Lateral Wall Of Nose

ANATOMY:
  • Irregular due to pressence of 3 conchae
  • Seperates the nose from:
  1. Above orbit
  2. Below maxillary sinus
  3. Front Lacrimal groove & naolacrimal canal
  • Subdivided into:
  1. Vestibule small depressed area in ant. 
  2. Atrium of middle meatus in middle
  3. Posterior contains conchae
  • Bony part:
  1. Nasal
  2. Frontal process of maxilla
  3. Lacrimal
  4. Labryinth of ethmoid with superior & middle conchhae
  5. Inferior conchae
  6. Palatine bone (perpendicular plate, Orbital & sphenoidal process)
  7. Medial pterygoid Plate
  • Cartilagenous part:
  1. Superior nasal 
  2. Inferior nasal
  3. 3 to 4 from ala
CONCHAE:
  • Curved paired bony projection directed downward & medially:
  1. Inferior conchae:Independant bone
  2. Middle conchae:projects from medial surface of ethmoidal labyrinth
  3. Superior conhae(smallest): projects from medial surface of ethmoidal labyrinth
MEATUS:
  • Passage beneath overlying conchae
  • Communicates with nasal cavity proper
  1. Inferior meatus(largest): Under inferior conchae
  2. Give opening to nasolacrimal duct (at junction of ant.1/3 & post. 2/3)guarded by hasner's valve or lacrimal fold.
  3. 2. Middle meatus:Under middle conchae.
Structures present in it:
  1. Ethmoidal bulla: round elevation produced by underlying ethmoidal sinus. Gives opening to middle ethmoidal air sinus.
  2. Hiatus semilunaris: semicircular sulcus below bulla. Gives opening to 
  3. Ant.: frontal air sinus
  4. Post. maxillary sinus(2 openings)
  5. Anterior ethmoidal sinus
  • c. Infundibulum: Passage at ant. end of hiatus 
  1. Superior meatus(shortest & shallowest): under superior conchae.
  2. Recives opening of posterior ethmoidal air sinus
  3. Triangular Fossa above superior conchae that recieves opening of sphenoidal air sinus
BLOOD SUPPLY:
  • ARTERIAL SUPPLY:
  1. Anterosuperior: Anterior ethmoidal , posterior ethmoidal & facial arteries
  2. Anteroinferior: Facial & greater palatine
  3. Posterosuperior: Sphenopalatine
  4. Posteroinferior: Greater palatine
VENOUS DRAINAGE:
  • Forms a venous plexus that drains
  • Ant. Facial vein
  • Post. Pharyngeal plexus of vein
  • Middle: Pterygoid plexus of vein
NERVE SUPPLY:
  • General sensory:
  • Anterosuperior: Anterior ethmoidal of opthalmic nerve
  • Anteroinferior: Anterior superior alveolar of maxillary nerve
  • Posterosuperior: Posterior superior lateral nasal from pterygopalatine gangalion
  • Posteroinferior:Ant. or greater palatine from pterygopalatine ganglion
  • Special sensory:
  • Olfactory from upper part below cribriform plate of ethmoid to superior concha
LYMPHATIC DRAINAGE:
  • Anterior half: Submandibular nodes
  • Posterior half: Retropharyngeal & upper deep cervical nodes

Exam Question
  • Hiatus semilunaris gives opening to maxillary sinus, Anterior ethmoidal sinus& frontal sinus
  • Maxillary, ethmoidal & frontal sinus drains into middle meatus.
  • Maxillary sinus opens into middle meatus at the level of hiatus semilunaris.
  • Posterior ethmoidal sinus drains into superior meatus.
  • Inferior conchae is a paired bone
  • Opening of the nasolacrimal duct is inferior meatus 
  • Frontal sinus drain into middle meatus
  • Hiatus semilunaris is present in middle meatus of lateral wall of nose
  • Bulla ethmoidalis is seen in middle meatus of lateral wall of nose
  • Sphenoidal sinus opens into sphenoethmoidal recess

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