Kiesselbach's plexus is an

anastomotic An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be normal ...

arterial network (plexus) of four or five

arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...

in the

nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...

supplying the

nasal septum The nasal septum () separates the left and right airways of the Human nose, nasal cavity, dividing the two nostrils. It is Depression (kinesiology), depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal ...

. It lies in the anterior inferior part of the septum known as Little's area, Kiesselbach's area, or Kiesselbach's triangle. It is a common site for

nosebleed A nosebleed, also known as epistaxis, is bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significant that low bloo ...

Structure

Kiesselbach's plexus is an anastomosis of four or five arteries: * the

anterior ethmoidal artery The anterior ethmoidal artery is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen. The posterior ethmoidal artery is posterior to it. Structure The anterior ethmoidal artery branches from th ...

, a branch of the

ophthalmic artery The ophthalmic artery (OA) is an artery of the head. It is the first branch of the internal carotid artery distal to the cavernous sinus. Branches of the ophthalmic artery supply all the structures in the orbit around the eye, as well as some st ...

.Moore, Keith L. et al. (2014) ''Clinically Oriented Anatomy'', 7th Ed, p.959 * the

sphenopalatine artery The sphenopalatine artery (nasopalatine artery) is an artery of the head, commonly known as the artery of epistaxis. Course The sphenopalatine artery is a branch of the maxillary artery which passes through the sphenopalatine foramen into the cavi ...

, a terminal branch of the

maxillary artery The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible. Structure The maxillary artery, the larger of the two terminal branches of the external carotid artery ...

. * the

greater palatine artery The greater palatine artery is a branch of the descending palatine artery (a terminal branch of the maxillary artery) and contributes to the blood supply of the hard palate and nasal septum. Course The descending palatine artery branches off of th ...

, a branch of the

. * a septal branch of the

superior labial artery The superior labial artery (superior labial branch of facial artery) is larger and more egregious than the inferior labial artery. It follows a similar course along the edge of the upper lip, lying between the mucous membrane and the orbicularis ...

, a branch of the

facial artery The facial artery (external maxillary artery in older texts) is a branch of the external carotid artery that supplies structures of the superficial face. Structure The facial artery arises in the carotid triangle from the external carotid arte ...

. * a

posterior ethmoidal artery The posterior ethmoidal artery is an artery of the head which supplies the nasal septum. It is smaller than the anterior ethmoidal artery. Course Once branching from the ophthalmic artery, it passes between the upper border of the medial rectus mu ...

, a branch of the

. There is contention as whether this is truly part of Kiesselbach's plexus. Most sources quote that it is not part of the plexus, but rather one of the blood supplies for the nasal septum itself. It runs vertically downwards just behind the columella, and crosses the floor of the

. It joins the venous plexus on the lateral nasal wall.

Function

Kiesselbach's plexus supplies blood to the

Clinical significance

Ninety percent of

s (epistaxis) occur in Kiesselbach's plexus. It is exposed to the drying effect of

inhaled Inhalation (or Inspiration) happens when air or other gases enter the lungs. Inhalation of air Inhalation of air, as part of the cycle of breathing, is a vital process for all human life. The process is autonomic (though there are exceptions ...

air. It can also be damaged by trauma from a

finger nail A nail is a claw-like plate found at the tip of the fingers and toes on most primates. Nails correspond to the claws found in other animals. Fingernails and toenails are made of a tough protective protein called alpha-keratin, which is a polymer. ...

(

nose-picking Nose-picking is the act of extracting nasal mucus with one's finger (rhinotillexis) and may include the subsequent ingestion of the extracted mucus (mucophagy). In Western cultures, this act is generally considered to be social deviant; parents ...

), as it is fragile. It is the usual site for nosebleeds in children and young adults. A

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

may use a nasal speculum to see that an anterior nosebleed comes from Kiesselbach's plexus.

History

James Lawrence Little (1836–1885), an

American American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...

surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...

, first described the area in detail in 1879. Little described the area as being "about half an inch ... from the lower edge of the middle of the column eptum. Kiesselbach's plexus is named after

Wilhelm Kiesselbach Wilhelm Kiesselbach (1 December 1839 – 4 August 1902) was a German otolaryngologist born in Hanau. From 1859 he studied medicine at the universities of Göttingen, Marburg and Tübingen. In 1877/78 he worked as assistant under Wilhelm Olivi ...

(1839–1902), a

German German(s) may refer to: * Germany (of or related to) **Germania (historical use) * Germans, citizens of Germany, people of German ancestry, or native speakers of the German language ** For citizens of Germany, see also German nationality law **Ger ...

otolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...

who published a paper on the area in 1884. The area may be called Little's area, Kiesselbach's area, or Kiesselbach's triangle.

References

External links

Epistaxis
- utmb.edu

- emedicine.com

- fpnotebook.com {{Portal bar, Anatomy Human anatomy Anatomy named for one who described it

Structure

Function

Clinical significance

History

See also

References

External links