This document discusses the nose and paranasal sinuses. It begins with the development of the nose and sinuses from the 4th week of gestation. It then covers the anatomy including bones, cartilages, walls and meatuses of the nasal cavity. The document discusses the functions, blood supply, nerve supply and applied aspects such as sinusitis. In summary, it provides a comprehensive overview of the nose and paranasal sinuses from early development through applied clinical considerations.
The Middle Third Of The Facial Skeleton Is Defined As An Area Bounded,
Superiorly –Line Drawn Across The skull from the Zygomatico frontal Suture across the Frontonasal & Frontomaxillary sutures to the Zygomaticofrontal suture on the opposite side
Inferiorly –by the occlusal plane of the upper teeth./upper alveolar ridge.
Posteriorly-The region is demarcated by the sphenoethmoidal junction but includes the free margin of the pterygoid laminae of the sphenoid bone inferiorly.
Inferiorly –by the occlusal plane of the upper teeth./upper alveolar ridge.
Posteriorly-The region is demarcated by the sphenoethmoidal junction but includes the free margin of the pterygoid laminae of the sphenoid bone inferiorly.
It is made up of the following bones:
1. Two maxillae
2. Tw o palatine bones
3. Two zygomatic bones and their temporal processes
4. Two zygomatic processes of the temporal bone
5. Two nasal bones
this presentation describes about each bone individually and its applied anatomy
The Middle Third Of The Facial Skeleton Is Defined As An Area Bounded,
Superiorly –Line Drawn Across The skull from the Zygomatico frontal Suture across the Frontonasal & Frontomaxillary sutures to the Zygomaticofrontal suture on the opposite side
Inferiorly –by the occlusal plane of the upper teeth./upper alveolar ridge.
Posteriorly-The region is demarcated by the sphenoethmoidal junction but includes the free margin of the pterygoid laminae of the sphenoid bone inferiorly.
Inferiorly –by the occlusal plane of the upper teeth./upper alveolar ridge.
Posteriorly-The region is demarcated by the sphenoethmoidal junction but includes the free margin of the pterygoid laminae of the sphenoid bone inferiorly.
It is made up of the following bones:
1. Two maxillae
2. Tw o palatine bones
3. Two zygomatic bones and their temporal processes
4. Two zygomatic processes of the temporal bone
5. Two nasal bones
this presentation describes about each bone individually and its applied anatomy
USMLE RESP 02 nose and paranasal sinuses anatomy medical .pdfAHMED ASHOUR
The nose and paranasal sinuses are interconnected structures in the upper respiratory system that play essential roles in the respiratory and olfactory processes.
Disorders of the nose and paranasal sinuses can include sinusitis (inflammation of the sinuses), nasal polyps, deviated septum, and various infections.
Proper care and treatment are essential to maintain respiratory function and overall health.
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
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
USMLE RESP 02 nose and paranasal sinuses anatomy medical .pdfAHMED ASHOUR
The nose and paranasal sinuses are interconnected structures in the upper respiratory system that play essential roles in the respiratory and olfactory processes.
Disorders of the nose and paranasal sinuses can include sinusitis (inflammation of the sinuses), nasal polyps, deviated septum, and various infections.
Proper care and treatment are essential to maintain respiratory function and overall health.
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
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
9. DEVELOPMENT OF PARANASAL
SINUSES
At about 25 – 28 weeks of gestation, three medially
directed projections arise from the lateral wall of the
nose.
Between these projections small lateral diverticula
invaginate into the primitive choana to eventually form
the meati of the nose.
This serves as the beginning of the development of
paranasal sinuses.
Sinuses begin developing as small sacculations of the
mucosa of the nasal meati and recesses.
As the pouches or sacs develop and grow they will
invade the respective bones to form air sinuses and
cells.
Development is brougt about by resorption of inner
surface and apposition on the outer surface by
remodelling to accomidate the stresses.
10. Maxillary sinus - first to be
developed and aerated at
birth.
shows biphasic growth. The
first growth phase during the
first three years of life, and
the next growth phase occur
between 7 – 18 years.
Initially located medial to the
orbit, later sinus extends
laterally & Inferiorly.
Floor of sinus does not
extend below the level of
nasal cavity until the
eruption of permenant teeth.
1=newborn,
2=12 yrs
3=adult
11. Sphenoidal sinus
is undevoleped and
non-aereated at
birth.
Aeration begins at
age 3years and then
progresses
posteriorly.
sphenoid: 1=newborn, 2=3yo,
3=5yo, 4=7yo, 5=12yo, 6=adult,
12. Ethmoid air cells-develop during puberty and
develop slowly until approximately 17-18 years
of age.
