What is the function of the nose and nasal cavity?
- Filter + humidify air
- Resonating chamber for speech
- Drainage of paranasal sinuses + nasolacrimal ducts
Which bones form the root of the external nose?
- 2 x Nasal bones
Name the boundaries of the nasal cavity and the associated bones:
Roof: Cribriform plate - nasal + frontal + ethmoid + sphenoid
Floor: Hard + soft palates - maxilla + palatine
Medial: Nasal septum - ethmoid + vomer + septal cartilage
What nerve gives general sensation to the nasal cavity?
Anterior-Superior = CN V1 Posterior-Inferior = CN V2
What is a septal haematoma? What is the complication of this if it isn’t treated promptly?
Blood between the perichondrium + septal cartilage
Saddle deformity of the nose due to necrosis of cartilage
What are the symptoms associated with nasal polyps?
- Blocked nose
- Watery rhinorrhoea
- Post-nasal drip = cough
- Decreased sense of smell
- Decreased sense of taste
What is a nasal polyp?
Fleshy benign swelling of mucosa Mobile + painless Usually bilateral Pale/yellow Usually 40+ yrs
What is rhinitis?
Inflammation of nasal mucosal lining, usually caused by viral infection or allergen
What are the symptoms of rhinitis?
- Nasal congestion
- Nasal irritation
- Post nasal drip = cough
Name the 4 paired paranasal sinuses:
Most paranasal sinuses drain into which meatus?
What is the epithelium lining the paranasal sinuses?
Ciliated pseudostratified columnar + goblet cells
What are the symptoms associated with acute sinusitis?
- Pain + tenderness over affected sinuses
- Non-resolving cold/flu
Which bacteria most commonly infect the paranasal sinuses?
- Haemophilus influenzae
- Streptococcus pneumoniae
How can sinusitis cause orbital cellulitis?
Infections of the ethmoidal air cells can infiltrate into the medial wall of the orbit
Name the area of the nose from which 90% nosebleeds occur:
Which arteries supplying the nasal mucosa arise from the roof of the cavity?
- Anterior Ethmoid artery
- Posterior Ethmoid artery
Which artery supplying the nasal mucosa arises from the posterior wall, and accounts for 5% nosebleeds?
Which arteries supplying the nasal mucosa arise from the floor of the cavity?
- Greater palatine artery
- Superior labial artery
What is epistaxis?
What is the management of epistaxis?
- Pinch in front of bridge of nose + lean forward
- Cauterise visible bleeding point
- Anterior packing
- Posterior packing
- Surgical ligation
How can CSF reach the nasal cavity following trauma?
- Cribriform plate of ethmoid bone fractures
- Dura mater around christa galli ruptures
- CSF leaks into nasal cavity
Why might a patient with sinusitis complain of toothache?
- Underlying cause of sinusitis may be tooth abscess, as some teeth roots are very close to maxillary sinus and can erode into the sinus
- Referred pain due to shared sensory innervation to the maxillary sinus and teeth, upper jaw + cheek (CN V2)