Anatomy: Nasal Cavities And Pterygopalatine Fossa

Question 1

Why would you not use adrenaline containing LA’s near the nasal cartilages?

Answer 1

Because adrenaline is a vasoconstrictor. It could potentially constrict the arteries supplying the nasal cartilages to the point that they die without any supply

Question 2

What are the four main bones of the nasal cavity?

Answer 2

1. Nasal bone
2. Ethmoid bone
3. Perpendicular plate of ethmoid bone
4. Vomer bone

Question 3

The roof of the nasal cavities is formed by what features of the ethmoid bone?

Answer 3

The cribiform plate and Crista galli

Question 4

The lateral wall of the nasal cavities is formed by what structures?

Answer 4

The superior and middle conchae

Question 5

The septum of the nasal cavity is formed by what bones?

Answer 5

The perpendicular plate of the ethmoid bone and the vomer

Question 6

What is the function of the crista galli?

Answer 6

It serves as an attachment point for dura mater, specifically falx cerebri

Question 7

Where do the ethmoid air cells sit in the nasal cavity?

Answer 7

The lateral border

Question 8

Which le fort fractures can disrupt the cribifrom plate of ethmoid bone and what is the major concern associated?

Answer 8

Le fort fractures II and III.
There is a danger of infection spreading from nasal cavity and paranasal sinuses into the anterior cranial fossa

Question 9

What type of mucosa is found in the anterior nasal cavity?

Answer 9

Keratinised stratified squamous epithelium

Question 10

What type of mucosa is found in the majority of the nasal cavity ( middle and posterior)?

Answer 10

Respiratory epithelium

Question 11

What type of mucosa is found in a small section and the superior/posterior border of the nasal cavity?

Answer 11

Olfactory mucosa

Question 12

What do olfactory receptor cells relay?

Answer 12

Nerves associated with sense of smell

Question 13

Where do receptor cells pass through as the first neurones in the chain?

Answer 13

The cribriform plate of the ethmoid bone

Question 14

Where do receptor cells pass through after the cribriform plate of the ethmoid bone?

Answer 14

To the olfactory bulbs

Question 15

What are the olfactory bulbs?

Answer 15

Cell bodies of second neurones

Question 16

Where are second order neurones passed along to reach the temporal lobe of the brain?

Answer 16

Olfactory tract

Question 17

What happens to nerve signals once at the temporal lobe?

Answer 17

They are transmitted to higher centres

Question 18

What can be described as having a Dual blood supply?

Answer 18

The nasal cavity and nose

Question 19

Where does the blood supply to the nasal cavities originate from?

Answer 19

The external and internal carotid arteries

Question 20

Which arteries that supply the nasal cavities branch from the external carotid artery?

Answer 20

Facial artery
Maxillary artery

Question 21

Which arteries that supply the nasal cavities branch from the internal carotid artery?

Answer 21

Ophthalmic artery

Question 22

Via what arteries does the ophthalmic artery supply the nasal cavities?

Answer 22

Anterior and posterior ethmoidal arteries

Question 23

Via what arteries does the maxillary artery supply the nasal cavities?

Answer 23

Sphenopalatine and greater palatine arteries

Question 24

Via what arteries does the facial artery supply the nasal cavities?

Answer 24

Via the lateral nasal branch of the facial artery or septal branch of superior labial artery

Question 25

What is the importance of kiesselbach’s “little’s” area?

Answer 25

It is an arterial anastomosis on the nasal septum. The most common site for nosebleeds ( epistaxis)

Question 26

Name the conchae of the lateral wall of nasal cavities

Answer 26

- superior -middle - inferior

Question 27

What function do the conchae have?

Answer 27

They warm and humidity air we breathe in

Question 28

Name the meatus’ of the nasal cavities

Answer 28

- sphenoethmoidal recess - superior meatus - middle meatus - inferior meatus

Question 29

What are paranasal sinuses?

Answer 29

Air filled spaces within bones

Question 30

How many sinuses are there in the frontal bone?

Answer 30

Two, called frontal sinuses

Question 31

How many sinuses are in the two maxillary bones?

