Nasal Cavity and

Paranasal Sinuses
 Objectives
1. Name the parts of the nose and the structures that form its
skeleton
2. Name the bony structures that form the walls of the nasal
cavity
3. Name the openings found in each of the nasal meatuses and
describe the anatomical features of the lateral wall of the
middle nasal meatus
4. Describe the location and functions of the olfactory and
respiratory parts of the nasal mucosa
5. Describe the blood and nerve supply of the nasal cavity
6. Name the paranasal sinuses and list their functions
7. Describe the location, anatomical relations, communication
with the nasal cavity and blood and nerve supply of the
paranasal sinuses
8. Discuss common disorders affecting the nasal cavity and
paranasal sinuses
 Nose
• pyramidal in shape
• its upper end is known as root and is continuous with forehead
• its free tip is known as apex
• dorsum: extends from root to apex, in midline
• 2 inferior apertures called nares (nostrils)
• each nostril is limited laterally by ala of nose
• supporting framework of nose is composed of bone and hyaline
cartilage
• bony framework supports upper part of nose and consists of nasal
bones and frontal processes of maxillae
 Nose
Cartilaginous framework support consisting of 3 major pieces
that are connected to each other and to bones by fibrous tissue.
1. One septal cartilage forms anterior part of nasal septum and
has 2 lateral processes (triangular in shape, located below
the inferior border of nasal bones)
2. Two major alar cartilages: U-shaped with lateral and medial
crura and form lateral and medial borders of nostrils
 Nasal Cavity
Nasal mucosa:
• lines entire nasal cavity, except vestibule
• firmly bound to periosteum and perichondrium of
supporting structures
• continuous with mucosal lining of nasopharynx, paranasal
air sinuses and nasolacrimal duct
• types of mucosa: olfactory and respiratory
• olfactory mucosa: lines highest part of roof and adjacent
parts of septum and lateral wall and contains olfactory
receptor cells
• respiratory mucosa lines rest of nasal cavity and is covered
by respiratory epithelium (pseudostratified, columnar,
ciliated)
 Nasal Cavity
• chamber consisting of bony and cartilaginous walls, covered
with mucosa
• has a floor, a roof, 2 lateral walls and a midline partition (nasal
septum), which divides nasal cavity into right and left parts
• opens anteriorly on face via nares (nostrils)
• communicates posteriorly with pharynx (nasopharynx) via
posterior nasal apertures (choanae)
• vestibule is lined with skin and contains stiff hairs.
 Nasal Cavity
Functions:
1. Olfaction
2. Conditioning of inspired air (filtration, humidification,
warming)
3. Reception of secretions from paranasal air sinuses and
nasolacrimal duct
Relationships:
• superior: anterior
cranial fossa
(separated by
cribriform plate)
• lateral to upper
part of nasal
cavity: ethmoidal
air cells and orbit
• lateral to lower
part of nasal
cavity: maxillary
sinus
 Nasal Cavity
Relationships (cont.):
• inferior: oral cavity (separated by hard palate)
• posterior: nasopharynx (communicates via choanae)
Composition of bony walls:
Floor: hard palate (palatine
processes of maxillae and
horizontal plates of palatine
bones)
Medial wall
(nasal septum):
perpendicular
plate of Ethmoid
and Vomer
(smaller
contributions
from sphenoid,
maxilla and
palatine)
 Nasal Cavity
Composition of walls (cont.):
Lateral wall: maxilla, lacrimal bone, inferior nasal concha,
ethmoidal labyrinth, perpendicular plate of palatine and medial
pterygoid plate.
 Lateral Wall continued
Three scroll-like bony
projections named
superior, middle and
inferior nasal conchae
(superior and middle
conchae belong to
ethmoid, inferior
concha is a separate
bone)
• space between each
concha and lateral wall
is called meatus named
superior, middle and
inferior.
• sphenoethmoidal recess:
part of nasal cavity located
above and behind superior
nasal concha
Lateral Wall
Medial Wall

Netter’s Plate 38
 Paranasal Sinuses
Pneumatic spaces in frontal, maxilla, ethmoid and sphenoid bones,
lined by a mucous membrane continuous with that of nasal cavity.
Sinuses develop as evaginations of nasal mucosa that invades bone
surrounding nasal cavity causing progressive bone resorption.
At birth, sinuses are rudimentary. There is a slow, continuous
growth during childhood and a rapid growth during adolescence.
Sinuses attain maximum size in adulthood.
Functions:
• Resonating chambers for voice
• Lighten skull bones
 Maxillary Sinus
Largest of paranasal sinuses
Lies within body of maxilla.
Roughly pyramidal in shape. Its’ base is directed medially,
toward nasal cavity while its apex is directed laterally, toward
zygomatic bone
Relationships:
• superior: orbit and its contents (infraorbital canal runs
within superior wall of sinus)
• medial: nasal cavity (maxillary ostium located high in
medial wall and provides poor drainage in erect posture)
 Maxillary Sinus
Relationships (cont.):
• inferior: alveolar process of maxilla and roots of maxillary
teeth
Communicates with middle nasal meatus via an opening located
in lower part of semilunar hiatus.
