耳鼻喉科Otolaryngology topic seven: Nose /paranasal sinuses_anatomy

Nose /paranasal sinuses_anatomy

1. Surface

-- root-->bridge/dorsum-->tip-->membranous septum-->columella

-- GNRTP: glabella-->nasion-->rhinion-->tip-defining point-->philtrum

2.  Upper lateral cartilage

-- lower border: limen vestibuli, internal valve(resistance MAX, narrowest) 

-- below limen vestibuli : nasal vestibules((stratified squamous epithehum)

3. Lower lateral cartilage

-- lower border: external valve

4. Lateral wall bones

-- nasal, frontal, lacrimal

-- sphenoid, palatine

-- ethmoid, inferior concha (independent)

5. Openings

-- inferior meatus: nasolacrimal duct; E-tube(posterior)

-- middle meatus( hiatus semilunar ): sphenoid, anterior ethmoid, frontal sinuses

-- superior meatus: posterior ethmoid sinus

***posterior to E-tube: torus tubarius

** division of ant./post. ethmoid: basal lamella

6. Concha

-- Agger nasi: anterior border of ethmoid air cell

7. Olfactory pathway

-- olfactory bulb: 1st & 2nd neuron conjugation

-- mechanism: air particles dissolved in excreted fluid 

8. Nerves

-- anterior-->incisive canal= canal of Stenson 

-- posterior-->greater palatine foramen=  descending palatine vessels , greater palatine nerve

-- surface-->CN5-1, 5-2

-- inside-->CN5-2-->foramen rotundum-->pterygopalatine ganglion-->concha, greater palatine foramen(posterior)

-- parasympathetic-->brain stem-->geniculate ganglion-->superficial petrosal n.-->vidian n.-->pterygopalatine ganglion-->secondary neuron 

-- sympathetic-->superior cervical ganglion-->deep petrosal n.-->vidian n.-->pterygopalatine ganglion-->gland

9. Arteries

-- external carotid: internal maxillary a. /facial a. 

-- internal carotid: ophthalmic a. 

10. Veins

-- ethmoid v.-->ophthalmic v.-->cavernous sinus-->thrombosis, meningitis, brain abscess

-- NO valves

11. Sinuses

-- development: E(14wks~birth, X ray:6 months)-->M(10wks~birth, X ray:6 months, nasal floor: 12 years)-->S(2~6 years)-->F(3~18 years, X ray: 7 years)

-- frontal sinus drainage: affected by uncinate process

-- ostiomeatal complex(OMC)

-- sphenoid sinus development: sellar >presellar > conchal type