Nose And Paranasal Sinus

Front 1

Functions Of The Nose

Back 1

Respiration (conduction of air to the nasopharynx)
Olfaction
Filtration of particles in the inspired air
Humidification of the inspired air
Warming of the inspired air
Reception of secretions from paranasal sinuses and nasolacrimal duct

Front 2

The External Nose

Back 2

Piriform aperture – the anterior nasal aperture
B. Nares – the external openings
C. Columnella – lower part of the septum which separates the nares

Front 3

Piriform aperture

Back 3

the anterior nasal apertere

Front 4

Nares

Back 4

external openings

Front 5

Columnella

Back 5

lower part of the septum which separates the nares

Front 6

Skeletal Structures Associated with the Nasal Cavity

Back 6

1. Frontal bone
2. Nasal bones
3. Ethmoid bone’s cribriform plate
4. Sphenoid

Front 7

Lateral Wall

Back 7

1. Ethmoid bone’s superior and middle conchae
2. Inferior nasal concha (not part of ethmoid bone)
3. Maxilla
4. Nasal bone
5. Perpendicular plate of palatine bone
6. Medial pterygoid plate of sphenoid bone
7. Lacrimal bone
8. Alar cartilage

Front 8

Floor

Back 8

1. maxilla’s palatine process
2. palatine bone’s horizontal plate

Front 9

Medial Wall (Nasal Septum) – it divides the nasal cavity into left and right portions

Back 9

1. Perpendicular plate of ethmoid
2. Vomer
3. Minor contributions from the palatine, maxilla, frontal, sphenoid, and nasal bones
4. Septal cartilage

Front 10

Superior Relationships of Structures to the Nasal Cavity

Back 10

1. Frontal lobe of the brain
2. Olfactory bulbs

Front 11

InferiorRelationships of Structures to the Nasal Cavity

Back 11

Oral cavity

Front 12

Lateral Relationships of Structures to the Nasal Cavity

Back 12

1. Ethmoid sinuses
2. Orbit
3. Maxillary sinus

Front 13

Posterior Relationships of Structures to the Nasal Cavity

Back 13

1. Nasopharynx note: the posterior apertures into the nasopharynx are called choanae
2. Sphenoid sinus

Front 14

Posterior Structures in the Lateral Wall

Back 14

Conchae turbinates (sup, mid, inferior)
Sphenoethmoidal reces
Meatuses (sup, middle, inferior)

Front 15

Sphenoethmoidal Recess

Back 15

space superior and posterior to the superior concha

Front 16

meatus

Back 16

air passageway located inferior and lateral to the conchae
with the same name

Front 17

Conchae

Back 17

serve to rotate air as it enters the nasal cavity.

Front 18

Anterior Structures in the Lateral Wall

Back 18

Nasal vestibule
Limen nasi
Atrium
Agger nasi
olfactory sulcus

Front 19

Nasal vestibule

Back 19

an expanded portion at the entrance to the nasal cavity; it is lined with skin containing hairs called vibrissae

Front 20

Limen nasi

Back 20

a crescent-shaped ridge on the lateral surface, and it is caused by the alar cartilage; the mucocutaneous junction at the superior boundary of the vestibule

Front 21

Atrium

Back 21

the portion of the middle meatus that is anterior to the middle concha

Front 22

Agger nasi –

Back 22

rounded elevation in front of the attachment of the middle concha

Front 23

Olfactory sulcus

Back 23

a channel in the nasal cavity superior to the agger nasi; it allows air to reach the olfactory area

Front 24

Openings and Features of the Lateral Wall

Back 24

Sphenoethmoid recess with openings to sphenoid sinus
Superior meatus with opening of posterior ethmoidal sinus
Middle meatus
ethmoidal bulla-
infundibulum
semilunar hiatus

Front 25

Ethmoidal bulla

Back 25

a prominence caused by the middle ethmoidal air cells

Front 26

Infundibulum,

Back 26

a funnel-shaped chamber in the anterior portion of the middle meatus; it is located between the ethmoidal bulla and the uncinate process of ethmoid

Front 27

Semilunar hiatus

Back 27

a plane that is the medial boundary to the infundibulum

Front 28

The infundibulum contains openings for the following

Back 28

(1) the frontal sinus
(2) anterior ethmoidal cells
(3) maxillary sinus
d. Opening of the nasolacrimal duct into the inferior meatus

Front 29

The four pairs of paranasal sinuses drain into the _______.

