provide for you a brief overview of anatomy of the upper—our digestive tract. The reason is that
you will then be able to look at other materials on Bastian Medical Media and be oriented to what
you're looking at. So let's get started. On the Left you'll see a frontal lateral view of a model. Just
so that you can understand the nature of the lateral view that we're going to spend a little
time on first. So let's go over here to the right and just look at—kind of orient ourselves—here's
the opening between the lips, here's the opening of the nose, and through the mouth we come on top
of the tongue and down with air into the larynx, entrance of the larynx, past the vocal folds and
down into the trachea. So this is the airway, but we use this same space through the mouth
to swallow food posteriorly down into the food way so it's a shared airway and foodway until we
get to about here, where we develop a dedicated airway and a dedicated food way. So we can't put
food into the airway and we're set up so that that doesn't happen. Now if we look at the nose, you see
the, or the palate—I guess I should say the upper part of the mouth, is this hard palate first, and
then there's a soft palate which in the middle ends with that little finger like projections
called the uvula. Here you see the opening of the eustachian tube. These are called turbinates that
congest when you get a cold and make your nose stuffy. So that's the orientation in, in general.
Let's go a little closer in now and let's begin to look a little more closely at the larynx which is
this area here, and let's go even more close—close up—and here is the larynx. It's comprised of the
epiglottis cartilage here, the thyroid cartilage, which is the Adam's apple or the Eve's apple and
then there's a little dent. And if you feel this on your own neck you can feel that little dent.
And then there's the second lower hard bone, this is called the cricoid cartilage. In women this is
a little more prominent often and in men this is more prominent. Here's the back end of the cricoid
cartilage. So it's like a signet ring swinging around to the side and it actually rises along
here until it rises to the top of the cricoid. So that's the contour of the cricoid cartilage. And
on the top of this cricoid cartilage, right in here, buried in this soft tissue is the
arytenoid cartilage, and to the arytenoid cartilage is attached the vocal fold coming forward. So this
is the free margin—the white line here. But the muscle of the vocal fold inhabits this area right
here. And then though for those who are interested in more detail, this is called the ventricle, this
this slit-like space, and then this is the false fold. This we call the petiole of the epiglottis
right here. This is called the aryepiglottic fold in here, this part. And then you see the
epiglottis that ends in its tip. This is called the vallecula, or little valley. So that's maybe
too much information but there it is. Now we've looked from the side, let's take the journey from
above, down in to the larynx. And so, turn your orientation from the side view of just one
vocal fold. Now we're going to come from the front, travel across the base of the tongue across the
top of the tongue first, and then—so we're gonna come across the top of the tongue and look down
into the voice box here and the throat—and then we'll look come up above the palate through the
nose and come down and look into the voice box. So let's do those. Get you oriented there. Here's from
the front, you see the jaw bone or mandible, the lower teeth. You see the tongue sitting just a
little bit above what you would see if you looked in the mouth. This is the voice box right here, the
thyroid cartilage, the cricoid cartilage here, by the way is one of the lobes of the thyroid gland,
and there are a lot of muscles that have been taken away, but here's one set of muscles. Now
I'm going to tip and come over to the right and you're beginning to see the top of the tongue
a little better, and I'm going to keep rotating it—tip of the tongue—downwards and you're gonna start
to see what's beyond the base of the tongue back here. And you can see now the arytenoid cartilages
are just beginning to peek into view. And then as I rotate even farther, now you can see the epiglottis
start to appear here and this dark space right here is where air goes, and food goes back here
behind down into the esophagus. So we're tipping it even more. Base of tongue is here, this is the
epiglottis, and the food when you swallow it comes around here and down into the piriform sinus here
and into the esophagus which is behind the larynx. This is the other piriform sinus. And the vocal
folds are in the dark, the right one here, the left one here. So let's go to the right of the screen
and you—we have some light showing now, the right vocal fold here, the left vocal fold is here. This
pinker part is the false fold. Between this false fold and this true fold is that ventricle that I
showed you from the side. Now let's show you how we get through, how do we get the images that are
in the Encyclopaedia, in the photo gallery, in the video gallery. Well, we come across the base of
the tongue—is one method, and through the nose as the other. It looks impressive on the right
side, but with a little topical anesthesia it's actually very easily tolerated. I'd say easily
four out of five people can tolerate this. With a little topical anesthesia you just lift up
on the palate and there's a little tiny lens right here my arrow point, and that lens looks
downward like it like a periscope does, but it's looking downward and at either 90 degrees or 70
degrees, and now coming through the nose, and again don't feel sorry for the nose because it's numb, it
doesn't really care as long as there's a little spray put in there, and then it's flexible and
it's turned downward to look into the voice box. There you see a little bit of light, there's a
tiny lens. It's going to either be fiber-optic or it can be distal chip video technology. Now let's
take the voyage through the mouth. Here you see obviously the tongue, and we're headed way back
to the back of the tongue. This is the uvula or that little finger-like projection—the person
saying "aaahhh" so it's pulled upwards and shortened and fattened here it is a little more relaxed, that's
that same uvula. So we've gone way to the back of the throat and we're about to go past the base of
tongue. Here's the base of tongue and look what's peeking into view, those are the arytenoids. And
then over here to the lower right you can see the vocal folds coming into view here and here.
