上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件 rhinology

RhinologyNasaldissectionandphysiology

RhinologyNasaldissectionand1dissection鼻（Nose)ExternalnoseNasalcavityNasalsinusesdissection鼻（Nose)2Dissection

—externalnoseShapeofexternalnose：pyramidNasalrootNasalapexNasalbridgeNasaldorsumAlaenasiBasisnasi—anteriornares，columellanasi，nasolabialfoldDissection—externalnoseShape3Dissection

—externalnose

nosestretcher：bone—prefrontalbonenasalboneascendingprocessesofthemaxillaepalatineprocess

PyriformapertureDissection—externalnosenose4nosestretcher：cartilage—lateralnasalcartilagegreateralarcartilagenosestretcher：cartilage—late5Dissection

—externalnoseThevenousdrainageoftheexternalnoseTheseveinsmainlydraintointernalcarotidveinviaangularveinandfacialvein，butangularveincommunicatetocavernoussinusviathetheophthalmicveins。facialvein----novalve。dangertriangleoffaceDissection—externalnoseThev6Dissection

—nasalcavityNasalvestibulenasalcavity

Dissection—nasalcavityNasal7鼻前庭：位于鼻腔最前部，由皮膚復(fù)蓋，富有皮脂腺和汗腺，并長(zhǎng)有鼻毛。固有鼻腔：通稱鼻腔，有內(nèi)、外、頂、底四壁。

鼻的應(yīng)用解剖—鼻腔鼻前庭：位于鼻腔最前部，由皮膚復(fù)蓋，富有皮脂腺和汗腺，并長(zhǎng)8Dissection

nasalcavitynostril、choanaeinternal、external、top、bottomDissectionnasalcavity9Nasalcavitytop:

anterior:prefrontalbonenasalboneposterior:anteriorwallofsphenoidsinusintermediate:cribriformplatebottom:1.palatineprocessofmaxilla2.horizontalprocessofpalateboneNasalcavitytop:10Dissectionmedialwallofnasalcavity

Nasalseptum：cartilageofnasalseptum,laminaplateofethmoidboneandvomer。Nosebleedarea：thebranchesofarteriesaggregateinintramembraneofnasalseptum,easytobleeding,sonamedLittlearea.Dissectionmedialwallofnasal11

Lateralwallofnasalcavity

Threeturbinatesdisposelikeladder(superior,middle,inferiorturbinate)superior,middle,inferiormeatus

Lateralwallofnasalcavity12LateralwallofnasalcavityInferiorturbinateandinferiormeatus:middleturbinateandmiddlemeatus:Lamellaofmiddleturbinate(devideethmoidsinustoanteriorpartandposteriorpart)Thegapbetweenthenasalseptumandfreemarginofturbinate,namedmeatusofnoseLateralwallofnasalcavityIn13LateralnasalpassageFrontalsinusdraintoanteriorsuperiorpartofethmoidalinfundibulumvianasofrontalduct,seconddrainageisanteriorpartofethmoidsinus，lastopenismaxillarysinus.uncinateprocess，ethmoidbulla，semilunarhiatus，ethmoidalinfundibulumLateralnasalpassageFrontals14Dissection

Ostiomeatalcomplex,OMC：middleturbinateandmiddlemeatus，andotheranatomicalstructure,

anatomybasisofFunctionalEndoscopicSinusSurgery,FESS.DissectionOstiomeatalcomplex15Dissectionartery：externalcarotidartery——MaxillaryArtery——Inferiorpartofnasalcavityinternalcarotidartery——ophthalmicartery——anteriorethmoidartery/posteriorethmoidartery——superiorpartofnasalcavityDissectionartery：16Dissection—SINUSESNasalsinusesanteriorsinusesapertures

maxillarysinusmiddlemeatusanteriorethmoidsinusmiddlemeatusfrontalsinusmiddlemeatus

posteriorsinusesaperturesposteriorethmoidsinussuperiormeatusSphenoidsinusrecessussphenoethmoidalisDissection—SINUSESNasalsinuse17DISSECTIONmaxillarysinusanteriorwall—caninefossaposteriorsidewall—nearinternalpterygoidmusclesuperiorwall—orbitalplatefootwall—alveolarprocess（odontogenicmaxillarysinusitis）medialwall—hardtodrainbecauseofhighapertureDISSECTIONmaxillarysinus18frontalsinusfrontalsinus19ethmoidsinusethmoidsinus20sphenoidsinussphenoidsinus21Nose–skullhomologicanatomyanteriorcranialfossa:hangingwallofnasalcavitymidpiece，posteriorwalloffrontalsinus,hangingwallofethmoidsinusmiddlecranialfossa：hangingwall/lateralwallofsphenoidsinus（pituitarygland、cavernoussinus、internalcarotidartery）Nose–skullhomologicanatomya22Nose–oralhomologicanatomyposteriorsidewallofmaxillarysinus

：internalpterygoidmuscleFootwallofmaxillarysinus

：secondbicuspidandfirstmolar、secondmolarFootwallofnasalcavity：parspalatalisNose–oralhomologicanatomypo23Nasal

physiologyNasalcavityphysiologyrespiratoryfunction—laminarflowANDturbulentflow—nasalairwayresistanceANDnasalcycleProtectionfunction—cleaningan