What is the name of the bone in the nose? How does the human nose work inside?

The main components of the respiratory organ include the external nose, nasal cavity and paranasal sinuses. These departments have their own anatomical features, which should be considered in more detail.

The structure of the outer part of the nose

The anatomy of the nose, more precisely, its outer part, is represented by a skeleton consisting of bones and cartilage. Joined together, they form a pyramid with three sides. The base of this pyramid faces downwards. The upper part of the outer part of the nose is in contact with the frontal bone, and is the root of the nose.

Going downwards, the nose forms a back, ending at an apex. Side surfaces in this part of the respiratory organ they have a soft structure and are called the wings of the nose.

The wings of the nose have free edges that form the nostrils. They are separated by a movable segment of the nasal septum - the bridge of the nose.

The bones of the skeleton are placed in pairs and form the back of the nose. On the sides of the back are the frontal processes of the upper part of the jaw. Grouping with them, the cartilages of the nose form the nasal slopes and ridge, which, in turn, connecting with the nasal bone, form an opening in the skeleton, reminiscent of a pear in shape. It is the outer part of the human nose.

Features of cartilage tissue

The cartilage of the nose is firmly attached to its bones. They are formed from the upper (triangular) cartilages, arranged in pairs, and the lower (large) cartilages of the organ. The wings of the nose are made up of them.

The large cartilage consists of a medial and lateral crus. Between these cartilages - the lateral and major - there are small cartilaginous processes, which are also part of the wings of the nose.

Muscles and soft tissues

The external nose consists of soft tissues. Their structure, in turn, is formed from such components as nasal muscles, fat cells and epidermal integuments. The structure and thickness of the skin and fat layer varies for each person depending on the individual characteristics of his body.

The nasal muscles cover the lateral and major cartilages, which help retract the alar bones and compress the nostrils. Muscle tissue is also attached to the crura of the alar cartilage, which helps lower the nasal septum and raise the upper lip.

Structure of the nasal cavity

The anatomy of the nose (its internal part) is more complex. The nasal cavity consists of 4 walls:

side;
internal;
top;
bottom.

The nasal cavity is divided by the bridge of the nose (nasal septum), which can sometimes be curved in one direction or the other. If the curvature is insignificant, it does not affect the functioning of the organ.

On the inside, the bridge of the nose is covered by the nasal mucosa. This is a very sensitive layer of epithelium that is easily subject to mechanical stress. If its integrity is violated, not only nosebleeds can occur, but also a bacterial infection.

Damage to the nasal mucosa can lead to the development of an inflammatory process - rhinitis. It is accompanied by copious secretion of clear mucus. When a bacterial or viral infection is attached, it may acquire a yellowish or greenish tint.

Three structures are directly involved in the formation of the nasal cavity:

anterior third of the bony base of the skull;
eye sockets;
oral cavity.

The nasal cavity in front is limited by the nostrils and nasal passages, while behind it smoothly passes into top part throats. The bridge of the nose divides the nasal cavity into two parts, which contribute to the uniform division of incoming air. Each of these components consists of 4 walls.

Inner nasal wall

The bridge of the nose plays a special role in the formation of the inner wall of the nose. Due to this, the wall is divided into 2 sections:

posterosuperior, which consists of the plate of the ethmoid bone;
posteroinferior, formed from the vomer.

Features of the outer wall

The outer wall is one of the most complex structures of the nose. It is formed by compounds:

nasal bones;
frontal process and medial surface of the bone of the upper jaw;
the lacrimal bone, which is in contact with the back of the nasal wall;
ethmoid bone.

The bony portion of the outer nasal wall is the place to which the 3 turbinates are attached. Due to the bottom, fornix and shells, a cavity is formed, which is called the common nasal passage.

The nasal turbinates are directly involved in the formation of three nasal passages - upper, middle and lower. The nasal cavity ends with the nasopharyngeal passage.

Features of the paranasal sinuses

The sinuses, located above and on the sides of the nose, also play a huge role in the functioning of the respiratory organ. They are closely interconnected with the nasal cavity. If they are damaged by bacteria or viruses, the pathological process also affects neighboring organs, so they also become involved in it.

The sinuses consist of a large number of various passages and openings. They are an excellent breeding ground. pathogenic microflora. Due to this, the pathological processes occurring in the human body are significantly intensified, resulting in a worsening of the patient’s health.

Types of paranasal sinuses

There are several types of paranasal sinuses. Let's look at each briefly:

Maxillary sinus , which is directly related to the roots of the backmost teeth (back quadruples, or wisdom teeth). If the rules of oral hygiene are not followed, an inflammatory process can begin not only in the gums and nerves of the tooth, but also in these sinuses.
Frontal sinus - paired formations located deep in the bone tissue of the forehead. It is this part of the sinuses that is adjacent to the ethmoid labyrinth, which is subject to aggressive attacks by pathogenic microflora. Due to this arrangement, the frontal sinuses quickly intercept the inflammatory process.
Lattice Maze – education with big amount cells, between which there are thin partitions. It is located in close proximity to important organs, which explains its enormous clinical significance. With the development of a pathological process in this part of the sinuses, a person suffers intense pain, since the ethmoid labyrinth is located close to the nasociliary branch of the ophthalmic nerve.
Main sinus , the lower wall of which is the vault of the human nasopharynx. When this sinus becomes infected, the health consequences can be extremely dangerous.
Pterygopalatine fossa , through which quite a lot of nerve fibers pass. It is with their inflammation that most clinical signs of various neurological pathologies are associated.

As you can see, the organs that are closely connected with it are a complex anatomical structure. If there are diseases affecting the systems of this organ, their treatment must be approached extremely responsibly and seriously.

