NASAL CAVITY

LARA, ROMEO JOSE DALISAY

LI, MING CHEN YU
MWABAFU, SIMATAA
NAVARRO, MICHAELA ANGELICA
Location
Nasal Cavity Definition

● The nose is one of the primary sensory organs responsible for the sense of
smell, while it also plays major roles in respiration and speech production.
● The nasal cavity lies just behind the two nostrils and forms the interiors of
the nose
● It makes up the upper respiratory system along with the paranasal sinuses,
oral cavity, pharynx, and larynx and is the first of the structures that form
the respiratory tract
Where
Locationis the Nasal Cavity Located?
● The nasal cavity begins from the base of the skull and is separated from the oral cavity below by the hard palate (roof
of the mouth)
Structure and Anatomy Divisions
● Vestibule: The area lying just posterior to the nostrils, this is the part of the nasal
cavity most exposed to the threats of the environment. So, this part is lined with
multiple layers of the same cells that make up our skin (stratified squamous
epithelium), forming a protective barrier. This area also has stiff nose hairs
(vibrissae) embedded in the cell lining and covered by thick mucus
● Respiratory region: It begins at the end of the vestibular area, and includes the entire
nasal cavity, apart from the olfactory region. This region has a ciliated
pseudostratified epithelium lining (single cell layer) containing goblet cells that
secrete mucus that forms the mucus membrane.
● Olfactory Region: The top part of the nasal cavity, near the septum, is lined with
olfactory cells and olfactory mucosa [3]. The mucosa houses countless cilia,
containing olfactory receptor proteins that are responsible for the sense of smell.
Walls and Boundaries of the Nasal Cavity
● Medial Wall: This refers to the septum dividing the nasal cavity into two equal sections. The bony upper- and
lower-back parts of the septum are formed by the perpendicular plate of the ethmoid bone, and the vomer. The
lower front part is formed by a quadrangular hyaline cartilaginous structure, known as the septum cartilage.
The lower part of the smooth medial wall can be seen from the outside, dividing the two nostrils.
● Superior Border (Roof): The two nasal bones, the lower part of the frontal bone, the cribriform plate (of
ethmoid bone), and the sphenoid bone [1, 10] make up the roof.
● Anterior Border (Lateral Wall): The lower parts of the nasal bones, the cartilage attached to them, the outer
nose, and the nostrils are there in the front part of the nasal cavity.
● Posterior Border (Back Wall): The upper-back and sides are bordered with a number of cranial bones
including the maxilla, ethmoid bone, palatine bone, sphenoid bone, lacrimal bone, as well as the inferior
concha
● Floor: Apart from keeping the nasal cavity separated from the oral cavity, the hard palate, formed by the
maxilla (palatine process) and the palatine bones (horizontal plates), also makes up its smooth floor.

The nasal and oral cavities are connected with each other through the nasopharynx at the back of
the throat. The soft palate and the uvula (a fleshy protrusion at the back of the throat) together
move up to close off this connection during eating to prevent food from entering the nasal cavity
Nasal Conchae (Nasal Turbinates) Structure
The three pairs of conchae on either side of the nasal cavity project horizontally into the breathing
space, dividing it into the inferior, middle and superior meatuses and the sphenoethmoidal recess. Each
pair, placed over and facing toward the corresponding meatus, is identified by different names,
depending on its location:
● Inferior nasal concha: The largest and lowest of the three turbinate bones, the inferior concha or
inferior turbinate is located on the septum, separating the two nasal cavities.
● Middle nasal concha: As the name suggests, the middle nasal concha is the bone located between the
superior and inferior conchae.
● Superior nasal concha: It is the small, delicate seashell shaped bone located above the two other
turbinates.
● Sphenoethmoidal recess: between the superior concha and the nasal cavity roof

The superior and middle turbinates both originate from the cranial region of the skull, being
considered structural parts of the cranial bones.
The function of the conchae is to increase the surface area of the nasal cavity –
this increases the amount of inspired air that can come into contact with the cavity
walls. They also disrupt the fast, laminar flow of the air, making it slow and
turbulent. The air spends longer in the nasal cavity, so that it can be humidified.
Inferior Nasal Concha
Middle Nasal Concha
Superior Nasal Concha
Sphenoethmoidal Recess
Paranasal Sinus Openings into the Nasal Cavity
“para” = near, “nas” = nose, -al = pertaining to

sinus - can be sac or cavity in any organ; however, most commonly refers to the paranasal sinus

There are some mucus-lined air-filled spaces among the bones of the face and skull that help to keep the head lightweight and
play vital roles in respiration as well as speech. Four sets of sinuses have been recognized; frontal, sphenoid, ethmoid, and
maxillary, all having an opening into the nasal cavity.

