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Head and Neck > Anatomy/Physiology of Nose & Sinus > Flashcards

Anatomy/Physiology of Nose & Sinus Flashcards

1
Q

What is the function of the nasal airway?

A
  • Warms and humidifies inhaled air

* Important for neonate - obligate nasal breather, choanal atresia

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2
Q

What is obligate nasal breathing in children?

A

Breathing through their nose rather than mouth

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3
Q

What is choanal atresia?

A

Congenital disorder where the back of the nasal passage (choana) is blocked causing breathing difficulties

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4
Q

How does the nasal airway warm and humidify inhaled air?

A
  • Turbinate + septum - laminar flow

* Mucosal lining - humidification and contains sinuses which acts a reservoir of warm humid air

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5
Q

What is the function of the nasal?

A
  • Nasal airway
  • Immune barrier
  • Smell
  • Drainage and aeration of middle ear
  • Drainage of paranasal sinuses and lacrimal duct
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6
Q

What nasal structures are important for smell?

A

• Olfactory nerve
Through cribriform plate
• Olfactory mucosa

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7
Q

What is the name of the tube involved in drainage and aeration of middle ear?

A

Eustacian tube

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8
Q

What are 5 function of the sinus?

A
  • Reservoir of warm humid air
  • Lighten skull
  • Crumple zones
  • Vocal resonance
  • Line with same mucosa - immune barrier
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9
Q

What are the different sections to the external nasal anatomy?

A
  • Lower and upper laterals
  • Nasal septum
  • External subunits
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10
Q

How much of the external nasal anatomy is bony and cartilaginous?

A

1/3 bony and 2/3 cartilaginous

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11
Q

What are the different parts to the external nose?

A
  • Columella
  • Tip + supra tip
  • Dorsum
  • Nasion
  • Glabella
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12
Q

Why is it important to know the external nasal anatomy?

A

For nasal trauma:
• Broken bone: move back before they heal
• Broken/bent cartilage: hard to unbend

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13
Q

What are the structures of the internal nose?

A
  • Midline - septum
  • Roof: skull base/cribriform plate
  • Walls: turbinates
  • Floor: hard plate
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14
Q

Name four additional structures found in the internal nose

A
  • Paranasal sinuses
  • Orbits - lamina papyracea
  • Eustacian tube
  • Adenoids
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15
Q

What are the parts to the septum?

A

• Septal cartilage
• Vomer
Perpendicular plate of ethmoid

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16
Q

Describe the blood supply of the septum

A
  • Poor blood supply
  • Gets blood supply from mucosa overlying it
  • Relevant in septal haematoma
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17
Q

What is a septal haematoma?

A

When blood collects in the septum of your nose

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18
Q

How does a septal haematoma form?

A
  • Post trauma
  • Usually bilateral
  • Disruption of blood supply to septum -> septum necroses
  • Leads to perforation - bleeding - must be drained ASAP

• Drugs and digital trauma

19
Q

What are turbinates?

A

Bony scroll-like structure from lateral wall of nose
• Superior
• Middle
• Inferior

20
Q

What is the function of turbinates?

A

Increases surface area of the nose for humidification and warming

21
Q

What covers the turbinate and what is its function?

A

Erectile tissue - swells in response to tissue

22
Q

What ducts open underneath the turbinates?

A

Sinuses and nasolacrimal

23
Q

What is the function of the nasolacrimal duct?

A

Drainage pathway of lacrimal sections (tears) from the lacrimal sac (medial to eye) to under inferior turbinate into the inferior meatus

Causes runny nose when crying

24
Q

Where are the paranasal sinuses located?

A
  • 2 Frontal
  • 2 Maxillary
  • Sphenoid
  • Ethmoid air cells - anterior and posterior
25
Q

Where do the frontal sinus drain to?

A

Drains into frontal recess behind eyebrows into the middle meatus (lateral to middle turbinate)

Site of Potts puffy (tumour of frontal bone) - complication of acute sinusitis

26
Q

Describe structure of the ethmoid

A
  • Honeycomb structure between eyes
  • Anterior and posterior
  • Middle turbinate turns at the back of the nose to attach to the lateral nasal wall - ground lamella
27
Q

Where does the ethmoid drain to?

A

Ground lamella separate anterior and poster ethmoid sinuses
• Anterior ethmoids - drains into middle meatus
• Posterior ethmoids - drains into superior meatus (lateral to superior turbinate)

28
Q

What is the lamina papyracea?

A

Paper thin bone between the ethmoids and orbit

29
Q

What is the clinical relevance of lamina papyracea?

A

Any infection (i.e. sinusitis of ethmoid air spaces) can spread to the orbit and cause periorbital/orbital cellulitis

Wont improve until sinusitis treated

30
Q

How does the sphenoid sinus drain?

A

Via sphenoethmoidal recess

31
Q

What are anatomical relation to the sphenoid sinus?

A
  • Optic nerve runs above
  • Internal carotids either side
  • Pituitary posterior
32
Q

How does the maxillary sinus drain?

A

From behind each cheek and drains via the middle meatus

Site of facial pain

33
Q

What arteries supply blood to the nose?

A

Internal and external carotid arteries

34
Q

What two branches does the external carotid artery give off?

A

Maxillary and superficial temporal artery

35
Q

What branches of the ECA supply the nose?

A
  • Via maxilary: sphenopalatine and greater palatine

* Via facial: superior labial

36
Q

What branches of the ICA supply the nose?

A

Via opthalmic artery: anterior and posterior ethmoid artery

37
Q

What is the Little’s Area of the nose?

A

A region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus (Kiesselbach’s plexus)

38
Q

What is the clinical significance of Little’s Area?

A

Most common site for nose bleeding

Pinch soft part of the nose for epistaxis (nosebleed), not the bony part

39
Q

What is the main nerve that provides nasal innervation?

A

Trigeminal nerve (CN V):
• V1 Ophthalmic
• V2 Maxillary

40
Q

What nerve provides sensation to the nose?

A

Vidian nerve (parasympathetic)

41
Q

What is the clinical significance of the Vidian nerve?

A

Can cause vasomotor rhinitis and crocodile tears which are treated by a Vivian neuronectomy

42
Q

What structures lie in the post-nasal space?

A
  • Adenois
  • Eustacian tube opening
  • Soft palate muscles (attach to Eustachian tube)
  • If middle ear problems, think back of nose
  • Fossa of Rosenmuller
43
Q

What is fossa of rosenmuller?

A

A bilateral projection of the nasopharynx just below the skull base
• Node of rouvier
• Nasopharyngeal carcinoma

Head and Neck (12 decks)

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