The Nose, Paranasal Sinuses, and Maxillary Nerve

(47) The blood supply for the nasal cavities are by: 1) 2) 3) 4)

1) The branches of the anterior ethmoidal artery (from the ophthalmic artery) 2) The branches of the posterior ethmoidal artery (from ophthalmic artery) 3) The branches of the facial artery 4) The branches of the sphenopalatine artery (terminal branch of the maxillary artery)

Also lined with mucosa, the paranasal sinuses are normally filled with?

Air

10 to 15 small cells are classically described in three groups (on each side)

Anterior Middle Posterior

Note the specifics: The ______: a depression in the front of the middle concha. The ______: An area anterior and inferior to the atrium, close to the opening of the nostrils. The _______: A space superior to the superior concha, just inferior to the roof of the nasal cavities.

Atrium Vestibule Sphenoethmoidal Recess

(51) The ethmoidal sinuses are in the ethmoid bone, between what two strucutres?

Between the nasal cavities and the orbit, on the right and left side.

Each frontal sinus opens in the ________ of the middle ________.

Each frontal sinus opens in the infundibulum of the middle meatus.

(45) The nasal septum is composed of several bones/cartilage: 1) The vertical plate of the ______ bone 2) The ______, posteriorly and inferiorly 3) The ______ _______, anteriorly

Ethmoid bone Vomer Septal cartilage

(42) The nose is composed of the ______ nose and the ________

External nose Nasal Cavities

(61) This slide allows us to review the maxillary division of CN V. Recall that V2 passes through the _____ _______ and V3 through the ______ ______.

Foramen Rotundum Foramen Ovale

The main groups of sinuses are? (FEMS)

Frontal Ethmoidal Maxillary Sphenoidal

The maxillary nerve passes in the superior part of the pterygopalatine fossa. This fossa is a small space below and behind the orbital cavity. It communicates laterally with the ______ fossa through the _______ fissure.

It communicates laterally with the infratemporal fossa through the pterygomaxillary fissure.

It communicates medially with the ______ through the ______ foramen.

It communicates medially with the nasal cavity through the sphenopalatine foramen.

The space below each concha of the nose is called a?

Meatus

The branches of the maxillary nerve in this area are

Meningeal branch 2 ganglionic branches to the pterygopalatine ganglion Posterior superior alveolar nerve Zygomatic nerve Middle superior alveolar nerve (infraorbital nerve) Anterior superior alveolar nerve (infraorbital nerve)

Moistening is due to the presence of abundant production of mucus secreted by glands and specialized cells found in the _______.

Mucosa

The bony and cartilaginous framework of the external nose is composed of the following:

Nasal Bones Frontal process of the maxilla Nasal part of the frontal bone upper and lower nasal cartilages additional small cartilages

Each half of the nasal cavity has a floor, a roof, a lateral wall, and a medial wall which is the?

Nasal Septum

(46) The olfactory nerves are well shown in this Netter plate. The olfactory nerves arise in the?

Olfactory Mucous Membrane

(48) The nerves providing sensory innervation to the anterior lateral wall of the nasal cavities are the branches of?

Ophthalmic and Maxillary divisions of V The branches of the anterior ethmoidal nerve (V1) The branches of the infraorbital nerve (V2)

The anterior boundary of the nasal cavity is the _________ and the posterior boundary is the ________

The anterior boundary is the nostril, the posterior boundary is the choanae

The Anterior Ethmoidal sinus opens in the _______ and the ______.

The anterior ethmoidal sinus opens in the infundibulum and the middle meatus.

(31, 44) The anterior group of the ethmoidal sinuses opens into the ________ of the middle meatus The middle group opens on or above the ______ The posterior group opens in the _______

The anterior group of the ethmoidal sinuses opens into the infundibulum of the middle meatus. The middle group opens on or above the ethmoidal bulla The posterior group opens in the superior meatus

(45) The roof is narrower than the floor of the nose and is covered with mucosa. It is composed from posterior to anterior of:

The body of the sphenoid The cribiform plate of the ethmoid The frontal bone The nasal bone The nasal cartilages

(44) When the superior concha is removed, we can observe two other structures that are part of the ethmoid bone: 1) _________: a round prominence caused by the middle ethmoidal sinuses

The ethmoidal bulla

The floor of the nasal cavities is formed anteriorly by the _________ of the _______ and posteriorly by?

The floor of the nasal cavities is formed anteriorly by the palatine process of the maxilla and posteriorly by the palatine bone.

The frontal sinus opens in the _____ ____ through the _______.

The frontal sinus opens in the middle meatus through the infundibulum.

(15) The floor of the nasal cavities is?

The hard palate

Note that the innervation to the mucous membrane of the sphenoidal sinuses is by the _______ nerves.

The innervation to the mucous membrane of the sphenoidal sinuses is by the Posterior Ethmoidal nerves.

So, the Maxillary sinus opens in the _______ _____ through the _____ ______

The maxillary sinus opens in the middle meatus through the semilunar hiatus.

The middle ethmoidal sinus opens in the ______ and on or above the _______.

The middle ethmoidal sinus opens in the middle meatus and on or above the bulla ethmoidalis.

The middle meatus is below and lateral to the ______ conchae with the inferior meatus being below and lateral to the _____ conchae.

