Chapter 10: Applied Anatomy and Physiology of the Nose Flashcards by Karen Joy Coloma

Subserves the sense of smell
Prepares inhales air for use in the lungs
Furnishes the air resistance necessary for normal functioning of the lungs
Exerts certain reflex effects upon the lungs
Modifies speech

Nose

How well did you know this?

Not at all

Perfectly

Midline structure projecting outward from the plane of the cheeks and upper lip

External nose

How well did you know this?

Not at all

Perfectly

Division of external nose

Bony vault: most superior, immobile
Cartilaginous vault: slightly movable
Nasal lobule: movable

How well did you know this?

Not at all

Perfectly

External nasal skeletal structures

Ascending processes of the maxillae
Two nasal bones
All supported by the nasal process of the frontal bone and a portion of the perpendicular plate of the ethmoid bone

How well did you know this?

Not at all

Perfectly

Representing the portions of the embryologic medial maxillary process that engulfs the anterior premaxilla
Part of the external nose

Anterior nasal spine

How well did you know this?

Not at all

Perfectly

Made up of the upper lateral cartilages
Fused with each other in the midline
Also fused with the upper margin of the quadrangular septal cartilage

Cartilaginous vault

How well did you know this?

Not at all

Perfectly

Has its shape maintained by the lower lateral cartilages
Encloses the nasal vestibule
Medial: columella
Lateral: alae of the nose
Anterosuperior: nasal tip
Mobility is necessary for facial expression, sniffing and sneezing

Nasal lobule

How well did you know this?

Not at all

Perfectly

Narrowest structure of the entire upper respiratory tract

Limen nasi (os internum)/ nasal valve of Mink

How well did you know this?

Not at all

Perfectly

Soft tissue division between the internal and external nose

Inferior: pyriform crest with its skin cover
Medial: nasal septum
Superior and lateral: lower margin of the upper lateral cartilage

How well did you know this?

Not at all

Perfectly

Extends from the os internum anteriorly to the posterior choana, which divides the nasal cavity from the nasopharynx

Internal nose

How well did you know this?

Not at all

Perfectly

A bony structure which divides the organ into two noses

Nasal septum

How well did you know this?

Not at all

Perfectly

Provides sinus ostia for the frontal, anterior ethmoid and maxillary sinuses

Hiatus semilunaris of the middle meatus

How well did you know this?

Not at all

Perfectly

Empties into the inferior meatus anteriorly

Nasolacrimal duct

How well did you know this?

Not at all

Perfectly

Drain into the superior meatus

Posterior ethmoid sinus cells

How well did you know this?

Not at all

Perfectly

Drains into the sphenoethmoid recess

Sphenoid sinus

How well did you know this?

Not at all

Perfectly

Skeletal portion of the septum is composed of

Anterior: septal cartilage (quadrangular)
Above: perpendicular plate of the ethmoid
Posterior: vomer and rostrum of the sphenoid
Below: ridge, comprising the crest of the maxillas and the crest of the palatines

How well did you know this?

Not at all

Perfectly

Minor septal deformities rarely alter nasal air flow because of…

Turbinate compensation

How well did you know this?

Not at all

Perfectly

All sinuses are lined with…

Modified respiratory epithelium

Capable of producing mucus and having cilia, of emptying. Into the nasal cavities

How well did you know this?

Not at all

Perfectly

Most consistently present at birth

Rudimentary maxillary sinus or antrum

How well did you know this?

Not at all

Perfectly

Histology of respiratory apparatus

Ciliated, pseudostratified columnar epithelium

How well did you know this?

Not at all

Perfectly

Histology of the anterior ends of the turbinates and septal mucosa

Stratified squamous epithelium without cilia–an extension of the skim of the nasal vestibule

How well did you know this?

Not at all

Perfectly

Along the main path of the inspiratory currents the cells become…

Columnar; cilia are short and slightly irregular

How well did you know this?

