Nose anatomy

INTRODUCTION 

the nose is the most prominent part of the face.

It is the opening for the respiratory pathway and it acts as an olfactory sensor in our body.
it contains various olfactory receptors and nasal sinus 
the olfactory mucosa lines 

the nose is divided into the following sections 
                
  • external Nose 
  • nasal cavity 
  • lateral wall of Nose 
  • conchae and meatuses 


EXTERNAL NOSE 

the external nose is further divided into 
  • root 
  • dorsum 
  • tip 
    Gray852.png

bones in the nose:

  - nasal bone - forms the nasal bridge 

cartilages in nose :

 - septa nasal cartilage 
 - lateral nasal cartilage 
 - major alar  cartilage 
 - minor alar cartilage 
 - vomerovaginal cartilage

muscles in the nose:
- dilator naris 
- depressor septi 
- levator labi superiors alaeque nasi 

Nasalis.png

the skin over external nose is supplied external nasal, infratrochlear and infraorbital nerve.

NASAL CAVITY 

the nasal cavity extends from nostrils to posterior nasal aperture.
it is divided into right and left half 

each half has a floor, roof, medial wall and lateral wall

roof:

  • about 5 - 7 cm long 
  • has an anterior and posterior slope 
  • the anterior slope is formed by a nasal plate of the frontal bone 
  • posterior bone is formed by the inner surface of the sphenoid bone 

 floor:

  • made by the palatine process of the maxilla and horizontal plate of palatine
  • about 5 cm long 

lateral wall:
  • lateral walls contain concha 

 NASAL SEPTUM 

it separates both nasal cavities 
it contains both boney and cartilaginous part

boney part is formed by:
  • vomer
  • perpendicular part of the ethmoid
  • frontal, sphenoid, palatine and maxillary bone contribute to the margins 
Gray854.png
cartilaginous part is formed by :
  • septal process 
  • septal part of inferior nasal cartilage 
cuticular part- fibrofatty tissue 

the nasal septum is usually deflected 

ARTERIAL SUPPLY 
  
anterosuperior - anterior and posterior ethmoidal artery 

anteroinferior - septal branch of superior labial artery 

posterosuperior - sphenopalatine artery ( also called the artery of epistaxis)

the anteroinferior region has anastomoses of all the arteries that form a capillary network called kiesselbach's plexus

VENOUS DRAINAGE 

anterior - facial vein 
posterior - sphenopalatine vein

NERVE SUPPLY 

1. General sensory nerves   
    they arise from the trigeminal nerve 
  •     anterosuperior part -
    •  internal nasal branch of the
      ethmoid nerve 
  •     posteroinferior part 
    • nasopalatine branch of the pterygopalatine ganglion 

2. special sensory nerves (olfactory nerves)
  • olfactory nerves are confined to the upper part of the olfactory area
  • the olfactory area contains olfactory mucosa
  •  the mucus protects the olfactory epithelium and allows diffusion of odour

LYMPHATIC DRAINAGE 

anterior half  - submandibular nodes 
posterior half - reterophyrageal and deep cervical nodes

 
Lymphatic drainage of the nasal fossae and nasopharynx: Preliminary  anatomical and radiological study with clinical implications - Pan - 2009 -  Head & Neck - Wiley Online Library


LATERAL WALL OF NOSE

it contains shelf-like boney projections called conchae. they increase the surface area of air conditioning 

the lateral wall separates the nose from
- orbit
- ethmoidal air sinus 
- maxillary air sinus 
- lacrimal sac
- nasolacrimal duct

it is divided into 3 parts
  • vestibule - small depressed part in the anterior 
  • atrium - middle space 
  • conchae and conchae meatus 
the lateral wall is partly cartilaginous and partly boney 
nasal cavity
the boney parts are formed by 
  • nasal 
  • frontal process of the maxilla 
  • superior and  middle nasal conchae (made from the labyrinth of ethmoid)
  • inferior conchae formed by spongy bone 
  • palatine bone and their processes 

cartilaginous part 
  • superior nasal cartilage 
  • inferior nasal cartilage 
  • cartilage of ala 
the cuticular lower part is formed by fibrofatty tissue


CONCHAE 

nasal conchae are boney projections that are present in the lateral wall

there are 3 conchas 
  • superior concha 
    • smallest concha
    • situated above the posterior part of the middle concha 
  • middle concha 
    • from the medial wall of the ethmoid labyrinth
  • inferior concha 
    • it is an independent bone 
Nasal concha - Wikipedia



MEATUS 
meatus of the nose is the passage below the conchae 

1. inferior meatus 
  • the largest meatus 
  • nasolacrimal duct opens in the middle 
  • the opening is guarded by lacrimal fold or hasners valve 
2. middle meatus 

    • middle ethmoidal sinus opens at ethmoidal bulla 
      • ethmoidal bulla is a rounded prominence 
    • the infundibulum is a short passage below the meatus 
    • hiatus semilunaris is a deep semicircular sulcus below bulla 
      • frontal air sinus opens in the anterior part 
      • ethmoidal air sinus opens behind frontal sinus 
      • maxillary sinus opens in the posterior partPartial and Complete Ethmoidectomy - ScienceDirect
3. superior meatus 
  • below superior concha 
  • receives opening of posterior ethmoidal air sinus 
4. sphenoethmoidal recess 
  • triangular fossa above superior concha 
  • opening of sphenoidal air sinus     
5. Atrium of the middle meatus 
  • a shallow depression in front of the middle meatus 

ARTERY SUPPLY 

anterosuperior quadrant - anterior ethmoidal artery 
anteroinferior quadrant - facial artery 
posterosuperior quadrant  - sphenopalatine artery 
posteroinferior quadrant - great plalatine artery 

VENOUS DRAINAGE 

veins from plexus to drain into 
  • facial vein 
  • pharyngeal plexus 
  • pterygoid plexus 

NERVE SUPPLY 

1. general sensory nerves 
  • anterosuperior quadrant - anterior ethmoidal nerve 
  • anteroinferior quadrat - anterior superior alveolar nerve 
  • posterosuperior quadrant - posterior superior nasal branch from pterygopalatine ganglion 




   2. special sensory nerves 
            - upper part of the lateral wall 

LYMPHATIC DRAINAGE 

- drained by submandibular, retropharyngeal and deep cervical node

 






Comments

Popular Posts