It is important to remember that this should only be done by a doctor. The patient’s task is to promptly detect alarming symptoms and contact a doctor, since if the disease is taken to a dangerous limit, the consequences can be catastrophic.

Useful video about the nasal cavity

The nose is an important part of the human body. It has a rather complex structure and performs many functions, ensuring free breathing and. From the point of view of clinical anatomy, the nose is usually divided into external and internal parts.

Structure of the external nose

The nose consists of outer and inner parts.

The outside of the nose is covered with skin, which contains many sebaceous glands. This section of the nose consists of cartilage and bone tissue and is shaped like a triangular pyramid. Its upper part is usually called the root of the nose, which, lengthening, passes downwards into the back and ends at the apex. The wings of the nose are located on the sides of the back, they are movable structures and form the entrance to the nasal cavity.

The bony skeleton of the nose consists of thin and flat nasal bones; they are connected to each other (along the midline), as well as to other structures of the facial skeleton. Its cartilaginous part is represented by paired lateral cartilaginous plates located above and below.

This section of the nose is abundantly supplied with blood by the branches of the external carotid artery. The outflow of venous blood from this area has certain features, which is carried out into the anterior facial vein, which communicates with the ophthalmic vein and the cavernous sinus. This structure allows for the rapid spread of pathogens of infectious diseases through the bloodstream into the cranial cavity.

Inner part of the nose

The nasal cavity is located between the oral cavity, the orbits and the anterior cranial fossa. She has a message with environment(through the nostrils) and pharynx (through the choanae).

The lower wall of the nasal cavity is formed by the palatine bones and the processes of the same name of the upper jaw. In the depths of this wall, closer to the anterior, there is an incisive canal in which nerves and vessels pass.

The roof of the inner nose is formed by the following bone structures:

cribriform plate of the same bone;
nasal bones;
anterior wall of the sphenoid sinus.

Olfactory nerve fibers and arteries penetrate here through the cribriform plate.

The nasal septum divides the nasal cavity into two parts - cartilaginous and bone:

The latter is represented by the vomer, the perpendicular plate of the ethmoid bone and the nasal ridge of the upper jaw.
The cartilaginous part is formed by the own cartilage of the nasal septum, which has the shape of a quadrangle, which participates in the formation of the dorsum of the nose and is part of the movable part of the septum.

The lateral wall of the nasal cavity is the most complex. It is formed by several bones:

lattice,
palatal,
wedge-shaped
lacrimal bone,
upper jaw.

It has special horizontal plates - the upper, middle and lower nasal concha, which conditionally divide the internal part of the nose into 3 nasal passages.

Inferior (located between the nasal concha and the bottom of the nasal cavity; the nasolacrimal canal opens here).
Middle (limited by two nasal conchas - inferior and middle; has anastomosis with all paranasal sinuses, except the sphenoid).
Superior (located between the vault of the nasal cavity and the superior nasal concha; the sphenoid sinus and the posterior cells of the ethmoid bone communicate with it).

In clinical practice, the common nasal passage is distinguished. It looks like a slit-like space between the septum and the nasal turbinates.

All parts of the inside of the nose, except the vestibule, are lined with mucous membrane. Depending on its structure and functional purpose, the respiratory and olfactory zones are distinguished in the nasal cavity. The latter is located above the lower edge of the middle turbinate. In this area of the nose, the mucous membrane contains a large number of olfactory cells that can distinguish more than 200 odors.

The respiratory region of the nose is located below the olfactory region. Here the mucous membrane has a different structure; it is covered with multinucleated ciliated epithelium with many cilia, which in the anterior sections of the nose make oscillatory movements towards the vestibule, and in the posterior sections, on the contrary, towards the nasopharynx. In addition, this zone contains goblet cells that produce mucus and tubulo-alveolar glands that produce serous secretions.

The medial surface of the lower part of the middle turbinate has a thickened mucous membrane due to cavernous tissue, which contains a large number of venous dilations. This is precisely why its ability to quickly swell or contract under the influence of certain stimuli is associated.

The blood supply to the intranasal structures is carried out by vessels from the carotid artery system, both from its external and internal branches. That is why, with massive ones, it is not enough to bandage one of them to stop it.

A feature of the blood supply to the nasal septum is the presence in its anterior part weak point with thin mucous membrane and dense vascular network. This is the so-called Kisselbach zone. There is an increased risk of bleeding in this area.

The venous network of the nasal cavity forms several plexuses in it, it is very dense and has numerous anastomoses. The outflow of blood goes in several directions. This is due to high risk development of intracranial complications in diseases of the nose.

The nose is innervated by the olfactory and trigeminal nerves. The latter is associated with possible irradiation of pain from the nose along its branches (for example, into the lower jaw).

In addition, adequate functioning of the nose is necessary for normal blood gas exchange. Chronic diseases nose with or narrowing of the respiratory space lead to insufficient oxygen supply to the tissues and disruption of the nervous system.

Prolonged difficulty in nasal breathing in childhood contributes to delayed mental and physical development, as well as the development of deformation of the facial skeleton (changes in bite, high “Gothic” palate).

Let us dwell in more detail on the main functions of the human nose.

Respiratory (regulates the speed and volume of air entering the lungs; due to the presence of reflexogenic zones in the nasal cavity, it provides broad connections with various organs and systems).
Protective (warms and moisturizes the inhaled air; the constant flickering of the cilia cleanses it, and the bactericidal effect of lysozyme helps prevent pathogens from entering the body).
Olfactory (the ability to distinguish odors protects the body from the harmful influences of the environment).
Resonator (together with other air cavities, it participates in the formation of the individual timbre of the voice and ensures clear pronunciation of some consonant sounds).
Participation in lacrimal drainage.

