The document describes the anatomy of the nose, including its external structures, internal nasal cavity, blood supply, nerve supply, and lymphatic drainage. It details the bones and cartilages that make up the external nose and nasal septum, and describes the nasal vestibule, nasal cavities, nasal conchae and meatuses within the nasal cavity. It also outlines the skin lining, blood vessels, nerves and lymphatic drainage of the nose.

2.  External Nose
 Internal Nose
 Blood Supply
 Nerve Supply
 Lymphatic Drainage
 PNS
 Embryology

3.  Triangular pyramidal structure
 Bony (upper 1/3rd) and Cartilaginous (lower 2/3rd
)
 Root of nose – upper angle of nose where it is
continous with forehead.
 Base of nose – triangular, directed downwards
 Tip of nose – free angle of nose below
 Dorsum of nose – lower cartilaginous part
connected to tip
 Bridge of nose – upper bony part of dorsum
connected to root. It is a junction between 2
nasal bones
 Glabella – point between root of nose and
forehead

5.  Upper 1/3rd
 Paired nasal bones
 Paired frontal process of maxilla
 Nasal process of frontal bones
 Nasal bones articulate
 Sup – nasal process of frontal bone
 Inf – upper lateral cartilage
 Lat – frontal process of maxilla
 Med – opp nasal bone
 Nasion – upper point where they meet
 Rhinion – lower point where they meet

6.  Paired upper lateral cartilages
 Paired lower lateral cartilages (alar)
 Sesamoid cartilage (lesser alar)
 Septal cartilage (ant sup part)
 Hyaline cartilage
 Bone and cartilage connected to each other
by periosteum and perichondrium which is
continous

8.  Upper lateral cartilages
 Triangular in shape
 Form dorsum of nose
 Middle 1/3rd
 Lower lateral cartilages (alar)
 Maintain projection and shape of tip
 Lower 1/3rd
 Parts
 Slender medial crus – 2 in midline form columella
 Wider lateral crus – form ala of nose each side
 Projection between two – form tip of nose

9.  Sesamoid cartilage (lesser alar)
 Minor
 2 or more in number
 Present between upper and lower nasal cartilage
 External Nasal Skin
 Continous with skin of vestibule and columella
 Thin and freely mobile – nasal bones and upper
lateral cartilage
 Thick and adherent – alar cartilage, contains
sebaceous glands – hypertrophy (rhinophyma)

10.  Facial muscles bring about movement of nose
 Procerus
 Nasalis (transverse and alar)
 Levator labii superioris alaeque nasi
 Depressor septi
 Ant and post dilator nares
 Arise from fascia and inserted into skin
 Facial N

12.  Right and left by nasal septum
 Communicates with external (ant nares),
nasopharynx (choanae), sinuses (ostium)
 Each nasal cavity 5-7 cm length, 5 cm height,
1.5 cm transversely at floor, 1-2 mm at roof
 Parts
 Skin lined – Vestibule
 Mucosa lined – cavity proper
 Nasal cavity proper – medial wall, lateral
wall, roof, floor

13.  Ant inf part of nasal cavity, entrance
 Lined by skin
 Contains hairs (vibrissae), hair follicles,
sebaceous glands, sweat glands
 Limen nasi – sup margin of lower lateral
cartilage, separates vestibule from nasal
mucosa. Upper limit of nasal vestibule
 Part of dangerous area of face – triangular
area extending from nasion to angle of
mouth (includes external nose and upper lip)
– without valve venous drainage – lead to CST

14.  Narrowest part of nasal cavity
 Triangular shaped
 Area of high resistance, mild narrowing
causes nasal obstruction
 Regulates air flow
 Medially – cartilaginous septum, caudally –
floor, laterally – ant end of inf turbinate,
lower border of upper lateral cartilage
 Columella – between two nasal vestibules,
formed by medial crusa of alar cart, forms
caudal end of nasal septum

15.  Framework – Floor, Roof, Medial wall and
lateral wall
 Floor
 Made up of hard palate
 Palatine process of maxilla (ant 3/4th)
 Horizontal process of palatine bones (post
1/4th)
 5cm long, 1.25 cm wide

16.  Highest part of nasal cavity
 Ant sloping part – nasal bones
 Post sloping part – body of sphenoid
 Middle horizontal part – cribriform plate of
ethmoid
 Part of olfactory area
 Olfactory area
 Bounded lat by sup turbinate, med by septum
and sup by cribriform plate
 Dangerous area as olfactory nerve fibres from
this area pass through cribriform plate to ant
cranial fossa and carry infection, ass with CSF
rhinorrhoea

17.  Bony and cartilaginous framework lined by
mucoperiosteum and mucoperichondrium
 Columellar septum – covered by skin, medial crus
 Membranous septum – b/w columella and septum
proper, no bone or cartilage, double layer of skin
 Septum proper
 Cartilaginous part – large quadrangular cartilage
with contributions from upper and lower lateral
cartilage
 Septal cartilage provides support to tip and
dorsum of nose

