The external nose consists of bone and cartilage and is covered with soft tissue.
And has a slightly conical shape with a nasal root, a nasal tip, a bridge of the nose, a nasal wing, a front nasal opening, a nasal columella and the like. Skeletal support of external nose: it consists of nasal bone, frontal nasal process and maxillary frontal process.
The nasal bones are paired left and right, and the midline is connected. The nasal process of the frontal bone is connected on the upper side, and both sides are connected with the frontal process of the maxilla. The lower edge of nasal bone, the inner edge of maxillary frontal process and the free edge of maxillary palatal process form pear-shaped holes.
External nasal cartilage scaffold: it consists of nasal septum cartilage, lateral nasal cartilage and alar cartilage. Cartilage is connected by connective tissue.
The alar cartilage is left and right, and the bottom is horseshoe-shaped, each with inner and outer feet. The lateral foot forms the support of the alar, and the two medial feet clamp the anterior lower part of the nasal septum cartilage, forming the main support of the nasal columella.
The skin of nose tip, alar and nasal vestibule is thick, closely attached to subcutaneous tissue and perichondrium, and rich in sebaceous glands and sweat glands, which are the prone parts of acne, acne and rosacea. When boils are inflamed, there will be slight swelling and pain.
The external nasal vein flows into the internal and external jugular veins through the internal canthus vein and facial vein, and the internal canthus vein communicates with the superior ophthalmic vein and the inferior ophthalmic vein, and finally flows into the intracranial cavernous sinus. There is no valve in the facial vein, so blood can circulate up and down. If the furuncle on the nose or upper lip (called the danger triangle) is not handled properly or squeezed at will, it may cause the risk of serious intracranial complications such as cavernous sinus thrombophlebitis.
The nose structure of vertebrates is different, but it is generally composed of external nose, nasal cavity and sinus. The mucosal blood vessels in the lower part of the nasal cavity are rich, which can adjust the air temperature and humidity. Accessory sinuses are several bone cavities communicating with the nasal cavity, which can help regulate the temperature, humidity and timbre of the air. Some animals have nose hair in the front of the nasal cavity, which plays a role in filtering dust in the air. Liver cirrhosis has an external nostril and an olfactory sac, but it still receives nerves from a pair of olfactory lobes. Fish usually have external nostrils and paired olfactory sacs. The external nostril of cartilaginous fish is located on the ventral surface of snout, while teleost fish is located on the dorsal surface. Terrestrial vertebrates breathe air, and the olfactory organs communicate with the oral cavity, which leads to the appearance of internal nostrils. After the appearance of the inner nostril, the nasal cavity has both olfactory and respiratory functions. In amphibians, the inner nostril is open in front of the mouth, and the olfactory mucosa in the nasal cavity is flat, and part of it is transformed into vomeronasal organ, which is a taste receptor. Reptiles have a developed sense of smell, and the nasal cavity and olfactory mucosa are enlarged. The nasal cavity structure of birds is similar to that of reptiles. Mammals have a second jaw and the internal nostril moves back to the pharynx. Because the sense of smell is highly developed and the structure is complex, it is characterized by enlarged nasal cavity and turbinate bone. The turbinate is a thin bone block with complex coils, which is covered with olfactory mucosa covered with olfactory nerve, greatly increasing the olfactory surface area. The olfactory degeneration of aquatic species, such as whales and manatees; Some animals, such as dogs, have a keen sense of smell because their olfactory mucosa extends beyond the nasal cavity.
There are nasal mucosa in the nasal cavity, and there are abundant capillaries and mucus glands in the nasal cavity, which can secrete mucus. These structures can make the air inhaled into the nasal cavity warm and moist, and reduce the stimulation to the lungs. There are also olfactory cells stimulated by odor in the mucosa of upper nasal cavity. External nose refers to the part protruding from the face, which is supported by bones and cartilage and covers the skin. The external nose is shaped like a triangular pyramid, protruding from the center of the face and vulnerable to trauma. The upper end is narrow, and the uppermost part is located between the eyes, which is called nasal root.