Pneumatization of this sinus begins during the
4th year of childhood and gets completed by the
17th year of life
13. Frontal sinus is last
sinus to develop ,as a
direct continuation or by
upward migration of
anterior ethmoidal air
cells.
Remains as a small blind
sac within the frontal
bone till 2 years of
age,from 2 to 9 years
secondary
pneumatization of frontal
bone proceeds.
frontal: 4=newborn, 5=1yo,
6=4yo, 7=7yo,9=adult
14. CONGENITAL ANOMALIES OF
THE NOSE
HALF NOSE
due to unilateral absence of
nasal placode
ARHINIA
due to bilateral absence of
nasal placodes
15. CONGENITAL ANOMALIES OF
THE NOSE
PROBOSCIS LATERALIS
due to imperfect fusion
between the maxillary process
and the lateral nasal process.
POLYRRHINIA
duplication of the medial
nasal processes.
16. CONGENITAL ANOMALIES OF
THE NOSE
NASAL CLEFTS :
failure of the frontal nasal
process to develop
appropriately results into
two separated halves of
the nose.
SUPERNUMERARY NOSTRIL
MIDLINE NASAL
SINUS:
incomplete fusion of
the right and left
medial nasal
prominence
17. FUNCTIONS OF
NOSE & PARANASAL SINUSES
To breath
Olfaction
To filter the air
To taste
Humidifying and warming inspired air
Increasing surface area for olfaction
Lightening the skull
Resonance
Absorbing shock
Contribute to facial growth
31. LATERAL WALL OF NOSE
Marked by 3 projections:
Superior concha
Middle concha
Inferior concha
The space below each
concha is called a
meatus.
32. SUPERIOR MEATUS
Space below the
superior concha.
Superior concha is a
process of ethmoid
bone.
Smallest of all meatus.
Posterior ethmoidal
sinuses opens into it.
Sphenoethmoidal
recess is space above
superior concha.
Sphenoidal sinus
opens into it.
33. MIDDLE MEATUS
Space below middle
concha.
Middle concha is the
medial process of
ethmoidal labrynth.
Hiatus semilunaris
(curved opening)
-frontal & maxillary
sinuses
Bulla ethmoidalis
(rounded opening)
-middle ethmoidal air
cells.
34. INFERIOR MEATUS
Largest of the
meatuses.
Space below the
inferior concha.
Inferior concha is thin,
curved ,independent
bone.
Naso lacrimal duct
opens in the anterior
part.
35. SKIN OVER THE NOSE
Skin is mobile over
upper thirds but firmly
adherent in the lower
part to cartilages.
36. MUCOUS MEMBRANE
Upper 1/3 rd –olfactory region,
mucous membrane- more delicate
and yellowish.
Lower 2/3 rd – Respiratory
region, Lined by pseudo stratified
ciliated columnar epithelium,
mucoperiosteum-Thick ,spongy
,highly vascular with numerous
mucous glands.
Mucous membrane covering
vestibule of nose carries stiff hairs /
vibrissae.
Contains Arteriovenous anastamosis
–warms the air passing through it.
39. MUSCLES OF THE NOSE
PROCERUS:
most cephalic muscle of
the nose, pyramidal
shaped.
Origin –facial
aponeurosis.
Insertion –from glabellar
area.
Assists in dilatation of
the nares.
40. NASALIS:
It has 2 components:
(1)transverse nasalis /compressor
nasi: the muscle spans the dorsum
of the nose, covering the upper
lateral cartilages.
ORIGIN :maxilla above and lateral to incisive
fossa.
INSERTION: with its counterpart and procerus &
levator labi superioris aeque nasi muscle.
(2) the pars alaris (alar nasalis).
ORIGIN: above lateral and canine.(more lateral &
slightly caudal to the bony origin of the depressor
septi nasi muscles).
INSERTION : into ala above lateral crus of the
41. Levator labii
superioris
alaequae nasi
Origin: upper part of frontal
process of maxilla.
It extends lateral to the
nose in a cephalocaudal
direction and has fibers
that are attached to the
nostril, contributing to the
dilatation of the nares.
Insetion:lateral crus of
major alar cartilage and
lateral part of upper lip.
Release of the muscles will
dilate the nostrils,
42. Dilator naris anterior
Small muscle
Origin:ULC and alar part
of nasalis.
Encircles nares
Primary dilator of nose
Depressor alae or
myrtiforme.
originates from the border
of the pyriform crest and
then rises vertically, like
a fan, up to the ala,
acting as a depressor
and constrictor of the
nostrils.
Depressor septi
Arises from the maxilla
(just below the nasal
spine), sometimes
fuses with some fibers
of the orbicularis oris
muscle.
Inserted along the
columella, medial crus
of alar cartilage.
