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Respiratory block-Anatomy

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Contents:
Team leaders:
1) Muscles involved in respiration ● Abdulrahman Shadid
2) Anatomy of the Nasal Cavity & Pharynx ● Ateen Almutairi
3) Anatomy of the Larynx, Trachea & Bronchi
Girls team :
4) Anatomy Lung & Pleura ● Noura Al Turki
5) Embryology of Respiratory system ● Nouf Al Humaidhi
6) Mediastinum ● Jude Al Khalifah
7) Radiological Anatomy of chest ● Rahaf Al Shabri
● Rema Al Mutawa
● Maha Al Nahdi
Give us your feedback:
● Ajeed Al Rashoud
 1. Muscles involved in respiration
Thoracic cage :
- formed by sternum & costal cartilages anteriorly, ribs & intercostal spaces laterally, thoracic
vertebrae posteriorly.
- Has 2 apertures (openings): Superior (thoracic outlet) and Inferior.

Openings Anteriorly Laterally Posteriorly

boundaries

2 Superior opening Superior Medial borders T1

border of the of 1st rib
manubrium

Inferior opening Xiphisternal Costal margin T12

joint

Articulations:
Type: Primary cartilaginous Plane synovial

Examples: - Sternocostal (1st) - Sternocostal (2nd-7th)

- Costochondral joints - costovertebral joints
- Interchondral joints

Respiratory movements:
1) movements of diaphragm:
- Inspiration: contraction of diaphragm increases the vertical
diameter of thoracic cavity
- Expiration: relaxation of diaphragm
2) movements of ribs:
- Pump handle movement > increase in anteroposterior diameter
- Bucket handle movement > increase in transverse(lateral) diameter

Inspiratory muscles

Normal inspiration Origin insertion Nerve supply

Diaphragm - lower 6 ribs and their costal Central tendon Phrenic nerve
cartilages (lies at the level (C3,4,5)
- xiphoid process of T9) Action:
- upper 3 lumbar vertebrae Contraction of diaphragm
(right & left crura + arcuate increase the vertical diameter
ligaments) of thoracic cavity

External Lower border of rib above Upper border of Intercostal nerves

intercostal muscle rib below Action:
Rib elevators
Direction of fibers:
downward & medially

Forced inspiration Origin insertion Action

Scalene muscles Cervical vertebrae 1st & 2nd ribs Elevates 1st & 2nd ribs

Pectoralis major Sternum and costal cartilages Humerus Increases the anteroposterior
diameter of thoracic cavity,
when arm is fixed
 1. Muscles involved in respiration
Expiratory muscles (act only during forced expiration)

Forced expiration Muscles direction

Rib depressors: 1- Internal intercostal Backward & laterally

- supplied by ventral rami of T1-T11 2- Innermost intercostal

- intercostal vessels and nerves 3- subcostal

3
-
(neurovascular bundle) lie in intercostal space 4- transversus thoracis

Anterior abdominal wall muscles: 1- External oblique downward & medially

- compression of abdominal viscera to 2- internal oblique Upward & medially

help in ascent of diaphragm

- supplied by lower 5 intercostal nerves 3- transversus abdominis Transverse

(T7-T11), subcostal nerve(T12), and first
lumbar nerve(L1)

4- Rectus abdominis Vertical

2. Anatomy of the Nasal Cavity & Pharynx

Definition The external (anterior ) nares or nostrils, lead to the nasal cavity.
It’s Formed by : bone+ hyaline cartilage and Extends from the external (anterior) nares
It’s divided by the septum to : to the posterior nares (choanae).

1- Roof Narrow & formed (from behind forward) by the:

1.Body of sphenoid. 2.Cribriform plate of ethmoid bone.
3.Frontal bone. 4-nasal bone and cartilage.

2- Floor Separates it from the oral cavity.

Formed by : the hard (bony) palate.

3- Medial wall (the Osteocartilaginous partition.

septum) Formed by: 1.Perpendicular plate of ethmoid bone.
2.Vomer. 3.Septal cartilage.

4- Lateral wall Contains : superior, middle & inferior conchae. superior, middle & inferior meatuses
and a sphenoethmoidal recess.

Nasal mucosa *Olfactory : It is delicate and contains olfactory nerve cells.

It is present in the upper part of nasal cavity.

