Anatomy of Nose

1. Dr Ajeet Kumar Khilnani
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2.  Bony part: Upper one-third
- Two nasal bones
- Nasal process of frontal bones
- Frontal processes of maxillae
 Cartilaginous part: Lower two-thirds
- Upper lateral cartilages (limen vestibuli)
- Lower lateral cartilages (Alar cartilages) U
shaped
- Lesser Alar (Sesamoid) Two or more in number
- Septal cartilage
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4.  Procerus
 Nasalis (transverse and alar parts)
 Levator labii superioris alaeque nasi
 Anterior and posterior dilator nares
 Depressor septi
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5. Nasal skin
 Upper skin is loose while lower is thick and
adherent
 Rhinophyma: Hypertrophy of sebaceous
glands
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6. It consists of
 Nasal vestibule
 Nasal cavity
- Lateral nasal wall
- Nasal septum
- Roof of nose
- Floor of nose
- Lining of internal nose
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7.  Anterior and inferior part of nasal cavity
 Lined by skin which contains sebaceous
glands and hair (vibrissae)
 Upper limit on lateral wall is marked by limen
nasi
 Medial wall is formed by columella and lower
part of nasal septum
 In recurrent vestibulitis always rule out DM
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8.  Lateral nasal wall
 Medial nasal wall
 Roof
 Floor
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9.  The Turbinates
- They are scroll-like bony projections
covered by mucous membrane
- Superior, Middle & Inferior (sometimes
Supreme)
 The Meatuses
- These are spaces below the turbinates
- Superior, Middle & Inferior
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11.  Inferior turbinate
- It is a separate bone
- Nasolacrimal duct open into inferior meatus
- NLD guarded by Hasner’s valve
 Middle turbinate
- It is a part of ethmoid bone
- Attached to lateral wall (S shaped) by
ground/basal lamella
 Middle meatus
- Uncinate process
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13.  Infundibulum
- Space limited medially by uncinate process
and laterally by lamina papyracea
- Natural ostium of maxillary sinus is sitauted
in the lower part of infundibulum
 Bulla ethmoidalis
- Ethmoidal cell situated behind uncinate
- Anterior surface forms the posterior
boundary of hiatus semiluaris
- Can be pneumatised or solid
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14.  Bulla ethmoidalis
- Suprabullar and retrobullar space together
form the lateral sinus of Grunwald
- Cleft like communication between bulla and
skull base is called hiatus semilunaris
superior
 Agger nasi cells are situated anterior to the
attachment of MT
 Concha bullosa is pneumatised MT
 Haller cells situated at roof of maxillary sinus
(infraorbital cells)
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15.  Superior turbinate is also a part of ethmoid
bone
 Posterior ethmoid cells (1 to 5) open into it
 Onodi cell is a posterior ethmoid cell which
may grow posterior to sphenoid. Optic nerve
is related to its lateral wall
 Sphenoethmoidal recess is situated above the
superior turbinate. Sphenoid sinus opens into
it
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18.  Olfactory nerves
- Carry sense of smell
- End in olfactory bulb
- These nerves carry sheaths of dura, pia &
arachnoid with them into the nose. Injury to
these nerves can cause CSF rhinorrhoea or
meningitis
 Nerves of common sensation
- Anterior Ethmoidal nerve (anterior and superior
part of nasal cavity)
- Branches of sphenopalatine ganglion (posterior
2/3rd of nasal cavity)
- Branches of infra-orbital nerve (vestibule)
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19.  Autonomic Nerves
- Parasympathetic fibres (Vasodilation)
Come from GSPN travel in nerve of
pterygoid canal Sphenopalatine ganglion
- Sympathetic fibres (Vasoconstriction)
Come from upper thoracic segments of spinal
cord Superior cervical ganglion travel
in nerve of pterygoid canal Sphenopalatine
ganglion
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21.  Internal carotid system
- Anterior ethmoidal Branches of
- Posterior ethmoidal Ophthalmic artery
 External carotid system
- Posterior lateral nasal branches (from
sphenopalatine artery)
- Greater palatine (from maxillary artery)
- Nasal branch of anterior superior dental
(from infraorbital branch of maxillary artery)
- Branches of facial artery (vestibule)
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23.  Columellar Septum
- Formed by medial crura of alar cartilages
 Membranous Septum
 Septum proper
- Perpendicular plate of ethmoid
- Vomer
- Septal (quadrilateral) cartilage
- Minor bones: crest of nasal bones, nasal
spine of frontal bone, rostrum of sphenoid,
crest of palatine bones & maxilla, and the
anterior nasal spine of maxilla
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26.  Internal carotid system
- Anterior ethmoidal Branches of
- Posterior ethmoidal Ophthalmic artery
 External carotid system
- Sphenopalatine artery (branch of maxillary)
gives nasopalatine and posterior medial nasal
branches
- Septal branch of greater palatine artery
(branch of maxillary artery)
- Septal branch of superior labial artery
(branch of facial artery)
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27.  Little’s Area
 Located at antero-inferior part of septum
 Formed by anterior ethmoidal,
sphenopalatine, greater palatine and septal
branch of superior labial artery
 Commonest site for epistaxis
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29.  Roof
- Anterior sloping part formed by nasal bones
- Posterior sloping part formed by body of
sphenoid
- Middle horizontal part formed by cribriform
plate
 Floor
- Palatine process of maxilla (anterior 3/4th)
- Horizontal plate of palatine bone (posterior
1/4th)
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30.  Vestibule lined by skin
 Olfactory region present in upper 1/3rd of
lateral wall, roof and upper 1/3rd of septum
 Respiratory region is the lower 2/3rd of nasal
cavity
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