Conclusion

Changes in the structure of the nose (developmental anomalies, curvature of the nasal septum, etc.) inevitably lead to disruption of its normal functioning and the development of various pathological conditions.

Rice. 1. The basis of the cartilaginous part of the external nose is the lateral cartilage, the upper edge of which borders on the nasal bone of the same side and partially on the frontal process of the upper jaw. The upper edges of the lateral cartilages form a continuation of the dorsum of the nose, adjoining in this section the cartilaginous part of the upper parts of the nasal septum. The lower edge of the lateral cartilage borders the greater wing cartilage, which is also paired. The large wing cartilage has medial and lateral crura. Connecting in the middle, the medial crura form the tip of the nose, and the lower parts of the lateral crura form the edge of the nasal openings (nostrils). Between the lateral and greater cartilages of the nasal wing in the thickness connective tissue sesamoid cartilages may be located, different shapes and magnitude.

The wing of the nose, in addition to large cartilage, includes connective tissue formations from which the posterior sections of the nasal openings are formed. The inner sections of the nostrils are formed by the movable part of the nasal septum.

The outer nose is covered with the same skin as the face. The external nose has muscles that are designed to compress the nasal openings and pull down the wings of the nose.

The blood supply to the external nose is provided by the ophthalmic artery (a. ophthalmicа), dorsal nasal (a. dorsalis nasi) and facial (a. facialis) arteries. Venous outflow occurs through the facial, angular and partially ophthalmic veins, which in some cases contributes to the spread of infection in inflammatory diseases of the external nose to the sinuses of the dura mater. Lymphatic drainage from the external nose occurs in the submandibular and superior parotid lymph nodes. The motor innervation of the external nose is provided by the facial nerve, and the sensory innervation is provided by the trigeminal nerve (I and II branches).

The anatomy of the nasal cavity is more complex. The nasal cavity is located between the anterior cranial fossa (above), the orbits (laterally) and the oral cavity (below). In front, the nasal cavity communicates with the nostrils external environment, behind with the help of the choana - with the nasopharynx area.

There are four walls of the nasal cavity: lateral (lateral), internal (medial), upper and lower. Most complex structure has a lateral wall of the nose formed by several bones and bearing the turbinates. Its bone formations include the nasal bones, the upper jaw, the lacrimal bone, the ethmoid bone, the inferior nasal concha, the vertical plate of the palatine bone and the pterygoid process of the sphenoid bone. On the side wall there are three longitudinal projections formed by shells. The largest is the inferior nasal concha; it is an independent bone; the middle and superior conchas are outgrowths of the ethmoid bone.

The lower wall of the nasal cavity (bottom of the nasal cavity) is actually the hard palate; it is formed by the palatine process of the upper jaw (in the anterior sections) and the horizontal plate of the palatine bone. At the anterior end of the bottom of the nose there is a canal that serves for the passage of the nasopalatine nerve (n. nasopalatinus) from the nasal cavity to the oral cavity. The horizontal plate of the palatine bone limits the lower parts of the choanae.

The inner (medial) wall of the nasal cavity is the nasal septum (Fig. 2). In the lower and posterior sections it is represented by bone formations (the nasal crest of the palatine process of the upper jaw, the perpendicular plate of the ethmoid bone and an independent bone - the vomer). In the anterior sections, these bone formations are adjacent to the quadrangular cartilage of the nasal septum (cartilage septi nasi), the upper edge of which forms the anterior section of the nasal dorsum. The posterior edge of the vomer limits the choanae medially. In the anteroinferior section, the cartilage of the nasal septum is adjacent to the medial processes of the large cartilage of the nasal wing, which, together with the skin part of the nasal septum, form its movable part.

Rice. 2. Nasal septum 1. Lamina cribrosa 2. Crista sphenoidalis 3. Apertura sinus sphenoidalis 4. Sinus sphenoidalis 5. Ala vomeris 6. Clivus 7. Pars ossea 8. Pars cartilaginea 9. Septum nasi 10. Lamina medialis processus pterygoidei 11. Processus palatineus maxillae 12. Crista nasalis 13. Canalis incisivus 14. Spina nasalis anterior 15. Cartilago alaris major 16. Cartilago vomeronasalis 17. Cartilago septi nasi 18. Cartilago nasi lateralis 19. Vomer 20. Processus posterior 21. Os nasale 22. Lamina perpendicularis ossis alis 23. Crista gali 24. Sinus frontalis

Rice. 2. The upper wall of the nasal cavity (roof) in the anterior sections is formed by the nasal bones, the frontal processes of the upper jaw and the partially perpendicular plate of the ethmoid bone. In the middle sections, the upper wall is formed by the ethmoid bone (lamina cribrosa), in the posterior sections - the sphenoid bone (the anterior wall of the sphenoid sinus). The sphenoid bone forms the upper wall of the choana. The cribriform plate is pierced by a large number (25-30) of openings through which the branches of the anterior ethmoidal nerve and the vein accompany the anterior ethmoidal artery and connect the nasal cavity with the anterior cranial fossa.

