Nose Flashcards by Geno Sadaya

The bony nasal septum is composed of what bones?

A. Vomer and perpendicular plate of ethmoid bone
B. Nasal and lacrimal bones
C. Vomer and lacrimal bones

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Middle third of external nose is supported by

A. nasal bone
B. alar cartilage
C. lateral cartilage

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Landmark structure that would indicate on CT scan that the level is in anterior ⅓ of the nose.

A. middle turbinate
B. planum sphenoidale
C. crista galli
D. uncinate process

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A sagittally-oriented structure that attaches to the lateral nasal wall and guards the infundibulum:

A. middle turbinate
B. ethmoidal bulla
C. inferior turbinate
D. uncinate process

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True of the infundibulum:

A. A two-dimensional space behind the uncinate process
B. Receives the ostia of frontal maxillary and ethmoid sinuses
C. The largest of the anterior ethmoidal air cells
D. Hourglass shaped structure under the frontal sinus

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Which is NOT a part of the osteomeatal complex?

A. Superior turbinate
B. ethmoidal bulla
C. Middle turbinate
D. Uncinate process

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Roof of the ethmoid is bounded by this structure.

a) lamina papyracea
b) Lateral lamina
c) fovea ethmoidalis
d) crista galli

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Not part of the ethmoid complex

a. uncinate process
b. crista galli
c. inferior turbinate

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Narrowest part of the nasal passage

a. osteomeatal
b. inferior turbinate
c. internal nasal valve
d. external nasal valve

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NOT TRUE for the vestibule

a. has vibrissae or tiny hairs
b. composed of keratinizing squamous epithelium
c. from the nares up to inferior turbinate
d. can easily accommodate the thumb or the index finger

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TRUE of nasal valves

A. External valve is the narrowest part of the nose
B. Internal valve is bounded by the lower border of the upper lateral cartilage and nasal septum
C. Middle turbinate is found in the internal nasal valve
D. Pulling the cheek laterally to open up the nasal valves is Hatzel’s sign (Cottles’s sign)

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Features of an aesthetically pleasing nose

A. Columellar show is visible on lateral view of the face
B. Columella-labial angle is more than 105 degrees
C. Alar edges are wider than the vertical line limit of medial canthi
D. Greater than one third of the face

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Which provide stability to the nasal bones

A. arch structure
B. nasal spine of frontal bone
C. internasal suture
D. AOTA

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Erectile tissues are present in the following areas, EXCEPT

A. Inferior Turbinate
B. Middle Turbinate
C. Superior Turbinate
D. Adjacent Septum

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Which is TRUE for the turbinates?

A. The middle and superior turbinates are almost symmetrical and have same length
B. The inferior turbinate is an independent bone
C. The fontanelles serve as ostia of the maxillary sinus
D. Erector tissues are found in all turbinates

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When you pull the ala of the nose laterally and this results in better breathing, this is a sign of?

A. Hatzel
B. Hasner
C. Tonybee
D. Cottle

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Which is true of the infundibulum?

A. 2D space behind uncinate process
B. Receives ostia of ethmoidal, frontal, maxillary sinuses
C. largest of anterior ethmoidal cells
D. Hour glass structure of frontal sinus

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Which of the following is NOT TRUE?

A. Posterior bleeding is due to the Little’s area
B. Anterior bleeding can easily be controlled by pinching the nose
C. Mucosal blanket is swept posteriorly to the pharynx
D. Posterior choanae are bigger than the nares

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Which does not directly contrinute to Kiesselbach’s plexus?

a. Spenopalatine artery
b. Greater palatine artery
c. Anterior Ethmoid artery
d. Superior Labial artery

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True about rhinoscopy?

a. Middle and superior conchae can be seen in anterior rhinoscopy
b. The torus tubarius is not seen in posterior rhinoscopy
c. Light source is not needed
d. In posterior rhinoscopy, what the examiner sees on the right side of the mirror is actually the left side of the patient

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Which produce the mucous membrane of the nasal cavity?

a. Betty’s glands
b. Bowman’s glands
c. Bratholin’s glands
d. Brodmann’s glands

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The following are TRUE about odorants EXCEPT

A. water soluble
B.high vapor pressure
C.low polarity
D. molecular weight greater than 294

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TRUE of vomeronasal organ:

