The document provides information on the anatomy and embryology of the nose and paranasal sinuses. It discusses the development of the nose from facial swellings in the embryo. It describes the bones that make up the nasal cavity including the ethmoid, sphenoid, frontal, vomer, nasal, maxillary and palatine bones. It details the structures of the nasal cavity such as the vestibule, respiratory region, olfactory region and turbinates. It also summarizes the blood supply, innervation and embryology of the paranasal sinuses. Finally, it outlines the endoscopic anatomy seen during nasal endoscopy.
Pterygopalatine fossa and approaches by Dr.Ashwin MenonDr.Ashwin Menon
The pterygopalatine fossa is a small pyramidal space located between the posterior maxilla and pterygoid processes. It contains the maxillary nerve, pterygopalatine ganglion, vidian nerve and branches of the maxillary artery. The fossa has anterior, posterior, medial, lateral and superior walls. Imaging shows its low density due to contained fat. Conditions involving the fossa include referred otalgia, foramen ovale lesions, and hay fever. Nerve blocks of the maxillary, mandibular and inferior alveolar nerves provide anesthesia to the region. The transantral approach is commonly used to access the fossa during procedures like vidian neurectomy.
The middle ear cavity is located between the tympanic membrane and inner ear. It contains the auditory ossicles (malleus, incus, stapes), muscles (tensor tympani, stapedius), and is connected to the nasopharynx via the Eustachian tube. The cavity has thin bony walls that separate it from important structures like the cranial fossa and carotid artery. The ossicles transmit sound vibrations from the tympanic membrane to the inner ear.
The nose has several important functions: respiration, protection of the lower respiratory tract, vocal resonance, olfaction, drainage of secretions, and maintaining eustachian tube function. It filters and conditions air through mechanisms like mucociliary clearance and the nasal cycle. Secretions produced in the nose help fight infections and allergens with lysozymes, immunoglobulins, and interferons. The olfactory epithelium allows for smell detection which is important for functions like regulating food intake and detecting toxins.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
The lateral wall of the nasal cavity is formed by several bones including the nasal, maxilla, lacrimal, ethmoid, palatine and sphenoid bones. It contains three bony projections called turbinates. Several anatomical structures are located within the lateral wall including the agger nasi cell, ethmoid bulla, uncinate process and ostiomeatal complex. The document describes the bones, turbinates, sinuses and various anatomical variations that can be present within the lateral wall of the nasal cavity.
I have tried my level best to complete this one. Basics & subjective details as much possible, are included here with understandable diagrams, CT-scans & charts. Clinical associations with possible anatomical structures are also touched . Frequent questions based on the topic discussed, will be there at the middle & end of presentation.
If you find it helpful then please like it & if any query regarding this ppt or upcoming ppts then mail me
drsuraj1997@gmail.com
Development of the middle ear is not covered in this presentation. If you are interested then please mail me. I will try to upload it as a separate one.
The document discusses the mucosal folds of the middle ear, which develop as the primitive tympanic cavity expands into the middle ear cleft between 3-7 months of fetal development. This forms four primary sacs that enlarge and replace the mesenchyme, with their walls becoming the mucosal lining of the middle ear. Mucosal folds are the planes of contact between neighboring sacs and carry ligaments and blood vessels to the ossicles. There are 10 important mucosal folds described, including the anterior and posterior malleal folds, lateral malleal ligamental fold, and tensor tympani fold. The folds divide the epitympanum (attic) and orient the progression of
Pterygopalatine fossa and approaches by Dr.Ashwin MenonDr.Ashwin Menon
The pterygopalatine fossa is a small pyramidal space located between the posterior maxilla and pterygoid processes. It contains the maxillary nerve, pterygopalatine ganglion, vidian nerve and branches of the maxillary artery. The fossa has anterior, posterior, medial, lateral and superior walls. Imaging shows its low density due to contained fat. Conditions involving the fossa include referred otalgia, foramen ovale lesions, and hay fever. Nerve blocks of the maxillary, mandibular and inferior alveolar nerves provide anesthesia to the region. The transantral approach is commonly used to access the fossa during procedures like vidian neurectomy.
The middle ear cavity is located between the tympanic membrane and inner ear. It contains the auditory ossicles (malleus, incus, stapes), muscles (tensor tympani, stapedius), and is connected to the nasopharynx via the Eustachian tube. The cavity has thin bony walls that separate it from important structures like the cranial fossa and carotid artery. The ossicles transmit sound vibrations from the tympanic membrane to the inner ear.
The nose has several important functions: respiration, protection of the lower respiratory tract, vocal resonance, olfaction, drainage of secretions, and maintaining eustachian tube function. It filters and conditions air through mechanisms like mucociliary clearance and the nasal cycle. Secretions produced in the nose help fight infections and allergens with lysozymes, immunoglobulins, and interferons. The olfactory epithelium allows for smell detection which is important for functions like regulating food intake and detecting toxins.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
The lateral wall of the nasal cavity is formed by several bones including the nasal, maxilla, lacrimal, ethmoid, palatine and sphenoid bones. It contains three bony projections called turbinates. Several anatomical structures are located within the lateral wall including the agger nasi cell, ethmoid bulla, uncinate process and ostiomeatal complex. The document describes the bones, turbinates, sinuses and various anatomical variations that can be present within the lateral wall of the nasal cavity.
I have tried my level best to complete this one. Basics & subjective details as much possible, are included here with understandable diagrams, CT-scans & charts. Clinical associations with possible anatomical structures are also touched . Frequent questions based on the topic discussed, will be there at the middle & end of presentation.
If you find it helpful then please like it & if any query regarding this ppt or upcoming ppts then mail me
drsuraj1997@gmail.com
Development of the middle ear is not covered in this presentation. If you are interested then please mail me. I will try to upload it as a separate one.
The document discusses the mucosal folds of the middle ear, which develop as the primitive tympanic cavity expands into the middle ear cleft between 3-7 months of fetal development. This forms four primary sacs that enlarge and replace the mesenchyme, with their walls becoming the mucosal lining of the middle ear. Mucosal folds are the planes of contact between neighboring sacs and carry ligaments and blood vessels to the ossicles. There are 10 important mucosal folds described, including the anterior and posterior malleal folds, lateral malleal ligamental fold, and tensor tympani fold. The folds divide the epitympanum (attic) and orient the progression of
Anatomy of inner ear by Dr. Aditya TiwariAditya Tiwari
The document summarizes the anatomy and development of the inner ear. It describes how the inner ear develops from the otic placode and otocyst in the early embryo. It then discusses the detailed structures within the inner ear, including the bony and membranous labyrinths, semicircular canals, cochlea, vestibule, and organ of Corti. The organ of Corti contains hair cells and supporting cells that detect sound vibrations and transmit signals to the auditory nerve.
Introduction
Functions
Development
Structure
Nasal cavity
Nasal septum
Lateral wall
Applied anatomy and pathology –
- danger area of nose
- nose bleeding
- foreign body in nose
- developmental nasal deformities
- nasal polyps
- mouth breathing
- rhinitis
Mucosal folds and ventilation of middle ear AlkaKapil
The document discusses the anatomy and embryology of the middle ear spaces and mucosal folds.
1. The middle ear develops from the tubotympanic recess which buds into sacs including the saccus anticus, medius, superior and posterior. Remnants of mesenchyme become ligaments and blood vessels.