The space between the nasal septum and the turbinates is called the common meatus. In the lateral sections of the nasal cavity, corresponding to the three nasal conchae, there are three nasal passages (Fig. 3). The lower nasal passage (meatus nasi inferior) is limited from above by the inferior nasal concha, from below by the bottom of the nasal cavity. In the anterior third of the lower nasal meatus, at a distance of 10 mm from the anterior end of the concha, there is an opening of the nasolacrimal canal. The lateral wall of the lower nasal passage in the lower sections is thick (has a spongy structure), closer to the place of attachment of the inferior nasal concha, it becomes significantly thinner, and therefore puncture of the maxillary sinus (correction of the nasal septum) is carried out precisely in this area: at a distance of 2 cm from the anterior end of the lower shells

Rice. 3. Nasal cavity 1. Bulla ethmoidalis 2. Concha nasalis inferior 3. Concha nasalis media 4. Concha nasalis superior 5. Apertura sinus sphenoidalis 6. Sinus sphenoidalis 7. Meatus nasi inferior 8. Meatus nasi medius 9. Bursa pharyngealis 10. Meatus nasi inferior 11. Tonsilla pharyngealis 12. Torus tubarius auditivae 13. Ostium pharyngeum tubae 14. Palatum molle 15. Meatus nasopharyngeus 16. Palatum durum 17. Plica lacrimalis 18. Ductus nasolacrimalis 19. Labium superius 20. Vestibulum nasi 21. Apex nasi 22. Limen nasi 23. Agger nasi 24. Dorsum nasi 25. Processus uncinatus 26. Hiatus semilunaris 27. Radix nasi 28. Aperturae sinus frontalis 29. Sinus frontalis

Rice. 3. The middle nasal passage (meatus nasi medius) is located between the inferior and middle nasal concha. Its lateral wall is represented not only by bone tissue, but also by a duplication of the mucous membrane, which is called “fontanella” (fontanelles). If the middle turbinate is partially removed, a semilunar cleft (hiatus semilunaris) will open, bounded in the antero-inferior parts by a bone plate (uncinate process), and in the postero-superior parts by a bone vesicle (bulla etmoidalis). In the anterior sections of the semilunar fissure, the mouth of the frontal sinus opens, in the middle sections - the anterior and middle cells of the ethmoid bone sinuses, and in the posterior sections there is a depression formed by the duplication of the mucous membrane and called the funnel (infundibulum), which ends with a hole leading into the maxillary sinus.

The superior nasal passage (meatus nasi superior) is located between the superior and middle nasal concha. The posterior cells of the ethmoid bone open into it. The sphenoid sinus opens into the sphenoethmoidal recess (recessus sphenoethmoidalis).

The nasal cavity is lined with mucous membrane, which covers all the bone sections of the walls, and therefore the contours of the bone section are preserved. The exception is the vestibule of the nasal cavity, which is covered with skin and has hairs (vibrissae). In this area, the epithelium remains stratified squamous, as in the area of the external nose. The mucous membrane of the nasal cavity is covered with multirow cylindrical ciliated epithelium.

Depending on the structural features of the nasal mucosa, the respiratory and olfactory sections are distinguished. The respiratory department occupies the area from the bottom of the nasal cavity to the middle of the middle turbinate. Above this border, the ciliated columnar epithelium is replaced by a specific olfactory epithelium. The respiratory section of the nasal cavity is characterized by a large thickness of the mucous membrane. Its subepithelial section contains numerous alveolar-tubular glands, which, based on the nature of the secretion, are divided into mucous, serous and mixed. The respiratory part of the mucous membrane is characterized by the presence in its thickness of cavernous plexuses - varicose veins with a muscular wall, due to which they can contract in volume. The cavernous plexuses (corpus cavernosa) regulate the temperature of the air passing through the nasal cavity. Cavernous tissue is contained in the thickness of the mucous membrane of the inferior turbinates, located along the lower edge of the middle turbinate, in the posterior parts of the middle and superior turbinates.

In the olfactory region, in addition to the specific olfactory epithelium, there are supporting cells that are cylindrical, but lack cilia. The glands present in this section of the nasal cavity secrete a more liquid secretion than the glands located in the respiratory part.

The blood supply to the nasal cavity is carried out from the system of external (a. carotis externa) and internal (a. carotis interim) carotid arteries. The sphenopalatine artery (a. sphenopalatina) originates from the first artery; passing through the main palatine opening (foramen sphenopalatinum) into the nasal cavity, it gives off two branches - the posterior nasal lateral and septal arteries (aa. nasales posteriores laterales et septi), providing blood supply to the posterior sections of the nasal cavity, both the lateral and medial walls. The ophthalmic artery originates from the internal carotid artery, from which branches of the anterior and posterior ethmoidal arteries arise (aa. ethmoidales anterior et posterior). The anterior ethmoidal arteries pass into the nose through the cribriform plate, the posterior ones through the posterior ethmoidal foramen (foramen ethmoidale post.). They provide nutrition to the area of the ethmoid labyrinth and the anterior parts of the nasal cavity.

The outflow of blood occurs through the anterior facial and ophthalmic veins. Features of blood outflow often determine the development of orbital and intracranial rhinogenic complications. In the nasal cavity, particularly pronounced venous plexuses are present in the anterior sections of the nasal septum (locus Kilsselbachii).

Lymphatic vessels form two networks - superficial and deep. The olfactory and respiratory areas, despite their relative independence, have anastomoses. Lymphatic drainage occurs in the same lymph nodes: from the anterior sections of the nose to the submandibular, from the posterior to the deep cervical.

Sensitive innervation of the nasal cavity is provided by the first and second branches of the trigeminal nerve. The anterior part of the nasal cavity is innervated by the first branch of the trigeminal nerve (anterior ethmoidal nerve - n. ethmoidalis anterior - branch of the nasociliary nerve - n. nasociliaris). The nasociliary nerve from the nasal cavity penetrates through the nasociliary foramen (foramen nasociliaris) into the cranial cavity, and from there through the cribriform plate into the nasal cavity, where it branches in the region of the nasal septum and the anterior sections of the lateral wall of the nose. The external nasal branch (ramus nasalis ext.) between the nasal bone and the lateral cartilage extends onto the dorsum of the nose, innervating the skin of the external nose.

