Dr. Sami Zaqout Faculty of Medicine IUG
Nasal
Cavity
External
Nose
The Nose
Dr. Sami Zaqout Faculty of Medicine IUG
External Nose
Dr. Sami Zaqout Faculty of Medicine IUG
Blood and Nerve Supplies of the External Nose
• Blood Supply of the External Nose – The skin of the external nose
• Branches of the ophthalmic and the maxillary arteries
– The skin of the ala and the lower part of the septum • Branches from the facial artery
• Nerve Supply of the External Nose • The infratrochlear and external nasal branches of the
ophthalmic nerve
• The infraorbital branch of the maxillary nerve
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity
Dr. Sami Zaqout Faculty of Medicine IUG
Choanae
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity - Floor
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity - Roof
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity - Lateral Wall
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity - Lateral Wall
Dr. Sami Zaqout Faculty of Medicine IUG
Nasal Cavity - Medial Wall
Dr. Sami Zaqout Faculty of Medicine IUG
Ethmoid bone
Dr. Sami Zaqout Faculty of Medicine IUG
Ethmoid bone
Dr. Sami Zaqout Faculty of Medicine IUG
Mucous Membrane of the Nasal Cavity
• The vestibule is lined with modified skin and has coarse hairs.
The area above the superior concha is lined with olfactory mucous membrane.
The lower part of the nasal cavity is lined with respiratory mucous membrane.
Dr. Sami Zaqout Faculty of Medicine IUG
Function of Warm Blood and Mucus of Mucous Membrane
• The presence of warm blood in the venous plexuses serves to heat up the inspired air as it enters the respiratory system.
• The presence of mucus on the surfaces of the conchae traps foreign particles and organisms in the inspired air.
Dr. Sami Zaqout Faculty of Medicine IUG
Nerve Supply of the Nasal Cavity.
Dr. Sami Zaqout Faculty of Medicine IUG
Arterial Supply to the Nasal Cavity
Dr. Sami Zaqout Faculty of Medicine IUG
Venous drainage of the nasal cavities
Dr. Sami Zaqout Faculty of Medicine IUG
Lymphatic drainage of the nasal cavities
Dr. Sami Zaqout Faculty of Medicine IUG
Examination of the Nasal Cavity
• It should be remembered that the nasal septum is rarely situated in the midline.
• A severely deviated septum may interfere with drainage of the nose and the paranasal sinuses.
Dr. Sami Zaqout Faculty of Medicine IUG
Trauma to the Nose
• Fractures involving the nasal bones are common.
• Blows directed from the front may cause one or both nasal bones to be displaced downward and inward.
• Lateral fractures also occur in which one nasal bone is driven inward and the other outward; the nasal septum is usually involved.
Dr. Sami Zaqout Faculty of Medicine IUG
Infection of the Nasal Cavity
• Organisms may spread via the nasal part of the pharynx and the auditory tube to the middle ear.
• It is possible for organisms to ascend to the meninges of the anterior cranial fossa, along the sheaths of the olfactory nerves through the cribriform plate, and produce meningitis.
Dr. Sami Zaqout Faculty of Medicine IUG
Foreign Bodies in the Nose
• Foreign bodies in the nose are common in children.
• The presence of the nasal septum and the existence of the folded, shelflike conchae make impaction and retention of balloons, peas, and small toys relatively easy.
Dr. Sami Zaqout Faculty of Medicine IUG
Nose Bleeding - Epistaxis
• The most common cause is nose picking.
• The bleeding may be arterial or venous, and most episodes occur on the anteroinferior portion of the septum and involve the septal branches of the sphenopalatine and facial vessels.
Dr. Sami Zaqout Faculty of Medicine IUG
The Paranasal Sinuses
Dr. Sami Zaqout Faculty of Medicine IUG
Functions of Paranasal Sinuses
Act as resonators to the voice
Reduce the weight of the skull
Dr. Sami Zaqout Faculty of Medicine IUG
Maxillary Sinus • The maxillary sinus is pyramidal in shape and located within
the body of the maxilla behind the skin of the cheek. The roof is formed by the floor of the orbit The floor is related to the roots of the premolars and molar
teeth.