A. serves as a receptor for smelling
B. large organ inside the nose
C. detects human pheromones but not animal pheromones

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Life span of olfactory neurons

A. two weeks
B. one month
C. one and a half months
D. three weeks

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What functions as the mechanical defense of the nasal cavity? A. flagella B. stereocilla C.pseudopodia D. mucociliary elements

Major supplier of the lateral nasal wall A. descending palatine B. nasopalatine C. sphenopalatine D. lateral nasal

The antrum of Highmore is also known as A. sphenoid sinus B. maxillary sinus C. ethmoid sinus D. frontal sinus

What is the Little’s area? A. the area of the little finger B. a part of the brain located in the occipital region C. the area where epistaxis usually happens due to exposure to the drying effect of air D. none of the above

The nasolacrimal duct opens into the A. inferior turbinate B. supreme turbinate C. middle turbinate D. superior turbinate

Which guards the infundibulum? ``` A. frontal recess B. uncinate process C. ethmoid bullae D. all of the above E. B and C only ```

The middle ethmoid cells drain into A. superior meatus B. middle meatus C. inferior meatus D. supreme meatus

Roof of ethmoid bone A. crista galli B. cribriform plate C. dorsum sellae D. clinoid process

The roof of the maxillary sinus is formed by the A. roof of the orbit B. zygomatic arch C. floor of orbit D. wing of the sphenoid bone

Why is the nose likened to the male sex organs? A. It is proboscis-shaped and anterior to face. B. It has erectile tissue in its middle and inferior turbinates. C. It produces watery secretions when irritated. D. It sneezes dirt and mucosa out to the environment.

The vestibule is found in the following except A. Orbit B. Nasal cavity C. Inner ear D. Oral cavity

Function of paranasal sinuses A. Humidifies air B. Voice resonance C. Warms air D. Filters…

Facial aesthetics dictates that A. Nasal bridge slopes at 45 degrees from the vertical line B. Columella and labial ridge form an acute angle C. The columella is higher than the alar level D. Nares are flats

Which is true? A. Sniffing draws air towards the upper 1/3 of the nasal cavity B. Nasal mucosal blanket flows anteriorly toward the nares C. Inferior turbinate is a part of the ethmoid bone D. Supreme turbinate is found in 50% of cases

Which of the following is true? A. The posterior ethmoid cells drain toward the sphenoethmoidal recess. B. Immediately lateral to the ethmoid cells is the lamina papyracea. C. The nasolacrimal duct opens under the posterior end of the inferior turbinate. D. The anterior nares are larger than the posterior ones.

True about the frontal sinus A. lies between the anterior and posterior tables of the skull B. drains inferiorly C. the frontal recess is tubular D. always present in adults

True of ethmoidal group of sinuses A. separated from the orbit by the lacrimal bones B. cribriform plate allows passage of the olfactory nerves at the foramen cecum C. anterior ethmoidal air cells found posterior to middle turbinates D. posterior ethomoidal cells open towards superior meatus

Which is true about the nasal aperture? A. The nasal septum is not always in the midline. B. Anterior concha is larger than the posterior one. C. Ethmoidal recess is always in the midline

Into which structure does the anterior ethmoidal sinus drain into? A. maxillary ostium B. fronto-ethmoidal recess C. spheno-ethmoidal recess D. frontal ostium

Which is true? a. Sniffing directs air towards upper third of cavity b. Nasal mucosa blanket flows anteriorly towards nares c. Inferior conchae is part of the ethmoid d. Supreme turbinate is found in 50% of cases

Drainage of the nose and the sinuses is accomplished via: a. Gravity b. Negative pressure when blowing c. Mucociliary drainage d. Swallowing

Not true of the ethmoid groups: a. like a scaffold in shape b. the cribiform plate allows passage of olfactory nerves c. the anterior ethmoidal artery is found in the floor of the ethmoid cells d. the posterior ethmoidal air cells open towards the superior meatus

Floor of the nasal cavity: a. Soft palate b. Hard palate c. Inferior maxilla

How many main cartilages make up the cartilaginous part of the nose?

5 Two lateral cartilage, Two alar cartilage, One septal cartilages

What structure divides the chamber of the nose into two nasal cavities?

Nasal septum

Main components of the nasal septum

Perpendicular plate of the ethmoid bone, vomer, septal cartilage

Entrance to the nasal cavity anteriorly

External nares

The nasal cavity opens posteriorly to the nasopharynx through which opening?

