Please enable JavaScript.
Coggle requires JavaScript to display documents.
Nose and Paranasal Sinuses - Coggle Diagram
Nose and Paranasal Sinuses
External Nose
List the Parts of the External Nose
External Nose has a:
Root
Dorsum
Dorsum of the Nose connect the Root of the Nose to the Apex of the Nose
Apex
2 Nostrils (Naris)/ Anterior nasal apertures
Nasal Septum
Ala of Nose
External Nose is covered in Skin
Skin is thicker over the cartilages
Skin also contains sweat glands and sebaceous glands
Describe the Structure of the External Nose
External Nose is mostly made up of cartilage
Skeleton of the External Nose is made up of two main parts:
Bony Part
Cartilaginous Part
Bony Part has the following Bones:
Nasal Bone
Frontal Process of the Maxilla
Nasal Part of the Frontal Bone
Cartilaginous Part has the following Cartilages:
2 Lateral Cartilages
2 Alar Cartilages
1 Septal Cartilage
Nasal Septum
List the structures which make up the Nasal Septum
Nasal Septum is a structure which separates the Left and Right Nostrils
Nasal Septum is made up of the following structures:
Perpendicular Plate of the Ethmoid Bone
Vomer Bone
Septal Cartilage
Cribriform Plate is located above the Perpendicular plate of the Ethmoid Bone
Nasal Mucosa
Describe the Features of the Nasal Mucosa
Nasal Mucosa is bound to the Periosteum and the Perichondrium
Nasal Mucosa is continuous with the:
Nasopharynx
Paranasal Sinuses
Lacrimal Sac
Conjunctiva
Superior 1/3 of the Nasal Mucosa is the Olfactory Area (Olfactory Mucosa)
Inferior 2/3 of the Nasal Mucosa is the Respiratory Area (Respiratory Mucosa)
Squamous Mucosa is located at the tip of the Nostrils
Boundaries of the Nasal Cavity
Describe the Nasal cavity according to its Boundaries
Nasal Cavity is marked by the following boundaries:
Roof of the Nasal cavity is marked by a Curved structure of 3 parts:
Frontonasal Bone
Ethmoidal Bone
Sphenoidal Bone
Floor of the Nasal Cavity is formed by the:
Palatine Process of the Maxilla
Horizontal Plates of the Palate Bone
Medial Wall is formed by the Nasal Septum
Lateral Wall is an irregular wall formed by Nasal Concha
Nasal Concha
Outline the Features of the Nasal Concha
Nasal Concha are shell-like turbinates located on the Lateral Wall of the Nasal cavity
Organisation and structure of the Nasal Concha increases the surface area of the Nasal Cavity
This allows for a larger heat exchange
Turbinate structure of the Concha allows for a disruption in the flow of air and the humidification of air
There are 3 Nasal Conchae:
Superior Nasal Concha
Middle Nasal Concha
Inferior Nasal Concha (Largest Concha)
The Passages within the Lateral Wall of the Nasal Cavity are known as the Meatus
There are 5 Passages:
Spheno-ethmoidal Meatus (1)
Spheno-Ethmoidal Meatus is located superior-posterior to the Superior Nasal Concha
Superior Meatus
Superior Meatus is located below the Superior Nasal Concha
Middle Meatus
Middle Meatus is located below the Middle Nasal Concha
Inferior Meatus
Inferior meatus is located below the Inferior Nasal Concha
Common Nasal Concha (1)
Common Nasal Meatus is located between the Conchae and the Nasal Septum
Bones of the Nasal Conchae
List the Bones which make up the Nasal Conchae
Superior Nasal Concha and the Middle Nasal Concha are formed by the Medial Process of the Ethmoid Bone
Inferior Nasal Concha is formed by the Inferior Concha Bone
Drainage of the Concha
Describe the Pattern of Drainage of the Nasal Meatus
Spheno-Ethmoidal Meatus receives the opening of the Sphenoidal Sinus
Superior Meatus drains the Posterior Ethmoidal Sinus and Ethmoidal Bulla
Middle Meatus drains the Frontal Sinus, Maxillary Sinus and Anterior Ethmoidal Sinus via the Semilunar Hiatus
Inferior Meatus drains the Naso-Lacrimal Duct
Blood Supply to the Nose
Outline the Blood Supply to the Nose
Nose is supplied by 5 Main Blood Vessels:
Anterior Ethmoidal Artery
Anterior Ethmoidal Artery is from the Ophthalmic Artery
Posterior Ethmoidal Artery
Posterior Ethmoidal Artery is from the Ophthalmic Artery
Spheno-Palatine Artery
Spheno-Palatine Artery is from the Maxillary Artery
Greater Palatine Artery