*Respiratory : It is thick, ciliated highly vascular and contains mucous glands &
goblet cells .
It lines the Lower part of the nasal cavity.
It functions to moisten, clean and warm the inspired air.
( moistening by the glands, cleaning by the cilia and warming it by the venous plexus )
The Vestibule is lined by Skin.
 2. Anatomy of the Nasal Cavity & Pharynx
meatus
Frontal air sinus
choncha

Sphenoidal
air sinus

Paranasal Sinuses Air filled cavities located in the bones around the nasal cavity: Ethmoid, Sphenoid,
Frontal bones & Maxillae.

4
( fun fact : horses have paranasal sinuses as Lined by respiratory mucosa.
well!!)

1- Lighten the skull.

2- Act as resonance chambers for speech.
Paranasal Sinuses function
3- Air conditioning: The respiratory mucosal lining helps in warming, cleaning and
moistening the incoming air.

Paranasal sinus drainage :

Sphenoethmoidal recess sphenoidal sinus.

Superior meatus posterior ethmoidal sinus.

Middle meatus middle ethmoidal ,anterior ethmoidal, Maxillary & frontal sinuses.

Inferior meatus nasolacrimal duct.

It is a Muscular tube Extending from the base of the skull to level of the 6th cervical
DEFINITION vertebra, where it is continuous with the esophagus

The anterior wall is deficient and shows Posterior nasal apertures.

(from above downward)
Opening of the oral cavity.
Laryngeal inlet.

Muscles
Circular (Constrictor) •Superior constrictor. *Propel the bolus of food down
Muscles •Middle constrictor.
into the esophagus.

*lower fibers of the inferior

•Inferior constrictor.
s constrictor (Cricopharyngeus )
m The three muscles overlap each other. act as a sphincter, preventing the
I entry of air into the esophagus
between the acts of swallowing.

Longitudinal Muscles •Stylopharyngeus.

•Salpingopharyngeus.
Elevate the larynx & pharynx
•Palatopharyngeus. during swallowing.
 2. Anatomy of the Nasal Cavity & Pharynx
Pharynx is divided into three parts

*Extends from the base of skull to *Pharyngeal tonsils (Adenoides) present in the submucosa

5 the soft palate. covering the Roof.

*communicates with the nasal *Lateral wall shows:

cavity through posterior nasal 1)Opening of auditory tube.
1- Nasopharynx 2)Tubal elevation (produced by posterior margin of the
apertures
auditory tube).
3)Tubal tonsil.
4)Pharyngeal recess.
5)Salpingopharyngeal fold (raised by
salpingopharyngeus muscle).

2- Oropharynx *Extends from soft palate to upper Lateral wall shows:

border of epiglottis. 1)Palatopharyngeal fold.

*communicates with the oral 2)Palatoglossal fold

3)Palatine tonsil located between them in a depression
cavity through the oropharyngeal called the tonsillar fossa
isthmus

3- Laryngopharynx *Extends from upper border of epiglottis to lower border of cricoid cartilage.
*Lies behind the laryngeal inlet & the posterior surface of larynx.
*communicates with the larynx through the laryngeal inlet
*A small depression situated on either side of the laryngeal inlet is called ‘Piriform Fossa’.
Branches of internal laryngeal & recurrent laryngeal nerves lie deep to the mucous membrane
of the fossa and are vulnerable to injury during removal of a foreign body

3. Larynx, Trachea & Bronchi

Larynx: is the part of the respiratory tract which contains the vocal cords.
starts from laryngopharynx and End in trachea.
has function in:
➢ Respiration (breathing)➢ Phonation (voice production)➢ Deglutition (swallowing)

Relations of the Larynx : its related to major critical structures in the neck

Arteries Veins Nerves

3 Carotid arteries: (common, Laryngeal

external and internal). nerves:(Superior
3 Thyroid arteries: (superior
laryngeal & recurrent
& inferior thyroid arteries 2 Jugular veins (external
thyroidema artery). & internal)
laryngeal).

Vagus nerves.
 3. Larynx, Trachea & Bronchi

Larynx components
The Cartilaginous Skeleton is made up of All the cartilages are hyaline
9 cartilages: EXCEPT the Epiglottis, its
6 Cartilaginous
elastic.
3 single:1. Epiglottis
skeleton 2. Thyroid 3. Cricoid The cartilages are: Connected
by joints, & ligaments. Lined
3 pairs 1. Arytenoid by membranes.
2. Coniculate 3. Cuneiform Moved by muscles.

