Nasal region. cartilages: septal cartilage (l); lateral nasal cartilage (2); greater alar cartilages (2); lesser alar cartilages (?

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1 Nasal region skull bones: nasal and frontal processes of maxilla cartilages: septal cartilage (l); lateral nasal cartilage (2); greater alar cartilages (2); lesser alar cartilages (?) 1

2 Nasal cavity Roof : cartilage, nasal bone, spine of frontal bone, cribriform plate of ethmoidal bone, body of sphenoid bone. Floor: palatine process of maxilla, horizontal plate of palatine Medial wall: septal cartilage, perpendicular plate of ethmoid bone, vomer Lateral wall is made irregular by three conchae, vertical plate of hard palatine, med. pterygoid plate 2

3 Nasal cavity Perpendicular plate of ethmoid Septal cartilage Vomer Medial wall: septal cartilage, perpendicular plate of ethmoid bone, vomer 3

4 Nasal cavity Sphenoethmoid recess Superior concha Superior meatus Middle concha Middle meatus Inferior meatus Inferior concha Lateral wall is made irregular by three conchae superior concha & middle concha: are processes of the ethmoid bone inferior concha an independent bone 4

5 Lateral wall of the nasal cavity Sphenoethmoid recess Superior meatus sphenoethmoidal recess: a recess lying above and behind the superior concha sphenoid sinus superior meatus : is above the posterior 1/2 of the middle concha post. ethmoidal air cells 5

6 Lateral wall of the nasal cavity Middle meatus Inferior meatus middle meatus under the overhang of the middle concha Ethmoidal infundibulum: frontal sinus via frontonasal duct to it Semilunar hiatus: ant. ethmoidal sinus, maxillary sinus, Ethmoidal bulla: middle ethmoidal cell inferior meatus: nasolacrimal duct 6

7 Lateral wall of the nasal cavity Superior concha Middle concha Sphenopalatine foramen Inferior concha Medial pterygoid plate vertical plate of hard palatine 7

8 Nerve supply of nasal cavity Special sensory: olfactory n., innervates the olfactory area of the nasal cavity anterior ethmoidal n.: supply the anterior superior areas of the septum and lateral wall, and provides the external and internal nasal branches to supply the lower 1/2 of the nose. Nasopalatine: from spheonpalatine foramen, supply the septum 8

9 Nerve supply of nasal cavity post. inferior lateral nasal n.: from the greater palatine n., supply the conchae and meatuses of the lateral wall. ant. sup. alveolar n. distribute the floor and inferior meatus 9

10 Sphenopalatine foramen Frontal view of nasal cavity Nasopalatine n. Sphenopalatine a. post. inferior lateral nasal n.: from the greater palatine n., supply the conchae and meatuses of the lateral wall. 10

11 Nerve supply of nasal cavity post. inferior i lateral l nasal n Olfactory n. Ant. ethmoid br. Special sensory: olfactory n., innervates the olfactory area of the nasal cavity anterior ethmoidal n.: supply the anterior superior areas of the septum and lateral wall, and provides the external and internal nasal branches to supply the lower 1/2 of the nose. post. inferior lateral nasal n post. inferior lateral nasal n.: from the greater palatine n., supply the conchae and meatuses of the lateral wall. 11

12 Blood supply of nasal cavity ophthalmic a ant. ethmoidal br, post. ethmoidal br maxillary a sphenopalatine a, greater palatine a facial a. septal branch of superior labial a. 12

13 Blood supply of nasal cavity 13

14 Paranasal sinuses Including frontal, ethmoid, sphenoid & maxillary sinus 14

15 Paranasal sinuses Frontal sinuses empties into the anterior part of the middle meatus via the frontonasal duct. Ethmoidal air cells (i) anterior: opens into the depth of anterior part of the semilunar hiatus, (ii) middle: opens into the ethmoidal bulla, (iii) posterior: opens into the superior meatus of the nose. Sphenoidal sinuses opens into the sphenoethmoidal recess. Maxillary sinuses opens from its upper medial wall into the posterior part of the semilunar hiatus 15

16 Paranasal sinuses 16

17 Paranasal sinuses Frontal sinuses empties into the anterior part of the middle meatus via the frontonasal duct. supplied by supraorbital nerve Ethmoidal air cells (i) anterior: opens into the depth of anterior part of the semilunar hiatus, (ii) middle: opens into the ethmoidal bulla, (iii) posterior: opens into the superior meatus of the nose. nerve supply by anterior and posterior ethmoidal n. 17

18 Paranasal sinuses Sphenoidal sinuses opens into the sphenoethmoidal recess. supply by posterior ethmoidal n. Maxillary sinuses opens from its upper medial wall into the posterior part of the semilunar hiatus nerve supply by(ant., mid. & post) superior alveolar nerve 18

