrane.

The occurrence of internal injuries is facilitated by damage to the walls and tissues of the throat by sharp foreign objects and bone fragments that fall inside through natural ways. Children especially often receive such throat injuries when they fall. Injuries vary in severity; a harmless abrasion can form on the mucous membrane or severe damage covering the walls of the throat and surrounding cavities.

Anatomical structure of the pharynx

The pharynx, another name is the pharynx. It starts at the back oral cavity and continues further down the neck. The wider part is located at the base of the skull for strength. The narrow lower part connects to the larynx. The outer part of the pharynx continues the outer part of the mouth - it has quite a lot of glands that produce mucus and help moisten the throat during speech or eating.

When studying the anatomy of the pharynx, it is important to determine its type, structure, functions and risks of disease. As mentioned earlier, the pharynx is shaped like a cone. The narrowed part merges with the laryngopharynx, and the wide side continues the oral cavity. There are glands that produce mucus and help moisten the throat during communication and eating. From the front side it connects to the larynx, from above it adjoins the nasal cavity, on the sides it adjoins the cavities of the middle ear through the Eustachian canal, and from below it connects with the esophagus.

The larynx is located as follows:

opposite 4 - 6 cervical vertebrae;
behind - the laryngeal part of the pharynx;
in front - formed due to the group of hyoid muscles;
above - hyoid bone;
lateral - adjacent to the thyroid gland with its lateral parts.

The structure of a child's pharynx has its own differences. Tonsils in newborns are underdeveloped and do not function at all. Their full development is achieved by two years.

The larynx includes in its structure a skeleton, which contains paired and unpaired cartilages connected by joints, ligaments and muscles:

unpaired consist of: cricoid, epiglottis, thyroid.
paired ones consist of: corniculate, arytenoid, wedge-shaped.

The muscles of the larynx are divided into three groups and consist of:

thyroarytenoid, cricoarytenoid, oblique arytenoid and transverse muscles - those that narrow the glottis;
posterior cricoarytenoid muscle - is paired and expands the glottis;
vocal and cricothyroid - strain the vocal cords.

Entrance to the larynx:

behind the entrance there are arytenoid cartilages, which consist of cornuform tubercles, and are located on the side of the mucous membrane;
in front - the epiglottis;
on the sides there are aryepiglottic folds, which consist of wedge-shaped tubercles.

The laryngeal cavity is also divided into 3 parts:

The vestibule tends to stretch from the vestibular folds to the epiglottis.
Interventricular section - stretches from the lower ligaments to the upper ligaments of the vestibule.
Subglottic region - located below the glottis, when it expands, the trachea begins.

The larynx has 3 membranes:

mucous membrane - consists of multinucleated prismatic epithelium;
fibrocartilaginous membrane - consists of elastic and hyaline cartilages;
connective tissue - connects part of the larynx and other formations of the neck.

Pharynx: nasopharynx, oropharynx, swallowing department

The anatomy of the pharynx is divided into several sections.

Each of them has its own specific purpose:

The nasopharynx is the most important section, which covers and merges with special openings into the back of the nasal cavity. The function of the nasopharynx is to moisturize, warm, clear pathogenic microflora inhaled air and recognize the smell. The nasopharynx is an integral part of the respiratory tract.
The oropharynx includes the tonsils and uvula. They border the palate and the hyoid bone and are connected by the tongue. The main function of the oropharynx is to protect the body from infections. It is the tonsils that prevent the penetration of germs and viruses inside. The oropharynx performs a combined action. Without its participation, the functioning of the respiratory and digestive system impossible.
Swallowing department (hyopharynx). The function of the swallowing department is to carry out swallowing movements. The laryngopharynx is related to the digestive system.

There are two types of muscles surrounding the pharynx:

stylopharyngeal;
muscles are compressors.

Their functional action is based on pushing food towards the esophagus. The swallowing reflex occurs automatically when muscles tense and relax.

The process looks like this:

In the oral cavity, food is moistened with saliva and crushed. The resulting lump moves towards the root of the tongue.
Further, the receptors, irritating them, cause muscle contraction. As a result, the sky rises. At this second, a curtain closes between the pharynx and nasopharynx, which prevents food from entering the nasal passages. The lump of food moves deep into the throat without any problems.
Chewed food is pushed down the throat.
Food passes to the esophagus.

Since the pharynx is an integral part of the respiratory and digestive system, it is able to regulate the functions assigned to it. It prevents food from entering the respiratory tract during swallowing.

What functions does the pharynx perform?

The structure of the pharynx makes it possible to carry out serious processes necessary for human existence.

Functions of the pharynx:

Voice-forming. Cartilage in the pharynx takes control of the movement of the vocal cords. The space between the ligaments is constantly subject to change. This process regulates the volume of the voice. The shorter the vocal cords, the higher the pitch of the sound produced.
Protective. The tonsils produce immunoglobulin, which prevents a person from becoming infected with viral and antibacterial diseases. At the moment of inhalation, the air entering through the nasopharynx is warmed and cleared of pathogens.
Respiratory. The air inhaled by a person penetrates the nasopharynx, then the larynx, pharynx, and trachea. The villi located on the surface of the epithelium prevent foreign bodies from entering the respiratory tract.
Esophageal. The function ensures the functioning of swallowing and sucking reflexes.