In addition to the paranasal sinuses, other structures open into the nasal cavity:

Nasolacrimal duct – acts to drain tears from the eye. It opens into the inferior meatus.

Auditory (Eustachian) tube – opens into the nasopharynx at the level of the inferior meatus. It allows the middle ear to
equalise with the atmospheric air pressure.
1. Frontal Sinuses
2. Ethmoid Sinuses
3. Sphenoid Sinuses
4. Maxillary Sinuses
Frontal Sinuses
There are two frontal sinuses located within the frontal bone of the skull. They are the
most superior of the paranasal sinuses, and are triangular in shape.

Drainage is via the frontonasal duct. It opens out at the hiatus semilunaris, within the
middle meatus of the nasal cavity.

Sensation is supplied by the supraorbital nerve (a branch of the ophthalmic nerve),

and arterial supply is via the anterior ethmoidal artery (a branch of the internal
carotid).
Ethmoid Sinuses
There are three ethmoidal sinuses located within the ethmoid bone:

● Anterior – Opens onto the hiatus semilunaris (middle meatus)

● Middle – Opens onto the lateral wall of the middle meatus
● Posterior – Opens onto the lateral wall of the superior meatus

They are innervated by the anterior and posterior ethmoidal branches of the
nasociliary nerve and the maxillary nerve. The anterior and posterior ethmoidal
arteries are responsible for arterial supply.
Sphenoid Sinuses
The sphenoid sinuses are situated within the body of the sphenoid bone. They open
out into the nasal cavity in an area supero-posterior to the superior cocha – known as
the spheno-ethmoidal recess.

They are innervated by the posterior ethmoidal nerve (a branch of the ophthalmic
nerve), and branches of the maxillary nerve. They receive blood supply from
pharyngeal branches of the maxillary arteries.
Maxillary Sinuses
The maxillary sinuses are the largest of the sinuses. They are located laterally
and slightly inferiorly to the nasal cavities.

They drain into the nasal cavity at the hiatus semilunaris, underneath the
frontal sinus opening. This is a potential pathway for spread of infection –
fluid draining from the frontal sinus can enter the maxillary sinus.
Blood Supply
The nose has a very rich vascular supply – this allows it to effectively change humidity and temperature
of inspired air. The nose receives blood from both the internal and external carotid arteries:
Internal carotid branches:
● Anterior ethmoidal artery
● Posterior ethmoidal artery
The ethmoidal arteries are branch of the ophthalmic artery. They descend into the nasal cavity through
the cribriform plate
External carotid branches:
● Sphenopalatine artery
● Greater palatine artery
● Superior labial artery
● Lateral nasal arteries
Internal Carotid Branches

The anterior ethmoid artery is a branch of the ophthalmic artery. It supplies the
anterior and middle ethmoidal sinuses, frontal sinus, the lateral nasal wall and the
nasal septum.
The posterior ethmoidal artery, the smaller of the ethmoidal arteries (branches of
the ophthalmic artery), passes through the posterior ethmoidal canal, supplies the
posterior ethmoidal cells, and, entering the cranium, gives off a meningeal branch
to the dura mater, and nasal branches which descend into the nasal cavity through
apertures in the cribriform plate, anastomosing with branches of the
sphenopalatine.
External Carotid Branches
The sphenopalatine artery, formerly known as the nasopalatine artery, is the terminal branch of the maxillary artery that is
the main supply to the nasal cavity. It is colloquially known as the artery of epistaxis given its common involvement in
cases of nose bleeds. It is a major contributor to the rich arterial plexus known as Kiesselbach's plexus on the anteroinferior
nasal septum.

origin: continuation of the third part of the maxillary artery as it enters the sphenopalatine foramen

course: courses anterior from the posterior aspect of the nasal cavity just posterior to the superior meatus

branches: numerous posterior lateral nasal branches course anteriorly along the lateral nasal wall and turbinates and
anastomose with branches of the anterior and posterior ethmoidal arteries, numerous septal branches course anteriorly
along the nasal septum and anastomose with branches of the greater palatine artery, and pharyngeal branch passes through
the vomerovaginal canal between the sphenoid body and vomer

Termination: on the nasal septum the artery becomes the posterior septal branch which anastomose with the anterior
ethmoidal artery, terminal ascending branch of the greater palatine artery and the septal branch of the superior labial artery
of the facial artery

supply: supplies the mucosa of the majority of the nasal septum and the turbinates and conchae
Greater Palatine Artery