●Thyrohyoid membrane ➔ it has 2 ●Quadrangular

thickenings: median thyrohyoid (aryepiglottic) Membrane
ligament and 2 x lateral thyrohyoid ➔ Its lower margin form the
ligaments vestibular ligament which
Membranes ●Cricotracheal Membrane forms the vestibular fold or
●Cricothyroid Membrane (Conus Elasticus) false vocal fold.
and Ligaments ➔ Its lower margin is attached to the ●In between the epiglottis and
upper border of cricoid cartilage. the hyoid bone Hyoepiglottic
➔Its upper margin form the vocal ligament
ligament which forms the vocal fold or ●In between the epiglottis and
true vocal fold. the thyroid Thyroepiglottic
ligament

● The laryngeal cavity is lined by:

The ventricle part has an
ciliated columnar epithelium
Mucosal EXCEPT the surface of the vocal cords its
upward vagination called
saccule that contains goblet
Lining lined by:
cells (mucous glands) to
Non-keratinized stratified squamous
lubricate the vocal cords.
epithelium

Extrinsic muscles Intrinsic muscles:

Muscles
● Suprahyoid(MSGD): controlling
Oblique Arytenoid muscle
Elevators of Mylohyoid,Stylohyoid,Geniohyoid and the
the Larynx Digastric laryngeal
Aryepiglottic muscle
● Longitudinal muscles of the pharynx (SSP) inlet

Muscles ● Decrease Vocal cord length and tension

(Vocalis): Thyroarytenoid muscle
Muscles ● Increase vocal cord length and tension:
● Infrahyoid : controlling Cricothyroid muscle (Only one can found
Depressors Infrahyoid Movement outside the larynx)
of the Sternothyroid of the vocal ●Adductors:
Larynx Omohyoid cord 1)Lateral Cricoarytenoid
2)Transverse Arytenoid
●Abductors: Posterior Cricoarytenoid
 3. Larynx, Trachea & Bronchi
Trachea : Mobile, fibrocartilage tube.
● Begins: Below the cricoid cartilage (at C6) Ends: Thorax (behind sternal angle) lower
border of T4 dividing into: right and left primary(main) bronchi.
● its wall supported by 16-20 horseshoe cartilage anteriorly.
7 ● The ridge at the bifurcation from inside is called carina
➔ It is the most sensitive part of the respiratory tract ➔ Its associated with the cough
reflex

Relations in the trachea

Anterior Posterior Right Left

-Sternum -Left vagus

- Thymus nerve
-Left brachiocephalic vein -Left phrenic
-Arch of the aorta, nerve
origin of: brachiocephalic -Left pleura
artery -Esophagus -Azygos vein -Arch of the
left common carotid artery -Left recurrent -Right vagus aorta
laryngeal nerve nerve -left common
carotid artery
-left subclavian
artery

Bronchi
Right Bronchus: Left Bronchus :
● One inch long., wide,short,more vertical ● Two inches long., narrow,long, more
bronchus horizontal bronchus
● Gives superior lobar before entering ● Gives superior and inferior lobar after
the hilum and gives the inferior and entering the hilum. (no middle lobar)
middle lobar after. ● Passes below the aortic arch and in
front of the esophagus.

Divisions :
Primary bronchus ➔Secondary bronchus (Lobar)➔ Tertiary bronchus (segmental) ➔
Bronchiole ➔ Terminal bronchiole ➔ Respiratory bronchiole ➔ Alveolar duct ➔ Alveoli
 4. Anatomy of lung & pleura
1. Pleura layers

Parietal Visceral
“lines the thoracic walls” “covers the surfaces of the lung”

1. Cervical 2. Costal 3.Mediastinal 4.Diaphragmatic

pleura pleura pleura pleura

2. Surface anatomy (pleura): 3. Surface anatomy (Lung):

Apex, Correspond nearly to the lines of
Apex: Lies one inch above the medial 1/3 of the Clavicle.
anterior Pleura but are slightly away from the
border: median plane.

Right pleura: Represented by a line extending from

extends vertically from Sternoclavicular joint to Oblique
3rd or 4th thoracic spine, obliquely
xiphisternal joint (6th costal cartilage). fissure:
ending at 6th costal cartilage.
Anterior
margin:

Transverse
Left pleura: fissure: Represented by a line extending from
extends from Sternoclavicular joint to the 4th costal (Only in 4th right costal cartilage to meet the
cartilage, then deviates laterally and extends to the right oblique fissure.
lateral margin of the sternum to form cardiac notch lung)
then turns sharply downward to xiphisternal joint (
6th costal cartilage).
passes around the chest wall , on the
6th rib in midclavicular line , 8th rib in
mid-axillary line and finally reaching
Passes around the chest wall, on the 8th rib in Inferior
margin:
Inferior

to 10th rib adjacent to vertebral

midclavicular line, 10th rib in mid-axillary line and margin
column posteriorly.
finally reaching to12th rib adjacent to vertebral
-as pleura but more horizontally and
column posteriorly (T12).
finally reaching to the (T10).
Posterior
margin :

