Outline
Nasal Cavity and Palate
Dr. Bennett-Clarke
The nose is made up of the external nose and the nasal cavity.
***Everyone’s nose looks different due to skeletal elements
5 external cartilages & 1 Nasal septum cartilage
EXTERNAL NOSE- is pyramidal in shape. It is primarily composed of cartilages (5 pair) and
fibro-fatty tissue. These determine the size and shape of the external nose.
Terms associated with the external nose:
Nares
Dorsum
Root
Apex
Ala
Nasal septum On the interior of the nasal cavity
From dorsum of the nose to the apex supplied by Ophthalmic branch of Trigeminal (CN V1)
The lateral aspect of nose supplied by Maxillary Branch of Trigeminal (CN V2)
NASAL CAVITY- is the internal aspect of the nose and is divided by nasal septum. It begins
at the anterior openings the nares and ends at the posterior openings the choanae. The nasal
cavity opens into the nasopharynx.
1. Vestibule- entrance into the nasal cavity.
a. Transition area from the nose skin to the mucous membrane of the cavity
i. Has hair follicles in it
ii. Branches from the infraorbital nerve innervates it (CN V2)
****Mucous membrane of the nasal cavityMucous membrane & Periosteum in close contact
Highly Vascular
Majority of it is respiratory epithelium (Ciliated with lots mucous glands)
 Functions = humidify & warm the entering air (By blood vessel plexus & mucous there)
2. Nasal septum- composed of bone and cartilage. All between mucoperiosteum
Bony portion:
Upper : Perpendicular plate of the ethmoid bone = forms the upper part of the ethmoid
Lower: Vomer = one bone & only on nasal septum
Cartilage portion: (Naso)-Septal cartilage
:
Innervation to the nasal
septum:
1) Olfactory – CN I = in olfactory mucous membrane in nasal cavity mucous membrane
Olfactory Epithelium (Most superior & lateral part of the nasal septum)
 Bipolar neurons
 Peripheral processes = with chemoreceptors
 Sense odorants that are dissolved in the mucous
And branches of trigeminal nerve
2) Respiratory – CN V1 & V2
Branches of the Trigeminal
1. Anterior Ethmoidal Nerve (CN V1)
2. Nasopalatine Nerve
Blood supply to nasal septum
Branches of ophthalmic a.
1. Anterior Ethmoidal Artery
2. Posterior Ethmoidal Artery
Branches of maxillary a.
1. Sphenopalatine Artery
3. Lateral nasal wall- has a very irregular contour. Three curved shelves of bone extend
from the lateral nasal wall, these are known as the conchae. They are curve shaped.
Inferior nasal concha:
 2 of them = own independent bone
Middle nasal concha:
 Part of the Ethmoid bone
Superior nasal concha:
 Part of the Ethmoid bone
There is a passageway that lies deep to each concha; they are called the nasal meatuses. In
each of these spaces there are distinctive markings and openings.
Under the inferior nasal concha is the inferior meatus
Passage way deep to or inferior to inferior nasal concha
Under the middle nasal concha is the middle meatus
Passage way deep to or inferior to Middle nasal concha
Under the superior nasal concha is the superior meatus
Passage way deep to or inferior to superior nasal concha
Above the superior nasal concha is the sphenoethmoidal recess
Nasolacrimal duct
 Tears will flow into the inferior nasal meatus through here
 Causes our nose to run when we cry
Ethmoidal Bulla  is a bulging bone = ethmoidal cells bulging into the cavity
Opening of the Maxillary Sinus = floor of hiatus semilunaris
Frontonasal duct = from frontal sinus
Spenoidal Sinus = opens into sphenoethmoidal recess
Innervation of the lateral nasal wall (Similar to the Nasal Suptum)
Olfactory nerve
Branches of trigeminal nerve
1. Anterior Ethmoidal from
ophthalmic (CN V1)
2. Infraorbital nerve from maxillary
(CN V2)
3. Posterior lateral nasal branches of
the maxillary nerve (CN V2)
Blood supply to the lateral nasal wall
Vascular plexus has a look of erectile
tissue
Branches of ophthalmic a.
1. Anterior ethmoid artery
2. Posterior Ethmoid artery
Branches of maxillary a.
1. Lateral Branches of
Sphenopalatine
2. Greater palatine artery first
supplies hard palate & then go
through incisive foramen and up
into nasal cavity to anastomose
PARANASAL SINUSES- these are considered diverticula (out pockets) of the nasal cavity.
