Nose
Only externally visible part of
the respiratory system
Has a free tipand is attached
to the forehead by the rootor
the bridge
Has two openings, the
anterior (external) nares or
nostrils, which lead to the
nasal cavity
Each nostril is bounded
laterally by the alaand
medially by the nasal septum
root
tip
external nares
septum
ala
Nose: Structure
Nose consists of bony &
cartilaginousframework
Formed aboveby the:
•Nasal bones
•Frontal processes of
maxillae
•Nasal part of frontal bone
Formed belowby plates of
hyaline cartilage, which
include upper& lowernasal
cartilagesand the septal
cartilage
Nasal part of
Frontal bone
Nasal Cavity
Extends from the
external (anterior)
nares to the posterior
nares (choanae)
Divided into right & left
halves by the nasal
septum
Each half has a:
Floor
Roof
Lateral wall
Medial wall (septum)
Roof
Is narrow & formed (from
behind forward) by the:
•Body of sphenoid
•Cribriform plate of
ethmoid bone
•Frontal bone
•Nasal bone & cartilage
Floor
•Separates it from the
oral cavity
•Formed by the hard
(bony) palate
Medial Wall (Nasal
Septum)
Osteocartilaginous
partition, only rarely lying
in the midline
Covered by the
mucoperiosteum
Formed:
•Superiorlyby the
vertical (perpendicular)
plate of ethmoid bone
•Posteriorlyby the vomer
bone
•Anteriorlyby the septal
cartilage
Lateral Wall
Shows three horizontal bony
projections, covered by
mucous membrane, the
superior,middle&inferior
conchae (turbinates)
The superior and middle
conchae are parts of the
ethmoid bone, whereas the
inferior concha is a separate
bone
The cavity below each
concha is called a meatus
and are named as superior,
middle& inferior
corresponding to the
conchae
The small space above
the superior concha is
called the
sphenoethmoidal recess
•The middle meatus is
continuous in front with a
depression called the
atrium
•Atrium is limited bove by
a ridge calledagar nasi
•Below and in front of
atrium, and just within
the nostril lies the
vestibule
The conchae
increase the surface
area of the nasal
cavity
Therecess& meati
receive the
openings of the:
Paranasal
sinuses
Nasolacrimal duct
Sphenoethmoidal
recess:Receives the
opening of the
sphenoidal sinus
Superior meatus:
Receives the opening
of the posterior
ethmoidalsinus
Inferior meatus:
Receives the opening
of thenasolacrimal
duct. The opening is
guarded by a valve, a
fold of mucous
membrane
Middle meatus:
•Shows a rounded eminence,
the ethmoidal bulla, caused by
the bulging of the underlying
middle ethmoidal sinus, which
opens on its upper border.
•A curved groove, hiatus
semilunaris, lies below the
bulla. Hiatus receives the
opening of the maxillary sinus
•Anterior end of hiatus leads to
funnel-shapedinfundibulum,
which receives the openings
of the frontal & theanterior
ethmoidal sinuses
Lining of the Nasal Cavity
Vestibuleis lined by
modified skin, and has
short, curved hair called
vibrissae
The roof, upper part of the
septum, upper surface of
the superior concha, and
the sphenoethmoidalrecess
are lined by the olfactory
mucosa
The rest of the cavity is
lined by the respiratory
mucosa
V
V
A
Olfactory Mucosa
Contains olfactory cells (bipolar sensory
ganglion cells), which serve as receptors for
olfactory stimuli.
Distinct smells are far more numerous than
tastes
The sense of smell plays a major role in the
flavor of foods and it is common for
individuals who lose their sense of smell to
report that food loses its taste. (food seems
somewhat tasteless when a person has
cold)
Most air breathed in normally flows through
the nose but only a small part reaches the
olfactory mucosa, enough to get a response
to an odor. Sniffing, however, increases the
flow of air over the smell receptor cells,
greatly increasing their exposure to odors.
Respiratory Mucosa
Pseudostratified ciliated columnar epithelium with
goblet cells
Rests on thick network of thin walled veins that
warms the air as it flows through the cavity
Glandsproduce ‘mucus’, which:
moisten the air
cleans the air by trapping the incoming bacteria
and foreign debris
Cilia help in moving the contaminated mucus
posteriorly towards the throat, where it is
swallowed and digested by the stomach juices
NerveSupply
Nasal cavity receives sensory&
visceralinnervation
Sensory innervation
Olfactory mucosasupplied by
olfactory nerves
Nerves of general sensation are
derived from opthalmic&
maxillary nerves
Anterior part supplied by the
anterior ethmoidal nerve
(branch of opthalmic nerve)
Posterior part supplied by
nasal, nasopalatineand
palatine branches (of maxillary
nerve)
Visceral Innervation
Sympathetic fibers arise from
neurons of superior cervical
ganglionand are distributed
through plexuses around the
arteries, supply mainly
vascular smooth muscle
Parasympathetic fibers arise
from neurons of the
pterygopalatine ganglionthat
course in the nasopalatine
nerve(branch of maxillary)
and its branches, supply the
mucosal glands.
