1. Nose and paranasal sinuses
Introduction-
External nose- boney and cartilagenous part,
Bones- nasal bones & the frontal processes of the maxillae
Cartilages- superior & inferior nasal cartilages, septal cartilage and some small cartilages

2. Nose and paranasal sinuses
Nasal cavity-
Extent-external nares to the posterior nasal apertures.
Rt and lt halves by nasal septum
Each half- roof, floor, medial & lateral walls
Measurement-5cm height, 5-7cm length & 1.5cm wider near the floor and near the roof is 1-2mm

3. Nose and paranasal sinuses
Nasal septum-
Osseocartilaginous partition betw the 2halves of the nasal cavity
Mucous membrane & forms the medial wall of both the nasal cavities
Boney part- vomer & perpendicular plate of the ethmoid. Nasal spine of the frontal bone, the rostrum of the sphenoid & the nasal crests of nasal, palatine and maxillary bones
Cartilaginous part- septal cartilage & the septal processes of the inferior nasal cartilages
Cuticular part- fibrofatty tissue covered by the skin
Borders- sup, inf, ant and post & rt and lt surfaces

4. Nose and paranasal sinuses
Arterial supply-
Anterosuperior- ant ethmoidal artery
Posteroinferior-sphenopalatine artery
Anteroinferior- superior labial branch of facial artery
Posterosuperior- post ethmoidal artery
Kiesselbach’s plexus- common site of bleeding from the nose or epistaxis and know as “Little’s Area”
Venous drainage-
From little’s area there are venous plexus which drains into the facial vein, posteriorly through the sphenopalatine vein to the pteryoid venous plexus

5. Nose and paranasal sinuses
Nerve supply-
General sensory-
Anterosuperior-internal nasal branch of the anterior ethmoidal nerve
Posteroinferior-nasopalatine branch of the pterygopalatine ganglion
Posterosuperior- medial,posterior, superior nasal branches of the pterygopalatine ganglion
Special sensory or olfactory nerves are confined to the upper part or olfactory area

6. Nose and paranasal sinuses
Lymphatic drainage-
Anterior half- submandibular nodes
Posterior half- retropharyngeal & deep cervical nodes

7. Nose and paranasal sinuses
Clinical anatomy-
Little’s area on the septum is the common site of bleeding from the nose or epistaxis
Pathological deviation of the nasal septum is often responsible for the repeated attacks of common cold, allergic rhinitis, sinusitis.

8. Nose and paranasal sinuses
Lateral wall of nose-
Irregular and having presence of 3 shelf-like bone projections- conchae
Lateral wall separates the nose: orbit above, with the ethmoidal air sinuses & maxillary sinus below, from lacrimal groove and nasolacrimal canal in front

9. Nose and paranasal sinuses
Lateral wall- 3parts
Vestibule- small depression area in the anterior part
Middle part-atrium of the middle meatus
Posterior part-conchae

10. Nose and paranasal sinuses
Skeleton of the lateral wall
Boney- nasal, frontal process of the maxilla, labyrinth of the ethmoid with superior and middle conchae, inferior nasal conchae, perpendicular plate of the palatine bone together with its orbit and sphenoidal processes and medial pteyroid plate
Cartilaginous- superior nasal cartilage, inferior nasal cartilage and 3-4 small cartilages of ala
Cuticular lower part- fibrofatty tissue covered with skin

11. Nose and paranasal sinuses
Conchae and meatuses
inferior concha is independent bone
Middle concha- projection from the medial surface of the ethmoidal labyrinth
Superior concha- projection from the medial surface of the ethmoidal labyrinth
Inferior meatus- nasolacrimal duct
Middle meatus- ethmoidal bulla is a rounded elevation produced by the underlying middle ethmoidal sinus; hiatus semilunaris is a deep semicircular sulcus below the bulla; infundulum is a short passage at the anterior end of hiatus; opening of the frontal sinus, maxillary air sinus and middle ethmoidal air sinus
Superior meatus- opening of the posterior ethmoidal air sinuses
Sphenoethmoidal recess- opening of the sphenoidal air sinus

12. Nose and paranasal sinuses

13. Nose and paranasal sinuses
Arterial supply of the lateral wall
Anterosuperior quadrant- ant ethmoidal artery assisted by the post ethmoidal and facial arteries
Anteroinferior quadrant- branches from the facial artery and greater palatine arteries
Posterosuperior quadrant- sphenopalatine artery
Posteroinferior quadrant- branches from the greater palatine artery
Venous drainage-
Veins forms plexus which drains anteriorly into the facial vein, posteriorly into the pharyngeal plexus of veins and from the middle part to the pterygoid plexus of the vein

14. Nose and paranasal sinuses
Nerve supply-
General sensory nerves
Anterosuperior quadrant- ant ethmoidal nerve branch of ophthalamic nerve
Anteroinferior quadrant-ant superior alveolar nerve branch of maxillary nerve
Posterosuperior quadrant- post superior lateral nasal branches from the pterygopalatine ganglion suspended by the maxillary nerve
Posteroinferior quadrant- ant or greater palatine branch from the pterygopalatine ganglion suspended by the maxillary nerve
2. Special sensory or olfactory nerve-

15. Nose and paranasal sinuses
Lymphatic drainage-
Anterior half- submandibular nodes
Posterior half- retropharygeal and upper deep cervical nodes

16. Nose and paranasal sinuses
Clinical anatomy-
Common cold or rhinitis
Paranasal air sinuses may get infected from the nose. Maxillary sinusitis is the commonest of such infections
Hypertrophy of the mucosa over the inferior nasal concha is the common feature of allergic, rhinitis, which is characterized by sneezing, nasal blockage and excessive watery discharge from the nose

17. Nose and paranasal sinuses
Frontal sinus
Maxillary sinus
Sphenoidal sinus
Ethmoidal sinus

18. Nose and paranasal sinuses