Not at all

Perfectly

Cells of the middle and inferior meatuses, handling most of the expiratory flow path..

Grow long and evenly spaced cilia

How well did you know this?

Not at all

Perfectly

Sources of the mucous blanket, are found in proportion to the thickness of the lamina propia

Secretion-producing glands and goblet cells

Very viscous and sticky mucous blanket catches dust, inspissated foreign bodies and bacteria

How well did you know this?

Not at all

Perfectly

Are found in the mucous blanket and give further protection against pthogens

Lysozyme | Immunoglobulin A

The mucous blanket in the nose is renewed about...

3-4 times an hour

5-7 microns in length Located on the end plates of the surface cells in the epithelium Work almost automatically

Cilia

Built up of two single central microtubules surrounded by 9 pairs of microtubules, all enclosed within the thin fragile, trilaminar cell membrane

Cilia

Each stroke has a powerful, rapid phase in the direction of flow with the cilium straight and stiff, followed by a slower phase recovery during which the cilium bends

Cilia movement/stroking

Olfactory pseudostratified columnar epithelium is composed of 3 cell types

1. Olfactory bipolar nerve cells 2. Sustentacular, supporting cells (most numerous) 3. Few, small basal cells (stem cells for the sustentacular cells)

Represents the only portion of the CNS that reaches the body's surface

Olfactory bipolar neurons

Provide lateral support Represent a means of intraepithelial ionic communication via their junctional complexes with the olfactory bipolar neurons

Sustentacular cells

Tiny outpouchings of the cell membrane | Incease the surface area

Microvilli

Supplies the conchae, meatus and septum

Sphenopalatine branch of the internal maxillary artery

Supply the ethmoidal and frontal sinuses and the roof of the nose

Anterior and posterior ethmoidal branches of the ophthalmic artery

Supply the maxillary sinus

Branch of the superior labial artery | Infraorbital and alveolar branches of the internal maxillary artery

Venous drainage

1. Ophthalmic 2. Anterior facial 3. Sphenopalatine veins

The nose has a rich supply of lymphatics occurring in an...

Anterior network | Posterior network

Small and drains along the facial vessels to the neck | Serve the most anterior portion of the nose--the vestibule and the preturbinal area

Anterior network of lymphatics

Serves the majority of the nasal anatomy, joining 3 main channels in the posterior area of the nose--superior, middle and inferior channels

Posterior network of lymphatics

From the middle and superior turbinates and that portion of the nasal wall Pass above the ET and empty into the retropharyngeal lymph nodes

Superior group

Passing below the ET | Drain the inferior turbinate, inferior meatus and a portion of the floor and go to the jugular chain of lymph nodes

Middle group

From septum and part of the floor of the nose | Pass through the lymph nodes along the internal jugular vessels

Inferior group

To control the diameters of veins and arteries in the nose as well as mucous production

Sphenopalatine ganglion

Nerve supply

1. 1st CN for olfaction 2. Ophthalmic and maxillary divisions of the trigeminal nerve (sensory afferent impulses) 3. Facial nerve (movement of the respiratory muscles of the externa, nose 4. ANS

Theories about olfaction

1. Chemical theory | 2. Undulation theory

Particles of odorous substances are distributed by diffusion throughout the air and cause a chemical reaction when they reach the olfactory epithelium

Chemical theory

Waves of energy similar to light impinge upon the olfactory nerve endings

Undulation theory

Conveys air through the upper and lower respiratory tract to the alveoli of the lung in sufficient volume, with sufficient pressure, moisture, warmth and cleanliness, to assure optimal conditions for oxygen uptake, and in the reverse process optimal elimination of carbon dioxide brought to the alveoli by the blood stream

Act of breathing

Changes in air pressure which take place inside the nose during the respiratory cycle have been measured using

Rhinomanometry

Air pressure changes inside the nose are minimal and normally are not greater than 10 to 15 mm H2O

