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The Nasal Cavity
The Nasal Cavity
• Parts:
– Root, dorsum or bridge, tip, alae, base, nares
( nostril) separated by the septum
• Nerves
• Motor, facial to muscles
• Sensory, to infratrochlear from nasociliary
br. Of ophthalmic(V) to skin of root, alae,
nostril; infraorbital br. To maxillary(V) to
sides of nose
Blood vessels
• Vessels:
• Arteries: facial to side, alae, septum;
dorsal nasal br. Of ophthalmic to root and
dorsum; infraorbital branch of maxillary to
sides.
• Veins, drain into ophthalmic and anterior
facial vein.
Woodruff's plexus:
• Is responsible for posterior bleeds.
• This area is located over the posterior end of the middle turbinate.
• The anastomosis here is made up of branches from the internal
maxillary artery namely its sphenopalatine and ascending
pharyngeal branches.
• The maxillary sinus ostium forms the dividing line between the
anterior and posterior nasal bleeds.
• Posterior nasal bleeds are difficult to treat because bleeding area is
not easily accessible.
• Bleeding from Woodruff's plexus commonly occur in patients with
extremely high blood pressure. Infact this plexus acts as a safety
valve in reducing the blood pressure in these patients, lest they will
bleed intracranially causing more problems.
• In patients with posterior bleeds it is difficult to access the amount of
blood loss because most of the blood is swallowed by the patient.
• Etiology: The etiology of epistaxis is not just simple or straight nasal
bleeding.
Framework
• Hyaline cartilage
– Septal, between right and left nasal cavities,
attachment: perpendicular plate of ethmoid,
vomer, maxilla, nasal, septal process of lower
nasal passages.
– Lateral nasal ( upper lateral), attached to
nasal bone, frontal process of axilla, lower
nasal cartilage continuous with septal
cartilage.
Framework:
• Hyaline cartilage
• Bones:
– 2 nasal bones
– Frontal process of
maxillae
Nasal cavities
• Separated by nasal septum into L and R
cavities.
• Anterior aperture: ( nares) open into:
– Vestibule, a dilated area bounded by ala and
crus of nasal cartilage.
Boundaries of nasal cavities
• Roof = frontonasal, ethmoidal, sphenoidal
• Floor = wider, formed by palatine process
• Medial wall = nasal septum
• Lateral wall = nasal conchae, irregular
• Conchae = form a meatus, a passage of
the nasal cavity
Nasal conchae
• 4 passages
• Sphenoethmoidal recess
• Superior meatus
• Middle meatus
• Inferior meatus
Nasal cavities
• Lateral wall: division created by the nasal
conchae:
– Sphenoethmoidal recess, above superior
concha
– Superior meatus, below superior concha,
above middle concha.
– Middle meatus, below lateral to middle
concha, above inferior concha.
– Inferior meatus, below and lateral to middle
concha above palate.
Cavities
• Openings into the meatus or recesses:
– Sphenoethmoidal recess: sphenoidal sinis
– Superior meatus: posterior ethmoidal air cells
– Middle meatus:
• Anteriorly, forntonasal duct, ant. Ethmoidal air cells
• post.: ostium from maxillary sinus
• On or above bulla: middle ethmoidal air cells
– Inferior meatus: naso lacrimal duct
Nasal cavities
• Medial wall: recess, spaces, or hiatus
– Nasopalatine recess: depression in septum
over incisive canal.
– Vomeronasal organ