The nose and paranasal sinuses: applied anatomy and examination

Figure 15.1

The lateral nasal wall

Cribriform plate

Figure 15.2

The paranasal sinuses

Figure 15.4 Auriscope

An auriscope can be used to examine the nose if you do not have access to an endoscope

Figure 15.3 The mist test

Testing the nasal airway

The nasal cavities extend from the vestibule in front to the nasopharynx behind. The nasal septum (made of cartilage and bone) separates the nose into two nasal cavities. The soft cartilaginous septum can be distorted during birth or in later life as a result of injury. A deviated nasal septum is common and can sometimes cause a blocked nose and can be treated surgically if required (see Chapter 17).

The rich blood supply to the nasal cavities is derived from both the internal and external carotid artery systems (see Chapter 16). Venous drainage is through valveless veins that follow the arterial pattern and have direct communication with the cavernous sinuses. This has a bearing on spread of infection to the intracranial cavity.

The nasal vestibule is lined with squamous epithelium. The nasal cavity itself is covered with pseudo-stratified ciliated columnar respiratory epithelium, rich in seromucinous glands. Figure 15.1 outlines the anatomy of the lateral nasal wall, where the paranasal sinuses and the lacrimal duct drain.

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