Posterior Choanae

Lining of the nasal cavity

Nasal mucosa

Lining of the nasal vestibule

Skin

The nasal mucosa is firmly bound to the poriosteum and perichondrium. T/F

Which part of the nasal mucosa is the olfactory area?

Superior one-third

Which part of the nasal mucosa is the respiratory area?

Inferior two-thirds

Air passing over the respiratory area is cooled and moistened before it passes to through the rest of the upper respiratory tract to the lungs. T/F

F Air is warmed and moistened.

Contains the peripheral organ of smell

Olfactory area (the superior one-third of the nasal mucosa)

Parts of the roof of the nasal cavity

Fronto-nasal, ethmoidal, sphenoidal

The roof of the nasal cavities is wider than the floor. T/F

F The floor is wider than the roof. The roof is curved and narrow.

Bones that form the floor of the nasal cavities

Palatine process of the maxilla, | Horizontal plates of the palatine bone

The medial wall of the nasal cavity is formed by the nasal septum. T/F

The nasal conchae make up the medial wall of the nasal cavity. T/F

F They make up the lateral wall.

The three pairs of nasal conchae

Superior, middle and inferior

Function of the nasal conchae

Provide surface area for heat exchange

A nasal meatus underlies each of the bony formations. T/F

The five passages of the nasal cavity

Sphenoethmoidal recess; Superior, middle, inferior meatus; Common nasal meatus

The longest and broadest of the nasal conchae

Inferior nasal concha

Which of the nasal conchae is an independent bone?

Inferior nasal concha

The mucous membrane of the inferior concha contains large vascular spaces that can enlarge to control the caliber of the nasal cavity. T/F

Which of the nasal conchae are part of the ethmoid bone?

Superior and middle

The superior and middle conchae are part of which bone?

Ethmoid bone

When infected or irritated, the mucosa covering the conchae may swell rapidly, blocking the nasal passages on that side. T/F

The passage lying superioposterior the superior concha

Sphenoethmoidal recess

Location of sphenoethmoidal recess

Superoposterior the superior concha

The sphenoidal sinus opens to which passage?

Sphenoethmoidal recess

The superior nasal meatus is between which turbinates?

Superior and middle

The passage between the superior and middle turbinate

Superior nasal meatus

The superior nasal meatus is longer and deeper than the middle one. T/F

F The middle is deeper.

Passages that open to the superior nasal meatus

Posterior ethmoidal sinus

The ethmoidal infundibulum is under which conchae

Middle

The anterosuperior part of the middle nasal meatus leads to this opening

Ethmoidal infundibulum

Through which opening does the middle nasal meatus communicate with the frontal sinus?

Ethmoidal infundibulum

The passage that leads inferiorly from each frontal sinus to the infundibulum

Frontonasal duct

Semi-circular groove into which the frontal sinus opens

Semilunar hiatus

Passages physically associated with frontal sinus

Ethmoidal infundibulum, frontonasal duct, semilunar hiatus

The ethmoidal bulla is visible when what structure is removed?

Middle nasal concha

Location of inferior nasal meatus

Inferolateral the inferior nasal concha

Which duct opens into the anterior part of the inferior nasal meatus?

Nasolacrimal duct

The nasolacrimal duct opens into the anterior part of this passage

Inferior nasal meatus

The medial part of the nasal cavity between the conchae and the nasal septum

Common nasal meatus

The three arteries of the medial and lateral septum that divide in to lateral and medial

Anterior ethmoidal, posterior ethmoidal, sphenopalatine arteries

The anterior and posterior ethmoidal arteries are from which artery?

Opthalmic artery

The sphenopalatine and greater palatine artery are from which artery?

Maxillary

The septal branch of the superior labial artery is from which main artery?

Facial artery

Which artery enters the incisive canal?

Greater palatine artery

Contributors of the Kiesselbach area

Anterior and posterior ethmoidal artery, Sphenopalatine and greater palatine artery, Septal branch of superior labial artery

The external nose receives blood from the anterior ethmoidal and from septal branch of the superior labial arteries. T/F

Arterial supply of the external nose

Anterior ethmoidal artery, septal branch of superior labial artery, infraorbital artery, lateral nasal branches of facial artery

The submucosal venous plexus drains into these veins

Sphenopalatine, facial, opthalmic veins

Venous blood from the external nose drains mostly into which vein?