The protruding part at the lower end is called the tip of the nose.
The central bulge is called the bridge of the nose, and the sides of the bridge of the nose are the back of the nose.
The protruding parts on both sides of the tip of the nose are called the alar.
The skin at the tip of nose and alar is thick, rich in sebaceous glands and sweat glands, closely connected with deep subcutaneous tissue and perichondrium, and prone to furuncle. Therefore, when inflammation occurs, local swelling compresses nerve endings, which can cause severe pain.
Nasal bone: paired left and right, connected with the midline, connected with the nose end of the frontal bone to form a nasal frontal suture, the outer edge connected with the frontal process of the left and right maxilla, the nasal bone crest connected with the middle plate of the ethmoid bone behind, and the lower edge connected with the lateral nasal cartilage with soft tissue. The upper part is narrow and the lower part is thick, and the lower part is wide and thin, which is easy to fracture due to trauma and saddle nose. Because of the rich blood vessels, the fracture is easy to heal after reduction.
Blood vessels: the veins of the external nose mainly flow into the internal and external jugular veins through the internal canthus vein and facial vein. Because the inner canthus vein communicates with the intracranial cavernous sinus through the upper and lower ophthalmic veins, and the facial vein has no valve, the blood can move up and down. If the nose or upper lip (called the dangerous triangle) suffers from furuncle, it is likely to cause thrombophlebitis in the cavernous sinus. Nasal cavity is a cavity between two lateral skulls, which is based on bony nasal cavity and cartilage, and its surface is lined with mucosa and skin. The nasal cavity is an irregular long and narrow cavity with a narrow upper part and a wide lower part, and the front and rear diameter is larger than the left and right sides. It begins in the anterior nostril and ends in the posterior nostril, leading to the nasopharynx. The nasal cavity is divided into left and right cavities by nasal septum, the front cavity communicates with the outside world through nostril, and the back cavity communicates with pharyngeal cavity through rear nostril. Each nasal cavity can be divided into nasal vestibule and inherent nasal cavity.
Nasal vestibule refers to the enlarged space surrounded by the alar, and its inner surface is lined with skin, which has the function of retaining and inhaling dust. In addition, the skin is tightly attached to the perichondrium, so when the furuncle is swollen, the pain is severe. The front of the nasal vestibule is equivalent to the inner corner of the tip of the nose, and there is a concave protruding outward, which is called the nasal vestibule recess, and it is often the place where boils and acne occur.
The proper nasal cavity refers to the part behind the nasal vestibule, and the inner wall is the nasal septum. The proper nasal cavity is connected with the pharynx through the retronasal foramen, and its shape is basically the same as that of the bony nasal cavity, and it is composed of bone and cartilage covering the mucosa. Each nasal cavity has four walls: upper, lower, inner and outer. The upper wall (roof) is relatively narrow, adjacent to the anterior cranial fossa, and consists of nasal bone, frontal bone, ethmoid plate and sphenoid bone. The ethmoid foramen of the sieve plate is penetrated by olfactory nerve, and the lower wall (bottom) is the top of the mouth and consists of hard palate. The medial wall is the nasal septum, which consists of bony nasal septum and nasal septum cartilage. The nasal septum is biased to one side, especially to the left.
There are abundant vascular convergence and anastomotic plexus in the mucosa of the anterior lower part of the nasal septum, which is called Lee's artery area or Kirschner needle vein plexus. About 90% of nosebleeds (nosebleeds) occur here, which is clinically called bleeding-prone area. The outer wall structure is complex, consisting of frontal process of nasal bone, lacrimal bone, ethmoid bone, vertical part of palatine bone and pterygoid process of sphenoid bone. 【 As shown in the figure 】 There are three protruding long bone fragments (turbinectomy) on the lateral wall of the nasal cavity, which are arranged in a stepped manner and slightly shell-shaped, and are called turbinates. The turbinates are called upper turbinate, middle turbinate and lower turbinate respectively from top to bottom, and the gaps below each turbinate are called upper nasal meatus, middle nasal meatus and lower nasal meatus respectively. The recess behind the superior turbinate is called sphenoid recess. The gap between turbinate and nasal septum is called common nasal meatus. After the middle turbinate is removed, a concave upward arc fissure can be seen in the middle of the middle nasal meatus, which is called semilunar fissure, and the round pillow-shaped protrusion above the fissure is called ethmoidal vesicle.
