NOSE / HIDUNG / OS NASALE

 Is a part of the respiratory tract superior to the hard palate

ex : pernafasan cuping hidung
 Contains the peripheral organ of smell
 Includes the external nose and nasal cavity

Functions
ᵹ Olfaction (smelling)
ᵹ Respiration
ᵹ Filtration of dust
ᵹ Humidification of inspired air
ᵹ Reception and elimination of secretions form the paranasal sinuses and nasolacrimal ducts.

External nose / Nasi externus

Pyramid shape:
* Apex nasi / tip
* Bridge / radix / pangkal
* Nares anterior
* Alae nasi

҈ Skeleton of the external nose

҈ Nasal septum / septum nasi  kalo terjadi deviasi akan terjadi turbulensi dari udara

Skeleton of the external nose

❶ Bone / tulang (1/3 tulang atas)
❷ Cartilage / cartilago / tulang rawan  karena itu sering terjadi fraktur

❶ Bony part / Kerangka tulang

√ Os Nasale
√ Proc. Frontalis os maxilla
√ Proc. Nasalis ossis frontalis

❷ Cartilaginous Part / Kerangka Tulang Rawan

Formed By :
∆ Cartilago nasi lateralis (2)
∆ Cartilago alaris major (2)
∆ Cartilago alaris minor (2)
∆ Cartilago septi nasi (1)

Nasal Fractures (karena terbuat dari tulang rawan)

Ø Common because of the prominence of the nose
Ø Complication : deformation of the nose and epistaxis
Ø Severe injury : fracture of the cribiform plate

Muscle / Otot
1. M. Procerus
2. M. Levator labii superioris alaque nasi
3. M. Nasalis pars transversa
4. M. Nasalis pars alaris
Tujuan : alae nasi menjadi lebih besar pada pernafasan cuping hidung  ventilasi menjadi lancar

Nasal Cavity / Cavum Nasi

Ѡ Divided into right and left halves by the nasal septum
Ѡ Open anteriorly through the nares
Ѡ Open posteriorly through the choanae / choana
Ѡ Mucosa lines the nasal cavity except for the nasal vestibule / vestibulum nasi, which is lined with the
skin (sering terjadi deviasi pada tulang rawan)

Nasal Cavity Region

© The nasal vestibulae
© The respiratory region (inferior two third of the nasal mucosa)
© The olfactory region (superior one third of the nasal mucosa)

Boundaries of the nasal cavity

A. Roof / Superior
ᴥ Is curved and narrow, except at its posterior end
ᴥ It is divided 3 parts (frontonasal, ethmoidal, and sphenoidal)
B. Floor / Inferior
Ȣ Wider than the roof
Ȣ Formed by the palatine processes of the maxilla and the horizontal plates of the palatine bone
C. Medial Wall
Formed by the nasal septum
D. Lateral Wall
Are irregular owing to three bony plates, the nasal conchae, which project inferiorly.

Nasal Septum / Septum Nasalis

Ø Divides the chamber of the nose into two nasal cavities
Ø Main components :
- Perpendicular plate of ethmoid / lamina perpendicularis (ossis ethmoidalis)
- Vomer
- Septal cartilage
 Deviation of The Nasal Septum
a. Caused : birth injury, trauma in adolescence & adulthood
b. Complication : obstructs breathing or exacerbates snoring  sering dg keluhan tidur ngorok !

Lateral Cavum Nasi

 Bagian depan tampak licin
 Bagian belakangnya tdd concha nasalis dan meatusnya (muara dari sinus paranasalis).

Removal of the middle and inferior conchae reveals :

- Hiatus semilunaris (3)
- Ethmoid bullae (bulge formed by ethmoid air cells) (4)
- Small bulge formed by the nasolacrimal duct (5) (not always apparent)
Concha Nasalis
a. Suprema c. Superior
b. Media d. Inferior

 Superior Nasal Meatus (sering terjadi sinusitis)

- A narrow passage between superior and middle nasal conchae
- Received the opening of the posterior ethmoidal sinuses and sphenoidal sinus
 Middle Nasal Meatus (kalo tersumbat  terjadi sinusitis)
- Longer and deeper than the superior nasal meatus
- Received the opening of the frontal sinus, maxillaries sinus and ethmoidalis anterior
 Inferior Nasal Meatus
- A horizontal passage inferior lateral to the inferior nasal conchae
- Received the opening of the nasolacrimal duct
* Kalo benar2 menangis dari hidung biasanya keluar air

Drainage
- Sphenoid sinus  Sphenoethmoid recess
- Frontal sinus  Infundibulum of the middle meatus
- Anterior ethmoid sinus  Middle meatus
- Middle ethmoid sinus  Ethmoid bulla of middle meatus
- Maxillary sinus  Middle meatus

Vascularisasi Cavum Nasi = A Fascialis N. VII

 Front : branch of facial artery (A. Fascialis)
 Upper : A. Ethmoidalis anterior dan A. Ethmoidalis posterior (Cabang A. Opthalmicus  A. Carotis Interna)
 Lower : A. Sfenopalatina dan A. Palatina Mayor. (Cabang A. Maxillaris  A. Carotis Externa)

Plexus Kiesselbach ( Little’s area)  sering terjadi pendarahan pada Epistaksis

℗ Contain Anastomosis of : 1. A. Ethmoidalis anteri
2. A. Shenopalatina
3. A. Palatina mayor
4. A. Labialis superior
℗ In front of Nasal Septum
* Kalo terjadi Epistaksis yang ditekan daerah ini, bagian atas depan
Innervation of The Nasal Cavities
- Olfaction is carried by the Olfactory nerve (NI)
- General sensation is carried by the Trigeminal nerve, the anterior region by the Ophthalmic nerve and the posterior
region by the Maxillary nerve.
- All glands are innervated by parasympathetic fibers in the facial nerve.
* Fungsi : penghidu = 1/3 atas
respiratory = 2/3 bawah
Paranasal Sinuses
Air filled extensions of the respiratory part of the nasal cavity into the cranial bones.
Functions of The Paranasal Sinuses
- Reduce the weight of the skull
- Add to the resonance of the voice
- Contribute to warming and humidifying the inspired air
- Provide thermal insulation to the eyes and braina

Frontal Sinuses
@ Between the outer and the inner tables of the frontal bone
@ Posterior to the superficiliary arches and the root of the nose
@ Detactable in children by 7 – 8 y.o
@ Each sinus drains through a frontonasal duct into the ethmoidal infundibulum, which opens into the semilunar hiatus
of the middle nasal meatus
@ Innervated by branches of the supraorbital nerve (Cn V1)