## Anatomy of Epistaxis Bleeding Sites **Key Point:** Kiesselbach's plexus (also called Little's area) is the most common source of anterior epistaxis, accounting for ~90% of cases. ### Location and Vascular Supply Kiesselbach's plexus is located in the anteroinferior part of the nasal septum, in the region of the cartilaginous-bony junction. It is formed by the anastomosis of five arteries: 1. Anterior ethmoidal artery (superiorly) 2. Sphenopalatine artery branch (posteriorly) 3. Greater palatine artery (inferiorly) 4. Septal branch of superior labial artery (anteroinferiorly) 5. Septal branch of the nasal septum ### Clinical Significance | Feature | Anterior Epistaxis | Posterior Epistaxis | | --- | --- | --- | | **Source** | Kiesselbach's plexus (90%) | Sphenopalatine artery branches | | **Frequency** | 90% of all cases | 10% of all cases | | **Bleeding pattern** | Visible from nostril | Flows into nasopharynx/oropharynx | | **Management** | Anterior packing, cautery | Posterior packing, endoscopic control | | **Severity** | Usually self-limiting | Often massive, requires intervention | **High-Yield:** The term "Kiesselbach's triangle" or "Little's area" is synonymous and refers to this highly vascular zone where multiple arteries converge, making it prone to trauma and epistaxis. **Clinical Pearl:** Most nosebleeds in children and young adults are from Kiesselbach's plexus due to digital trauma (nose picking), while posterior epistaxis is more common in elderly patients with hypertension and atherosclerotic disease. [cite:Scott-Brown's Otolaryngology Ch 18] 
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.