Facial vein via the angular and lateral nasal veins

Nerve supply of posteroinferior nasal mucosa

Nasopalatine nerve of V2, | Greater palatine nerve (posterior superior lateral nasal and inferior lateral nasal branches)

Nerve supply of the anterosuperior part of the nasal mucosa

Anterior and posterior ethmoidal nerves of the nasocilliary branch of the opthalmic nerve

Most of the innervation of the external nose comes from which nerves?

External nasal branch of the anterior ethmoidal nerve and the infratrochlear nerve (V1)

Innervation of the alae of the nose

Nasal branches of infraorbiral nerve (V2)

Paranasal sinuses

Frontal, ethmoid, sphenoid, maxilla

The right and left frontal sinuses are between the outer and inner table of the frontal bone, posterior to the superciliary arches and the root of the nose. T/F

Frontal sinuses are usually detected in children of which age?

7 years old

The right and left frontal sinuses each drain through which opening into the ethmoidal infundibulum

Frontonasal duct

Innervation of the frontal sinuses

Supraorbital nerves (V1)

The right and left frontal sinuses must be of equal size. T/F

F They are rarely of equal size.

The septum between the right and left sinuses is usually not situated entirely in the median plane. T/F

The two parts of the frontal sinus

Vertical part in the squamous part of frontal bone, horizontal part in the orbital part of frontal bone

Ethmoidal cells are usually not visible in plain radiographs before what age?

2 years old

Ethmoidal cells are usually not visible in plain radiographs before 2 years of age but are recognizable in CT scans. T/F

The anterior ethmoidal cell drains directly or indirectly to this passage

Middle nasal meatus

The anterior ethmoidal cell drains into the middle nasal meatus through this passage

Ethmoidal infundibulum

The middle ethmoidal cells open directly into this passage

Middle nasal meatus

Aka bullar cells

Middle ethomoidal cells/sinuses

Cells that form the ethmoidal bulla

Middle ethmoidal cells

The posterior ethmoidal cells open directly into this passage

Superior nasal meatus

Innervation of the ethmoidal cells

Anterior and posterior ethmoidal branches of the nasocilliary nerve (V1)

The sphenoud sinuses are evenly divided. T/F

F They are unevenly divided.

The sphenoidal sinuses are derived from which sinuses?

Posterior ethmoidal cells

When does the posterior ethmoidal cells begin to invade the sphenoid?

2 years of age

In some people, several posterior ethmoidal cells invade the sphenoid, giving rise to multiple sphenoidal sinuses that open separately into the spheno-ethmoidal recess. T/F

Innervation of sphenoid sinuses

Anterior and posterior ethmoidal nerves

Largest paranasal sinuses

Maxillary sinuses

The maxillary sinuses drain into which openings?

Maxillary ostium (ostia), and then semilunar hiatus to the middle nasal meatus

The apex of the maxillary sinus extends towards and often to which bone?

Zygomatic bone

The base of the maxillary sinus forms the inferior part of which structure?

Lateral wall of the nasal cavity

The floor of the maxillary sinus is formed by which structure?

Alveolar part of the maxilla

Which teeth produces the conical elevation in the floor of the maxillary sinus?

First two molars of the maxilla

Arterial supply of the maxillary sinus

Superior alveolar artery, descending and greater palatine arterues

Innervation of maxillary sinus

Anterior, middle and posterior superior alveolar nerves (V2)

Molecular characteristic of odorants A. Low vapor pressure B. Lipophilicity C. Low water solubility D. High polarity

What demonstrates proper anterior rhinoscopy using a nasal speculum? A. Placing the head mirror over the examiner’s dominant eye. B. Place the examiner’s ring finger on the patient’s nose to stabilize the speculum. C. Close the nasal speculum fully before taking it out of the patient’s nose. D. The light can be placed lower than the patient’s head.

Valve of _______ guards the opening of the nasolacrimal duct. A. Mink B. Hassner C. Haller D. Agger

Rhinitis is the swelling of the sinuses. T/F

T It is the swelling of the nasal mucosa. Sinusitis is the swelling of the mucosa of the sinuses.

Pansinusitis is the selling of the mucosa in multiple sinuses. T/F