Transcript Nose and paranasal sinuses

Nose and paranasal sinuses
NoseIntroductionExternal nose- boney and
cartilagenous part,
Bones- nasal bones & the
frontal processes of the
maxillae
Cartilages- superior & inferior
nasal cartilages, septal
cartilage and some small
cartilages
Nose and paranasal sinuses
Nasal cavity• Extent-external nares
to the posterior nasal
apertures.
• Rt and lt halves by
nasal septum
• Each half- roof, floor,
medial & lateral walls
• Measurement-5cm
height, 5-7cm length
& 1.5cm wider near
the floor and near the
roof is 1-2mm
Nose and paranasal sinuses
Nasal septum• Osseocartilaginous partition
betw the 2halves of the
nasal cavity
• Mucous membrane & forms
the medial wall of both the
nasal cavities
• Boney part- vomer &
perpendicular plate of the
ethmoid. Nasal spine of the
frontal bone, the rostrum of
the sphenoid & the nasal
crests of nasal, palatine and
maxillary bones
• Cartilaginous part- septal
cartilage & the septal
processes of the inferior
nasal cartilages
• Cuticular part- fibrofatty
tissue covered by the skin
• Borders- sup, inf, ant and
post & rt and lt surfaces
Nose and paranasal sinuses
Arterial supply• Anterosuperior- ant ethmoidal
artery
• Posteroinferior-sphenopalatine
artery
• Anteroinferior- superior labial
branch of facial artery
• Posterosuperior- post ethmoidal
artery
• Kiesselbach’s plexus- common
site of bleeding from the nose
or epistaxis and know as
“Little’s Area”
Venous drainage• From little’s area there are
venous plexus which drains into
the facial vein, posteriorly
through the sphenopalatine vein
to the pteryoid venous plexus
Nose and paranasal sinuses
Nerve supplyGeneral sensory• Anterosuperior-internal nasal
branch of the anterior
ethmoidal nerve
• Posteroinferior-nasopalatine
branch of the pterygopalatine
ganglion
• Posterosuperiormedial,posterior, superior
nasal branches of the
pterygopalatine ganglion
Special sensory or olfactory
nerves are confined to the
upper part or olfactory area
Nose and paranasal sinuses
Lymphatic drainage• Anterior halfsubmandibular nodes
• Posterior halfretropharyngeal &
deep cervical nodes
Nose and paranasal sinuses
Clinical anatomy• Little’s area on the septum is the common site of
bleeding from the nose or epistaxis
• Pathological deviation of the nasal septum is often
responsible for the repeated attacks of common
cold, allergic rhinitis, sinusitis.
Nose and paranasal sinuses
Lateral wall of
nose• Irregular and having
presence of 3 shelflike bone projectionsconchae
• Lateral wall
separates the nose:
orbit above, with the
ethmoidal air sinuses
& maxillary sinus
below, from lacrimal
groove and
nasolacrimal canal in
front
Nose and paranasal sinuses
Lateral wall3parts
• Vestibule- small
depression area in
the anterior part
• Middle part-atrium
of the middle
meatus
• Posterior partconchae
Nose and paranasal sinuses
Skeleton of the lateral
wall
Boney- nasal, frontal process
of the maxilla, labyrinth of
the ethmoid with superior
and middle conchae,
inferior nasal conchae,
perpendicular plate of the
palatine bone together with
its orbit and sphenoidal
processes and medial
pteyroid plate
Cartilaginous- superior nasal
cartilage, inferior nasal
cartilage and 3-4 small
cartilages of ala
Cuticular lower part- fibrofatty
tissue covered with skin
Nose and paranasal sinuses
Conchae and meatuses
• inferior concha is independent bone
• Middle concha- projection from the medial surface of the ethmoidal
labyrinth
• Superior concha- projection from the medial surface of the ethmoidal
labyrinth
• Inferior meatus- nasolacrimal duct
• Middle meatus- ethmoidal bulla is a rounded elevation produced by the
underlying middle ethmoidal sinus; hiatus semilunaris is a deep
semicircular sulcus below the bulla; infundulum is a short passage at
the anterior end of hiatus; opening of the frontal sinus, maxillary air
sinus and middle ethmoidal air sinus
• Superior meatus- opening of the posterior ethmoidal air sinuses
• Sphenoethmoidal recess- opening of the sphenoidal air sinus
Nose and paranasal sinuses
Nose and paranasal sinuses
Arterial supply of the lateral wall
• Anterosuperior quadrant- ant
ethmoidal artery assisted by the
post ethmoidal and facial arteries
• Anteroinferior quadrant- branches
from the facial artery and greater
palatine arteries
• Posterosuperior quadrantsphenopalatine artery
• Posteroinferior quadrant- branches
from the greater palatine artery
Venous drainageVeins forms plexus which drains
anteriorly into the facial vein,
posteriorly into the pharyngeal
plexus of veins and from the
middle part to the pterygoid plexus
of the vein
Nose and paranasal sinuses
Nerve supply1.
a)
General sensory nerves
Anterosuperior quadrantant ethmoidal nerve branch
of ophthalamic nerve
b) Anteroinferior quadrant-ant
superior alveolar nerve
branch of maxillary nerve
c)
Posterosuperior quadrantpost superior lateral nasal
branches from the
pterygopalatine ganglion
suspended by the maxillary
nerve
d) Posteroinferior quadrantant or greater palatine
branch from the
pterygopalatine ganglion
suspended by the maxillary
nerve
2. Special sensory or olfactory
nerve-
Nose and paranasal sinuses
Lymphatic drainageAnterior half- submandibular nodes
Posterior half- retropharygeal and
upper deep cervical nodes
Nose and paranasal sinuses
Clinical anatomy1. Common cold or rhinitis
2. Paranasal air sinuses may get infected
from the nose. Maxillary sinusitis is the
commonest of such infections
3. Hypertrophy of the mucosa over the inferior
nasal concha is the common feature of
allergic, rhinitis, which is characterized by
sneezing, nasal blockage and excessive
watery discharge from the nose
Nose and paranasal sinuses
1. Frontal sinus
2. Maxillary
sinus
3. Sphenoidal
sinus
4. Ethmoidal
sinus
Nose and paranasal sinuses