2. The middle ear is divided into several compartments by mucosal folds including the protympanum, mesotympanum, epitympanum, hypotympanum, and retrotympanum.
3. The epitympanum or attic is further divided by mucosal folds into the upper unit above
This document summarizes the anatomy of the external ear. It describes the pinna (auricle), which is made of elastic cartilage covered in skin. It is attached to the skull by ligaments and muscles supplied by the facial nerve. The external auditory canal extends from the bottom of the concha to the tympanic membrane. The outer third is cartilaginous while the inner two thirds are bony. The tympanic membrane separates the external ear from the middle ear. It consists of the pars tensa and pars flaccida and is innervated by the auriculotemporal, vagus, and glossopharyngeal nerves.
The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus.
The larynx is located in the neck and regulates airflow during breathing and phonation. It contains 9 cartilages including the thyroid and cricoid cartilages which provide the skeletal framework. Intrinsic muscles like the cricothyroid and thyroarytenoid act on the vocal cords to produce sound. The larynx is supplied by the recurrent and internal laryngeal nerves and drains lymphatically into cervical nodes. Examination of the larynx provides insight into vocal cord function and pathology.
The larynx is a tube-shaped organ located in the neck that contains the vocal cords. It functions in swallowing, breathing, and voice production. The larynx is composed of cartilage, including the thyroid, cricoid, arytenoid, and epiglottic cartilages. It has three compartments divided by vocal folds. Muscles of the larynx control the vocal cords and laryngeal opening. The larynx is supplied by the internal and recurrent laryngeal nerves, and superior and inferior laryngeal arteries.
Anatomy of temporal bone By Dr.Vijay kumar , AMUvijaymgims
The temporal bone is divided into four parts - squamous, mastoid, petrous, and tympanic. The petrous part is pyramid-shaped and contains important structures like the internal acoustic meatus. The mastoid part projects backward and contains air cells. The squamous part forms the lateral skull base. The tympanic part forms much of the external acoustic meatus. The temporal bone articulates with other bones of the skull base and contains multiple important structures and passages.
This document describes the anatomy and physiology of the nose and paranasal sinuses. It discusses the development, external anatomy, internal anatomy including the nasal septum and lateral nasal wall, blood supply, nerve supply, paranasal sinuses, and physiology of the nose. Key structures mentioned include the nasal valve, osteomeatal complex, turbinates, and mucociliary clearance mechanism that protects the lower airways.
This document provides an overview of the osteology and anatomy of the nose. It discusses the bones that make up the nasal skeleton including the maxilla, frontal, ethmoid, sphenoid, inferior turbinate, lacrimal and palatine bones. It then describes each bone in more detail highlighting their features and landmarks. The document also covers the cartilages of the nose including the upper and lower cartilaginous vault. It discusses the lateral wall of the nose, nasal septum, turbinates and osteomeatal complex. In under 3 sentences, this document summarizes the key bones and structures involved in the anatomy of the nasal skeleton.
The infratemporal fossa is located below the temporal fossa. It is bounded by the ramus of the mandible laterally, the maxilla anteriorly, and the lateral pterygoid plate medially. The infratemporal fossa contains the mandibular nerve, maxillary artery, pterygoid venous plexus, and the medial and lateral pterygoid muscles. The maxillary artery passes through the infratemporal fossa and gives off several branches including the middle meningeal artery, accessory meningeal artery, inferior alveolar artery, and infraorbital artery. It communicates with surrounding areas through gaps in bones and openings in the skull.
The middle ear is an air-filled cavity that acts as an acoustic transformer, decreasing the amplitude of sound waves and increasing force. It contains the tympanic membrane, ossicles, and oval window. Sound waves have low impedance in air but high impedance in cochlear fluid. The middle ear structures match these impedances through three mechanisms: the lever action of the ossicles increases force 1.3 times, the larger tympanic membrane area produces a hydraulic pressure gain of 17 times, and the buckling tympanic membrane further increases effectiveness fourfold. The stapedius and tensor tympani muscles contract during loud sounds to attenuate sound by 30-40 dB, protecting the cochlea from
The pterygopalatine fossa is a small pyramidal space located behind the maxilla and below the orbit. It contains the maxillary nerve, pterygopalatine ganglion, maxillary artery and veins. The fossa communicates with several areas through canals including the orbit, nasal cavity, infratemporal fossa and middle cranial fossa. It is an important distribution center for branches of the maxillary nerve and artery.
The document summarizes key aspects of larynx anatomy. It discusses:
1) The larynx functions to protect the lower respiratory tract, provide a controlled airway, and enable phonation, coughing, and lifting.
2) It consists of cartilages including the thyroid, cricoid, epiglottis, and arytenoid cartilages joined by membranes and ligaments.
3) Intrinsic muscles control the laryngeal inlet and vocal cord movements to modulate phonation, respiration, and protection of the airway.
Embryology and anatomy of external and middle earAyesha Ather
The document discusses the embryology and anatomy of the external, middle, and mastoid parts of the ear. Regarding embryology, it describes how the external ear, auditory canal, middle ear spaces/folds, and ossicles develop from the branchial arches and pouches during fetal life. For anatomy, it outlines the structures of the external ear including the pinna, auditory canal, and tympanic membrane. It also details the walls, spaces, blood supply and contents of the middle ear, as well as the anatomy of the eustachian tube, mastoid air cells and their relationships.
The document discusses the anatomy of the sinus tympani, a cavity located in the posterior region of the tympanic cavity. It describes how the sinus tympani was first named and discussed in 1820. It defines the two portions of the retrotympanum based on the position of the facial nerve. It outlines different shapes that the sinus tympani can take, including classical, confluent, partitioned, and restricted, and different types - A, B, and C - based on its extension in relation to the facial nerve. The shapes and types of the sinus tympani can influence the surgical approach used for cholesteatoma surgery.
This document provides information on the embryology, structure, blood supply, nerve supply, and clinical importance of the external ear, external auditory canal, and tympanic membrane. It discusses the development of these structures from the first and second branchial arches. The pinna, external auditory canal, and tympanic membrane each have distinct embryological origins and anatomical structures. Common anomalies are also described. The clinical significance of various anatomical parts is outlined.
The nose serves several important physiological functions:
- It warms, humidifies, and filters incoming air, protecting the lower airways. Nasal secretions containing enzymes, antibodies, and other proteins help fight infections.
- Airflow through the nose is turbulent due to its irregular shape and variable cross-section. The nasal cycle causes periodic congestion of one side to control airflow.
- Rhinomanometry measures nasal resistance by determining the relationship between pressure and airflow, providing information about nasal patency and function.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.All Good Things
Dentist in pune. (BDS. MDS) - Dr. Amit T. Suryawanshi. Seminar- Nose & Paranasal sinuses.
Email ID- amitsuryawanshi999@gmail.com
Contact -Ph no.-9405622455
Subscribe our channel on youtube - Copy and paste this URL. https://www.youtube.com/channel/UC_gylEXTrjmEbbOTSXjuZ4Q/videos?view_as=public
Follow us on slideshare
The nasal cavity is divided by the nasal septum into left and right cavities. Each cavity contains 4 passages formed by the nasal conchae: the sphenoethmoidal recess, superior meatus, middle meatus, and inferior meatus. The nasal cavities are lined with mucous membrane and contain paranasal sinuses. Epistaxis or nosebleeds can occur due to various causes like trauma, infections, or anatomical abnormalities. Posterior nosebleeds from Woodruff's plexus are difficult to treat due to its inaccessible location.