The diagram of the pharynx can be seen in the next photo.

Diseases affecting the throat and pharynx

They can provoke an attack of a viral or bacterial infection. But pathology is also caused by fungal infections, the development various tumors, manifestation of allergies.

Pharynx diseases manifest themselves:

sore throat;
tonsillitis;
pharyngitis;
laryngitis;
paratonsillitis.

Define accurate diagnosis Only a doctor can do this after a thorough examination and laboratory results.

Possible injuries

The pharynx can be injured as a result of internal, external, closed, open, penetrating, blind and through injuries. Possible complication- blood loss, suffocation, development of a retropharyngeal abscess, etc.

First aid:

in case of injury to the mucous membrane in the oropharynx area, the damaged area is treated with silver nitrate;
deep injury requires the administration of tetanus toxoid, analgesic, antibiotic;
expressed arterial bleeding stops with finger pressure.

Specialized health care includes tracheostomy and pharyngeal tamponade.

Anatomical structure of the larynx

The larynx (larynx) is lined with various tissue structures, blood and lymphatic vessels, and nerves. The mucous membrane, covered from the inside, consists of multilayered epithelium. And underneath there is connective tissue, which in case of illness manifests itself as swelling. When studying the structure of the throat and larynx, we observe a large number of glands. They are absent only in the region of the edges of the vocal folds.

See the photo below for the structure of the human throat with a description.

The larynx is located in the throat in the form hourglass. The structure of the larynx in a child differs from that of an adult. In infancy, she is two vertebrae higher than normal. If in adults the plates of the thyroid cartilage are connected at an acute angle, then in children they are at a right angle. The structure of the larynx in a child is also distinguished by a long glottis. In them it is shorter, and the vocal folds are of unequal size. The diagram of a child’s larynx can be seen in the photo below.

What does the larynx consist of?

The structure of the larynx in relation to other organs:

superiorly, the larynx is attached to the hyoid bone by thyroid ligaments. This provides support for the external muscles;
below, the larynx is attached to the first ring of the trachea with the help of the cricoid cartilage;
on the side it borders with thyroid gland, and behind with the esophagus.

The skeleton of the larynx includes five main cartilages that fit tightly together:

cricoid;
thyroid;
epiglottis;
arytenoid cartilages - 2 pieces.

From above the larynx passes into the laryngopharynx, from below into the trachea. All cartilages found in the larynx, except the epiglottis, are hyaline, and the muscles are striated. They have the property of reflex contraction.

What functions does the larynx perform?

The functions of the larynx are determined by three actions:

Protective. It does not allow third-party objects into the lungs.
Respiratory. The structure of the larynx helps regulate air flow.
Voice. The vibrations caused by the air are created by the voice.

The larynx is one of the important organs. If its functional activity is disrupted, irreversible consequences may occur.

Diseases affecting the larynx

The pathological process that occurs in the larynx is often infectious nature. The reason is decreased immunity.

As a result, it develops:

laryngitis;
angina;
polyps;
granuloma;
laryngeal stenosis;
tuberculosis of the larynx;
arthritis of the larynx joints;
laryngeal cancer.

All of the above diseases require the right approach to treatment.

Possible injuries

Injuries to the larynx can occur as a result of external and internal, blunt and sharp injuries, as well as thermal and chemical burns. Throat burns often occur. This type of damage may be irreversible. At best, the condition causes various diseases.

Signs of a throat injury include:

shortness of breath;
pain while swallowing;
persistent cough;
drooling;
swelling of the neck;
displacement of the larynx;
hemorrhages in the anterior neck.

Injury to the larynx is life-threatening, so it is recommended to call immediately ambulance. When provided, medical assistance can save a person’s life.

Anatomy of cartilage

When studying the structure of the larynx Special attention should be given to the cartilage present.

They are presented as:

Cricoid cartilage. This is a wide plate in the form of a ring, covering the back, front and sides. On the sides and edges, the cartilage has articular areas for connection with the thyroid and arytenoid cartilages.
Thyroid cartilage, consisting of 2 plates that fuse in front at an angle. When studying the structure of a child’s larynx, these plates can be seen to converge in a rounded manner. This happens in women too, but in men it usually develops an angular protrusion.
Arytenoid cartilages. They have the shape of pyramids, at the base of which there are 2 processes. The first, the anterior one, is the place for fastening the vocal cord, and the second, the lateral cartilage, is where the muscles are attached.
Horn-shaped cartilages, which are located on the tops of the arytenoids.

Informative video: The structure of the human throat, pharynx and larynx, what do they consist of and what functions do they perform?

The lymphatic pharyngeal ring (Waldeyer-Pirogov ring), consisting of the pharyngeal, 2 tubal, 2 palatine, lingual tonsils and lymphoid tissue of the posterior wall of the pharynx, is poorly developed before birth and in the first months after birth. In the postnatal period, the tonsils undergo a number of changes. In newborns, the tonsils are underdeveloped and functionally inactive. The palatine tonsils are not yet fully developed, forming follicles are visible in them, and development takes a long time.

