Applied Basic Science

Nosebleeds (epistaxis) are common. They occur mainly in children and in middle-aged and elderly adults. A nosebleed can be fatal. The nose has a rich blood supply (Figure 16.1). A network of vessels derived from both the internal and external carotid arteries converge in the nasal septum in Little’s area or Kiesselbach’s plexus. This is a common site of bleeding (Figure 16.2).

Air flows over this area during respiration. It can become dried with crusted secretions and a vessel wall can break through the mucosa causing a bleed. Children often have a prominent vein running just above the junction between the skin and the mucosa of the nasal septum known as a retrocolumellar vein. This area is also prone to bleeding.

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