Rogeli Montallana Cagulada Dentristry 1-C

Anatomy of Nose

INTRODUCTION
Nose performs two functions:
- Respiratory passage
-Organ of smell
Receptors of smell are placed in the upper one third of the nasal cavity and this is lined by
respiratory mucosa.
This Mucosa is highly vascular and warms the Inspired air.
The secretions of the serous glands make the air moist and secretions of the mucous glands
trap dust and other particles.

NASAL CAVITY
It extends from the Nostrils to the posterior Nasal apertures.
It is divided into right and left half by Nasal septum.
Each half has- Roof, Floor, Lateral & Medial walls
The Middle horizontal part is formed by the Cribriform plate of the Ethmoid.
The anterior slope is formed by the Nasal part of Frontal bone, Nasal bone &Nasal cartilages.
The Floor is formed by the Palatine process of Maxilla &Horizontal plate of Palatine bone

. NASAL SEPTUM
It is an Osteo cartilagineous partition b/w the two halves, which form the medial wall of both
cavities.
Bony part is formed by: - Vomer - Perpendicular plate of Ethmoid
Cartilagenous part is formed by: -Septal cartilage -Septal process of Inf nasal cartls
Cuticular part (lower end) is formed by Fibro fatty tissue, covered by skin.
Lower margin of the septum is called as Columella.
Nasal septum is strictly median,if at all is deflected, is produced by the over growth of one or
more constituent parts.

BLOOD SUPPLY
Ant sup part :- Ant Ethmoidal artery -Sup Lab branch of Facial artery Postero Inf part:-
Sphenlpalatine artery
Ant Inf part( vestibule):-Anast b/w Lab branch of Facial artery and Sphenopalatine artery.
This is common site of Bleeding from Nose (EPISTAXIS), known as Littles area/ Kiesselbachs
area

VENOUS DRAINAGE
The veins form a Plexus in the lower part of the septum- LITTLES AREA
The plexus drains anteriorly into facial vein and post by Sphenopalatine vein to Pterygoid
venous plexus.
Lymphatic drainage: Ant half: by submandibular nodes. Post half: to the retro pharyngeal &
deep cervical nodes
NERVE SUPPLY
General sensory nerves: Trigeminal nerve. A) Ant sup part :- Int nasal branch of Ant Ethmoidal
nerve B)Post Inf part :-Nasopalatine branch of Pterygopalatine ganglion.
Special sensory nerves (Olfactory) are confined to upper part (Olfactory area)

LATERAL WALL OF NOSE
It contains 3 bony projections called CONCHAE, these increase the surface area for effective
conditioning of the air.
Lateral wall separates the Nose from: A) Orbit above by Ethmoidal air sinus B) Max sinus
below C) Lacrimal groove &Naso lacrimal canal in front

o It can be subdivided into 3 parts:A) small depressed area in the ant area called
Vestibule, lined by modified skin containing short stiff curved hairs called Vibrissae. B)
Middle part is known as the Atrium of the middle meatus. C)Post part contains Conchae,
spaces separating Conchae are called Meatus.
o Skeleton of Lateral wall:- partly bony & partly Cartilagenous.
o Bony part:- Nasal, Frontal process of Max, Lacrimal, Labrinth of Ethmoid with sup and
middle conchae, Inf nasal concha, Perpendicular plate of Palatine bone together with
Orbital and Sphenoidal process, and medial pterygoid plate.
o Cartilaginous part:- Upper & Lower nasal cartilage, 3 or 4 small cartilages of ala.

NASAL BONE MIDDLE NASAL CHONCHA NASAL SPINE SUP NASAL CHONCHA NASAL SEPTUM
Cuticular part:- is formed by the fibro fatty tissue covered with skin. It contains:-
A)Nasal concha- 3 in nos
1)Inf concha-is an independent bone
2)Middle concha- projections from the medial surface of the Ethmoidal
labyrinth
3)Sup concha- also a projection from Ethmoidal labyrinth
B) Meatus of the Nose:- They are the passages beneath the over hanging concha.
1)Inf meatus- it is the largest and lies underneath the Inf conchae. Naso-
lacrimal duct opens into it, the opening is guarded by the Hasners valve/ Lacrimal fold.
2)Middle meatus- lies underneath the middle concha, contains: -
Ethmoidal bulla -Hiatus Semilunaris -Infundibulum -Opening of Frontal air sinus -Opening of
Max air sinus -Openingwww.indiandentalacademy.com of Middle Ethmoidal sinus

ATRERIAL SUPPLY
Ant Sup quadrant:- Ant Ethmoidal artery, assisted by Post Ethmoidal and Facial arteries.
Ant Inf quadrant:-Branches of Facial and Gr palatine artery
Post Sup quadrant:-Sphenopalatine artery
Post Inf quadrant:-Branches of Gr Palatine artery
Venous drainage:- Form a Plexus which drains Ant into Facial vein, Post into Pharyngeal
Plaexus of veins, and middle into Pterygoid Plexus of veins.


NERVE SUPPLY
General sensory nerves:- from Trigeminal nerve
1)Ant Sup quadrant- Ant Ethmoidal nerve(branch of Ophthalmic
nerve)
2)Ant Inf quadrant-Ant Sup alveolar nerve(Max nerve)
3)Post Sup quadrant-Post Sup lateral nasal nerve from
Pterygopalatine ganglion( max nerve)
4)Post inf quadrant-Ant Palatine branch from Pterygopalatine
ganglion( Max nerve)
Special sensory nerve (Olfactory):They are distributed to the upper part of the Lat wall just
below the Cribriform plate of the Ethmoid upto the Sup Conchae. Note:- All Olfactory mucosa
lies partly on nasal septum and Lateral wall.
Lymphatic drainage:- Ant half passes to the Submandibular nodes, Post half Retro Pharyngeal,
and upper deep cervical nodes.

APPLIED ANATOMY
TRAUMA:- fractures involving nasal bones are common. due to the direct blow nasal bones
are displaced downward and inward.
Lateral fractures also occur in which one nasal bone is driven inward and the other
outward.
Nasal septum is usually involved.
INFECTION:- common cold(rhinitis) is the commonest infection of the nose.
Hypertrophy of mucosa over the inferior nasal concha is a common feature of allergic
rhinitis characterized by sneezing blockage and excessive discharge from nose.
Infection of nasal cavity can spread in a variety of directions. Paranasal sinuses are
especially prone to infection.
Organisms may spread via the nasal part of the pharynx and the auditory tube to the
middle ear.
It is also possible to ascend to the meninges of the anterior cranial fossa, along the
sheaths of the olfactory nerves through the cibriform plate, and produce meningitis.
Dangerous area of face:- deep connections of the facial vein include a) comm between
supraorbital and superior opthalamic veins b) with the pterygoid venous plexus through the
deep facial vein. The facial vein comm with the cavernous sinus through these connections.
Infections of the upper lip and in lower part of the nose can spread in retrograde direction and
cause thrombosis of the cavarnous sinus.