Back 29

nasal cavity

Front 30

Paranasal sinuses

Back 30

These sinuses are air-filled extensions of the nasal cavity. They are lined with respiratory epithelium and are mucus secreting; they are created when this epithelium grows into and then replaces the diploë of neighboring bones. Their names are:
1. Frontal sinuses
2. Ethmoidal sinuses
3. Sphenoidal sinuses
4. Maxillary sinuses

Front 31

Which paranasal sinuses are present at birth?

Back 31

maxillary and ethmoidal sinuses
These are rudimentary in size

Front 32

At approximately two years of age, an_______ grows into the frontal bone, and a _______ invades the sphenoid bone.

Back 32

anterior ethmoidal sinus ;posterior ethmoidal sinus
These invasions mark the beginning of the frontal sinuses and the sphenoid sinuses.

The sinuses grow slowly during childhood, but growth accelerates following the onset of puberty. This growth is important in changing the size and shape of the face, and in adding resonance to the voice.

Front 33

________ sinuses are composed of three sets of air cells: anterior, middle, and posterior

Back 33

Ethmoidal

Front 34

Anterior and middle ethmoidal cells drain into _______

Back 34

middle meatus.

Front 35

Middle ethmoidal cells form the ____

Back 35

ethmoidal bulla

Front 36

Posterior ethmoidal cells drain into the_______

Back 36

superior meatus

Front 37

Frontal sinuses

Back 37

a. Not present at birth; formed from anterior ethmoidal cells
b. Rarely of equal size
c. Open into the middle meatus via frontonasal duct

Front 38

Frontal sinuses open into the middle meatus via

Back 38

frontonasal duct

Front 39

sphenoidal sinuses

Back 39

a. Not present at birth; formed from posterior ethmoidal cells
b. Drain into the sphenoethmoidal recess
c. Have important relationships to the optic nerve, optic chiasma, pituitary gland, internal carotid arteries, and cavernous sinuses

Front 40

Sphenoidal sinuses drain into

Back 40

sphenoethmoidal recess

Front 41

Which sinuses are the largest of the paranasal sinuses?

Back 41

Maxillary

Front 42

A maxillary sinus is sometimes referred to as the _________, and its drainage is usually through an opening into the ________.

Back 42

antrum of Highmore; ethmoidal infundibulum

Front 43

The maxillary sinuses have the following relationships:

Back 43

posterior relationship with the pterygopalatine fossa
b. superior relationship is with the orbit
c. medial relationship is with the nasal cavity
d. inferior relationship is with the oral cavity

Front 44

Note the relationship of the roots of the maxillary molars and premolars with the maxillary sinus. Sometimes the separation is only by _________. The close proximity of the _________ may cause exposure of the maxillary sinus during the extraction of teeth.

Back 44

a thin layer of bone; roots of molars and premolars

Front 45

The maxillary sinuses receive sensory (afferent) supply from the anterior, middle, and
posterior _______.

Back 45

superior alveolar nerve

Front 46

Superior alveolar nerves are branches of the

Back 46

maxillary division of V

Frequently, a patient with a sinus infection or a head cold interprets sinus pain as pulpal pain due to the fact that the same nerves supply both the tooth and the sinuses. Occasionally, the reverse is true.

Front 47

Infection can spread from the periodontal tissue to the ____ because of their common blood supply.

Back 47

maxillary sinus ( and vice versa )

Front 48

The nasal cavity receives its blood supply from branches of _______

Back 48

both the internal and external carotid arteries

Front 49

The ophthalmic artery is one branch off

Back 49

the internal carotid artery

Front 50

Anterior and Posterior Ethmoidal Arteries

Back 50

These arteries are branches from the ophthalmic artery.
b. These arteries supply the walls of the nasal cavity and the nasal septum.

