Gen Ana: Nose, Nasal Cavity, Paranasal sinuses

Nose

prominent anatomic structure

Inferior and medial to the eyes

Location of the nose

helps in breathing and olfaction

Function of the nose

• pseudostratified columnar epithelium with cilia

• Highly vascular and easily congested

Respiratory epithelium of the nose

Its blood vessels reflexively dilate and the glands secrete, normally leading to sneezing.

What happened when the tissue of irritated nose occur

Sagittal section

Lateral dissection

pyramidal in form

the nose is a ___________

because these are the most frequently broken bones in the face.

Fractures of the nasal bones are common —

piriform aperture

the opening in the skull is _________

• Nasal

• Maxilla

piriform aperture is bounded by 2 bones

• frontal (nasal process)

• maxilla (frontal process)

• nasal

3 pairs of bones form the root of the nose

Because the root of the nose is made of bone.

why the anatomy of the nose is fixed

• septal

• lateral nasal (upper nasal)

• Major alar (lower nasal)

3 different major cartilages form the dorsum and the apex of the nose

• lesser alar (3 to 4 cartilages)

• vomeronasal

minor cartilages that complete the nose are the

because the dorsum and the apex are cartilaginous

why the nose is quite mobile

vestibule

the cavity of the nose opposite the alar cartilage

vibrissae

is lined by many coarse hairs

keratinized stratified squamous epithelium

what epithelium cover the skin over the nose

atrium

the cavity of the nose to the vestibule

2 nostrils or anterior nares

What can be found at the apex are found the ______, which are separated by septum connecting the apex to the philtrum of the upper lip

Because it helps connect the cartilages together and posteriorly to the maxilla

why fibrous tissue in the nose is important

submandibular lymph nodes

the primary lymphatic drainage of the nose is into the

• ophthalmic artery

• maxillary artery

• facial artery

the blood supply to the nose arises from the 3 major arteries

• these vessels are derived from the external and internal carotid arteries

• these arteries anastomose along the nose

• many nosebleeds are due to trauma to the septal branch of the superior labial artery from the facial artery

• ophthalmic artery

• maxillary artery

• facial artery

its due to trauma to the septal branch of the superior labial artery from the facial artery

Why they are many nosebleeds occur

Ophthalmic artery

• enters the orbit through the optic foramen immediately inferior and lateral to the optic nerve

• crosses the optic nerve to reach the medial part of the orbit

• while in the orbit, besides other branches including the orbital vessels, it gives 2 major branches that supply the nose:

  • Dorsal nasal

  • External nasal from the anterior ethmoidal artery

internal carotid artery

where does ophthalmic artery innervates

Dorsal nasal artery

• 1 of 2 terminal branches of the ophthalmic artery

• exits the orbit along the superomedial border along with the infratrochlear nerve

• supplies the area along the bridge of the nose

ophthalmic artery

dorsal nasal artery innervates

external nasal artery

• a terminal branch of the anterior ethmoid artery

• supplies the area along the external nose at the junction between the nasal bone and the lateral nasal cartilage

anterior ethmoid artery

external nasal artery innervates

maxillary artery

Gives rise to a series of branches; only 1 provides blood

supply to the nose: nasal branch of the infraorbital a.

Nasal branch of the infraorbital artery

what is the only one branch that provides blood that supply to the nose

external carotid artery

maxillary a. innervates

nasal branch of the infraorbital a.

• Infraorbital is the continuation of the maxillary a.

• Arises with the inferior palpebral branch and the superior labial branch

• Supplies the lateral aspect of the nose

Facial Artery

• Passes superiorly immediately deep to the posterior belly

of the digastric m. and the stylohyoid m.

• Passes along the submandibular gland, giving rise to the

submental a., which helps supply the gland

• Passes superiorly over the body of the mandible at the

masseter, giving rise to the:

• Premasseteric a.

• Continues anterosuperiorly across the cheek to the angle

of the mouth, giving rise to the:

• Superior labial a.

• Inferior labial a.

• Passes superiorly along the side of the nose, giving rise

to the:

• Lateral nasal a.

• Following the last branch, it continues on the side of the

nose as the angular a. that terminates along the medial

side of the eye

Tortuous

Premasseteric a.

Passes superiorly over the body of the mandible at the masseter, giving rise to the:

• Superior labial a.

• Inferior labial a.

