Anatomy and Physiology of Nose and Paranasal Sinuses Click to edit Master subtitle style

Prepared by : Nurul Syazwani Binti Ramli

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Anatomy of Nose

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External Nose

Pyramidal in shape (root up & base downward) Consists of osteocartilaginous framework covered by muscles and skin.

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External Nose

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External Nose

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External Nose

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Internal Nose

Divided into right and left nasal cavities Communicates with:

Exterior: through naris (nostril Nasopharynx: through post. nasal aperture (choana)

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Internal Nose

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Internal Nose

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Internal Nose

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Internal Nose

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Lining Membrane of Internal Nose

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Mucose membrane

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Blood Supply of Nose

Nasal septum :
Internal carotid :

Anterior ethmoid Posterior ethmoid

External carotid :

Sphenopalatine Greater palatine Superior labial

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Blood Supply of Nose

Lateral wall :
Internal carotid : Anterior ethmoid Posterior ethmoid External carotid : Sphenopalatine Greater palatine Anterior superior dental (infraorbital ) Facial artery

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Littles Area (Plexus Kiesselbach)

Anterior inferior nasal septum Anastomoses from :

Anterior ethmoid Superior labial Sphenopalatine Greater palatine

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Plexus Kiesselbach

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Nerve Supply of Nose

Olfactory nerve :

Autonomic :
Parasympathetic greater superficial petrosal vidian sphenopalatine ganglion Sympathetic upper 2 thoracic superior cervical gangglion deep petrosal nerve join parasympathetic to form vidian

Carry sense of smell and supply olfactory region of nose Arranged into 10-12 nerves which pass through the cribriform plate and end in the olfactory bulb

Nerves of common sensation :

Anterior ethmoidal nerve Sphenopalatine ganglion Infraorbital nerve Greater palatine nerve

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Lymphatic Drainage

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Physiology of Nose
Functions of the nose:
1) 2) 3) 4) 5) 6)

Respiration Air conditioning of the inspired air Protection of Lower Airway Vocal resonance Nasal reflex functions Olfaction

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RESPIRATION

Nose = natural pathway for breathing

INSPIRATION: air thru middle part of nose btwn turbinates and nasal septum. Very little air passes thru inferior meatus or olfactory region.

EXPIRATION : same but entire air current is not expelled directly thru nares friction at limen nasi converts it into eddies under cover of inferior and middle turbinates 3/29/13 and this ventilates the

air-conditioner for lungs:

a)

AIR CONDITIONING OF INSPIRED AIR

nasal vibrissae filters larger particles (3m) Finer particles adhere to the mucus over surface of mucous membrane (0.5-3.0m)

Filtration and Purification :

v v

Smaller than 0.5m can pass thru nose into lower airways without difficulty

b)

Temperature control : mucous membrane (region of middle and inferior turbinates and adjacent parts of the

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septum) is highly vascular with cavernous venous spaces

PROTECTION OF LOWER AIRWAY

a)

Mucociliary mechanism:

Rich in goblet cells, secretory glands both mucous and serous) Form a cont. sheet called mucous blanket which consist of superficial mucus layer and deeper serous layer that floating on top of cilia which constantly beating to carry it towards nasopharynx = conveyer belt

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a)

Enzymes and Immunoglobulins: (in nasal secretion)

VOCAL RESONANCE

Resonating chamber for certain consonant in speech. In phonating nasal consonants ( M/ N/ NG ), sound passes thru nasopharyngeal isthmus and is emitted thru the nose. When blocked, speech becomes denasal.

Eg:- M/ N/ NG are uttered as B/ D/ G respectively

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NASAL REFLEXES

Nasal Mucosa reflex receptors closely related to gastrointestinal and pulmonary functions.

Examples: - irritation of nasal mucosa cause sneezing - smell of palatable food reflex secretion of saliva and gastric

juice.

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OLFACTION

Sense of smell:

Animal :- give warning of environmental danger Man :- for pleasure and enjoying the taste of food upper one-third of lateral Wall corresponding part of nasal septum roof of nasal cavity of smell:

Olfactory region :

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Paranasal Sinuses

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Paranasal Sinuses

The paranasal sinuses are aircontaining 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 The maxillary and ethmoid sinuses 3/29/13

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Maxillary Sinus

pyramidal in shape located within the body of the maxilla behind the skin of the cheek Roof is formed by the floor of the orbit, and the floor is related to the roots of the molars, premolars and canine teeth

The maxillary sinus opens into the middle meatus of the nose through 3/29/13 the hiatus semilunaris

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Frontal Sinuses

The two frontal sinuses are contained within the frontal bone They are separated from each other by a thin 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

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Sphenoidal Sinuses

The two sphenoidal sinuses lie within the body of the sphenoid bone Each sinus opens into the sphenoethmoidal recess above the superior concha

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Ethmoid Sinuses

The ethmoidal sinuses are thin walled air cavities within the ethmoid bone between the nose and the orbit The number varies from 3 to 18. Divided into anterior, middle, and posterior.

They are separated from the orbit by a thin plate of bone (lamina 3/29/13 papyracea) so that infection can

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Ethmoid Sinuses

The anterior sinuses open into the infundibulum The middle sinuses open into the middle meatus, on or above the bulla ethmoidalis

The posterior sinuses open into the 3/29/13 superior meatus

Physiology of Paranasal Sinuses

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Ventilation of Sinuses

Takes place through their ostia. Inspiration:

air current causes (ve) pressure in nose. Varies from -6mm to -200mm of H2O, depend on force of inspiration. (+ve) pressure created in nose and sets up eddies which ventilate the sinuses

Expiration:

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Drainage of Mucus

The mucus produced by the mucous membrane is moved into the meatus of the nose by very active ciliary action of the columnar cells Drainage of the mucus is also achieved by the siphon action created during the blowing of the nose

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Functions of Paranasal Sinuses

Provide resonance to voice reduce weight of the skull (lighten skull bones) Air-conditioning of inspired air by providing large surface area over which the air is humidified and warmed

Act as thermal insulators to protect the delicate structures in the orbit 3/29/13

Thank you
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