Answer 31

Two, maxillary sinuses (one in each bone)

Question 32

How many sinuses are in the ethmoid bone?

Answer 32

Two sets of ethmoidal air sinuses

Question 33

How many sinuses are in the sphenoid bone?

Answer 33

Two sphenoidal sinuses

Question 34

What mucosa lines sinuses?

Answer 34

Mucous-secreting respiratory mucosa

Question 35

Via what structure does mucous drain into nasal cavities?

Answer 35

Ostia

Question 36

Where do the frontal sinuses drain to?

Answer 36

The middle meatus

Question 37

Where do the ethmoidal air cells drain to?

Answer 37

Superior and middle meatus

Question 38

Where do sphenoidal sinuses drain to?

Answer 38

Sphenoethmoidal recess

Question 39

Where do the maxillary sinuses drain to?

Answer 39

The middle meatus

Question 40

What do lacrimal glands produce?

Answer 40

Tears

Question 41

Where do tears from the lacrimal gland drain to?

Answer 41

Nasolacrimal duct

Question 42

Where does the nasolacrimal duct drain to?

Answer 42

The inferior meatus

Question 43

Define sinusitis

Answer 43

The inflammation of the mucosa of paransal sinuses

Question 44

What nerves cause pain sensation related to sinusitis?

Answer 44

CN V1 and V2

Question 45

What dental related infection can cause sinusitis?

Answer 45

Dental abscess

Question 46

Give an example of referred pain in regards to sinusitis

Answer 46

Maxillary sinusitis may present as a toothache of an upper or lower tooth due to the common sensory nerve supply form CN V

Question 47

‘Holes’ in the recesses and meatuses of the lateral walls that allow drainage of mucosa from paranasal sinuses are known as?

Answer 47

Ostia

Question 48

What are the two main functions of nasal cavities?

Answer 48

- convey respiratory gases between atmosphere and nasopharynx - special sense of smell

Question 49

What is the more common term used for allergic rhinitis?

Answer 49

Hay fever

Question 50

What structure is termed the “ ganglion of hay fever”?

Answer 50

Pterygopalatine ganglion

Question 51

Describe the Pterygopalatine fossa

Answer 51

A small, clinically inaccessible space located deep in the face

Question 52

Where does the maxilla sit in relation to the Pterygopalatine fossae?

Answer 52

Anteriorly

Question 53

What fissure extends into the Pterygopalatine fossa?

Answer 53

Pterygomaxillary fissure

Question 54

Where does the Pterygopalatine fossa sit in relation to the infra-temporal fossa?

Answer 54

Medially

Question 55

In what direction does the Pterygopalatine fossa communicate with the orbit?

Answer 55

Anteriorly

Question 56

What direction does the Pterygopalatine fossa communicate with the middle cranial fossa?

Answer 56

Posteriorly

Question 57

in what direction does the Pterygopalatine fossa communicate with the infra-temporal fossa?

Answer 57

Laterally

Question 58

In what direction does the Pterygopalatine fossa communicate with the nasal cavity?

Answer 58

Medially

Question 59

Via what structure does the Pterygopalatine fossa communicate with the orbit?

Answer 59

The inferior orbital fissure

Question 60

Via what structures does the Pterygopalatine fossa communicate with the middle cranial fossa?

Answer 60

Foramen rotundum and pterygoid canal

Question 61

Via what structure does the Pterygopalatine fossa communicate with the infratemporal fossa?

Answer 61

Ptergyomaxillary fissure

Question 62

Via what structure does the Pterygopalatine fossa communicate with the nasal cavity?

Answer 62

Sphenopalatine foramen

Question 63

Where is the Sphenopalatine from and found?

Answer 63

In the lateral wall of the nasal cavity. Between the body of sphenoid and perpendicular plate of palatine bone.

Question 64

What are the three key structures that the Pterygopalatine fossa contains?

Answer 64

- terminal 1/3rd of maxillary artery - CN V2/b - Pterygopalatine ganglion

Question 65

Which part of the maxillary artery is important in regards to the Pterygopalatine fossa?

Answer 65

The 3rd part

Question 66

What are the branching arteries of the 3rd part of the maxillary artery?