Continues anterosuperiorly across the cheek to the angle

of the mouth, giving rise to the:

Lateral nasal artery

Passes superiorly along the side of the nose, giving rise

to the:

Tortuous

Following the last branch, it continues on the side of the

nose as the angular a. that terminates along the medial

side of the eye

Nasal (Septum) Artery

supplies the septum

superior labial artery

Nasal (septum innervates

Alar Artery

supplies the ala of the nose

superior labial artery

Alar innervates

Lateral nasal

supplies the ala and dorsal surface of the nose

facial artery

lateral nasal innervates from

Facial Vein

• Begins as the angular v.

• Passes inferiorly along the side of the nose, receiving the lateral nasal v.

• Continues in a posteroinferior path across the angle of the mouth to the

  cheek, receiving the superior and inferior labial vv.

• While passing toward the mandible, the deep facial v. connects the facial vein to the pterygoid plexus

• In the submandibular triangle, the facial v. joins the anterior branch of the

  retromandibular to form the common facial v.

• Has no valves that can allow blood to backflow

Angular

• From the confluence of the supraorbital and supratrochlear vv. along the medial part of the eye

• Travels along the lateral side of the nose to become the facial v.

Superior ophthalmic

• Receives blood from the roof of the orbit and the scalp

• Anastomoses with the angular v.

• Travels posteriorly to communicate with the pterygoid plexus

Inferior ophthalmic

• Receives blood from the floor of the orbit

• Anastomoses with the angular v.

• Travels posteriorly with the infraorbital v. that passes through the inferior orbital fissure to communicate with the pterygoid plexus

• branches of the ophthalmic

• maxillary divisions of the trigeminal nerve

the sensory supply to the nose arises from

Ophthalmic division of the trigeminal

• Arises from the trigeminal in the middle cranial fossa

• Passes anterior on the lateral wall of the cavernous sinus immediately inferior to the oculomotor and trochlear nn., but superior to the maxillary division of the trigeminal n.

• lacrimal

• frontal

• nasociliary

Immediately prior to entering the orbit, through the superior orbital fissure, the ophthalmic division into 3 major branches

• anterior ethmoid nerve

• infratrochlear nerve

the nasociliary branch terminates as the

External nasal nerve

Exits between the lateral nasal cartilage and the inferior border of the nasal bone

Supplies the skin of the ala and apex of the nose around the nares

Internal nasal nerve

Supplies the skin on the internal surface of the vestibule as

the:

• Medial internal nasal n.

• Lateral internal nasal n.

anterior ethmoid nerve

what external nasal nerve and internal nasal nerve innervates from

Infratrochlear nerve

Passes anteriorly on the superior border of the medial rectus m.

Passes inferior to the trochlea toward the medial angle of the eye

Supplies the skin of the bridge of the nose

Also supplies the eyelids, the conjunctiva, and all lacrimal structures

nasociliary nerve

Infratrochlear nerve innervates from

Maxillary division of the trigeminal

Travels along the lateral wall of the cavernous sinus

Passes from the middle cranial fossa into the pterygopalatine fossa via the foramen rotundum 4 branches:

• Infraorbital—this is the continuation of the maxillary division

• Posterior superior alveolar

• Zygomatic

• Ganglionic

what are the 4 branches does the maxillary division of the trigeminal have

Infraorbital nerve

Passes through the inferior orbital fissure to enter the orbit

Passes anteriorly through the infraorbital groove and

infraorbital canal and exits onto the face via the infraorbital foramen

• Nasal (supplies the ala of the nose)

• Inferior palpebral (supplies the skin of the lower eyelid)

• Superior labial (supplies the skin of the upper lip)

once the infraorbital nerve exits onto the face, it divides into 3 terminal branches

continuation of maxillary division of the trigeminal nerve

Infraorbital innervates from

Nasal branch of the infraorbital nerve

supplies the ala of the nose

infraorbital nerve

nasal branch of the infraorbital nerve innervates from

pseudostratified columnar epithelium with cilia

Nasal cavity is lined by

Nasal cavity

inferior portion is larger than superior portion

Olfactory epithelium

located at the superior part of the nasal cavity around the cribriform plate

piriform aperture

anterior opening bounded by the nasal bones and maxilla

nasal septum

frequently deviates to 1 side, giving rise to unequal chambers

lateral walls of the nasal cavity

• Composed o large venous plexuses that have the appearance o erectile tissue

• 3 large elevations, known as conchae, protrude rom the lateral wall

• All o the paranasal sinuses and the nasolacrimal duct drain into the lateral walls of the nasal cavity

• The sphenopalatine foramen, located in the posterior portion o the lateral walls,

connects the nasal cavity to the pterygopalatine ossa

choanae (posterior nasal apertures)

these openings connect the nasal cavity to the nasopharynx