Head and Neck Anatomy PDF

Nasal Cavity Relations: Nasopharynx - choanae Cranial cavity - ethmoid bone (cribriform plate and foramen cecum) Oral cavity - maxilla (incisive canal) Middle ear - pharyngotympanic tube Nasal sinuses External - nares Nasal Skeleton External nasal s...

Nasal Cavity Relations: Nasopharynx - choanae Cranial cavity - ethmoid bone (cribriform plate and foramen cecum) Oral cavity - maxilla (incisive canal) Middle ear - pharyngotympanic tube Nasal sinuses External - nares Nasal Skeleton External nasal skeleton is made up of: Choanae is the boundary between the nasal cavity and the Nasal and maxilla bones nasopharynx - formed by the vomer, sphenoid and palatine bones Septal and lateral cartilages Major/minor alar cartilages FIbrofatty TIssue Nares can be flared via nasalis, depressor septi nasi, levator labii superioris alaeque nasi m.  Nasal Skeleton Internal Nasal Septum: From 12o’clock clockwise: frontal, ethmoid, sphenoid, palatine, maxilla, septal cartilage, nasal Central point: Vomer The palatine and maxilla form the hard palate  Nasal Skeleton Lateral Wall: From 12 o’clock clockwise: frontal, ethmoid, sphenoid, palatine, maxilla, septal cartilage, nasal Central bones: lacrimal, inferior nasal concha Forms 3 (4?) nasal conchae: (highest), superior, middle, inferior - works to increase SA ○ Note the inferior nasal concha is a separate bone Under the conchae = Superior, middle and inferior meatus Entry and Exit Sphenopalatine foramen Sphenopalatine a. (maxillary a.) - Communicates with Maxillary (V2) branches: nasopalatine n. pterygopalatine fossa (medial wall), posterior lateral nasal nerves (Posterior nose stuff) (lateral wall) Incisive canal Greater palatine a. enters Nasopalatine n. Exits → oral cavity (Anterior nose stuff) Foramen Cecum Nasal vein → superior sagittal sinus Cribriform plate Olfactory n. (CNI) Anterior ethmoidal n. (Ophthalmic V1 branch) Anterior/posterior ethmoidal a. Around naris Internal nasal branches of infraorbital n. (from V2) Alar branches of nasal a. From facial a. Small foramina Inferior nasal branches from greater palatine branch of V2 Entry and Exit - Nerves Sphenopalatine foramen Sphenopalatine a. (maxillary a.) - Communicates with Maxillary (V2) branches: nasopalatine n. pterygopalatine fossa (medial wall), posterior lateral nasal nerves (Posterior nose stuff) (lateral wall) Incisive canal Greater palatine a. enters Nasopalatine n. Exits → oral cavity (Anterior nose stuff) Foramen Cecum Nasal vein → superior sagittal sinus Cribriform plate Olfactory n. (CNI) Anterior ethmoidal n. (Ophthalmic V1 branch) Anterior/posterior ethmoidal a. Around naris Internal nasal branches of infraorbital n. (from V2) Alar branches of nasal a. From facial a. Small foramina Inferior nasal branches from greater palatine branch of V2 Entry and Exit - Nerves Sphenopalatine foramen Sphenopalatine a. (maxillary a.) - Communicates with Maxillary (V2) branches: nasopalatine n. pterygopalatine fossa (medial wall), posterior lateral nasal nerves (Posterior nose stuff) (lateral wall) Incisive canal Greater palatine a. enters Nasopalatine n. Exits → oral cavity (Anterior nose stuff) Foramen Cecum Nasal vein → superior sagittal sinus Cribriform plate Olfactory n. (CNI) - olfaction Anterior ethmoidal n. (Ophthalmic V1 branch) Anterior/posterior ethmoidal a. Most mentioned nerves are sensory Around naris Internal nasal branches of infraorbital n. (from CNI = olfaction (special sensory) V2) Glands receive: Alar branches of nasal a. From facial a. SNS via T1 → superior cervical sympathetic ganglion → travel with V2 Small foramina Inferior nasal branches from greater palatine PNS via facial n. (CNVII) via greater