Lecture 8.2: Epistaxis (Nosebleeds) Flashcards
(26 cards)
What is Epistaxis?
Bleeding from the nose
Where does the Greater Palatine Artery originate from?
From the 3rd part of the maxillary a.
Where does the Greater Palatine Artery enter?
Enters the greater palatine foramen
Where does the Greater Palatine Artery give rise to?
Gives lesser palatine branch
Where does the Sphenopalatine Artery originate from?
External carotid artery system
Where does the Sphenopalatine Artery enter?
Enters the sphenopalatine foramen
Where does the Sphenopalatine Artery give rise to? (2)
- Posterior lateral nasal arteries
- Posterior septal branches
What is the first branch of the Internal
Carotid Artery? What does it supply?
- Ophthalmic Artery
- Eyes and also the upper part of the nose
What are the distributing vessels of the Ophthalmic Artery? (2)
- Anterior ethmoidal artery
- Posterior ethmoidal artery
What percentage of nosebleeds have an anterior cause?
90%
What percentage of nosebleeds have an posterior cause?
10%
Where is the venous drainage of the anterior nose?
- Facial vein
Where is the venous drainage of the posterior nose? (2)
- Cavernous venous sinus
- Pterygoid venous plexus
Little’s Area (Kiesselbac’s plexus) is supplied by External Carotid artery branches…? (2)
- Greater Palatine Artery
- Superior Labial Artery
Where does Little’s Area anastomose with the Internal Carotid Artery?
- Anterior Ethmoidal Artery
Where do anterior nosebleeds bleeds originate from?
Little’s Area (Kiesselbach`s plexus)
Where do posterior nosebleeds bleeds originate from?
- Woodruffs Plexus
- Predominant flow in the Sphenopalatine branch
(external carotid and maxillary artery) - Some superior supply by the posterior ethmoidal
artery (internal carotid artery)
What are the most common causes of Epistaxis?
- Nose Picking
- Trauma
- URTIs
- Dry Air
Other Rarer Causes of Epistaxis (5)
- Congenital Diseases
- Inflammatory Causes (nasal granulomatosis, SLE)
- Neoplasia
- Hypertension
- Drugs
What Congenital Diseases can cause Epistaxis? (6)
- Platelet Issues (platelet function defect)
- Coagulation Issues (von WiIlebrand’s disease)
- Vascular Issues (Ehlers Danlos)
- Haemophilia
- Haemangiomas
- Hereditary Haemorrhagic Telangiectasia (HHT).
What Drugs can cause Epistaxis? (6)
- NSAIDS
- Aspirin
- Intra Nasal Sprays (especially steroids)
- Anticoagulants
- Cocaine
*Alcohol
Epistaxis at home Treatment
- Sit upright and lean your body and your head
slightly forward - Breathe through your mouth
- Use a tissue or damp washcloth to catch the blood
- Use your thumb and index finger to pinch together
the soft part of your nose - Keep pinching your nose continuously for at least
five minutes before checking if the bleeding has
stopped - If your nose is still bleeding, continue squeezing
your nose for another 10 minutes - If you’d like, apply an ice pack to the bridge of your
nose to further help narrow blood vessels
Cautery (Silver Nitrate or Electro) for Epistaxis Treatment
Nasal Tampons/Merocel/Rapid Rhino for Epistaxis Treatment