Anatomy of inner ear by Dr. Aditya TiwariAditya Tiwari
The document summarizes the anatomy and development of the inner ear. It describes how the inner ear develops from the otic placode and otocyst in the early embryo. It then discusses the detailed structures within the inner ear, including the bony and membranous labyrinths, semicircular canals, cochlea, vestibule, and organ of Corti. The organ of Corti contains hair cells and supporting cells that detect sound vibrations and transmit signals to the auditory nerve.
Introduction
Functions
Development
Structure
Nasal cavity
Nasal septum
Lateral wall
Applied anatomy and pathology –
- danger area of nose
- nose bleeding
- foreign body in nose
- developmental nasal deformities
- nasal polyps
- mouth breathing
- rhinitis
Mucosal folds and ventilation of middle ear AlkaKapil
The document discusses the anatomy and embryology of the middle ear spaces and mucosal folds.
1. The middle ear develops from the tubotympanic recess which buds into sacs including the saccus anticus, medius, superior and posterior. Remnants of mesenchyme become ligaments and blood vessels.
2. The middle ear is divided into several compartments by mucosal folds including the protympanum, mesotympanum, epitympanum, hypotympanum, and retrotympanum.
3. The epitympanum or attic is further divided by mucosal folds into the upper unit above
This document summarizes the anatomy of the external ear. It describes the pinna (auricle), which is made of elastic cartilage covered in skin. It is attached to the skull by ligaments and muscles supplied by the facial nerve. The external auditory canal extends from the bottom of the concha to the tympanic membrane. The outer third is cartilaginous while the inner two thirds are bony. The tympanic membrane separates the external ear from the middle ear. It consists of the pars tensa and pars flaccida and is innervated by the auriculotemporal, vagus, and glossopharyngeal nerves.
The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus.
The larynx is located in the neck and regulates airflow during breathing and phonation. It contains 9 cartilages including the thyroid and cricoid cartilages which provide the skeletal framework. Intrinsic muscles like the cricothyroid and thyroarytenoid act on the vocal cords to produce sound. The larynx is supplied by the recurrent and internal laryngeal nerves and drains lymphatically into cervical nodes. Examination of the larynx provides insight into vocal cord function and pathology.
The larynx is a tube-shaped organ located in the neck that contains the vocal cords. It functions in swallowing, breathing, and voice production. The larynx is composed of cartilage, including the thyroid, cricoid, arytenoid, and epiglottic cartilages. It has three compartments divided by vocal folds. Muscles of the larynx control the vocal cords and laryngeal opening. The larynx is supplied by the internal and recurrent laryngeal nerves, and superior and inferior laryngeal arteries.
Anatomy of temporal bone By Dr.Vijay kumar , AMUvijaymgims
The temporal bone is divided into four parts - squamous, mastoid, petrous, and tympanic. The petrous part is pyramid-shaped and contains important structures like the internal acoustic meatus. The mastoid part projects backward and contains air cells. The squamous part forms the lateral skull base. The tympanic part forms much of the external acoustic meatus. The temporal bone articulates with other bones of the skull base and contains multiple important structures and passages.
This document describes the anatomy and physiology of the nose and paranasal sinuses. It discusses the development, external anatomy, internal anatomy including the nasal septum and lateral nasal wall, blood supply, nerve supply, paranasal sinuses, and physiology of the nose. Key structures mentioned include the nasal valve, osteomeatal complex, turbinates, and mucociliary clearance mechanism that protects the lower airways.
This document provides an overview of the osteology and anatomy of the nose. It discusses the bones that make up the nasal skeleton including the maxilla, frontal, ethmoid, sphenoid, inferior turbinate, lacrimal and palatine bones. It then describes each bone in more detail highlighting their features and landmarks. The document also covers the cartilages of the nose including the upper and lower cartilaginous vault. It discusses the lateral wall of the nose, nasal septum, turbinates and osteomeatal complex. In under 3 sentences, this document summarizes the key bones and structures involved in the anatomy of the nasal skeleton.
The infratemporal fossa is located below the temporal fossa. It is bounded by the ramus of the mandible laterally, the maxilla anteriorly, and the lateral pterygoid plate medially. The infratemporal fossa contains the mandibular nerve, maxillary artery, pterygoid venous plexus, and the medial and lateral pterygoid muscles. The maxillary artery passes through the infratemporal fossa and gives off several branches including the middle meningeal artery, accessory meningeal artery, inferior alveolar artery, and infraorbital artery. It communicates with surrounding areas through gaps in bones and openings in the skull.
The middle ear is an air-filled cavity that acts as an acoustic transformer, decreasing the amplitude of sound waves and increasing force. It contains the tympanic membrane, ossicles, and oval window. Sound waves have low impedance in air but high impedance in cochlear fluid. The middle ear structures match these impedances through three mechanisms: the lever action of the ossicles increases force 1.3 times, the larger tympanic membrane area produces a hydraulic pressure gain of 17 times, and the buckling tympanic membrane further increases effectiveness fourfold. The stapedius and tensor tympani muscles contract during loud sounds to attenuate sound by 30-40 dB, protecting the cochlea from
The pterygopalatine fossa is a small pyramidal space located behind the maxilla and below the orbit. It contains the maxillary nerve, pterygopalatine ganglion, maxillary artery and veins. The fossa communicates with several areas through canals including the orbit, nasal cavity, infratemporal fossa and middle cranial fossa. It is an important distribution center for branches of the maxillary nerve and artery.
The document summarizes key aspects of larynx anatomy. It discusses:
1) The larynx functions to protect the lower respiratory tract, provide a controlled airway, and enable phonation, coughing, and lifting.
2) It consists of cartilages including the thyroid, cricoid, epiglottis, and arytenoid cartilages joined by membranes and ligaments.
3) Intrinsic muscles control the laryngeal inlet and vocal cord movements to modulate phonation, respiration, and protection of the airway.
Embryology and anatomy of external and middle earAyesha Ather
The document discusses the embryology and anatomy of the external, middle, and mastoid parts of the ear. Regarding embryology, it describes how the external ear, auditory canal, middle ear spaces/folds, and ossicles develop from the branchial arches and pouches during fetal life. For anatomy, it outlines the structures of the external ear including the pinna, auditory canal, and tympanic membrane. It also details the walls, spaces, blood supply and contents of the middle ear, as well as the anatomy of the eustachian tube, mastoid air cells and their relationships.
The document discusses the anatomy of the sinus tympani, a cavity located in the posterior region of the tympanic cavity. It describes how the sinus tympani was first named and discussed in 1820. It defines the two portions of the retrotympanum based on the position of the facial nerve. It outlines different shapes that the sinus tympani can take, including classical, confluent, partitioned, and restricted, and different types - A, B, and C - based on its extension in relation to the facial nerve. The shapes and types of the sinus tympani can influence the surgical approach used for cholesteatoma surgery.
This document provides information on the embryology, structure, blood supply, nerve supply, and clinical importance of the external ear, external auditory canal, and tympanic membrane. It discusses the development of these structures from the first and second branchial arches. The pinna, external auditory canal, and tympanic membrane each have distinct embryological origins and anatomical structures. Common anomalies are also described. The clinical significance of various anatomical parts is outlined.
The nose serves several important physiological functions:
- It warms, humidifies, and filters incoming air, protecting the lower airways. Nasal secretions containing enzymes, antibodies, and other proteins help fight infections.