Answer 66

- Sphenopalatine - descending palatine - posterior superior alveolar - middle superior alveolar - anterior superior alveolar

Question 67

Which foramen does the Sphenopalatine artery travel through into the nasal cavity?

Answer 67

The Sphenopalatine foramen

Question 68

What artery branches from the Sphenopalatine artery once in the nasal cavity?

Answer 68

The descending palatine artery

Question 69

What does the descending palatine artery supply?

Answer 69

The palate and part of nasal cavity

Question 70

At what point does the maxillary artery pass through the infra-orbital foramen?

Answer 70

After the branching of the posterior alveolar nerve to supply the posterior upper dentition

Question 71

What arteries are given off from the infra-orbital foramen?

Answer 71

The middle and anterior superior alveolar arteries

Question 72

What artery does the maxillary artery arise from?

Answer 72

External carotid artery

Question 73

What does the Sphenopalatine artery supply?

Answer 73

The nasal cavity

Question 74

At what point does the maxillary artery become the Sphenopalatine artery?

Answer 74

At the Sphenopalatine foramen

Question 75

Which nerve does the Sphenopalatine artery travel alongside on the nasal septum?

Answer 75

Nasopalatine nerve

Question 76

What cranial nerve gives sensory innervates to the nasal cavity?

Answer 76

Trigeminal nerve ( CN V)

Question 77

What is the somatic sensory supply to the nasal cavity?

Answer 77

The anterior ethmoidal branch of nasociliary (CN V1)

Question 78

What part of the nasal septum does the anterior ethmoidal nerve innervate?

Answer 78

The posterioinferior nasal septum

Question 79

What nerves gives somatic sensory innervation to majority of the nasal cavity and nasopharynx?

Answer 79

Nasopalatine nerve (CNV2) And Lateral nasal branches of greater palatine nerve (CNV2)

Question 80

What are the two main nerve branches off the Pterygopalatine ganglion?

Answer 80

- nasopalatine nerve - greater and lesser palatine

Question 81

What foramen does CN V2 travel through?

Answer 81

The foramen rotundum

Question 82

What condition does the autonomic nerve supply to nasal cavities give an explanation for?

Answer 82

Hay fever

Question 83

Explain the route of preganglionic sympathetic fibres from the brain to the cervical sympathetic ganglion

Answer 83

From the brain, they travel down spinal cord, exit the spinal cord at T1 spinal nerve, then travel superiorly in the sympathetic chain to synapse in the cervical sympathetic ganglion

Question 84

Where do nerve fibres from the carotid plexus run to?

Answer 84

The deep petrosal nerve

Question 85

Where does the deep petrosal nerve pass through and to supply what?

Answer 85

Runs and passes through the pterygoid canal, then the Pterygopalatine ganglion to supply the mucosa of nasal cavities

Question 86

What type of nerve fibres does CN VII carry towards the Pterygopalatine ganglion?

Answer 86

Pre-synaptic parasympathetic nerve fibres

Question 87

The pre-synaptic parasympathetic nerve fibres synapse at the Pterygopalatine ganglion. True or false?

Answer 87

True

Question 88

Where do post-synaptic parasympathetic fibres run towards and innervate?

Answer 88

Will head towards the lacrimal gland, to the mucosa of nasal and palatine regions

Question 89

What two nerves comprise the nerve of pterygoid canal?

Answer 89

The greater petrosal and deep petrosal

Question 90

What type of nerve fibres does the greater petrosal nerve carry?

Answer 90

Pre-syntactic parasympathetic nerve fibres from CN VII

Question 91

What type of nerve fibres does the deep petrosal nerve carry?

Answer 91

Post-synaptic sympathetic fibres

Question 92

Which structure contains both pre-synaptic parasympathetic fibres and post-synaptic sympathetic fibres?

Answer 92

Nerve of pterygoid canal

Question 93

CN V2/b distributes sympathetic and parasympathetic secretomotor fibres from Pterygopalatine ganglion to what structures?

Answer 93

- lacrimal gland - mucous glands of nasal cavity - minor salivary glands of palate