18.  Bony part
 Perpendicular plate of ethmoid – post superior
part
 Vomer – post inferior part
 Maxillary crest – inf most part
 Palatine crest
 Small contributions from nasal spine of frontal
bone, rostrum of sphenoid, ant nasal spine of
maxilla
 Jacobson’s organ – concerned with smell in
lower animals, vestigeal in adult humans,
defined in foetus as blind tubular pouch 2-6 mm
long

20.  Irregular
 Atrium – lies b/w vestibule and concha in the
lateral wall
 Covered by respiratory epithelium
 Formed by various bones
 Main area for drainage of sinus secretions
 Formed by medial wall of maxilla, middle and
sup concha (ethmoid bone), inf concha, medial
pterygoid process of sphenoid, nasal bones,
perpendicular plate of palatine bones
 Has scroll/shelf shaped ridges/ bony horizontal
elevations called turbinates (sup/middle/inf)
and beneath and lateral to them depressions
called meatus (sup/middle/inf)

21.  Superior turbinate
 Smallest
 Part of ethmoid bone
 The area above it and its medial part lined
by olfactory epithelium
 Ostium of sphenoid sinus lies medial to it
 Supreme turbinate
 60% of cases, U/L or B/L
 Small ridge above sup turbinate

22.  Middle turbinate
 Part of ethmoid bone
 Formed by middle concha
 Has basal lamina – joins lamina papyracea
 Ascending limb – joins cribriform plate
 Bony lamella (basal or ground) – attached to lateral wall
 Concha bullosa – pneumatized middle turbinate by
ethmoidal air cells
 Paradoxically curved – narrowed middle meatus
 Post end – sphenopalatine foramen (gap b/w fusion of
sphenoid, palatine and ethmoidal bones)


23.  Inferior turbinate
 Largest
 Separate bone
 Composed of inf concha
 Submucosa – contains rich cavernous venous plexus
 Superior meatus
 Smallest, lies beneath sup concha
 Opening for post ethmoid air cells (1-5)
 Sphenoethmoidal recess
 Triangular area above sup turbinate
 Sphenoidal sinus opens here

24.  Middle meatus
 Lies below middle concha
 Major structure jere forms osteo meatal complex
 Frontal, maxillary, ant ethmoidal sinus drain
here
 Inferior meatus
 Largest
 Present along the whole length of lateral wall
 NLD opens in the ant part, under genu of inf
turbinate, opening guarded by a valve – hasner’s
valve (plica lacrimalis)

26.  Skin
 Stratified squamous epithelium covers vestibule
 Olfactory epithelium
 Upper 1/3rd of lateral wall till sup concha, roof, nasal
septum
 Mucous membrane – pale (yellowish) in colour
 Respiratory epithelium
 Lower 2/3rd of nasal cavity
 Thickest over concha, thick over septum
 Thin over meatus and floor
 Pink in colour, pseudostratified ciliated columnar
epithelium

27.  Arterial supply
 ICA and ECA
 ECA – maxillary artery (sphenopalatine, greater
palatine), facial artery (sup labial)
 ICA – ophthalmic artery (ant and post ethmoidal)
 Lateral wall
 Main artery – sphenopalatine artery – all meatus
and turbinates
 Roof and sup part – ant ethmoidal artery
 Alae nasi – sup labial artery

28.  Medial wall (septum)
 Ant sup part – ant ethmoidal artery
 Ant inf part – sphenopalatine artery – main
artery to septum, also called artery of epistaxis
 Keisselbach’s plexus (little’s area)
 Anastomotic plexus b/w sphenopalatine, greater
palatine, sup labial and ant ethmoidal artery
 Frequent site for bleeding (90%, ant epistaxis)
 Site for origin of bleeding polyposis
(haemangioma of nose)

30.  Ant part – ant facial vein and ophthalmic vein
 Middle part – pterygoid venous plexus
 Post part – pharyngeal plexus of veins
 Cavernous plexus – beneath the middle meatus formed of
sphenopalatine vein, ophthalmic vein, sup saggital sinus
 Retrocolumellar vein – just behind the columella,
common site for venous bleeding
 Woodruff’s plexus – site for venous bleed inf to post end
of inferior turbinate
 Arterial bleed post to middle turbinate
 Site for post epistaxis, maxillary sinus ostia dividing line

32.  Erectile tissue
 Subepithelial venous plexus
 Seen mainly in inf turbinate, post part of
middle turbinate, septum
 Controlled by ANS – maintains congestion and
decongestion of turbinates

33.  Trigeminal nerve – sensory supply
 Ophthalmic nerve – ant ethmoidal nerve – ant
and sup part of nasal cavity – blocked by placing
pledgets high up
 Maxillary nerve – sphenopalatine branch – post
2/3rd of nasal cavity – blocked by placing
pledgets post extension of middle meatus
 Infra orbital nerve – vestibule of nose
 Facial nerve – motor supply
 Olfactory nerves – 20 in number - smell

35.  Secretomotor supply – vidian nerve (nerve of
pterygoid canal)
 Formed by
 Deep petrosal nerve – sympathetic plexus
around ICA
 Greater sup petrosal nerve – parasympathetic
supply to nasal glands and controls nasal
secretions

36.  Submental lymph nodes (anterior part and
external nose)
 Retropharyngeal ln (post part)
 Upper deep cervical ln (post part)
 Preauricular ln