1. By: Aminah Alessa . Hawra Alabad . Zainab Alsaleh
Anatomy of nose
and physiology
By: Aminah Alessa . Hawra Alabad . Zainab Alsaleh

2. Nose
Origin:
Originates from the nasofrontal process during 4th to 8th week of IU life.
Consists of : - External nose. - Nasal cavity.

3. External nose

4. External nose:
It is pyramidal in shape with its root up and the base directed downwards.
Consist of:
Osteo-cartilaginous structure.
Muscles of the nose.
Nasal skin.

5. OSTEOCARTILAGINOUS Upper one-third of the external nose is bony part:
made up of two nasal bones meeting in the middle, resting on the frontal bone.
lower two thirds are cartilaginous consist of :
upper lateral cartilage: Extending from the lower surface of the frontal bones, to connect with the alar cartilage.
lower lateral cartilage( alar) : U-shaped cartilage. Medially, they connect with the upper lateral cartilage.
sesamoid cartilage: A supporting cartilage planted on a bone. Connects with the lateral part of the Alar cartilage, but minimally contributes to nostrils’ structure.
septal cartilage: Running on the entire length of the nose anteriosuperiorly.

7. Internal nose

8. Internal nose
It is divided into right and left nasal cavities by nasal septum.
Each nasal cavity consists of a:
skin-lined portion—the vestibule
a mucosa-lined portion, the nasal cavity proper.

9. LINING MEMBRANE OF INTERNAL NOSE
Vestibule:
Anterior and inferior part of nasal cavity
Lined by skin containing hair, hair follicles, sebaceous glands.
Olfactory region:
Upper one-third of lateral wall (up to superior concha).
Lined with olfactory mucous membrane and contains nerve endings sensitive to the reception of smell.
Respiratory region:
Lower two-thirds of the nasal cavity
Mucous membrane shows varible thickenings.
It is highly vascular and also contains erectile tissue

10. NASAL CAVITY PROPER
a lateral wall
a medial wall
a roof and
a floor.

11. Lateral Walls
The lateral wall of the nose is subdivided into three areas which are:
Vestibule
Conchae
- They are bony plates covered with mucous membrane.
- Marked by 3 projections:
Superior concha (turbinate).
Middle concha (turbinate).
3. Inferior concha (turbinate).
Meatuses
The cavity below and lateral to each concha
(superior, middle, and inferior meatuses).
The small space above the superior concha is the sphenoethmoial (suprameatal) recess.

13. Lateral Walls
Sphenoethmoidal recess: - It receives the opening of the sphenoidal air sinus.
Superior meatus: It receives the opening of posterior ethmoidal air sinus.
Inferior meatus: It receives the nasolacrimal duct.
Middle meatus:
It receives the following openings:
Anterior ethmoidal air sinus.
Frontal air sinus.
Maxillary air sinus.

14. B. Medial Walls
Osteo-cartilaginous partition between the two nasal cavities called nasal septum.
Nasal septum consists of three parts:
1. Columellar septum.
2. Membranous septum.
columellar and membranous parts are freely movable from side to side.

15. 3. Septum proper.
It consists of osteocartilaginous framework, covered with nasal mucous membrane.
Its principal constituents are :
Anterior: Septal cartilage.
Superior: Perpendicular plate of ethmoid bone.
Posteroinferiorly : Vomer.
Inferior : crest of the maxillary bone 
Inferior : crest of the palatine bone 

16. C. Roof
Anterior: formed by nasal bones& nasal spine of the frontal bone
Posterior: formed by the body of sphenoid bone
Middle: formed by the cribriform plate of ethmoid bone through which the Olfactory nerves enter the nasal cavity.

