The Nose

Blood Supply of the External Nose

Chapter 11 p.639

The skin of the External nose - is supplied by

branches of the
ophthalmic and the maxillary arteries

The nose consists of the external nose and

the nasal cavity,both of which are divided by a
septum into right and left halves.

Skin of the Ala and the lower part of the Septum

- branches from the facial artery.

Nerve Supply of the External Nose

-

attached to the forehead by the root, or

bridge of the nose
external orifices: nostrils or nares
o
boundaries:

lateral: ala

medial: nasal
septum
framework:
o
above: (bony)

nasal bones

frontal process of
maxillae

nasal part of the

frontal bone
o
below: (cartilages)

upper and lower

nasal cartilage

septal cartilage

The infratrochlear and external nasal

branches of the ophthalmic nerve (CN V) and
the infraorbital branch of the maxillary nerve
(CN V)

NASAL CAVITY

NASAL CAVITY

extends from the nostrils in front to the

choanae behind
divided into right and left halves by
nasal septum

Each half has a :

1. floor:

2. roof:

palatine process of
the maxilla
horizontal plate of the
palatine bone
is narrow
formed from behind
forward:

body of the
sphenoid

cribiform
plate of
ethmoid

frontal bone

nasal bone

nasal
cartilages

3. lateral wall:
o
marked by 3 projections:
o
superior nasal concha
o
middle nasal concha
o
inferior nasal concha

area below each

concha is called
meatus
Sphenoethmoidal recess
a small area of the nose that lies
o
above the superior
concha
o
in front of the body of
sphenoid bone
o
receives the opening of
sphenoidal air sinus
superior meatus
lies below & lateral to the
superior concha
receives the openings of the
posterior ethmoidal sinuses
middle meatus
below and lateral to the middle
concha
has on its lateral wall, a rounded
prominence, the bulla
ethmoidalis caused by bulging
of the underlying middle
ethmoidal air sinuses
hiatus semilunaris: below the
bulla opening of maxillary sinus
4.) medial wall, or nasal septum
osteocartilaginous partition
covered by adherent mucous
membrane
a)
b)
c)

upper part: vertical

plate of ethmoid
posterior part:
vomer
anterior: septal
cartilage

Mucous Membrane of the Nasal

Cavity
Vestibule - lined with modified skin and has
coarse hairs.
area above the superior concha - lined with
olfactory mucous membrane and contains
nerve endings sensitive to the reception of
smell
lower part of the nasal cavity - lined with
respiratory mucous membrane

Function of Warm Blood

Mucus of Mucous
Membrane

and

warm blood in the venous plexuses - heat

up the inspired air as it enters the respiratory
system. The presence
of mucus on the
surfaces of the conchae traps foreign
particles and organisms in the inspired air,
which are then swallowed and destroyed by
gastric acid.
GATEWAYS
- Routes by which nerves and vessels enter and
leave the soft tissues lining each nasal cavity
1. Cribriform plate
2. Sphenopalatine foramen
3. Incisive Canal
4. Small foramina in the lateral wall
5. Margin of the nares

Nerve Supply of the Nasal Cavity

The olfactory nerves from the olfactory
mucous membrane ascend through the
cribriform plate of the
ethmoid bone to the
olfactory bulbs .
The nerves of ordinary
sensation are branches of the ophthalmic
division (V1) and the maxillary division
(V2) of the trigeminal nerve

Blood Supply to the Nasal Cavity

KIESSELBACHS PLEXUS
- Lies in the Kiesselbachs area, Kiesselbachs
triangle or Littles Area
- 90% of nosebleeds occur / anterior epistaxis
- Often traumatized due to nose-picking
- Region on the anteroinferior part of the nasal
septum where 4 arteries anastomose to form a
vascular plexus
1. Anterior ethmoidal artery (opthalmic)
*Posterior ethmoidal artery is seldom
mentioned
because anterior is larger

2. Sphenopalatine artery (maxillary)

3. Greater palatine artery (maxillary)
4. Septal branch of the superior labial
artery
(branches from facial
artery)
arterial supply - the nasal cavity is from
branches of
the maxillary artery, one of the terminal
branches of
the external carotid artery .The
most important
branch is the
sphenopalatine artery

The sphenopalatine artery - anastomoses

with the septal
branch of the superior
labial branch of the facial
artery in
the region of the vestibule. The submucous
venous plexus is drained by veins that
accompany the
arteries.
WOODRUFFS PLEXUS
- Lies in posterior middle turbinate
- Posterior epistaxis
Clinical Notes:
EPISTAXIS
- bleeding from the nose
- most common cause is nose-picking
- Bleeding may be arterial or venous
- Most episodes occur on the anteroinferior
portion of the septum (Kiesse;bachs area) and
involve the septal branches of the
sphenopalatine and facial vessels

-lined with mucoperiosteum

-filled with air
Sinuses present in a rudimentary form at birth
A. Maxillary sinus
B. sphenoidal sinus
eighth year - they enlarge appreciably
Adolescence - become fully formed

Drainage of Mucus and Function of

Paranasal
Sinuses

Lymph Drainage of the Nasal

Cavity
The lymph vessels draining the vestibule
end in the
submandibular nodes
The remainder of the nasal cavity is
drained
by vessels that pass to the upper deep
cervical nodes.

The Paranasal
Sinuses
cavities found in the interior of the
maxilla, frontal, sphenoid, and ethmoid bones.

The mucus produced by the mucous membrane

is moved
into the nose by ciliary action of the columnar
cells.
Drainage of the mucus is also achieved by the
siphon action created during the blowing of the
nose.
Function
a. resonators to the voice
b. Reduce the weight of the skull
When the apertures of the sinuses are blocked
or they become filled with fluid, the quality of
the voice is markedly changed.

A. Maxillary Sinus
- is pyramidal in shape and located within the
body of the maxilla behind the skin of the cheek
Roof: formed by the floor of the orbit
Floor: related to the roots of the premolars and
molar
Teeth

-maxillary sinus opens into the middle meatus of

the nose through the hiatus semilunaris

B. Frontal Sinuses
- The two frontal sinuses are contained
within the
frontal bone
- separated from each other by a bony
septum
- roughly triangular
- extending:
Upward: above the medial end of the
eyebrow
Backward: into the medial part of the
roof of
the orbit
Each frontal sinus opens into the middle meatus
of the
nose through the infundibulum

C. Sphenoidal Sinuses
- The two sphenoidal sinuses lie within the
body of
the sphenoid bone
- Each sinus opens into the
sphenoethmoidal
recess above the superior concha

D. Ethmoid Sinuses
The ethmoidal sinuses are anterior,
middle, and posterior and they are contained
within the ethmoid bone, between the nose
and the orbit
anterior sinuses: open into the
infundibulum
middle sinuses: pen into the middle
meatus,on or above the bulla ethmoidalis
posterior sinuses: open into the superior
meatus

Eikosi 2020