AIRWAYS
Respiratory system: nose and pharynx upper airways & larynx, trachea, bronchi and lungs lower airways
Nose
External nose
Apex and root:
Dorsum
Nares as the inferior opening of nostrils to the nasal cavity
Alae as the lateral portions or wings of nostrils encircling nares (nostrils)
Vestibule as the inside nose enlargement with long hairs and skin trapping particles
Nasal part of frontal bone, nasal bones, fontal processes of maxillae and bony nasal septum
Ethmoid bone with perpendicular plate and vomer
Cartilaginous framework:
Septal cartilage, 2 lateral nasal cartilages and 2 alar cartilages
Nasal septum
½ of the nasal cavities
Bony part:
Perpendicular plate of ethmoid bone with postero-superior cribriform plate and crista galli
Vomer which is postero-inferior
Cartilaginous part: septal cartilage of hyaline cartilage occurring anterior to perpendicular
plate and vomer bone
,Nasal cavity
Nasal cavity between nares anteriorly and superior, middle & inferior choanae posteriorly
2
Inferior 3 of nasal mucosa is the respiratory area that warms and moistens air
1
Superior 3 is the olfactory area for smell
Boundaries
Roof: frontal nasal bone, cribriform plate of ethmoid bone and body of sphenoid bone
2 1
Floor: hard palate, 3 palatine process of maxilla anteriorly and 3 horizontal plates palatine
bone posteriorly
Medial wall: nasal septum
Lateral wall: conchae, meatus and recess
➔ Nasal conchae or turbinate are 3 shelves formed by projections of superior, middle
and inferior nasal conchae extending out each lateral wall
Superior & middle conchae is ethmoid bone and inferior conchae is a separate bone
➔ Meatus is a deep in the nasal cavity forming a groovelike passageway
➔ Spheno-ethmoidal recess is postero-superior receiving spheno-ethmoidal sinuses
,Paranasal sinuses
Paranasal sinuses are air filled extensions of respiratory nasal cavity into frontal sinuses,
ethmoidal cells, sphenoidal sinuses and maxillary sinuses
Increases surface are for cleaning, humidifying air and lightens weight of skull
Frontal sinuses of frontal bone: posterior root of nose where nose attaches occurring more
superiorly
Apertures: frontonasal duct -> ethmoid infundibulum -> middle meatus
Nerve supply: cranial nerve 1 CNV1
Ethmoidal sinuses of ethmoid bone: ethmoidal cells of middle and superior meatus
occurring more anteriorly
Apertures: anterior into middle meatus, middle into middle meatus and posterior into
superior meatus
Nerve supply: CNV1
Sphenoidal sinuses of the body of sphenoid bone: separated by thin-walled septum
occurring more posteriorly
Apertures: spheno-ethmoidal recess
Nerve supply: CNV1
Maxillary sinuses is the largest of the body of maxilla: apex -> zygomatic bone, base -> hard
palate, roof -> orbit and floor -> inferior wall of the nasal cavity occurring more inferiorly
Apertures: middle meatus
Nerve supply: CNV2
Drains into
➔ Speno-ethmoidal recess: sphenoid sinus
➔ Superior meatus: posterior ethmoidal cells into the lateral wall
➔ Middle meatus
Semilunar hiatus: inferior to ethmoidal bulla as a semi-circular groove
Frontal sinus -> fronto-nasal duct -> ethmoidal infundibulum
Anterior ethmoidal air cells -> ethmoidal infundibulum
Maxillary sinus
Ethmoidal bulla formed by middle ethmoidal cells (elevation)
➔ Inferior meatus: nasolacrimal duct
, Vasculature of nose
ARTERIES
Blood supply of medial and lateral walls of nose
➔ Ophthalmic artery -> ICA (external nose)
➔ Maxillary artery -> ECA
➔ Facial artery -> ECA (external nose)
Kiesselbach area forms an anastomosis with five arteries supplying the nasal septum
Lateral wall of nasal cavity: branches of sphenopalatine artery from the maxillary artery
Lateral nasal branches of facial artery
Medial wall of nasal septum: Kiesselbach anastomosis with arteries supplying septum
Posterior and anterior ethmoidal arteries
Septal branch superior labial artery
Greater palatine artery
Branches of sphenopalatine artery
VEINS
Medial and lateral walls drain via submucosal venous plexus to the ophthalmic, facial and
sphenopalatine veins assisting in thermoregulation altering temperature of external air
