Anatomy And Physiology Of The Nose

Question 1

What is the principal physiological function of the nose?

Answer 1

Humidify and warm inspired air

Question 2

What can a blocked nose cause?

Answer 2

Dry mouth, disturbed sleep

Question 3

What do tracheostomy/ Laryngectomy ‘patients need?

Answer 3

Humidifiers

Question 4

What are other functions of the nasal airway?

Answer 4

Remove noxious particles from the air
Protects delicate distal lower respiratory tract

Question 5

What is the olfaction?

Answer 5

Sense organ, housing the olfactory apparatus

Question 6

What is the function of olfaction?

Answer 6

Smell substances for pleasure and defence purposes
Important role in protection from danger, such as fire
Central in forming positive and negative memories
Taste: while chewing, chemicals from food can activate olfactory receptors to identify food flavour

Question 7

What can dysfunction in olfactory apparatus result in?

Answer 7

Poor quality of life

Question 8

What is Choanal atresia?

Answer 8

Failed recanalization of the nasal fossae during foetal dvelopment

Question 9

Why is choanal atresia an emergency?

Answer 9

Neonates are obligate nasal breathers, so will be unable to breathe

Question 10

How is choanal atresia treated?

Answer 10

Surgical repair

Question 11

How does the immune function of the nose work?

Answer 11

Mucus consists of compounds that are able to neutralise antigens (IgA and IgE).

Question 12

What can affect the immune response of the nose ad why?

Answer 12

Smoking, reduces the number of cilia and change the mucous viscosity

Question 13

How does the nose contribute to speech?

Answer 13

Nasal airflow modifies speech and produce nasal clicks or click consonants. Paranasal sinuses also contribute to viral resonance

Question 14

What is nasal airflow like as it enters the nasal vestibule?

Answer 14

Laminar- no mixing of the different air layers at low velocity

Question 15

Where does the velocity of air increase?

Answer 15

The nasal valve, narrowest site of upper respiratory tract

Question 16

What type of airflow is observed at nasal valve?

Answer 16

Turbulent flow, with different layers swirling together.

Question 17

What does the charge from laminar to turbulent flow allow?

Answer 17

The velocity to reduce, allowing prolonged contact with the nasal mucosa

Question 18

What are paranasal sinuses?

Answer 18

Air filled, arise from the nasal cavit

Question 19

What is the dorsum of the nose?

Answer 19

Surface between root of nose and tip

Question 20

What is the opening of the nose called?

Answer 20

Nares

Question 21

What are the opening of the nose separated by?

Answer 21

Columella

Question 22

What is the nasal skeleton made up of?

Answer 22

Bony and cartilagenous components

Question 23

What are the main cartlages?

Answer 23

Upper lateral cartilage
Lower lateral cartilage

Question 24

What can nasal bone fracture result in?

Answer 24

Permanent deformity

Question 25

Treatment for a nasal bone fracture?

Answer 25

Possible to correct before bone heals Most often performed under local anaesthesia

Question 26

What do yiu need to be aware of with nasal bone fracture?

Answer 26

Septal haematoma

Question 27

What can cause a saddle nose deformity?

Answer 27

Nasal trauma - septal haematoma

Question 28

What leads to a saddle nose deformity?

Answer 28

Can’t relate has no blood supply of its own Relies on surrounding perichondrium Haematoma results in ischaemia and necrosis of the septum Support of the nose is lost

Question 29

What is the vasculature of the skin of external nose?

Answer 29

Skin of external nose receives arterial supply from suratrochlear and dorsal nasal arteries and infra orbital artery

Question 30

What is the vasculature of the septum and alar cartilages?

Answer 30

Angular artery and lateral nasal artery - both branches of the facial artery

Question 31

What is the venous drainage of the external nose?

Answer 31

Facial vein and the internal jugular vein

Question 32

What does highly anastomotic venous system of the nose allow?

