Expansion
Five vessels kiss at the front of the septum
Mnemonic
LEGS, for the four arteries anastomosing in Little’s area (Kiesselbach’s plexus) on the anterior nasal septum:
- L - superior Labial artery, from the facial
- E - anterior Ethmoidal artery, from the ophthalmic
- G - Greater palatine artery, from the maxillary
- S - Sphenopalatine artery, from the maxillary
This single site accounts for around 90 per cent of nosebleeds, because it is where the internal and external carotid territories meet and the mucosa is thin and exposed.
Posterior bleeds come from the sphenopalatine artery proper, are commoner in the elderly and hypertensive, bleed into the pharynx rather than out of the nose, and often need packing or arterial ligation.
Expansion
- Anterior ethmoidal artery
- Sphenopalatine artery
- Greater palatine artery
- Septal branch of the superior labial artery