Along the vertebral column from the apex (C7) to the Posterior Along the vertebral column from the
inferior margin (T12). margin : apex ( C7 ) to the inferior margin ( T10 )

4. Roots Differences Mediastinum surface

Vagus nerve posterior to the root of the

- Bronchi: 2 bronchi 1. Divided by 2
●
lung.
“posterior” fissures.
Right Lung

● Phrenic nerve anterior to the root of the

lung.
● Cardiac impression: related to right
- Pulmonary artery: “Superior” 2. Larger & shorter atrium.
Azygos vein & its arch posterior & over
- 2 Pulmonary veins: than left lung. ●
the root of the lung.
“Are inferior & anterior“ ● Esophagus posterior to the root.
Below hilum and in front of pulmonary
*the Left lung is the same* 3. Has 3 lobes. ●
ligament : groove for I.V.C.

- Bronchi: One bronchi 1. Divided by one

“posterior” oblique fissure. ● Vagus nerve posterior to the root of the
lung & over the root.
Left Lung

● Phrenic nerve anterior to the root of the

2. It has a cardiac lung.
// Cardiac impression: related to left
notch at lower
●
ventricle.
part of its anterior ● Descending aorta & it’s arch posterior &
over the root of the lung.
border. ● Groove for left common carotid and left
subclavian arteries.
3. Has 2 lobes.
 5. Embryology of respiratory system
Lung development
Occurs in five stages. Initial development includes development of lung bud from distal end of respiratory diverticulum during
week 4.

Stage Important terms Notes

Embryonic Lung bud → trachea → bronchial buds Errors at this stage

(weeks 4–7) → mainstem bronchi → secondary (lobar) can lead to
→ bronchi → tertiary (segmental) bronchi. tracheoesophageal
fistula.

Pseudoglandular Endodermal tubules → terminal bronchioles. Respiration

(weeks 5–17) Surrounded by modest capillary network. impossible,
incompatible with
life.
(weeks 5–17)

Canalicular Terminal bronchioles → respiratory bronchioles By 24 weeks each

(weeks 16–25) → alveolar ducts. Surrounded by prominent terminal
capillary network. bronchiole has
given rise
to two or more
respiratory
bronchioles.

Saccular Alveolar ducts → terminal sacs. Terminal sacs. Surfactant

(week 26–birth) Pneumocytes develop. production begins
by 20 weeks.

Alveolar Terminal sacs → adult alveoli. At birth: 20–70

(week 36–8 years) In utero, “breathing” occurs via aspiration million alveoli. By 8
and expulsion of amniotic fluid → ↑vascular years: 300–400
resistance through gestation. million alveoli.
At birth, fluid gets replaced with air → ↓in
pulmonary vascular resistance.

Tracheoesophageal Fistula An abnormal passage between the trachea and esophagus.

Esophageal Atresia esophagus ends in a blind-ended pouch “close end” rather than connecting normally to the
stomach.
 6. Mediastinum
-It is a thick moveable partition between right & left pleural sacs & lungs.
-It includes all structures lie in the intermediate compartments of the thoracic cavity

Boundaries :
Superior: Thoracic outlet Inferior: Diaphragm It is the Level of:
Anterior: Sternum Posterior:Thoracic vertebrae Lateral: Lungs & pleurae Sternal angle
Second costal cartilage
Why the Level of T4 is important:
Divisions : Bifurcation of trachea
Bifurcation of pulmonary trunk

10 by a horizontal plane from sternal angle to lower border of T4 into: Beginning & termination of arch of aorta

Superior Mediastinum
Boundaries Contents :From superficial to deep:
Superior: Thoracic outlet (1) Gland :Thymus gland
Inferior: Horizontal plane (3) Veins: right & left brachiocephalic -
Anterior: Manubrium of sternum superior vena cava
Posterior: T1-T4 (4) Arteries: arch of aorta & its branches-
Lateral: lungs & pleurae brachiocephalic artery-left common carotid
- left subclavian
(4) Nerves: right & left vagus -right & left phrenic
(2) Tubes: Trachea-Esophagus (most posterior)
(1) Duct: thoracic duct
Lymph nodes

