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ENT Week 1 2017/18 > 2: Anatomy 1 - nose > Flashcards

2: Anatomy 1 - nose Flashcards

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1
Q

From superior to inferior, name the parts of the external nose.

A

Root (between eyebrows)

Dorsum (the bridge of the nose)

Apex (tip of the nose)

Septum (separates the right and left nasal cavities)

Philtrum (indentation in the midline, just superior to the upper lip)

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2
Q

Which bone forms the bridge of the nose?

A

Nasal bone

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3
Q

What are the sides of the nose found on either side of the apex?

A

Ala

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4
Q

What is the technical name for the nostrils?

A

Nares

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5
Q

Which two bones make up the nasal septum?

A

Perpendicular plate of the ethmoid bone

Vomer

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6
Q

Apart from the vomer, which bone forms the superior part of the nasal septum?

A

Ethmoid bone

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7
Q

What are the two important structures of the roof of the nasal cavity?

Which bone do they belong to?

A

Cribriform plate

Crista galli

Both part of the ethmoid bone

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8
Q

In which cranial fossa are the cribriform plate and crista galli found?

A

Anterior cranial fossa

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9
Q

Which ganglia of CN I sit on the cribriform plate of the ethmoid bone and are separated by the crista galli?

A

Olfactory bulbs

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10
Q

Which structures of the ethmoid bone are found on the lateral wall of the nasal cavities?

A

Orbital plates

Superior and middle conchae

Ethmoidal air cells

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11
Q

Which part of the ethmoid bone separates the nasal cavity from the bony orbit?

A

Orbital plate

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12
Q

Which of the three conchae are part of the ethmoid bone?

A

Superior and middle conchae

Inferior conchae is its own thing

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13
Q

Which particular part of the ethmoid bone makes up the nasal septum?

A

Perpendicular plate

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14
Q

Is the nasal septum always found in the midline?

A

No

Slightly deviated in most people

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15
Q

Which type of fracture can damage the cribriform plate of the ethmoid bone?

Which types specifically?

A

Le Fort fracture

II & III

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16
Q

Why can Type II & III Le Fort fractures cause meningeal infections?

A

Transmission of bacteria from

nasal cavity and paranasal sinuses

to

anterior cranial fossa

via damaged cribriform plate

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17
Q

The conchae are found on the (medial / lateral) sides of the nasal cavities.

A

lateral sides

medial side is quite featureless

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18
Q

Which bone joins with the maxilla to form the hard palate at the floor of the nasal cavity?

A

Palatine bone

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19
Q

Which parts of the sphenoid bone act as insertions for the medial and lateral pterygoids and is found near the nasal cavity?

A

Pterygoid plates

(remember medial CLOSES the jaw and lateral OPENS it)

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20
Q

The cribriform plate is shaped like a sieve - why?

A

Allows passage of CN I (olfactory nerve)

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21
Q

The ethmoid air cells form one of the paranasal ___.

A

paranasal sinuses

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22
Q

Is the inferior concha part of the ethmoid bone?

A

No

Superior and middle concha ARE

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23
Q

The stratified squamous epithelium at the anterior part of the nasal cavity is ___.

What does this achieve?

A

keratinised

Stops foreign stuff getting into the nasal cavities

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24
Q

Most of the nasal cavity is lined with respiratory epithelium.

What is this specifically?