Answer 32

Terograde preadolescent of infection to cavernous sinus via opthalmic veins

Question 33

What can spread of infection to cavernous sinus be

Answer 33

Life and sight threatening

Question 34

What can infection of cavernous sinus lead to?

Answer 34

Ptosis, chemosis, cranial nerve palsies Sensory deficits of opthalmic and maxillary branches Papilloedema, retinal haemorrhages, decreased visual acuity and blindness may occur Fever, sepsis and tachycardia may be present Headache with nuchal rigidity

Question 35

What nerve is the innervation of external nose derived from?

Answer 35

Trigeminal nerve.

Question 36

Describe the innervation of the external nose?

Answer 36

Infratroch;ear and external nasal nerves, branches of the opthalmic nerve, supply the skin of the dorsum of the nose, nasal alae and nasal vestibule Lateral aspects of the nose are supplied by infra orbital nerve, a branch of the maxillary nerve Motor innervation to the nasal muscles via the facial nerve

Question 37

What muscle covers the dorsum of the nose>

Answer 37

Nasalis

Question 38

What is the innervation of nasalis

Answer 38

Buccaneers branch of facial nerve

Question 39

What is the action of nasalis?

Answer 39

Alar part: drepress ala laterally, dilates nostril Transverse part: wrinkles skin of dorsum and nose

Question 40

What muscle occupies the glabella

Answer 40

Procerus

Question 41

What is the innervation of procerus

Answer 41

Temporal, lower zygomatic or buccaneers branches of facial nerve

Question 42

What is the action of procerus?

Answer 42

Depress medial ends of the eyebrows, wrinkles skin over glabella- creates facial expression of frowning or when exposed to bright lights or other eye irritants

Question 43

What separates the left and right nasal cavities?

Answer 43

Midline nasal septum

Question 44

What 3 parts is the nasal cavity split into?

Answer 44

Vestibule Respiratory region Olfactory region

Question 45

What is the vestibule

Answer 45

entrance to cavity, lineed hair bearing skin

Question 46

What is the respiratory region?

Answer 46

Lined by ciliates pseudostratified epithelium, with mucous secreting goblet cells

Question 47

What is the olfactory region?

Answer 47

At the apex of the nasal cavity. Lined by olfactory cells with olfactory receptors

Question 48

What makes up the nasal septum

Answer 48

Quadrangular cartilage Perpendicular plate of ethmoid Vomer Maxillary crest Palatine bone

Question 49

What are the paired bony projection from the lateral nasal wall?

Answer 49

Superior turbinate Middle turbinate Inferior turbinate

Question 50

What does the presence of turbinates produce?

Answer 50

Meati

Question 51

What does the rich vascular supply of the internal nose allow?

Answer 51

Allow humidification and warmin of inspired air

Question 52

Branches of what arteries supply the internal nose?

Answer 52

ICA and ECA

Question 53

What branches of the ICA supply the internal nose?

Answer 53

Anterior ethmoidal artery Posterior ethmoidal artery

Question 54

What branches of the ECA supply the internal nose?

Answer 54

Sphenopalatine artery Greater palatine artery Superior labial artery Lateral nasal arteries

Question 55

What are paranasal sinuses lined by?

Answer 55

Respiratory epithelium

Question 56

What are the four paired sinuses?

Answer 56

Frontal Ethmoidal Sphenoid Maxillary

Question 57

Where do the frontal sinuses drain into?

Answer 57

Via the frontonasal duct into the hiatus semilunaris, within the middle meatus of the nasal cavity

Question 58

What is sensation to the frontal sinus supplied by?

Answer 58

Supraorbital nerve

Question 59

What is the arterial supply for frontal sinus?

Answer 59

Anterior ethmoidal artery

Question 60

Where does the sphenoid sinus drain to?

Answer 60

Via sphenoethmoidal recess, supero-posterior to the superior turbinate

Question 61

what is the sphenoid sinus innervated by?