The posterior sections of the nasal cavity are innervated by the second branch of the trigeminal nerve, which enters the nasal cavity through the posterior ethmoidal foramen and branches in the mucous membrane of the posterior cells of the ethmoid bone and the sinus of the sphenoid bone. The second branch of the trigeminal nerve gives off the nodal branches and the infraorbital nerve. The nodal branches are part of the pterygopalatine ganglion, but most of them pass directly into the nasal cavity and innervate the postero-superior part of the lateral wall of the nasal cavity in the region of the middle and superior nasal conchae, the posterior cells of the ethmoid bone and the sinus of the sphenoid bone in the form of rr. nasales.

A large branch runs along the nasal septum from back to front - the nasopalatine nerve (n. nasopalatinus). In the anterior parts of the nose, it penetrates through the incisive canal into the mucous membrane of the hard palate, where it anastomoses with the nasal branches of the alveolar and palatine nerves.

Secretory and vascular innervation comes from the superior cervical sympathetic ganglion, the postganglionic fibers of which penetrate into the nasal cavity as part of the second branch of the trigeminal nerve; parasympathetic innervation is carried out through the pterygopalatine ganglion (gang. pterigopalatinum) due to the nerve of the pterygoid canal. The latter is formed by the sympathetic nerve, originating from the superior cervical sympathetic ganglion, and the parasympathetic nerve, originating from the geniculate ganglion of the facial nerve.

Specific olfactory innervation is carried out by the olfactory nerve (n. olfactorius). Sensitive bipolar cells of the olfactory nerve (I neuron) are located in the olfactory region of the nasal cavity. The olfactory filaments (filae olfactoriae), extending from these cells, penetrate into the cranial cavity through the cribriform plate, where, connecting, they form the olfactory bulb (bulbus olfactorius), enclosed in the vagina formed by the dura mater. The pulpy fibers of the sensitive cells of the olfactory bulb form the olfactory tract (tractus olfactorius - II neuron). Next, the olfactory pathways go to the olfactory triangle and end in the cortical centers (gyrus hippocampi, gyrus dentatus, sulcus olfactorius).

The nose is the initial section of the upper respiratory tract and is divided into the external nose and the nasal cavity with the paranasal sinuses.

The external nose consists of bone, cartilage and soft parts and has the shape of an irregular triangular pyramid. The root of the nose is isolated - the upper section connecting it to the forehead, the back - middle part nose, going down from the root, which ends at the tip of the nose. The lateral convex and movable surfaces of the nose are called the wings of the nose; their lower free edges form the nostrils, or external openings.

The nose can be divided into 3 sections: 1) external nose; 2) nasal cavity; 3) paranasal sinuses.

The external nose is an elevation resembling an irregular triangular pyramid in shape, protruding above the level of the face and located along its midline. The surface of this pyramid is made up of two lateral slopes, which descend towards the cheeks and converge along the midline, forming here a rounded edge - the back of the nose; the latter is obliquely directed anteriorly and downward. On the third, lower surface of the pyramid there are two nasal openings - nostrils. The upper end of the bridge of the nose, which rests on the forehead, is called the root of the nose, or the bridge. The lower end of the bridge of the nose, where it meets the inferior surface, is called the tip of the nose. The lower, movable section of each lateral surface of the nose is called the ala of the nose.

The skeleton of the external nose consists of bones, cartilage and soft tissue. The external nose consists of paired nasal bones, frontal processes of the maxillary bones and paired cartilages: the lateral nasal cartilage, the major cartilage of the nasal wing and the small cartilages located in the posterior part of the nasal wing.

The skin on the bony part of the nose is mobile, while on the cartilaginous part it is inactive. The skin contains many sebaceous and sweat glands with wide excretory openings, which are especially large on the wings of the nose, where the mouths of their excretory ducts are visible to the naked eye. Through the edge of the nasal opening, the skin passes to the inner surface of the nasal cavity. The strip separating both nostrils and belonging to the nasal septum is called the movable septum. The skin in this place, especially in older people, is covered with hair, which delays the penetration of dust and other harmful particles into the nasal cavity.

The nasal septum divides the nasal cavity into two halves and consists of bone and cartilaginous parts. Its bony part is formed by the perpendicular plate of the ethmoid bone and the vomer. The corner between these bone formations includes the quadrangular cartilage of the nasal septum. Adjacent to the anterior edge of the quadrangular cartilage is the inwardly curled cartilage of the greater wing of the nose. The anterior cutaneous-cartilaginous section of the nasal septum, unlike the bone section, is mobile.

The muscles of the external nose in humans are rudimentary and have almost no practical significance. Of the muscle bundles that are of some importance, the following can be noted: 1) the levator ala nasi muscle - starts from the frontal process of the upper jaw and attaches to the posterior edge of the ala nasal, partly passes into the skin of the upper lip; 2) narrowing the nasal openings and pulling down the wings of the nose; 3) a muscle that pulls the nasal septum down.

The vessels of the external nose are branches of the external maxillary and orbital arteries and are directed to the tip of the nose, which is characterized by a rich blood supply. The veins of the external nose drain into the anterior facial vein. The skin of the external nose is innervated by the first and second branches of the trigeminal nerve, and the muscles by branches of the facial nerve.

The nasal cavity is located in the center of the facial skeleton and is bordered above by the anterior cranial fossa, on the sides by the orbits, and below by the oral cavity. In front, it opens with nostrils located on the lower surface of the external nose, which have a variety of shapes. At the back, the nasal cavity communicates with. the upper part of the nasopharynx through two adjacent oval-shaped posterior nasal openings called choanae.

