Nasal septum/ medial nasal wall

Kiesselbach’s area, also Kiesselbach’s plexus, Kiesselbach^‘s triangle, and Little’s area, is a region in the anteroinferior part of the nasal septum, where four arteries anastomose to form a vascular plexus called Kiesselbach’s plexus. The arteries are

1. Anterior ethmoidal artery (from the ophthalmic artery)
2. Sphenopalatine artery (from the maxillary artery)
3. Greater palatine artery (from the maxillary artery)
4. Septal branch of the superior labial artery (from the facial artery)

Ophthalmic artery

The lacrimal bone does not form part of the nasal septum.

• Anteriorly by the quadrilateral cartilage and maxilla.
• Posteriorly by perpendicular plate of the ethmoid bone and sphenoid crest.
• Inferiorly by crest of the vomer, maxillary, and palatine bones.

• The skin within the nasal vestibule is  a keratinized squamous cell epithelium containing vibrissae and sebaceous glands.
• At the leading edge of the inferior turbinate the epithelium transitions into a cuboidal cell type and then into pseudostratified ciliated columnar respiratory epithelium.
• At the most posterior aspect of nasopharynx, the mucosa returns to a non keratinized squamous cell epithelium.

All Correct

A i.e., Anterior half of nasal septum drain to the submandibular node B i.e., Tonsils drain in upper deep cervical nodes C i.e., Inevitably all lymphatics ultimately supply to the lower deep cervical nodes 

B. i.e. Crest of maxilla; C. i.e. Septal cartilage; A. i.e. Perpendicular plate of ethmoid

Nasal septum is the osseocartilagenous partition between the two halves of nasal cavity.

Its constituents are:

1. Osseous part

• The vomer
• Perpendicular plate of ethmoid
• Nasal crest of nasal bone
• Nasal spine of frontal bone
• Nasal crest of palatine bone
• Nasal crest of maxillary bone
• Rostrum of sphenoid bone

2. Cartilaginous part

Septal (Qudrilateral) cartilage

• Lupus vulgaris is the chronic and more common form of tubercular infection affecting the skin and mucous membrane of nose
• Apple-jelly appearances are brown gelatinous nodules and are typical skin lesions of lupus.

• Little area (also called as Kiesselbach’s plexus) is a highly vascular area in the anteroinferior part of nasal septum just above the vestibule
• It is the most common site for nasal bleeding as this area is exposed to the drying effect of inspiratory current and to finger nail trauma.

Ans. is ‘d’ i.e., Lesser palatine artery

Four arteries contribute to little’s area :

i) Anterior ethmoidal artery.

ii) Septal branch of superior labial artery (Branch of facial A).

iii) Septal branch of sphenopalatine artery (Branch of maxillary A).

iv) Greater palatine artery (Branch of maxillary A).

Artery is anterior ethmoidal 

Anterior and posterior ethmoidal arteries are branches of ophthalmic artery which is a branch of Internal carotid artery

Ans. is ‘c’ i.e., Lupus vulgaris

Lupus vulgaris

• It is an indolent and chronic form of tuberculous infection.
• Female to male ratio is 2:1.
• Most common site is the mucocutaneous junction of the nasal septum, the nasal, vestibule and the ala.
• Characteristic Feature is the presence of apple- jelly nodules (Brown gelatinous nodules) in skin.
• Lupus can cause perforation of cartilaginous part of nasal septum.
• Confirmation is by Biopsy

Ans. is ‘d’ i.e., Nasal bone