The main part of the lymphoid ring of the pharynx is presented at birth in the form of small spherical accumulations of lymphocytes. “Reactive centers” appear in them in the first 2-3 months of life. The final development of follicles is completed in the first 6 months of a child’s life, and sometimes by the end of the 1st year. In infants, the active development of the lymphoid ring begins. Adenoids form more actively than other tonsils. The folds of the mucous membrane thicken and lengthen, taking on the appearance of ridges, between which grooves are clearly visible. In children of the 1st year of life, the nasopharyngeal cavity is low and acute-angled, and therefore even a slight enlargement of the pharyngeal tonsil can significantly disrupt nasal breathing.

In newborns, the integumentary epithelium is multirowed cylindrical. There are few furrows, they are shallow. In the underlying tissue, lymphoid cellular elements such as small and medium-sized lymphocytes, many blood vessels and mucous glands are diffusely located. Development tonsil begins with the formation of folds of the mucous membrane, which are penetrated by lymphoid tissue. Lingual tonsil develops due to the accumulation of lymphoid tissue at the root of the tongue. After birth, the tonsil tissue is in a constant state of irritation. In young years pharyngeal tonsil covered with multirow cylindrical ciliated epithelium, in older children and adults - with flat epithelium.

Palatine tonsils reach full development in the 2nd year of life. Gaps of the palatine tonsils in children early age deep, narrow at the mouth, densely branched, often extending to the capsule. The lacunae are not always directed deep into the tonsils; sometimes they turn sharply and go under the integumentary epithelium; the narrow passages of individual lacunae end in expansions. All this contributes to the occurrence of the inflammatory process. Tubal tonsils reach their greatest development in childhood. Children have less lymphoid tissue in the area of the tongue root than adults; The crypts of the lingual tonsil are smaller and less branched.

In young children, between the prevertebral aponeurosis and the muscles of the pharynx, from the arch of the nasopharynx to the entrance to the esophagus, between the two leaves of the aponeurosis, the retropharyngeal muscles are located in a chain The lymph nodes and loose connective tissue on both sides of the spine. These nodes are regional to the posterior parts of the nose, nasopharynx and tympanic cavity. Their suppuration leads to the formation of a retropharyngeal abscess.

In the area of the nasopharynx, the retropharyngeal space is divided into two halves by a ligament, so retropharyngeal abscesses in the upper parts of the pharynx are often unilateral.

Tonsils reach their greatest size by 5-7 years. At this age, children experience the highest incidence of infectious diseases and an increased need for protection against infections. At the same age, children receive the largest number of preventive vaccinations, which mobilize all lymphoid tissue to develop immunity. Hypertrophy of lymphoid tissue is caused by the intensive formation of active immunity with local production of antibodies during endo- or exogenous penetration of an infectious agent into the lymphoid tissue of the pharynx. As antibodies accumulate in the body and the immune system improves after 9-10 years, the child begins age-related involution of lymphoid tissue with partial degeneration and replacement with fibrous, connective tissue. The size of the tonsils decreases, and by the age of 16-20, small remnants of them usually remain, sometimes they completely disappear due to atrophy of the lymphoid tissue. During this period, a thin peripheral belt of mature lymphocytes appears, the number of reticular cells in the center of the tonsils.

This article will help you learn about the structure of the throat and larynx.

The inside of the human throat has almost the same structure as the part of the neck in front of the vertebrae in many mammals. Naturally, there are differences and there are many of them.

From the beginning of the tongue to the beginning of the shoulder there are many nerve roots, arteries and other systems.
Otorhinolaryngology is a science that studies and treats this area.
You will find a detailed description of the structure of the throat and larynx in this article.

Anatomy of the human pharynx and larynx: photo with description

The pharynx and larynx are located nearby, they have similar functions and they participate in the process of absorption of food and the respiratory process together. Let's look at these departments separately:

Pharynx:

The pharynx or pharynx begins at the end of the mouth and continues to the bottom of the neck. In its shape, this section is similar to a conical pipe, which is expanded towards the top, and narrow part located at the base of the larynx. On the outside of the pharynx there is a lot of glandular tissue, which produces a mucous fluid necessary to lubricate the throat during stress: speaking and eating. The pharynx consists of 3 parts:

Nasopharyngeal section:

Beginning of the department. Soft palatal tissue protects the nasal passages from food particles getting into them
At the top are the adenoids - tissues that accumulate on the back.
The nasopharynx, throat and middle ear are connected by the Eustachian tube.
The nasopharynx is almost motionless.

Oropharynx:

Middle of the department. It is located in the mouth - behind, deeper than the nasopharyngeal region.
Promotes air to the pulmonary and bronchial tubes.
The mouth contains the tongue, which pushes food into the esophagus.
The tonsils are the most important organ of this department. They protect against infections, but they themselves are most often exposed to diseases.

Swallowing department:

Bottom part pharyngeal section. Equipped with nerve roots that help in the work of both breathing and the esophagus.
Thanks to this department, everything happens correctly: pieces of food enter the esophagus, and air enters the lungs, and all this at one moment.