- Airflow through the nose is turbulent due to its irregular shape and variable cross-section. The nasal cycle causes periodic congestion of one side to control airflow.
- Rhinomanometry measures nasal resistance by determining the relationship between pressure and airflow, providing information about nasal patency and function.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.All Good Things
Dentist in pune. (BDS. MDS) - Dr. Amit T. Suryawanshi. Seminar- Nose & Paranasal sinuses.
Email ID- amitsuryawanshi999@gmail.com
Contact -Ph no.-9405622455
Subscribe our channel on youtube - Copy and paste this URL. https://www.youtube.com/channel/UC_gylEXTrjmEbbOTSXjuZ4Q/videos?view_as=public
Follow us on slideshare
The nasal cavity is divided by the nasal septum into left and right cavities. Each cavity contains 4 passages formed by the nasal conchae: the sphenoethmoidal recess, superior meatus, middle meatus, and inferior meatus. The nasal cavities are lined with mucous membrane and contain paranasal sinuses. Epistaxis or nosebleeds can occur due to various causes like trauma, infections, or anatomical abnormalities. Posterior nosebleeds from Woodruff's plexus are difficult to treat due to its inaccessible location.
The nasal cavity is divided by the nasal septum into left and right cavities. Each cavity contains 4 passages formed by the nasal conchae: the sphenoethmoidal recess, superior meatus, middle meatus, and inferior meatus. The nasal cavities are lined with mucous membrane and contain paranasal sinuses. Epistaxis or nosebleeds can occur due to various causes like trauma, infections, or anatomical abnormalities. Posterior nosebleeds from Woodruff's plexus are difficult to treat due to its inaccessible location.
nasal_cavity human anatomy lateral wall and venous drainage_1.pptxsiddhimeena3
This document provides an overview of the nasal cavity, including its parts, boundaries, blood supply, nerve supply and applied aspects. It discusses the vestibule, nasal cavity proper, roof, floor and septum of the nasal cavity in detail. The septum has bony, cartilaginous and membranous parts. It receives its blood supply from various arteries and drains into facial and pterygoid veins. The septum is innervated by branches of various cranial nerves. Applied aspects of the nasal septum include its role in nasal obstruction and importance of preserving the septal cartilage.
Nose, nasal cavity and paranasal sinuses.pptxSundip Charmode
This document discusses the nose, nasal cavity, and paranasal sinuses. It begins by outlining the boundaries and features of the nasal cavity, including its roof, floor, and lateral walls. It then describes the nasal septum in detail, including its bony, cartilaginous, and vascular components. Finally, it briefly introduces the paranasal sinuses, noting their locations, characteristics, and functions in humidifying and warming inhaled air.
The maxilla is the second largest bone of the face that forms the upper jaw. It develops from the first branchial arch and maxillary processes by the fourth week of gestation. The maxilla has four surfaces - anterior, posterior, superior and medial - as well as four processes - frontal, zygomatic, alveolar and palatine. It contains the maxillary sinus and provides attachments for muscles like the buccinator. The maxilla is supplied by the maxillary nerve, facial artery and drains into the facial and pterygoid veins.
Uppermost parts of the respiratory tract and contain the olfactory receptors
Elongated wedge-shaped spaces with a large inferior base and a narrow superior apex
Skeletal framework consisting mainly of bone and cartilage
Nares – external opening of nose
Choanae - open into the nasopharynx
Bones that contribute to the skeletal framework of the nasal cavities include
Unpaired: ethmoid, sphenoid, frontal bone, and vomer;
Paired: nasal, maxillary, palatine and lacrimal bones, and inferior conchae
The nose and paranasal sinuses have complex anatomy. The nose is divided into an external cartilaginous portion and internal bony nasal cavities separated by a nasal septum. The nasal cavities contain turbinates and drain into various meatuses. Several pairs of paranasal sinuses surround the nasal cavities. The sinuses are lined with ciliated respiratory epithelium and drain into the nasal cavities. The nose has roles in breathing, warming, and filtering air as well as detecting smells. Congenital anomalies like choanal atresia can cause nasal obstruction.
The summary of the document is:
1. The nose and paranasal sinuses develop between 4-8 weeks of fetal life from the frontonasal process and maxillary processes.
2. By 5-6 weeks, nasal placodes form and invaginate to form nasal pits which later fuse to form the primitive nasal cavity.
3. Between 7-10 weeks, the paranasal sinuses begin to form from outpocketings of the nasal mucosa. The maxillary sinus is the first to form around 3 months of gestation.
4. The external nose is made up of bones, cartilages and overlying skin and muscle. The internal nasal cavity has
The document summarizes the anatomy of the nose. It describes the external nose, nasal cavity, and structures within including bones, cartilages, walls, openings, blood supply, nerves and lymph drainage. Key points are the pyramidal external nose composed of bones and cartilage, the nasal cavity divided into three regions and outlined by four walls, and various sinuses and structures that open into the nasal cavity.
The Respiratory System in the Head and NeckHadi Munib
The document describes the anatomy and structures of the respiratory system in the head and neck region, including the nose, nasal cavity, paranasal sinuses, pharynx, and larynx. It discusses the external features, internal structures, blood supply, nerve innervation, and functions of these areas. The nasal cavity is divided by the septum and contains three meatuses for drainage of the paranasal sinuses. The larynx contains cartilages like the thyroid and cricoid that support the vocal cords.
The nose has two main parts: the external nose and the nasal cavity. The nasal cavity is divided into right and left halves by the nasal septum. It has several important functions including respiration, olfaction, filtration of dust, and humidification. The nasal septum contains Little's area, a highly vascular region supplied by several arteries, which is a common site for nosebleeds. The lateral wall of the nasal cavity contains three curved bony shelves called conchae that divide it into air spaces called meatuses.
The nose has two main parts: the external nose and the nasal cavity. The nasal cavity is divided into right and left halves by the nasal septum. It has several important functions including respiration, olfaction, filtration of dust, and humidification. The nasal septum contains important blood vessels and is a common site of nosebleeds. The lateral wall of the nasal cavity contains projections called conchae and depressions called meatuses which contain many openings of glands and sinuses.
The nose develops from the frontonasal process which divides into medial and lateral processes. The primitive nasal cavities are initially closed but rupturing forms openings called choanae. The external nose consists of bone and cartilage while the internal nose includes the nasal cavity lined with mucosa and divided by the nasal septum. The septum contains cartilage, bones, and receives blood supply from the external and internal carotid arteries. Nerves also provide sensation from branches like the anterior ethmoidal nerve.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Anatomy and physiology of nose and paranasal sinusesAnwaaar
The document discusses the anatomy and physiology of the nose and paranasal sinuses. It describes the external and internal structures of the nose, including bones, cartilages, muscles and blood supply. It also outlines the locations and relationships of the four pairs of paranasal sinuses - the frontal, ethmoidal, maxillary, and sphenoid sinuses.
Anatomy of nose dental courses /certified fixed orthodontic courses by Indian...Indian dental academy
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Anatomy of ear(Part 2-Middle Ear) by Dr.K.AmrithaAnilkumarAmritha Anilkumar
This document provides an in-depth overview of the anatomy of the middle ear, including its structures and blood supply. Key points covered include:
- The middle ear contains the eustachian tube, tympanic cavity, aditus, and mastoid air cells. The tympanic cavity houses the ossicles and contains walls, floors and openings like the oval and round windows.
