Download Nose and paranasal sinuses

‫بسم هللا الرمحن الرحيم‬
By
Dr. Adel Sahib Al-Mayaly
Nose
External nose
Nasal cavity
paranasal sinuses
Introduction
 The nose is an integral part of the respiratory tract.
 It contains the peripheral organ of smell (Olfactory
area).
 It is a resonating chamber for voice
 It includes the external nose and nasal cavity
 The nasal cavity is divided into right and left cavities
by the nasal septum (midline partition).
Functions of the nose
 1- Olfaction (smelling).
 2- Respiration (breathing),
 3- Filtration of dust.
 4- Humidification of inspired air.
 5- Reception and elimination of secretions from the
paranasal sinuses and nasolacrimal ducts.
 6- Resonating chamber.
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Nasal profile
External Nose
 The external nose triangular-shaped projection in the center of
the face .
 It consists of osteocartilaginous framework covered by muscles
and skin.
 Its upper end or root is continuous with the forehead
 . At its lower end (base) are the nares (nostrils).
 The sides of the nose meet in the midline anteriorly to form the
dorsum.
 The upper part of the dorsum is the bridge and at the
 lower end of the dorsum is the tip of the nose.
 The lower flared part of the side of the nose is the ala.
The external nose
The framework of the external nose
 It is made up
 1- Above by:- Bony
 the nasal bones, the frontal processes of the maxillae,
and the nasal process of the frontal bone
 2- Below:- Cartilaginous
 the framework is formed of plates of hyaline cartilage
 ( two upper lateral, two alar & septal process).
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The external nose
Framework(bony)
Blood Supply of the External Nose
 The skin of the external nose is supplied by branches
of the ophthalmic and the maxillary arteries
 The skin of the ala and the lower part of the septum
are supplied by branches from the facial artery.
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Nasal Cavity
 It extends from; the nostrils in front to the posterior nasal apertures
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or choanae behind.
it is divided into two cavities by the nasal septum.
Each cavity has 4 walls:1- Medial & lateral.
2- Roof & floor
Nasal cavity
 Nasal vestibule:- is the anterior and inferior part
of nasal cavity.
 It is lined by skin and contains sebaceous glands,hair
follicles and hair(vibrissae) easy to infection.
The lateral wall
 has three projections of bone called (turbinates or conchae)
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superior, middle, and inferior nasal conchae
The space below each concha is called a meatus.
Inferior, Middle & Superior meati
Sphenoethmoidal Recess
is a small area above the superior concha. It receives the
opening of the sphenoid air sinus
Lateral wall
Middle Meatus
 The middle turbinate has by far the greatest functional
importance.
 Most of the drainage tracts from the surrounding paranasal
sinuses open into the middle meatus.
 Maxillary , frontal & anterior ethmoid sinuses
 Collectively called anterior group
Medial Wall (Nasal septum)
 The nasal septum has a:
 •Bony part
 •Cartilaginous part
 •Membranous part
Components of nasal septum
 Bony part:
 •Posterosuperiorly: The perpendicular plate of the
ethmoid.
 •Posteroinferiorly: Vomer BONE
 Cartilaginous part:
 •Anteriorly quadrilateral septal cartilage
 •Medial crus of the alar cartilage
 Membranous part:
 •This is the anterior most part of the nasal septum lined by
skin and fibrofatty tissue.
Septum deviation
Result in－
Nasal obstruction
Nasal bleeding
Headache
Anosmia
Sinusitis
External deformity
Roof & Floor
 Roof :- Is by cribriform plate of ethmoid
 Floor:- Hard palate. a- palatal processes of palatine
bone & horizontal plates of maxilla
Arterial supply of the nose
 Sphenopalatine artery; - It is a branch from the maxillary artery (main arterial
supply).
 Septal branch of the superior labial artery from facial
artery.
 Septal branch of the superior
from facial artery.
labial artery
Arterial supply of the nose
 3- Ascending branch of the greater palatine artery
 4- Anterior & post. Ethmoidal Aa.
(Little’s area). Or
“Kieselbach's plexus
This area is a
common site for
epistaxis (bleeding
from the nose).
Paranasal sinuses
 Are air-filled spaces in the facial & skull bones
 The paranasal sinuses consist of the paired frontal,
ethmoid ,maxillary, and sphenoid sinuses.
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Maxillary Sinus
 The maxillary sinus usually is the largest of the paranasal sinuses
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and is situated in the body of the maxilla.
Anterior wall:- The facial surface of maxilla.
Posterior wall:- The infratemporal surface.
Medial wall :- The nasal cavity.
The roof:Floor of the orbit.
the floor is related to the roots of the premolars and molar
teeth.
 The maxillary sinus drains into the middle meatus of the nasal
cavity
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Ethmoid Sinuses
 1he ethmoid sinuses consist of a variable number of
separate cavities.
It lies between the upper part of the lateral nasal wall
and the medial wall of the o:rbit.
Each sinus is divided into
1- anterior ethmoid sinus: - drains into middle meatus
2- posterior ethmoid
:- drains into the superior
meatus
Frontal Sinuses
 The two frontal sinuses are contained within the frontal
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bone.
They are separated from each other by
a 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.
Each frontal sinus opens into the middle meatus via the
nasofrontal recess.
Sphenoid Sinuses
 The two sphenoid sinuses lie within the body of the
sphenoid bone
 Each sinus opens into the sphenoethmoidal recess
above the superior concha.
Paranasal Sinuses and Their Site of
Drainage into the Nose
Sinus
Site of Drainage
1- Maxillary sinus
2- Frontal sinuses
Middle meatus
Middle meatus
3- Sphenoid sinuses
4- Ethmoid sinuses
Anterior
Sphenoethmoidal recess
Posterior
Middle meatus
Superior meatus
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