Larynx:

It has a skeleton with cartilage, which is held together by articular and muscle ligaments. The larynx consists of the hyoid bone, adjacent to the thyroid gland. It functions by contracting the hyoid muscles. The larynx is a complex department that is responsible for the important process of functioning of the body in this area. Each part of this department is responsible for the functionality of one or another part of the throat.

Laryngeal muscles are responsible for the following work:

Narrowing and increasing the diameter of the glottis with the help of the thyroarytenoid, cricoarytenoid, oblique arytenoid and transverse muscles.
The ligaments work with the help of the vocal and cricothyroid soft tissue.

Inlet section of the larynx:

Behind the inlet section are the arytenoid cartilages, consisting of small tubercles.
Anteriorly, the epiglottis is located.
On the sides there is aryepiglottic folded tissue consisting of blade-shaped tubercles.

Cavity region of the larynx:

Origin - extends from the vestibular fold tissue to the epiglottis. This tissue consists of a moistened shell.
The interventricular section is the narrowest part of the larynx. It starts from the vocal cords and ends at the top, near the vestibular cords.
Subvocal section - located below, near the slit, which is responsible for the voice. At the end it has an extension from which the trachea begins to extend.

Laryngeal membranes:

Mucous membrane - consists of a covering with many nuclei and a prism.
Fibrous-cartilaginous - delicate, soft, hyaline cartilages. They are surrounded by fibers. Together all this forms the laryngeal frame.
Connective tissue - connects the laryngeal region and other parts of the neck from the inside.

The anatomy of these two sections is related to their functional characteristics.

Functions of the human pharynx and larynx: photo with description

The throat consists of 2 sections: the pharynx and larynx. These departments are interconnected. The anatomy of the pharynx and larynx is directly related to their functions.

Functional features of the laryngeal region:

Protection— the mucous membrane is equipped with a special movable layer with many glandular tissues. When pieces of food pass by, the nerve roots carry out reflexive movements, causing a cough. With its help, pieces of food fall from the laryngeal region back into the mouth.
Breath- has a direct relationship with protective functions. The hole, which is equipped with vocal binding muscles and glands, sometimes decreases and sometimes increases, directing air flows.
Voice and speech education— the timbre of the voice directly depends on the anatomical structure of the larynx and the condition of the connecting muscles and tissues.

Functional features of the pharynx similar to the functions of the larynx. The differences are in the following nuances:

Respiratory feature- all individual parts of the pharynx are involved: nose, mouth, throat. Oxygen enters it from the nose, and then further into the body.
Voice, speech- sounds appear (consonants and vowels) and are formed in the soft tissues of the palate and with the help of the tongue. These parts are a “curtain” for the nasopharynx, due to which the timbre sounds and pitch of the voice are formed.
Protection and pathologies in the pharynx are associated with nasal breathing. The lymphoid circle of the pharynx, together with nearby soft tissues and lymphs, forms one entire immune system of the body. If a person has defects (congenital or acquired), tissue growth occurs, their sensitivity decreases and bacteria begin to multiply. The pharynx protects other parts of the throat by collecting all pathogens. If there is inflammation in the throat, then the nose and ears suffer.
Eating- this functional feature consists of swallowing and sucking. On top of this section there are ciliated receptors. When they work, they begin to function soft fabrics, a contraction process occurs, fluid is released in the form of mucus and a pharyngeal, gag or cough reflex occurs. All harmful substances, which have accumulated on the eyelashes, we cough them up or we swallow them.

So, the trachea connects the larynx with the bronchi, which means it carries air and oxygen into the lungs. The trachea is a hollow, tube-shaped organ. Its length ranges from 8.5 cm to 15 cm depending on physiological characteristics body. The third part of this tube is located at the level of the neck, the rest is lowered into thoracic region. At the end, the trachea divides into 2 bronchi at the level of the 5th thoracic spine. A more detailed description of the trachea:

The thyroid gland is located in front at the level of the neck.
At the back is the esophagus.
On the sides there is a cluster of nerve endings, carotid arteries and internal veins.

Anatomy of the trachea:

Mucous membrane- consists of a ciliated layer. Mucus is secreted on its surface in small quantities. Endocrine cells of the trachea secrete substances such as serotonin and norepinephrine.
Submucosal layer- consists of tiny vessels and nerve endings. This connective tissue has a fiber structure - loose and soft.
Cartilage- hyaline incomplete cartilages, which make up 2/3 of the entire trachea. The joints for the cartilage are special annular ligaments. The membranous wall, located posteriorly, is in contact with the esophagus. Thanks to this, the two processes - eating and breathing - do not interfere with each other.
Adventitia- a thin shell in its structure, consisting of connective fibers.

Functions of the trachea are very important in the functioning of the body, despite the simple anatomy of this organ. The functions are as follows:

The main purpose of this section of the larynx is to conduct air to the lungs.
On mucous layer trachea, small particles unnecessary for the body settle, which come from external environment. They are enveloped in mucus, and the cilia are pushed into the larynx.

As a result, the trachea cleans the air that the lungs need. From the larynx and pharynx, all the dirt that has been removed from the trachea rises up and with the help of coughing, all these organs are cleansed.

