Kiesselbach's plexus
Also known as: Kiesselbach plexus, Little's area
Kiesselbach's plexus is a network of anastomosing arteries on the anterior nasal septum, located in Little's area. It is the most common source of anterior nosebleeds (epistaxis).
Kiesselbach's plexus is a vascular network on the anteroinferior nasal septum, in a region called Little's area. Several arteries converge and anastomose there, placing a rich blood supply just beneath a thin mucosal surface at the front of the nose.
The plexus is classically formed by branches from both the internal and external carotid systems: the anterior ethmoidal artery (from the ophthalmic artery), the sphenopalatine artery and greater palatine artery (from the maxillary artery), and the septal branch of the superior labial artery (from the facial artery). This dual carotid origin is a favorite anatomy exam point.
Clinically, Kiesselbach's plexus matters because it is the source of roughly 90% of nosebleeds. Its location makes it vulnerable to digital trauma (nose picking), dry air, and minor injury, and anterior bleeds from this area are usually visible and controllable with direct pressure. By contrast, posterior epistaxis typically arises from branches of the sphenopalatine artery in Woodruff's plexus, tends to occur in older patients, and is harder to control.
USMLE Step 1 tests Kiesselbach's plexus in head and neck anatomy and its respiratory system material. High-yield associations: anterior epistaxis originates from Kiesselbach's plexus in Little's area, the plexus receives contributions from both carotid systems, and posterior bleeds implicate the sphenopalatine artery.
Key takeaways
- Kiesselbach's plexus sits in Little's area on the anterior nasal septum.
- It is formed by anastomoses of the anterior ethmoidal, sphenopalatine, greater palatine, and superior labial arteries.
- It receives blood from both the internal and external carotid artery systems.
- It is the most common source of anterior epistaxis, accounting for about 90% of nosebleeds.
- Posterior epistaxis, by contrast, usually involves the sphenopalatine artery and is harder to control.