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Nose and Paranasal Sinuses Respiratory Tract Upper Tract Lower Tract Nose Thoracic part of the trachea Pharynx Main bronchi Larynx Lungs Cervical part of the trachea The No...
Nose and Paranasal Sinuses Respiratory Tract Upper Tract Lower Tract Nose Thoracic part of the trachea Pharynx Main bronchi Larynx Lungs Cervical part of the trachea The Nose The nose consists of the external nose and the nasal cavity, Both are divided by a septum into right and left halves. Function of The Nose Respiration Olfaction Filtration of the dust Humidification of the air Reception of secretions from the paranasal sinuses and nasolacrimal ducts External Nose Root Apex Dorsum nasi External Nose External Nose The external nose has two elliptical orifices called the naris (nostrils), which are separated from each other by the nasal Nasal septum septum. Alae nasi The lateral margin, the ala nasi, is rounded and mobile. External Nose which one of the bones below make up the external nose? The framework of the external nose is made up above by the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bone. Below, the framework is formed of plates of hyaline cartilage Cartilages of The Nose Septal cartilage Pars mobilis septi nasi Lateral nasal cartilage Major alar cartilage Lateral crus Medial crus Minor alar cartilage Accessory nasal cartilages Septal cartilage Lateral Nasal Cartilage LNC Cartilaginous skeleton of the nose Major Alar Cartilage Lateral crus Medial crus Blood Supply of the External Nose The skin of the external nose is supplied by branches of the ophthalmic and the maxillary arteries. The skin of the ala and the lower part of the septum are supplied by branches from the facial artery. The Nerves of the External Nose external nose is innervated by infratochlear and infraorbital nerves. The infratrochlear and external nasal branches of the ophthalmic nerve (CN V) and the infraorbital branch of the maxillary nerve (CN V). Nasal Cavity The nasal cavity has a floor, a roof, a lateral wall, a medial or septal wall. Roof of the Nasal Cavity posterior to anterior; body of the sphenoid bone, cribriform plate of the ethmoid bone, frontal bone nasal bone Floor of the Nasal Cavity palatine process of the maxilla, horizantal part of the palatine bone Medial Wall (Nasal Septum) Bony part; vomer and perpendicular plate of ethmoid bone Cartilagenous part; septal cartilage Membranous part; inferior part of septum LATERAL WALL Medial pterygoid proc of sphenoid bone Sup & middle nasal concha Perpendicular plate of palatine inf nasal concha Lacrimal bone Frontal proc of maxilla Lateral Wall where does the nasolacrimal duct drain to? Lateral Wall 1. Inferior meatus: nasolacrimal duct 2. Middle meatus: Maxillary sinus Frontal sinus Anterior ethmoid sinuses 3. Superior meatus: posterior ethmoid sinuses 4. Sphenoethmoidal recess: sphenoid sinus Lateral Wall Spheno‐ethmoidal recess Spheno‐palatine foramen spheno ethmoidal recces is onr etmoid bone while shenoplantine froamen on perpedicular plate of palatine. Lateral Wall Ethmoidal bulla Uncinate proc Lateral Wall Semilunar hiatus Infundibulum which one of below frontal /ant etmodial is wrong ? Fronto‐nasal duct air cells drain into in middle ethmoidal air fundibulum. cells darin into etmo maxillary sinus drain idal bull s intio semilunar hia Opening of the tus. maxillary sinus Opening of the nasolacrimal duct Openings Into the Nasal Cavity Sphenoid sinus opens into sphenoethmoidal recess Anterior & middle ethmoid air Posterior ethmoidal air cells cells, maxillary and frontal open into superior meatus sinuses open into middle meatus Nasolacrimal Canal drains into Inferior Meatus Clinical Notes Examination of the Nasal Cavity Trauma to the Nose Infection of the Nasal Cavity Foreign Bodies in the Nose Nose Bleeding (Epistaxis) Sinuses Drainage region Frontal sinus Middle nasal meatus (infundibulum) Maxillary sinus Middle nasal meatus (semilunar hiatus) Anterior ethmoidal sinus Middle nasal meatus (infundibulum) Middle ethmoidal sinus Middle nasal meatus (ethmoidal bulla) Posterior ethmoidal sinus Superior nasal meatus Sphenoidal sinus Superior nasal meatus (spheno‐ethmoidal recess) The Communications of the Nasal Cavity Nasal septum Posterior communication of the nasal cavity: Choanae Body of sphenoid Medial pterygoid Vomer plate of sphenoid Horizontal plate of palatine Nasal Mucosa on the Lateral Wall of the Nasal Mucosa on the Lateral Wall Ethmoidal Bulla Spheno‐ethmoidal recess Infundibulum Coronal section of the nasal cavity Parts of the Nasal Cavity vestibule olfactory region respiratory region The Nasal Cavity Vestibule Vibrissae Limen nasi Atrium Ager nasi Blood Supply to the Nasal Cavity infra orbital and infra trocherlar were fro external nose not nasal cavity. 