- Structures inside the tympanic cavity include the malleus, incus, and stapes ossicles, the tensor tympani and stapedius muscles, nerves like the chorda tympani, and blood vessels.
- The mastoid air cells are interconnected air spaces behind the middle ear that
Direct laryngoscopy allows visualization of the larynx and hypopharynx. It is used diagnostically to examine these areas for lesions, growths, or foreign bodies and therapeutically to remove benign lesions, foreign bodies, or dilate laryngeal strictures. The patient is placed in a supine position with their head extended and neck flexed. A laryngoscope is lubricated and inserted past the tongue to lift the epiglottis and provide a view of the laryngeal structures. Potential complications include injury to the lips, tongue, or teeth as well as bleeding or laryngeal edema.
A 15-year-old male presented with a swelling in his neck for 2 months. Clinical examination revealed a fluctuant, transilluminant swelling over the submental and left submandibular region that was not fixed to underlying structures. An MRI scan was performed. The plan was to excise the ranula and sublingual gland through a trans-cervical approach under general anesthesia. Post-operatively, the patient was started on IV antibiotics and analgesics. The neck drain was removed on day 3 and sutures were removed on day 4. Histopathology revealed a mucous retention cyst of the salivary gland.
This document describes an 88-year-old male patient who presented with a swelling on his right ear pinna for one year with discharge for the past 10 days. On examination, a 5 cm proliferative growth was seen on the right pinna. Differential diagnoses included cutaneous horn, verrucous hyperplasia, verrucous carcinoma, and invasive squamous cell carcinoma. The patient underwent wide local excision of the lesion under general anesthesia. Histopathology revealed squamous cell hyperplasia without evidence of invasive cancer.
Sino Nasal malignancy & Anterior skull base surgery, Endoscopy is the best ???Ajay Manickam
1) The document compares endoscopic versus open surgery for sinonasal and anterior skull base tumors. It finds that endoscopic surgery provides comparable oncologic outcomes to open surgery, with lower morbidity, faster recovery, and shorter hospital stays.
2) A review of studies found no difference in margins or survival between the two approaches. Endoscopic surgery was associated with significantly shorter hospital stays.
3) Complications were also lower with endoscopic surgery. While open surgery remains necessary in some complex cases, endoscopic surgery is presented as a valid alternative for most sinonasal and anterior skull base malignancies.
This document discusses neoadjuvant chemotherapy in head and neck cancer. It provides background on when neoadjuvant chemotherapy is given, what regimens are used, and evidence from studies comparing neoadjuvant chemotherapy plus radiation/surgery versus radiation/surgery alone. Several large studies found that adding docetaxel, cisplatin and fluorouracil as neoadjuvant chemotherapy improved overall and progression-free survival compared to cisplatin and fluorouracil alone. However, other studies found no difference in outcomes between neoadjuvant chemotherapy followed by chemoradiation versus chemoradiation alone. Concomitant chemoradiation appears superior to induction chemotherapy for larynx preservation.
This document discusses cancer of the nasopharynx (NPC). Some key points:
- NPC is uncommon globally but more common in certain regions like Southern China.
- Risk factors include EBV infection, consumption of salted fish.
- Staging involves MRI and biopsy. Treatment depends on stage but often involves chemotherapy and radiation therapy.
- Advanced stages may receive neoadjuvant chemo followed by concurrent chemo-radiation. IMRT has improved treatment.
- Sequelae can include cranial neuropathy, xerostomia, endocrine issues. Lifelong follow up is needed due to risk of recurrence or second cancers. Outcomes have improved but salvage options after relapse present challenges
Inter group rhabdomyosarcoma study group (irsg)Ajay Manickam
1. The IRSG study from 1972-1997 evaluated treatment protocols for rhabdomyosarcoma and established a staging and grouping system to determine prognosis and guide therapy.
2. Results showed surgery is important, with Group I having the best outlook while Group IV has the worst. Radiation therapy improved outcomes for Groups II and III. Chemotherapy including VAC or VIE improved failure-free and overall survival.
3. IRSG V recommendations incorporate risk stratification to allow for multidisciplinary treatment tailored to histology, with the goal of local control while preserving function.
Thoracic duct injury in neck dissectionAjay Manickam
The thoracic duct is the body's largest lymphatic conduit, draining upwards of 75% of lymphatic fluid per day. Injury to the thoracic duct during neck dissection can result in a chylous fistula. Management depends on the output and may include nutritional approaches to decrease lymph production, somatostatin analogs to minimize lymph excretion, negative pressure wound therapy, or surgical ligation/repair of the thoracic duct. Surgical management is usually reserved for high output fistulas or those persisting after conservative measures. Functional repair of the thoracic duct is preferred to occlusion to avoid unwanted consequences from redistribution of lymphatic flow.
This document discusses sentinel node biopsy (SNB) for oral cancers. The study evaluated 480 patients with oral squamous cell carcinoma (SCC) of size 0.5-4cm without neck node involvement on imaging. SNB using radiocolloid and blue dye identified occult cervical lymph node metastases in 23% of patients. SNB had a sensitivity of 86% and negative predictive value of 95% for detecting occult disease. While SNB failed to detect occult metastases in 14% of patients, it also identified unexpected contralateral lymphatic drainage in 12% of cases. The results support SNB as a safe and effective technique for staging the neck in early oral cancers, while also sparing over 70% of patients unnecessary neck
This document discusses procedures related to the frontal sinus. It begins with the anatomy of the frontal sinus, noting its variable size and drainage patterns. It then describes different surgical approaches for treating conditions of the frontal sinus such as inflammatory diseases, trauma, tumors, and malformations. These approaches include endoscopic procedures, external approaches, and cranialization of the frontal sinus. The document provides details on each procedure and highlights key considerations for surgical treatment of various frontal sinus pathologies.
This document discusses the case of a 14-year neck swelling in a patient, found to be a thyroglossal cyst extending into the larynx. Examination found a mobile neck mass moving with swallowing and tongue protrusion. Imaging showed a cystic mass in the supraglottis extending to the vallecula. The patient underwent a Sistrunk operation to remove the thyroglossal cyst, and pathology confirmed it was a thyroglossal cyst that had extended into the larynx. Thyroglossal cysts can rarely extend into the larynx, so this must be considered in diagnostic evaluations of midline neck masses.
This document discusses glomus tumors, which are rare, hypervascular tumors that arise from glomus bodies. They most commonly occur in the middle ear, jugular foramen, or neck regions. Symptoms depend on location but may include hearing loss, tinnitus, and cranial nerve deficits. Diagnosis involves imaging like MRI and CT. Surgery is the primary treatment and approach depends on tumor size and involvement. Preoperative embolization can help reduce bleeding risk during removal of these vascular tumors.
This document discusses the use of lasers in ear surgery. It outlines four FDA-approved medical lasers, including CO2 and YAG lasers that emit in the infrared spectrum. Lasers are useful for stapedotomy and stapedectomy procedures due to their ability to precisely vaporize bone and collagen with minimal heating of surrounding tissues. The document also notes some advantages of laser ear surgery, including improved precision of the stapedotomy and reduced risk of infection compared to other techniques. Potential applications of lasers mentioned include tumor removal and emission spectroscopy procedures in the inner ear.
