Describe the Anatomy of Posterior Wall of Nose under the following Headings – Boundaries, Roof & Floor, Divisions, Contents & Applied Anatomy

Anatomy of the Posterior Wall of the Nose (Choanae / Posterior Nasal Apertures)

The "posterior wall" of the nasal cavity is not a flat wall like the roof, floor, or septum — it is formed by the two posterior nasal apertures (choanae), through which each nasal cavity opens behind into the nasopharynx. Because of this, its anatomy is usually described together with the nasopharynx that lies immediately behind it.

Boundaries

Each choana (posterior nasal aperture) is bounded by:
  • Medially – the posterior border of the nasal septum (vomer)
  • Laterally – the medial pterygoid plate of the sphenoid bone
  • Superiorly – the body of the sphenoid bone (ala of the vomer articulating with the sphenoidal rostrum)
  • Inferiorly – the posterior free border of the hard palate (posterior edge of the horizontal plate of the palatine bone)
The two choanae are separated from each other by the posterior edge of the septum and lead directly into the nasopharynx, which itself lies behind the posterior apertures of the nasal cavities and above the level of the soft palate - Gray's Anatomy for Students.

Roof and Floor

  • Roof – formed by the sloping base of the skull: the posterior part of the body of the sphenoid above and the basilar part of the occipital bone (basiocciput) behind, forming a domed vault at the top of the nasopharynx that is always patent - Gray's Anatomy for Students.
  • Floor – formed by the upper surface of the soft palate, which separates the nasopharynx from the oropharynx below. During swallowing, elevation of the soft palate together with contraction of the palatopharyngeal sphincter (part of superior constrictor) closes this pharyngeal isthmus, sealing the nasopharynx off from the oropharynx.

Divisions

The posterior wall of the nose opens into the nasopharynx, the uppermost of the three anatomical divisions of the pharynx:
  1. Nasopharynx – behind the choanae, above the soft palate (the region continuous with the posterior wall of the nose)
  2. Oropharynx – from the soft palate to the tip of the epiglottis
  3. Laryngopharynx (hypopharynx) – from the epiglottis to the lower border of the cricoid cartilage, continuing into the oesophagus
Within the nasopharynx itself, the important sub-regions related to the posterior nasal wall are the roof-posterior wall junction (site of the adenoids), the lateral walls (Eustachian tube openings and fossa of Rosenmuller), and the pharyngeal isthmus at the junction with the oropharynx.

Contents

  • Adenoids (pharyngeal tonsil) – a mass of lymphoid tissue situated at the junction of the roof and posterior wall of the nasopharynx; forms the superior component of Waldeyer's ring (along with the palatine and lingual tonsils) - Bailey and Love's Short Practice of Surgery, p. 8994.
  • Eustachian (pharyngotympanic) tube opening – located on the lateral wall, posterosuperiorly, just above and behind the level of the hard palate.
  • Torus tubarius – a mucosal elevation formed by the cartilaginous end of the Eustachian tube, projecting into the nasopharynx from a posterolateral direction.
  • Fossa of Rosenmuller (pharyngeal recess) – a slit-like recess situated dorsal and superior to the tubal opening, bounded anteriorly by a ridge raised by the salpingopharyngeus muscle; a common site for development of nasopharyngeal carcinoma - Bailey and Love's Short Practice of Surgery, p. 9021.
  • Salpingopharyngeal fold – mucosal fold overlying the salpingopharyngeus muscle running down from the torus tubarius.
  • Mucosa here is lined mainly by respiratory (ciliated columnar) epithelium, transitioning to stratified squamous over areas of friction such as the roof.

Applied Anatomy

  • Adenoid hypertrophy – physiological enlargement of the pharyngeal tonsil in childhood can obstruct the choanae/nasopharynx, causing mouth breathing, snoring, nasal twang, "adenoid facies," and predisposing to otitis media with effusion (via Eustachian tube blockage).
  • Choanal atresia – a congenital failure of canalization of the posterior nasal aperture, presenting with respiratory distress (especially if bilateral) in neonates who are obligate nasal breathers.
  • Nasopharyngeal carcinoma (NPC) – classically arises in the fossa of Rosenmuller; can present with unilateral nasal obstruction, epistaxis, unilateral serous otitis media (Eustachian tube involvement), or a neck node with an occult primary, and may invade the skull base.
  • Posterior epistaxis – bleeding from the posterior nasal cavity/nasopharyngeal region (Woodruff's plexus) is harder to control than anterior (Little's area) bleeds and may need posterior nasal packing or sphenopalatine artery ligation/cautery.
  • Posterior rhinoscopy / nasopharyngoscopy – clinical examination of this region (mirror or endoscope) to assess adenoids, choanal patency, and the fossa of Rosenmuller, important in diagnosing NPC, adenoid hypertrophy, and choanal masses (e.g., antrochoanal polyp presenting through the choana).
  • Antrochoanal polyp – arises in the maxillary antrum and prolapses through the choana into the nasopharynx, illustrating the direct communication between the nasal cavity and nasopharynx via this posterior aperture.
Sources: Bailey and Love's Short Practice of Surgery, 28th Ed., pp. 8993-9022; Gray's Anatomy for Students, pp. 4447-4465.