Diseases, pathologies, injuries of the throat and larynx: description

In order to promptly begin treatment for a particular problem associated with the pharynx, larynx or trachea, it is necessary to correctly recognize the symptoms. Only a doctor can do this. Let us highlight 4 main acute inflammatory diseases of this part of the body:

Acute catarrhal laryngitis- inflammation of the mucous membrane of the larynx:

Occurs as a result of pathogenic bacteria entering the mucosa, as well as under the influence of exogenous and endogenous factors: hypothermia, when eating too cold or hot food, talking for a long time in the cold and other irritations of the mucous membrane. Read more about this disease.
First symptoms — hoarse voice, soreness, unpleasant feeling in the throat, dry cough.
If the disease is not treated, then various changes in the blood may occur, small cell infiltration appears, and the mucous membrane is saturated with serous fluid.
Diagnosis of the disease is simple- visual inspection. The doctor makes a diagnosis based on the symptoms: acute hoarseness, severe swelling of the mucous membrane, incomplete closure of the vocal folds. The disease can progress to chronic form. Also arises erysipelas mucous membrane, which can simultaneously occur with a disease of the facial skin.
Treatment- if treatment is started in a timely manner and it is correct, then the disease will go away within 10 days. If the disease lasts more than 3 weeks, then there is a high probability that the disease will become chronic. It is important to remain silent during treatment until the symptoms begin to subside. Read how to treat laryngitis in children.

Laryngeal sore throat- an acute infectious disease that affects lymphadenoid tissue:

Etiology- inflammation is caused by bacterial, fungal and viral flora. It also occurs from hypothermia or injury. The pathogen penetrates the mucous membrane through airborne droplets or alimentary routes. In you will learn everything about sore throat in children.
Symptoms- sore throat, which gets worse when swallowing and turning the neck. Difficulty breathing, increased temperature - up to 39 degrees, and increased heart rate may appear. Upon palpation, enlarged lymph nodes of the throat are felt.
Diagnostics — clinical picture allows you to visually recognize the disease during examination. But if such a sore throat is suspected, diphtheria, which has the same course, should be excluded.
Treatment- are appointed antibacterial drugs, antihistamines, mucolic and analgesic medicines. If stenosis occurs, then an emergency tracheotomy is prescribed. Read how you can cure a sore throat with the help of rinses.

- rapidly developing vasomotor-allergic edematous process in the mucous membrane:

Etiology- often manifests itself as a consequence after the manifestation of some disease: inflammation of the larynx, infections, tumors, injuries, allergies, various pathologies.
Clinical picture- the lumen of the larynx and trachea narrows due to spasm, foreign body entry, or infections. Moreover, the faster the stenosis develops, the more great danger represents for health. Read how sore throat in children can cause swelling of the larynx and what needs to be done after this.
Diagnostics- The laryngoscopic picture helps to make the correct diagnosis. But it is important that the doctor finds out why the swelling appears. After all, the edematous membrane can cover an existing tumor or foreign body. Therefore, the doctor usually prescribes bronchoscopy, x-rays and other studies.
Treatment- medications are prescribed to help cope with bacteria: antibiotics wide range actions. It is important to restore during treatment external breathing. If drug treatment does not help, then a tracheostomy is performed. This procedure is necessarily prescribed for decompensated stenosis. You also need to limit fluid intake, try not to talk a lot and limit physical activity.

— inflammatory process mucous membrane in the lower respiratory tract:

Causes— pathogenic bacteria that enter the body and, against the background of reduced immunity, begin to progress. In winter, immunity weakens, especially when hypothermia occurs or during viral infections, occupational hazards, and so on.
Clinical picture- paroxysmal cough with discharge of purulent sputum, swelling of the mucous membrane, dilation of blood vessels on the mucous membrane. Fever, weakness, bad feeling, hoarseness in the voice - all these are the first signs of tracheitis.
Treatment- expectorants, antihistamines, and medications to reduce fever are prescribed. If the temperature does not go away and rises within 3-4 days, then antibiotics are prescribed. It is written how tracheitis can be cured using mustard plasters.
Forecast- if treated correctly, the disease goes away within 2-3 weeks. If treatment is incorrect, then the disease can develop into a chronic form. Complications such as pneumonia or bronchopneumonia may also occur.

There are many diseases of the pharynx, larynx and trachea. Only a doctor can recognize and make the correct diagnosis. Do not self-medicate, as this may lead to undesirable consequences and complications. Here is another list of common throat diseases:

A sore throat can also appear as a result of a concomitant disease. Here are the problems that lead to sore throat:

The throat is the hardest part bodies. From the outside of this part of the body there are many blood vessels and nerves. All parts are important, both individually and together. Breathing, swallowing, eating - all these processes require an organ such as the throat, consisting of the pharynx, larynx and trachea.

Video: Anatomy of the larynx

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In newborns, the tonsils are underdeveloped and functionally inactive. The palatine tonsils are not yet fully developed, forming follicles are visible in them, and development takes a long time.

