Nasal Cavity Flashcards
(123 cards)
1
Q
what are the 3 regions in each nasal cavity
A
nasal vestibule, respiratory region, and olfactory region
2
Q
what is the nasal vestibule region
A
small dilated space just internal to the external nose, lined by skin and contains hair follicles
3
Q
what is the respiratory region
A
largest part of the nasal cavity, lined by respiratory epithelium and ciliated mucous cells
4
Q
where is the olfactory region
A
at the apex of the nasal cavity, lined by olfactory epithelium (contains olfactory receptors)
5
Q
what is olfaction
A
inspired air is passed through the olfactory region for smelling
6
Q
how much mucus is produced per day
A
about 1 liter per day
7
Q
where does the mucus normally drain
A
brushed towards the back of the throat by cilia and swallowed
8
Q
what are alar cartilages
A
they form most of the nostrils
9
Q
what is the fibroelastic tissue
A
forms the inferior-most parts of the nostrils
10
Q
how many bones contribute to the skeletal framework of the nasal cavities
A
14 bones
11
Q
what parts of the nasal cavity does the ethmoid contribute to
A
roof, lateral wall and medial wall of both nasal cavities
12
Q
where are the ethmoidal labyrinths
A
two rectangular boxes, one on each side, united superiorly across the midline by the cribiform plate
13
Q
what is the cribiform plate
A
a perforated sheet of bone at the apex of the nasal cavities, separates the cavities from the cranial cavity
14
Q
where do the fibers of the olfactory nerve (CN 1) pass through into the nasal cavity
A
through the small perforations in the cirbiform plate
15
Q
what is the perpendicular plate
A
vertical sheet of bone that forms the upper part of the nasal septum, descends from the midline of the cribiform plate
16
Q
where is the orbital plate of the ethmoid bone
A
a lateral sheet of bone that is flat and forms part of the medial wall of the orbit
17
Q
what 2 conchae are part of the ethmoid bone
A
the superior and middle (inferior is separate)
18
Q
where are the ethmoidal bulla
A
inferior to the origin of the middle concha, forms a prominent bulge
19
Q
what are some causes of CSF rhinorrhea
A
head trauma, complication of ear or nasal surgery, can be spontaneous, likely related to chronic elevated intracranial pressure
20
Q
what are some symptoms of CSF rhinorrhea
A
salty post-nasal drainage, severe headache eased by intermittent, unilateral clear rhinorrhea
21
Q
what is the treatment for CSF rhinorrhea
A
surgery (push protrusion back into cranial vault and fix bony defect), management of the high ICP (diuretics, lumbar peritoneal drain)
22
Q
what is a complication of CSF rhinorrhea
A
meningitis
23
Q
what is CSF rhinorrhea
A
occurs if the meninges are compromised and torn, the CSF leaks into the nasal cavity
24
Q
what part of the nasal cavities does the sphenoid bone conrtibute to
A
most of the posterior part of the nasal cavities (houses the sphenoidal sinuses)
25
what bones form the choncae
sphenoid, vomer, and palatine bones
26
what part of the nasal cavities do the maxillae bones conrtibute to
most of the lateral and inferior parts (houses the maxillary sinuses)
27
what part of the nasal cavities does the frontal bone conrtibute to
small part of the roof (frontal sinuses housed here)
28
how many bones make up the lateral nasal wall
8 bones
29
what are the 8 bones of the lateral nasal wall
ethmoidal labyrinth, perpendicular plate of palatine bone, medial plate of pterygoid process of sphenoid bone, medial surfaces of lacrimal bones, inferior conchae, maxillae, frontal, and nasal bones
30
what makes up the nasal septum
septal nasal cartilage anteriorly, vomer, and the perpendicular plate of the ethmoid bone posteriorly
31
what is a deviated septum
slightly crooked nasal septum
32
what causes a deviated septum
congenital, nasal fracture or through aging
33
what is the treatment for a deviated septum
severe deviations are repaired with septoplasty, decongestants, antihistamines
34
how many people have a deviated septum
about 80%
35
what are the symptoms of a deviated septum
obstruction of one or both nostrils, nasal congestion, epistaxis, snoring, chronic sinusitis
36
what percentages of facial fractures include the nasal bones
about 40%
37
what are the causes of a nasal fracture
injury from contact sports, physical fights, motor vehicle accidents, falls, accidental trauma
38
what are the symptoms of a nasal fracture
pain, tenderness, swelling, epitaxis, bruising around nose or eyes, crooked nose, difficulty breathing, rhinorrhea
39
what are some complications of a nasal fracture
deviated septum, cartilage fracture, septal hematoma
40
what are the treatments for a nasal fracture
icing for minor fractures, closed reduction, surgery
41
what bones make up the nasal cavity floor
horizontal plates of the palatine bones and the palatine processes of the maxillary bones
42
what bones make up the roof of the nasal cavity
cribiform plate of the ethmoid bone (frontal and nasal bones contribute small parts)
43
what 2 things pass through the cribiform plate
CN 1 exits the nasal cavity to the cranial cavity and the posterior ethmoidal vessels pass into the nasal cavity
44
what passes through the anterior ethmoidal canal