Front 51

Branches of Maxillary Artery

Back 51

Sphenopalatine artery
Descending palatine artery
Infraorbital, greater palatine, sphenopalatine, and posterior alveolar arteries
Pharyngeal branch

Front 52

Sphenopalatine artery

Back 52

(1) A terminal branch of the maxillary artery
(2) It supplies:

(a) Most of the nasal mucosa
(b) Walls of the nasal cavity
(c) Nasal septum
(d) All 4 paranasal sinuses

Front 53

_________ is the largest artery to enter the nasal cavity, and it enters the cavity through the ________.

Back 53

Sphenopalatine artery; sphenopalatine foramen

Front 54

Descending palatine artery

Back 54

branches into the greater and lesser palatine arteries; the greater palatine arteries supply blood to the hard palate, and then it passes through the incisive canal to supply the anterior–inferior part of the nasal septum

Front 55

Infraorbital, greater palatine, sphenopalatine, and posterior alveolar arteries supply the ______

Back 55

maxillary sinus

Front 56

Pharyngeal branch supplies the _______

Back 56

sphenoid sinus

Front 57

Septal branch of the superior labial artery supplies the _______

Back 57

anterior-inferior nasal septum

Front 58

lateral nasal branch supplies the ______

Back 58

alar region

Front 59

Branches of the Facial Artery

Back 59

Septal branch of the superior labial artery
Lateral nasal branch

Front 60

Kiesselbach’s Area

Back 60

1 It is the location of most nosebleeds.
2. It is located in the anterior part of the septum where vessels that supply the nasal septum anastomose: anterior ethmoidal, sphenopalatine, greater palatine, and the septal branch of the superior labial arteries.
3. Epistaxis is the term used for nasal hemorrhage or nosebleed.

Front 61

Veins which drain the nasal cavity generally

Back 61

parallel the nerves

Front 62

Functions and associated nerve supply

Back 62

1. olfaction – cranial nerve I (olfactory nerve)
2. general sensation – cranial nerve V (trigeminal nerve)
3. autonomic
a. glandular secretion - parasympathetic
b. vasoconstriction – sympathetic

Front 63

______covers the superior aspect of the nasal septum and the superior nasal concha.

Back 63

Olfactory mucosa

Front 64

The epithelium contains ______ whose dendrites extend to the surface. The dendrite endings have ______ which act as chemoreceptors. These olfactory neurons pass through the cribriform plate (of the ethmoid bone) to enter the ______.

Back 64

bipolar neurons; immotile olfactory cilia; olfactory bulb

Front 65

Olfactory nerves are surrounded by _____ and the subarachnoid space containing CSF as they pass through the cribriform plate.

Back 65

3 meningeal layers

Front 66

cerebrospinal fluid rhinorrhea

Back 66

Leakage of CSF from the nose
If the meninges surrounding the olfactory nerves get torn, CSF can leak into the nose, and then bacteria from the nose can travel into the cranial cavity

Front 67

Anosmia

Back 67

loss of smell

Front 68

General sensation (pain, temperature, touch) from the nasal cavity is mediated through the ______

Back 68

ophthalmic and maxillary divisions of the trigeminal nerve (that is, V1 and V2).

Front 69

Cell bodies for general sensation are located in the trigeminal ganglion

Back 69

trigeminal ganglion

Front 70

Nasopalatine nerve

Back 70

(from V2) - innervates the posterior inferior part of the nasal mucosa

Front 71

Anterior and posterior ethmoidal nerves

Back 71

(from the nasociliary nerve of V1) – innervate the anterior superior part of the nasal mucosa

Front 72

Great palatine nerve

Back 72

(from V2) – innervates the lateral nasal wall

Front 73

Anterior superior alveolar nerve

Back 73

(from V2) - innervates the anterior part of the nasal cavity

Front 74

Infraorbital nerve

Back 74

(from V2) – innervates the vestibule and alae

Front 75

Infratrochlear nerve and anterior ethmoidal nerve

Back 75

(from the nasociliary nerve of V1) -innervate most of the dorsum and apex of the external nose

Front 76

Preganglionic parasympathetic cell bodies are located

Back 76

superior salivatory nucleus of VII

Front 77

Postganglionic parasympathetic cell bodies are located

Back 77

pterygopalatine ganglion

Front 78

Preganglionic Sympathetic cell bodies are located

Back 78

intermediolateral cell column of upper thoracic spinal cord

Front 79

Posteganglionic sympathetic cell bodies are located in

Back 79

superior cervical ganglion