THE NOSE

Nose
= organon olfactus
Sense of smell
 Receive smell impuls from the air
dependent on olfactory cells located
within olfactory epithelium high in the
roof of the nasal cavity where each cell
ends in a tuft of about five olfactory
cilia, which bear receptor proteins for
odor molecules, continued to the brain
As part of respiration system
How the Brain Receives Odor Information
Parts:
External nose (nasus
externus )
Nasal cavity (cavum nasi)
EXTERNAL NOSE
 consists of a bony and cartilaginous
framework closely overlaid by skin
and fibrofatty tissues
 The bones are the two nasal bones and
the frontal processes of the maxilla
 The ala is composed solely of fatty
tissue at its lower free edge.
 Parts:
 radix nasi, dorsum nasi, apex nasi,
nares
Skeleton
Superior: Os nasal, os frontal, os
maxilla
Inferior : hyaline cartilage
Vascularization:
branch of a. maxillaries and a.
opthalmica
Innervation:
n. nasalis externus, n.
infratrochlearis (Sensible
fibres)
Muscles of the nasal
alar:

1. Dilators :
- m. dilator nares ( anterior
dan posterior )
- m. proserus
- kaput angulare m. kuadratus
labii superior
2. Constrictors :
- m. nasalis
- m. depresor septi
 NASAL CAVITY
 divided into right and left halves
by a median nasal septum formed by
the perpendicular plate of the
ethmoid bone, the septal cartilage
and the vomer
 Each cavity extends from the nostril
(or anterior nares) in front to the
posterior nasal aperture behind,
communicating through the latter
with the nasopharynx
 Behind the nostril vestibule, an
area that contains many sebacea
glands and hairs that are called
vibrisae
The lateral wall is very
irregular, due to the projection
of the three conchae (superior,
middle and inferior) and the
underlying meatuses ( superior,
middle and inferior)
Nasal Cavity
Structures:
Roof
formed by: os nasale, os frontal,
os ethmoid dan corpus os sphenoidale
Floor
corresponds to the roof of the
mouth; it comprises the palatine
process of the maxilla, the
horizontal process of the palatine
bone and the soft palate.
Lateral wall
formed by: os nasal, os maxilla,
os lacrimal, os ethmoidal, concha
nasalis inferior and os sphenoid
Lateral Wall of Nasal cavity
Nasal Sinuses
Vascularization
3 main sources
1. a. etmoidalis anterior, supplies superior
anterior part of nose septal and lateral wall
of the nose
2. a. etmoidalis posterior ( branch from a.
oftalmika ), supplies superior posterior part
of nose septal
3. a. sfenopalatina, divided into a. nasales
posterolateral (supplies lateral wall of nose
and dan a. septi posterior that spread on
nasal septal)
Just within the vestibule of the nose, on the
anteroinferior part of the septum, it links
with a septal branch of the facial artery and
it is from this zone, Little’s area( pleksus
Kiesselbach ) that 90% of nose-bleeds occur.
The veins drain
downwards into the facial
vein and upwards to the
ophthalmic veins.
Nose Vascularization
PARANASAL SINUSES
are air-containing sacs lined by ciliated
epithelium
communicating with the nasal cavity
through narrow, and therefore easily
occluded, channels
The exact function of the sinuses is
unknown, but they may help to :
 make the head lighter (by replacing bone
with air)
 improve the resonance of the voice,
 provide a larger surface area for the
lining of the nose to help with cleaning,
warming and humidifying the air we breath.
Types: frontal, maxillary, sphenoidale
and ethmoidale sinuses
 Frontal sinuses
 contained in frontal bone / os
frontal
 Shapes are roughly triangular
 separated from each other by a
median bony septum
 Each sinus drains into the
anterior part of the middle nasal
meatus via the infundibulum into
the hiatus semilunaris.
Structures:
 its posterosuperior wall
lying adjacent to the frontal
lobe of the brain
its floor abutting against
the ethmoid cells, the roof
of the nasal fossa and the
orbit
2. Maxillary sinus
(Antrum of Highmore)
Is the biggest paranasal sinus
a pyramidal-shaped sinus occupying the
cavity of the maxilla
Its medial wall forms part of the
lateral face of the nasal cavity and
bears on it the inferior concha
Above this concha is the opening, or
ostium, of the maxillary sinus into the
middle meatus in the hiatus semilunaris
(½ - 1 cm lower than nasal cave floor)
its floor bears the impressions of the
upper premolar and molar roots
 3. Ethmoid Sinuses
are made up of a group of 8–10 air
cells within the lateral mass of the
ethmoid
lie between the side-walls of the upper
nasal cavity and the orbits
Superiorly, they lie on each side of
the cribiform plate and are related
above to the frontal lobes of the
brain.
These cells drain into the superior and
middle meatus
 4. Sphenoid Sinuses
• These lie one on either side of the midline,
within the body of the sphenoid

• They vary a good deal in size and may extend

laterally into the greater wing of the sphenoid or
backwards into the basal part of the occipital
bone

• Each sinus drains into the nasal cavity above

the superior concha (the sphenoethmoidal
recess).
Opening of the sinuses
 The lateral wall of the right nasal cavity;
the conchae have been partially removed to show structures which drain into
the nose.
 Clinical Features

1. The maxillary sinus, or antrum, may become

infected either from the
• nasal cavity or from caries of the upper molar teeth.

 Antral puncture can be carried out using a trocar and cannula

passed through the nasal cavity in an outward and backward
direction below the inferior concha
.
2. The numerous symptoms and signs which may be produced by a
carcinoma of the maxillary sinus can be as follow:

(a) Medial invasion encroaches on the nasal cavity  obstruction of the

nares and epistaxis. Blockage of the nasolacrimal duct  cause
epiphorea (leakage of tears down the face).
(b) Invasion of the orbit  displaces the globe and causes diplopia
(c ) Invasion of the sinus floor may produce a visible bulge or even
ulceration in the palatal roof.
(d) Lateral spread may produce a swelling of the face or a palpable mass
in the gingivolabial fold.
(e) Posterior spread may involve the palatine nerves and produce severe
pain referred to the teeth of the upper jaw.