branch of ophthalmic nerve (V1): anterior ethmoidal nerve, arteries and vein
45
where is the anterior ethmoidal canal
small foramen between cribiform plate and surrounding bone
46
what is the foramen caecum
connection between nasal veins and superior sagittal sinus (midline between crista galli and frontal bone), nasal vein passes here
47
where is the sphenopalatine foramen
in the posteriorolateal wall of the superior nasal meatus
48
what structures pass through the sphenopalatine foramen
sphenopalatine branch of maxillary artery, nasopalatine nerve, superior nasal branches of the maxillary nerve (V2)
49
what is the communication route for the sphenopalatine foramen
between nasal cavity and pterygopalatine fossa
50
where is the incisive canal
in the floor of the nasal cavities (lateral to the nasal septum and posterosuperior to the root of the central incisor in the maxilla)
51
where does the incisive canal open into
into the incisive fossa in the roof of the oral cavity
52
what 2 things travel in the incisive canal
nasopalatine nerve and posterior septal branch of sphenopalatine artery
53
what 3 things go through the nares
they allow small internal nasal branches of the infraorbital nerve (V2), alar and septal branches of superior labial artery (Facial) and small alar branches of lateral nasal artery to enter the nostrils
54
how many paranasal sinuses are there
4- each named according to the bone where it is found
55
how do the paranasal sinuses develop
as outgrowths from the nasal cavities and erode into the surrounding bones
56
when do the paranasal sinuses grow
develop throughout childhood and grow throughout life- never stopping
57
what lines the paranasal sinuses
respiratory mucosa, ciliated and mucus secreting and open into the nasal cavities
58
where are the ethmoidal air cells located in the ethmoid bone
in the ethmoidal labyrinths, separated from the orbit by thin orbital plates (divided into anterior, middle, posterior)
59
what is the largest paranasal sinus
the maxillary sinuses
60
what do the nasal conchae do
increase the surface area of contact between tissues of the lateral wall and respired air, divide each nasal cavity into 4 air channels
61
what are the 4 air channels that are created by the nasal conchae
inferior nasal meatus, middle nasal meatus, superior nasal meatus, and sphenoethmoidal recess
62
where is the inferior nasal meatus
between the inferior concha and nasal floor- contains the opening of the nasolacrimal duct
63
where is the middle nasal meatus
between the inferior and middle concha
64
what does the middle nasal meatus contain
the ethmoidal bulla and the hiatus semilunaris (ostium of the maxillary sinus)
65
where is the superior nasal meatus
between the middle and superior concha
66
where are the sphenoethmoidal recess
between the superior concha and the nasal roof
67
what does the sphenoethmoidal recess contain
the opening of the sphenoidal sinus
68
where does the frontal sinus drain into
into the lateral wall of the middle meatus via the frontonasal duct (penetrates the ethmoidal labyrinth and enters anterosuperior part of hiatus semilunaris)
69
where do the anterior ethmoidal cells open into
the frontonasal duct or anterior part of hiatus semilunaris
70
where do the middle ethmoidal cells open into
the ethmoidal bulla
71
where do the posterior ethmoidal cells open into
superior meatus
72
where does the maxillary sinus drain into
the center of the hiatus semilunaris
73
where does the sphenoidal sinus drain into
into the roof of the cavity via apertures on the posterior wall of the sphenoethoidal recess
74
what is the function of the sphenoidal and frontal sinuses in carnivores
smell
75
what may be the function of the maxillary sinuses
phonation (resonance), conservation of heat, lightening of skull
76
what may be the function of the ethmoidal air cells
reduction of olfactory area of nasal cavities
77
what is rhinitis
irritation and inflammation of the mucous membrane inside the nose
78
what are some symptoms of rhinitis
stuffy or runny nose, postnasal drop
79
what are some triggers of rhinitis
environmental, weather changes, viral infections, alcohol, NSAID's, hypertension medications, sedatives, antidepressants, oral contraceptives, decongestant sprays, stress, and hormone changes
80
what are 3 complications of rhinitis
nasal polyps, chronic sinusitis, and middle ear infections
81
what are some treatments for rhinitis
nasal rinses, humidifiers, oral decongestants, saline or antihistamine nasal sprays
82
what is sinusitis
swollen sinus mucosa that blocks off routes of drainage
83
what is acute sinusitis
usually a cold that becomes bacterial infection, resolves within a month
84
what is chronic sinustitis
allergies, pollutants, injuries, biofilms - cause 3/4 cases
85
what are symptoms of sinusitis
purulent rhinorrhea (green/yellow discharge), nasal congestion, facial pain, fever, feeling of facial "fulness", worsens with bending over, aching teeth, sore throat, ear pain
86
what are 3 treatments for sinusitis
anti-inflammatories, antibiotics, or surgery
87
what is a complication of sinusitis
can be life-threatening
88