The nasal cavity communicates with the nasopharynx, the pterygopalatine fossa and the paranasal sinuses. Through the Eustachian tube, the nasal cavity also communicates with the tympanic cavity, which determines the dependence of some ear diseases on the condition of the nasal cavity. The close connection of the nasal cavity with the paranasal sinuses also determines that diseases of the nasal cavity most often, to one degree or another, transfer to the paranasal sinuses and through them can affect the cranial cavity and the orbit with their contents. The topographic proximity of the spit cavity to the orbits and the anterior cranial fossa is a factor that contributes to their combined damage, especially during trauma.

The nasal septum divides the nasal cavity into two not always symmetrical halves. Each half of the nasal cavity has an inner, outer, upper and lower wall. The inner wall is the nasal septum (Fig. 18, 19). The outer, or side, wall is the most complexly constructed. There are three protrusions on it, the so-called nasal conchas: the largest is the lower, middle and upper. The inferior turbinate is an independent bone; the middle and superior shells are processes of the ethmoid labyrinth.

Rice. 18. Anatomy of the nasal cavity: lateral wall of the nose.
1 - frontal sinus; 2 - nasal bone; 3 - lateral cartilage of the nose; 4 - middle shell; 5 - middle nasal passage; 6 - lower sink; 7 - hard palate; 8 - lower nasal passage; 9 - soft palate; 10 - pipe roller; 11 - Eustachian tube; 12 - Rosenmüller fossa; 13 - main sinus; 14 - upper nasal passage; 15 - upper sink; 16 - cock's comb.

Rice. 19. Medial wall of the nose.
1 - frontal sinus; 2 - nasal bone; 3 - perpendicular plate of the ethmoid bone; 4 - cartilage of the nasal septum; 5 - sieve plate; 6 - sella turcica; 7 - main bone; 8 - opener.

Under each turbinate there is a nasal passage. Thus, between the inferior concha and the bottom of the nasal cavity there is the inferior nasal passage, between the middle and inferior concha and the side wall of the nose there is the middle nasal passage, and above the middle concha there is the superior nasal passage. In the anterior third of the lower nasal meatus, approximately 14 mm from the anterior edge of the concha, there is an opening of the nasolacrimal canal. In the middle meatus, narrow openings open: the maxillary (maxillary) sinus, the frontal sinus and the cells of the ethmoidal labyrinth. Under the superior concha, in the area of the superior nasal passage, the posterior cells of the ethmoidal labyrinth and the main (sphenoidal) sinus open.

The nasal cavity is lined with a mucous membrane that continues directly into the paranasal sinuses. In the mucous membrane of the nasal cavity, two areas are distinguished: respiratory and olfactory. The olfactory region includes the mucous membrane of the superior concha, part of the middle concha and the corresponding part of the nasal septum. The rest of the nasal mucosa belongs to the respiratory region.

The mucous membrane of the olfactory region contains olfactory, basal and supporting cells. There are special glands that produce serous secretions that facilitate the perception of olfactory stimulation. The mucous membrane of the respiratory region is tightly fused to the periosteum or perichondrium. The submucosal layer is absent. In some places, the mucous membrane thickens due to cavernous (cavernous) tissue. This occurs most consistently in the area of the inferior concha, the free edge of the middle concha, and also the elevation on the nasal septum, corresponding to the anterior end of the middle concha. Under the influence of various physical, chemical or even psychogenic factors, cavernous tissue causes instant swelling of the nasal mucosa. By slowing down the speed of blood flow and creating conditions for stagnation, cavernous tissue favors the secretion and release of heat, and also regulates the amount of air entering the respiratory tract. The cavernous tissue of the inferior turbinate is connected to the venous network of the mucous membrane of the lower part of the nasolacrimal canal. Swelling of the inferior concha can therefore cause closure of the nasolacrimal duct and lacrimation.

The blood supply to the nasal cavity is carried out by branches of the internal and external carotid arteries. The ophthalmic artery departs from the internal carotid artery, enters the orbit and gives off the anterior and posterior ethmoidal arteries there. The internal maxillary artery and the artery of the nasal cavity - the sphenopalatine - depart from the external carotid artery. The veins of the nasal cavity follow the arteries. The veins of the nasal cavity also connect with the veins of the cranial cavity (hard and soft
meninges), and some flow directly into the sagittal sinus.

The main blood vessels of the nose pass in its posterior sections and gradually decrease in diameter towards the anterior sections of the nasal cavity. This is why bleeding from the back of the nose is usually more severe. In the initial part, immediately at the entrance, the nasal cavity is lined with skin, the latter curves inward and is equipped with hairs and sebaceous glands. The venous network forms plexuses that connect the veins of the nasal cavity with neighboring areas. This is important due to the possibility of infection spreading from the veins of the nasal cavity to the cranial cavity, orbit and to more distant areas of the body. Particularly important are venous anastomoses with the cavernous (cavernous) sinus, located at the base of the skull in the area of the middle cranial fossa.

In the mucous membrane of the anterior inferior part of the nasal septum there is a so-called Kisselbach place, characterized by a rich arterial and venous network. Kisselbach's place is the most frequently injured area and is also the most common site of recurrent nosebleeds. Some authors (B.S. Preobrazhensky) call this place the “bleeding zone of the nasal septum.” It is believed that bleeding here is more frequent because in this area there is cavernous tissue with underdeveloped muscles, and the mucous membrane is more tightly attached and less extensible than in other places (Kisselbach). According to other data, the reason for the slight vulnerability of blood vessels is the insignificant thickness of the mucous membrane in this area of the nasal septum.

The innervation of the nasal mucosa is carried out by the sensory branches of the trigeminal nerve, as well as by branches emanating from the pterygopalatine ganglion. From the latter, sympathetic and parasympathetic innervation of the nasal mucosa is also carried out.

The lymphatic vessels of the nasal cavity are connected to the cranial cavity. The outflow of lymph occurs partly to the deep cervical nodes and partly to the retropharyngeal lymph nodes.