There are four pair:
Function
1. Lighten Skull
2. Change Resonance of voice
**At birth are very small
**With age = increase in size
1. Frontal
 Use Frontonasal duct
Opens into middle meatus
 Opens on hiatus semilunaris
2. Maxillary
 Largest & in maxilla
Open into middle meatus
Opens on floor of hiatus semilunaris
3. Sphenoid
 In the body of the sphenoid bone
Just deep to pituitary fossa
Open into sphenoethmoidal recess (superior to Superior Ethmoidal Concha)
4. Ethmoid
Sometimes called the ethmoidal air cells
8-10 on each side
Grouped by position (Anterior, Middle, Posterior)
Anterior – opens on hiatus semilunaris
Middle – opens on surface of ethmoidal bulla
Posterior – opens into superior nasal meatus
Only the frontal sinus drains easily by
gravity. Maxillary sinus has to go up to
get into nasal cavity.
Innervation:
Branches of the trigeminal
Example = anterior ethmoidal Nerve
Innervates anterior & Middle
Clinical Implications:
When the mucous membranes inflame
they block off the openings to the ducts
that allow drainage
With age = Maxillary sinus can
impinge on maxillary molars
Abscess of one of the molars has access to the maxillary sinus
PALATE–is the structure, which separates the nasal cavity from the oral cavity.
The palate consists of a bony portion the HARD PALATE and the muscular portion the SOFT
PALATE. Both are covered by Oral Mucous Membrane or Mucoperiosteum.
Have fold or ridges = Rugae
Under the mucous membrane are
Palatine glands
1. Hard palate
Bones:
Features:
2. Soft palate-attaches anteriorly to the hard palate and blends laterally with the pharynx.
 There is a core of dense connective tissue in it = Palatine Aponeurosis
- Involved in attachment of muscles of soft palate
Help elevate the soft palate to close the Nasopharynx
Help depress soft palate (especially during initial mastication) = keep oropharynx closed
Muscles of the soft palate
1. Levator veli palatini
Origin: Auditory Tube
Insertion: Palatine aponeurosis
Action: Elevate soft palate
Innervation: CN X
2.Tensor veli palatini
Origin: Auditory tube
Insertion: palatine aponeurosis
Tendon travels around the hamulus of the medial
pterygoid plate
Action: Elevate the soft palate & Tenses the aponeurosis
Innervation: CN V3
3.Musculus uvulae
Origin: a boney spine on the hard palate
Insertion: Blends with other muscles of soft palate & Insert of palatine aponeurosis
Action: Final closure of the nasopharynx
Innervation: CN X
4.Palatoglossus
Origin: Palatine Aponeurosis
Insertion: lateral aspect of tongue
Action: Depress soft palate
Innervation: CN X
5.Palatopharyngeus
Origin: Palatine Aponeurosis
Insertion: Blend with muscles of pharyngeal wall
Action: Depress the soft palate & Hold elevate/open the pharynx
Innervation: CN X
Innervation to the palate
Branches of the maxillary nerve
1. Greater palatine
Runs in the Palatine Canal (Originates in the Ptergopalatine Fossa)
Exits canal & travels anteriorly to hard palate
- Supplies mucous membrane of hard palate
2. Lesser palatine
Runs in the Palatine Canal (Originates in the Ptergopalatine Fossa)
Exits canal & Travels posteriorly to the soft palate
- Supplies mucous membrane of soft palate
Blood supply to the palate
Branches of the maxillary artery
Descending Palatine Artery enters Pterygopalatine canal and divides into 2 arteries:
1. Greater palatine
Exits canal & travels anteriorly to hard palate
- Supplies mucous membrane of hard palate
2. Lesser palatine
Exits canal & Travels posteriorly to the soft palate
- Supplies mucous membrane of soft palate
Incisive foramen
 Greater Palatine artery goes through to nasal septum
 Nasopalatine nerve goes through to supply anterior hard palate
Pterygopalatine fossa
Dr. Bennett-Clarke
Definition: The PT fossa is a small pyramidal shape space located posterior and inferior to the
apex of the orbit.
It has three walls;
• The anterior wall is formed by the posterior aspect of the maxilla.
• The posterior wall is formed by the pterygoid process (Medial & Lateral Plates together)
of the sphenoid bone.
• The medial wall is formed by the vertical portion of the palatine bone.
 Palatine Bone = small & L-shaped
o Vertical plates of the palatine bones make up the medial wall
Lateral wall = open laterally to infratemporal fossa
Ptergomaxially fissure = opening to the fossa
Openings on the walls of the PT fossa: The PT fossa communicates with the orbit,
nasopharynx, nasal and oral cavities, middle cranial fossa and the infratemporal fossa.
