ENT exam 4 Flashcards
(44 cards)
what is bilateral nasal specific technique? BLNS
a nasal procedure where a balloon is inserted into each nasal passage in 3 different positions and briefly inflated in each position before removing.
what is the goal of the BLNS procedure?
to open the nasal passages and allow for optimal function to support breathing and drainage of sinuses
what is the purpose of the nasal turbinates?
to modulate air flow so that air is moistened and warmed before entering the lungs.
what are the 3 structures in the nasal passage?
inferior, middle and superior meatus
where does the inferior meatus drain to?
nasolacrimal duct
where does the middle meatus drain to?
anterior and middle ethmoid, maxillary sinus and frontal sinus
where does the superior meatus drain?
posterior ethmoid and sphenoid sinus
what is the function of fascia?
transmits mechanical tension throughout its network, tightens and restricts movement during injury/inflammation, helps with flow of blood and lymph
what are the indications for BLNS?
sinusitis, snoring, headaches, difficulty breathing through nose, hx of facial trauma leading to pain or dysfunction
what other conditions can BLNS help?
TMJ dysfunction, seizures, nasal polyps, sphenoid malposition
what are the contraindications of BLNS?
implanted hardware, severe epistaxis, recent nasal surgery, post cleft palate surgery, foreign body in nose, latex allergy
what to PARQ patient on for BLNS procedure?
patient will experience abrupt brief strong pressure, brief pinch or pain, lots of postnasal drainage, tenderness around nose post procedure, mucosal irritation, crepitus- cracking, popping or grinding sound, potential epistaxis
steps of the procedure?
inspect nasal canal for foreign body, note asymmetry and for any narrowing, insert deflated balloon into first meatus, have pt inhale through their mouth and hold their breath, secure and seal balloon in nostril, give two pumps of air and then quickly release pressure, repeat for other meatus
how many layers of cots are needed for the balloon in BLNS?
1-2 layers for first tx
what do you do post BLNS procedure?
pt should gently blow nose, do cranial hold or occipital release. follow up visit 1-4x, pt should return 1 month after last tx
what are the signs/sx of acute bacterial rhinosinusitis?
purulent nasal discharge, maxillary tooth or facial pain, unilateral maxillary sinus tenderness, worsening symptoms after initial improvement
what lab is done to help predict strep pneumonia and hempohilus influenza rhinosinusitis?
CRP
what is primary ciliary dyskinesia?
triad of chronic sinusitis, bronchiectasis and situs inversus that is genetic and characterized by abnormal ciliary motion and impaired mucociliary clearance.
how do you diagnose primary ciliary dyskinesia?
chest x ray, PE for situs inversus, saccharin test which places saccharin in the inferior turbinates and assess how long it takes to taste it (normal less than 30 mins), nasal NO, biopsy with electron microscopy
what are the secondary causes of secondary ciliary dyskinesia?
smoking, asthma, allergic rhinitis, chronic rhinitis, sinusitis, chronic bronchitis, sick building syndrome. air pollution, cystic fibrosis, lung carcinoma
when does the maxillary and ethmoid present?
at birth
when does the sphenoid develops from ethmoid?
at 9 years old
when does the frontal sinus develop?
from ethmoid at 5-7 years old
what are the risk factors for pediatric rhinosinusitis?
allergic rhinitis, URIs, dairy/food allergies, as well as septal defects, craniofacial anomalies, adenoidal hypertrophy or nasal foreign bodies, masses, polyps