The paranasal sinuses include (Fig. 20) the maxillary, frontal, main sinuses and ethmoid cells.

Rice. 20. Paranasal sinuses.
a - front view: b - side view; 1 - maxillary (maxillary) sinus; 2 - frontal sinus; 3 - lattice labyrinth; 4 - main (sphenoidal) sinus.

The maxillary sinus is known as the maxillary sinus and is named after the anatomist who described it. This sinus is located in the body of the maxillary bone and is the most voluminous.

The sinus has the shape of an irregular quadrangular pyramid and has 4 walls. The anterior (facial) wall of the sinus is covered by the cheek and is accessible to palpation. The upper (orbital) wall is thinner than all the others. The anterior part of the upper wall of the sinus takes part in the formation of the upper opening of the nasolacrimal canal. The inferoorbital nerve passes through this wall, which leaves the bone in the upper part of the anterior wall of the sinus and branches in the soft tissues of the cheek.

The inner (nasal) wall of the maxillary sinus is the most important. It corresponds to the lower and middle nasal passages. This wall is quite thin.

The lower wall (bottom) of the maxillary sinus is located in the area of the alveolar process of the upper jaw and usually corresponds to the alveoli of the upper posterior teeth.

The maxillary sinus communicates with the nasal cavity by one, and often two or more openings located in the middle nasal passage.

The frontal sinus is shaped like a triangular pyramid. Its walls are as follows: facial - anterior, posterior - bordering the cranial cavity, lower - orbital, internal - forms a partition between the sinuses. The frontal sinus can rise upward to the scalp, extends outward to the outer corner of the eyes, and the frontonasal canal opens in the anterior section of the middle nasal passage. The frontal sinus may be absent. It is often asymmetrical and is larger on one side. A newborn already has it in the form of a small bay, which increases every year, but their underdevelopment or incomplete absence (aplasia) of the frontal sinus occurs.

The main (sphenoid, sphenoid) sinus is located in the body of the sphenoid bone. Its shape resembles an irregular cube. Its size varies greatly. It borders on the middle and anterior cranial fossae, adjoining its bony walls to the medullary appendage (pituitary gland) and other important formations (nerves, blood vessels). The hole leading into the nose is located on its front wall. The main sinus is characterized by asymmetry: in most cases, the septum divides it into 2 unequal cavities.

The lattice labyrinth has a bizarre structure. The cells of the ethmoidal labyrinth are wedged between the frontal and sphenoid sinuses. Outside, the lattice labyrinth borders the orbit, from which it is separated by the so-called paper plate; from the inside - with the upper and middle nasal passages; above - with the cranial cavity. The size of the cells is very different: from a small pea to 1 cm 3 or more, and the shape is also varied.

The cells are divided into anterior and posterior, of which the first open in the middle meatus. The posterior cells open into the superior meatus.

The ethmoid labyrinth is bounded by the orbit, the cranial cavity, the lacrimal sac, the optic nerve and other optic nerves.

Basic anatomical formations of the head and neck.

The nose is the most prominent part of the face, located in close proximity to the brain. To understand the mechanisms of development of pathological processes and ways to prevent the spread of infection, it is necessary to know the structural features. The basics of studying at a medical university begin with the alphabet, in this case with the study of the basic anatomical structures of the sinuses.

Being the initial link of the respiratory tract, it is connected with other organs of the respiratory system. The connection with the oropharynx suggests an indirect relationship with digestive tract, since often mucus from the nasopharynx enters the stomach. Thus, one way or another, pathological processes in the sinuses can affect all these structures, causing diseases.

In anatomy, it is customary to divide the nose into three main structural parts:

External nose;
Directly the nasal cavity;
Paranasal sinuses.

Together they form the main olfactory organ, the main functions of which are:

Respiratory. It is the first link in the respiratory tract; it is through the nose that inhaled air normally passes; the wings of the nose play the role of auxiliary muscles in case of respiratory failure.
Sensitive. It is one of the main sense organs, thanks to the receptor olfactory hairs, it is able to capture odors.
Protective. The mucus secreted by the mucous membrane allows it to retain dust particles, microbes, spores and other large particles, preventing them from passing deep into the body.
Warming. Passing through the nasal passages, cool air is heated thanks to the mucous capillary vascular network located close to the surface.
Resonator. Participates in the sound of one’s own voice, determines the individual characteristics of voice timbre.

The video in this article will help you better understand the structure of the paranasal cavities

Let's look at the structure of the nose and sinuses in pictures.

External departments

The anatomy of the nose and paranasal sinuses begins with the study of the external nose.

The outer part of the olfactory organ is represented by bone and soft tissue structures in the form of a triangular pyramid of irregular configuration:

The upper part is called the dorsum, which is located between the brow ridges - this is the narrowest part of the external nose;
Nasolabial folds and wings limit the organ on the sides;
The tip of the nose is called the apex;

Below, on the base, are the nostrils. They are represented by two round passages through which air enters the respiratory tract. Bounded by the wings on the lateral side, and by the septum on the medial side.

The structure of the external nose.

The table shows the main structures of the external nose and the designations where they are located in the photo:

Structure	How they work
Bone frame	· Nasal bones (2), two pieces; · Nasal region of the frontal bone (1); · Processes from the upper jaw (7).
Cartilaginous part	· Quadrangular cartilage, forming the septum (3); · Lateral cartilages (4); · Large cartilages that form the wings (5); Small cartilages that form wings (6)
Nasal muscles.	These are predominantly rudimentary, belong to the facial muscles and can be regarded as auxiliary, since they are connected during respiratory failure: · Raising the wing of the nose; · Elevator of the upper lip.
Blood supply.	The venous network communicates with the intracranial vessels of the head, so infection from the nasal cavity can enter the brain structures by hematogenous route, causing serious septic complications. Arterial system: · Orbital; · Facial. Venous system: · External veins of the nose; · Kieselbach's venous network; · Nasofrontal; · Angular – anastomoses with intracranial veins.