The document discusses otosclerosis, a disease affecting the bones of the middle ear. It causes stapes fixation and conductive hearing loss. It most commonly affects Caucasians between 15-45 years of age and is more prevalent in females. Etiology includes genetic and hormonal factors. Symptoms include conductive deafness and better hearing in noisy environments. Diagnosis involves tests showing conductive hearing loss like negative Rinne's test. Treatment options include stapedectomy surgery to replace or remodel the stapes bone.
This document discusses various techniques for reconstructing skin and soft tissue defects in the head and neck region. It describes different types of grafts, local flaps, regional flaps, and free flaps that can be used including split thickness grafts, full thickness grafts, axial pattern flaps, transposition flaps, pedicled flaps like pectoralis major and latissimus dorsi flaps. Careful preoperative planning is important when using local flaps for head and neck reconstruction.
The document summarizes the mechanism of hearing in three main steps: 1) Mechanical conduction of sound through the pinna, ear canal, and middle ear bones, which function as an acoustic transformer to increase sound pressure; 2) Transduction of mechanical energy into electrical impulses by hair cells in the cochlea; 3) Conduction of electrical impulses through the auditory nerve pathway to the brain. It then describes four historical theories of hearing: Helmholtz's place theory in which different frequencies excite different regions of the cochlea, Rutherford's frequency theory in which all frequencies activate the entire cochlea, Wever's volley resonance theory involving asynchronous discharges, and von
This document provides an overview of assessing deafness. It discusses taking a thorough history including details on onset and progression of hearing loss. It also describes examining the external ear, ear canal, tympanic membrane, and performing neurological tests. Relevant investigations include audiological tests like pure tone audiometry, tympanometry and BERA. Radiological tests like X-ray and HRCT are also discussed. The document concludes with describing how to make a diagnosis based on the history, examinations and test results.
The document discusses Meniere's disease, including:
- Its history dating back to Dr. Robert Meniere in 1861 and discoveries in the 1920s and 1930s.
- Key symptoms are episodic vertigo, fluctuating hearing loss, tinnitus, and aural fullness.
- It affects ages 40-60 predominantly in Caucasians, and has a familial link.
- Treatment includes conservative options like lifestyle changes and medications, as well as surgical options for resistant cases.
- No definitive cure exists due to the unpredictable nature and evolutionary pattern of the disease over time.
This document discusses various conditions affecting the external ear, including congenital deformities, traumatic injuries, and inflammatory conditions. It covers topics like perichondritis, fungal infections like otomycosis, furuncles, eczema, and cerumen impaction. For each condition, it describes etiology, symptoms, examination findings, and treatment approaches.
This document discusses ossiculoplasty procedures for reconstructing the ossicular chain in the middle ear. It describes the history of different prosthetic materials used, including wires, homografts, and plastics. An ideal prosthesis is said to be durable, biocompatible, and easy to manipulate. Current prostheses discussed include plastipore covered in cartilage to prevent extrusion, ceramic implants which have higher extrusion rates, and hydroxylapatite which can directly contact the tympanic membrane. Surgical techniques are explained for different ossicular discontinuities classified by Austin and Wullstein. Key factors for success are described as infection control, tissue health, and eustachian tube function.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Anatomy of lateral wall of nose & pns ajay m
1. ANATOMY OF NOSE & PNS
FUNCTIONS OF NOSE & PNS
Dr. Ajay Manickam
Junior Resident
Dept of Otorhinolaryngology
R G Kar Medical College
2. EMBRYOLOGY
• Facial development takes place between 4 – 8 weeks of intra
uterine life
• Face develops from 5 facial swellingsthat surround the
Primitive mouth by the end of 4th week
Central unpaired frontonasal process
Pair of maxillary process
Pair of mandibular process
3. At 5th week thickening appear in fronto nasal
process called nasal placodes
At 6th week nasal placode invaginates to form
nasal pits
6th and 7th week maxillary process increase in size
to grow medially
They fuse with medial nasal process & then with
lateral nasal process
This separates nasal pits from stomadeum
4. Medial nasal process fuse with eachother to form inter
maxillary process
Which forms central bridge of nose and the central portion of
upper lip philtrum
Inter maxillary process grows backward to form nasal
septum
lateral nasal process enlarge to form alae, grow backward to
form lateral nasal wall, which show ant post elevation to form
turbinates.
5. • Maxillary process fuses with the lateral
nasal process
• The junction is marked by a groove called
nasolacrimal/ naso optic groove
• By 7th week groove invaginates into
mesenchyme to form nasolacrimal duct
• Canalization continues throughout
pregnancy and may not be complete till
after birth
6.
7. Anatomy of nose
• Nose can be divided into external nose & nasal cavity
• External nose consists of
8. External nares
• Oval apertures on the inferior
aspect of external nose
• Held open by the alar cartilages
and septal cartilages
• Inferior nasal spine and adjacent
margins of maxillae
9. ANATOMY OF NOSE
• Nasal cavities are elongated wedge
shaped spaces with large inferior
base and narrow superior apex
• Ant apertures are the nares, open
onto inferior surface of nose
• Post apertures are the choanae,
which open into the nasopharynx
10. DIVISIONS OF NASAL CAVITY
• Nasal cavities
• Lateral wall of
nose
Conchae divide
nasal cavities into
four air channels
Conchae increase
surface area of
contact between
lateral wall and
respired air
11. Regions of Nasal Cavity
• Nasal vestibule
• Respiratory region
• Olfactory region
13. Ethmoidal Bone
• Complex bone of skull
• Contributes to roof, lateral wall,medial wall
of nasal cavity and contains ethmoidal
cells
14. Ethmoidal bone
• Cuboidal in shape
• 2 ethmoidal labyrinths – united by cribriform
plate – separates nasal cavity from cranium
• 2nd sheet – perpendicular plate descends
vertically from cribriform plate
• Ethmoidal labyrinth 2 sheets
Lateral sheet – orbital plate
Medial sheet – upper part of lat wall of nose
• Irregular projection the uncinate process
• Articulates
Ant – nasal spine of frontal bone
Post – sphenoidal crest of sphenoid , vomer
Inf – ant – septal cartilage
15. Sphenoidal bone
• Closes the back of nasal cavity and
separates it from ant and middle
cranial fossa
• Lesser wing attached to body by two
roots between which lies optic canal
• Medial pterygoid plate forms the
lateral wall of post choana
• Inferomedian funnel shaped foramen
vidian canal
• Supero lateral foramen is foramen of
rotundum transmits maxillary nerve
16. Frontal bone
• Centre of frontal bone is a hiatus
that’s filled with cribriform plate of
ethmoid
• Either side of hiatus are aircells of
ant & post ethmoidal cells
• Lateral border of these aircells
articulate with lamina papyracea of
ethmoidal bone
• At the junction of these suture lines
lies ant and post ethmoidal
foramina
• Anteriorly midline frontal bone
elongated to form the nasal spine
17. Vomer
• It is located in the midsagittal line,
and articulates with thesphenoid,
the ethmoid, the left and
right palatine bones, and the left and
right maxillary bones.
• The vomer forms the posterior part
of the nasal septum, with the
anterior part formed by the ethmoid.
