8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

1/9

NERVES & BLOOD VESSELS OF NOSE ANDNASAL CAVITY.

Learning Objectives. At the end of lecture, students should be able to know:

Arterial supply of nose and nasal cavity.

Venous supply of nose and nasal cavity.

Nerve supply of nose and nasal cavity.

BLOOD SUPPLY OF NOSE AND NASAL CAVITY.

There is a rich blood supply to the nasal

cavity.

Blood supply comes from branches of both

the internal and external carotid artery.

Including branches of the facial artery and

maxillary artery.

Blood supply of nose and nasal cavity.

The arterial supply of medial and lateral walls ofnasal cavity is from five sources:

Anterior ethmoidal artery (from ophthalmicartery).

Posterior ethmoidal artery (from ophthalmicartery).

http://en.wikipedia.org/wiki/Internal_carotid_arteryhttp://en.wikipedia.org/wiki/External_carotid_arteryhttp://en.wikipedia.org/wiki/Facial_arteryhttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Internal_carotid_arteryhttp://en.wikipedia.org/wiki/External_carotid_arteryhttp://en.wikipedia.org/wiki/Facial_arteryhttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Maxillary_artery

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

2/9

Sphenopalatine artery (from maxillary artery).

Greater palatine artery (from maxillary artery).

superior labial artery (from facial artery).

Venous supply of nose.

Submucosal venous plexus.

BLOOD SUPPLY(MEDIAL WALL).

BLOOD SUPPLY(LATERAL WALL).

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

3/9

Internal

External

Arterial Supply.

The arteries make a rich anastomosis in the region of thevestibule and anterior portion of the septum.

Sphenopalatine Artery.

The sphenopalatine artery(nasopalatine artery) is an artery of the

head.

commonly known as the artery of

epistaxis.

http://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Artery

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

4/9

Course of Sphenopalatine Artery.

The sphenopalatine artery passes through the sphenopalatine foramen

into the cavity of the nose.

it gives offposterior lateral nasal branches.

It ends on the nasal septum as theposterior septal branches.

Greater Palatine Artery.

The greater palatine artery is a terminal

branch of the maxillary artery.

It branches off the maxillary artery in the

pterygopalatine fossa.

It descends through the greater palatine

foramen.

It anastomosis through the incisive canal with the sphenopalatine

artery to supply the nasal cavity.

Anterior Ethmoidal Artery.

It accompanies the nasociliary nerve through

the anterior ethmoidal canal

Nasal branches:

They descend into the nasal cavity

supply branches to the lateral wall and

septum of the nose. a terminal branch which appears on the

dorsum of the nose between the nasal bone

and the lateral cartilage.

http://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Posterior_lateral_nasal_brancheshttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Posterior_septal_brancheshttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Pterygopalatine_fossahttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Incisive_canalhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Anterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Lateral_wallhttp://en.wikipedia.org/wiki/Septumhttp://en.wikipedia.org/wiki/Nasal_bonehttp://en.wikipedia.org/wiki/Lateral_cartilagehttp://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Posterior_lateral_nasal_brancheshttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Posterior_septal_brancheshttp://en.wikipedia.org/wiki/Posterior_septal_brancheshttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Pterygopalatine_fossahttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Greater_palatine_foramenhttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Incisive_canalhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Anterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Lateral_wallhttp://en.wikipedia.org/wiki/Septumhttp://en.wikipedia.org/wiki/Nasal_bonehttp://en.wikipedia.org/wiki/Lateral_cartilage

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

5/9

Posterior Ethmoidal Artery. It is smaller than the anterior ethmoidal

artery.

Route:

It passes through theposterior ethmoidal

canal.

It suppliesposterior ethmoidal cells, and,

entering the cranium.

Branches and supply of posterior ethmoidalartery.

When it enters the cranium it gives off a meningeal branch to the dura

materand nasal branches.

It then descends into thenasal cavity through apertures in the

cribriform plate.

It supplies the posteriorethmoidal air sinuses, dura materof the

anterior cranial fossa, and the upper part of the nasal mucosa.

Septal branch of SuperiorLabial Artery.

It runs along the edge of the upper lip, lying

between the mucous membrane and the

Orbicularis oris.

It supplies the upper lip. It ascends to the nose.

a septal branch ramifies on the nasal septum

It supplies the ala of the nose.

http://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_cellshttp://en.wikipedia.org/wiki/Craniumhttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Cribriform_platehttp://en.wikipedia.org/wiki/Ethmoidal_air_sinuseshttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Anterior_cranial_fossahttp://en.wikipedia.org/w/index.php?title=Nasal_mucosa&action=edit&redlink=1http://en.wikipedia.org/wiki/Upper_liphttp://en.wikipedia.org/wiki/Mucous_membranehttp://en.wikipedia.org/wiki/Orbicularis_orishttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Ala_of_the_nosehttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_canalhttp://en.wikipedia.org/wiki/Posterior_ethmoidal_cellshttp://en.wikipedia.org/wiki/Craniumhttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Cribriform_platehttp://en.wikipedia.org/wiki/Ethmoidal_air_sinuseshttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Anterior_cranial_fossahttp://en.wikipedia.org/w/index.php?title=Nasal_mucosa&action=edit&redlink=1http://en.wikipedia.org/wiki/Upper_liphttp://en.wikipedia.org/wiki/Mucous_membranehttp://en.wikipedia.org/wiki/Orbicularis_orishttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Ala_of_the_nose

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

6/9

Venous Supply of Nose.