19 Nasal cavity: y roof, floor, lateral and medial wall. Floor: palatine process of maxilla, horizontal plate of palatine Medial wall: septal cartilage, perpendicular plate of ethmoid bone, vomer. Lateral wall: Sphenoethmoidal recess (sphenoid sinus) Superior concha Superior meatus (post. ethmoidal sinus) Middle concha Middle meatus: ethmoidal infundibulum (frontal sinus), semilunar hiatus (ant. ethmoidal and maxillary sinus), ethmoidal bulla (middle ethmoidal sinus) Inferior concha Inferior meatus: nasolacrimal duct 19

20 Blood supply of nasal cavity: ophthalmic a., facial a., maxillary a. (sphenopalatine & greater palatine a.) Nerve innervation of nasal cavity Special: olfactory n. General: ophthalmic n. (ant. & post. ethmoidal n.), maxillary n. (nasopalatine & greater palatine n.) Frontal sinus: surpraorbital n. Ethmoidal sinus: ant. & post. ethomidal n. Sphenoidal sinus: post. ethmoidal n. Maxillary sinus: ant., middle, & post. Superior alveolar n. 20

21 Nasal Region Dr. Lue, Grossanatomy Surface Anatomy Examine the external nose noting its bony and cartilagenous parts skull bones: nasal and frontal processes of maxilla cartilages: septal cartilage (l); lateral nasal cartilage (2); greater alar cartilages (2); lesser alar cartilages (6) Nasal cavity Each nasal cavity has a roof, floor, lateral wall and a medial wall formed by the nasal septum Roof: cartilage, nasal bone, spine of frontal bone, cribriform plate of ethmoidal bone, body of sphenoid bone Floor: palatine process of maxilla, horizontal plate of palatine Medial wall: septal cartilage, perpendicular plate of ethmoid bone, vomer Lateral wall is made irregular by three conchae, vertical plate of hard palatine, medial pterygoid plate superior concha & middle concha: are processes of the ethmoid bone inferior concha an independent bone sphenoethmoidal recess: a recess lying above and behind the superior concha sphenoid sinus superior meatus : is above the posterior 1/2 of the middle concha post. ethmoidal air cells middle meatus under the overhang of the middle concha. Ethmoidal infundibulum: frontal sinus via frontonasal duct to it Semilunar hiatus: 1) ant. ethmoidal sinus; 2) maxillary sinus Ethmoidal bulla: middle ethmoidal cell inferior meatus: nasolacrimal duct Nerve supply Special sensory: olfactory n., innervates the olfactory area of the nasal cavity. General sensory: the nerves of general sensation for pain, temperature and touch are derived from the first two divisions of the Vn. anterior ethmoidal n.: supply the anterior superior areas of the septum and lateral wall, and provides the external and internal nasal branches to 1

22 supply the lower 1/2 of the nose. posterior ethmoid n.: ethmoid cells Nasopalatine & post. superior lateral nasal n.: via sphenopalatine foramen, supply the septum and lateral wall of nasal cavity, respectively post. inferior lateral nasal n.: from the greater palatine n., supply the conchae and meatuses of the lateral wall. ant. sup. alveolar n. distribute the floor and inferior meatus. Arterial supply ophthalmic a. ant. ethmoidal brr. post. ethmoidal brr. both of the two arteries supply the anterior portions of the superior and middle conchae and an adjacent area of septum, as well as providing twigs to the frontal, ethmoidal and sphenoid sinuses maxillary a. sphenopalatine a. greater palatine a. facial a. septal branch of superior labial a. Venous drainage Posteriorly, by the sphenopalatine to the pterygoid plexus Anteriorly, by radicles which join the facial vein; Superiorly, by ethmoidal veins to the ophthalmic v. Paranasal sinuses : these sinuses are pneumatic areas in the frontal, ethmoid, sphenoid, and maxillary bones Principal functions of the sinuses a) as resonating chambers for the voice b) as a means of lightening the bones of the head Frontal sinuses located on either side of the median line within the frontal bone and behind the superciliary arches it empties into the anterior part of the middle meatus via the frontonasal duct 2

23 supplied by supraorbital nerve Ethmoidal air cells - small, numerous, thin-walled cells located within the ethmoidal labyrinth of the ethmoidal bone they are divided into three groups: (i) anterior: opens into the depth of anterior part of the semilunar hiatus (ii) middle: opens into the ethmoidal bulla (iii) posterior: opens into the superior meatus of the nose nerve supply by anterior and posterior ethmoidal n. Sphenoidal sinuses paired, located in the body of the sphenoid bone, and separated from each other by a bony septum it opens into the sphenoethmoidal recess of its own side supply by posterior ethmoidal n. Maxillary sinuses the largest of the paranasal sinuses maxillary sinusitis is frequently accompanied by tooth-ache opens from its upper medial wall into the posterior part of the semilunar hiatus nerve supply by ant., middle, and post. superior alveolar nerve blood supply by superior alveolar and greater palatine aa. 3

Bisection of Head & Nasal Cavity 頭部對切以及鼻腔. 解剖學科馮琮涵副教授分機

Bisection of Head & Nasal Cavity 頭部對切以及鼻腔解剖學科馮琮涵副教授分機 3250 E-mail: thfong@tmu.edu.tw Outline: The structure of nose The concha and meatus in nasal cavity The openings of paranasal sinuses Canals, foramens