Greater Palatine Artery is from the Maxillary Artery
Septal and Lateral Branch from the Superior Labial Artery
Septal and lateral Branch from the Superior Labial Artery are from the Facial Artery
Kiesselbach Area
Define the Kiesselbach Area
Kiesselbach Area is an anastomotic arterial plexus made up of 4 Blood Vessels
Blood Vessels which make up the Kiesselbach Area include:
Anterior Ethmoidal Artery
Posterior Ethmoidal Artery
Spheno-Palatine Artery
Greater Palatine Artery
Injury to the Blood Vessels in the Arterial Plexus of the Kiesselbach Area result in Epistaxis (Nose Bleed)
Venous Drainage of the Nose
Outline the Venous Drainage of the Nose
Venous Drainage of the Nose is via Submucosal Venous Plexus
Submucosal Venous Plexus is located deep to the Nasal Mucosa
Venous Drainage of the Nose is via the Veins of the Submucosal Venous Plexus which include:
Spheno-Palatine Veins
Ophthalmic Veins
Facial Veins
Innervation of the Nose
Describe the Innervation of the Nose
Innervation of the Nose is divided according to the Nasal Mucosa and the External Nose
Innervation of the Nasal Mucosa is divided into two main portions:
Antero-Superior Portion
Postero-Inferior Portion
Antero-Superior Portion of the Nasal Mucosa is mainly innervated by the Ophthalmic Division of the Trigeminal Nerve (CN V1)
Ophthalmic Division of the Trigeminal Nerve (CN V1) innervates the Antero-Superior Portion of the Nasal Mucosa via the following branches:
Anterior Ethmoidal Nerve
Posterior Ethmoidal Nerve
Postero-Inferior Portion is mainly innervated by the Maxillary Division of the Trigeminal Nerve (CN V2):
Maxillary Division of the Trigeminal Nerve (CN V2) innervates the Postero-Inferior Portion of the Nasal Mucosa via the following branches:
Nasopalatine Nerve
Nasopalatine Nerve innervates the Nasal Septum
Greater Palatine Nerve
Greater Palatine Nerve innervates the Lateral Wall of the Nasal Cavity
Innervation of the External Nose is divided into:
Dorsum and Apex
Ala (Wings) of the Nose
Dorsum and Apex of the External Nose is mainly innervated by the Ophthalmic Division of the Trigeminal Nerve (CN V1)
Ophthalmic Division of the Trigeminal Nerve then uses the following branches to innervates the Dorsum and Apex of the External Nose:
Infra-Trochlear
Anterior Ethmoidal Nerve
Ala of the External Nose are mainly innervated by the Maxillary Division of the Trigeminal Nerve (CN V2)
Maxillary Division of the Trigeminal Nerve (CN V2) uses the following branches to innervate the Ala of the External Nose:
Infra-Orbital Nerve
Olfactory Mucosa
Outline the Innervation of the Olfactory Mucosa
Olfactory Mucosa is innervated by the Olfactory Nerve (CN I)
Olfactory Bulb is a collection of the Olfactory Nerve branches
Pterygopalatine Fossa
Define the Pterygopalatine Fossa
Pterygopalatine Fossa is a pyramidal space from the Infra-temporal Fossa to the Nasal Cavity
Describe the Pterygopalatine Fossa according to its Borders
Pterygopalatine Fossa is marked by the following borders:
Anterior: Maxillary Sinus
Posterior Border: Pterygoid Process of the Sphenoid Bone
Lateral Border: Pterygo-Maxillary Fissure
Medial Border: Perpendicular Plate of the Palatine Bone
Inferior Border: Palatine Bone
Superior Border: Infra-Orbital Fissure
Pterygopalatine Fossa
List the Contents of the Pterygopalatine Fossa
Pterygopalatine Fossa has the following contents:
Maxillary Artery
Specifically the Pterygopalatine Part
Maxillary Artery branches including the:
Sphenopalatine Artery
Greater Palatine Artery
Associated veins
Maxillary Division of the Trigeminal Nerve (CN V2)
Pterygopalatine Ganglion
Pterygopalatine Ganglion is the largest parasympathetic ganglion
Receives Parasympathetic Fibres from Greater Petrosal Nerve (Branch of the CN VII)
Post-Ganglionic Fibres are secretomotor in function and supply the Lacrimal Gland and Mucosal Glands of the Oral Cavity, Nose and Pharynx
Pterygopalatine Fossa is surrounded by a Fatty Matrix
Paranasal Sinuses
Define Paranasal Sinuses
Paranasal sinuses are air-filled extension of the Respiratory Part of the Nasal Cavity into the following bones:
Frontal Bone
Ethmoidal Bone
Sphenoidal Bone
Maxillary Bone
List the Types of Sinuses