The greater (descending) palatine artery is a branch of the third part of the
maxillary artery which passes through the greater palatine foramen to supply
most of the hard palate.
After branching off from the third (pterygopalatine) part of the maxillary artery,
the greater palatine artery exits the pterygopalatine fossa via the greater palatine
canal and travels along the roof of the palate where it gives off lesser palatine
branches. The artery reaches the end of the canal where is turns superiorly and
traverses the incisive foramen where it anastamoses with branches of the
sphenopalatine artery within the nasal cavity.
Superior Labial Artery
Superior labial artery (old name: superior coronary artery) is one of the facial branches of the facial artery. It is bigger and
more serpiginous than the inferior labial artery. It supplies the upper lip, including its labial glands, mucous membranes and
muscles.

origin: facial branch of the facial artery, just distal to the origin of the inferior labial artery and lateral to the angle of the
mouth

course: it passes superiorly and anteriorly, behind the depressor anguli oris muscle, before piercing the orbicularis oris
muscle, and taking a meandering path between the muscle and the labial mucous membrane along the inferior margin of the
upper lip, close to the wet line

branches:

Nasal

septal: branching out on the anterior cartilaginous septum

alar: supplies the nasal ala

termination: anastomosis with the contralateral superior labial artery

Lateral Nasal Artery
The lateral nasal artery is one of the arteries responsible for perfusing the nose. The lateral nasal
artery branches from the facial artery and ascends the nose parallel to the ala of the nose. The lateral
nasal artery travels toward the tip of the nose. The lateral nasal artery forms anastomoses with the
septal branches of the superior labial artery, the angular artery, the ophthalmic artery, the internal
maxillary artery, and some of the smaller arteries on the surface of the nose. The lateral nasal artery
also provides perfusion to deeper structures of the nose, such as the cartilage.
The lateral nasal artery perfuses the skin on the surface of the nose. The lateral nasal artery also
perfuses the cartilage that makes up the nose. The lateral nasal artery forms anastomose with the
contralateral lateral nasal artery. The structures that surround the nose receive perfusion from the
lateral nasal artery via the anastomoses. The lateral nasal artery provides collateral blood flow to the
lip via the anastomosis with the columellar artery and the septal branches of the superior labial
artery. The anastomoses form a network around the region of the nose and the bordering cheek. This
network is a way the facial artery can provide collateral blood supply to the contralateral facial
artery.
Kiesselbach’s Plexus
Kiesselbach’s plexus is an integral anastomosis of five branches converging in the anterior
inferior quadrant of the nasal septum (over the septal cartilage). The area has been referred
to as Little’s Area, Kiesselbach’s Triangle or Kiesselbach’s Area. Little’s area is a common
site of epistaxis (nose bleeds) in both paediatric and adult cases.
Epistaxis
Epistaxis, or nose bleeds, is the most common pathological processes associated with
Little’s area. While the exact aetiology remains elusive, there are several conditions that may
precipitate nasal bleeding. Some cases have been described as spontaneous. These are
usually precipitated by trauma or an underlying infection and most often occur at Little’s
area. Spontaneous nose bleeds are most often seen in young adults and children.
Alternatively, epistaxis may occur without external trauma and originate in the superior
posterior region of the nasal cavity. This is often referred to as hypertensive epistaxis and is
more prevalent in individuals in the older age groups.
Innervation
● Special sensory innervation refers to the ability of the nose to smell. This is carried out by the
olfactory nerves. The olfactory bulb, part of the brain, lies on the superior surface of the
cribriform plate, above the nasal cavity. Branches of the olfactory nerve run through the
cribriform plate to provide special sensory innervation to the nose.

