anatomy and physiology of nose
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rhinology anatomyTRANSCRIPT
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Anatomy and Physiology of Nose
Prepared by : Nurul Syazwani Binti Ramli
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Anatomy of Nose
Nose
External
Bony Part Cartilaginous Part
Internal (nasal cavities)
Skin-lined portion
(Vestibule)
Mucosa-lined portion (Nasal cavity proper)
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External Nose
• Pyramidal in shape (root up & base downward)• Consists of osteocartilaginous framework
covered by muscles and skin.
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External NoseNasal Skin-over nasal bone and upper lateral cartilages is thin and freely
mobile-cover alar cartilges is thick and adherent and contain many
sebaceous gland
Nasal Musculature-F(x) : movement of nasal tip, ala and the overlying skin-eg: procerus, nasalis (transverse and alar parts), levator labii
superioris laeque nasi, ant. and post. dilator nares and depressor septi.
Osteocartilaginous frameworkBony Part
-Upper one-third-2 nasal bone
Cartilaginous Part
-lower two-thirds-it consists of :
a) Upper lateral cartilagesb) Lower lateral cartilages (alar cartilages)
c) Lesser Alar (sesamoid) cartilagesd) Septal cartilage
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External Nose
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Internal Nose
• Divided into right and left nasal cavities• Communicates with:– Exterior: through naris (nostril– Nasopharynx: through post. nasal aperture (choana)
Internal Nose
Vestibule
-lined by skin and contains sebaceous glands, hair follicles and hair (vibrissae)
Nasal Cavity Proper
Has a lateral wall, a medial wall, a roof and a floor
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Internal NoseNasal Cavity Proper
Lateral nasal wall
Turbinates (conchae)
-superior-middle-inferior
Meatus
-superior-middle-inferior
Medial wall
Roof
Floor
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Internal NoseNasal Cavity Proper
Lateral nasal wall
Medial wall(nasal septum)
1) Columellar septum2) Membranousseptum
3) Septum proper
Roof
Floor
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Internal NoseNasal Cavity Proper
Lateral nasal wall
Medial wall
Roof
Anterior Sloping Part :- nasal bones
Posterior Sloping Part :- body of sphenoid bone
Middle Horizontal Part :- cribriform plate of ethmoid
Floor
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Internal NoseNasal Cavity Proper
Lateral nasal wall
Medial wall
Roof
Floor
Anterior three-fourths :- palatine process of the maxilla
Posterior one-fourth :- horizontal part of the palatine bone
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Lining Membrane of Internal Nose
Vestibule
• Lined by skin containing hair, hair follicles and sebaceous glands
Olfactory region
• Mucous membrane is paler in colour
Respiratory region
• Lined by pseudostratified ciliated columnar epithelium which contains plenty of goblet cells
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Mucose membrane
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Paranasal Sinuses
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Lymphatic Drainage
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Blood Supply of Nose
Nasal septum :– Internal carotid :• Anterior ethmoid • Posterior ethmoid
– External carotid :• Sphenopalatine• Greater palatine • Superior labial
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Blood Supply of NoseLateral wall :
– Internal carotid :• Anterior ethmoid • Posterior ethmoid
– External carotid :• Sphenopalatine• Greater palatine • Anterior superior dental (infraorbital )• Facial artery
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Little’s Area (Plexus Kiesselbach)
– Anterior inferior nasal septum– Anastomoses from :• Anterior ethmoid • Superior labial • Sphenopalatine • Greater palatine
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Plexus Kiesselbach
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Nerve Supply of Nose• Olfactory nerve :
– Carry sense of smell and supply olfactory region of nose
– Arranged into 10-12 nerves which pass through the cribriform plate and end in the olfactory bulb
• Nerves of common sensation :– Anterior ethmoidal nerve– Sphenopalatine ganglion– Infraorbital nerve – Greater palatine nerve
• Autonomic :– Parasympathetic greater superficial
petrosal vidian sphenopalatine ganglion
– Sympathetic upper 2 thoracic superior cervical gangglion deep petrosal nerve join parasympathetic to form vidian
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Physiology of Nose
Functions of the nose:1) Respiration 2) Air conditioning of the inspired air3) Protection of Lower Airway 4) Vocal resonance 5) Nasal reflex functions6) Olfaction
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RESPIRATION
• Nose = natural pathway for breathingINSPIRATION: air thru middle part of nose btwn turbinates and nasal septum. Very little air passes thru inferior meatus or olfactory region.
EXPIRATION : same but entire air current is not expelled directly thru nares friction at limen nasi converts it into eddies under cover of inferior and middle turbinates and this ventilates the sinuses thru the ostia
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AIR CONDITIONING OF INSPIRED AIR• ‘air-conditioner’ for lungs:
a) Filtration and Purification : nasal vibrissae filters larger particles (3µm) Finer particles adhere to the mucus over surface of mucous
membrane (0.5-3.0µm) Smaller than 0.5µm can pass thru nose into lower airways without
difficultyb) Temperature control : mucous membrane (region of middle and inferior
turbinatesand adjacent parts of the septum) is highly vascular with cavernous venous spaces or sinusoids which control the blood flow)this increase and decrease the size of turbinates efficient ‘radiator’ mechanism to warm up the cold air (near body T0 = 370C)
c) Humidification : adjust relative humidity of inspired air to 75% or more that is essential for integrity and function of ciliary epithelium.
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PROTECTION OF LOWER AIRWAYa) Mucociliary mechanism:
Rich in goblet cells, secretory glands both mucous and serous) Form a cont. sheet called mucous blanket which consist of superficial
mucus layer and deeper serous layer that floating on top of cilia which constantly beating to carry it towards nasopharynx = ‘conveyer belt’
b) Enzymes and Immunoglobulins: (in nasal secretion) Muramidase (lysozyme) :- kills bacteria and viruses. IgA and IgE and Interferon :- provide immunity against URTI
c) Sneezing : protective reflex. Foreign particles which irritate nasal mucosa are expelled by sneezing.
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VOCAL RESONANCE
• Resonating chamber for certain consonant in speech.
• In phonating nasal consonants ( M/ N/ NG ), sound passes
thru nasopharyngeal isthmus and is emitted thru the nose.
• When blocked, speech becomes denasal.Eg:- M/ N/ NG are uttered as B/ D/ G respectively
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NASAL REFLEXES
• Nasal Mucosa reflex receptors closely related to gastrointestinal
and pulmonary functions.
• Examples:
- irritation of nasal mucosa cause sneezing
- smell of palatable food reflex secretion of saliva and gastric
juice.
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OLFACTION
• Sense of smell:– Animal :- give warning of environmental danger– Man :- for pleasure and enjoing the taste of food
• Olfactory region : – upper one-third of lateral Wall– corresponding part of nasal septum– roof of nasal cavity
• Disorder of smell:– Anosmia– Hyposmia– Parosmia
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Thank You