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 ...

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

. * 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

. * 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

. 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, 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).

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

Other

See also

References

External links