The middle meatus is below and lateral to the middle conchae with the inferior meatus being below and lateral to the inferior concha.

The nasal cavities are covered with mucosa and divided into right and left halves by?

The nasal septum

It communicates anteriorly with the orbit through inferior orbital fissure and inferiorly to the oral cavity through?

The palatine canal

(50) The _______ sinuses are defined as cavities found in the interior of the _____, _______, _______, and _____ bones.

The paranasal sinuses are defined as cavities found in the interior of the maxilla, frontal, sphenoid, and ethmoid bones.

The posterior ethmoidal sinus opens in the ______ meatus.

The posterior ethmoidal sinus opens in the superior meatus.

(46) The nerves innervating the posterior lateral wall of the nasal cavities are the branches of the maxillary divisions of CN V. These branches are?

The posterior superior lateral branches from the maxillary nerve The posterior inferior lateral nasal branches from the greater palatine nerve (V2).

The Sphenoidal sinus opens in the ________.

The sphenoidal sinus opens in the sphenoethmoidal recess.

The _____ and ______ conchae are part of the _____ bone.

The superior and middle conchae are part of the ethmoid bone

The superior meatus of the nasal cavity is between the ______ and ______ conchae.

The superior meatus of the nasal cavity is between the superior and middle conchae.

(43) The lateral wall of the nose is theoretically identical on the right and left side. Also covered with mucosa, the lateral presents with several important structures. First observe three bony projections on the lateral wall, called:

The superior, middle, and inferior conchae (turbinates)

The Olfactory Nerves line essentially the upper surface of the _____ ______ and the ______ _______ on the lateral wall, the matching area on the ________ and the part of the roof in between these two.

This one lines essentially the upper surface of the superior concha and the sphenoethmoidal recess on the lateral wall, the matching area on the nasal septum, and the part of the roof in between these two.

The axons of these cells (CN II) pass through the foramina of the cribiform plate of the ethmoid bone to end where?

To end in the olfactory bulb found in the anterior cranial fossa.

The frontal sinuses (there are two of them) are found in the frontal bone. These sinuses are roughly _____ in shape

Triangular

The inferior part of the nasal conchae is part of what bone?

Trick question, it is a bone on its own called the inferior nasal bone

The roots of some of the upper teeth can project where?

Up in the sinus (1st and 2nd premolar, 3rd molar).

(46) The nerves of the medial wall (nasal septum) are:

a branch of the anterior ethmoidal nerve (medial internal nasal branch) anteriorly the nasopalatine nerve (V2) posteriorly

What is the conca bullosa?

a normal anatomical variant in which the ethmoid sinuses have pushed down into the middle concha.

Note that the mucous membrane for the ethmoidal sinuses is innervated by the

anterior and posterior ethmoidal nerves.

The nasal cavities extend anteriorly from the __________ to the ______ posteriorly

anteriorly from the nostrils to the choanae posteriorly

Warming is thought to take place through exchange of heat between the air and the?

blood circulating in the network of arteries and plexus of veins in the mucosa itself.

(67) The posterior boundary of the nasal cavities is called the

choanae *note the hamulus hanging from the medial pterygoid plate

Cleaning occurs as the dust particles stick to the mucous membrane. Note that the particles and mucus are removed backward by what?

ciliary action of the columnar epithelium of the mucosa, pushing the mucus to the pharynx where it is swallowed.

Note that the maxillary sinus is the most difficult one to _____ due to the high positioning of its opening.

drain

(51) The maxillary sinuses are located with the body of the maxilla. The roof of the maxillary sinus is formed by what two structures?

floor of the orbit and the floor of the alveolar process.

The external nose is an appendage of the face continuous with the ________ and the ________.

frontal bone and the maxilla

Observe that this sinus opens in the middle meatus through the ______ _______

hiatus semilunaris

The second part of the ethmoid bone that can be seen with removal of the superior concha is the uncinate process and a curved cleft called the hiatus ________. The funnel shaped anterior end of the hiatus is called the

hiatus semilunaris infundibulum

Each frontal sinus opens in the _________ of the middle meatus, through the ________ duct.

infundibulum of the middle meatus through the frontonasal duct

The floor is covered by

mucosa

The external nose presents two external orifices, the nostrils. Each orifice is bound medially by the ________ and laterally by a set of _______

nasal septum and laterally by a set of cartilages

This mucous membrane possesses specialized olfactory nerve cells designed for reception of

olfactory stimuli

(45) The medial wall, also called the nasal septum, is an _______-________ structure covered with mucous membrane

osteo-cartilaginous

What provides parasympathetic innervation to the mucosa of the nasal cavities?

other branches of V2, the greater and lesser palatine nerves.

After passing through the Foramen Rotundum, the maxillary nerve continues anteriorly by passing through the _______ fossa to enter the ______; it is then called the _______ nerve.

passing through the pterygopalatine fossa to enter the orbit; it is then called the infraorbital nerve.

The sinuses are believed to play a role in ______ and in reducing the weight of?

phonation and in reducing the weight of the skull

(43) The sphenoidal sinuses (there are two of them) are located in the body of the sphenoid. The opening of these sinuses is in what structure?

sphenoethmoidal recess.