18. Nasal bone
• 2 small rectangular bones , forming bridge
of nose
• 2 surfaces and 4 borders
• External surface- covered by procerus and
nasalis muscle
• Internal surface concave side to side,
groove for ant ethmoidal nerve
• Superior border-frontal bone
• Inferior border = upper lateral cartilage
• Medial border –opposite nasal bone-part
of septum
• Lateral border-frontonasal process of
maxilla
19. Maxillary bone
• Forms base of framework on
which lat nasal wall is built
• Large opening in maxillary bone
is closed off by processes of
different bones
• Descending process - lacrimal
bone ant
• Uncinate process - ethmoidal
bone antinferiorly
• Maxillary process - inf turbinate
inferiorly
• Perpendicular plate of palatine
bone post
20. Maxillary Bone
• Fronto nasal process of
maxilla
• Medial surface of this process
has 2 crests
• Ethmoidal crest- ant part of
middle turbinate is attached
• Lower crest gives attachment
to inf turbinate
• Immediately below
frontonasal process groove-
canal for NLD
• Maxillary tuberosity- canal for
greater palatine vessels
21. Palatine Bone
• L shaped bone
• Perpendicular plate- ant border of plate
has maxillary process, inferiorly
continues with horizontal plate, superiorly
with maxilla by orbital process and
sphenoid by sphenoid process
• Horizontal plate- anteriorly articulates with
horizontal process of maxilla to form floor,
post free end
• Pyamidal process articulates with the
notch between two pterygoid plates
22. Lacrimal Bone
• Smallest and most fragile cranial bone
separates lacrimal fossa from nasal cavity
• Articulates anteriorly with frontonasal
process,
• Orbital surface has a crest, between two
crest is the lacrimal fossa containing sac
• Nasal surface of the lacrimal bone is
pneumatised by an anteriorly migrated
ethmoidal cell the agger nasi cell
23. Inferior conchal bone
• Separate scroll like bone
• 3 processes
• Anteriorly lacrimal process articulates
with descending process of lacrimal
bone assists in NLD
• Ethmoidal process- articulates with
ucinate process of ethmoid bone
• Maxillary process-forms part of inf
meatus
24.
25. Floor Of Nasal Cavity
• Smooth, concave, much wider
than roof
• Consists of
1. soft tissues of ext nose
2. upper surface of palatine process
of maxilla and horizontal plate of
palatine bone, which together form
hard palate
26. Roof Of Nasal Cavity
• Its narrow, highest in the central
region, where it is formed by the
cribriform plate of the ethmoid bone
• Anterior to cribriform plate roof
slopes inferiorly to nares formed by
1.Nasal spine of frontal bone,nasal
bone
2.Septal cartilage and alar cartilage
• Posteriorly roof slopes into choana
and formed by
1.Ant surface of sphenoid bone
2.Ala of vomer
3.Vaginal process of medial plate of
pterygoid
27. Medial wall of
nose
• Mucosa covered surface of thin nasal
septum, separates right and left nasal cavities
• Nasal septum consists of
1.Septal nasal cartilage anteriorly
Posteriorly
1.Vomer
2.Perpendicular plate of ethmoid
• Small contribution
1.nasal bone
2.Nasal spine of frontal bone
3.Nasal crests of maxillary and palatine bones
4.Rostrum of sphenoid bone
5.Incisor crest of maxilla
28. Lateral wall of nose • Formed by bone,cartilage,soft
tissues
• Bony support for lateral wall of
nose is provided by
1.Ethmoidal labyrinth and uncinate
process
2.Perpendicular plate of palatine
bone
3.Pterygoid process of the
sphenoidal bone
4.Medial surfaces of lacrimal bone
5.Medial surface of maxillary bone
6.Inferior concha
29. Lateral wall of nose • Inferior,middle,superior conchae
extend medially across nasal
cavity spreading into four air
channels
• Lateral wall of middle meatus
elevates to form dome shaped
bulla ethmoidalis, middle
ethmoidal cells ,which expands
the medial wall of ethmoidal
labyrinth
• Inferior to ethmoidal bulla is
curved gutter semilunar hiatus, its
anterior end forms channel the
ethmoidal infundibulum, which
curves upward and continues as
the fronto nasal duct
30. Lateral wall of nose
• Naso lacrimal duct- under ant lip of
inferior concha
• Frontal sinus- frontonasal duct and
ethmoidal infundibulum into anterior
end of semilunar hiatus
• Ant ethmoidal cells- drain into
frontonasal duct or ethmoidal
infundibulum
• Middle ethmoidal cells open onto
ethmoidal bulla
• Posterior ethmoidal cells open onto
lat wall of superior nasal meatus
• Maxillary sinus open into semilunar
hiatus
31. Choanae
• Choanae are rigid openings completely surrounded by bones
between nasal cavity and the nasopharynx
• Margins formed by
1.Post border of horizontal plate of palatine bone
2.Medial plate of pterygoid process
3.Medially by post border of vomer
• Roof formed by
1.Ant by ala of vomer
2.Post by body of sphenoid
32. Gateways of nasal cavity
• Cribriform plate
• Sphenopalatine foramen
• Incisive canal
• Small foramina in the lateral wall
34. Blood supply
• Spheno palatine.a terminal br of maxillary.a
Post lat nasal br
Post septal br
• Greater palatine artery br of maxillary.a
• Sup labial & lat nasal artery br of facial.a
• Post ethmoidal & ant ethmoidal.a br of ophthalmic.a
35. Venous drainage
• Veins pass with branches
that ultimately originate
from maxillary artery, drain
into pterygoid plexus of
veins
• Veins from anterior region
of nasal cavity join the
facial vein
• Veins accompanying ant
and post ethmoidal arteries
tributaries of superior
ophthalmic vein, largest
emmissary vein drain into
cavernous sinus
36. Innervation
• Olfactory nerve
• Branches of ophthalmic and maxillary nerves for general
sensation
• Parasympathetic
• Sympathetic
37. • V1
Ant & post ethmoidal nerve
• V2
Post sup lat nasal n
Post sup medial nasal n
Nasopalatine n
Post inferior nasal n
• Parasympathetic - secreto motor innervation of glands of
mucosa of nasal cavity & PNS
Preganglionic – greater petrosal br of facial n
Post ganglionic – join br of maxillary n
• Sympathetic – regulates blood flow
preganglionic – sup cervical sympathetic ganglion
Post ganglionic – deep petrosal n join greater petrosal n
38. Blood & nerve supply of external
nose
• External nose
39.