The swallowing crescent I sometimes call it, is the right piriform sinus here, back behind the larynx,
and then the left piriform sinus. So that's where food goes when we swallow, and air goes between
the vocal folds when we breathe. Now let's take the journey through the nose. We've started at
the nostril so there are the nose hairs or the vibrissae as they're called. Here on the upper
right we're about halfway through the nose. You see the turbinate bone here on the right of the
screen, and then this is the septum which divides the nose into two parts. Come to the lower left,
this is clearly a young person because look how prominent the adenoids remain—the atrophy as we
get older—this is the top of the soft palate right here. Now we're gonna go down around the
soft palate and head straight downwards, and here we see the base of tongue, the epiglottis, the right
vocal fold, left vocal fold and that dark space is the airway, the chink through which we breathe
down into the windpipe. And do keep in mind right we'll always be on your left and left will always
be on your right, just as when you're looking at a person in front of you, their right is to your left.
All right now let's actually take a video journey through the nose. We're going to start,
because there you see the little vibrissae, or the nose hairs. Through the nose. So we come along
the floor of the nose and again the nose doesn't care. We're getting to the back of the nose, and
there is the soft palate coming up and down. So the person saying "pa pa pa" for example, and there
you see the palate rising and falling. Now while they're breathing through their nose. And we're
coming over the top there's the epiglottis, here we see the vocal folds now coming into view. There's
the swallowing crescent posteriorly. There's the right vocal fold right here, left vocal fold right
here, and we're almost on the way down into the windpipe and not quite. Changing light to something
called narrowband illumination, back to normal light, and there you see it. Well let's go to the
next one. This is another view through the nose; there are the vibrissae. We're coming along the
floor of the nose, and this time we're just going to go straight over the top of the palate because
the person's breathing through their nose so the palate is down. And notice that these vocal folds
don't come fully apart, and you'll see the reason why the person is breathing and yet that vocal
folds are not separated, and if you look carefully you'll see a little scar band up here at the top.
You see that scar band there? That's from an injury. There's the scar band right there, tethering those
vocal folds so that they can't fully pull apart or abduct. Here is a telescope view so let's just
show you this. This shows the blurring of the vocal folds when you vibrate them because vibrations are so
rapid that the naked eye can't see individual vibrations. So it just registers as a blur. So
let's show you that. Open breathing, there's closed sound making. See how they blur? Blur.
And there's the windpipe below. That's a low breathy voice so you see the blurring more
easily. It's an intentional kind of "hhhhhhaa" that kind of a voice. And then let's show you slow-motion
vibration. This is using strobe light to create an apparent slow-motion. So you'll see the vocal
folds flapping up the—coming apart and together as they vibrate. So let's trigger that video.
Now that's hundreds of times per second that we're slowing down, so that it looks
like it's two vibrations per second. Same idea, this time with the scope that's going through
the nose. So you see the base of tongue, the epiglottis, the right fold, left fold
and I think you have it in mind now, so let's trigger the video.
A little laugh.
We go down closer, there you see some rings of the trachea deep inside. And then in a minute the person will make voice.
A little staccato.
And then we'll go to blue strobe light. Here comes the strobe. Slow motion vibration
Nice match.
Technically they should close completely, touch all along their length. But nice straight margins,
at least we can say that. A little bit of gap. And then this is what I just want to line up,
I think it's about here. This is someone who's overdone it with their voice, and so they're hoarse
as you will hear, and they have little bumps on the vocal folds that are from the vibratory
trauma; overuse the voice and the vocal folds thicken.
See the bumps, here and here? The vocal folds can't come together
You'll hear the often hoarseness in a minute, especially as she goes higher.
Hear the distortion?
Well, there is your overview of the anatomy, and I,
as you look at other images, again I hope this helps. Thanks for listening!