Please enable JavaScript.
Coggle requires JavaScript to display documents.
Applied Anatomy & Physiology of Nose & Paranal sinuses :sunflower:
Applied Anatomy & Physiology of Nose & Paranal sinuses
:sunflower:
External nose
Structures
Skin
Muscle
Bone
Nasal bone
Frontal process of maxilla
Piriform aperture รูที่กระดูกด้านล่างเปิดสู่ External nose
Cartilage
Upper lateral cartilages
Lower lateral cartilages
Medial crus
Lateral crus
Control patency of nasal vestibule
Alar collapse
Mucosa
Medial nose?
Nasal septum
Vomer bone
Horizontal plate of palatine bone
Palatine process of maxilla
Septal cartilage
Deviated
nasal septum
Causes
Development
Post-traumatic
Symptoms
Nasal obstruction
Sinusitis
Perpendicular plate of ethmoid bone
Nasal vestibules
Respiratory
region
Olfactory
region
Nasopharynx
Auditory tube opening
Nasal valve
Surrounded by
Junction between upper & lower lateral cartilages
Septum
Anterior end of Inferior turbinate
Isthmus region (resistant 50%)
Muscle dilator naris (innervate by CN7)
Lateral nasal wall
Turbinate or concha
Inferior
Middle
+- Supreme
Superior
Meatus
Mee correlate to
Turbinate
Inferior
Nasolacrimal duct
(Valve of Hasner or Plica lacrimalis)
Middle
(
Osteomeatal complex contain these 3)
Frontal sinus
Ant. Ethmoid sinus
Maxillary sinus
Superior
Post. Ethmoid sinus
Opening of ...
Sphenoethmoidal recess
Sphenoid sinus
Nasal mucosa
:rabbit2:
Epithelium
Keratinized, stratified squamous
Pseudostratified ciliated columnar
Ciliated columnar cell
Non-ciliated columnar cell
Goblet cell
Basal cell
Olfactory
:rabbit2:
Basement mb
:rabbit2:
Laminate propia
(nasal submucosa)
Connective tissue
WBC (mononuclear cells)
Nasal gland
Nerve
Vessels
Blood vessels
Resistance:
Arterioles
Exchange:
Capillaries
Shunt:
Arteriovenous
Capacitances (nasal airway resistance): :star:
Venous sinus
—
Cavernous sinusoid
Nasal glands
Anterior serous gland
Vestibule
Seromucous gland
Located Submucosa
Serous
: mucous =
8
: 1
Found in Trachea, Bronchi
Intraepithelial gland
Paranasal air sinuses
(PNS)
Frontal sinus
Ethmoid sinus
Maxillary sinus
Sphenoid sinus
Superior
Pituitary gland
Optic nerve
Lateral
:star:Cavernous sinus
Internal carotid a
CN 3, 4, 6, 5(1), 5(2)
Posterior
Film
Film PNS (Water’s view)
or Occipitomental view or Nose-chin position
Maxillary sinus
Sphenoid sinus (if อ้าปาก)
Film PNS (Caldwell’s view)
Frontal sinus
Ethmoid sinus
CT: coronal, axial & sagittal For
Frontal sinus
Develop-Xrays
Vascular & Lymphatic supply
:<3:
External nose
Arterial
supply
ECA
br into
Facial a.
Superior labial a.
Lateral nasal a.
Angular a.
ICA
Br into
Dorsal nasal a.
External nasal a.
Venous
drainage
(
no valves
):star:
⇦
Ant. Facial v.
⇦ Common facial v.
IJV
⇦
Angular v.
⇦ Inf. Ophthalmic v.
Cavernous sinus
⇦
Ant. Facial v.
⇦ Infraorbital v.
⇦ Pterygoid venous plexus
Cavernous sinus
Danger triangle of Face
as no valves so infection can spread to all
Lympathic drainage
Lympathic vv. around Ant. Facial v.
⇨ Submandibular nodes
:star::star:
Nasal cavity & PNS
Arterial supply
⇦
ECA
Ophthalmic a.
Ant. & Post. Ethmoidal a.
Supraorbiral & Supratrochlear a.
⇦
ICA
Internal maxillary a.
:star:
Sphenopalatine a.
:star:
Descending palatine a.
Infraorbital, Posterosuperior alveolar, Anterosuperior alveolar a.
Pharyngeal a.
Superior labial a.
Kisselbach’s plexus
/ Little’s area
Anterior ethmoid (ICA)
Superior labial a (Facial)
Sphenopalatine a (IMAX)
Greater palatine a (IMAX)
Woodruff’s plexus
Sphenopalatine a.(pharyngeal & nasal branches) (IMAX)
Posterior ethmoid (ICA)
Venous
drainage
⇦
Supratrochlear/supraorbital/Ant&Post ethmoidal v.
⇦ Ophthalmic v.
Cavernous sinus
⇦
SP/Alveolar/Palatine v,
⇦ Maxillary v.
⇦ Posterior facial v.
⇦ Common facial v.
IJV
Lymphatic
drainage
Ant. 1/3
of nasal cavity,
Frontal, Maxillary, Ant. Ethmoid
Lympathic vv around
Ant. Facial v.
⇨ Submandibular nodes
Post. 2/3
of nasal cavity,
Post. Ethmoid, Sphenoid
Retropharyngeal nodes (Node of Rouviere)
Neural supply
Olfactory n.
Sensory n. ⇨ CN5(1), 5(2)
Autonomic innervation
Sympathetic system
Superior cervical gg.
Supply blood vv.
#
Vasoconstriction
⇨ :arrow_down: nasal airway resistance
Parasympathetic system
Pterygopalatine gg,
Supply blood vv & nasal gl.
#
Vasodilatation & Glandular secretion
Physiology of Nose
:one:
Breathing
Obligate nasal breathing (not until 6-9 mo ถึงจะหายใจทางปากได้)
Nasal cycle
Nasal valve ⇨ Turbulent flow
Func
Adjust Temp & Humidify Air
Filter air & Protect Lower airway
Mucous blanket
(dust > 4 micron)
Sol
layer
(preciliary layer)
Gel
layer
(mucous layer)
Nasal mucociliary clearance
Cilia ส่วนต้น ⇨ พัดออกนอกจมูก
Cilia ส่วนหลัง ⇨ พัดลงคอ
Prolonged
mucociliary transport time
Infection
Dehydration
Trauma
Atrophic rhinitis
Cystic fibrosis
Lysozyme, Lactoferrin, oxidized form of Thiocyanate, IgA, IgG
Bacteria flora (S. Viridans)
:two:
Smell
Olfactory mucosa
Volatile substance
water&fat soluble จะรับกลิ่นได้ดี
Vomeronasal organ
จุดบุ๋มตรง septum
:three:
ออกเสียง
Hyponasal voice may cause fr Sick or บีบจมูก
:four: ถ่ายเทอากาศ & รับของเหลวจาก nearby organ
Nasolacrimal duct
Eustachian tube
Physiology of Sinuses
Resonance (เสียงก้องกังวาน)
Perceive odor
Adjust by Humidify & Warm air
Makes skull เบา & keep balance
Shock absorbance ( :arrow_down: severity fr กระทบกระแทก)
พยุง upper air way when อยู่ในน้ำ
ฉนวนป้องกัน skull & eyeballs fr too hot or cold
Adjust pressure within nasal cavity
Defense mech of Sinuses
Mucociliary transport - cilia
Patency of sinus ostia
Paranasal secretion - Ig, NO