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Head And Neck > Nose, Nasal Cavity And Paransal Sinuses > Flashcards

Nose, Nasal Cavity And Paransal Sinuses Flashcards

1
Q

What are 3 functions of the nose and nasal cavity

A
  • Olfaction
  • Filtering + humidifying inspired air
  • Drainage of secretions from Paranasal sinuses and Nasolacrimal ducts
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2
Q

The External nose is mainly cartilaginous.

What structures form its root?

A
  • Frontal processes of maxillae

- 2 Nasal bones

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3
Q

List 3 possible injuries to the nose due to its prominent position

A
  • Septal Haematoma
  • Septal deviations (Obstruction to airflow)
  • Nasal bone fractures
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4
Q

Describe the boundaries of the nasal cavity

A
  • Extends from Nostrils anteriorly to Choanae posteriorly

- Has a Roof, Floor and Medial + Lateral walls

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5
Q

What forms the Medial wall of the nasal cavity?

A

Nasal septum, which consists of;

  • Perpendicular plate (of ethmoid bone)
  • Septal cartilage
  • Vomer bone
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6
Q

Where does the Cartilaginous portion of Nasal Septum (septal cartilage) get its blood supply from?

A

Relies on overlying perichondrium

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7
Q

What happens in a Septal Haematoma?

Suggest a complication

(Can appear as bulge when looking into nostrils)

A
  • Blood collects between Septal cartilage and its Perichondrium, stripping away blood supply-> ischaemia of cartilage
  • Necrosis of cartilage can occur-> Saddle deformity
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8
Q

Why is the Lateral Wall of the bony cavity irregular?

A

Due to presence of Conchae (Bony projections)

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9
Q

Name the 3 Conchae and the spaces formed by them

How do they affect airflow?

A

Superior, Middle, Inferior Conchae form the Superior, Middle, Inferior Meatuses

  • Slow airflow by causing turbulence
  • Increased SA over which air flows, allowing better humidification
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10
Q

Through what holes do the Paranasal Air Sinuses and Nasolacrimal Ducts drain into Nasal Cavity?

A

Through openings under the meatuses (3, on lateral wall of cavity)

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11
Q

What 4 bones make up the roof of the nasal cavity

A
  • Nasal
  • Frontal
  • Ethmoidal (Cribriform plate)
  • Sphenoid (E.g Transpehnoidal surgery to reach Pit gland)
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12
Q

What nerve branch innervates sensory function of the nasal cavity and paransal sinuses

A

Vb

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13
Q

Describe the lining and contents of the nasal cavity

A
  • Respiratory mucosa (Excluding Vestibule which is lined by skin)
  • Olfactory region (superior) has Olfactory Mucosa and contains dendrites of Olfactory nerves
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14
Q

Describe the Respiratory Mucosa lining most of the Nasal Cavity

What are 3 ways air is changed in the cavity?

A

Pseudostratified ciliated epithelia rich in goblet cells

  • Filtered (Mucus, Cilia)
  • Humidified (Watery secretions)
  • Warmed (Rich blood supply)
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15
Q

What are Nasal Polyps?

How do they present typically? (Not symptoms)

A

Benign swellings of Nasal Mucosa

  • Usually Bilateral
  • Usually seen over 40 years old
  • Pale/ yellow or fleshy, reddened
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16
Q

List 4 symptoms of Nasal Polyps

A
  • Blocked nose and watery rhinorrhoea (both sides)
  • Post-nasal drip (watery secretions run down back of pharynx)
  • Decreased smell and reduced taste
  • Unilateral polyp may suggest tumour (may be blood-tinted secretion)
17
Q

What is Rhinitis?

What are 4 symptoms?

(Causes: Acute infective OR allergic)

A

Inflammation of Nasal Mucosal lining

  • Rhinorrhea (runny nose)
  • Nasal congestion
  • Post nasal drip
  • Sneezing + Nasalirritation
18
Q

Describe the blood supply to the Nasal Mucosa

A

Branches of Opthalmic and Maxillary arteries, which anastomose in the Anterior Septum.

This anastomosis is called Kiesselbach’s Plexus/ Little’s Area

19
Q

What is the most common source of Epistaxis? (Nose bleed)

How is it treated?

A

Keisselbach’s Plexus (If from here, usually unilateral)

Pinching nose

20
Q

Describe the venous drainage of the nasal cavity

A

Into Pterygoid venous plexus, Cavernous Sinus and Facial Vein

21
Q

What 2 branches of Opthalmic artery feed into Keisselbach’s plexus

Name 2 branches of Maxillary artery that do so.

A

Ophthalmic;

  • Anterior Ethmoid
  • Posterior Ethmoid

Maxillary;

  • Sphenopalatine (Bleed here causes some nosebleeds, is more serious and difficult to treat)
  • Greater Palatine (Less important than SP)
22
Q

What are the 4 major Paranasal sinuses?

These are all paired, except for which one?
Which is largest?

A
  • Maxillary, largest
  • Frontal
  • Sphenoid, not paired
  • Ethmoidal
23
Q

What are 3 components of the Ethmoidal sinus?

Describe the Paransal sinus’ drainage into Nasal Cavity

A

Anterior, Middle and Posterior air cells

  • Drain into a Meatus via Ostia (small channels)
  • Most through Middle Meatus
24
Q

Which Sinus is most commonly affected by infection?

A

Maxillary

25
Q

Obstruction to Sinus drainage can cause accumulation of mucosal secretions and infection develops-> Acute Sinusitis

How does this present in 4 ways?

A
  • Pain
  • Tenderness over sinus involved
  • Nasal discharge
  • General systemic upset (fever, malaise)
26
Q

Suggest 2 causes of Sinusitis?

A
  • Infections of nose (URT)

- Dental infections (Roots of some upper teeth lie in floor of maxillary sinus)

27
Q

What are 3 outcomes of Sinusitis? (Usually due to viral infection)

A
  • Impaired ciliary function
  • Increased mucosal secretions

Mucosal oedema;

  • Can obstruct drainage if involving openings into nasal cavity
  • Stagnant pool collecting which can become infected by bacteria
28
Q

How can Sinusitis be treated?

Most causes are self limiting and improve within 1-2 weeks

A
  • Analgesia

- Antibiotics if secondary bacterial infection present

29
Q

Complications from Sinusitis are rare.

Suggest 1

A

Orbital cellulitis (Infected Ethmoidal air cells can break through thin medial orbital wall and enter)

30
Q

What 3 things suggest that Acute Bacterial Sinusitis is more likely?

A
  • Symptoms severe at onset
  • Symptoms >10 days with no improvement
  • Symptoms worsen after initial improvement

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