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3/29/13

Anatomy andPhysiology of Nose

and ParanasalSinuses

Prepared by : Nurul Syazwani Binti Ramli


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Anatomy ofNose


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External Nose

Pyramidal in shape (root up & basedownward)

Consists ofosteocartilaginous

framework covered by muscles andskin.


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External Nose


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External Nose


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External Nose


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Internal Nose

Divided into right and left nasal

cavities Communicates with:

Exterior: through naris (nostril

Nasopharynx: through post. nasal aperture(choana)


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Internal Nose


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Internal Nose


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Internal Nose


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InternalNose


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Lining Membrane of InternalNose


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Mucose membrane


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Blood Supply of Nose

Nasal septum : Internal carotid :

Anteriorethmoid

Posteriorethmoid

External carotid :

Sphenopalatine

Greaterpalatine

Superior labial


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Blood Supply of Nose

Lateral wall : Internal carotid : Anterior ethmoid

Posterior ethmoid

External carotid :

Sphenopalatine Greater palatine

Anterior superiordental

(infraorbital )

Facial artery


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Littles Area (PlexusKiesselbach)

Anterior inferior nasal septum

Anastomoses from :

Anterior ethmoid

Superior labial

Sphenopalatine

Greater palatine


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Plexus Kiesselbach


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Nerve Supply of Nose Olfactory nerve :

Carry sense of smell andsupply olfactory regionof nose

Arranged into 10-12nerves which passthrough the cribriformplate and end in the

olfactory bulb Nerves of common

sensation :

Anterior ethmoidalnerve

Sphenopalatineganglion

Infraorbital nerve

Greater palatinenerve

Autonomic : Parasympathetic greater

superficial petrosal vidiansphenopalatine ganglion

Sympathetic upper 2 thoracicsuperior cervical gangglion

deep petrosal nerve joinparasympathetic to form vidian


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Lymphatic Drainage


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Physiology of Nose

Functions of the nose:

1) Respiration

2) Air conditioning of the inspired air3) Protection of Lower Airway

4) Vocal resonance

5) Nasal reflex functions

6) Olfaction


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RESPIRATION

Nose = natural pathway forbreathing

INSPIRATION: air thru middle

part of nose btwn turbinates andnasal septum. Very little air passesthru inferior meatus or olfactoryregion.

EXPIRATION : same but entire aircurrent is not expelled directly thrunares friction at limen nasiconverts it into eddies under coverof inferior and middle turbinates

and this ventilates the


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AIR CONDITIONING OFINSPIRED AIR

air-conditioner for lungs:

a) Filtration and Purification :

v nasal vibrissae filters larger particles (3m)

v Finer particles adhere to the mucus over surface of

mucous membrane (0.5-3.0m)

v Smaller than 0.5m can pass thru nose into lower

airways without difficulty

b) Temperature control : mucous membrane (region of

middle and inferior turbinates and adjacent parts of the

septum) is highly vascular with cavernous venous spaces


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PROTECTION OF LOWERAIRWAY

a) Mucociliary mechanism:v Rich in goblet cells, secretory glands both mucous and

serous)

v Form a cont. sheet called mucous blanket whichconsist ofsuperficial mucus layer and deeper serouslayer that floating on top of cilia which constantlybeating to carry it towards nasopharynx = conveyerbelt

a) Enzymes and Immunoglobulins: (in nasal secretion)-


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VOCAL RESONANCE

Resonating chamber for certain consonant in

speech.

In phonating nasal consonants ( M/ N/ NG ),sound

passes thru nasopharyngeal isthmus and is

emitted thru the nose.

When blocked, speech becomes denasal.

Eg:- M/ N/ NG are uttered as B/ D/ G respectively


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NASAL REFLEXES

Nasal Mucosa reflex receptors closely related to

gastrointestinal and pulmonary functions.

Examples:

- irritation of nasal mucosa cause sneezing

- smell of palatable food reflex secretion of saliva and gastric

juice.


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OLFACTION

Sense of smell: Animal :- give warning of

environmental danger

Man :- for pleasure and enjoying thetaste of food

Olfactory region :

upper one-third of lateral Wall corresponding part of nasal septum

roof of nasal cavity

Disorder of smell:


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Paranasal Sinuses


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Paranasal Sinuses

The paranasal sinuses are air-containing cavities found in theinterior of the maxilla, frontal,

sphenoid, and ethmoid bonesThey are lined with mucoperiosteum

and filled with air

They communicate with the nasalcavity through relatively smallapertures

The maxillary and ethmoid sinuses


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Maxillary Sinus

pyramidal in shape

located within the body of themaxilla behind the skin of the cheek

Roofis formed by the floor of theorbit, and the floor is related to theroots of the molars, premolars andcanine teeth

The maxillary sinus opens into themiddle meatus of the nose throughthe hiatus semilunaris


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Frontal Sinuses

The two frontal sinuses are containedwithin the frontal bone

They are separated from each otherby a thin bony septum

Each sinus is roughly triangular,

extending upward above the medialend of the eyebrow and backwardinto the medial part of the roof of theorbit


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Sphenoidal Sinuses

The two sphenoidal sinuses lie withinthe body of the sphenoid bone

Each sinus opens into thesphenoethmoidal recess above the

superior concha


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Ethmoid Sinuses

The ethmoidal sinuses are thinwalled air cavities within the ethmoid

bone between the nose and the orbitThe number varies from 3 to 18.

Divided into anterior, middle, and

posterior.They are separated from the orbit by

a thin plate of bone(lamina

papyracea) so that infection can


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Ethmoid Sinuses

The anterior sinuses open into theinfundibulum

The middle sinusesopen into themiddle meatus, on or above the bulla

ethmoidalis

The posterior sinusesopen into the

superior meatus


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Physiology of Paranasal

Sinuses


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Ventilation of Sinuses

Takes place through their ostia.

Inspiration:-

air current causes (ve) pressure innose.

Varies from -6mm to -200mm of H2O,depend on force of inspiration.

Expiration:-

(+ve) pressure created in nose and setsup eddies which ventilate the sinuses


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Drainage of Mucus

The mucus produced by the mucousmembrane is moved into the meatus

of the nose by very active ciliaryaction of the columnar cells

Drainage of the mucus is also

achieved by the siphon actioncreated during the blowing of thenose

F ti f P l


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Functions of ParanasalSinuses

Provide resonance to voice

reduce weight of the skull (lighten

skull bones) Air-conditioning of inspired air by

providing large surface area over

which the air is humidified andwarmed

Act as thermal insulators to protect

the delicate structures in the orbit


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