The nose is an olfactory and respiratory organ.

It consists of nasal skeleton, which houses the

nasal cavity. The nose has a number of functions which include:

 Warms and humidifies the inspired air.

 Removes and traps pathogens and particulate matter from the inspired air.
 Houses the olfactory organ hence responsible for sense of smell.
 Drains and clears the paranasal sinuses and lacrimal ducts.
 Forms a resonating cavity for the voice

Divisions
The nasal cavity is the most superior part of the respiratory tract. It extends from the vestibule
of the nose to the nasopharynx, and has three divisions:
Vestibule – the area surrounding the anterior external opening to the nasal cavity.
Respiratory region – lined by a ciliated psudeostratified epithelium, interspersed with mucus-
secreting goblet cells.
Olfactory region – located at the apex of the nasal cavity. It is lined by olfactory cells with
olfactory receptors.
Cartilaginous features
The nasal cartilages provide structure and support to the nose. They are primarily composed of
hyaline cartilage, which is densely packed with collagen, a structural protein. They provide form
and support to the nasal cavity. There are several different kinds

Particles .Accessory nasal cartilages are small nasal cartilages that link the greater alar (nostril)
and lateral nasal cartilages Greater alar cartilage is a flexible cartilage that forms part of the
structure of the nostrils. Lateral nasal cartilage is a triangular structure, located below the
nasal bone. Cartilage of the septum — also known as the quadrangular cartilage because it is
roughly quadrilateral in shape — separates the nostrils. It also connects the nasal bones and the
lateral cartilages. Vomeronasal cartilage, also known as Jacobson’s cartilage, connects the nasal
septum (the wall of cartilage that separates the two airways of the nose) and the vomer bone
(a thin, flat bone that separates the nostrils). It was named in 1809 by Dutch anatomist, Ludwig
Levin Jacobson. It is close to, but not actually connected with, the vomeronasal organ of
Jacobson, which is the body’s scent organ that detects pheromones, chemicals that may affect
the behaviors of others who smell them.Lesser alar cartilages are three or four small nasal
cartilages connected to the upper jawbone.
EXTERNAL OPENING OF THE NOSE
The external nose is visible and is pyramidal in shape, with the root located in the upper region
and the base located in the lower region. The external part of the nose consists of a root
(superiorly), apex (inferiorly), dorsum, nares (nostrils) and the separating nasal septum.It
provides air for respiration, serves the sense of smell, conditions the air by filtering, warming,
and moistening it, and cleans itself of foreign debris extracted from inhalations. Nose hairs at
the entrance to the nose trap large inhaled particles

THE INTERNAL NOSE

FUNCTIONS

The internal nose is composed of pair of nostrils. Each pair consist of three regions, those are
vestibular, respiratory, and olfactory epithelium

The vestibular (nostrils) is the main entrance of air into the body it has hairs that trap large
inhaled particles and pathogens

The respiratory region functions to humidify, warm, filter, protect, and eliminate debris.
Covered in respiratory epithelium and mucous cells, this is the most substantial part of the
nasal cavity. As air traverses through the nasal cavity, it warms to body temperature and
reaches near one hundred percent humidity. The neurovascular supply of this region aids this.
It regulates the nasal airflow by controlling the blood volume in the erectile tissue on the
inferior turbinate and anterior septum. Under normal conditions, this tissue is continuously
stimulated by sympathetic signals via the superior cervical ganglia to keep the nasal cavity
uncongested
Olfaction requires orthonasal or retronasal airflow to transport odor-bearing particles up to the
olfactory epithelium located at the apex of the nasal cavity. As odorants become trapped in the
mucus, it binds to odorant binding proteins that concentrate and help solubilize the particles.
The particles are then attached to olfactory receptors on cilia that transmit specific signals up
through the cribriform plate to synapse with neurons of the olfactory bulb, which then sends
signals through the olfactory nerve (CNI) into the secondary neurons for higher processing
before entering the brain. A unique feature of the olfactory receptors is that a single receptor
cell can detect only one odorant type and cannot regenerat

DESCRIPTION
Anatomical Structure
The skeleton of the nose is formed by three types of tissue; bone, cartilage and fibro-fatty
tissue. When looking at the scaffolding of the nose, it is useful to divide the structures into two
parts; the external nasal skeleton and internal nasal septum
External nasal skeletal
The external skeleton extends the nasal cavities onto the front of the face (see Figure below). It
is partly formed by the nasal and maxillary bones, which are situated superiorly. The inferior
portion of the nose is made up of hyaline cartilages; lateral, major alar, minor alar, and the
cartilaginous septum. The lateral and major alar cartilages are the largest, and contribute the
most to the shape of the nose here. The minor alar cartilages vary in number, there are usually
3 or 4 on each side.
Internal Nasal Septum
The internal nasal septum separates the nasal cavity into two nostrils. The bones that
contribute to the nasal septum can be divided into:

 Paired bones: Nasal, maxillary and palatine bones

 Unpaired bones: Ethmoid and vomer bones.
In addition to the bones of the nose, the septal and greater alar cartilages also constitute part
of the nasal septum.
The ethmoid contributes to the central portion of nasal septum. It is one of the most complex
bones in the human body. The anterior and posterior parts are formed by the septal cartilage
and vomer bone respectively.
The floor of the nasal cavity is formed by the hard palate, separating it from the oral cavity. The
hard palate consists of the palatine bone posteriorly, and the palatine process of the maxilla
anteriorly. The cribriform plate of the ethmoid bone forms the roof of the nasal cavity.
Nasal Conchae
Projecting out of the lateral walls of the nasal cavity are curved shelves of bone. They
are called conchae (or turbinates). The are three conchae – inferior, middle and
superior.