The structure of the external nose.

Nasal cavity

It is represented by three choanae or nasal conchae, between which the human nasal passages are located. They are localized between the oral cavity and the anterior fossa of the skull - the entrance to the skull.

Characteristic	Top stroke	Average stroke	Bottom stroke
Localization	The space between the middle and superior conchae of the ethmoid bone.	· The space between the inferior and middle conchae of the ethmoid bone; · divided into basal and sagittal parts.	· The lower edge of the ethmoid bone and the bottom of the nasal cavity; · connected to the ridge of the upper jaw and the bone of the palate.
Anatomical structures	The olfactory region is the receptor zone of the olfactory tract, exiting into the cranial cavity through the olfactory nerve. The main sinus opens.	Almost all sinuses of the nose open, except for the main sinus.	· Nasolacrimal duct; · The mouth of the Eustachian (auditory) tube.
Function	Sensitive – smells.	Air flow direction.	Provides outflow of tears and communication with the inner ear (resonator function).

Structure of the nasal cavity.

When performing rhinoscopy, the ENT doctor can only see the middle passage; beyond the rhinoscope are the upper and lower ones.

Sinuses

The facial bones contain hollow spaces that are normally filled with air and connect to the nasal cavity - these are the paranasal sinuses. There are four types in total.

Photo of the structure of the human sinuses.

Characteristic	Wedge-shaped (basic) (3)	Maxillary (maxillary) (4)	Frontal (frontal) (1)	Lattice (2)
Are opening	Exit to the top passage.	Exit to the middle passage, anastomosis in the upper medial corner.	Middle nasal passage.	· Front and middle – in middle speed; · Rear – to the top.
Volume	3-4 cm 3	10.-17.3 cm 3	4.7 cm 3	Different
Peculiarities	Common boundaries with the base of the brain, where are: Pituitary gland, - optic nerves Carotid arteries.	The biggest; Have a triangular shape	From birth – not visualized, full development occurs by age 12.	· Individual quantity for each person – from 5 to 15 rounded hollow holes;
Blood supply	Pterygopalatine artery; branches of the meningeal arteries	Maxillary artery	Maxillary and ophthalmic arteries	Ethmoidal and lacrimal arteries
Inflammation of the sinuses	Sphenoiditis	Sinusitis	Frontitis	Ethmoiditis

Normally, air flows through the sinuses. In the photo you can see the structure of the nasal sinuses and their relative position. With inflammatory changes, the sinuses are often filled with mucous or mucopurulent contents.

The paranasal sinuses also communicate with each other, which is why the infection often spreads and flows from one sinus to another.

Maxillary

They are the largest and have a triangular shape:

Wall	Structure	Structures
Medial (nasal)	The bony plate corresponds to most of the middle and lower passages.	Excretory anastomosis connecting the sinus to the nasal cavity
Front (front)	From the lower edge of the orbit to the alveolar process of the upper jaw.	Canine (canine) fossa, 4-7 mm deep. At the upper edge of the fossa, the infraorbital nerve emerges. A puncture is made through this wall.
Superior (orbital)	Borders the orbit.	The infraorbital nerve passes through the thickness; The venous plexus borders the orbit through the cavernous sinus, located in the dura mater of the brain.
Rear	Tubercle of the upper jaw.	Pterygopalatine ganglion; Maxillary nerve; Pterygopalatine venous plexus; Maxillary artery;
Lower (bottom)	Alveolar process of the maxilla.	Sometimes there is protrusion into the sinus of the roots of the teeth.

Formations of the maxillary paranasal sinus

Lattice

The ethmoid labyrinth is a single bone where the ethmoid sinuses are located in humans, it borders on:

frontal superior;
wedge-shaped at the back;
maxillary from the side.

Possible spread into the orbit in the anterior or posterior regions, depending on individual characteristics anatomical structure. Then they border on the anterior fossa of the skull through the cribriform plate.

This justifies the instructions when opening the sinuses - only in the lateral direction, so as not to damage the plate. The optic nerve also passes close to the plate.

Frontal

They have a triangular shape and are located in the scales of the frontal bone. They have 4 walls:

Wall	Peculiarities
Orbital (lower)	Is the upper wall that forms the orbit; Located next to the cells of the ethmoid bone labyrinth and the nasal cavity; The canal is located - this is the connection between the nasal sinuses and the middle nasal meatus, 10-15 mm long and 4 mm wide.
Facial (front)	The thickest is 5-8 mm.
Brain (posterior)	Borders the anterior fossa of the skull; Consists of compact bone.
Medial	Is the septum of the frontal sinuses

Wedge-shaped

Formed by walls:

Wall	Peculiarities
Lower	Forms the roof of the nasopharynx; the roof of the nasal cavity; Consists of spongy bone.
Upper	The lower surface of the sella turcica; Above is the area of the frontal lobe (olfactory gyri) and the pituitary gland.
Rear	Basilar region of the occipital bone; The thickest.
Lateral	It borders the cavernous sinus and is in close proximity to the internal carotid artery; The oculomotor, trochlear, first branch of the trigeminal and abducens nerves pass through. Wall thickness – 1-2 mm.

The video in this article will help you understand where exactly the paranasal sinuses are located and how they are formed:

All medical workers and people suffering from sinusitis need to know about the anatomy of the paranasal sinuses. This information will help to understand where the pathological process develops and how it can spread.