A rich submucosal venous plexus

deep to nasal mucosa drains into:

Sphenopalatine, facial, and

ophthalmic veins.

Venous blood from the external

nose drains mostly into:

FACIAL VEIN via ANGULAR

and LATERAL NASAL VEINS.

Nerve supply of nose.

Sensory (Trigeminal nerve).Anterior superior Anterior-ethmoidal nerve (ophthalmic nerve).Anterior inferior Anterior superior alveolar nerve (maxillary nerve).Posterior superior Posterior superior, lateral nasal (maxillary

nerve).

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

7/9

Innervation of the nasal cavity responsible for the sense of

smell is via the olfactory nerve.

It sends microscopic fibers from the olfactory bulb through

the cribiform plate to reach the top of the nasal cavity. General sensory innervation is by branches of the trigeminalnerve (V1 & V2):

Nasociliary nerve (V1).

Nasopalatine nerve (V2).

Posterior nasal branches ofMaxillary nerve (V2) .

The entire nasal cavity is innervated by autonomic fibers.

Nasociliary Nerve. It passes through the anterior ethmoidal opening as the

anterior ethmoidal nerve.

It then enters the cranial cavity just above the cribriform

plate of the ethmoid bone.

It supplies branches to the mucous membrane of the nasal

cavity.

It finally emerges between the inferior border of the nasalbone and the side nasal cartilages as the external nasal

branch.

Branches.

The nasociliary nerve gives off the

following branches:

posterior ethmoidal nerve. long ciliary nerves.

infratrochlear nerve.

communicating branch to the

ciliary ganglion (long root of the

ciliary ganglion)

http://en.wikipedia.org/wiki/Olfactory_nervehttp://en.wikipedia.org/wiki/Olfactory_bulbhttp://en.wikipedia.org/wiki/Cribiform_platehttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Nasopalatine_nervehttp://en.wikipedia.org/wiki/Maxillary_nervehttp://en.wikipedia.org/wiki/Olfactory_nervehttp://en.wikipedia.org/wiki/Olfactory_bulbhttp://en.wikipedia.org/wiki/Olfactory_bulbhttp://en.wikipedia.org/wiki/Cribiform_platehttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Nasopalatine_nervehttp://en.wikipedia.org/wiki/Maxillary_nerve

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

8/9

anterior ethmoidal nerve.

NasopalatineNerve.

It enters the nasal cavity

through the

sphenopalatine foramen,

passes across the roof of

the nasal cavity below

the orifice of thesphenoidal sinus to reach

the septum.

It supplies thepalatal structures around the upper central and

lateral incisors and the canines (the upper front six teeth).

Maxillary Nerve.

The maxillary nerve (V2) is one of the three branches of the

trigeminal nerve.

Its function is the transmission of sensory fibers from the maxillary

teeth, the skin between thepalpebral fissure and the mouth, and the

nasal cavity and sinuses.

Nasal branches of maxillarynerve.

http://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Sphenopalatine_foramenhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Sphenoidal_sinushttp://en.wikipedia.org/wiki/Septumhttp://en.wikipedia.org/wiki/Palatalhttp://en.wikipedia.org/wiki/Canine_toothhttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Palpebral_fissurehttp://en.wikipedia.org/wiki/Mouthhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Sphenopalatine_foramenhttp://en.wikipedia.org/wiki/Nasal_cavityhttp://en.wikipedia.org/wiki/Sphenoidal_sinushttp://en.wikipedia.org/wiki/Septumhttp://en.wikipedia.org/wiki/Palatalhttp://en.wikipedia.org/wiki/Canine_toothhttp://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Palpebral_fissurehttp://en.wikipedia.org/wiki/Mouth

8/3/2019 lec8-sem2-hnsweek3-20110822 (1)

9/9

the maxillary nerve passes through the cavernous sinus and exits theskull through the foramen rotundum.

At its termination it divides branches into nose, the lowereyelid, and

the upperlip, joining with filaments of the facial nerve.

Kiesselbach's plexus. Kiesselbach's area, also Kiesselbach's plexus, Kiesselbach's

triangle, and Little's area, is a region in the anteroinferior part of the

nasal septum, where four arteries anastomose to form a vascular

plexus called Kiesselbach's plexus. The arteries are:

anterior ethmoid artery. great palatine artery.

sphenopalatine artery.

superior labial artery.

THANK YOU ALL.

http://en.wikipedia.org/wiki/Cavernous_sinushttp://en.wikipedia.org/wiki/Skullhttp://en.wikipedia.org/wiki/Foramen_rotundumhttp://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Eyelidhttp://en.wikipedia.org/wiki/Liphttp://en.wikipedia.org/wiki/Facial_nervehttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Anterior_ethmoid_arteryhttp://en.wikipedia.org/wiki/Great_palatine_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Superior_labial_arteryhttp://en.wikipedia.org/wiki/Cavernous_sinushttp://en.wikipedia.org/wiki/Skullhttp://en.wikipedia.org/wiki/Foramen_rotundumhttp://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Eyelidhttp://en.wikipedia.org/wiki/Liphttp://en.wikipedia.org/wiki/Facial_nervehttp://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Anterior_ethmoid_arteryhttp://en.wikipedia.org/wiki/Great_palatine_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Superior_labial_artery