The main part of the lymphoid ring of the pharynx consists of 2-4 thin folds of the mucous membrane of the anterior part of the tonsils, running in the sagittal plane, and 6 in the posterior part, shorter and slightly bent anteriorly, located in the frontal plane. Presented at birth in the form of small spherical clusters of lymphocytes. “Reactive centers” appear in them in the first 2-3 months of life. The final development of follicles is completed in the first 6 months of a child’s life, and sometimes by the end of the 1st year. The average size of the pharyngeal tonsil is normally 7x4x2 mm in newborns.

In children infancy active development of the lymphoid ring begins.

Differentiation of the follicles of the palatine tonsils occurs earlier, at 5-6 months of life, since after birth the body immediately begins to be exposed to bacteria and toxic substances that stimulate the formation of follicles.

Adenoids form more actively than other tonsils. The folds of the mucous membrane thicken and lengthen, taking on the appearance of ridges, between which grooves are clearly visible. The average size of the tonsil: after 3 months 10x7x4 mm and after 1 year 11x8x5 mm, the tonsil reaches full development by 2-3 years.

In children of the 1st year of life, the nasopharyngeal cavity is low and acute-angled, and therefore even a slight enlargement of the pharyngeal tonsil can significantly disrupt nasal breathing.

Microscopically, the structure of the tonsils in fetuses, newborns and infants is different.

In fruits, the integumentary epithelium of the mucous membrane is multirowed, cylindrical. In the subepithelial layer, lymphoid tissue is located in the form of a thin strip, consisting mainly of lymphoblasts, small and medium-sized lymphocytes. The reticular stroma is quite well defined. Blood vessels are filled with blood.

In newborns, the integumentary epithelium is multirowed cylindrical. There are few furrows, they are shallow. In the underlying tissue, lymphatic cellular elements such as small and medium-sized lymphocytes, many blood vessels and mucous glands are diffusely located.

The development of the palatine tonsil begins with the formation of folds of the mucous membrane, which are penetrated by lymphatic tissue.

The lingual tonsil develops due to the accumulation of lymphatic tissue at the root of the tongue.

After birth, the tonsil tissue is in a constant state of irritation.

In children in the first half of life, well-defined follicles with clear boundaries are already visible; The integumentary epithelium of the tonsils is multilayered flat, with sections of multirow cylindrical.

In children over 6 months of age, in the subepithelial tissue there are relatively many mature lymphoid follicles of various sizes and shapes with well-defined “reactive centers”. They are usually located around the furrows. There are many blood vessels among the lymphatic cells and in the connective tissue tissue.

At an early age, the pharyngeal tonsil is covered with multirow cylindrical ciliated epithelium; in older children and adults, it is covered with squamous epithelium.

The palatine tonsils reach full development in the 2nd year of life. The lacunae of the palatine tonsils in young children are deep, narrow at the mouth, densely branched, often extending to the capsule. The lacunae are not always directed deep into the tonsils; sometimes they turn sharply and go under the integumentary epithelium; the narrow passages of individual lacunae end in expansions. All this contributes to the occurrence of the inflammatory process.

In children over 5 years of age, hyperplasia of the follicles is observed, which are often separated from the surrounding lymphoid tissue.

Tubal tonsils reach their greatest development in childhood.

Children have less lymphatic tissue in the area of the tongue root than adults; The crypts of the lingual tonsil are smaller and less branched.

In young children, between the prevertebral aponeurosis and the muscles of the pharynx, from the arch of the nasopharynx to the entrance to the esophagus, between the two layers of the aponeurosis, a chain of retropharyngeal lymph nodes and loose connective tissue are located on both sides of the spine. These nodes are regional to the posterior parts of the nose, nasopharynx and tympanic cavity. Their suppuration leads to the formation of a retropharyngeal abscess.

In the area of the nasopharynx, the retropharyngeal space is divided into two halves by a ligament, so retropharyngeal abscesses in the upper parts of the pharynx are often unilateral.

After 4-5 years, these lymph nodes atrophy, and therefore retropharyngeal lymphadenitis does not occur in older children and adults.

For children younger age characterized by hypertrophy (age-related evolution) of lymphatic tissue. Enlarged tonsils are caused by hypertrophy lymphoid follicles, as well as an increase in their number.

As antibodies accumulate in the body and improve immune system after 9-10 years, the child begins age-related involution of lymphoid tissue with partial degeneration and replacement with fibrous, connective tissue. The size of the tonsils decreases, and by the age of 16-20, small remnants of them usually remain, sometimes they completely disappear due to atrophy of the lymphoid tissue. During this period, a thin peripheral belt of mature lymphocytes appears, and the number of reticular cells in the center of the tonsils increases.

1. Adenoids, their effect on hearing and speech. Difficulty in nasal breathing as a cause of impaired hearing and speech function.

