LEC64: Nose and Paranasal Sinuses Flashcards Preview

Structures: Part Deux > LEC64: Nose and Paranasal Sinuses > Flashcards

Flashcards in LEC64: Nose and Paranasal Sinuses Deck (67):
1

identify important structures

 

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2

where is the superior conchi 

 

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3

what are functions of nasal cavity? importance?

1) olfaction- for quality of life, not survival

2) respiration- matters for survival

4

what are macrosomatic animals

animals that use smell as primary sense- for detection of prey, spotting water resources, etc 

5

nose's general function re: air and inspiration?

nose prepares air - warms it to at or near body temperature - before it passes to lower respiratory tract 

6

how much air does nose condition daily?

10,000-20,000 L of air daily

7

what is state of breathed air, what must happen to it?

air contains billions of infectious, allergenic, irritative, toxic materials

air must be filtered, neutralized, eliminated

8

identify: 

root of nose, nasion, dorsum, margin, tip, ala, naris, columella

 

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9

what is piriform aperature

border of nasal cavity, entry portal to upper respiratory system

looks like a pear 

 

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10

components of piriform aperature?

maxilla and nasal bones

11

where is nasal cavity proper?

inside piriform aperature

bony partition divides nasal cavity into 2 

12

concha bullosa?

an inflated turbinate 

normal unless impedes flow of air through nasal cavity- then problematic

13

how many turbinates?

3- superior, middle turbinate, inferior turbinate; in nasal cavity proper

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14

what is the nasal septum?

perpendicular plate of the ethmoid

15

identify the bones 

 

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crista galli- anterior cranial fossa entry, connects to falx cerebra (orange/yellow at top)

PP: perpendicular plate of ethmoid, intrudes at midline

C: cartilagenous component 

V: vomer 

M: maxatine cavity- crest that arises above nasal cavity floor 

P: palatine cavity- crest that arises above nasal cavity floor 

 

16

what is this? how is it visualized? ID parts

 

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nasal cavity wall, visualized by removing nasal septum

 

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17

what must blood supply to nasal cavity pass through?

pterygomaxillary fissure

18

where is pterygopalatine ganglion? what is there with it?

through pterygopalatine fissure, in pterygopalatine fossa

find branches of CN V, trigeminal there also

19

what is maxillary artery? what is it a branch of? where does it travel through? where does it end up?

a terminal branch of external carotid a

goes through pterygomaxillary fissure, into pterygopalatine fossa, into sphenopalatine foramen, into nasal cavity proper

20

ID structures 10, 12

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10: nasal septum, reflected superiorly 

12: sphenopalatine artery - very thick! 

21

what is arterial supply of nasal cavity wall?

1) maxillary branch of external carotid artery

1) postero-lateral superior branch of sphenopalatine a

2) postero-lateral middle branch of sphenopalatine a

3) postero-lateral inferior branch of sphenopalatine a

 

2) opthalmic branch of internal carotid artery

1) anterior ethmoidal branch of opthalmic a

2) posterior ethmoidal branch of opthalmic a

22

identify the arteries

 

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23

where does greater palatine artery enter nasal cavity?

greater palatine foramen 

hugs oral cavity

24

identify these holes 

 

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greater palatine foramen- where greater palatine a comes out, greater palatine nerve 

lesser palatine foramen

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25

where does greater palatine artery enter nasal cavity floor

incisive foramen 

26

septal artery function?

facial artery branch 

goes superiorly; connects w/ dorsal nasal artery at orbit

 

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27

connection between a nasal and an eye-related artery?

external carotid > facial a > dorsal nasal a > opthalmic a

28

describe all arteries of eye orbit

 

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29

"place of least resistance" principle?

ethmoidal arteries go through bone 

surgeous can go through solid bone if have to, because if artery going thru bone by def'n, have osseus tunneling already, just have to snip to get pathologic site they want to access

 

30

what is this 

 

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anterior and posterior ethmoid foramena, where ethmoid artery goes through ethmoid bone 

 

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31

where do nasal bleeds occur?

little's area 

 

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32

major nervous contribution to nasal cavity?

branches of V2, maxillary a

 

33

nasopalatine n location

hugs nasal septum

descends through incisive canal 

sends branches to incisive dentition

34

pterygopalatine ganglion sends branches where

nasal septum, wall

35

branches of pterygopalatine ganglion in the nasal cavity are?

superior, middle, and inferior postero-lateral nasal branches

 

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36

4 sinuses?