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. Blood Supply to the Nasal Cavity Sphenopalatine a. Maxillary a. Netter, Frank H., Atlas of Human Anatomy. Ciba‐Geigy Corporation, Summit, N.J. 1993. Plate 35. in a pateint with nose bleed which one of the arties below are involed ? Nasal septum EPISTAXIS Submucosal venous plexus sphenopalatine facial opthalmic veins are important part of the body’s thermoregulatory system, exchanging heat and warming air before it enters the lungs. Innervation of the nose anterosuperior region opthalmic n posteroinferior region maxillary n all glands are innervated by the facial n (greater petrosal n) sympathetic fibers derived from the T1 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. Nerve Supply of the Nasal Cavity a person gets puched in the face which nerver is triggered ? CN I – Olfactory Nerves (SVA) Anterior ethmoidal branch of V1 in a nose surgery a patent gets a gut in their middle nasal concha which never is triggerned ? Posterior nasal Cut nasopalatine branches of V2 branch of V2 to septum The Special innervation of the nasal cavity Olfactory Bulb Olfactory Tract Olfactory Cortex Found in the frontal lobe just above the orbita Lymphatic Drainage Lymph vessels from the anterior part of the nasal cavity and external nose submandibular lymph nodes. Lymph vessels from the posterior 2/3 of the nasal cavity and paranasal sinuses retropharyngeal lymph nodes. The connections of the nasal cavity ant cranial fossa cribriform plate of ethmoid superior sagittal sinus emissary veins pterygopalatine fossa sphenopalatine foramen oral cavity incisive canal lacrimal sac nasolacrimal duct nasopharynx choanae The Paranasal Sinuses The paranasal sinuses are cavities found in the interior of the maxilla, frontal, sphenoid, and ethmoid bones. They are lined with mucoperiosteum and filled with air. They communicate with the nasal cavity through relatively small apertures. Drainage of Mucus and Function of Paranasal Sinuses 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. Functions: 1.Resonators of the voice 2.They also reduce the skulls weight 3.Help wam and moisten inhaled air 4.Act as shock absorbers in trauma Maxillary Sinus Pyramidal in shape Paired & symmetric Located within the body of the maxilla behind the skin of the cheek. The roof is formed by the floor of the orbit, and the floor is related to the roots of the 2nd premolars and 1st molar teeth. semilunar heitus The maxillary sinus opens into the middle meatus of the nose Frontal Sinuses infundibulum Rarely symmetrical Contained within the frontal bone. Separated from each other by a bony septum. Each sinus is roughly triangular Extending upward above the medial end of the eyebrow and backward into the medial part of the roof of the orbit. Opens into the middle meatus Sphenoidal Sinuses Lie within the body of the sphenoid bone Below sella turcica Extends between dorsum sellae and post clinoid processes Opens into the sphenoethmoidal recess above the superior concha Ethmoid Sinuses They are anterior, middle, and posterior They are contained within the ethmoid bone, between the nose and the orbit Anterior & middle Drains into middle nasal meatus Posterior Drain into superior nasal meatus Separated from the orbit by a thin plate of bone so that infection can readily spread from the sinuses into the orbit Sinus Drainage Schema Clinical Notes Examination of the Paranasal Sinuses Sinusitis Basal skull fracture Sphenoidal sinus Maxillary sinus The apex extends toward into the zygomatic bone The roof is formed by floor of the orbit The floor is formed by alveolar arch Maxillary Sinus The maxillary sinuses are the most commonly infected, because their ostium are high position and it has a poor drainage Maxillar Sinus Maxillary sinus 6 7 Infection of Ethmoidal Cells If the nasal drainage is blocked, infections may spread through the fragile medial wall of the orbit. Posterior eth air cells lie close to the optic canal Blood Suply & Innervation of the Sınuses Blood Suply & Innervation of the Sınuses