Adenoids pathological growth of the pharyngeal tonsil. They can occur alone or in combination with enlarged tonsils.
Adenoids develop during childhood; from about 12 years of age they become smaller, and in adults they often completely atrophy.
Adenoids are most often observed in children 3-10 years old, but can appear earlier - in the first years of life, as well as after puberty.
Children's adenoids contribute to enlargement infectious diseases(measles, scarlet fever, diphtheria), frequently recurring viral and microbial inflammatory diseases upper respiratory tract, immunodeficiency states, tendency to allergies. A role in their appearance cannot be ruled out hereditary factor. Manifested by impaired nasal breathing, heavy discharge mucous secretion filling the nasal passages, and then flowing into the nasopharynx, chronic swelling and inflammation of the nasal mucosa. Along with a runny nose, nasal congestion, patients experience congestion and sometimes pain in the ears, paroxysmal coughing at night, and snoring. Schoolchildren's performance often decreases due to weakening memory and attention.
hearing impairment. Normally, a person has a system that regulates the pressure difference between external atmospheric pressure and internal, which exists in the nasal cavity and nasopharynx. This process is regulated thanks to anatomical education, which is called the auditory (Eustachian) tube. Through this formation, air penetrates into the middle ear from the nasal cavity. The entrance to the auditory tube is located in the nasopharynx, in close proximity to the location of the adenoid tissue. Therefore, if a child increases nasopharyngeal tonsil, it blocks the mouth auditory tube, making it difficult for air to pass freely into the middle ear. As a result, eardrum loses its mobility, which affects the auditory sensations - the child does not hear well enough.
inflammatory diseases of the middle ear. It has already been noted that the growth of adenoids disrupts the physiology of the middle ear, as they block the mouth of the auditory tube. In this situation, favorable conditions are created for the penetration and development of infection in the middle ear. Therefore, a child suffering from adenoids often suffers from catarrhal and purulent otitis media. This can cause hearing loss, sometimes significant. Speech is distorted - the voice loses sonority and takes on a nasal tone. Disorders of the development of the facial skull and speech apparatus. As noted above, if a child has adenoids, the growth of the bones of the facial skeleton is disrupted. This in turn can adversely affect speech formation. The child cannot pronounce individual letters and constantly speaks through his nose (nasal). Moreover, parents often do not notice these changes, as they “get used” to the child’s pronunciation. In addition, the child develops malocclusion, which leads to the destruction of enamel and teeth.

2. Diagnostic value"hearing passport" “Hearing passport” in case of damage to the sound-conducting and sound-receiving apparatus.

The hearing test begins according to a specific plan (hearing passport).

First, it is necessary to determine the presence of subjective ear noise in the patient and its nature.

A scream study is being conducted using a Barani ratchet to muffle a healthy ear when determining complete one-sided deafness. -natural speech allows you to determine the state of auditory function + differentiate the nature of the lesion. 2-digit numbers from 21 to 99 are used. Hearing acuity is the distance at which one can distinguish words. Normal (whisper) - distinguishes words at a distance of at least 6 meters. Each ear is examined separately. a whisper is pronounced using reserve air after a calm exhalation, over a short distance with gradual removal. A scream test is used to determine complete deafness. A healthy ear is silenced with a RAM ratchet

A tuning fork study is being carried out air conduction using two tuning forks: bass and treble. Study bone conduction carried out using a bass tuning fork.

Tuning forks - the time during which the subject hears the sound of a tuning fork from the beginning of its sound to the threshold of audibility is determined. Tuning forks – bass – for determining bone conductivity, treble – for determining air conductivity

Schwabach's experiments are being carried out. Weber, Rinne.

In topical diagnosis of disorders auditory analyzer it is necessary to be based on the following indicators of the tuning fork study:

1. Comparison of the perception time of high-frequency and low-frequency tuning forks in the study of air conductivity.

2. Comparison of the duration of perception of a low-frequency tuning fork during air and bone conduction.

3. By the nature of bone lateralization.

4. By changes in the duration of perception on the bone in relation to the norm.

As additional tuning fork tests used in topical diagnostics, the Binta experiment is carried out, as well as the Jelle experiment, with the help of which the mobility of the stapes in the oval window is determined.

The Kuturskoto experiment is being carried out. based on a sharp impairment of ototopic function, which makes it possible to diagnose complete one-sided deafness (hearing loss in one ear).

(Zinder and Pokrovsky, Greenberg, etc.).

The study determines hearing threshold, which for normal hearing people corresponds to approximately 10 dB; intelligibility threshold i.e. 50% intelligibility (it is approximately 35 dB above the tonal threshold) and 100% speech intelligibility, which is normally achieved at an intensity of 45-50 dB. The results of the study are depicted graphically in the form of speech audiograms. The intensity of speech in dB is indicated on the abscissa axis, and intelligibility as a percentage of the total number of words given to the subject is indicated on the ordinate axis.

TICKET No. 19

1. Clinical physiology nasal cavity and paranasal sinuses. Acute purulent sinusitis, exacerbation of chronic purulent sinusitis (etiology, pathogenesis, clinical picture, diagnosis, types of treatment)

The nose does the following physiological functions: respiratory, olfactory, protective, resonator (speech).

The throat is an organ that belongs to the upper respiratory tract And
promotes the movement of air into respiratory system, and food into the digestive tract. The throat contains many vital blood vessels and nerves, as well as muscles of the pharynx. There are two sections in the throat: the pharynx and the larynx.

