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Flashcards in Nose Deck (43):
1

What is epistaxis

nose bleed

2

Where does epistaxis usually occur

At Kiesselbach's (little) area

3

Where is Little's area

on the anterior nasal septum

4

Which 2 main arteries give off branches to make up Little's area

internal carotid
external carotid

5

What branches does the external carotid give off

the facial and maxillary

6

What branches come off of the maxillary artery

spheno-palatine
greater palatine

7

What branches come off of the facial artery

lateral nasal
superior labial

8

What branch comes off of the internal carotid

the anterior and posterior ethmoidal arteries

9

What anastomoses of arteries is Little's area made up of

spheno-palatine
greater palatine
ethmoidal

10

what is the treatment for acute epistaxis

immediate first aid - external compression of the anterior lower portion of the external nose
-ice pack
- leaning forward to prevent swallowing blood

11

What else can be done for epistaxis if the nose keeps bleeding persistently

resus by IV access
packing
intranasal cautery

12

What are the main causes of nasal obstruction

rhinitis
nasal polyps
septal deviation
foreign bodies
sinonasal malignancy

13

what is the treatment for allergic rhinitis

allergen avoidance
topical steroids/ anti-histamines

14

What is the treatment for severe rhinitis

oral anti-histamines
immunotherapy

15

What are the causes of nasal polyps

allergy
infection
non-allergic asthma
aspirin sensitivity
nickel exposure
CF - if younger

16

what are nasal polyps

inflammation and oedema of the nasal mucousa

17

What would nasal polyps present as

usually in the middle meatus
"skinned grape" appearance
non-tender

18

What is the treatment for nasal polyps

intra-nasal steroids
if unresponsive - surgery

19

What cancer is more common in the nose (benign/malignant)

malignant (though still rare)

20

What is the most common type of benign nasal tumour

squamous papilloma

21

What is the most common type of malignant nasal tumour

SCC

22

When would you expect sinonasal malignancy

if there is unusual unilateral symptoms
e.g. paraesthesia of the cheek
- proptosis of the orbit

23

What is the treatment for septal deviation

most people have an asymptomatic deviated septum
if symptomatic (causing obstruction) - surgical correction

24

What is someone with a nasal foreign body likely to present with

usually children with unilateral discharge

25

What is the treatment for a nasal foreign body

removal either - in theatre
- under general anaesthetic

26

What will someone with a fractured nose present with

epistaxis
bruising around the eyes
nasal bridge swelling

27

What is the investigation for a nasal fracture

abnormalities difficult to see before swelling goes down
wait till swelling goes down then reset
head injury check
check for signs of septal haematoma

28

What will someone with a septal haematoma have

can cause nasal obstruction
painful
if fluctuant on pressing the nasal septum it has to be aspirated immediately

29

What is the treatment for a nasal fracture

if asymptomatic - nothing
If symptomatic - has to be reduced by manipulation within 2 weeks of the injury

30

What is the cut off for acute sinusitis

<4wks
> 4wks = chronic

31

What mild sinusitis present with

mild discomfort and tenderness across the frontal and maxillary sinuses due to congestion

32

What is the causes of sinusitis

viral (commonly)
bacterial - usually secondary
fungal
allergic
autoimmune
associated with URTI
can occur with asthma

33

What is the treatment for mild sinusitis

if < 10 days - nasal decongestants
if > 10 days - penicillin V (1st line)
- doxycycline (2nd line)
- clarithromycin (2nd line for children)

34

What are the most likely organisms for a secondary bacterial sinusitis

h. influenza
strep. pneumonia

35

What is the presentation of severe sinusitis

frontal headache
purulent rhinorrhoea
facial pain with tenderness
fever

36

what is the treatment for severe sinusitis

penicillin v (1st line)
Doxycycline (2nd line)
Clarithromycin (2nd line for children)
may need functional endoscopic sinus surgery

37

What does FESS do

ventilates and drains the sinuses

38

Nasopharyngeal carcinoma is caused by what

epstein barr virus

39

Where is a nasopharyngeal carcinoma most common

most common cancer in china and hong kong

40

what will someone with a nasopharyngeal carcinoma present with

posterior neck lump
hearing deficit

41

Why would a patient with a nasopharyngeal carcinoma get a hearing deficit

the tumour has blocked the eustachian tube causing negative pressure of the middle ear (glue ear)

42

What are the causes of nasal perforation

nose picking
cocaine abuse

43

What is the treatment for nasal perforation

if asymptomatic - do nothing
if small - medium - can surgically repair
if large - currently not treatment for large perforations