1. Laterally the PT fossa is directly communicates with the infratemporal fossa through the
pterygomaxillary fissure. (There is no lateral wall to the fossa.)
2. On medial wall, the sphenopalatine foramen opens into the nasal cavity.
3. On the posterior wall there are three openings
• Pharyngeal canal leads to the nasopharynx. (most medial)
• Pterygoid canal near the center of the posterior wall
• Foramen rotundum opens into the middle cranial fossa
4. On most superior aspect of the anterior wall, the inferior orbital fissure leads to the
infraorbital canal on the floor of the orbit.
5. Inferiorly the PT fossa opens to the oral cavity via the greater palatine canal
The contents of the PT fossa include:
• The third portion of the maxillary artery and its branches,
• The maxillary nerve and its branches,
• The pterygopalatine ganglion and the nerve of the pterygoid canal.
Maxillary artery: The third or terminal portion of the maxillary artery enters the PT fossa via
the pterygomaxillary fissure and will end as the Sphenopalatine onto the nasal septum.
Branches:
• Posterior superior alveolar artery is the first branch of this portion of the artery. It exits
the fossa via the pterygomaxillary fissure and pierces the maxilla to supply the upper
teeth (Maxillary Molars).
• Descending palatine artery exits through the palatine canal divides into greater and
lesser palatine arteries to supply hard (Greater) and soft palate (Lesser).
• Artery of the pterygoid canal enters the pterygoid canal.
• Pharyngeal artery exits via the pharyngeal canal and ends in the nasopharynx.
• Infraorbital artery traverses the inferior orbital fissure and then enters the infraorbital
canal and supplies the face
 May give rise to an Anterior Superior Alveolar artery to supply maxillary gums
and teeth.
• Sphenopalatine artery, the terminal branch, enters the nasal cavity via the
sphenopalatine foramen and supplies the mucosa of the nasal cavity ending on the nasal
septum.
Maxillary nerve (CN V2): The second division of the trigeminal or fifth cranial nerve is called
the maxillary nerve. This division of the trigeminal nerve transmits only sensory information.
The maxillary nerve exits the PT fossa through the foramen rotundum.
Infraorbital – Travel in infraorbital canal and exits the infraorbital foramen to supply skin
(lower eyelid, lateral nose include vestibule, cheek, upper lip)
Anterior superior alveolar – To the teeth and gums
Middle superior alveolar – often not there
Posterior superior alveolar – To the teeth and gums
Nasopalatine – supplies the nasal septum
Greater palatine nerve – in the palatine canal exits the greater palatine foramen to supply the
hard palate
Lesser palatine nerve - in the palatine canal exits the lesser palatine foramen to supply the soft
palate
Pharyngeal – Small nerve that ends on the superior aspect of the nasopharynx
Zygomatic – Two branches
1. Zygomaticofacial  sensory for skin of respective areas
2. Zygomaticotemporal  sensory of skin of respective areas
Pterygopalatine ganglion: Located in the PT fossa suspended from the maxillary nerve by two
roots.
• Parasympathetic ganglion (location of postganglionic neurons)
• Receives parasympathetic preganglionic fibers from CN VII in the greater petrosal nerve
• Parasympathetic fibers in greater petrosal join sympathetic fibers from deep petrosal
nerve to form the nerve of pterygoid canal
The nerve of the pterygoid canal enters the posterior aspect of the PT fossa and ends in the
pterygopalatine ganglion.
Summary of information transmitted through the pterygopalatine fossa
Sensory information from the nasopharynx, nasal and oral cavities travel in the infraorbital,
nasopalatine, pharyngeal, greater and lesser palatine nerves. Afferent fibers in these nerves
enter the PT fossa. Many of these nerve fibers will pass through the pterygopalatine ganglion.
Since they are sensory fibers, they do not synapse in the ganglion..
Preganglionic parasympathetic fibers traveling in the nerve of the pterygoid canal enter the
posterior aspect of the PT fossa and course toward the pterygopalatine ganglion. These
preganglionic fibers synapse in the pterygopalatine ganglion and postganglionic
parasympathetic fibers are distributed from the ganglion along the branches of the maxillary
nerve.
Postganglionic sympathetic fibers traveling in the nerve of the pterygoid canal enter the
posterior aspect of the PT fossa and course toward the pterygopalatine ganglion. These
postganglionic sympathetic fibers pass through the ganglion without synapsing are distributed
from the ganglion along the branches of the maxillary nerve.