otolaryngology

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Medical Language, Second Edition Susan Turley

CHAPTERCHAPTER

Medical LanguageMedical LanguageSecond Edition

Otolaryngology

16

Otolaryngology

• The medical specialty that studies the anatomy and physiology of the ears, nose, mouth, and throat (ENT) and uses diagnostic tests, medical and surgical procedures, and drugs to treat ENT diseases.

Figure 16-1 Ears, nose, and throat (ENT) system

Anatomy and Physiology

• The ears, nose, and throat (ENT) system is contained entirely in the head and neck.

• The head contains the external and internal structures of the ears, nose, and mouth, and the internal structures of the sinuses.

• The neck contains the internal structures of the pharynx and larynx.

Anatomy and Physiology (cont’d)

• The ENT system shares some structures with the gastrointestinal system and the respiratory system, so it serves as a passageway for both food and air.

• The ENT system also contains lymphoid tissue that functions as part of the immune response.

• The body’s senses of hearing and smell are also part of the ENT system.

Anatomy of the ENT System

• External Ear– Known as the auricle or pinna– The helix is the outer rim of tissue and cartilage

that forms a C and ends at the ear-lobe.– The external auditory meatus is the opening that

leads into the external auditory canal (EAC).

Figure 16-2 External ear

Anatomy of the ENT System (cont’d)

• External Ear (cont’d)– The canal has glands that secrete cerumen, a

waxy, sticky substance that traps dirt and has an antibiotic action against microorganisms that enter the canal.

– At the end of the canal is the tympanic membrane (TM), or eardrum, a thin dividing wall between the external ear and the middle ear.

Figure 16-3 Tympanic membranePearson Education/PH College


• External Ear (cont’d)– The mastoid process is a bony projection of the

temporal bone that lies just behind the external ear and contains tiny cavities filled with air.


• Middle Ear– The middle ear is a hollow area inside the

temporal bone of the skull.– It contains three tiny bones: the malleus, incus,

and stapes, collectively known as the ossicles.– It is connected to the nasopharynx by the

eustachian tube.


• Middle Ear– The eustachian tube allows air pressure in the

middle ear to equalize with air pressure in the throat and outside of the body.

Figure 16-4 Structures of the middle ear and inner ear


• Inner Ear– Contains three fluid-filled structures:

• Vestibule• Semicircular canals• Cochlea


• Vestibule is the entrance area to the inner ear.• One end of the vestibule becomes the three

semicircular canals.• The other end of the vestibule becomes the

coiled cochlea.

Anatomy of the ENT System

• External Nose and Mouth– The external nose is supported by the nasal bone,

which forms the bridge of the nose and the dorsum.

– At the nasal tip, the nasal bone becomes cartilage.– The nares are the external openings, or nostrils;

the flared cartilage on each side of the nostril is a nasal ala.

Figure 16-5 External nose, mouth, and neck


• External Nose and Mouth (cont’d)– The lips, cheeks, and chin are supported by the

maxilla (upper jawbone) and mandible (lower jawbone).

– The nasolabial fold is the crease in the cheek that goes from the nose to the corner of the mouth.

– The philtrum is the vertical groove above the upper lip.

– The chin is also known as the mentum.


• Sinuses– A sinus is a hollow cavity within a bone that is

lined with a mucous membrane.– Four pairs of sinuses: frontal, maxillary, ethmoid,

and sphenoid. – As a group, these are also known as the paranasal

sinuses.

Figure 16-6 Sinuses


• Nasal Cavity– The nasal cavitiy is formed by the ethmoid bone of

the cranium and by the maxilla of the upper jaw.– The nasal septum is a vertical wall of cartilage that

divides the nasal cavity into right and left sides.– In the posterior nasal cavity, this cartilage

becomes the ethmoid bone of the cranium.

Figure 16-7 Structures of the internal nose, mouth, and throat


• Nasal Cavity– Along the nasal cavity walls are three long, bony

projections − the superior, middle, and inferior turbinates, or nasal conchae.

– The turbinates divide and slow down inhaled air and give it warmth and moisture.

– The nasal cavity is lined with nasal mucosa, a mucous membrane that continuously produces mucus.


• Oral Cavity– Contains the tongue, hard palate, soft palate and

uvula, teeth, and salivary glands– Lined with the oral mucosa that is known as

buccal mucosa in the cheek area


• Oral Cavity– The hard palate or roof of the mouth divides the

oral cavity from the nasal cavity and is made up of 3 different cranial bones: the maxilla at the front of the mouth, the palatine bone, and the vomer bone at the back of the mouth.

– Submental lymph nodes in the tissue under the chin contain lymphocytes and macrophages that attack bacteria and viruses.


• Pharynx– Divided into three areas: the nasopharynx, the

oropharynx, and the laryngopharynx.– The eustachian tubes open into the nasopharynx. – The roof and walls of the nasopharynx contain the

pharyngeal tonsil, a collection of lymphoid tissue commonly known as the adenoids.


• Pharynx (cont’d)– The nasopharynx becomes the oropharynx or

middle portion of the throat, which contains the palatine tonsils.

– The laryngopharynx contains the lingual tonsils on either side of the base of the tongue.


• Pharynx (cont’d)– The tonsils and adenoids are part of the lymphatic

system, and they function in the immune response; they contain lymphocytes and macrophages that attack bacteria and viruses in the tissues around the oral cavity.