where are 4 routes of infection from the nasal cavities
infection can reach the anterior cranial fossa (via cribriform plate) the nasopharynx and retropharyngeal space, middle ear (via pharyngotympanic tube) and the orbit (nasolacrimal duct)
89
what are 2 routes of infection from the sphenoidal sinus
pituitary fossa and cavernous sinus
90
what is a route of infection from the ethmoidal sinus
to the orbit
91
what 3 sinuses can cause infection in the cranial cavity (meningitis or intracranial abcesses)
frontal, ethmoidal and sphenoidal sinuses
92
what is functional endoscopic sinus surgery (FESS)
preferred method for treating chronic sinusitis- natural drainage channels of paranasal sinuses are enlarged
93
what is transnasal transsphenoidal surgery (TNTS)
preferred method for removing pituitary tumors or cysts
94
what is the general afferent of the nasal cavities
trigeminal nerve (CN 5)
95
what general afferents innervate the anterior region of the nasal cavities
branches of V1 ophthalmic: anterior lateral, septal, and external nasal branches of anterior ethmoidal nerve
96
where does the posterior ethmoidal nerve go
ends in the ethmoidal air cells, does not pass through nasal cavity
97
what general afferents innervate the posterior region of the nasal cavity
branches of V2- maxillary: nasopalatine and posterior lateral nasal branches of pterygopalatine ganglion, internal nasal branches of infraorbital nerve and nasal branch of anterior superior alveolar nerve
98
what are the special afferents carried by
olfactory nerve CN 1
99
what is the visceral efferent innervation of the glands in the mucosa of the nasal cavity and paranasal sinuses
the greater petrosal branch of the facial nerve (7)
100
where do the visceral efferents synapse and how are they distributed
in the pterygopalatine ganglion and are distributed in general afferent branches of the maxillary nerve V2
101
how do the sympathetic fibers reach the nasal cavities
from the superior cervical ganglion along blood vessels (anterior region) or through internal carotid plexus and deep petrosal nerve (posterior region)
102
what does the sympathetic innervation do
involved with regulating blood flow in nasal mucosa
103
what nerve carries general afferents from the frontal sinus
branches of the supraorbital nerve (V1)
104
what 3 nerves carry general afferents from the ethmoidal air cells
anterior and posterior ethmoidal branches of the nasociliary nerve (V1) and orbital branches from pterygopalatine ganglion
105
what 2 nerves carry general afferents from the maxillary sinus
infraorbital and alveolar branches of maxillary V2
106
what 2 nerves carry general afferents from the sphenoidal sinuses
posterior ethmoidal branch of the ophthalmic nerve V1 and orbital branches from pterygopalatine ganglion
107
what 2 branches of the external carotid supply the nasal cavity
maxillary artery and facial artery
108
what is the branch of the internal carotid artery that supplies the nasal cavity
the opthalmic branch
109
what are the 2 branches of the maxillary artery that supply the nasal cavity
sphenopalatine artery- largest vessel in nasal cavity (posterior lateral nasal branches and posterior septal branches) and greater palatine artery
110
what are the 2 branches of the facial artery that supply the nasal cavity
superior labial artery (alar and septal branches) and lateral nasal artery (alar branches)
111
what are the 2 branches of the ophthalmic artery that supply the nasal cavity
anterior ethmoidal artery (septal, anterior lateral nasal, ext nasal branches) and posterior ethmoidal artery (septal branch)
112
where does the sphenopalatine artery travel
leaves the pterygopalatine fossa and through sphenopalatine foramen and onto lateral wall of nasal cavity
113
what is Kiesselbach's plexus
an extensive anastomose on anterior part of nasal septum between branches of greater palatine (through incisive canal), sphenopalatine, superior labial, and anterior ethmoidal arteries
114
what is epistaxis
nose bleeds- kiesselbach's plexus is close to surface for anterior nasal septum bleeds
115
what is the blood supply to the frontal sinus
branches of the anterior ethmoidal arteries
116
what is the blood supply to the maxillary sinus
branches from the infraorbital and superior alveolar branches of the maxillary arteries
117
what is the blood supply to the ethmoidal air cells
branches of anterior and posterior ethmoidal arteries
118
what is the blood supply to the sphenoidal sinus
pharyngeal branches of maxillary sinus
119
where do veins that pass with branches that originate from the maxillary sinus drain into
the pterygoid plexus of vein in the infratemporal fossa
120
where do veins from the anterior regions of the nasal cavity drain
join the facial vein
121
where do veins that travel with the anterior and posterior ethmoidal veins drain into
tributaries of the superior ophthalmic vein = cavernous sinus on either side of hypophyseal fossa
122
what arteries would cause a post nasal septum epitaxis
sphenopalatine arteries
123
where does the nasal vein travel
passes superiorly through foramen caecum in frontal bone anterior to crista galli and joins anterior end of the superior sagittal sinus
