Nose

Front 1

Anterior ethmoidal nerve

Back 1

Branch from opthalmic (V1)

Sensory branches to lateral and medial aspect of the nasal cavity before it terminates as external nasal nerve at the tip of the nose.

Front 2

Nasopalatine nerve

Back 2

From Maxillary nerve (V2)

Runs on either side of the vomer and then enters incisive canal in hard palate. Communicates with the greater palatine branch of the maxillary nerve.

Front 3

Greater palatine nerve

Back 3

From Maxillary nerve (V2)

Runs through and on the under surface of the hard palate where it communicates with the nasopalatine nerve.

Front 4

Pterygopalatine ganglion

Back 4

Suspended from maxillary nerve (V2) in the pterygopalatine fossa.

Post synaptic nerves from pterygopalatine ganglion (PG) allow you to lacrimate and innervates nasopalatine glands which produce mucus.

Motor parasympathetic through the greater petrosal nerve.

Sympathetic motor fibers from the carotid plexus.

Front 5

Sphenopalatine artery

Back 5

A terminal branch of the maxillary artery. Enters nasal cavity through sphenopalatine foramen, and then branches into multiple arteries that supply the nasal cavity.

Front 6

Blood supply of nasal cavity

Back 6

Sphenopalatine, anterior and posterior ethmoidal arteries (from ophthalmic), greater palatine artery (from maxillary), and superficially from the facial artery.

Front 7

Kiesselbach’s (or Little’s) area

Back 7

Important clinical anastomosis from branches of internal carotid artery (ophthalmic) and branches of external carotid artery in a portion of the nasal cavity. Most common site of epistaxis (hemorrhaging through eroded mucosa).

Front 8

Frontal sinus

Back 8

Drains into the middle meatus through frontonasal duct.

Innervation through supraorbital (V1)

Front 9

Ethmoid sinuses

Back 9

Three groups depending on where they drain (Posterior, Middle, and Anterior)

Anterior - semilunar hiatus

Middle - Semilunar hiatus via the ethmoidal bulla or middle meatus

Posterior - Superior meatus

Innervation primarily from anterior and posterior ethmoidal nerves, additionally innervated by branches from PG.

Front 10

Sphenoid sinus

Back 10

Most variable sinus. Drains into small groove between the superior concha and the sphenoid bone called the sphenoethmoidal recess.

Innervation from posterior ethmoidal nerve and through branches from PG.

1. Optic nerve can be intimately related to the superior-lateral part of sphenoid sinus.
2. Internal carotid artery often erodes into bony border of sphenoid sinus, as there is little separating these two structures.
3. Maxillary nerve and nerve to the pterygoid canal (runs in floor of sphenoid air sinus) are intimately related to sinus.

Front 11

Maxillary sinus

Back 11

Most commonly infected.

Drains into semilunar hiatus.

Innervated by anterior, middle, and posterior superior alveolar nerves.

Front 12

Anterior and middle superior alveolar nerves, posterior superior alveolar nerves.

Back 12

Branches from infraorbital nerve (V2). End in the upper teeth.

Front 13

Pterygopalatine fossa: Arteries

Back 13

Posterior superior alveolar, descending palatine, pterygoid canal, pharyngeal, sphenopalatine.

Front 14

Pterygopalatine fossa: Canals

Back 14

Vidian (also known as pterygoid canal), vomerovaginal, palatovaginal, greater palatine canal.

Front 15

Pterygopalatine fossa: Foramina

Back 15

Rotundum (v2 exiting middle cranial fossa), sphenopalatine (main passageway between infratemporal fossa and nasal cavity)

Front 16

Pterygopalatine fossa: Fissures

Back 16

Two fissures: inferior orbital, pterygomaxillary

Front 17

Roots of pterygopalatine ganglion

Back 17

Parasympathetic root via greater petrosal nerve

Sympathetic root via deep petrosal nerve (carotid plexus)

Small sensory root that is suspended from maxillary nerve