40. Para nasal air
sinuses
• At birth the volume of cranial vault is
7 times that of facial skeleton
• This ratio decreases during infancy
and childhood, as a result of growth
of 4 pairs of PNS& development of
teeth
• Sinuses develop from invaginations
of nasal cavity that extend into the
surrounding bone
• Maxillary and ethmoidal sinus
develop in utero during 3rd and 5th
fetal months
41. Embryology PNS
• With eruption of deciduous teeth, maxillary sinus enlarges to
become 3 times longer, 5 times greater in height & width
• Ethmoidal sinus are small before the age of 2 years then grow
rapidly 6-8 years, but donot complete the growth until puberty
• Around the 2nd year the most anterior ethmoidal cell grow into
the frontal bone to form frontal sinus
• Frontal sinuses are visible in x ray from 7th year
• Most posterior ethmoidal air cell grows into sphenoid bone to
form sphenoidal sinus
42. Frontal Sinus
• Most superior , triangular in shape
• Base of each triangle is oriented vertically in the bone, at the
midline above the bridge of nose apex is approximately 1/3rd
way along the upper margin of orbit
• Drainage-middle meatus
• Nerve- supra orbital nerve from ophthalmic nerve
• Blood supply- ant ethmoidal artery branches
43. Ethmoidal air cells
• 9-10th week of gestation, 6-7 folds appear in
lat wall of nasal capsule of foetus
• Over next weeks folds fuse into 3-4
remaining crests with ascending anterior,
and a posterior descending portion
• Ethmoidal air cells are divided into,
anterior,middle posterior
• Anterior- ethmoidal infundibulum
• Posterior- lat wall of sup nasal meatus
• Middle- ethmoidal bulla
• Nerve- ant&post ethmoidal branches of
nasociliary merve from ophthalmic nerve 7
maxillary nerve
• Blood- ant & post etmoidal arteries
44. Maxillary sinuses
• First sinus to appear
• Largest of all, pyramidal in
shape
• Medial wall or base of
maxillary sinus formed by
maxilla and by parts of inf
concha, palatine bone
• Roof = related orbit
• Anterolateral surface= roots of
upper molar and premolar
teeth
• Posterior wall= infra temporal
fossa
• Nerve- maxillary nerve-infra
orbital & alveolar br
• Blood- maxillary a- infra orbital
& sup alveolar br
45. Sphenoidal sinuses • Within body of sphenoid
• Opens into roof of nasal cavity
via apertures on post wall of
spheno ethmoidal recess
• Related above- pituitary gland
&optic chiasm
laterally – cavernous sinus
below & in front – nasal cavities
• Nerve-
post ethmoidal br ophthalmic N
maxillary nerve
• Blood- pharyngeal br maxillary
artery
46.
47. Endoscopic anatomy
• 1st pass- endoscope is passed
along floor of nasal cavity
between inf turbinate & septum
• Structures studied are
1.nasal septum
2.Inf turbinate
3.Post choana
4.Post wall & roof of nasopharynx
5.Eustachian tube opening
6.Fossa of rosenmuller
7.Opening of NLD- guarded by
hasner’s valve
48. Endoscopic anatomy
• 2nd pass
• Scope passed along floor upto post
choana, moved upward & medial to
middle turbinatealong the roof of post
choana and anterior surface of
sphenoid
• Structures seen
1.Superior turbinate and meatus
2.Sphenoethmoidal recess
3.Sphenoid ostium
4.Below ostium woodruff plexus
49. Endoscopic anatomy
• 3rd pass- examine contents of middle
meatus- by gently retracting middle
turbinate by freer’s elevator
• Structures seen are
1.Attachment of middle turbinate to cribriform
plate
2.Agger nasi cell
3.Uncinate process
4.Lamina papyracea
5.Accessory ostium
50. Anatomical variations of middle
turbinate
• Ballooned out air cell enclosed in it, from
frontal recess, agger nasi cell, ant
ethmoids, such a case middle turbinate is
called concha bullosa
• Vertical lamella may be pneumatized to
form intralamellar cell of grunwald
• May have paradoxical curve bending
laterally
• Bifid
• May attach to lat wall of maxillary sinus
• Lower part of normally curved middle
turbinate may curve far laterally to produce
a concavity within it called turbinate sinus
51. Histology
• Nasal septum
• Mucous membrane is
predominantly respiratory
with a small area of
olfactory epithelium,
adjacent to cribriform plate
• Composed of ciliated &
nonciliated
pseudostratified columnar
cells,basal pluripotential
stem cells & goblet cells
• Olfactory epithelium is
composed of receptor cells,
supporting cells with
microvilli & basal stem cells,
confering the capacity of
regeneration
52. Histology
• Lateral wall of nose
• Respiratory ciliated columnar epithelium, small variable
area superiorly of olfactory epithelium
• Areas of squamous metaplasia are often found on the lateral
wall, particularly in areas subject to greatest airflow
53. Histology
• Frontal sinus - respiratory
epithelium small number of goblet
cells, sero mucinous glands
• Maxillary sinus - ciliated columnar
epithelium with highest density of
goblet cells seromucinous glands
are infrequent
• Sphenoid sinus & ethmoid sinus –
respiratory epithelium is same
goblet cell population with least
sero mucinous glands
56. Heat exchange
• Temperature of inspired air vary from -50 –
50 degree C.
• By the process of thermoregulation, latent
heat of evaporation, direction of flow of
blood, heat exchange occurs
• Gas in the nose, arterial blood 2 fluids, that
are in thermal, but not with direct contact
57. Humidification
• Vaporization cools the surface and 10% body heat is lost this way
• Inspiration
• Energy required for 2 function raising temperature of inspired air, latent
heat of evaporation
• Despite variation in temperature of inspired air, air in post nasal space is
31degree C , 95% saturated
• Expiration
• Expired air at back of nose is slightly below body core temperature
• As temperature drops along the nose , some water condenses to mucosa
• Water production
• Water comes from serous glands
• Capillary leakage occurs during inflamation- additional water comes from
expiredair, NLD, oral cavity
58. Filtration
• Airflow pattern
• Inspiration
• directed upwards and backwards mainly
over ant part of inferior turbinate
• Then splits to two below and over middle
turbinate, rejoining post choana
• Expiration
• lasts longer
• More turbulent
59. Nasal resistance
• Difference exist between races
• Nose accounts for upto half the total airway resistance
• Resistance made of
• 1. bone,cartilage,attached muscles
• 2.variable , the mucosa
• Nasal resistance is high in infants
60. Nasal fluids and ciliary functions
• Nasal secretions 2 elements mucus &
water
• Composition of mucus
• Water & ions
• Glycoproteins
• Enzymes
• Circulatory proteins
• Proteins
• Imunoglobulins
• cells
62. Reflexes
• Axon reflexes
• Substance p vasodilator transmits anti dromic reflex
• Initiated by mechanical irritation or histamine release
• This amplifies the response
• Nasopulmonary reflexes
• Increasing airflow through one nose cause increased
ventilation on the homolateral lung
• Blowing air through the nose causes bronchiole muscle to
relax on the same side and increases respiratory activity
63. Reflexes from nasal stimuli
• Chemical, temperature change and physical stimuli cause
widespread cardiovascular and respiratory responses
• Response ranges from sneezing to cardio respiratory arrest
• Sneezing- change in respiratory rate with closure of larynx and
a variable cardiovascular response occurs
• Sensory stimulation accompanied by lower cardiac output
• Modification of submersion reflex
64. Nose and the voice
• Nose adds quality by allowing air to
escape
• Rhinolalaia clausa too little air escapes
• Rhinolalia aperta too much escapes
65. Olfaction
• Stimulus – odours react with lipid
bilayer of receptor cells at specific
sites, causes k+ & cl – to flow out
and depolarize cell
• Receptors – G protein coupled
receptorsreact with specific adenyl
cyclase
• Discrimination – man prefers to
detect pleasantness of an odour
67. Trigeminal input
• Most smell independent of trigeminal
nerve, but at high concentrations irritation
occurs
• Patient who are anosmic notice only
sweet,sour,salt & bitter & irritation.
• Irritation contributes to nature of smell
68. Olfaction areas of behaviour
• Helps in recognizing food types & initiation
of digestion
• Sexual behaviour
• Territorial markings
• Perception decreases with age and
neurodegenerative diseases
• Olfaction is fully developed at birth, but
recognition and learning come late,
probably after the age of 2 years
69. Physiological functions of sinuses
• Vocal resonance
• Dimnuition of auditory feedback
• Air conditioning
• Pressure damper
• Reduction of skull weight
• Floatation of skull in water
• Mechanical rigidity
• Heat insultation