H&N week 9- maxillary nerve, nasal cavity. Flashcards

1
Q

What are the nares?

A

The nares are the nostrils.

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2
Q

What do we call the posterior nares

A

The choanae

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3
Q

Discuss the lining of the nasal cavity.

A

The Nasal cavity is lined with respiratory epihthelium.

This is pseudostratifed columnar cells with cilia and goblet cells dispersed between them.

The nasal septum has olfactory epithelium on it.

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4
Q

What is the lateral nasal cartilage.

A

The lateral nasal cartilage is an extention of the septal cartilage which gives shape to the nose.

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5
Q

Discuss the function of the nose and how it works.

A

The nose warms and cleans air.

The high blood supply to the mucosa warms the air.

Mucosus sticks to the dust being inhaled.

The Cilia waft the mucous back into the nasopharynx to get rid of it.

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6
Q

Label this diagram of the lateral wall of the nasal cavity

A
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7
Q

Discuss the concha

A

Concha are large folds of bone covered by mucosal membrane that project into the nasal cavity from the lateral wall.

There are 3 concha:

Inferior-

Middle- A fold of bone above the inferior concha which is slightly smaller and at a bit of an angle.

Superior- A little peice of bone which is quite often fused with the middle concha at the front end.

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8
Q

What are the meatuses?

A

The Meatus is the space underneath the concha where air passes through.

We name the meatus after the concha located above it.

There is:

The inferior meatus

The middle meatus

Superior meatus.

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9
Q

What is the spheno-ethmoidal recess?

A

The area above the superior concha between the sphenoid bone and the ethmoid bone.

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10
Q

Label this diagram of the lateral wall of the nasal cavity with the concha removed

A
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11
Q

What is the frontal air sinus?

A

An air containing space found inside the frontal bone, there is one found on each side of the nose.

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12
Q

Where does the frontal air sinus open?

A

At the top end of the hiatus semilunaris.

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13
Q

What is the nasolacrimal duct?

A

A duct that is draining tears into the nasolacrimal sack.

The opening is on the lateral wall of the nasal cavity into the inferior meatus

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14
Q

What is the hiatus semi-lunaris?

A

A crescent moon shaped recess in the middle meatus.

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15
Q

What is the ethmodial bulla?

A

A bulging peice of bone covered by mucous membrane in the middle meatus. The bone contains lots of air cavities.

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16
Q

Why is it common for patients’ with frontal sinusitis to also have maxillary sinusitis?

A

because the sinus openings are located so close to each other it is easy for the bacteria to drop from one sinus to another.

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17
Q

What are the sphenoidal sinuses?

A

Air pockets that sit right below the sphenoid bone and are lined with respiratory epithelium.

18
Q

Where does the pituitary gland sit?

A

In the sella turcica.

19
Q

Where do the sphenoidal sinuses open?

A

Into the spheno-ethmoidal recess.

20
Q

label this diagram of the maxillary sinus

A
21
Q

What is the maxillary sinus?

A

An air cavity within the maxillary bone.

This makes the bone lighter and gives it strength.

The maxillary sinus is lined by respiratory epithelium.

22
Q

Discuss the opening of the maxillary sinus?

A

This opens at the inferior end of the hiatus semi-lunaris.

But this is at the top of the sinus- which makes it much more difficult to drain.

Cilia are more plentiful at the opening of the maxillary sinus.

23
Q

What are the ethmoidal sinuses?

A

Lots of little air spaces found in the ethmoid bone.

24
Q

Discuss the floor of the orbit?

A

The orbit floor acts as the roof of the maxillary sinus.

But the orbital floor is thin & weak so can break.

25
Q

What is the blowout fracture of the orbital floor?

A

When the orbital floor breaks.

This could involve the infra-orbital nerve or the contents of the orbit falling into the maxillary sinus.

26
Q

Compare an Oroantral communication to an Oro-antral Fistula.

A

Oro-antral communication-

When extraction of an upper tooth causes removal of the bone aswell leaving a gap between the mouth and the maxillary sinus.

On extraction we can also have the root fracturing (leaving it lodged in the maxillary sinus or stuck between the mucosa and bone)

Oro-antral Fistula-

When the opening has been there for a little while so the maxillary epithelium and oral cavity epithelium join together.

This creates a fistula which is an epithelium lined channel.

27
Q

Discuss cancer in the nose

A

Squamous cell carcinoma occurs where there is neoplastic change (metaplasia) from respiratory epithelium to flat squamous cell epithelium.

This presents as

Pain in the face (if the tumour is affecting the infra-orbital nerve)

A Tumour showing in the oral cavity (if the tumour passes through the floor of the maxillary cavity)

28
Q

Why are oro-antral communications common?

A

Because the bone between the floor of the maxillary sinus and the root of the teeth are quite thin,

29
Q

Label this diagram of the disection of the maxillary sinus

A
30
Q

Label this diagram of the nerve supply of the maxillary sinus.

A
31
Q

What branches does the infra-orbital nerve give off once it exits the infra-orbital foramen?

A

This gives off the nasal, palpebral and labial branches.

32
Q

Discuss the bony ridge of the maxillary sinus

A

this is a very thin bone which the infra-orbital nerve runs along.

33
Q

What is the sphenopalatine foramen?

A

Where the branches of the maxillary nerve and maxillary artery come in to supply the mucosa of the nasal cavity.

34
Q

Compare the greater and lesser palatine nerves

A

Greater palatine- found deep to the bony palate & provides sensation and innervation to the hard palate.

Lesser palatine nerves- Little branches coming off the greater palatine. These provide soft palate innervation.

35
Q

Why do you not want to anaesthetise the lesser palatien nerves?

A

As this would affect the soft palate and cause the patient to have difficulty swallowing.

36
Q

What is the lesser palatine foramina?

A

The little holes in the pyramidal process of the palatine bone where the lesser palatine nerves exit the bone into the soft palate

37
Q

What is the greater palatine foramen?

A

Where the greater palatine nerve and greater palatine artery leaves the bone.

38
Q

label this diagram of the nasal spetum

A
39
Q

Label this diagram of the maxillary nerve.

A
40
Q

What is the function of the pterygopalatine ganglion?

A

To innervate the lacrimal gland for tear production.