A

CILIATED PSEUDOSTRATIFIED COLUMNAR epithelium with GOBLET CELLS

Don’t forget this

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25
What kind of epithelium is found at the **superolateral** part of the nasal cavity?
**Olfactory epithelium**
26
Where is **olfactory epithelium** found? What is its function?
**Superolateral nasal cavity** Sense of smell
27
Which **cranial nerve** is responsible for **smell**?
**CN I** **Olfactory nerve**
28
Which structures do the nerve fibres for CN I pass into once they have gotten up through the cribriform plate?
**Olfactory bulbs**
29
What type of fibres are found in **CN I?**
**Special sensory** (Optic nerve is also special sensory because sight is one of the special senses)
30
Nerve fibres for **CN I** pass through which part of the ethmoid bone?
**Cribriform plate**
31
Where are the **receptors** for **CN I** found?
**Olfactory epithelium** Superolateral parts of nasal cavities
32
From the **olfactory bulbs**, **CN I** fibres travel to the **temporal lobes** via which structures?
**Olfactory tracts**
33
Are **cranial nerves** part of the CNS?
**No** CNS is **brain** and **spinal cord** only Cranial nerves are technically **peripheral nerves** (part of PNS)
34
Which **cranial nerves** give off the **somatic sensory** supply for the a) anterosuperior b) posteroinferior parts of the **nasal cavity**?
**a) CN V1** **b) CN V2**
35
Which divisions of the trigeminal nerve supply the upper and lower nasal cavities?
**a) CN V1 - ophthalmic division** **b) CN V2 - maxillary division**
36
Which parts of the nasal cavity are supplied by a) CN V2 b) CN V1?
**a) Posteroinferior** **b) Anterosuperior**
37
Which major arteries of the neck give off the vessels supplying the **nose?**
**External carotid artery** **Internal carotid artery**
38
Which **arteries** branch off the a) **external carotid artery** b) **internal carotid artery** to supply the nose?
**a) Facial artery** and **Maxillary artery** ## Footnote **b) Ophthalmic artery**
39
Which two arteries come off the **ophthalmic artery** (which comes off **internal carotid**) to supply the superior part of the nasal cavity?
**Anterior ethmoidal artery** **Posterior ethmoidal artery**
40
Which artery do the **anterior** and **posterior** **ethmoidal arteries** come off to supply the nasal cavity?
**Ophthalmic artery**
41
Which two arteries come off the **maxillary artery** to supply the posteroinferior part of the nasal cavity?
**Sphenopalatine artery** **Greater palatine artery**
42
Which artery do the **sphenopalatine** and **greater palatine arteries** come off of to supply the nasal cavity?
**Maxillary artery**
43
Which artery comes off the **facial artery** to supply the anterior part of the nasal cavity?
**Lateral nasal** branch of facial artery
44
Which arteries come off a) maxillary artery b) facial artery c) ophthalmic artery to supply the nasal cavity?
**a) Sphenopalatine** and **greater palatine arteries** **b) Lateral nasal branch** **c) Anterior** and **posterior ethmoidal arteries**
45
What is **Kiesselbach's area**?
**Arterial anastomosis in nasal cavity**
46
Is Kiesselbach's area found on the **lateral wall** or the **nasal septum**?
**Nasal septum**
47
Kiesselbach's area is a common site for what? What is a situation where you may cause this yourself?
**Epistaxis** (nosebleeds) **NG tube insertion** So you want to guide it laterally at first to avoid the anastomosis on the **nasal septum** (medial)
48
What two types of structure are found on the **lateral wall** of the nasal cavity?
**Conchae** **Meatuses**
49
What is a concha? What is their function?
**Ridge in wall of nasal cavity** **Increase surface area of respiratory epithelium** so blood vessels, glands can warm and humidify it
50
What is a **meatus**?
**Inferior space** created by each concha
51
What are the three important conchae in the nasal cavity? Which side of the cavity are they found on?
**Superior, middle** and **inferior conchae** ## Footnote **Lateral wall**
52
What are the **four** important meatuses found in the nasal cavity?
**Sphenoethmoidal recess** **Superior meatus** **Middle meatus** **Inferior meatus**
53
Which opening is found on the **lateral wall** of the **nasopharynx**?
**Eustachian tube** communication between **middle ear** and **nasopharynx**
54
Hard palate is found (**anteriorly / posteriorly**). Soft palate... ""
**Hard palate** is anterior **Soft palate** is posterior
55
Which **cranial nerve** are you going to give sensation to when you insert an NG tube? What do you need to avoid? What is the path of the NG tube into the stomach?
**CN V2** - maxillary division (inferoposterior) **Kiesselbach's area** (in case you cause an epistaxis) **Nasal cavity \> Nasopharynx \> Oropharynx \> Laryngopharynx \> Oesophagus \> Stomach**
56
To be confident that it's in the stomach, how far past the gastroesophageal junction should the NG tube be?
**10cm**
57
What allows you to **smell air** as it passes through the nasal cavity?
**Olfactory epithelium**
58
Every bone around the nose has what kind of spaces in it?
**Paranasal sinuses**
59
What is the function of **paranasal sinuses**?
Dunno really but **makes your head lighter, might trap infectious stuff and flush it out**
60
What type of epithelium lines the **paranasal sinuses**? What does it secrete?
**Respiratory epithelium** **Mucus** via goblet cells
61
Which sinuses are associated with the a) **frontal bone** b) **maxilla** c) **ethmoid bone** d) **sphenoid bone**?
**a) 2 frontal sinuses** **b) 2 maxillary sinuses** (called _antra_) **c) 2 sets of ethmoidal air cells** **d) 2 sphenoid sinuses**
62
What holes are found in the **lateral wall** of the nasal cavity and allow mucus to drain from the **paranasal sinuses**?
**Ostia** | (each one is called a sinus ostium)
63
Where does the **sphenoid sinus** drain?
**Sphenoethmoidal recess**
64
Where do the **ethmoidal air cells** drain?
**Superior** and **inferior meatuses**
65
Where does the **frontal sinus** drain?
**Middle meatus**
66
Where do the **antra** drain?
**Middle meatus**
67
Where do the **nasolacrimal ducts** drain?
**Inferior meatus** (only thing draining into inferior meatus is lacrimal fluid)
68
Where do the a) nasolacrimal ducts b) sphenoid sinuses c) frontal sinuses d) ethmoidal air cells e) maxillary sinuses / antra drain?
**a) Inferior meatus** (only structure which drains here) **b) Sphenoethmoidal recess** **c) Middle meatus** **d) Superior and middle meatuses** **e) Middle meatus**
69
Why do you get a runny nose when you cry?
**Increased drainage of lacrimal fluid through inferior meatus** **Which then comes out your nose**
70
What is **sinusitis**?
**Inflammation of the respiratory epithelium lining the sinuses**
71
What are some causes of sinusitis (think VINDICATE)?
**Infection** **Inflammation** **Autoimmune** (including allergy)
72
The problem in sinusitis usually revolves around the failure of mucus drainage through what?
**Ostia**
73
If the ostia of sinuses are closed off, what accumulates in the sinuses?
**Mucus** +/- infection
74
What cranial nerves supply the somatic sensory fibres which will be stimulated in **sinusitis**?
**CN V1** and **V2**
75
Where may **sinusitis** pain be referred? Why?
**Teeth** because teeth are also supplied by **CN V1 and V2**
76
Why are the **maxillary sinuses** / **antra** more likely to become inflamed than other sinuses?
**Ostia** is **superior** So mucus has to drain **against gravity**
77
What spaces can be connected by a **fistula** following dental surgery?
**Oral cavity** and **maxillary sinus**

ENT Week 1 2017/18 (10 decks)

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