4 Nasal Cavity, Nasopharynx and Pterygopalatine Fossa

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What forms the bony framework of the nose?

maxillae and nasal bones

What are the cartilages that make up the external nose?

lateral nasal, septal and alar

Blood supply to the external nose

facial and ophthalmic arteries

Sensation from external nose

carried by infratrochlear, external nasal and infraorbital nerves

Nasal septum

-bones and cartilage that divide nasal cavity into right and left
- bony septum is mainly from ethmoid bone and vomer

The nasal cavity is lined with mucosa except for

the vestibule

The nasal cavity opens to the nasopharynx through

choanae

The nasal cavity has openings for

paranasal sinuses

The nasal cavity communicates with surface of _____ via nasolacrimal duct

eye

What are the three functional areas of the nasal cavity

1. vestibule
2. respiratory area
3. olfactory area

CSF rhinorrhea

-CSF can leak into nasal cavity from fracture of cribriform plate.
- Injecting dye into CSF will show up on cotton place in nose.

The conchae are named

superior, middle and inferior

The meatuses are named

superior, middle and inferior

Superior meatus receives secretions from

posterior ethmoid air cells

What are the special features of the middle meatus

- bulla
- semilunar hiatus

Bulla

located in the middle meatus; bulge that receives secretions from middle ethmoid air cells

Semilunar hiatus

located in the middle meatus; has openings for secretions from frontal sinus, maxillary sinus and anterior ethmoid air cells

Inferior meatus receives secretions (tears) from

surface of eye through nasolacrimal duct

Sphenoethmoidal recess is posterior to ____ and receives secretions from ______

superior concha; sphenoid sinus

Maxillary sinus
-opens into
-foof forms ___
-innervated

-opens into middle meatus (via semilunar hiatus)
- roof forms floor of orbit
-innervated by V2

Frontal Sinus
- opens into
- left and right are usually ___
-innervated

- opens into middle meatus (via semilunar hiatus)
- left and right usually asymmetrical
-innervated by V1

Ethmoid Air cells
-how many
-anterior group drain into ___, middle into ___ and posterior into ___
- innervated
- infection can travel through this to ____

-From 3-18 in number
-Anterior group drain into semilunar hiatus, middle group onto surface of ethmoid bulla and posterior group into superior meatus.
- Innervated by V1
- Infection can travel into orbit

Sphenoid Sinus

- In the body of the sphenoid bone, under floor of hypophyseal fossa.
- Several important structures in the vicinity of this sinus, including: optic nerve, pituitary gland, cavernous sinus and internal carotid
arteries.

What are several important structures in the vicinity of the sphenoid sinus

optic nerve, pituitary gland, cavernous sinus and internal carotid arteries.

Arterial supply of nasal cavity

-anterior ethmoidal artery (from ophthalmic artery)
- posterior ethmoidal artery (from ophthalmic artery)
- sphenopalatine artery (from maxillary artery)
- greater palatine artery (from maxillary artery)
- septal branch of superior labial artery (from facial artery)

Anterior ethmoidal artery, posterior ethmoidal artery and sphenopalatine arter

divide into lateral and medial (septal) branches

The greater palatine artery reaches the septum via

the incisive canal

The anterior part of the nasal septum is the site of an ______ involving all five arteries supplying the septum called ____

anastomotic arterial plexus; Kiesselbach area

Kiesselbach area

anastomotic arterial plexus involving all
five arteries (above) supplying the anterior part of the nasal septum

The nerve supply of the posterior-inferior portion of the nasal mucosa is
mainly from the ______, by way of the ______ to the nasal septum, and ______ and ____branches of the _____ to the lateral wall.

maxillary nerve; nasopalatine nerve; posterior superior lateral nasal; inferior lateral nasal; greater palatine nerve

The nerve supply to the anterior-superior portion of the nasal mucosa is
from the ______ by way of the

ophthalmic nerve (V1); anterior and posterior
ethmoidal nerves, branches of the nasociliary nerve

Most of the external nose is supplied by V1 via the _____ and the _____ branch of the _____ nerve. Alae of the nose supplied by _____

infratrochlear nerve and the external nasal branch of the anterior ethmoidal nerve; Alae is supplied by the nasal branches of the infratrochlear nerve (from V2)

The _______, carries sensation regarding smell from the olfactory epithelium in the roof of the nasal cavity

olfactory nerve (CN I)

What area contains major nerves and blood vessels that supply the nasal cavity, upper jaw and the palate

Pterygopalatine fossa

What allows the infratemporal fossa, middle cranial fossa, nasopharynx, nasal
cavity and oral cavity to communicate?

Pterygopalatine fossa

Borders of the pterygopalatine fossa?
-Anteriorly
- Posteriorly
- Medially
- Superiorly
- Laterally

-Anteriorly: maxilla
-Posteriorly: pterygoid process of sphenoid bone
- Medially: perpendicular plate of palatine bone
- Superiorly: inferior surface of sphenoid bone
- Laterally: pyramidal process of palatine bone

Pterygomaxillary fissure allows communication of the ____ with _____

pterygopalatine fossa; infratemporal fossa

Sphenopalatine foramen allows communication of the ______ with the _____

pterygopalatine fossa with the nasal cavity

Inferior orbital fissure allows the pterygopalatine fossa allows communication with the

orbit

Foramen rotundum allows the pterygopalatine fossa to communicate with the

middle cranial fossa

Pterygopalatine ganglion

a parasympathetic ganglion of the facial
nerve (CN VII), The parasympathetics are delivered to the nasal cavity, oral cavity and the lacrimal gland in the orbit.

Maxillary division of trigeminal nerve: travels through roof of the
_________. It is carrying sensory information from the _____ and ____

pterygopalatine fossa; nasal and oral
cavities

Once the maxillary artery travels through the infratemporal fossa (from posterior to anterior) it dives into the

pterygopalatine fossa.

The sphenopalatine branch of the maxillary artery goes through the ____ to the ______ while the descending
palatine branch travels down to the ____

sphenopalatine foramen to the nasal cavity; palate

Nasopharynx

the region of the pharynx just posterior to the nasal cavity

Pharyngotympanic (auditory) tube: communication between ____ and _____

middle ear (tympanic) cavity and nasopharynx

Torus tubarius

elevation formed by cartilaginous portion of pharyngotympanic tube

Pharyngeal tonsil

lymphoid tissue in dorsal wall of nasopharynx

Pharyngeal recess

a groove between salpingopharyngeal fold and
posterior wall of nasopharynx

Levator veli palatini

muscle that elevates the soft palate during
swallowing. It runs from the cartilage of the pharyngotympanic tube to the
palatine aponeurosis. It is innervated by Vagus Nerve (CN X).

Tensor veli palatini

muscle that tenses the soft palate during swallowing. It runs from the medial pterygoid plate, sphenoid spine and auditory tube
to the soft palate. Its tendon loops around the pterygoid hamulus (of medial pterygoid plate). It is innervated by the Mandibular division of the
Trigeminal Nerve (V3).

Salpingopharyngeus

a muscle that forms the salpingopharyngeal fold. It runs from the posterior aspect of the cartilaginous part of the pharyngotympanic tube to blend with the palatopharyngeus muscle. It
helps to elevate the pharynx during swallowing. It is innervated by Vagus Nerve (CN X).

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