Flashcards in Head And Neck Session 7 Deck (63):
What gives innervation to the ala of the nose?
Nasal branches of the intra orbital nerve, a branch of CNV2
What gives innervation to the dorsum and apex of the nose?
Infratrochlear and external anterior ethmoid all nerves, branches of CNV1
What gives arterial supply to the nose?
Anterior ethmoidal, septal branch of superior labial and nasal branches of infra-orbital and facial artery
What gives venous drainage to the nose?
Angular and lateral nasal veins that drain into the facial vein and cavernous sinus
What allows the nares to constrict or dilate when the surrounding muscles act?
U-shaped major alar cartilage that are free to move
What type of skin covers the superior bony part of the nose?
What type of skin covers the cartilaginous part of the nose?
Thicker skin with sebaceous glands
What is the limen nasi?
Boundary between skin types from development as skin was drawn in from nasal pits
What skin is found in the vestibule of the nose?
Same as on the cartilaginous part with additional vibrissae
What forms the roof of the nasal cavities?
Frontonasal, ethmoidal and hollow body of sphenoid
What structures are found in the lateral wall of the nasal cavities?
What forms the nasal septum to make up the medial wall of the nasal cavities?
Crista galli, nasal spine of frontal bone, septal cartilage, nasal crest of maxilla, nasal crest of palatine bone, vomer, crest of sphenoid bone and perpendicular plate of ethmoid bone
What forms the floor of the nasal cavities?
Palatine processes of maxilla and horizontal plates of palatine bone
What are the openings of the nasal cavities?
Describe the arrangement of the nasal mucosa in the nasal cavities.
Firmly bound to periosteum and perichondrium, continuous with the nasopharynx, paranasal sinuses, lacrimal sac and conjunctiva
How does the inferior 2/3 of nasal mucosa differ from the superior 1/3?
Inferior 2/3 is respiratory and superior 1/3 is olfactory
What type of epithelium is respiratory mucosa?
Pseudostratified columnar with cilia and goblet cells
What type of epithelium is olfactory mucosa?
Olfactory cells with sustenacular cells and Bowman's glands
Which concha are associated with the ethmoid bone?
Superior and middle
What is the purpose of the large vascular spaces in the mucous membrane of the inferior concha?
Can swell and shrink to control diameter
What in the nasal cavity receives sphenoid all sinus drainage?
What drainage does each meatus in the nasal cavity receive?
Superior: posterior ethmoidal sinuses
Middle: maxillary, frontal and ethmoidal
Inferior: nasolacrimal duct and eustaschian tube
Where is the common nasal meatus found?
Between conchae and nasal septum
What does the ethmoidal infundibulum allow passage of?
Frontonasal duct through ethmoidal labyrinth
What is the semilunar hiatus?
Frontal sinus opening into the nasal cavity
Which two branches of the ophthalmic artery supply the medial wall of the nasal cavities?
Anterior ethmoidal and posterior ethmoidal
Which branches of the ECA supply the medial wall of the nasal cavities?
Septal branch of superior labial from the facial artery and greater palatine from the maxillary artery
What does the foramen cecum allow passage of in some patients?
Nasal veins to superior sagittal sinus
Which branch of the maxillary artery supplies the lateral wall of the nasal cavities?
Branches of the sphenopalatine artery
What gives venous drainage to the nasal cavities?
Sphenopalatine, facial and ophthalmic veins drain to the submucosal be venous plexus and into the pterygoid plexus and cavernous sinus
What is the function of the submucosal venous plexus of the nose?
Describe the innervation of the anterosuperior portion of the nasal cavities.
Ophthalmic nerve (CNV1) branches to nasociliary nerve giving rise to anterior and posterior ethmoidal nerves
Describe the innervation of the postoinferior portion of the nasal cavities.
Maxillary nerve (CNV2) gives rise to the greater palatine nerve to innervate the lateral wall and the nasopalatine nerve to innervate the septum
What are the functions of the nose?
Olfaction, filtration, drain and eliminate paranasal sinus and nasolacrimal duct secretions, registration and humidification
What are the paranasal sinuses?
Paired mucous membrane lined out-pocketings of nasal cavity named according to their bony location
What is the function of paranasal sinuses?
Where are the frontal sinuses located?
Posterior to superciliary arches and root of nose
At what age can the frontal sinuses be detected?
Describe the passage taken by contents draining from the frontal sinuses.
Frontonasal duct --> ethmoidal infundibulum --> semilunar hiatus of middle nasal meatus
What provides innervation to the frontal sinuses?
Supra-orbital nerves (CNV1)
Why does the septum near the frontal sinuses usually deviate?
Right and left frontal sinuses and rally equal in size
Where are the two parts of the frontal sinuses located?
Vertical in squamous frontal bone, horizontal in orbital frontal bone
What forms the roof of the frontal sinuses?
Floor of anterior cranial fossa
What forms the floor of the frontal sinuses?
Roof of orbit
What forms the apex of the maxillary sinuses?
What do the base of the maxillary sinuses form?
Inferior lateral wall of nasal cavity
What forms the roof of the maxillary sinuses?
Floor of orbit
What often causes conical elevations to appear on the maxillary sinus floor?
Roots of first two molars in the alveolar part of maxilla
Describe the passage of contents draining from the maxillary sinus.
Maxillary Ostia --> semilunar hiatus --> middle nasal meatus
What gives arterial supply to the maxillary sinuses?
Mainly superior alveolar branches of maxillary artery and descending and greater palatine arches to the floor
What gives innervation it the maxillary sinuses?
Anterior, middle and posterior superior alveolar nerves, all branches of the maxillary nerve
Describe the development of the maxillary sinuses through childhood.
Present at birth but do not enlarge until ~8 y.o.
Where are the ethmoidal sinuses found?
Between nasal cavity and orbit
If a patient is less than 2 y.o. What imaging method is. Needed to visualise the ethmoidal sinuses?
Describe the drainage of the anterior, middle and posterior ethmoidal air cells.
Anterior: ethmoidal infundibulum --> middle nasal meatus
Middle: --> middle nasal meatus
Posterior: --> superior meatus
What gives innervation to the ethmoidal sinuses?
Anterior and posterior ethmoidal branches of nasociliary nerves (CNV1)
At ~2 y.o. Which other sinus do the ethmoidal sinuses invade?
Describe the location of the sphenoid sinuses.
In body of sphenoid but may extend to wings, unevenly divided by bony septum
What do the thin plates of bone around the sphenoid sinus separate it from?
Optic nerves, optic chiasm, pituitary gland and fossa, ICA, cavernous sinuses, middle and posterior cranial fossae, pons and nasopharynx roof
What happens if several posterior ethmoidal air cells invade the sphenoid sinuses?
Sphenoidal sinuses open separately into sphenoethmoidal recess
What gives neurovascular supply to the sphenoid sinuses?
Posterior ethmoidal arteries and nerves
Describe the change in the sphenoid sinuses observed from birth to puberty.
Small at birth and enlarge after puberty