Answer 61

Posterior ethmoidal nerve

Question 62

What is arterial supply to sphenoid sinus?

Answer 62

Sphenopalatine and posterior ethmoidal artery

Question 63

What is trans-sphenoid surgery most often uses for?

Answer 63

Pituitary adenoma (also possible in other skull base tumours)

Question 64

What is the advantage of trans-sphenoidal surgery?

Answer 64

Avoids transcranial approach

Question 65

Who is trans-sphenoidal surgery a joint procedure between?

Answer 65

ENT and neurosurgery

Question 66

What is transphenoidal surgery in close proximity to?

Answer 66

Internal carotid artery

Question 67

What does a CSF leak require

Answer 67

Repair

Question 68

Where does the maxillary sinus drain to?

Answer 68

Via Ostia at hiatus semilunaris, underneath the frontal sinus opening

Question 69

What is maxillary sinus innervated by?

Answer 69

Superior alveolar nerves and greater palatine nerve

Question 70

What is the arterial supply of the maxillary sinus?

Answer 70

Branches of facial and maxillary arteries

Question 71

How many ethmoidal sinuses are there?

Answer 71

2- anterior and posterior

Question 72

Where does the anterior ethmoidal sinus open into?

Answer 72

Hiatus semilunaris, middle meatus via ethmoid bulla

Question 73

Where does the posterior ethmoidal sinus open into?

Answer 73

Lateral wall of the superior meatus

Question 74

What is the ethmoidal sinuses innervated by?

Answer 74

Anterior and posterior ethmoidal branches of the nasociliary nerve and the maxillary nerve

Question 75

What is the arterial supply of the ethmoidal sinuses?

Answer 75

Anterior and posterior ethmoidal arteries

Question 76

What is orbital cellulitis caused by?

Answer 76

Acute spread of infection from ethmoid or frontal sinuses

Question 77

What clinical signs differentiate orbital cellulitis from pre-septal cellulitis?

Answer 77

Portosis, chemosis Ophthalmopegia Painful eye movement Decreased visual acuity/ loss of colour vision

Question 78

What is the treatment for orbital cellulitis?

Answer 78

Requires IV antib, nasal decongestants, CT scan +/- surgical drainage

Question 79

What does the sphenoid sinus drain via?

Answer 79

The sphenoethmoidal recess

Question 80

What does the posterior ethmoid drain via?

Answer 80

The lateral wall of the superior meatus

Question 81

What does the anterior ethmoid, frontal and maxillary sinus drain via?

Answer 81

Ostiomeatal complex in the middle meatus

Question 82

Where does the nasolacrimal duct open into?

Answer 82

Inferior meatus

Question 83

What does blockage of ostiomeatal complex lead to?

Answer 83

Sinusitis

Question 84

What is sinusitis?

Answer 84

Inflammation of lining of the sinus

Question 85

How long does sinusitis occur for to be acute

Answer 85

<3 months

Question 86

What causes acute sinusitis?

Answer 86

Viral origin

Question 87

How long does sinusitis occur for to be chronic?

Answer 87

>3 months

Question 88

What can chronic sinusitis occur with?

Answer 88

Polyposis

Question 89

What can chronic sinusitis cause?

Answer 89

Nasal obstruction Chronic nasal discharge Affect on smell

Question 90

What can happen to static mucus?

Answer 90

Infection

Question 91

What is the nasopharynx?

Answer 91

Area posterior to nasal choanae, extending down the soft palate

Question 92

What is the contents of the nasopharynx?

Answer 92

Adenoids and tubal tonsils - lymphoid tissue, make up part of waldayers ring Eustachian tube opening

Question 93

What can obstruct Eustachian tubes?

Answer 93

Enlarged adenoids or post nasal space masses

Question 94

What may glue ear require?

Answer 94

Adenoidectomy and insertion of grommets

Question 95

What may unilateral glue ear indicate?

Answer 95

Nasopharyngeal mass