Respiratory system: nose and pharynx upper airways & larynx, trachea, bronchi and lungs lower airways
Nose
External nose
Apex and root:
Dorsum
Nares as the inferior opening of nostrils to the nasal cavity
Alae as the lateral portions or wings of nostrils encircling nares (nostrils)
Vestibule as the inside nose enlargement with long hairs and skin trapping particles
Nasal part of frontal bone, nasal bones, fontal processes of maxillae and bony nasal septum
Ethmoid bone with perpendicular plate and vomer
Cartilaginous framework:
Septal cartilage, 2 lateral nasal cartilages and 2 alar cartilages
Nasal septum
½ of the nasal cavities
Bony part:
Perpendicular plate of ethmoid bone with postero-superior cribriform plate and crista galli
Vomer which is postero-inferior
Cartilaginous part: septal cartilage of hyaline cartilage occurring anterior to perpendicular
plate and vomer bone
,Nasal cavity
Nasal cavity between nares anteriorly and superior, middle & inferior choanae posteriorly
2
Inferior 3 of nasal mucosa is the respiratory area that warms and moistens air
1
Superior 3 is the olfactory area for smell
Boundaries
Roof: frontal nasal bone, cribriform plate of ethmoid bone and body of sphenoid bone
2 1
Floor: hard palate, 3 palatine process of maxilla anteriorly and 3 horizontal plates palatine
bone posteriorly
Medial wall: nasal septum
Lateral wall: conchae, meatus and recess
➔ Nasal conchae or turbinate are 3 shelves formed by projections of superior, middle
and inferior nasal conchae extending out each lateral wall
Superior & middle conchae is ethmoid bone and inferior conchae is a separate bone
➔ Meatus is a deep in the nasal cavity forming a groovelike passageway
➔ Spheno-ethmoidal recess is postero-superior receiving spheno-ethmoidal sinuses
,Paranasal sinuses
Paranasal sinuses are air filled extensions of respiratory nasal cavity into frontal sinuses,
ethmoidal cells, sphenoidal sinuses and maxillary sinuses
Increases surface are for cleaning, humidifying air and lightens weight of skull
Frontal sinuses of frontal bone: posterior root of nose where nose attaches occurring more
superiorly
Apertures: frontonasal duct -> ethmoid infundibulum -> middle meatus
Nerve supply: cranial nerve 1 CNV1
Ethmoidal sinuses of ethmoid bone: ethmoidal cells of middle and superior meatus
occurring more anteriorly
Apertures: anterior into middle meatus, middle into middle meatus and posterior into
superior meatus
Nerve supply: CNV1
Sphenoidal sinuses of the body of sphenoid bone: separated by thin-walled septum
occurring more posteriorly
Apertures: spheno-ethmoidal recess
Nerve supply: CNV1
Maxillary sinuses is the largest of the body of maxilla: apex -> zygomatic bone, base -> hard
palate, roof -> orbit and floor -> inferior wall of the nasal cavity occurring more inferiorly
Apertures: middle meatus
Nerve supply: CNV2
Drains into
➔ Speno-ethmoidal recess: sphenoid sinus
➔ Superior meatus: posterior ethmoidal cells into the lateral wall
➔ Middle meatus
Semilunar hiatus: inferior to ethmoidal bulla as a semi-circular groove
Frontal sinus -> fronto-nasal duct -> ethmoidal infundibulum
Anterior ethmoidal air cells -> ethmoidal infundibulum
Maxillary sinus
Ethmoidal bulla formed by middle ethmoidal cells (elevation)
➔ Inferior meatus: nasolacrimal duct
, Vasculature of nose
ARTERIES
Blood supply of medial and lateral walls of nose
➔ Ophthalmic artery -> ICA (external nose)
➔ Maxillary artery -> ECA
➔ Facial artery -> ECA (external nose)
Kiesselbach area forms an anastomosis with five arteries supplying the nasal septum
Lateral wall of nasal cavity: branches of sphenopalatine artery from the maxillary artery
Lateral nasal branches of facial artery
Medial wall of nasal septum: Kiesselbach anastomosis with arteries supplying septum
Posterior and anterior ethmoidal arteries
Septal branch superior labial artery
Greater palatine artery
Branches of sphenopalatine artery
VEINS
Medial and lateral walls drain via submucosal venous plexus to the ophthalmic, facial and
sphenopalatine veins assisting in thermoregulation altering temperature of external air
