Kiesselbach's plexus is an
anastomotic arterial network (plexus) of four or five
arteries
An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...
in the
nose
A nose is a sensory organ and respiratory structure in vertebrates. It consists of a nasal cavity inside the head, and an external nose on the face. The external nose houses the nostrils, or nares, a pair of tubes providing airflow through the ...
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 s ...
. 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 anterior
nosebleed
A nosebleed, also known as epistaxis, is an instance of 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 significa ...
s.
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 alongside the anterior ethmoidal nerve. It contributes blood supply to the ethmoid sinuses, frontal sinuses, ...
, 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 ...
, a branch of the
internal carotid artery
The internal carotid artery is an artery in the neck which supplies the anterior cerebral artery, anterior and middle cerebral artery, middle cerebral circulation.
In human anatomy, the internal and external carotid artery, external carotid ari ...
.
[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. It passes through the sphenopalatine foramen to reach the nasal cavity. It is the main artery of the nasal cavity.
Course
The sp ...
, a terminal branch of the
maxillary artery
The maxillary artery (eg, internal 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 ...
, a branch of the
external carotid artery
The external carotid artery is the major artery of the head and upper neck. It arises from the common carotid artery. It terminates by splitting into the superficial temporal and maxillary artery within the parotid gland.
Structure
Origin
T ...
* 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 ...
, a branch of the
maxillary artery
The maxillary artery (eg, internal 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 ...
, a branch of the
external carotid artery
The external carotid artery is the major artery of the head and upper neck. It arises from the common carotid artery. It terminates by splitting into the superficial temporal and maxillary artery within the parotid gland.
Structure
Origin
T ...
.
* 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 orbiculari ...
, a branch of the
facial artery
The facial artery, formerly called the external maxillary artery, is a branch of the external carotid artery that supplies blood to superficial structures of the medial regions of the face.
Structure
The facial artery arises in the carotid t ...
, a branch of the
external carotid artery
The external carotid artery is the major artery of the head and upper neck. It arises from the common carotid artery. It terminates by splitting into the superficial temporal and maxillary artery within the parotid gland.
Structure
Origin
T ...
.
* a
posterior ethmoidal artery
The posterior ethmoidal artery is an artery of the head which arises from the ophthalmic artery to supply the posterior ethmoidal air cells, and the meninges. It is smaller than the anterior ethmoidal artery.
Anatomy
Origin
The posterior et ...
, 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 ...
, a branch of the
internal carotid artery
The internal carotid artery is an artery in the neck which supplies the anterior cerebral artery, anterior and middle cerebral artery, middle cerebral circulation.
In human anatomy, the internal and external carotid artery, external carotid ari ...
.
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
nose
A nose is a sensory organ and respiratory structure in vertebrates. It consists of a nasal cavity inside the head, and an external nose on the face. The external nose houses the nostrils, or nares, a pair of tubes providing airflow through the ...
. It joins the venous plexus on the lateral nasal wall.
Function
Kiesselbach's plexus supplies blood to 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 s ...
.
Clinical significance
Ninety percent of
nosebleed
A nosebleed, also known as epistaxis, is an instance of 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 significa ...
s (epistaxis) occur in Kiesselbach's plexus, whereas five to ten percent originate from
Woodruff's plexus.
It is exposed to the drying effect of
inhaled air.
It can also be damaged by trauma from a
finger nail (
nose picking
Nose picking is the act of extracting 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 socially deviant; parents and ...
), as it is fragile.
It is the usual site for nosebleeds in children and young adults.
A
physician
A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
may use a nasal speculum to see that an anterior nosebleed comes from Kiesselbach's plexus.
History
James Lawrence Little (1836–1885), an
American surgeon
In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...
, 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 (1839–1902), a
German
German(s) may refer to:
* Germany, the country of the Germans and German things
**Germania (Roman era)
* Germans, citizens of Germany, people of German ancestry, or native speakers of the German language
** For citizenship in Germany, see also Ge ...
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 subspecialty within medicine that deals with the surgical an ...
who published a paper on the area in 1884. The area may be called Little's area,
Kiesselbach's area, or Kiesselbach's triangle.
Other
A common mnemonic used to remember the arteries of the Kiesselbach's plexus is "Kiesselbach drives his Lexus with his LEGS" (
superior Labial artery,
anterior
Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
and
posterior Ethmoid artery,
Greater palatine artery,
Sphenopalatine artery).
See also
*
Anatomical terms of location
Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pr ...
References
External links
Epistaxis- utmb.edu
- emedicine.com
- fpnotebook.com
{{Portal bar, Anatomy
Human anatomy
Anatomy named for one who described it