Quiet respiration

Provides more than 50% of normal respiratory resistance

Nose

Narrowings in the vestibular segment of the nose

1. Between the posterior aspect of the upper lateral cartilage and the nasal septum (increased narrowing may cause symptomatic airway obstruction) 2. At the bony piriform aperture

Air conditioning

During the brief time that air traverses the horizontal portion of the nasal passage, 16-20 times a minute in normal respiration, the inspired air is warmed (or cooled) to near body temperature and its relative humidity is brought to near 100%

Play a role in air filtration

Hair or vibrissae of the skin-lined nasal vestibule

Air purification

Foreign body is either expectorated or carried by mucociliary transport to the stomach for sterilization by gastric secretions Soluble gases are also removed from the air as it passes through the nose The greater the water solubility of the gas, the more completely it is removed by the nasal mucosa Carbon monoxide and hydrocarbons have a very low solubility and thus pass straight through the lungs

A highly viscid, continuous sheet of secretion which exceeds into all of the spaces and angles of the nose, sinuses, ET, pharynx and the entire bronchial tree

Nasal epithelium with its mucous blanket

Rich in glycoprotein, more viscid, with a tensile strength that allows the cilia's stiff forward motion to keep the blanket moving posteriorly in a continuous stream

Upper layer thin mucous blanket

More serous, providing a little hindrance to the bending, ciliary recovery stroke

Lower, periciliary layer of mucous blanket

Mucous blanket is renewed by the submucosal glands...

2-3 times an hour

Is created by the pulling action of the cilia on the mucous blanket when any of the chambers is blocked by mucous plug This may result in intense sinus pain as the plug clears the ostium and as the mucous plug moves down the auditory canal, may cause atelectasis of the TM

Negative pressure

Compromised by extreme drying

Effective ciliary action

Transfer heat, normally warms inspired and cools expired air and humidifies the inspired air with more than a liter of moisture each day

Nasal mucus

Determined by neural stimulation of the seromucous submucosal glands in the nasal lining

Degree of moisture in the mucous blanket

Changes in response to changes in the physical properties of the inspired air

Anterior third of the nasal chamber

Becomes transitional or squamous and no cilia are observed The mucous blanket in this region becomes more viscid and movement is achieved only through the pulling transmitted along the mucous blanket from still-ciliated areas located posteriorly

Anterior portion of the tubinates (inferior turbinates)

Direction of mucous streaming in the nose...

Backward

Direction of flow on the septum...

Back and somewhat downward toward the floor

Direction of the flow on the floor...

Back with a tendency to flow under the inferior turbinate into the inferior meatus

Flow of mucous on the medial aspect of the turbinates...

Back and downward, passing under the inferior margin into the corresponding meatus

Area that collects most of the airborne contaminants

Anterior third of the nose

Direction of the flow in the sinuses...

Spiral

Barrier to allergens, viruses and bacteria

Mucous blanket

Immunoglobulins in the nasal mucosa

IgG, IgA, IgE

Occurs when an inhaled allergen comes into contact with the IgE antibodies to that antigen which are fixed to nasal mucosal and submucosal mast cells, generating and releasing inflammatory mediators that produce characteristic nasal mucosal changes

Allergic rhinitis

Dependent upon nasal breathing

Normal pulmonary physiology

Dependent upon nasopulmonary reflexes that also cause changes in total pulmonary resistance and perfusion

Bronchial tone

Process in speech production

1. Lungs acting as a power source 2. Larynx acting as a sound generator 3. Structures in the head and neck acting as articulators to change the basic laryngeal sounds into understandable speech

Results when velopharyngeal insufficiency allows too many sounds to resonate in the nasal spaces Eg. Unrepaired soft palate cleft

Hypernasality

Result when sounds that normally resonate in the nasal spaces are prevented from doing so Eg. URTI, adenoid hypertrophy, nasal tumor

Hyponasality

Chapter 10: Applied Anatomy and Physiology of the Nose Flashcards

(80 cards)