43. NERVE SUPPLY
Olfactory neves
Anterior ethmoidal
nerve
Nasal branches of
pterigo palatine
ganglion
Nasopalatine nerve
External nose –Infra orbital nerve, Infra trochlear,
External nasal nerve.
44.
45. BLOOD SUPPLY
EXTERNAL NOSE:
Dorsal nasal artery
Angular artery
Superior labial artery
INTERNAL NOSE:
Anterior & posterior ethmoidal
arteries
Sphenopalatine artery
Superior labial artery
Infraorbital and superior dental
arteries
Pharyngeal branch of maxillary
artery
Greater palatine artery
46. KESSELBACHS PLEXUS
These arteries are
(mnemonic –LEGS)
Superior Labial
Anterior Ethmoidal
Greater palatine
Sphenopalatine
Little's area, is a region in the anteroinferior part of the
nasal septum, where there is confluence of 4 arteries
forming this plexus.
47. LYMPHATIC DRAINAGE
Submandibular
lymphnodes: from the
external nose and anterior
part of the nasal cavity.
Upper deep cervical nodes:
drain the rest of the nasal
cavity, either directly or
through the
retropharyngeal nodes.
49. MAXILLARY SINUS
Antrum of Highmore.
largest of all paranasal
sinuses
Pyramidal shaped ,
Lying just under the
cheek.
Capacity of 30ml.
50. Anterior wall (anterolateral wall)–lateral wall of the
maxilla (canine fossa).
Posterior wall – temporal surface of maxilla.
Roof – floor of the orbit(infraorbital vessels and
nerve).
Floor – alveolar process of maxilla & hard palate.
Medial wall (base of maxillary sinus)- lateral wall of
the nasal cavity.
Laterally (apex of sinus) – zygomatic bone
51. OSTIUM OF MAXILLARY SINUS
Opens in the
Posteroinferior end of
hiatus semilunaris.
Close to roof of sinus.
Unfavorable for
drainage of sinus.
In children the floor lies
at or above the level of
the floor of the nasal
fossa.
In adults it lies about
1.25cm below the floor
of the nasal fossa
52. SPHENOIDAL SINUS
Lie within the body of
the sphenoid bone
Below sella turcica
(extends between
dorsum sellae and post
clinoid processes)
The average capacity is
7ml.
53. Superiorly – Pituitary gland (hypophysial
fossa) Lateral wall – Optic
nerve and internal carotid
artery
Floor – Nerve of pterygoid canal
RELATIONS OF SPHENOIDAL SIN
54. OPENING OF SPHENOID SINUS
Opens into the sphenoethmoidal recess above
the superior concha.
Ostium -Size (0.5-4mm)
55. ETHMOIDAL SINUS
They are anterior,
middle, and posterior.
They are contained
within the ethmoid bone,
between the nose and
the orbit.
Anterior & middle
drains into middle
nasal meatus
Posterior drain into
superior nasal
meatus
56. FRONTAL SINUS
Second largest sinuses
◦ 2 – 2.5 cm
Rarely symmetrical
Contained within the
frontal bone .
Separated from each
other by a bony septum.
Each sinus is roughly
triangular
Extending upward above
the medial end of the
eyebrow and backward
into the medial part of
the roof of the orbit.
57. FRONTONASAL DUCT
Opens into the middle meatus
The average capacity is about 7 ml in the adult.
True frontonasal duct only in 15% of people.
59. OSTEOMEATAL COMPLEX
This is the area bounded by the middle
turbiante medially, the lamina
papyracea laterally, and the basal
lamella superiorly and posteriorly. The
inferior and anterior borders of the
osteomeatal complex are open.
This is in fact a narrow anatomical
region consisting of :
1. Multiple bony structures (Middle
turbinate, uncinate process, Bulla
ethmoidalis)
2. Air spaces (Frontal recess,
ethmoidal infundibulum, middle
meatus)
3. Ostia of anterior ethmoidal, maxillary
and frontal sinuses.
61. Sinus infections refer to the inflammation of the para-
nasal cavities caused by irritation of the sinus
membranes.
Sinus cavities get irritated / infected
Overproduction of mucus
Sinus cavity openings may swell and block
Blocked/congested
Any accumulated mucus can become a haven for
bacteria propagation
Unbearable pain
SINUSITIS
62. Acute, which last for 3 weeks or less
Chronic, which usually last for 3 to 8 weeks but can
continue for months or even years
Recurrent, which are several acute attacks within a
year Sinusitis can be classified based on which
sinus cavities it affects:
Antritis/ maxillary sinusitis
Ethmoiditis / ethmoid sinusitis.