I aslo need images related to it

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nasopharynx lateral wall Eustachian tube opening fossa of Rosenmuller

**Imaging Modality:** Magnetic Resonance Imaging (MRI), T1-weighted sequence.

**Imaging Modality:** Magnetic Resonance Imaging (MRI), T1-weighted sequence.

This clinical diagnostic image is a high-definition endoscopic view of the right lateral nasopharynx in a healthy adult. The image clearly demonstrates the anatomical landmarks of the pharyngeal orifice of the Eustachian tube. Key structures labeled include the Eustachian tube opening appearing as a dark slit, the Rosenmüller fossa (pharyngeal recess) located posteriorly, and the torus tubarius. The muscular anatomy is delineated, showing the tensor veli palatini anteriorly and the levator veli palatini inferiorly. The salpingopharyngeus muscle is visible as a vertical fold of mucosa. Other landmarks include the soft palate forming the inferior boundary, the nasopharyngeal wall, and the posterior edge of the nasal septum. The mucosa appears healthy, pink, and well-vascularized without signs of inflammation, lymphoid hyperplasia, or obstruction. This image serves as a reference for normal nasopharyngeal anatomy and the study of peritubal muscle relationships relevant to Middle Ear Myoclonus (MEM) and Eustachian tube dysfunction.

This clinical diagnostic image is a high-definition endoscopic view of the right lateral nasopharynx in a healthy adult. The image clearly demonstrates the anatomical landmarks of the pharyngeal orifice of the Eustachian tube. Key structures labeled include the Eustachian tube opening appearing as a dark slit, the Rosenmüller fossa (pharyngeal recess) located posteriorly, and the torus tubarius. The muscular anatomy is delineated, showing the tensor veli palatini anteriorly and the levator veli palatini inferiorly. The salpingopharyngeus muscle is visible as a vertical fold of mucosa. Other landmarks include the soft palate forming the inferior boundary, the nasopharyngeal wall, and the posterior edge of the nasal septum. The mucosa appears healthy, pink, and well-vascularized without signs of inflammation, lymphoid hyperplasia, or obstruction. This image serves as a reference for normal nasopharyngeal anatomy and the study of peritubal muscle relationships relevant to Middle Ear Myoclonus (MEM) and Eustachian tube dysfunction.

This diagnostic image is an axial (transverse) Magnetic Resonance Imaging (MRI) scan of the human nasopharynx in a healthy subject. The view provides a detailed anatomical study of the upper airway and its surrounding mucosal landmarks. Centrally, the posterior aspect of the nasal septum is visible, exhibiting a slight lateral deviation. The nasopharyngeal lumen is clearly defined, showing key lateral and posterior wall structures. The Rosenmüller fossa (lateral pharyngeal recess) is identified as a deep indentation on the lateral wall, appearing with a heterogeneous signal intensity and ill-defined borders. Anterior to this fossa is the orifice of the Eustachian tube, visualized as a small opening with a dark signal. On the midline of the posterior wall, the pharyngeal bursa is depicted as a small, smooth-contoured protrusion. This imaging modality is essential for evaluating obstructive sleep apnea (OSA), nasopharyngeal carcinoma, or lymphoid hypertrophy, as it allows for precise assessment of spatial relationships and mucosal symmetry within the rhinopharynx.

