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. Physiology of nose
respiratory function: physiological turbinal cycle
protective function: clearing, filtration, warming,humidifying
olfactory function
resonant function
6. Physiology of accessory nasal sinuses
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Nose Function
Heat, Humidify and Filter the incoming gas
Smell
nasal blood vessels,
nasal glands, and
the mucociliarysystem
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Anatomy of the Nose
Bone and Cartilage
Partition in the nose is called the nasal septum
Air enters through the nostrils or nares Two nasal passages are called choanae
Vibrissaefilter the incoming gas
First 1/3 is stratified squamous epithelium (PROTECTION)
Posterior 2/3 is pseudostratified ciliated columnarepithelium (MUCUS SECRETION)
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Anatomy of the Nose Mucous secreting glands are found in the posterior 2/3
of nose
Bony Protrusions on the lateral wall are called nasalturbinates or conchae
Separate incoming gas into turbulentairstreams morecontact
Extensive capillary network Constrict or dilate to
change blood flow
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Sympathetic Vasomotor Control -- vasoconstrictor tone
Norepinephrine, pancreatic polypeptide and neuropeptide Y
Parasympathetic Vasomotor Control-- controllingsecretion, vasodilation
vasoactive intestinal polypeptide and peptide histamineisoleucine
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Conditioning of the
Inspired AirHumidification
Temperature regulation
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Respiration Modification of Inspired Air
Nasal Airway Resistance
1. nasal vestibule,2. nasal valve
3. nasal cavum
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Nasal Airflow
superiorly into the nares, determined by its positionand the anterior nasal valve
the anterior nasal valve is located 1.5-2 cm posterior tothe anterior nares and is the narrowest portion of theupper airway.
Humidification occurs by evaporation of moisture
from the mucosal blanketWarming of inspired air to 36C
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Nasal vestibule activation of the dilator nares muscles during
inspiration
Nasal Cavum
degree of engorgement of the erectile tissues of the turbinates and theseptum
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The NV a tridimensional structure, anteriorly outlined by the
ostium internum
a pear-shaped orifice, inferior border of the SLC as lateral border,
the nasal septum as the medial one and
the nasal cavity floor inferiorly, located at 1 to 1.5 cm
from the nostril
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Physical Principles
of Nasal Airflow
Nasal Air FlowLaminar vs Turbulent
Control of Nasal Resistance
Action of Dilator Nares
Vascular Control of Resistance
Nasal Cycle
Regulate by autonomic nervous system
80% of human each 2 hours
Positional Effect
Nasal Vascular Reflexes
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Protective
Functions of the
Nasal MucosaNonspecific DefenseMechanisms1. Mechanical defenses
(mucociliary apparatus)
2. Nonspecific protectivefactors (Interferon,
Proteases, Proteaseinhibitors , LysozymeAntioxidants)
3. Cellular defenses(phagocytic cells)
Specific Immune
Responses1. Humoral immuneresponse
2. Cellular immuneresponse
3. The endothelial cells
4. The epithelial cells
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an immunological function.
IgA and IgE, which are involved in local mucosal defense
mechanisms, andenzymes like lysozymes, lactoferrin, and complementand C reactive proteins.
Sensory nerve endings present in the nose can mediate
various reflexes
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Speech ProductionVarious organ systems are involved in the production of voice and speech: Glottis, Supraglottic vocal tract, Central nervous system
must be coordinated in order to produce a normal voice sound
Hyponasal speech (rhinophonia clausa) : occurs when these segmentscontribute less to sound production as a result of partial or complete nasal
obstruction or mass lesions in the nasopharynx
Hypernasal speech (rhinophonia aperta):develops when the nasopharynxand nasal cavities over contribute to sound production.cleft palate, velar palsy due to various causes
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Physiology of the Nose Nose can filter particles down to 5 m (microns)in
diameter
Two factors which decrease the humidification andfiltering ability of the nose is:
Mouth Breathing
Placement of an ET (endotracheal) tube
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Paranasal Sinuses Empty air spaces found in the bones of the skull;
Paired Frontal
Ethmoid Sphenoid
Maxillary
They contain mucous secreting goblet cells which
drain into the nasal cavity
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The physiological functions of the
paranasal sinuses are controversial
play a role in conditioning of the inspired air, pressuredamping, heat insulation and voice resonance
however are of the opinion that the sinuses mayindeed have no function at all and may merely bevestigeal structures assuming a significant role when
diseased.
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Nose and Nasal Cavities
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Abnormal Nasal Physiology
Environmental allergies
Nonallergic or vasomotor rhinitis
nasal cavities and paranasal sinuses are the mainsources of nitric oxide (NO)