Sphenoiditis, sphenoid
Frontal sinusitis
63. Symptoms of Sinusitis
location of pain depends on which sinus is affected.
Headache when you wake up in the morning is
typical of a sinus problem.
Infection in the maxillary sinuses can cause your
upper jaw and teeth to ache and your cheeks to
become tender to the touch.
Fever ,Weakness ,Tiredness etc.
A cough that may be more severe at night.
Runny nose (rhinitis) or nasal congestion .
postnasal drip.
64. General measures:
Drinking plenty of fluids to thin the secretions and
keep them flowing.
Hot showers to loosen the mucus.
Alternate hot and cold compresses- place the hot
compress across your sinuses for 3 minutes, then
the cold compress for 30 second.
Nasal irrigation
69. General measures:
The nostrils are compressed against the nasal
septum.
The patient is told not to swallow blood running
down the pharynx.
The patient is kept in an upright posture
An ice bag can be placed on the back of the
neck to induce reflex vasoconstriction.
Treatement
Anterior nasal bleed is treated by packing the
area with gauze soaked in L.A, by using
electrocautery, or with silver nitrate
If bleeding persists anterior nasal packing is
performed.
70. Anterior nasal packing
If it is posterior nasal
bleed, posterior nasal
packing has to be done.
Reliable method is by
using Foleys catheter.
posterior nasal packin
71. CYSTIC FIBROSIS
Cystic fibrosis is a systemic disease of unknown
etiology affecting the mucus producing exocrine
glands of upper respiratory tract, liver, pancreas,
intestine and the non-mucus producing salivary
and sweat glands.
The abnormal secretions produced may lead to
disease in any of the involved organ systems.
The paranasal sinuses are ultimately involved with
the viscous secretions generally result in chronic
pansinusitis.
75. NASAL FRACTURES
Type I – inferior one half of nasal bones.
Type II –entire nasal bone separated at nasofrontal
suture.
Type III –nasal bones and frontal process of
maxilla.
Type IV – nasal bones frontal process of maxilla.
nasal spine of frontal bone and ethmoid bone.
ASCH FORCEPS.
76. RADIOGAPHIC VIEWS
Lateral view
PA (Caldwell) view
Waters view
Open mouth Waters view
Sub Mento Vertex view
77. Image is done in vertical
position. air fluid level is clearly
demonstrated
Image is done vertically, but CR
is angled 45 degrees. gradual
fading of the fluid line.
Image is done horizontally and
the CR is vertical no evidence
of an air-fluid level.
Exudate in the sinuses is not a
fluid but is commonly a heavy
semi gelatinous material that
clings to the walls of cavity and
takes several minutes to shift
the position .so you must
position the patient for several
minutes to allow the exudate to
gravitate to the desired
location before the exposure is
made.
Part of MID FACE.
Entrance of the respiratory tract.
Plays role in warming ,humidifying and filtering the air.
Important role in facial esthetics.
Nostrils opens into nasal cavities.
Nasal cavities are housed in a frame work of bones and fibroelastic cartilages.
The bones surrounding the nasal cavities contains air filled cavities called paranasal sinuses.
Brain occupies most of head region.
Eyes are laterally located.
Stomodeum represents future mouth.
At the upper margin of Stomodeum – fronto nasal process formed from mesoderm.
The frontonasal process inferiorly differentiates into two projections known as “Nasal Placodes”.
Nasal pits are continuous with stomodeum, Sink to form the nostril.
Nasal pits –partly surrounded by unevenly grown median and lateral nasal processes.
Around the gut tube pharyngeal arches are formed.
The oronasal membrane is fully formed by the end of 5th week of development. It gives rise to the floor of the nose (palate develops from this membrane).
Later medial process joins the maxillary process forming closed maxillary arch.
Lateral nasal swelling also join maxillary process and gives nasolacrimal duct at their junction.
frontonasal prominence gives rise to inferior mesodermic projection-form the nasal septum dividing the nose into two cavities.
Medial swellings on both the sides fused forming middle part of nose,philtrum & premaxilla.
Lateral swellings forms the alae of nose.
Anterior most ethmoidal air cell is known as agger nasi.
Large agger nasi air cell can impede frontal sinus drainage due to its close proximity to the frontal sinus drainage pathway.
Haller cells belong to the anterior ethmoidal group of air cells. These cells are also known as infra orbital cells. Enlargement of this cell may block drainage of the maxillary sinus.
Extension of posterior ethmoidal cells supero lateral to the sphenoid sinus is known as onodi cell. This cell lies in close proximity to optic nerve. Inflammation of this cell may cause blindness. This anatomy is also crucial in endoscopic sinus surgical procedures
Separated from the orbit by a thin plate of bone so that infection can readily spread from the sinuses into the orbit
.