nose and paranasal sinuses Flashcards
upper 1/3rd of nose has what mucosa
olfactory mucosa
olfactory mucosa has special receptors called
olfactory cells
the external nose framework is made up of
partly bone and partly cartilaginous
bones involved in making of external nose
nasal bone, frontal process of maxilla
cartilages involved in making of external nose
inferior and superior nasal cartilages
septal cartilage and alar cartilages
skin over the external nose is supplied by
external nasal, infratrochlear, infraorbital nerve
the roof of nasal cavity is made up of
- the middle horizontal part is made up of cribriform plate of ethmoid
- anterior slope is made up of nasal part of frontal bone, nasal bone and nasal cartilages
- posterior slope is made up of inferior surface of the body of sphenoid
the floor of the nasal cavity is made up of
palatine process of the maxilla and horizontal plate of the palatine bone
which sinus is common for infections
maxillary sinus
csf rhinorrhea
fracture of cribriform plate cause rupture of meninges and may cause rupture of olfactory nerve rootlets and leakage of csf into nasal cavity
what is nasal septum and what membreane does it have?
osteocartilaginous partition which makes the median wall of one nasal cavity and it has mucous membrane
bones and cartilages involved in making of nasal septum
BONES:
- vomer
- perpendicular plate of ethmoid and margins from nasal spine of frontal bone, rostrum of sphenoid, nasal crest of nasal bone and palatine and maxillary bones
arterial supply of nasal septum:
anteriorsuperior part
anterior and posterior ethmoidal artery
arterial supply of nasal septum:
anteroinferior part
labial branch of facial artery
arterial supply of nasal septum:
posteriorsuperior part
sphenopalatine artery (main artery)
arterial supply of nasal septum:
posteriorinferior part
greater palatine artery
kiesselbach’s plexus
at the anterior inferior part the septum has anastomoses b/w labial branch of facial artery, greater palatine, sphenopalatine to form a plexus called as kiesselbach’s plexus which is prone to epistaxis
venous drainage of septum
venous drainage is from littles area
anteriorly into facial vein
posteriorly into sphenopalatine vein to pterygoid venous plexus
general nerve supply of septum is done by
arsises from trigeminal nerve
nerve supply of nasal septum anteriorsuperior
internasal anterior ethmoidal nerve
nerve supply of nasal septum
anteriorinferior
anterior superior alveolar nerve
nerve supply of nasal septum
posteriorsuperior
medial posterior superior nasal branch of pterygo palatine ganglion
nerve supply of nasal septum
posterior inferior
naso palatine branch of pterygopalatine ganglion (main nerve)
lymphatic drainage of nasal septum
anterior half submandibular nodes
posterior half retropharyngeal and deep cervical nodes
conchae and function
shelf like bony projections on the lateral wall of nose
increases surface area for air conditioning
lateral wall separates the nose:
orbit above with ethmoidal air sinus
maxillary sinus below
nasolacrimal duct and lacrimal duct in front
3 parts the lateral wall is divides into
anterior soft part called vestibule and has vibrissae
middle part called atrium of the middle meatus
posterior part called as the conchae
bony part of lateral wall
nasal
frontal process of maxilla
lacrimal
labyrinth of ethmoid with superior and middle nasal conchae
inferior nasal conchae made by spongy bones
perpendicular plate of palatine bone with its orbital and sphenoidal process
medial pterygoid plate
3 nasal conchae
inferior nasal conchae is an independent bone
superior and middle nasal conchae are projection from the medial part of the labyrinth of ethmoid
what are meatuses
passages below the conchae that communicate with the nasal proper
inferior meatus
its the largest of the meatus
has nasolacrimal duct opening at its junction at anterior 1/3rd and posterior 2/3rds
and is guarded by a lacrimal fold called as hasners valve
middle meatus
- ethmoidal bulla: which is rounded elevation of the underlying ethmoidal sinus at the upper margin of bulla
- hiatus semilunaris is a semicurcilar sulcus bellow the bulla
- infundibulum: passageway at the anterior part of hiatus semilunaris
- frontal air sinus open as the anterior part of hiatus
- anterior ethmoidal air sinus opens behind the frontal air sinus
- maxillary air sinus open posterior part of the hiatus
superior meatus
small
annd has the opening of posterior ethmoidal sinus
sphenoethmoidal recess
triangular fossa above superior conchae that has the opening to sphenoidal air sinus
venous drainage of conchae and meatus
anteriorly to facial vein
posteriorly to pharyngeal plexus of vein
and pterygoid venous plexus
nerve supply of conchae and meatus
anteriorsuperior: anterior ethmoidal nerve branch of ophthalmic nerve
anteriorinferior: anterior superior alveolar nerve branch of IO nerve continuation of maxillary nerve
posteriorsuperior: lateral posterior superior nasal branch from pterygopalatine ganglion
posteriorinferior: anterior palatine branch for pterygopalatine ganglion
allergic rhinitis
hypertrophy of mucosa over the inferior nasal conchae causes allergic rhinitis
(sneezing, discharge of fluid)
frontal air sinus location
in the frontal bone
deep into the supraciliary arch and extends upwards to median end of eyebrow and backwards to median end of the root of the orbit
frontonasal sinus opens
in the middle meatus
- at the anterior end of the hiatus semilunaris through the infundibulum or the frontonasal duct
sinuses developmental age
7-8 years
fully at puberty
arterial
venous
lymphatic
nerve supply of frontal air sinus
aterial: supraorbital
venous: supraorbital and superior opthalmic veins
lymphaic: submandibular
nerve: supraorbital nerves
location of maxillary sinus and shape and base and apex location
in the maxillary bone
pyramidal shape with its base at the lateral wall of nose and apex at the zygomatic process of maxilla
opening
middle meatus at the lower end of hiatus semilunaris
the opening is usually at the roof
the roof and floor of maxillary sinus is made by what bones
roof is made by the floor of the orbit (IO nerve)
and floor is made by the alveolar process of maxilla
which sinus is first to develop
maxillary sinus
arterial
venous
lymphatic
nerve supply of maxillary air sinus
arterial; facial, IO and greater palatine
venous: facial and pterygoid venous plexus
lymphatic: submandibular
nerve supply: posterior superior alveolar branches of maxillary nerve
middle and anterior superior alveolar branches of infraorbital nerve
location and opening of sphenoidal air sinus
sphenoid bone
opens into sphenopalatine recess
arterial
venous
lymphatic
nerve supply of sphenoidal air sinus
arterial: posterior ethmoidal and internal carotid
venous: PTERYGOID venous plexus and cavernous sinus
lymphatic: retropharyngeal
nerve supply: posterior ethmoidal and orbital branches of pterygopalatine ganglion
anterior ethmoidal sinus location and supply and lymph
1-11 air cells
opens at the anterior end of hiatus semilunaris
anterior ethmoidal nerve and arteries
and submandibular nodes
middle ethmoidal sinus locationa nd supply and lymph
in the middle meatus
anterior ethmoidal nerve and vessels and orbital branch of pterygopalatine ganglion
submandibular nodes
posterior ethmoidal sinus location supply lymph
at the superior meatus
posterior ethmoidal nerves and vessels
orbital branch of pterygopalatine ganglion
retrophyrngeal nodes