Arterial Supply
Sphenopalatine artery (branch
of the maxillary artery) is the
main supply
Alar and septal branches of
superior labial artery (branch
of the facial artery)
Anterior & posterior ethmoidal
arteries (branches of the
ophthalmic artery)
The arteries make a rich
anastomosis in the region of
the vestibule, and anterior
portion of the septum
Venous Drainage:
Veins begin as a rich plexus in the submucosa,
accompany the corresponding arteries, and drain
into the facial, ophthalmic, and sphenopalatine
veins.
LymphaticDrainage:
The lymphatics from the:
Vestibule drain into the submandibularlymph
nodes
Rest of the cavity drains into the upper deep
cervicallymph nodes
Functions of Nose & Nasal Cavities
Air conditioning: warming, cleaning and
humidifying the inhaled air
Add resonance to the voice
Vocal sounds are also produced in the nasal
cavity thus aiding in vocalisation
Involved in the special sense of smell
Central role of the nose in facial appearance
??
Paranasal Sinuses
Air filled cavities located in the
bones around the nasal cavity:
ethmoid, sphenoid, frontal bones
& maxillae
Lined by respiratory mucosa
which is continuous with the
mucosa of the nasal cavity
Drain into the nasal cavity
through relatively small apertures
Drainageof the sinuses mainly
depends on the movement of the
cilia, which propel the mucus
toward their openings in the
nasal cavity
The development of sinuses
begins in 3-4 month, but only
maxillary& ethmoid sinuses
are present in rudimentary
form at birth. The frontal&
sphenoidalsinuses are not
clinically perceptible at birth
and can rarely be
demonstrated on plain x-ray
before two years of age.
Continue to grow postnatally
Enlarge appreciably after 8
th
year & become fully formed at
adolescence
M
E
From a 3 months old fetus, showing
ethmoid & maxillary sinuses
Functions
Lighten the skull
Act as resonant chambers for speech
The respiratory mucosal lining helps in
warming, cleaning and moistening the
incoming air
Maxillary Sinuses
•Located within the body of the
maxilla
•Pyramidalin shape with the base
forming the lateral wall of nose &
the apex lies in the zygomatic
process of the maxilla
•Roof: formed by the floor of the
orbit
•Floor: formed by the alveolar
border. Roots of 1
st
and 2
nd
premolars and the 3
rd
molar
(sometimes canines) project into
the sinus
•Opens into the middle meatus
through the hiatus semilunaris
•Supplied by superior alveolar &
infraorbital nerves
M
Frontal Sinuses
Twoin number
Located within the frontal
bone, separated from
each other by a bony
septum
Triangularin shape,
extending backward into
the roof of the orbit
Opens into the middle
meatusthrough the
infundibulum
Supplied by the
supraorbital nerve
Ethmoidal Sinuses
Locatedwithin the
ethmoid bone, between
the nose and the orbit
Divided into three
groups: anterior, middle
& posterior
Anterior group opens
into the infundibulum,
middleopens on the
bulla, and posteriorinto
the superior meatus
Supplied by the anterior
and posterior ethmoidal
nerves
Sphenoidal Sinuses
Twoin number
Located within the
body of sphenoid
Open into the
sphenoethmoidal
recess
Supplied by the
posterior ethmoidal
nerve
Clinical Notes
Epistaxis:Little’s area,
common site of bleeding from
nose
Inflammation of the nasal
mucosa, Rhinitis, results in
nasal congestion and excessive
production of mucus leading to
‘postnasal drip’
Infections of the nasal cavity
can extend to the:
Paranasal sinuses
Nasolacrimal duct &
lacrimal sac
Inflammation of mucosa of
the sinuses, Sinusitis, causes
excessive production of mucus
leading to obstruction of the
drainage of sinuses. This
results in headache and
change in the voice
Infection of frontal & anterior
ethmoidal sinuscan easily
spread to maxillary sinus
because of the location of
their openings
Infection of upper teethcan
lead to inflammation of the
maxillary sinus
Extraction of an infected
upper tooth may result in a
fistula
The maxillary sinus is most
commonly the site of infection
The inflamed mucosa results
in excessive production of
mucus as well as narrowing of
its opening in the nasal cavity
The position of the drain
causes problems in that
mucus can collect in the sinus
below the drain. In this
situation, the sinus will only
drain if the patient lies on
their opposite side.
Pressure from the trapped
fluid/mucus causes sinus pain