The middle and upper nasal meatus and sphenoid recess have sinus openings, and the lower nasal meatus has nasolacrimal duct openings.
Top wall: very narrow and dome-shaped, separated from the anterior cranial fossa only by the vertical plate of ethmoid bone. Sieve plate is thin and brittle, and it is easy to fracture after trauma, which is a dangerous area for nasal surgery.
Bottom wall: the nasal surface of the hard palate, separated from the mouth.
Normal nasal mucosa can be divided into olfactory part and respiratory part according to its nature. The olfactory mucosa covers the upper turbinate and the nasal septum opposite it, showing pale yellow or light yellow, containing olfactory cells, which can feel the stimulation of smell. The rest is covered with pink respiratory mucosa, which is rich in capillaries and mucus glands, and the epithelium has cilia, which can purify the air and improve the temperature and humidity of the inhaled air.
There are abundant microvilli on the surface of ciliated columnar cells in nasal breathing area, and there are abundant mucus glands, serous glands and goblet cells in submucosa, which can secrete a lot of mucus and serous fluid and play a role in regulating the humidity in the air. The area of mucosa in nasal breathing area is large, and its inherent upper, middle and lower turbinates and the corresponding three nasal passages also increase the contact area between mucosa and air, and submucosal capillaries are abundant. When cold air enters the nasal cavity, the turbinate and submucosal blood vessels of the nasal passage heat it up like a radiator. According to the test, the cold air at 0℃ enters the lungs through the nose and pharynx, and the temperature can rise to 36℃, which is basically close to the normal body temperature. It can be seen that the nasal cavity has obvious warming effect on cold air. Sinus is an air-containing cavity around nasal cavity and in skull and facial bones, also known as paranasal sinus. The paranasal sinuses are composed of bony paranasal sinuses lined with mucosa, which is continuous with the nasal mucosa through the opening of each sinus. Accessory sinuses play a role in pronunciation and can also help regulate the temperature and humidity of inhaled air. Because the mucosa of nasal cavity and sinus is continuous, nasal inflammation can cause sinusitis.
There are generally four pairs, namely maxillary sinus, ethmoid sinus, frontal sinus and sphenoid sinus.
The size and shape of sinuses are different, and there are often developmental variations. The mucosa in the paranasal sinuses is continuous with the mucosa in the nasal cavity, and each paranasal sinus has a sinus opening communicating with the nasal teeth. According to the anatomical position and the position of the ostium, the sinuses can be divided into two groups: the anterior group includes maxillary sinus, anterior ethmoid sinus and frontal sinus, which all lead to the middle nasal meatus. The posterior group of sinuses includes posterior ethmoid sinus and sphenoid sinus, the former leads to the superior nasal meatus and the latter to the sphenoid recess. Therefore, if pus is found in the middle nasal meatus during endoscopic examination, it is known that it is caused by sinusitis in the former group, and pus in the latter group accumulates in the olfactory cleft when the sinuses are inflamed. If the posterior nasal endoscope is used, pus can be found in the upper nasal passage or the posterior segment of olfactory cleft, which is of great significance for clinical differential diagnosis. Among the four pairs of paranasal sinuses, the maxillary sinus is the largest, located in the maxilla, and the upper wall is the suborbital wall, which is thin. Maxillary sinusitis or tumor often destroys bone and invades orbit. The lower wall is adjacent to maxillary molars and thin roots, so root infection often spreads to maxillary sinus; The anterior wall below the suborbital foramen is thin, which is where the maxillary sinus is cut during surgery. The medial wall is the lateral wall of the nasal cavity, adjacent to the middle and lower nasal passages. The bone in the anterior upper part of the inferior nasal meatus is thin, and maxillary sinus puncture is done here. The maxillary sinus is open behind the semilunar hiatus. Because of the high position of the opening, the maxillary sinus is not well drained when it is inflamed and suppurated, which is easy to cause pus accumulation in the sinus. The frontal sinus opens at the front end of the semilunar hiatus. The ethmoid sinus leads to the middle and upper nasal meatus. The sphenoid sinus leads to the recess of sphenoid ethmoid bone. Blood vessels and nerves of the nose and sinuses
(1) artery
The ophthalmic artery mainly from the internal carotid artery and the internal jaw artery from the external carotid artery have the following behaviors:
(1) infraorbital artery: via infraorbital foramen → anterior segment of nasal wall and maxillary sinus.