They project into the nasal cavity, creating four pathways for the air to flow. These
pathways are called meatuses:

 Inferior meatus – between the inferior concha and floor of the nasal cavity.
 Middle meatus – between the inferior and middle concha.
 Superior meatus – between the middle and superior concha.
 Spheno-ethmoidal recess – superiorly and posteriorly to the superior concha.

The function of the conchae is to increase the surface area of the nasal cavity – this
increases the amount of inspired air that can come into contact with the cavity walls.
They also disrupt the fast, laminar flow of the air, making it slow and turbulent. The air
spends longer in the nasal cavity, so that it can be humidified

Blood supply
The nose has a very rich vascular supply – this allows it to effectively change humidity and
temperature of inspired air. The nose receives blood from both the internal and
external carotid arteries:

Internal carotid branches:

 Anterior ethmoidal artery

 Posterior ethmoidal artery

The ethmoidal arteries are branch of the ophthalmic artery. They descend into the nasal cavity
through the cribriform plate

External carotid branches:

 Sphenopalatine artery
 Greater palatine artery
 Superior labial artery
 Lateral nasal artery

In addition to the rich blood supply, these arteries form anastomoses with each other. This is
particularly prevalent in the anterior portion of the nose .

The veins of the nose tend to follow the arteries. They drain into the pterygoid plexus, facial vein
or cavernous sinus.

In some individuals, a few nasal veins join with the sagittal sinus (a dural venous sinus). This
represents a potential pathway by which infection can spread from the nose into the cranial
cavity.
Kiesselbach's plexus is a vascular network of four or five arteries in the nose. It supplies
the nasal septum. The arteries anastomose to form the plexus. It lies in the anterior
inferior part of the septum known as Little's area, Kiesselbach's area, or Kiesselbach's
triangle. It is a common site for nosebleeds.

NERVES

Olfactory Nerve (CNI):The olfactory nerve transmits signals from the nasal cavity to the
brain to give the sense of olfaction. The olfactory epithelium is in the superior portion of
the nasal cavity. Within this epithelium are sensory cilia that project up through the
cribriform plate to the olfactory bulb. From the olfactory bulb, signals are sent through
the olfactory nerve proper to a network of secondary neurons for processing before
ending up in the brain

Trigeminal Nerve (CNV):The trigeminal nerve is the sensory innervation to the external
and internal nose. The branches are the ophthalmic (V1), maxillary (V2), and mandibular
(V3). Sympathetic and parasympathetic fibers run with these branches to supply their
target tissues. The ophthalmic and maxillary branches innervate the nose and nasal
cavity.

Ophthalmic Branches (V1):As the ophthalmic nerve begins to branch, it gives off a
nasociliary branch, which then provides the anterior and posterior ethmoid nerves. The
anterior ethmoid gives off an external branch that supplies the nasal tip, an internal
branch that supplies the anterosuperior nasal cavity and a septal branch that supplies
the anterior superior nasal septum. The posterior ethmoid supplies the posterosuperior
nasal cavity. Two other branches of the ophthalmic branch of the trigeminal nerve are
the supratrochlear and infratrochlear nerves that supply the nasal dorsum.

Maxillary Branches (V2): The maxillary branches of the trigeminal nerve that innervate
the nose and nasal cavity branch in or near the pterygopalatine fossa then enter the
nasal cavity. The only external nasal branch is the infraorbital nerve, which supplies the
malar and lateral nose.

Openings of the internal nose

Air enters the nasal cavity from the outside through two openings: the nostrils or
external nares. The openings from the nasal cavity into the pharynx are the internal
nares.

The nostrils or nasal vestibule is completely lined by squamous epithelium. It is a

stratified epithelium composed of basal cells along the basal lamina and several layers
of squamous cells, which become progressively flatter toward the luminal surface. It
formes an entrance into the nasal cavity.

The nasopharynx is the upper part of the throat (pharynx) that lies behind the nose and
is the second opening of the internal nose. It’s a box-like chamber about 1½ inches on
each edge. It lies just above the soft part of the roof of the mouth (soft palate) and just
in back of the nasal passages

The nasopharynx is continuous with the nasal cavity and forms the upper part of the
respiratory system. It plays an important role in transferring air from the nose to the
larynx

Paranasal sinuses

The paranasal sinuses are air-filled extensions of the nasal cavity. There are four paired
sinuses – named according to the bone in which they are located – maxillary, frontal,
sphenoid and ethmoid. Each sinus is lined by a ciliated pseudostratified epithelium,
interspersed with mucus-secreting goblet cells. The sinuses are lined with mucous
membranes. Mucous membranes are thin layers of moist tissues that produce the
goopy material known as mucus.
The function of the paranasal sinuses is a topic of much debate. Various roles have been
suggested:

 Lightening the weight of the head

 Supporting immune defence of the nasal cavity

 Humidifying inspired air

 Increasing resonance of the voice

The paranasal sinuses are formed during development by the nasal cavity eroding into
the surrounding bones. All the sinuses therefore drain back into the nasal cavity –
openings to the paranasal sinuses can be found on the roof and lateral nasal walls.