 

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frontal

sphenoidal

maxillary

ethmoidal

 

37

roles of sinuses?

1) architectural: reduce cranial weight, shock absorption, accomodate growth, replace functionless bone

2) physiological: produce fluid for humidification, ventilation, secrete mucus, air conditioning, shock absorption, impart resonance to voice, aid in respiratory function 

3) evolutionary residuals: had a fxn once that's no longer needed

38

identify frontal and maxillary sinuses. should they be a/symmetrical?

 

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frontal: asymmetric

maxillary: symmetric

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39

which paranasal sinus develops first, embryologically?

maxillary sinus 

begins as bud along inferoalteral surface of ethmoid portion of nasal capsule 

day 65

40

borders of maxillary sinus?

 

roof: floor of orbit

floor: dental roots

 

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41

embryologic cell type of nasal cavity cells?

mesenchymal cells

42

what element of vault grows uniquely in humans only?

maxilla grows vertically 

 

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43

how does maxillary sinus grow?

medial > lateral

44

when do molar teeth erupt?

6 yrs old: 1st moral erupts

12 yrs old: 2nd moral erupts

17-25 yrs old: 3rd molar erupts

45

where is maxillary sinus floor re: nasal cavity floor?

in fetus, maxillary sinus floor is above level of floor of nasal cavity 

in grown person, maxillary sinus floor is below the level of the nasal cavity floor

 

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46

where do V2 branches go re: paransal sinuses?

V2 branches hug around maxillary sinus 

 

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47

autonomic innervation to lacrimal gland?

presynaptic: greater petrosal n., of VII, to pterygopalatine ganglion

postsynaptic: zygomatic n., lacrimal n. 

distribution root: V1, V2

48

autonomic innervation to mucous glands, nasal cavity, nasopharynx, palate?

presynaptic: VII via greater petrosal n. 

ganglion: pterygopalatine 

postsynaptic: branches of V2

49

what is within sinus wall epithelium that is the target for GVEs?

respiratory epithelial lining has serous glands, mucous glands, goblet cells

this is postganglionic GVE target

50

descrbe path of greater petrosal n > target glands

preganglionic parasympathetic fibers exit from midbrain

enter internal acoustic meatus

at GENICULATE BEND, greater petrosal n goes thru pterygoid canal 

synapses at pterygopalatine ganglion 

rides w/ V2 to get to target glands 

51

what is middle conchi

middle turbinate w/ epithelial lining

52

what are 3, 5, 7?

 

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3, inferior turbinate 

5, middle turbinate 

7, suprior turbinate 

53

lamina papyracea?

 

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paper thin part of ethmoid bone

where ethmoid sinus air cells are

each air cell has an opening 

are unique to individuals

54

what is norm for frontal sinus morphology?

asymmetric

55

what lines sinuses?

respiratory epithelium 

they produce fluid, which must drain

56

identify hiatus semilunaris

 

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anterior face of ethmoid bullop, sliver that is posterior bone of ulcinate process 

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57

what space is entered from the hiatus semilunaris?

ethmoid infindibulum

is the receptical space for frontal, maxillary, ethmoid inner sinuses

58

components of middle turbinate?

horizontal, vertical, superior components 

so attachment to middle turbinate is in 3 dimenstions, very solid

59

3 categories of sphenoid sinus?

1) conchal - tiny

2) pre-sellar - neumitization remains in front of sella turcica

3) post-sellar - neumitization grows beyond sella turcica 

 

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60

what leaves an imprint on walls of sphenoid sinus?

optic nerve

61

what is wrong with this pt? 

 

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papilloma in R eye, affecting his abducens

cannot abduct eye

62

how does infection get to middle ear from sinus?

via eustachian tube

63

how do lacrimal tears travel and where do they drain?

lacrimal tears bathe the occular globe from superolaterally > inferomedially

drain into inferior meatus 

64

what drains into middle meatus?

frontal, maxillary, anterior ethmoid sinuses

65

what drains into superior meatus?

sphenoid, posterior ethmoid sinuses

66

what drains into inferior meatus?

lacrimal tears

67

what is unique about sphenoid sinus drainage?

sphenoid drains into superior meatus

but must go through posterior ethmodi sinus to get to superior meatus

all other sinuses have direct route of drainage to their meatus