The trachea is a continuation of the pharynx and larynx. The pharynx is responsible for moving food into the digestive tract and air into the lungs. And the larynx bears responsibility for the vocal cords.

Pharynx

The pharynx, or as it is otherwise called “ pharynx“, is located behind the mouth and extends down the neck. The shape of the pharynx is a cone turned upside down. The upper part of the cone, wider, is located at the base of the skull - this gives it strength. The lower part, narrower, is connected to the larynx. Outer layer The pharynx is a continuation of the outer layer of the oral cavity. Accordingly, this layer has numerous glands that produce mucus. This mucus helps keep the throat moist during eating and speaking.

Nasopharynx

The pharynx consists of three parts. These parts have their own location and perform certain functions. The most top part- This nasopharynx. From below, the nasopharynx is limited by the soft palate and when swallowing, the soft palate moves upward and covers the nasopharynx, thereby preventing food from entering the nose. Top wall the nasopharynx has adenoids. Adenoids are a collection of tissue located on the back wall of the nasopharynx. The nasopharynx also has a passage that connects the middle ear and throat - this is Eustachian tube.

Oropharynx

Oropharynx- This is the part of the pharynx that is located behind the oral cavity. The main function of the oropharynx is to promote air flow from the mouth to the respiratory organs. The nasopharynx is less mobile than the oropharynx. Therefore, as a result of the reduction muscle mass speech is formed in the oral cavity. In the oral cavity there is a tongue, which, with the help of the muscular system, helps move food into the esophagus and stomach. But the most important organs of the oropharynx are the tonsils, which are most often involved in throat diseases.

The lowest part of the throat performs the function of swallowing. The movements of the throat must be very clear and synchronized to simultaneously ensure the penetration of air into the lungs and food into the esophagus. This is achieved through a complex of nerve plexuses.

Larynx

Larynx located opposite the 4th -6th cervical vertebrae. The hyoid bone is located above the larynx. In front of the larynx is formed by a group of hyoid muscles, the lateral parts of the larynx are adjacent to the thyroid gland, and the laryngeal part of the pharynx is located in the posterior region of the larynx.

The skeleton of the larynx is represented by a group of cartilages (paired and unpaired), which are connected to each other by muscles, joints and ligaments.

Unpaired cartilages include:

Cricoid
Thyroid
Epiglottic

Paired cartilages include:

Arytenoids
Corniculate
Wedge-shaped

No human organ can function without muscles. Muscular system The larynx is divided into three groups: muscles that narrow the glottis, muscles that dilate the vocal cords and muscles that tense the vocal cords. The muscles that narrow the glottis can be divided into several groups: cricoarytenoid, thyroarytenoid, transverse and oblique arytenoid muscles. The only muscle that widens the glottis is the paired posterior cricoarytenoid muscle. The cricothyroid and vocalis muscles are considered muscles that tense the vocal cords.

Structure of the larynx

An entrance is distinguished in the laryngeal cavity. In front of this entrance is the epiglottis, on both sides there are aryepiglottic folds, the arytenoid cartilages are located posteriorly. The aryepiglottic folds are represented by wedge-shaped tubercles, and the arytenoid cartilages are represented by corniculate tubercles. Horn-shaped tubercles are located on the sides of the mucous membrane. The laryngeal cavity contains the vestibule, interventricular region and subglottic region.

The vestibule of the larynx extends from the epiglottis to the vestibular folds. The mucous membrane forms the folds of the vestibule. Between them is the vestibular fissure.

Interventricular department- This is the narrowest section of the larynx. It stretches from the upper folds of the vestibule to the lower vocal cords. The narrowest part of the larynx is the glottis. It is formed by membranous tissue and intercartilaginous tissue.

The larynx has three membranes:

Mucous
Fibrocartilaginous
Connective tissue

The mucous membrane is formed by multinucleated prismatic epithelium. The vocal folds do not have this epithelium. They are formed by flat non-keratinizing epithelium. The fibrocartilaginous membrane is represented by hyaline cartilage and elastic cartilage. These cartilages are surrounded connective tissue fibrous. Their main function is to provide a framework for the larynx. The connective tissue membrane serves as a connecting link between the larynx and other structures of the neck.

Main functions

Protective
Respiratory
Voice-forming

The protective and respiratory functions go side by side, at the same level.. Respiratory function ensures air flow into the lungs. Control and direction of air occurs due to the fact that the glottis has the function of compression and expansion. The mucous membrane has ciliated epithelium, which contains great amount iron

It is these glands that perform the protective function of the larynx. That is, if food gets into vestibular apparatus, then thanks to the nerve endings that are located at the entrance to the larynx, a cough occurs. Coughing moves food from the larynx to the mouth.

You need to know that the glottis closes reflexively when a foreign body enters it, which can result in laryngospasm. And this is already very dangerous; this condition can lead to suffocation and even death.

The voice-forming function is involved in the reproduction of speech, as well as the sonority of the voice. It should be noted that the pitch and sonority of the voice depend on anatomical structure larynx. If the ligaments are not sufficiently moistened, then friction occurs, and accordingly the elasticity of the ligaments is lost, and the voice becomes hoarse.