Anatomically most are anterior (kiesselback's plexus). Roughly 10% are posterior which cant be visualized with rhinoscopy Causes: Trauma, nose picking, dried mucus membranes, anticoagulants, intanasal drug use and etc. Approach: - Pressure : Patients directly blows to expel and clots - Vasoconstriction : Topical treatment such as oxymetazoline - Packing : Apply direct pressure and lean forward - Surgery