Inferior mediastinum
Anterior Mediastinum Middle Mediastinum Posterior Mediastinum

Boundaries: Boundaries:
Site: Between anterior &
Superior: Horizontal plane Superior: Horizontal plane
Inferior: Diaphragm posterior mediastinum Inferior: Diaphragm
Anterior: Body & xiphoid of sternum Contents: Anterior: Heart
Posterior: Heart Heart & pericardium Posterior: vertebrae from T5 to T12
Lateral: Lungs & pleurae Ascending Aorta Lateral: Lungs & pleurae
Contents: Pulmonary trunk Contents:
Thymus gland Superior & inferior vena Esophagus (most anterior)
Lymph nodes cava Right & left Vagus nerves: around esophagus
Right & left pulmonary Thoracic duct: posterior to esophagus
NOTE: There are 6 structures present in more veins Azygos vein: posterior & to the right of
than one region in mediastinum Right & left phrenic esophagus
3 in superior and posterior : nerves Descending aorta: posterior & to the left of
Thoracic duct ,Esophagus , vagus nerves Lymph nodes esophagus
2in superior and middle:
phrenic nerves ,superior vena cava Right & left sympathetic trunks
1in superior and anterior: Thymus gland Lymph nodes

Aorta Vagus Phrenic Lymph vessels & Thoracic duct

Ascending aorta: 10th cranial nerve. -Root value: C3,4,5 Beginning: continuation of Cysterna chyli at
Beginning: at aortic The right vagus: → to the -Motor & sensory fibers the level of L1
orifice of left right of trachea→forms to diaphragm Course: It passes through the aortic opening
ventricle. the posterior esophageal of diaphragm.
-Sensory fibers to pleurae
End: continues as plexus → continues in →ascends in the posterior mediastinum
& pericardium
arch of aorta (at abdomen as posterior The right phrenic (posterior to esophagus)→ascends in the
level of T4) gastric nerve superior mediastinum ( left to esophagus).
descends on the right side
Arch of aorta: The left vagus →between of SVC & heart. End: in the left brachiocephalic vein.
continues as left common carotid & left The left phrenic descends
descending thoracic subclavian arteries→ ●Lymph from the lower half of the body →
on the left side of heart.
aorta (at level of T4) forms the anterior Cysterna chyli → Thoracic duct.
Descending aorta: esophageal plexus → Both nerves terminate in Lymph from the upper left side of the body
continues as continues in abdomen as the diaphragm. → Thoracic duct
abdominal aorta anterior gastric nerve.
through diaphragm ●Lymph from the upper right side of the
body → the Right lymphatic duct → right
brachiocephalic vein
 7. Radiological anatomy of the chest
Posteroanterior (PA) Anteroposterior (AP)
The x-rays enter through the posterior aspect of the chest, and exit out of the The x-rays enter through the anterior aspect
anterior aspect where they are detected by an x-ray film. and exit through the posterior aspect of the
Gives a good assessment of the Cardiac Size by avoiding the magnification of chest.
the heart.
It is identified by the presence of the fundal gas bubble and the absence of the
scapulae in the lung fields.
11 Lateral: Indicated only for further interpretation Decubitus: lying at the side

A chest x-ray may be used to diagnose, plan treatment and follow up for various conditions, including:
●Fractures of the chest bones.
●Lung disorders
●Heart disorders
●Screen for job-related lung diseases in industries.
●Sometime its Requested as pre-employment demand.

For Posteroanterior radiograph, the following systems must be examined in order:

