Anatomy/Physiology of Nose

Question 1

Epithelium of lining of the nose

Answer 1

columnar ciliated epithelium

Question 2

Components of the external nose

Answer 2

Glabella 
Nasion 
Dorsum 
Supratip 
Tip 
Columnella

Question 3

The nasal bones are composed of

Answer 3

the frontal processes of the maxillae and nasal part of the frontal bones

Question 4

Deformities of the nose can be

Answer 4

congenital or acquired

Question 5

Cause of acquired nose deformity

Answer 5

Trauma

Question 6

What are the five cartilages of the nose?

Answer 6

One septal
Two lateral
Two alar

Question 7

Components of internal nose

Answer 7

Midline partition
Lateral walls
Roof
Floor

Question 8

What structures form the midline partition of the internal nose?

Answer 8

Nasal septum - septal cartilage and perpendicular plate of ethmoid and vomer

Question 9

What structures form the lateral walls of the internal nose?

Answer 9

Turbinates - superior, middle and inferior

Meati

Question 10

What forms the roof of the internal nose?

Answer 10

Cribriform plate

Question 11

What forms the floor of the internal nose?

Answer 11

Hard palate

Question 12

How is the septum clinically relevant?

Answer 12

Can be deviated, perforated or septal haematoma

Question 13

What turbinate is most clinically relevant and why?

Answer 13

Inferior turbinate - can cause nasal blockage due to infection or inflammation

Question 14

How is infection/inflammation of the inferior turbinate usually managed?

Answer 14

Medically with topical steroid sprays, surgery is unusual

Question 15

Blood supply to the nose is broadly divided into

Answer 15

anterior and posterior supply

Question 16

Anterior blood supply to the nose is derived from

Answer 16

branches of the internal carotid artery - anterior/posterior ethmoid arteries from ophthalmic artery

Question 17

Posterior blood supply to the nose is derived from

Answer 17

branches of the external carotid artery - sphenopalatine artery from the maxillary branch

Question 18

What is the blood supply of the mucosal lining of the septum? Why is this clinically relevant?

Answer 18

Capillary plexus - Little’s area

Most common site of epistaxis

Question 19

The nose receives innervation from fibres from the

Answer 19

neuro-olfactory epithelium via the olfactory nerve

and from the infraorbital nerve

Question 20

How might damage to the olfactory nerve occur?

Answer 20

Trauma
Virus
Tumours

Question 21

Damage to the olfactory nerve might result in

Answer 21

hyposmia or anosmia

Question 22

Damage to infraorbital nerve can result in

Answer 22

paraesthesia

Question 23

What is the primary function of the nose?

Answer 23

To act as an airway in respiration

Question 24

Other functions of the nose

Answer 24

Filtration
Humidification/warming of inhaled air
Mucus production, trapping, ciliary clearance
Immune protection
Olfaction
Drainage/aeriation of middle ear
Drainage of paranasal sinuses and nasolacrimal duct

Question 25

What are the four groups of paranasal sinuses?

Answer 25

Frontal Ethmoid Sphenoid Maxillary

Question 26

Frontal, maxillary and anterior ethmoid sinuses are known as the

Answer 26

anterior sinuses

Question 27

Where do the anterior paranasal sinuses drain?

Answer 27

To middle meatus via natural mucociliary pathways

Question 28

Sphenoid and posterior ethmoid sinuses are known as

Answer 28

posterior sinuses

Question 29

Posterior sinuses draw into the

Answer 29

inferior meatus

Question 30

What is the lining of the paranasal sinuses?

Answer 30

Mucociliary - continuous with the nose

Question 31

Important anatomical relations of the paranasal sinuses are

Answer 31

Frontal and ethmoid - anterior cranial fossa Maxillary - orbits Sphenoid - optic nerve, internal carotid artery and cavernous sinus

Question 32

Why are the anatomical relations of the paranasal sinuses clinically important?

Answer 32

Infections of sinuses can spread via anatomical relations to cause serious infection e.g. meningitis, intracranial abscess, orbital sepsis

Question 33

Risks of sinus surgery are

Answer 33

CSF leak | Orbital complications

Question 34

Blood supply and sensory innervation of maxillary sinus

Answer 34

Branches of internal maxillary artery | Branches of second division of trigeminal nerve, infraorbital nerve, greater palatine nerves

Question 35

Blood supply and sensory innervation of frontal sinus

Answer 35

Supraorbital and supratrochlear arteries | Supraorbital and supratrochlear nerves (first division of trigeminal)

Question 36

Blood supply and sensory innervation of sphenoid sinus

Answer 36

Sphenopalatine artery | Branches of first and second divisions of trigeminal nerve

Question 37

Blood supply and sensory innervation of ethmoid sinus

Answer 37

Anterior and posterior ethmoidal arteries | Anterior and posterior ethmoidal nerves and orbital branches of pterygopalatine ganglion

Question 38

Functions of paranasal sinuses

Answer 38

Vocal resonance Decrease weight of skull and facial bones Act as buffer for trauma

Question 39

What is the epithelial lining of the nasopharynx?

Answer 39

Mucociliary

Question 40

What are the boundaries of the nasopharynx?

Answer 40

Choana Sphenoid sinuses Prevertebral fascia and muscle Soft palate

Question 41

What are the important contents of the nasopharynx?

Answer 41

Eustachian openings and adenoids

Question 42

What is a sinus ostium?

Answer 42

The opening that connects a sinus to the nasal cavity

Question 43

What will blockage of a sinus ostia cause?

Answer 43

Accumulation of fluid in the sinuses