Pterygopalatine Fossa/ Nasal Cavity

Question 1

Nasal Cavity Innervation

Answer 1

CN 1

CN V1

CN V2

Question 2

Nasal Cavity Blood Supply

Answer 2

Maxillary A
    Sphenopalatine A
    Anterior and posterio 
      ethomoidal As 
    Greater palatine A

Facial A
Superior labial A
Lateral nasal branches

Anastamose–> Kiesselbach area

Question 3

Nasal Cavity Venous Drainage

Answer 3

drain to sphenopalatine, facial and ophthalmic veins–> cavernous sinus

Question 4

What is the main cause of epistaxis?

Answer 4

Trauma–> bleeding from anterior 1/3 of nose via *Kiesselbach area

*facial and maxillary A anastomoses

Question 5

Pterygopalatine Fossa Bounderies

Answer 5

Anterior: Maxillary tuberosity

Posterior: lateral pterygoid plate

Medial: perpendicular plate of palatine

Lateral: infratemporal fossa

Roof: greater wing of sphenoid

floor: pyramidal process of palatine bone

Question 6

Pterygopalatine Contents

Answer 6

CN V2

Pterygopalatine ganglion

3rd part of maxillary A

Question 7

Maxillary A contribution to nasal region

Answer 7

Pterygopalatine portion:

Sphenopalatine A to nasal cavity

Infraorbital A to eye

Posterior superior alveolar A to teeth

Question 8

Nerves r/t Pterygopalatine Ganglion

Answer 8

Maxillary N (CN V3)
---> Zygomaticotemporal N and Pterygopalatine N

Facial N (CN VII) via autonomics
---> greater petrosal N

Question 9

Pterygopalatine Ganglion r/t Glands

Answer 9

Facial nerve–> Greater petrosal N that synapses in pterygopalatine ganglion

joins deep petrosal N (postsynaptic symp.) from internal carotid plexus —> N to Pterygoid Canal

Sympathetic: palatinen glands, mucosa glands of pharynx and nasal cavity

Parasympathetic: lacrimal glands, nasal cavity, palate, pharynx mucus glands (hitch ride on zygomaticotemporal N of maxillary N)

Question 10

Bones of nasal cavity

Answer 10

Frontal
Nasal
Sphenoid
Ethmoid
  --->superior and middle 
         nasal conchae
Inferior nasal concha
Maxilla
Palatine

Question 11

Nasal cavity mucosa

Answer 11

Olfactory area: superior 1/3, house CN 1 nerve endins

Respiratory: inferior 2/3 (middle and inferior conchae area)

Question 12

Nasal cavity boundaries

Answer 12

Roof: frontal, ethmoid sphenoid

Floor: palatine process of maxilla, horizontal plate of palatine bone

Medial wall: nasal septum

Lateral wall: conchae

Question 13

Nasal Conchae

Answer 13

Divide nasal cavity in to 4 passages

Superior and middle are part of ethmoid bone

Inferior is separate bone

Question 14

What is the opening of the sphenoid sinus?

Answer 14

Spheno-ethmoidal recess (above superior nasal concha)

Question 15

What is the opening for the ethmoid sinuses?

Answer 15

Superior nasal meatus (under concha)–> posterior ethmoid sinus

Middle nasal meatus–> anterior and middle ethmoid sinuses

Question 16

What is the opening for the frontal sinus?

Answer 16

Middle nasal meatus under concha

Question 17

What is the opening for the nasolacrimal duct?

Answer 17

Inferior nasal meatus under concha

Question 18

What is the opening for the maxillary sinus?

Answer 18

Maxillary ostium

—> posterior part of semilunar hiatus of MIDDLE nasal meatus

Question 19

Maxillary Paranasal Sinus

Answer 19

CN V2: superior alveolar branches

Superior alveolar branches of Maxillary A and greater palatine A

LARGEST SINUS

drains via maxillary ostium into middle meatus

Question 20

Ethmoid Paranasal Sinus

Answer 20

CN V1: nasociliary N

Ethmoidal A from ophthalmic As (ICA)

Air cells b/t orbits

Anterior and middle drain into middle meatus

Posterior drains into superior meatus

Question 21

Sphenoid Paranasal Sinus

Answer 21

CN V1: Posterior ethmoidal N

Posterior ethmoidal A via ophthalmic A (ICA)

drains via spheno-ethmoidal recess

unevenly divided by bony part of nasal septum

Question 22

Frontal Paranasal Sinus

Answer 22

CN V1: supraorbital N

Supraorbital and anterior ethmoidal As via ophthalmic A (ICA)

b/t outer and inner frontal bone, posterior to supercililary arches

drains via frontonasal duct into semilunar hiatus of middle meatus

Question 23

What sinus allow surgical access to pterygopalatine fossa?

Answer 23

Maxillary sinus