Nose & Para nasal

sinuses
AYMAN YAKOUT
GMU AJMAN UAE

NOSE

External nose
Bones
Nasal cavity
Mucous membrane
Olfactory portion
Respiratory portion
Communications of nasal cavity

Floor
Roof
Lateral wall
Medial wall

Olfactory membrane Located on the roof of the nasal cavity. Contains

cells/receptors which are in contact with the Olfactory bulb and nerve to
provide sense of smell. (5% of nasal cavity area)

Relations of nasal
cavity
Important in the spread of infection
Direct continuity with
(i) the anterior cranial
fossa (via the cribriform plate of the ethmoid bone)
(ii) the nasopharynx and, through the
pharyngotympanic tube, the middle ear
(iii) the paranasal air sinuses
(iv) the lacrimal apparatus and conjunctiva.

Nasal Mucosa

Cross section of nasal mucosal

layer. Cilia is beating

Functions of Nose

Olfaction
Respiration
Filtration of dust
Humidification
Elimination of secretions from
paranasal sinuses and nasolacrimal
ducts

Arteries supplying the Nose

External Carotid Artery

-Sphenopalatine artery

-Greater palatine artery

-Ascending pharyngeal artery

-Posterior nasal artery

-Superior Labial artery

Internal Carotid Artery

-Anterior Ethmoid artery

-Posterior Ethmoid artery

Blood supply
The upper part of the nasal cavity
receives its arterial supply from the
ethmoidal branches of the ophthalmic
artery, a branch of the internal
carotid.
The sphenopalatine branch of the
maxillary artery, a terminal of the
external carotid, supplies the lower
part of the cavity.

 Just within the vestibule of the nose,

on the anteroinferior part of the
septum, it links with a septal branch
of the facial artery and it is from this
zone, Littles area, that 90% of nosebleeds occur.

BLOOD SUPPLY OF MEDIAL WALL

OF NOSE

BLOOD SUPPLY OF LATERAL WALL

OF NOSE

Kesselbachs
Plexus/Littles Area:
-Anterior Ethmoid (Opth)
-Superior Labial A (Facial)
-Sphenopalatine A (IMAX)
-Greater Palatine (IMAX)

Woodruffs Plexus:
-Pharyngeal & Post. Nasal
AA of Sphenopalatine A
(IMAX)

Epistaxis

venous drainage
Veins accompany the arteries
The veins drain downwards into the
facial vein
and upwards to the ethmoidal
tributaries of the ophthalmic veins.

Innervation
Sense of smell is via the olfactory nerve,
which sends microscopic fibers from the
olfactory bulb through the cribiform plate
to reach the top of the nasal cavity.
General sensory innervation is by
branches of the
Trigeminal nerve (V1 & V2)
Nasociliary nerve (V1)
Nasopalatine nerve (V2)
Posterior nasal branches of Maxillary nerve
(V2)

 The entire nasal cavity is innervated

by autonomic fibers.
Sympathetic innervation to the blood
vessels of the mucosa causes them to
constrict, while the control of
secretion by the mucous glands is
carried on postganglionic
parasympathetic nerve fibers
originating from the facial nerve.

Lymphatics

 Lymph from anterior regions of the nasal

cavities drains forward onto the face by
passing around the margins of the nares.
These lymphatics ultimately connect with
the submandibular nodes.
Lymph from posterior regions of the
nasal cavity and the paranasal sinuses
drains into upper deep cervical nodes.
Some of this lymph passes first through
the retropharyngeal nodes.

Clinical features

Nasal Fractures
Epistaxis
Rhinitis
Deviated nasal septum
Nasal polyps
Boil on nose

Danger area of the face

The skin of the external nose and its surrounds
contains many sebaceous glands and hair
follicles which may become blocked and
infected
Facial veins, which may become
secondarily infected, communicate directly
with the ophthalmic veins and hence with
the cavernous sinus. For this reason, this
zone is often known as
the danger area of the face.

Deviated Nasal Septum

The septum is frequently deviated to
one or other side, interfering both
with inspiration and with drainage of
the nose and accessory sinuses.

Pathology
Deviation
Usually in
cartilagenous part
Different shapes
C shaped
S shaped

Spur
At junction of
cartilage and bone

Symptoms
Nasal obstruction
Nasal deformity
Sense of smell and
taste are disturbed
Recurrent epistaxis

Nasal Polyp
Smooth glistening
grape like masses
Pale but Protruding
polyp may appear pink
Insensitive to probing
Do not bleed on touch

Multiple and bilateral

Broadening of nose
Increased intercanthal
distance

Paranasal air sinuses

Air filled spaces in bones

Frontal
Ethmoidal
Sphenoidal
Maxillary

Sinuses

Functions of sinuses
Warm and humidify inspired air
Resonance of voice
Reduce the weight of skull

Guess what?

Guess what?