Dr. Sami Zaqout Faculty of Medicine IUG
Frontal Sinuses • The two frontal sinuses are contained within the frontal
bone. • They are separated from each other by a bony septum. • Each sinus is roughly triangular, extending upward above
the medial end of the eyebrow and backward into the medial part of the roof of the orbit.
Dr. Sami Zaqout Faculty of Medicine IUG
Sphenoidal Sinuses • The two sphenoidal sinuses lie within the body of the
sphenoid bone
Dr. Sami Zaqout Faculty of Medicine IUG
Ethmoid Sinuses • The ethmoidal sinuses are anterior, middle, and posterior
and they are contained within the ethmoid bone, between the nose and the orbit.
• They are separated from the latter by a thin plate of bone so that infection can readily spread from the sinuses into the orbit.
Dr. Sami Zaqout Faculty of Medicine IUG
Paranasal Sinuses and Their Site of Drainage Into the Nosea
Dr. Sami Zaqout Faculty of Medicine IUG
Sinusitis
Dr. Sami Zaqout Faculty of Medicine IUG
Sinusitis
• The frontal sinus is innervated by the supraorbital nerve, which also supplies the skin of the forehead and scalp as far back as the vertex.
• The maxillary sinus is innervated by the infraorbital nerve and, in this case, pain is referred to the upper jaw, including the teeth.
Dr. Sami Zaqout Faculty of Medicine IUG
Examination of the Paranasal Sinuses
Dr. Sami Zaqout Faculty of Medicine IUG
Transillumination - Radiologic examination
Dr. Sami Zaqout Faculty of Medicine IUG
Dr. Sami Zaqout Faculty of Medicine IUG
The Larynx Protective sphincter at the inlet of the air passages.
Responsible for voice production.
• Lies at the level of the fourth, fifth, and sixth cervical vertebrae.
Dr. Sami Zaqout Faculty of Medicine IUG
Larynx
Dr. Sami Zaqout Faculty of Medicine IUG
Cartilages of the Larynx
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilages
Cuneiform cartilages
Corniculate cartilages
Epiglottis
Dr. Sami Zaqout Faculty of Medicine IUG
Thyroid cartilage
Dr. Sami Zaqout Faculty of Medicine IUG
Cricoid cartilage
Dr. Sami Zaqout Faculty of Medicine IUG
Arytenoid cartilages
Dr. Sami Zaqout Faculty of Medicine IUG
Corniculate and cuneiform cartilages
Dr. Sami Zaqout Faculty of Medicine IUG
Epiglottis
Dr. Sami Zaqout Faculty of Medicine IUG
Epiglottis
Dr. Sami Zaqout Faculty of Medicine IUG
Membranes and Ligaments of the Larynx
Thyrohyoid membrane
Cricotracheal ligament
Quadrangular membrane
Cricothyroid ligament
Dr. Sami Zaqout Faculty of Medicine IUG
Thyrohyoid membrane + Cricotracheal ligament
Dr. Sami Zaqout Faculty of Medicine IUG
Quadrangular membrane
Dr. Sami Zaqout Faculty of Medicine IUG
Cricothyroid ligament.
Dr. Sami Zaqout Faculty of Medicine IUG
Inlet + Cavity of the Larynx
Dr. Sami Zaqout Faculty of Medicine IUG
Vestibular Fold
• The vestibular fold is a fixed fold on each side of the larynx.
• It is formed by mucous membrane covering the vestibular ligament and is vascular and pink in color.
Dr. Sami Zaqout Faculty of Medicine IUG
Vocal Fold (Vocal Cord)
• The vocal fold is a mobile fold on each side of the larynx and is concerned with voice production.
• It is formed by mucous membrane covering the vocal ligament and is avascular and white in color.
Dr. Sami Zaqout Faculty of Medicine IUG
Vocal Fold (Vocal Cord)
• The gap between the vocal folds is called the rima glottidis or glottis.
• The glottis is bounded in front by the vocal folds and behind by the medial surface of the arytenoid cartilages.
• The glottis is the narrowest part of the larynx and measures about 2.5 cm from front to back in the male adult and less in the female.
Dr. Sami Zaqout Faculty of Medicine IUG
In children the lower part of the larynx within
the cricoid cartilage is the narrowest part
Dr. Sami Zaqout Faculty of Medicine IUG
Laryngeal Cavity - Laryngoscope
Dr. Sami Zaqout Faculty of Medicine IUG