There are 4 types of Sinuses:
Frontal Sinus
Ethmoidal Sinus
Sphenoidal Sinus
Maxillary Sinus
Describe the Innervation of the Paranasal Sinuses
Frontal Sinus, Ethmoidal Sinus, and Sphenoidal Sinus are innervated Ophthalmic Division of the Trigeminal Nerve (CN V1)
Maxillary Sinus is innervated by the Maxillary Division of the Trigeminal Nerve (CN V2)
Frontal Sinuses
Describe the features of the Frontal Sinus
Frontal Sinuses are located between the Outer and Inner tables of the Frontal Bone, Posterior to the Superciliary Arch and the Root of the Nose
Frontal Sinuses are drained via the Fronto-Nasal Duct through the Semi-Lunar Hiatus into the Middle Meatus
Frontal Sinuses are the main region of pain in Sinusitis
Outline the Innervation of the Frontal Sinuses
Frontal Sinuses are innervated by the Supra-orbital Branches
Supra-Orbital Branches of the Ophthalmic Division of the Trigeminal nerve (CN V1)
Ethmoidal Sinus (Cells)
Outline the features of the Ethmoidal Sinus
Ethmoidal Sinuses are formed by the invagination of the mucous membrane of the Superior Nasal Meatus into the Ethmoidal Bone
Ethmoidal Sinuses are not easily visible in thee Radiographs but more visible in the CT Scans
There are 3 Ethmoidal Sinuses:
Anterior Ethmoidal Sinus
Anterior Ethmoidal Sinus is drained by the Middle Nasal Meatus via the Semilunar Hiatus
Middle Ethmoidal Sinus
Middle Ethmoidal Sinus forms the Ethmoidal Bulla
Ethmoidal Bulla drain in to the Superior Nasal Meatus
Posterior Ethmoidal Sinus
Posterior Ethmoidal Sinus drains into the Superior Nasal Meatus
Outline the Innervation of the Ethmoidal Sinus
Ethmoidal Sinuses is innervated by the Anterior Ethmoidal Nerve and Posterior Ethmoidal Nerve
Anterior Ethmoidal Nerve and Posterior Ethmoidal Nerve are part of the Nasociliary Branch
Nasociliary Branch belong to the Ophthalmic Division of the Trigeminal Nerve (CN V1)
Sphenoidal Sinuses
Describe the Features of the Sphenoidal Sinuses
Sphenoidal Sinuses are located int he Body of the Sphenoid Bone
Sphenoid Bone is fragile due to extensive Pneumatisation
Sphenoidal Sinus drains into the Spheno-Ethmoidal Meatus
Outline the Innervation of the Sphenoidal Sinus
Sphenoidal Sinus is innervated by the Posterior Ethmoidal Nerve
Posterior Ethmoidal Nerve belongs to the Nasociliary Branches of the Ophthalmic Division of the Trigeminal Nerve
Maxillary Sinus
Outline the features of the Maxillary Sinus
Maxillary Sinus is the largest paranasal sinus
Maxillary Sinuses occupy the body of the Maxillary Bone
Maxillary Sinus drains into the Middle Nasal Meatus via the Semilunar Hiatus
Outline the Innervation of the Maxillary Sinus
Maxillary Sinus is innervated by the Anterior, Middle and Posterior Branches of the Superior Alveolar Nerves
Superior Alveolar Nerves belong to the Maxillary Division of the Trigeminal Nerve (CN V2)
Describe the Maxillary Sinus according to its Borders
Maxillary Sinus is lined by the following borders:
Apex: Zygomatic Bone
Base: Forms the Inferior Part of the Floor of the Lateral Wall of the Nasal Cavity
Roof: Formed by the Floor of the Orbit
Floor: Formed by Alveolar of the Maxilla
Allergic Rhinitis and Acute Sinusitis
Differentiate between Allergic Rhinitis and Acute Sinusitis
In Allergic Rhinitis:
Frontal Sinus, Ethmoidal Sinus and Maxillary Sinus have clear contents
Middle Nasal Meatus have clear contents
There is Nasal Obstruction
Clear water discharge
In Acute Sinusitis:
Frontal Sinus, Ethmoidal Sinus and Maxillary Sinus are inflamed and purulent
Middle Nasal Meatus has indications of astial inflammation
Nasal Obstruction
Purulent Discharge
Deviated Septum
Deviated Septum refers to when the Nasal Septum separating the Left and Right Nostrils has deviated to the right or left
Epistaxis
Epistaxis occurs when there is an injury to the 4 blood vessels of the Kiesselbach Area resulting in an Anterior Nose Bleed
More commonly seen in adolescents and children due to nose-picking
Epistaxis can occur when there has been injury to the Woodruff's Plexus resulting in Posterior Nose Bleeds
This is associated with Hypertension and Atherosclerosis
More commonly seen in adults