This diagnostic image is an axial (transverse) Magnetic Resonance Imaging (MRI) scan of the human nasopharynx in a healthy subject. The view provides a detailed anatomical study of the upper airway and its surrounding mucosal landmarks. Centrally, the posterior aspect of the nasal septum is visible, exhibiting a slight lateral deviation. The nasopharyngeal lumen is clearly defined, showing key lateral and posterior wall structures. The Rosenmüller fossa (lateral pharyngeal recess) is identified as a deep indentation on the lateral wall, appearing with a heterogeneous signal intensity and ill-defined borders. Anterior to this fossa is the orifice of the Eustachian tube, visualized as a small opening with a dark signal. On the midline of the posterior wall, the pharyngeal bursa is depicted as a small, smooth-contoured protrusion. This imaging modality is essential for evaluating obstructive sleep apnea (OSA), nasopharyngeal carcinoma, or lymphoid hypertrophy, as it allows for precise assessment of spatial relationships and mucosal symmetry within the rhinopharynx.

This diagnostic endoscopic image captures the nasopharynx, demonstrating an extraosseous plasmacytoma in a 75-year-old male. The primary finding is a large, smooth, fleshy pink-to-red mass protruding into the nasopharyngeal space. The mass exhibits prominent surface vascularity with branching vessels and is shown effacing the posterior pharyngeal wall. Key anatomical landmarks are annotated, including the Eustachian tube opening and the Fossa of Rosenmuller located superior to the lesion. The mass is positioned adjacent to the posterior nasal septum and the posterior lateral nasal wall. This clinical photograph illustrates the typical presentation of a rare extramedullary plasma cell neoplasm in the upper respiratory tract, which may present with symptoms such as epistaxis. The image serves as an educational resource for Otolaryngology and Oncology, highlighting the importance of endoscopic examination in evaluating nasopharyngeal masses.

This diagnostic endoscopic image captures the nasopharynx, demonstrating an extraosseous plasmacytoma in a 75-year-old male. The primary finding is a large, smooth, fleshy pink-to-red mass protruding into the nasopharyngeal space. The mass exhibits prominent surface vascularity with branching vessels and is shown effacing the posterior pharyngeal wall. Key anatomical landmarks are annotated, including the Eustachian tube opening and the Fossa of Rosenmuller located superior to the lesion. The mass is positioned adjacent to the posterior nasal septum and the posterior lateral nasal wall. This clinical photograph illustrates the typical presentation of a rare extramedullary plasma cell neoplasm in the upper respiratory tract, which may present with symptoms such as epistaxis. The image serves as an educational resource for Otolaryngology and Oncology, highlighting the importance of endoscopic examination in evaluating nasopharyngeal masses.

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posterior nasal aperture choana anatomy skull

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adenoids pharyngeal tonsil nasopharynx sagittal section

Here are relevant images to go with the anatomy of the posterior wall of the nose (choanae) and nasopharynx:
1. Components of the pharynx (nasopharynx, oropharynx, hypopharynx) - shows how the nasal cavity's posterior wall opens into the nasopharynx, the uppermost division of the pharynx (Bailey and Love's Short Practice of Surgery, Fig. 52.1):
Component parts of the pharynx
2. Mucosal features of the pharynx - lateral, posterior, and superior views - demonstrates the roof/lateral wall relationships, Eustachian tube opening, and torus tubarius near the posterior nasal aperture (Gray's Anatomy for Students, Fig. 8.200):
Mucosal features of the pharynx
3. Endoscopic view of the lateral nasopharyngeal wall - clearly labels the Eustachian tube opening, fossa of Rosenmuller, torus tubarius, tensor/levator veli palatini, and salpingopharyngeus fold, all key "Contents" of this region:
Endoscopic view of nasopharynx lateral wall with Eustachian tube opening and fossa of Rosenmuller
4. Axial MRI of the nasopharynx - shows the posterior nasal septum, nasopharyngeal lumen, Rosenmuller fossa, and Eustachian tube orifice in cross-section, useful for understanding spatial boundaries:
Axial MRI of nasopharynx showing septum, Rosenmuller fossa and Eustachian tube orifice
Applied anatomy note (pathology example): the endoscopic image below shows a nasopharyngeal mass (plasmacytoma) effacing the posterior pharyngeal wall near the fossa of Rosenmuller and Eustachian tube opening, illustrating how tumors in this region present clinically and why this area is examined endoscopically:
Nasopharyngeal mass near fossa of Rosenmuller and Eustachian tube opening
I could not find a dedicated skeletal diagram isolating just the bony choanae (posterior nasal apertures) or an adenoid/pharyngeal-tonsil sagittal illustration in the library - those two specific searches returned no matches. If you want, I can try a slightly different search term (e.g. "vomer sphenoid choana skull base" or "adenoid hypertrophy lateral neck X-ray") to look for those separately.
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