17. D. Floor Anterior: 3/4th formed by palatine process of the maxilla
Posterior: 1/4th formed by the palatine bone.

18. Blood supply of lateral wall
INTERNAL CAROTID SYSTEM:
1. Anterior ethmoidal.
2. Posterior ethmoidal.
EXTERNAL CAROTID SYSTEM:
1. Posterior lateral nasal Branches → From sphenopalatine artery.
2. Greater palatine artery → From maxillary artery.
3. Nasal branch of anterior superior dental → From infraorbital branch of maxillary Artery.
4. Branches of facial artery to nasal vestibule.
Branches of ophthalmic
artery

19. Blood Supply to the Nasal septum
INTERNAL CAROTID SYSTEM:
1. Anterior ethmoidal artery
2. Posterior ethmoidal artery
EXTERNAL CAROTID SYSTEM:
1. Sphenopalatine artery → (maxillary artery) gives
nasopalatine and posterior medial nasal branches.
2. Septal branch of greater palatine artery → maxillary artery.
3. Septal branch of superior labial artery → facial Artery.
Branches of ophthalmic
artery

21. NERVE SUPPLY Olfactory nerves:
They carry sense of smell and supply olfactory region of nose. Which pass through the cribriform plate and end in the olfactory bulb
2.Nerves of common sensation. They are:
Anterior ethmoidal nerve.
Branches of sphenopalatine ganglion.
(c) Branches of infraorbital nerve
3. Autonomic nerves.

22. Lymph Drainage of the Nasal Cavity
The anterior part :
drains into submental and submandibular lymph nodes.
posterior part:
drains into the retropharyngeal nodes.
All of these nodes finally drain into the upper deep cervical lymph nodes

23. Para-nasal sinuses

24. Para-nasal sinuses Functions:
The paranasal sinuses are air-filled cavities in the interior of the maxilla and the frontal, sphenoid, and ethmoid bones.
The sinuses develop as outgrowths from the nasal cavity; hence they all drain directly or indirectly into the nose.
Functions:
1. Warming and humidifying the inspired air.
2. Reduce the skull weight.
3. They add resonance to the voice.
4. Act as shock absorbers in trauma.
5. Immunologic defence against microbes.

25. Para nasal air sinuses:
Frontal sinuses
Ethmoid cells
Sphenoid sinuses
Maxillary sinuses

26. Maxillary sinuses Relations: Are the largest of all paranasal sinuses.
Completely fill the bodies of the maxillae.
Symmetric paired, one on each side pyramidal in shape ,lying just under the check.
with apex directed laterally and the base deep to the lateral wall of adjacent nasal cavity .
Present at birth.
Relations:
The superolateral surface “roof” : floor of the orbit.
Anterolateral surface: roots of the 2nd premolar and 1st molar teeth
Posterior wall: infratemporal fossa.

27. Ethmoid cells
The ethmoid cell on each side fill the ethmoidal labyrinth.
Located between nose and orbit.
Variable number of individual air chamber.
Divided into anterior, middle, posterior ethmoid cells based on location of their apertures on lateral wall of the nasal cavity.
Anterior ethmoid cell open into the ethmoidal infundibulum or frontonasal duct.” middle nasal meatus)”
Middle ethmoidal cells open into ethmoidal bulla.” middle nasal meatus)
Posterior ethmoidal cell open into lateral wall of superior nasal meatus.

28. Frontal sinuses Relation: Paired rarely symmetrical.
Contained within frontal bone.
Separated from each other by a bony septum .
Each sinus is roughly triangular
Relation:
Posterior wall :anterior cranial fossa
Floor: is formed by the upper part of orbit.
Opens into the middle meatus

29. Sphenoidal sinuses Lie within the body of the sphenoid bone
Below Sella turcica (extends between dorsum sellae and post clinoid processes)
Opens into the sphenoethmoidal recess above the superior concha.
Laterally related to ophthalmic nerve , internal carotid artery
So it’s sensitive area for surgeon when they need to remove pituitary gland .

30. Physiology of Nose 1. Respiration.
2. Air-conditioning of inspired air.
3. Protection of lower airway.
4. Vocal resonance.
5. Nasal reflex functions.
6. Olfaction.

31. Reference