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The nose is an important part of the face; it gives the individual his characteristic
appearance.
The nose is divided into 2 parts:
1- The external nose.
2- The internal nose (nasal cavities)
The nasal cavity is divided by midline partition (the nasal septum) into right and left
chambers,. It extends from the nostrils in front into the choanae behind (where it opens into
the nasopharynx)
The entrance to the nasal cavity is called the nasal vestibule which ends at the
mucocutaneous junction, it is lined by skin and contains skin appendages.
Clinical point(3) : the vestibule is a common site of boil development because it is hair bearing area
The rest of nasal cavity lined by respiratory mucosa ( pseudo- stratified columnar ciliated
epithelium ), and small area lined by olfactory epithelium.
Each cavity has a roof ,floor, medial and lateral walls .The floor is formed by the
palatine process of the maxilla and the horizontal process of palatine bone. The roof
is narrow and is formed (from behind forward) by the body of the sphenoid
,cribriform plate of the ethmoid and the frontal bone.
Clinical point(4): cribriform plate is a thin plate of bone and easily to be fractured in head injury
and may associated with CSF leak through the nose.
The superior meatus receives the opening of the posterior ethmoid sinus.
The sphenoethmoidal recees receives the opening of the sphenoid sinus.
Blood supply of the nasal cavity
It supplied by branches of internal and external carotid arteries.
i branches of the internal carotid artery that supply the nose are the anterior and
posterior ethmoidal arteries.
While the external carotid artery supplies the nose through it`s maxillary branch and
small contribution of the facial artery.
The internal carotid artery and external carotid artery branches anastomose
freely in the nose ,the common site of anastmosis is in the antero-inferior part of the
nasal septum (little`s area) ,the arteries that share in this anastmosis are the
sphenopalatine artery ,greater palatine artery, superior labial artery and branch from
the anterior ethmoidal artery .
The venous drainage
The nose characterized by rich submucosal plexus of venous sinusoids ,these drained
by veins that accompany the arteries.
Nerve supply of the nasal cavity
1- Olfactory nerves: they arise from a specialized olfactory epithelium in the olfactory
mucosa .they ascend through the cribriform plate to reach the olfactory bulb.
2- Nerves of ordinary sensation: They are from the ophthalmic and maxillary
divisions of the trigeminal nerve.
3-vasomotor nerve supply (the autonomic nerve supply):
A-Parasympathetic when it is simulated it causes vasodilatation. And stimulate
glandular secretion
B- Sympathetic nerves it causes vasoconstriction when stimulated and inhibit
glandular secretion
lymphatic drainage
The nose drained to the submandibular lymph nodes and the upper deep cervical
lymph nodes .
paranasal sinuses :
These are air filled cavities within the bones of the skull .They are 4 pairs of
sinuses divided into anterior and posterior groups . The anterior group contains the
frontal sinus ,maxillary sinus and the anterior ethmoid sinus .The posterior group
includes the sphenoid sinus and posterior ethmoid sinus.
The anterior group drain into the middle meatus of the nose and posterior ethmoid air
cells drain into the superior meatus and the sphenoid sinus drain into the
sphenoethmoidal recess.
maxillary sinus
It is pyramidal in shape and lies within the maxilla on each side of the nose. The roof
of the sinus is formed by the floor of the orbit and the floor is related to the roots of
the second premolar and first molar teeth .,medialy it is related to the nose,and
posteriorily to the pterygopalatine fossaThe maxillary sinus open into the middle
meatus.
frontal sinus :
The two frontal sinuses are contained within the frontal bone. A bony septum
separates the two commonly unequal frontal sinuses. It is related anteriorly to the
forehead, posteriorly to the anterior cranial fossa and inferiorly to the nose and orbit.
each sinus opens into the middle meatus
sphenoid sinus :
The two sinuses lie within the body of the sphenoid, each sinus opens into the
sphenoethoidal recess above the superior turbinate. It is related laterally to the
cavernous sinus, optic nerve and internal carotid artery. It is related superiorly to the
pituitary gland, and inferiorly to the nasopharynx.
Ethmoid sinus
The ethmoid sinuses divided into anterior and posterior air cells and contained within
the ethmoid bone on each side between the orbit laterally and the nose medially. A
thin sheet of bone lamina papyracea separates these sinuses from the orbit. Their
roof is directly related to the anterior nasal fossa. The anterior ethmoid air cells open
into the middle meatus and the posterior ethmoid air cells open into the superior
meatus.