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Anatomy of the Nose

Introduction to Nasal Anatomy

• The video introduces the anatomy of the nose, emphasizing its importance and indicating that it will focus on the external structure rather than internal components.

• Future videos will cover internal nasal structures, including nasal cavities. Viewers are encouraged to familiarize themselves with facial bones for a comprehensive understanding.

External Structure of the Nose

• The nose is described as a prominent organ on the face, consisting of both bony and cartilaginous components.

• Its shape is characterized as pyramidal, featuring three faces and three edges, along with a base and an upper root (or vertex).

Faces and Edges of the Nose

• The pyramid has two lateral faces that are triangular and oblique, which separate as they extend posteriorly towards the face.

• There is some variation in terminology regarding the upper part; some texts refer to it as "root" while others call it "vertex."

Detailed Description of Lateral Faces

• The lateral faces incline towards each other at their posterior ends, creating a separation that becomes more pronounced further back.

• The posterior face connects to the facial structure; different authors may define its boundaries differently based on surrounding bones.

Borders of the Nose

• There are three borders: two lateral borders where lateral faces meet the posterior face. These borders are marked by various grooves.

• Notable grooves include:

• Surco palpebral: Located between the nose and eyelid.

• Surco nasogeniano: Prominent in aesthetic medicine for cosmetic procedures.

Anatomy of the Nose: Key Features and Structures

Overview of Nasal Anatomy

• The anterior border of the nose is defined by the most forward part, known as the dorsum of the nose, which connects both lateral sides.

• The tip or apex of the nose, referred to anatomically as the lobe, extends from this dorsum to its root at the top.

• The lower portion of the nose is quite mobile compared to its upper section, which is firmly attached to facial bones.

Types and Shapes of Noses

• Various shapes exist for nasal dorsums; they can be straight (rectilinear), concave (mangada), or convex (aguileña).

• The root of the nose lies in the inter-ciliary space and appears concave when viewed vertically but convex laterally.

• A straight nasal bridge that aligns with forehead contours is termed a "Greek nose," reminiscent of ancient sculptures.

Base and Openings of the Nose

• The base typically appears flat but can also tilt upwards or downwards, influencing overall nasal shape.

• The inferior nasal openings (nostrils/narinas) vary in shape across different ethnicities; for example, they are elliptical in Caucasians and Afro-descendants.

Skeletal Structure of the Nose

• The bony structure consists primarily of nasal bones and contributions from frontal bones and maxillae.

• Each side features two nasal bones that form part of this skeletal framework alongside other facial bones like maxillae.

Cartilaginous Components

• The cartilaginous structure includes a central cartilage known as septal cartilage that divides nostrils.

Anatomy of the Nasal Structure

Overview of Nasal Cartilages and Bones

• The superior border connects to the perpendicular plate of the ethmoid bone, while the inferior border attaches to the maxilla at the palatine position, linking it to the Böhmer bone.

• The anterior superior border connects with nasal cartilage, protruding at the bridge of the nose.

• The anterior-inferior border joins with nasal cartilages at a specific level, creating a space for an extension of cartilage known as the posterior process of the nasal septum.

Lateral Cartilages and Their Functions

• Two triangular lateral cartilages connect to both nasal bones and ascend from the maxilla; they play a significant role in shaping the nose.

• Alar cartilages (major alar cartilages) are concave backward or convex forward, forming a U-shape supported by two pillars: an external/lateral pillar and an internal/medial pillar.

Accessory Cartilages and Fibrous Tissue

• Accessory cartilages can vary in number (1 to 4), often referred to as minor alar cartilages located in lower lateral areas.

• Sesamoid cartilages exist between lateral and major alar cartilages; their presence is variable, hence termed accessory.

Functions of Nasal Structures

• Fibrous tissue fills inter-cartilage spaces, closely associated with periosteum; this tissue contributes significantly to structural integrity.

• The primary functions of the nose include olfaction (smell), air conduction/filtering/humidifying/warming for lung usability, self-cleaning through cilia that remove debris.

Musculature Surrounding Nasal Anatomy

• Four main muscles contribute to facial expression around the nose:

• Piriformis (also called procerus)

• Transverse muscle of the nose (dorsalis nasi)

• Multiforme muscle located inferiorly

• Dilator naris muscle affecting nostril shape

Vascular Supply and Venous Drainage

Arterial Supply and Innervation of the Nose

Overview of Nasal Arteries

• The dorsal nasal artery originates from the internal maxillary artery, contributing to the blood supply of the nose.

• The infraorbital artery, a branch of the external carotid artery, emerges through the infraorbital foramen and supplies parts of the nasal structure.

• The anterior ethmoidal artery branches off from the ophthalmic artery, giving rise to both anterior septal and lateral nasal arteries that supply the lateral walls of the nose.

Detailed Anatomy and Blood Flow

• The anterior lateral nasal artery runs between the nasal bone and cartilage, providing essential vascular support to these structures.

• The facial artery contributes to supplying blood via its lateral nasal branches, which enter through the nostrils.

Key Vascular Connections

• The external nasal branch arises from the anterior lateral nasal artery, traveling between bone and cartilage in a critical area for vascularization.

• Main arterial sources for nasal irrigation include facial arteries, ophthalmic arteries, and internal maxillary arteries; these are crucial for maintaining healthy tissue in this region.

Innervation of Nasal Structures

• Motor innervation for facial expression muscles is provided by the facial nerve; this includes muscles associated with nose movement as part of mimetic functions.