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Anatomy

The Nasal Mucosa

  • Mucosa lines the entire nasal cavities except for the vestibule of the nose.
  • The nasal mucosa is firmly bound to the periosteum and perichondrium of the supporting structures of the nose.
  • It is continuous with the adjoining cavities to which the nasal cavity communicates (e.g., the nasopharynx and paranasal sinuses).
  • The inferior 2/3 of the nasal mucosa is called the respiratory area and air passing over this is warmed and moistened before it passes into the lungs.
  • The superior 1/3 is called the olfactory area.

The Olfactory Area of Nasal Mucosa

  • This area contains the peripheral organ of smell.
  • Sniffing draws air into this area
  • Olfactory receptor cells (from the olfactory nerve, CN I, are located in the mucosa of this area in the nose.

Nerves to the Respiratory Area of Nasal Mucosa

  • The inferior 2/3 of the nasal mucosa are supplied chiefly by the trigeminal nerve (CN V).
  • The mucous membrane of the nasal septum is supplied chiefly by the nasopalatine nerve, a branch of the maxillary nerve (CN V2).
  • Its anterior portion is supplied by the anterior ethmoidal nerve (a branch of the nasociliary nerve) which is derived from the ophthalmic nerve (CN V1).
  • The lateral walls of the nasal cavity are supplied by branches of the maxillary nerve (CN V2); the greater palatine nerve, and the anterior ethmoidal nerve.

Arteries of the Nasal Mucosa

  • The blood supply of the mucosa of the nasal septum is derived mainly from the maxillary artery.
  • The sphenopalatine artery, a branch of the maxillary, supplies most of the blood of the nasal mucosa.
  • It enters by the sphenopalatine foramen and sends branches to the posterior regions of the lateral wall and to the nasal septum.
  • The greater palatine artery, also a branch of the maxillary, passes through the incisive foramen to supply the nasal septum.
  • The anterior and posterior ethmoidal arteries, branches of the ophthalmic artery, supply the anterosuperior part of the mucosa of the lateral wall of the nasal cavity and nasal septum.
  • Three branches of the facial artery (superior labial, ascending palatine, and lateral nasal) also supply the anterior parts of the nasal mucosa.

Veins of the Nasal Mucosa

  • The veins of the nasal mucosa form a venous network of plexus in the connective tissue of the nasal mucosa.
  • Some of the veins open into the sphenopalatine vein and drain to the pterygoid plexus.
  • Others join the facial and infraorbital veins.
  • Some empty into the ophthalmic veins and drain into the cavernous sinus.

The Sublingual Glands

  • These are the smallest of the three paired salivary glands and the most deeply situated.
  • They are almond-shaped and lie in the floor of the mouth between the mandible and the genioglossus muscle.
  • The paired glands unite to form a horseshoe-shaped glandular mass around the lingual frenulum.
  • Numerous small ducts (10 to 12) open into the floor of the mouth.
  • Sometimes one of the ducts opens into the submandibular duct.
  • The nerves the accompany the submandibular and sublingual glands are derived from the lingual and chorda tympani nerves and from the sympathetic nerves.
  • The parasympathetic secretomotor fibres are from the submandibular ganglion.

Genioglossus Muscle

  • Origin: Mental spine of the mandible.
  • Insertion: Dorsum of the tongue and hyoid bone.
  • Nerve Supply: Hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual and submental arteries.
  • Action: Depresses and protrudes the tongue.

The Lips

  • These are mobile muscular folds that surround the mouth, the entrance of the oral cavity.
  • The lips (L. labia) are covered externally by skin and internally by mucous membrane.
  • In between these are layers of muscles, especially the orbicularis oris muscle.
  • The upper and lower lips are attached to the gingivae in the median plane by raised folds of mucous membrane, called the labial frenula.

Sensory Nerves of the Lips

  • The sensory nerves of the upper and lower lips are from the infraorbital and mental nerves, which are branches of the maxillary (CN V2) and mandibular (CN V3) nerves.

  • This is the second cranial nerve (CN II) and is the nerve of sight.

Stylohyoid Muscle

  • Origin: Posterior border of the styloid process of the temporal bone.
  • Insertion: Body of the hyoid bone at the junction with the greater horn.
  • Nerve Supply: Facial nerve (CN VII).
  • Arterial Supply: Muscular branches of the facial artery and muscular branches of the occipital artery.
  • Action: Elevates the hyoid bone and base of the tongue.

Muscles Around the Eyelids

  • The function of the eyelid (L. palpebrae) is to protect the eye from injury and excessive light. It also keeps the cornea moist.

The Orbicularis Oculi Muscle

  • This is the sphincter muscle of the eye.
  • Its fibres sweep in concentric circles around the orbital margin and eyelids.
  • It narrows the eye and helps the flow of tears from the lacrimal sac.
  • This muscle has 3 parts: (1) a thick orbital part for closing the eyes to protect then from light and dust; (2) a thin palpebral part for closing the eyelids lightly to keep the cornea from drying; and (3) a lacrimal part for drawing the eyelids and lacrimal punta medially.
  • When all three parts of the orbicularis oculi contract, the eyes are firmly closed and the adjacent skin becomes wrinkled.
  • The zygomatic branch of the facial nerve (CN VII) supplies it.

The Levator Palpebrae Superioris Muscle

  • This muscle raises the upper eyelid to open the palpebral fissure.
  • It is supplied by the oculomotor nerve (CN III).

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