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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 a 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/ Kiesselbach’s 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

• 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.

• Skeleton of Lateral wall:- partly bony & partly Cartilagenous.

• 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. • Cartilaginous part:- Upper & Lower nasal cartilage, 3 or 4 small cartilages of ala.





• 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 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.


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