(2) The great palatal artery: the palatal foramen passes through the hard palate and enters the incisor canal → the anterior lower part of the nasal septum.
The anterior ethmoidal artery, the septal branch of the posterior ethmoidal artery, the superior labial artery, the great palatine artery and the nasopalatine artery form a rich arterial plexus in the anterior and inferior part of the nasal septum, which is the prone site of epistaxis.
(2) Veins
The vein in the lower part of the nasal cavity flows into the sphenopalatine vein, into the maxillary vein and finally into the external jugular vein. The anterior vein leads to the anterior vein, and the superior middle nasal vein leads to the ophthalmic vein along the anterior ethmoidal vein and the posterior ethmoidal vein, and finally flows into the cavernous sinus.
(3) Nerve
1, olfactory nerve is composed of olfactory cell nerve fibers in the mucosa of nasal olfactory region.
The sieve plate reaches the olfactory bulb, and the olfactory nerve is wrapped by the tubular sheath, which is connected with the dura mater, so the olfactory mucosa is damaged and infected, and bacteria can infect the skull through the olfactory nerve sheath, causing rhinogenic intracranial complications. 2. Sensory nerve mainly comes from the first branch (ophthalmic nerve) and the second branch (maxillary nerve) of trigeminal nerve. The anterior ethmoidal nerve is separated from the eye through the nasociliary nerve and distributed in the nasal septum and the front of the lateral wall of the nasal cavity. The maxillary nerve forms a sphenopalatine ganglion in pterygopalatine fossa, which separates the superior posterior nasal nerve from the inferior posterior nasal nerve. The former is distributed in the nasal cavity and sinuses above the middle turbinate, while the latter is distributed in the nasal cavity below the middle meatus. Maxillary nerve is also divided into posterior branch of superior alveolar nerve and infraorbital nerve. The former is distributed in maxillary sinus and alveolar fossa. The latter is distributed in nasal vestibule, nasal floor and anterior segment of inferior nasal meatus.
3. Vegetative nerves include sympathetic nerves and parasympathetic nerves.
(1) Sympathetic nerve fibers contract the blood vessels of nasal mucosa and reduce secretion. The deep petrosal nerve, pterygoid nerve and sphenopalatine ganglion from the sympathetic plexus of the internal carotid artery are distributed in the blood vessels and secretory glands of the nasal cavity.
(2) Parasympathetic nerve fibers dilate the blood vessels of nasal mucosa and increase secretion, from the greater superficial petrosal nerve and pterygoid nerve of facial nerve to sphenopalatine ganglion, and then the postganglionic fibers are distributed in the nasal cavity. The mucosa in the nasal olfactory region is mainly distributed in the medial surface of the upper turbinate and its corresponding nasal septum, and a small part can extend to the medial surface of the middle turbinate and its corresponding nasal septum. The olfactory mucosa consists of sensory cells, supporting cells and basal cells. Sensory cells receive olfactory stimulation, and their synapses converge to synthesize olfactory nerve fibers, which reach the olfactory center through olfactory bulb. Secretions of olfactory glands contained in lamina propria can dissolve odorous particles that reach the olfactory region, stimulate olfactory hairs to produce impulses, and introduce them into the olfactory region of the brain to produce sense of smell. Such as olfactory sulcus obstruction, olfactory mucosa atrophy, anterior cranial fossa fracture or pathological changes involving olfactory pathway, can all lead to olfactory loss or loss.