Frontal sinuses

There are two frontal sinuses located within the frontal bone of the skull. They are the most
superior of the paranasal sinuses, and are triangular in shape.

Drainage is via the frontonasal duct. It opens out at the hiatus semilunaris, within the middle
meatus of the nasal cavity.

Sensation is supplied by the supraorbital nerve (a branch of the ophthalmic nerve), and arterial
supply is via the anterior ethmoidal artery (a branch of the internal carotid).
 Ethmoidal Sinuses

There are three ethmoidal sinuses located within the ethmoid bone:

• Anterior – Opens onto the hiatus semilunaris (middle meatus)

• Middle – Opens onto the lateral wall of the middle meatus
• Posterior – Opens onto the lateral wall of the superior meatus

They are innervated by the anterior and posterior ethmoidal branches of the nasociliary nerve and
the maxillary nerve. The anterior and posterior ethmoidal arteries are responsible for arterial
supply.

Sphenoid Sinuses
The sphenoid sinuses are situated within the body of the sphenoid bone. They open out into the
nasal cavity in an area supero-posterior to the superior cocha – known as the spheno-ethmoidal
recess.They are

innervated by the posterior ethmoidal nerve (a branch of the ophthalmic nerve), and branches of the
maxillary nerve. They recieve blood supply from pharyngeal branches of the maxillary arteries.

Maxillary Sinuses

The maxillary sinuses are the largest of the sinuses. They are located laterally and slightly
inferiorly to the nasal cavities.

They drain into the nasal cavity at the hiatus semilunaris, underneath the frontal sinus
opening. This is a potential pathway for spread of infection – fluid draining from the
frontal sinus can enter the maxillary sinus.

Olfactory Receptors

The olfactory bulb of the brain processes information from the olfactory receptors lining
the nose. The olfactory system is at the roof of the nasal cavity at the cribriform plate – a
perforated portion of the ethmoid bone separating the frontal lobe of the cerebrum
from the nasal cavity. Odorant molecules within the nasal passages first encounter
receptors on the primary cilia of olfactory sensory neurons.
The olfactory epithelium is composed of three basic cell types (sensory, sustentacular,
and basal cells).

Olfactory receptor, also called smell receptor, protein capable of binding odour
molecules that plays a central role in the sense of smell (olfaction).The receptors are
located on olfactory receptor cells, which are present in very large numbers (millions)
and are clustered within a small area in the back of the nasal cavity, forming an olfactory
epithelium. Each receptor cell has a single external process that extends to the surface
of the epithelium and gives rise to a number of long, slender extensions called cilia. The
cilia are covered by the mucus of the nasal cavity, facilitating the detection of and
response to odour molecules by olfactory receptors.

Within the cell membrane, olfactory receptor proteins are oriented in such a way that
one end projects outside the cell and the other end projects inside the cell. This makes it
possible for a chemical outside the cell, such as a molecule of an odorant, to
communicate with and produce changes in the cellular machinery without entering the
cell. The outerand inner ends of receptor proteins involved in smell are connected by a
chain of amino acids.

Mucus membrane
The nasal mucosa lines the nasal cavity. It is part of the respiratory mucosa, the mucous
membrane lining the respiratory tract. The nasal mucosa is intimately adherent to the
periosteum or perichondrium of the nasal conchae. It is continuous with the skin
through the nostrils, and with the mucous membrane of the nasal part of the pharynx
through the choanae. From the nasal cavity its continuity with the conjunctiva may be
traced, through the nasolacrimal and lacrimal ducts; and with the frontal, ethmoidal,
sphenoidal, and maxillary sinuses, through the several openings in the nasal meatuses.
The mucous membrane is thickest, and most vascular, over the nasal conchae. It is also
thick over the nasal septum where increased numbers of goblet cells produce a greater
amount of nasal mucus. It is very thin in the meatuses on the floor of the nasal cavities,
and in the various sinuses. It is one of the most commonly infected tissues in adults and
children. Inflammation of this tissue may cause significant impairment of daily activities,
with symptoms such as stuffy nose, headache, mouth breathing, etc.

Nasal Mucus glands

The nasal glands are the seromucous glands in the respiratory region of the nasal
mucous membrane. The three major types of nasal glands are anterior serous glands,
seromucous glands, and Bowman glands.Nasal mucus contains 90% water and
glycoproteins as well as ions. It is produced by submucosal, seromucous glands, goblet
cells, transsudation of blood plasma, mucosal tissue fluid and tear fluid.