Figure 16-8 Pharynx


• Larynx (cont’d)– Pharynx divides into two parts: the larynx leads to

the trachea and the esophagus leads to the stomach.

– The larynx, or voice box, is a short, triangular structure.

– Is surrounded by two thick rings of cartilage that can be clearly seen at the front of the neck as the laryngeal prominence (Adam’s apple)


• Larynx (cont’d)– At the superior end of the larynx is the epiglottis;

in the middle of the larynx are the glottis, ligaments, and the vocal cords.

– When you swallow, the larynx moves superiorly and closes against the epiglottis to keep food from entering the lungs.

– Remains open during breathing, speaking, or singing to allow air to pass over the vocal cords.


• Larynx (cont’d)– Muscles in the larynx relax or tighten the vocal

cords to lower or raise the pitch.– Surface layer of each vocal cord vibrates,

producing sound waves that travel through the vocal cords and past the soft palate, tongue, and lips, all of which shape the sound waves into words.

Physiology of the Sense of Hearing

• The external ear captures sound waves. • The tympanic membranes move the malleus,

the incus, and then the stapes.• The stapes transmits this mechanical motion

to the oval window, which causes inner ear fluid on the other side of the oval window to move.

Physiology of the Sense of Hearing (cont’d)

• The vibration is transmitted to the cochlea. • Tiny hair cells detect the loudness and pitch of

the sound and send this sensory information as nerve impulses through the cochlear branch of the vestibulocochlear nerve to the medulla oblongata in the brainstem.

• From there, the impulses are relayed to the auditory cortex in the brain.

Figure 16-9 The sense of hearing

Diseases and Conditions

• Ears– Acoustic neuroma – Cerumen impaction

Figure 16-10 Cerumen impaction

Diseases and Conditions (cont’d)

• Ears (cont’d)– Cholesteatoma – Hearing loss


• Ears (cont’d)– Hemotympanum – Labyrinthitis– Meniere’s disease– Motion sickness


• Ears (cont’d)– Otitis externa – Otitis media

Figure 16-11 Myringitis

Figure 16-12 Perforated tympanic membraneISM/Phototake NYC


• Ears (cont’d)– Otorrhea – Otosclerosis– Ruptured tympanic membrane– Tinnitus– Vertigo


• Sinuses, Nose, and Nasal Cavity– Allergic rhinitis– Anosmia – Epistaxis


• Sinuses, Nose, and Nasal Cavity (cont’d)– Polyp – Rhinophyma– Septal deviation


• Sinuses, Nose, and Nasal Cavity (cont’d)– Sinusitis – Upper respiratory infection (URI)

Figure 16-13 SinusitisISM/Phototake NYC


• Mouth, Oral Cavity, Pharynx, and Neck– Cancer of the mouth and neck– Cervical lymphadenopathy– Cleft lip and palate

Figure 16-14 Cleft lip and palateCourtesy of Dr. Elizabeth Peterson


• Mouth, Oral Cavity, Pharynx, and Neck (cont’d)– Cold sores– Glossitis– Leukoplakia

Figure 16-15 LeukoplakiaCaliendo/Custom Medical Stock Photo, Inc.


• Mouth, Oral Cavity, Pharynx, and Neck (cont’d)– Pharyngitis – Temporomandibular joint (TMJ) syndrome– Thrush – Tonsillitis

Figure 16-16 ThrushCaliendo/Custom Medical Stock Photo, Inc.

Figure 16-17 TonsillitisDr. P. Marazzi / Photo Researchers, Inc.

Figure 16-19 AudiometryPhanie / Photo Researchers, Inc..

Figure 16-20 Rinne testPearson Education/PH College

Laboratory and Diagnostic Procedures (cont’d)

• Laboratory and Radiologic Tests– Culture and sensitivity (C&S)– Rapid strep test – RAST– Sinus series

Figure 16-21 Throat swab

Medical and Surgical Procedures

• Medical Procedures– Nose, sinus, mouth, and throat examinations – Otoscopy – Romberg’s sign

Figure 16-22 OtoscopySaturn Stills/Photo Researchers, Inc.

Medical and Surgical Procedures (cont’d)

• Surgical Procedures– Cheiloplasty– Cochlear implant– Endoscopic sinus surgery– Mastoidectomy– Myringotomy

Figure 16-23 Myringotomy and tympanostomy


• Surgical Procedures (cont’d)– Otoplasty– Polypectomy – Radical neck dissection – Rhinoplasty


• Surgical Procedures (cont’d)– Septoplasty – Stapedectomy – Tonsillectomy and adenoidectomy (T&A) – Tympanoplasty

Drug Categories

• These categories of drugs are used to treat ENT Diseases and Conditions:– Antibiotic drugs– Antihistamine drugs– Antitussive drugs– Antiyeast drugs– Corticosteroid drugs

Drug Categories (cont’d)

• These categories of drugs are used to treat ENT Diseases and Conditions:– Decongestant drugs– Drugs used to treat vertigo and motion sickness

Abbreviations

otolaryngology

Documents

ent system contdexternal

ent system contdvestibule

ent systemexternal nose

physiology contdthe

ent diseases

throat ent systemanatomy

gastrointestinal system

respiratory system