petrosal branch of V2 n. Joining V2 in pterygopalatine fossa Entry and Exit - Arteries Sphenopalatine foramen Sphenopalatine a. (maxillary a.) - Communicates with Maxillary (V2) branches: nasopalatine n. pterygopalatine fossa (medial wall), posterior lateral nasal nerves (Posterior nose stuff) (lateral wall) Incisive canal Greater palatine a. enters Nasopalatine n. Exits → oral cavity (Anterior nose stuff) Foramen Cecum Nasal vein → superior sagittal sinus Cribriform plate Olfactory n. (CNI) Anterior ethmoidal n. (Ophthalmic V1 branch) Anterior/posterior ethmoidal a. (From internal carotid) Around naris Internal nasal branches of infraorbital n. (from V2) Alar branches of nasal a. From facial a. Small foramina Inferior nasal branches from greater palatine branch of V2 Entry and Exit - Arteries Sphenopalatine foramen Sphenopalatine a. (maxillary a.) - Communicates with Maxillary (V2) branches: nasopalatine n. pterygopalatine fossa (medial wall), posterior lateral nasal nerves (Posterior nose stuff) (lateral wall) Incisive canal Greater palatine a. enters Nasopalatine n. Exits → oral cavity (Anterior nose stuff) Foramen Cecum Nasal vein → superior sagittal sinus Cribriform plate Olfactory n. (CNI) Anterior ethmoidal n. (Ophthalmic V1 branch) Anterior/posterior ethmoidal a. (From internal carotid) Around naris Internal nasal branches of infraorbital n. (from V2) Alar branches of nasal a. From facial a. Small foramina Inferior nasal branches from greater palatine branch of V2  Kiesselbach’s Area/ Little’s Area Huge vascular supply + anastomosis between internal and external carotid a. are on both medial and lateral walls of the nasal cavity Kiesselbach’s is on the nasal septum - site of epistaxis due to anastomosis between: Internal carotid → ophthalmic a. → anterior/posterior ethmoidal a. External carotid → maxillary a. → greater palatine a., sphenopalatine a.  Nose - Venous and Lymphatic Drainage Veins: *Note chance of infection of CNS Anteriorly → facial v. Posteriorly → pterygoid plexus Superiorly → ethmoidal v. → superior ophthalmic v. → cavernous sinus Nasal vein (1% people) passes through foramen cecum into superior sagittal sinus Lymphatics: Anteriorly → forward onto face → submandibular nodes Posteriorly → upper deep cervical nodes  Nasal Sinuses Air-filled spaces in your skull formed in childhood (to make your skull more lightweight). They all open into the nasal cavity. Sinus Drainage Innervation Arterial Supply Frontal Middle meatus: Supra-orbital n. (from Anterior Semilunar hiatus [V1]) ethmoidal Ethmoidal Middle meatus: Anterior/ posterior Anterior/ - anterior - ethmoidal ethmoidal branches posterior infundibulum/ semilunar of nasociliary n. (from ethmoidal hiatus [V1]) - Middle - ethmoid bulla Superior meatus: Orbital branches - posterior cells from pterygopalatine ganglion (from [V2]) Sphenoidal Sphenoethmoidal Pharyngeal recess Maxillary Middle meatus: Infraorbital and Infra-orbital and Semilunar hiatus alveolar branches of superior alveolar [V2]  Nasal Sinuses - Drainage (High Yield) Air-filled spaces in your skull formed in childhood (to make your skull more lightweight). They all open into the nasal cavity. Sinus Drainage Frontal Middle meatus: Semilunar hiatus Ethmoidal Middle meatus: - anterior - ethmoidal infundibulum/ semilunar hiatus - Middle - ethmoid bulla Superior meatus: - posterior cells Spheno-ethmoidal recess Sphenoid sinus Sphenoidal Sphenoethmoidal recess Superior meatus Posterior ethmoidal cells Middle meatus Semilunar hiatus: Frontal sinus, anterior ethmoidal cells Maxillary Semilunar hiatus Maxillary sinus Openings on ethmoid bulla: Middle ethmoidal cells Inferior meatus Nasolacrimal duct, pharyngotympanic tube