● General sensory innervation to the septum and lateral walls is delivered by the nasopalatine
nerve (branch of maxillary nerve) and the nasociliary nerve (branch of the ophthalmic nerve).
Innervation to the external skin of the nose is supplied by the trigeminal nerve.
Nasopalatine Nerve
The nasopalatine nerve is the largest nerve emerging from the PPG. It travels through
the sphenopalatine foramen to enter the nasal cavity and crosses its roof to reach the
nasal septum. It descends in an oblique direction anteroinferiorly between the
periosteum and mucous membrane of the nasal septum within a groove on the vomer
bone. After anastomosing with the contralateral nasopalatine nerve, the nerve exits the
floor of the nasal cavity by entering the incisive canal. It emerges onto the
premaxillary region of the palate via the incisive foramen. At this point the
nasopalatine nerve communicates with both of the greater palatine nerves, supplying
the nasal septum and the anterior hard palate
Olfactory Bulb
The olfactory bulb is an essential structure in the olfactory system (the system devoted to
the sense of smell). Olfaction begins when odorant molecules enter the nasal cavity
through inhalation or by rising from the mouth (e.g. during the chewing of food). Those
molecules interact with olfactory receptors, which are part of a family of G-protein
coupled receptors. Stimulation of these receptors causes the production of second
messengers like cyclic AMP (cAMP), which leads to the opening of ion channels and the
generation of action potentials in olfactory receptor cells.
Cribriform Plate
The cribriform plate (less commonly also called the lamina cribrosa of the
ethmoid bone) is a sieve-like structure between the anterior cranial fossa and the
nasal cavity. It is a part of ethmoid bone and supports the olfactory bulb, which lies
in the olfactory fossa. It is perforated by foramina for the passage of the olfactory
nerves and the anterior ethmoidal nerves to the upper part of the nasal septum, the
latter of those to the superior nasal concha. The lateral lamella forms the lateral
border of the plate.
Olfactory Nerve
The olfactory nerve is the first cranial nerve and conveys special sensory information related to
smell. It is the shortest of the cranial nerves and passes from its receptors in the nasal mucosa to
the forebrain. It enters the skull through the cribriform plate of the ethmoid bone. It then sends
its impulses to be interpreted at various brain regions including the temporal lobe, amygdala,
and entorhinal cortex. Simple bedside testing of the olfactory nerve can be done using vanilla
essence or coffee extracts. The sense of smell can be altered due to a variety of conditions
referred to as hyperosmia, hypoosmia, anosmia, and dysosmia. However, the most common
pathology to affect the olfactory nerve is the common cold.
Nasociliary Nerve
The nasociliary nerve passes through the superomedial aspect of the sphenoid fissure, within the
common tendinous ring (annulus of Zinn). It runs towards the medial part of the orbital cavity to
end at the medial anterior orbital foramen.

The collateral branches of the nasociliary nerve are:

● the ophthalmic ganglion
● the ciliary nerves
● the spheno-ethmoidal branch (the posterior ethmoidal nerve), which supplies the
sphenoidal and ethmoidal sinuses.
The Nasal Cavity: Functions
The nasal cavity is the inside of your nose. It is lined with a mucous membrane that
helps keep your nose moist by making mucus so you won't get nosebleeds from a
dry nose. There are also little hairs that help filter the air you breathe in, blocking dirt
and dust from getting into your lungs.

● A passageway for air to lungs

● Organ of smell
● Filters impurities from inspired air
● Warms and humidifies inspired air
● Receives secretions from paranasal sinuses
● Receives secretions from nasolacrimal duct
Conditions associated with nasal cavity

Nose disease
The cause of the disease
The nose is often affected by external adverse factors. It is prone to
various diseases. Microbial infection can cause nasal furuncle,
nasal vestibulitis, inflammation of the nasal cavity and sinuses; the
nasal cavity is the gateway for allergens to enter the body, and it is
the site where allergic diseases occur. Therefore, hay fever and
allergic rhinitis are common diseases. The nose is anatomically
adjacent to the cranial cavity, eye sockets and oral cavity. Diseases
of the nasal vestibule, nasal cavity and paranasal sinuses can lead
to serious complications, such as meningitis, orbital cellulitis;
blood can cause cavernous sinus infection, severe cases can be
blind, or even life threatening.
Clinical manifestations
Mainly manifested as mucosal irritation and respiratory and olfactory
dysfunction

Abnormal vocalization is caused by the influence of nasal resonance.

Occlusive nasal sounds appear when the nose is blocked; open nasal
sounds appear when soft palsy
Prevention & Treatment
Infectious diseases such as acute sinusitis, nasal boils, etc., antibiotics
are the most effective treatment method; patients with nosebleeds can
use petrolatum gauze, gelatin sponge, etc. to fill the nasal cavity to stop
bleeding, and carry out corresponding treatments for the causes of
nosebleeds. To prevent rebleeding, patients with hay fever and perennial
allergic rhinitis should minimize the inhalation of allergens (pollen,
house dust, etc.). Desensitization therapy (immunotherapy) can change
the immune status of the body to achieve no disease or obvious
symptoms Purpose of mitigation: Patients with nasal polyps need to
undergo nasal polypectomy, chronic hypertrophic rhinitis, structural
rhinitis, etc. often need surgery to treat congenital nasal deformities,
traumatic nasal defects, etc. Plastic surgery can not only improve
appearance, but also to varying degrees To restore nasal function
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