• nerve supply: superior alveolar nerves (from V2)
• blood supply: superior alveolar arteries (branches of maxillary
and infraorbital arteries)
 Frontal Sinuses
• located within frontal bone, behind superciliary arches
• vary in size and are rarely symmetrical
• usually extend superiorly into frontal squama and posteriorly
into orbital plates (roof of orbit)
• open into corresponding middle nasal meatus
• nerve supply: supraorbital nerve (branch of frontal nerve,
from V1)
• blood supply: supraorbital artery (branch of ophthalmic
artery)
 Ethmoidal Air Cells
• thin-walled spaces within ethmoidal labyrinths
• number of cells varies from 3 to 18
• anterior cells open into infundibulum of middle nasal meatus
• middle cells open on surface of ethmoidal bulla of middle nasal
meatus
• posterior cells open into superior nasal meatus
• nerve supply: anterior and posterior ethmoidal nerves (branches of
nasociliary nerve, from V1)
• blood supply: anterior and posterior ethmoidal arteries (branches
of ophthalmic artery)
 Sphenoidal Sinuses
• located posterior to upper part of nasal cavity, within body of
sphenoid
• related superiorly to pituitary gland and optic chiasm
• related laterally to cavernous sinus and internal carotid artery
• vary in size and are rarely symmetrical
• open into corresponding sphenoethmoidal recess
• nerve supply: posterior ethmoidal nerve (branch of nasociliary
nerve, from V1), pharyngeal nerve (from pterygopalatine ganglion
that contains V2 sensory fibers)
• blood supply: posterior ethmoidal artery (branch of ophthalmic
artery), pharyngeal branch of maxillary artery
 Nasal Cavity
Communications of
nasal meatus:
The superior
meatus
communicates
with the
posterior
ethmoidal air
cells via small
orifices in its
lateral wall.
The middle meatus:
• Ethmoidal bulla:
elevation in lateral
wall of middle meatus
caused by middle
ethmoidal air cells
(openings of middle
ethmoidal air cells are
found on ethmoidal
bulla)
• semilunar hiatus:
curved cleft anterior
and inferior to
ethmoidal bulla
• ostium of maxillary
sinus located in lower
part of semilunar
hiatus
 Nasal Cavity
Communications of nasal
meatuses (cont.)
Middle meatus (cont.):
The superior end of semilunar
hiatus leads into a curved channel
known as infundibulum that receives
openings of anterior ethmoidal air
cells. In some individuals, the
infundibulum also receives opening
of frontal sinus. In others,
infundibulum has superior blind
end, and frontal sinus opens directly
into anterior part of middle nasal
meatus.
Inferior meatus:
• Opening of
nasolacrimal duct
is located in
anterior part of its
lateral wall
• Sphenoidal
sinus opens into
sphenoethmoidal
recess
Review Plate
Review Plate
 Nasal Cavity
Innervation
• Branches of ophthalmic and maxillary nerves
• Anterior ethmoidal nerve: branch of nasociliary nerve (from
ophthalmic nerve) passes from orbit to anterior cranial fossa
via anterior ethmoidal foramen runs forward on cribriform
plate to leave anterior cranial fossa and enters nasal cavity via
small slit at side of crista galli. It divides into internal and
external nasal branches with internal branches supply mucosa
of anterior parts of septum and lateral wall. The external nasal
nerve supplies skin of lower part of nose
 Nasal Cavity
• Innervation (cont.):
• posterolateral nasal branches: originate from pterygopalatine
ganglion and greater palatine nerve to supply mucosa of
posterior part of lateral wall
• nasopalatine nerve: supplies mucosa of posterior part of nasal
septum
Special sensory nerve
supply:
Olfactory receptor cells
are bipolar neurons
located in olfactory
mucosa. The peripheral
processes (dendrites) end
in a dilation called
(olfactory knob) It gives
rise to nonmotile cilia,
which spread over
mucosal surface. Central
processes (axons) join to
form olfactory nerves that
pass through openings of
cribriform plate to end in
the olfactory bulb.
 Nasal Cavity
Vasculature:
• Main sources: sphenopalatine and anterior ethmoidal arteries
1. sphenopalatine artery: terminal branch of maxillary
artery It supplies posterior parts of lateral wall and
septum
2. anterior ethmoidal artery: branch of ophthalmic artery 
supplies anterior parts of lateral wall and septum
• Minor sources: posterior ethmoidal artery, superior labial
artery (branch of facial artery), and greater palatine artery
 Nasal Cavity
Vasculature (cont.):
On anterior part of septal cartilage, septal branches of
sphenopalatine, greater palatine, anterior ethmoidal and superior
labial arteries anastomose with each other which is known as
Kiesselbach’s area. It is common site of epistaxis (nosebleed)
Veins: form rich plexus in submucosa that drains is into the
pterygoid venous plexus (via sphenopalatine vein), facial vein,
and superior ophthalmic vein (via anterior and posterior
ethmoidal veins)
 Objectives
1. Name the parts of the nose and the structures that form its
skeleton
2. Name the bony structures that form the walls of the nasal
cavity
3. Name the openings found in each of the nasal meatuses and
describe the anatomical features of the lateral wall of the
middle nasal meatus
4. Describe the location and functions of the olfactory and
respiratory parts of the nasal mucosa
5. Describe the blood and nerve supply of the nasal cavity
6. Name the paranasal sinuses and list their functions
7. Describe the location, anatomical relations, communication
with the nasal cavity and blood and nerve supply of the
paranasal sinuses
8. Discuss common disorders affecting the nasal cavity and
paranasal sinuses