PNS Anatomy
Transcript of PNS Anatomy
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7 bones4 paired sinuses4 turbinates3 meatiDrainage systemNervous supplyVascular supplyRelated structures
Sinus Anatomy Overview
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MaxilloturbinalEthmoturbinal Middle turbinate Superior turbinate Supreme turbinate
Agger nasiUncinate processEthmoid infundibulumSinuses Maxillary Ethmoid
Embryology
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SinusDevelopment
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EthmoidMaxillaPalatineLacrimalPterygoid plate of
SphenoidNasal Inferior Turbinate
Bony Structure
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Arterial Supply
External Carotid Maxillary A. SphenopalatineInternal Carotid Ophthalmic A. Ant. Ethmoid Post. Ethmoid Supraorbital Supratrochlear
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Innervation
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Neurovascular Supply
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Sinus Drainage Schema
Ethmoid Sinus
Development Present at birth Anterior/Posterior Variability
Structure Volume/shape Roof Lateral wall
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Ethmoid Roof
•Anterior 2/3•Posterior 1/3
Keros IKeros IIKeros III
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Ethmoid Cells
Supraorbital, Frontal Bulla, Concha Bullosa, Haller’s, Onodi Cells
Ethmoid Sinus—Related Structures Basal Lamella of the Middle Turbinate
Three planes Agger nasi cell
Childhood sinus Ethmoid Bulla
Hiatus Semiluninaris/Superior Hiatus Semilunaris Suprabullar/retrobullar recesses (Sinus Lateralis)
Ethmoid Infundibulum/Uncinate Process Anterior/Posterior Ethmoid Arteries Osteomeatal complex
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Basal/GroundLamella
Basal/Ground LamellaOf the Middle Turbinate
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The Agger Nasi Cell
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Ethmoid BullaUncinate Process
Hiatus Semilunaris
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Ethmoid Infundibulum
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Suprabullar/Retrobullar Recess
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Ethmoid Arteries
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Osteomeatal Complex Middle meatus Maxillary Sinus Ostium Anterior Ethmoid Drainage
Maxillary Sinus
Development Present at birth Biphasic growth Level of the floor
Structure Volume & shape Walls, floor, roof
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Maxillary Sinus
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Maxillary Sinus
Maxillary Sinus
Related Structures Fontanelles Natural ostium
Haller’s Cells &Sinusitis Osteomeatal complex
Accessory Ostium Nasolacrimal duct
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Fontanelles
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Natural Ostium -Haller’s cellsAccessory Ostium
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Nasolacrimal Duct
Frontal Sinus
Development Frontal bone at birth Age 5
Structure Volume and shape Ostium Walls
Anterior vs. posterior
Related Structures Frontal recess
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Frontal SinusOstiumFrontal recess Boundaries
Dumbbell shape
Sinus LateralisFrontal Bulla
Sphenoidal Sinus
DevelopmentArise within the nasal capsule (no pouch)Age 3 begins to pneumatize
Structure Volume/variable pneumatization Wall thickness Position within the sphenoid
Relation to sella turcica Sellar and postsellar relationships
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Sphenoid Sinus Pneumatization
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Sphenoid Sinus
Sphenoid Sinus
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Sphenoid Sinus
Sphenoid Sinus
Ostium Size (.5-4mm) Location (sinus floor, anterior nasal floor,
anterior sinus wall, superior turbinate, cribiform plate)
Bony dehiscence
Related Structures Sphenoethmoidal recess Sphenoid rostrum Onodi cell
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Sphenoid OstiumSphenoethmoid RecessSphenoid Rostrum
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The Onodi Cell
Microscopic Anatomy
Mucosa Cilliated columnar epithelial cells
Anatomy Beat frequency Inhibitory effects of contact
Noncilliated columnar cells Distribution Function
Basal cells
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Microscopic Anatomy—Cont’d
Goblet Cells Glycoproteins—viscosity and elasticity Innervation (para=thick, symp=thin)
Basement membrane Submucosal glands
Distribution
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Microscopic Anatomy
Mucous Blanket
Two layers Superficial layer Sol layer
Function Superficial layer traps bacteria and
particulate matter. Enzymes, antibodies, immune cells
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Mucociliary Transport
Directional Flow of Mucous Toward the choanae
Ostium drainage—a stubborn beast Hilding, MD
Contact inhibition Haller’s cells Surgery
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Mucociliary Transport
Function of Paranasal Sinuses
Humidifying and warming inspired air Regulation of intranasal pressure Increasing surface area for olfaction Lightening the skull Resonance Absorbing shock Contribute to facial growth
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