1- Superficial soft tissues 4- Trachea 6- Mediastinum

-The nipples in both sexes is seen in the midline of the neck as a -The right border of mediastinum; consists of:
-The breast in female are seen superimposed on dark area, superimposed by the lower (1) Right brachiocephalic vein (2) Superior
the lung fields cervical and upper thoracic vertebrae. vena cava (3) Right atrium (4) Inferior vena
cava (sometimes)
2- Bones of thoracic cage 5- Lungs
-Clavicle -The left border of mediastinum consists of: (1)
-Lung roots: relatively dense shadows
-Posterior rib Aortic knuckle(2) Pulmonary trunk (3) Left
caused by the presence of:
-Anterior rib auricle (4) Left ventricle and apex of heart.
Blood-filled pulmonary and bronchial
-Medial border of scapula: vessels
-Thoracic vertebrae: -The inferior border: (lower border of the
Large bronchi.
-Costotransverse joints heart) blends with the diaphragm and liver
Lymph nodes.
shadow.
3- Diaphragm -Notice that the lower margin of left
-Normally the transverse diameter of the
The diaphragm appears as a dome-shaped hilum lies at the level of the upper
heart should not exceed half of the width of
shadow on each side. margin of right hilum.
thoracic cage.
-The right side is slightly higher than the left.
-Beneath the right dome is the homogeneous, -The lung fields, by translucent.
dense shadow of the liver.
-Beneath the left dome a gas bubble mostly seen -The pulmonary blood vessels are seen
in the fundus of the stomach. as a series of small, rounded, white
-the costophrenic angle, where the diaphragm shadows radiating from the lung root. Right ventricle & left atrium
meets the thoracic wall.. -The large bronchi, are seen as similar Appear only in lateral view*
Aortic knuckle, pulmonary
-the cardiophrenic angle where the diaphragm round shadows.
trunk, and the thoracic
meet the heart. vertebrae can be seen also in
The smaller bronchi are not seen. lateral view

Bronchography Contrast visualization of Coronary Angiography

is special study of the bronchial tree by Esophagus an X-ray with radio-opaque contrast
introduction of contrast medium into a by swallowing a contrast media, in the coronary arteries*
particular bronchus. (barium swallow). The are visualized by introduction of
material into their lumen*
usually under fluoroscopic control. The Other barium contrast studies:
contrast media are non irritating and -Barium meal: stomach Pathological narrowing or blockage of
sufficiently radiopaque to allow good -Barium follow through: small intestine coronary artery can be identified.*
visualization of the bronchi.. -Barium enema: large intestine

Right
Left lateral
radiograph of the
chest of a normal
adult man after a
barium swallow.

Left
 All nerves and blood vessels supply
Nerve supply
Lung Sympathetic fibers > Pharynx
sympathetic trunk Nasopharynx > maxillary
Pulmonary
Sensory Oropharynx > glossopharyngeal
plexus

12
Parasympathetic fibers > Laryngopharynx > vagus
vagus nerve

Parietal Costal Intercostal All muscles > pharyngeal plexus

pleura Motor Stylopharyngeus >
glossopharyngeal
Mediastinal Phrenic

Diaphragmatic
Phrenic + lower 6 Nasal Sensory
Branches of: Ophthalmic, maxillary
intercostal and autonomic fibers
mucosa
Visceral Pulmonary
Autonomic fibers Motor Olfactory nerve
pleura plexus

Larynx Intrinsic muscle Diaphragm

>recurrent laryngeal
Motor Phrenic (C3-C4-C5)
Cricothyroid >external
laryngeal

Above vocal cords External

>internal laryngeal
Sensory
Below vocal cords intercostal Intercostal nerve
>recurrent laryngeal

Trachea Mucosal
Branch of vagus and Rip
recurrent laryngeal Intercostal nerves (T1-T11)
membrane
nerves depressors

Trachealis Sympathetic trunk

Anterior Lower 5 intercostal (T5-T11)/ subcostal(T12)/ L1
abdominal nerve

Lymph drainage
Larynx deep cervical lymph nodes

Trachea Pre/para-tracheal lymph nodes

Directly >deep cervical lymph nodes lymph nodes

Pharynx Indirectly > para-tracheal or retro-pharyngeal lymph nodes

Vestibule > sub-mandibular lymph nodes

Nasal mucosa
Rest of the cavity > upper deep cervical lymph nodes
 Blood supply
(Bronchial arteries) descending
Ascending pharyngeal artery
Aorta, carry Oxygenated blood to:
Ascending palatine artery
Lung / Bronchi / Tissues / Visceral
Lung
(Pulmonary arteries)
Carry non--oxygenated blood Maxillary artery
13 from right ventricle to lung alveoli
Pharynx
Upper half:
Superior laryngeal artery+branch Facial artery
of superior thyroid
Larynx
Lower half:
Inferior laryngeal artery+branch Lingual artery
of inferior thyroid

Inferior thyroid artery+bronchial Nasal Branches of:

Trachea arteries mucosa Maxillary, facial and ophthalmic

Venous drainage
Bronchial vein > azygos and hemiazygos
Lung
Pulmonary vein > carry oxygenated blood from lung alveoli to left atrium

Larynx Accompany corresponding arteries

Trachea Inferior thyroid vein

Pharynx Pharyngeal venous plexus > internal jugular vein

Nasal
Facial / ophthalmic / sphenopalatine
mucosa