Some children often have bleeding noses and always like to pinch their noses. It seems that their noses are always uncomfortable. They went to the hospital for examination, and the doctor said it didn't matter. Don't pinch your nose often, which may lead to nosebleeds. Of course, there will be a bloody scab in the nose after a nosebleed. If you don't feel uncomfortable, you can use paraffin oil to soften your nose. It doesn't matter if the child has a nosebleed and there is no substantive situation. Usually, be careful not to be picky about food and take vitamin K4. He will be fine when he grows up.
The nose is the initial part of the respiratory tract and the olfactory organ, which can be divided into three parts: the external nose, the nasal cavity and the paranasal sinuses.
The external nose is located in the center of the face. The upper end is narrow and protrudes between the two orbits, which is called nasal root. It extends down to the back of the nose and ends at the tip of the nose, and both sides of the tip of the nose expand to the alar. Under the condition of calm breathing, there is no obvious movement of the nasal alar, and patients with dyspnea can have obvious flapping of the nasal alar, which is a clinicopathological sign. There are two upper nostrils under the external nose, and the two holes are separated by the nasal septum.
Nasal cavity is an irregular cavity surrounded by bone and cartilage, and its inner surface is covered with mucosa and skin. The nasal cavity is divided into two cavities by the nasal septum, which communicate with the outside world through the nostril forward and communicate with the pharyngeal cavity through the posterior nostril backward. Each nasal cavity is divided into two parts: the anterior nasal vestibule and the posterior nasal cavity.
The nasal vestibule is a cavity surrounded by the alar, and its inner surface is lined with skin and thick nose hair, which has the function of filtering dust. Due to the lack of subcutaneous tissue, the pain is more severe when boils appear.
Inherent nasal cavity is the main part of nasal cavity, which is often called nasal cavity in clinic. It consists of a bony nasal cavity covering the mucosa. Upper turbinate, middle turbinate and lower turbinate can be seen on its lateral wall, and upper nasal meatus, middle nasal meatus and lower nasal meatus are formed under each turbinate respectively. The medial wall of the nasal cavity is the nasal septum, which consists of the bony nasal septum and the nasal septum cartilage covering the mucosa.
The mucosa of the proper nasal cavity can be divided into olfactory part and respiratory part. The olfactory part is located in the upper turbinate and the nasal septum opposite to the upper turbinate Mucosa contains olfactory cells, which can feel olfactory stimulation; The respiratory part is the part other than the olfactory part, which is rich in blood vessels, mucus glands and cilia, and can adjust the temperature and humidity of inhaled air; And purify the bacteria and dust in it.
Paranasal sinus paranasal sinus, also known as paranasal sinus, is composed of bony paranasal sinus lined with mucosa. There are 4 pairs of paranasal sinuses, all leading to the nasal cavity. Among them, the anterior and middle cavities of maxillary sinus, frontal sinus and ethmoid sinus are open to the middle nasal meatus; The posterior chamber of ethmoid sinus is open to the superior nasal meatus; The sphenoid sinus is open at the back and upper part of the superior turbinate. Because the mucosa of paranasal sinuses and nasal mucosa are continuous, when the nasal cavity is inflamed, it can spread to paranasal sinuses, causing paranasal sinusitis. The opening of the maxillary sinus is higher than the sinus floor, so when the maxillary sinus is inflamed and suppurated, it is often caused by poor drainage. Sinus can adjust the temperature and humidity of inhaled air and play the role of pronunciation.
The name of human anatomy. Same as the anatomical organ of the same name. As one of the five senses. Also known as Tang Ming, Tiancong, Xuanmen, Yuanmen and Lu Shen. The nose bulges in the center of the face, with a name added at the upper end. There is a nostril at the top of the front and lower bulges, a nose column from nostril to nostril, a nostril in the front lower hole, nose hair in the hole, and a nasal tunnel in the depth of the nostril. "Su Wenjin is in a tight array": "The west is white, entering the lungs and opening the nose." "Lingshu Pulse Degree": "The lung qi passes through the nose, and the smell can be known from the lung and nose."