Pterygopalatine fossa and Nasal Cavity

Question 1

What are the types of cartilage that make up the nose?

Answer 1

Lateral cartilage x2
Alar cartilage x2
Spetal cartilage

Question 2

What makes up the nasal septum?

Answer 2

Perpendicular plate of ethmoid bone
Septal cartilage
Vomer
nasal crests of maxillary and palatine bones

Question 3

What is the role of the nasal concha? Which nasal concha are part the ethmoid bone and which are their own?

Answer 3

Increase surface area which is important in warming and cooling

Superior and middle are part of ethmoid
Inferior own bone

Question 4

What part of the nasal cavity is not lined with nasal mucosa?

Answer 4

Vestibule of the nose

Question 5

Where is the nasal mucosa connected?

Answer 5

Firmly connected to the periosteum of the bony parts of the nasal cavity and perichondrium of the cartilaginous nasal components

Makes up respiratory (inferior 2/3) and olfactory (superior 1/3) areas

Question 6

What are the boundaries of the nasal cavity?

Answer 6

Roof= frontal bone, ethmoid bone, sphenoid bone
Floor= palatine process of maxilla, horizontal plate of palatine bone
Medial Wall= nasal septum
Lateral wall= superior, middle, and inferior nasal conchae

Question 7

What does the spheno-ethmoidal recess drain?

Answer 7

sphenoid sinus

Question 8

What does the superior nasal meatus drain?

Answer 8

Ethmoidal sinuses

Question 9

What does the middle nasal meatus drain?

Answer 9

Frontal sinus
Also maxillary sinus opens into in posterior part of semilunar hiatus at the maxillary ostium below the ethmoid bulla
Anterior and meiddle ethmoid sinus

Question 10

What does the inferior nasal meatus drain?

Answer 10

Nasolacrimal duct, most inferior

Question 11

What is the arterial supply to the nasal cavity?

Answer 11

Maxillary a.: mainly sphenoplatine a. but also anterior and posterior ethmoidal aa. and greater palatine

Anastomoses with facial artery: superior labial a. and lateral nasal branches

Question 12

What is the venous drainage of the nasal cavity?

Answer 12

Sphenopalatine, facial, and ophthalmic veins

Question 13

What is the drainage, arterial supply and innervation of the maxillary sinus?

Answer 13

Maxillary ostium into the middle meatus

Superior alveolar branches of maxillary a. and greater palatine a.

Superior alveolar nerve branches (CN V2)

Question 14

What is the drainage, arterial supply, and innervation of the ethmoid sinus?

Answer 14

Anterior and middle cells drain into middle meatus
Posterior drain into superior meatus

ethmoidal aa. (from ophthalmic a.)

nasociliary nerves (CN V1)

Question 15

What is the drainage, arterial supply, and innervation of the sphenoid sinus?

Answer 15

Unevenly divided by bony part of septum, drains via spheno-ethmoidal a.

posterior ethmoidal a.

posterior ethmoidal n. (CN V1)

Question 16

What is the location, drainage, arterial supply, and innervation of the frontal sinus?

Answer 16

Between out and inner tables of frontal bone, posterior to superciliary arches

Frontonasal duct into semilunar hiatus of middle meatus

suproribtal a. and anteriro ethmoidal aa.

supraorbital nerves (CN V1)

Question 17

What are the borders of the pterygopalatine fossa?

Answer 17

Anterior= maxillary tuberosity
Posterior= pterygoid process of spehnoid (lateral plate) 
Medial= perpendicular plate of palatine bone 
Lateral= infratemporal fossa via pterygomaxillary fissure 
Roof= greater wing of sphenoid 
Floor= pyramidal process of palatine bone

Question 18

What is the superior opening of the pterygopalatine fossa? Inferior opening?

Answer 18

inferior orbital fissure

closed except for palatine foramen

Question 19

What passes through the inferior orbital fissure of the pterygopalatine fossa?

Answer 19

Infraorbital n. with infraorbital a.
Zygomatic n. with inferior opthalmic v.
Orbital branches (CN V2)

Question 20

What passes through the foramen rotundum of the pterygopalatine fossa?

Answer 20

Maxillary n (CN V2)

Question 21

What passes through the pterygoid canal of the pterygopalatine fossa?

Answer 21

N. of pterygoid canal (greater and deep petrosal nerves) with a. and v. of the pterygoid canal

Question 22

What passes through the greater palatine canal of the pterygopalatine fossa?

Answer 22

Greater palatine n.

Descending and greater palatine aa.

Question 23

What passes through the lesser palatine canal of the pterygopalatine fossa?

Answer 23

Lesser palatine n. and lesser palatine a. (terminal branch of descending)

Question 24

What passes through the sphenopalatine foramen of the pterygopalatine fossa?

Answer 24

Nasopalatine . CN V2
- medial and lateral posterior superior and posterior inferior nasal branches
Spehnopalatine a. and v.

Question 25

What is the path of parasympathetic fibers in the pterygopalatine fossa?

Answer 25

Facial N. (CN VII) –> greater petrosal n. –> parasympathetic fibers to pterygopalatine ganglion via pterygoid canal
- synapse to nasal cavity (spenopalatine nerves), parynx (pharyngeal branch), palate (greater and lesser palatine nerves)
OR
ascend on Maxillary (CN V2) –> Zygomatic n –> communicating branch –> lacrimal nerve (CN V1) –> lacrimal gland

Question 26

What forms the nerve to the pterygoid canal?

Answer 26

greater petrosal and deep petrosal nerves

Question 27

How do the sympathetic fibers of the pterygopalatine fossa travel?

Answer 27

Presynaptic sympathetic fibers are from superior cervical region

Deep petrosal n. from internal carotid plexus and conveys postsynaptic sympathetic fibers which join branches of the maxillary n. via the pterygopalatine ganglion (don’t synapse there)