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Arterial supply of nose with diagram

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arterial supply of the nose diagram sphenopalatine facial ophthalmic artery

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Kiesselbach's plexus little's area nasal septum blood supply

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nasal cavity lateral wall arteries anatomy diagram

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Arterial Supply of the Nose

The nose receives blood from both the internal and external carotid artery systems, which anastomose freely with each other, especially on the anterior nasal septum. This dual supply is clinically important because it explains why epistaxis (nosebleed) can come from either circulation.

1. Internal Carotid Artery contribution (via Ophthalmic artery)

  • Anterior ethmoidal artery - descends through the cribriform plate to supply the anterior-superior lateral wall and septum
  • Posterior ethmoidal artery - supplies a small portion of the superior turbinate and adjacent posterior septum

2. External Carotid Artery contribution (via two main branches)

A. Maxillary (internal maxillary) artery branches:
  • Sphenopalatine artery - the terminal branch, entering the nasal cavity through the sphenopalatine foramen (posterior to the middle turbinate). It divides into:
    • Lateral nasal branch - supplies the lateral nasal wall/turbinates (most common site of posterior epistaxis)
    • Posterior septal branch - supplies the posterior septum
  • Greater (descending) palatine artery - supplies the anterior nasal septum and floor of the nose via its septal branch
B. Facial artery branches:
  • Superior labial artery - sends a septal branch to the anterior septum and nasal vestibule
  • Angular artery - courses along the nasofacial crease to supply the external nose (ala and dorsum)

Kiesselbach's Plexus (Little's Area)

On the anterior nasal septum, four vessels converge to form a rich anastomotic network called Kiesselbach's plexus, located within an area known as Little's area:
  1. Septal branch of the anterior ethmoidal artery
  2. Septal branch of the sphenopalatine artery
  3. Septal branch of the greater palatine artery
  4. Septal branch of the superior labial artery
This "watershed" zone is the most common site of anterior epistaxis (especially in children/young adults), while the sphenopalatine artery territory is the most common source of posterior epistaxis (more common in the elderly, often related to hypertension).
There is also a posterior plexus, Woodruff's plexus, near the posterior nasal floor/inferior meatus, which can be a source of posterior bleeds as well.

Diagrams

Lateral nasal wall arterial supply:
Vascular supply to the lateral wall of the nose
Nasal septum arterial supply (Kiesselbach's plexus):
Vascular supply to the nasal septum showing Kiesselbach's plexus
Sources:
  • Roberts and Hedges' Clinical Procedures in Emergency Medicine, Ch. 63 (Nose)
  • K J Lee's Essential Otolaryngology, Vascular Anatomy section
  • Bailey and Love's Short Practice of Surgery, 28th Ed. (Epistaxis)
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