W2-7 Ear and Nose Lecture

Anatomy HNSS Ear and Nose

- The auricle (L. auris, ear) is composed of an irregularly shaped plate of

elastic cartilage that is covered by thin skin.
- The arterial supply to the auricle is derived mainly from the posterior
auricular and superficial temporal arteries.
- The main nerves to the skin of the auricle are the great auricular and
auriculotemporal nerves.
- The great auricular nerve supplies the cranial (medial) surface
(commonly called the “back of the ear”) and the posterior part (helix,
antihelix, and lobule) of the lateral surface (“front”).
- The auriculo temporal nerve, a branch of CN V3, supplies the skin of
the auricle anterior to the external acoustic meatus
The petrous part of the temporal bone is where the auditory vestibular
apparatus is located.
- The structures from external ear to the cochlear nerve in the

inner ear – the anatomic pathway of sound.
The ear—the organ of hearing and equilibrium (balance)—is divided into

the external, middle, and internal ear.
The external ear and middle ear are mainly concerned with the transfer of
sound to the internal ear, which contains the organ for equilibrium as well
as for hearing.
- The external acoustic meatus is an ear canal that leads inward through
the tympanic part of the temporal bone from the auricle to the tympanic
membrane, a distance of 2–3 cm in adults.
- The lateral third of this slightly S-shaped canal is cartilaginous and is
lined with skin that is continuous with the auricular skin.
- The medial two thirds of the meatus is bony and lined with thin skin
that is continuous with the external layer of the tympanic membrane.
- The ceruminous and sebaceous glands in the subcutaneous tissue of
the cartilaginous part of the meatus produce cerumen (earwax).
-The tympanic membrane, approximately 1 cm in diameter, is a thin, oval

semitransparent membrane at the medial end of the external acoustic
meatus.
-This membrane forms a partition between the external acoustic meatus
and the tympanic cavity of the middle ear.
The middle ear is shaped like a lozenge or narrow box with concave sides.
It has six walls:
1. Roof : Formed by a thin plate of bone, the tegmen tympani, which
separates the tympanic cavity from the dura mater on the floor of the
middle cranial fossa.
2. Floor. The jugular wall (floor) is formed by a layer of bone that
separates the tympanic cavity from the superior bulb of the internal
jugular vein.
3. The membranous (lateral) wall is formed almost entirely by the
peaked convexity of the tympanic membrane; superiorly it is formed
by the lateral bony wall of the epitympanic recess. The handle of the
malleus is attached to the tympanic membrane, and its head extends
into the epitympanic recess.
4. The labyrinthine (medial) wall (medial wall) separates the tympanic
cavity from the internal ear. It also features the promontory of the
labyrinthine wall, formed by the initial part (basal turn) of the
cochlea, and the oval and round windows, which, in a dry cranium,
communicate with the internal ear.

5. The mastoid wall 6. The anterior carotid wall
The bony labyrinth is a series of cavities (cochlea, vestibule, and

semicircular canals) contained within the otic capsule of the petrous part
of the temporal bone.
- The membranous labyrinth consists of a series of communicating sacs

and ducts that are suspended in the bony labyrinth.
- The labyrinth contains endolymph, a watery fluid similar in
composition to intracellular fluid.
- The nose is the part of the respiratory tract superior to the hard palate;
it contains the organ of smell.
- It includes the external nose and nasal cavities, which are divided into
right and left cavities by the nasal septum.
- Each nasal cavity is divisible into an olfactory area and a
respiratory area.
• Nose size variations due to differences in nasal cartilages.

• Skin is thin & contains many sebaceous glands.
- The bony part: • Nasal bones • Frontal processes of the maxillae • Nasal part of
the frontal bone and its nasal spine • Bony part of the nasal septum
- The cartilaginous part : 5 main cartilages: two lateral cartilages, two alar
cartilages, and a septal cartilage.
- The U-shaped alar cartilages are free and movable; they dilate or constrict the nares
when the muscles acting on the nose contract.
- Coronal section showing the superior, middle, and inferior nasal

conchae and the corresponding meatuses.
- The nasal conchae (L. shells) divide the nasal cavity into four air
passages: spheno-ethmoidal recess, superior nasal meatus, middle
nasal meatus, and inferior nasal meatus.
Features and openings of lateral wall of nose. Parts of the conchae have
been removed to show the openings of sinuses and other structures.
The boundaries of the nasal cavity:

• The roof of the nasal cavity is curved and narrow, except at the posterior
end.
• The floor of the nasal cavity is wider than the roof and is formed by the
hard palate.
• The medial wall of the nasal cavity is formed by the nasal septum, the
main components of which are the perpendicular plate of the ethmoid,
vomer, septal cartilage, and the nasal crests of the maxillary and palatine
bones.
• The lateral wall of the nasal cavity is uneven because of the nasal
conchae (superior, middle, and inferior), three elevations that project
inferiorly like scrolls. The conchae curve inferomedially, each forming a
roof and partial medial wall for a meatus, or recess.
- The arterial supply of the medial and lateral walls of the nasal cavity
is from branches of the sphenopalatine artery, anterior and posterior
ethmoidal arteries, greater palatine artery, superior labial artery,
and the lateral nasal branches of the facial artery.
- On the anterior part of the nasal septum is an area rich in capillaries
(Kiesselbach area) where all five arteries supplying the septum
anastomose. This area is often where profuse bleeding( epistaxis)
from the nose occurs.
- A rich plexus of veins drains deep to the nasal mucosa into the
sphenopalatine, facial, and ophthalmic veins.
- The nerve supply of the postero-inferior half to two thirds of the

nasal mucosa is chiefly from CN V2(maxillary) by way of the
nasopalatine nerve to the nasal septum and posterior lateral nasal
branches of the greater palatine nerve to the lateral wall.
- The anterosuperior part of the nasal mucosa (both the septum and
lateral wall) is supplied by the anterior ethmoidal nerves, branches of
CN V1(ophthalmic).
- The paranasal sinuses are air-filled cavities that communicate with the
nasal cavities
- The arterial supply of the maxillary sinus is mainly from superior

alveolar branches of the maxillary artery;
however, branches of the greater palatine artery supply the floor of the
sinus.
- Innervation of the maxillary sinus mucosa is from the anterior, middle,
and posterior superior alveolar nerves , branches of CN V2.

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Anatomy HNSS Ear and Nose

Anatomy HNSS Ear and Nose

- The auricle (L. auris, ear) is composed of an irregularly shaped plate of

- The structures from external ear to the cochlear nerve in the

The ear—the organ of hearing and equilibrium (balance)—is divided into

-The tympanic membrane, approximately 1 cm in diameter, is a thin, oval

communicate with the internal ear.

The bony labyrinth is a series of cavities (cochlea, vestibule, and

- The membranous labyrinth consists of a series of communicating sacs

• Nose size variations due to differences in nasal cartilages.

- Coronal section showing the superior, middle, and inferior nasal

The boundaries of the nasal cavity:

- The nerve supply of the postero-inferior half to two thirds of the

- The arterial supply of the maxillary sinus is mainly from superior

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