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Nose & Sinus Disorders Flashcards

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1
Q

Functions of the Nose

A

Olfaction
Air filtration & warming
Something to hold up your glasses

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2
Q

Consequences of deficiency in ability to perceive smell

A 
Impairs sense of taste
Lead to nutritional deficiencies
Impairs social interactions
Depression
May be dangerous (fires)
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3
Q

Define Anosmia

A

Inability to detect orders

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4
Q

Define Hyposmia

A

Decreased ability to detect odors

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5
Q

Define Dysosmia

A

Distorted identification of smell

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6
Q

3 Types of Dysosmia

A

Parosmia
Phantosmia
Agnosia

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7
Q

Define Parosmia

A

Altered perceptions of smell in the presence of an odor, usually unpleasant

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8
Q

Define Phantosmia

A

Perception of smell without an odor present

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9
Q

Define Agnosia

A

Inability to classify or contrast odors, although able to detect odors

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10
Q

Conductive Olfaction Defects Affects:

A

Transmission of an odorant stimulus to the olfactory neuroepithelium is disrupted

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11
Q

Sensorineural Olfaction Defects Involves:

A

The more central neural structures

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12
Q

The most common causes of olfactory deficits

A

Viral URI

Head trauma

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13
Q

Causes of Anosmia

A

Midline facial abnormalities

Neurosensory hearing loss

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14
Q

Causes of Dysosmia

A 
Nasal & paranasal sinus disease
Head trauma
URI
Medications
Exposure to toxins
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15
Q

Causes of Parosmia & Hyposmia

A 
Aging & neurodegenerative processes
Nasal obstruction
URI
Head trauma
Facial trauma
Central olfactory damage
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16
Q

Main function of the mucociliary movement

A

Prevent infection & Subsequent problems

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17
Q

Chronic Nasal Congestion Affected by:

A

Allergic rhinitis
Vasomotor rhinitis
Mechanical obstruction
SE of certain drugs/meds

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18
Q

Define Rhinitis

A

Inflammation of the nasal mucosa which can be caused by infection, allergy, or environmental irritants

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19
Q

Types of Infection in Rhinitis

A

Viral
Bacteria
Fungal (rare)

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20
Q

Main type of drug/medication that causes rhinitis

A

Afrin addiction

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21
Q

Hormonal changes that causes rhinitis

A

Hypothyroidism

Pregnancy

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22
Q

Types of chronic inflammatory disease

A

Granulomatosis

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23
Q

Presentation of Rhinitis

A

Nasal congestion
Rhinorrhea/discharge
Epistaxis
Pain (nasal, sinus, pharyngeal, dental)

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24
Q

Define Infectious Rhinitis

A

Inflammation of the nasal passages commonly due to any number of respiratory viruses

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25
Tissues Inflamed in a URI
Nasal & nasopharyngeal tissues Oropharyngeal, laryngeal tissues Bronchial mucosa
26
Incidence of the common cold in children
6-10 colds/year
27
Incidence of the common cold in kindergarteners
12/year
28
Incidence of the common cold in school aged children
7/year
29
Incidence of the common cold in adolescents/adults
2-4/year
30
Clinical Presentation of Infectious Rhinitis (cold)
``` Pharyngitis Nasal congestion Rhinorrhea Obstruction Sneezing Facial/ear pressure Loss of smell/taste Productive cough Hoarseness Headache Malaise Fever >100 ```
31
Causes of the Common Cold
``` Weather Exercise & diet Englarrged tonsils/adenoids Psychological stressors Allergic disorders ```
32
Main types of Viral Rhinitis
``` Rhinoviruses Coronaviruses Adenoviruses Orthomyxoviruses Paramyxoviruses Echoviruses RSV Enteroviruses Coxsackieviruses ```
33
How to Transmit the Cold
Touching your skin or environmental surfaces | Inhaling drops of aerosolized mucous material
34
Differential Diagnosis of the Common Cold
``` Seasonal allergic rhinitis Sinusitis: bacterial Pharyngitis: Group A Strep CMV EBV Mumps Rubeola Influenza ```
35
Systemic Symptoms of Influenza
``` Fever >101 Myalgias Malaise Severe headache Lower respiratory tract congestion/cough ```
36
Treatment of the Common Cold
``` Rest Plenty of fluids Gargle with warm salt water Throat sprays, lozenges Petroleum jelly Aspirin, Ibuprofen, or acetaminophen ```
37
Why can you not use aspirin the children?
Reye's Syndrome
38
What does aspirin promote in children?
N/V Liver inflammation Progressive mental changes
39
Management of Rhinitis
``` Antihistamines NSAIDs Decongestants Topical Decongestants Oral Decongestants ```
40
What are the best antihistamines for the common cold?
Chlorpheniramine (Chlor-Trimeton) Diphenhydramine (Benadryl) Brompheniramine (Dimetapp)
41
What NSAIDs are most frequently use for the common cold?
Ibuprofen | Naproxen
42
What do decongestants decrease and how?
Nasal congestion by causing vasoconstriction
43
Types of Decongestants for the Common Cold
Pseudoephedrine (Sudafed) Phenylephrine Oxymetazoline
44
What are some unwanted side effects of decongestants?
Narrow-angle glaucoma Poorly controlled HTN CAD
45
Types of Topical Decongestants for the Common Cold
Phenylephrine | Oxymetazoline
46
Types of Oral Decongestants for the Common Cold
Pseudophedrine | Phenylephrine
47
Symptoms from unintentional overdose in cough and cold medicines
Hives Drowsiness Unsteady walking
48
Patient Education for the Common Cold
Reassurance Rest Increase fluids Discontinuation of tobacco & alcohol
49
Complications of the Common Cold
``` Lower respiratory infections Bronchial hyperreactivity Exacerbation of chronic lung diseases OM Acute sinusitis Rhinitis medicamentosa ```
50
Define Sinusitis
Inflammatory or infectious process in the paranasal sinuses caused by bacteria, viruses, fungi, allergies
51
Define Acute Rhinosinusitis
Symptoms that last less than 4 weeks
52
Define Subacute Rhinosinusitis
Symptoms for 4-12 weeks
53
Define Chronic Rhinosinusitis
Persists greater than 12 weeks
54
Define Recurrent Acute Rhinosinusitis
4+ episodes per year with interim symptoms resolution
55
Pathophysiology of Rhinosinusitis
Osteomeatal complex consisting of the outflow tracts of all of the sinuses into the nose
56
What conditions must be present for normal physiologic functioning of the sinuses?
Potency of the osteomeatal unit Normal mucociliary transport Normal quality/quantity of secretions
57
Factors which predispose one to recurrent sinus infections
``` Anatomical irregularities Infections Allergies Polyps Hormones Environment Foreign bodies Cystic fibrosis ```
58
Common Bugs in Bacterial Sinusitis
Strep Pneumo H. Flu M. cat
59
Common Bugs for Chronic Sinusitis
Staph aureus | Anaerobes
60
Symptoms of Sinusitis
``` Facial pain or tenderness Nasal congestion Purulent nasal & postnasal discharge Headache Maxillary tooth pain Malodorous breath Fever Eye swelling Pain/pressure in cheecks ```
61
What is the time frame for viral URI's?
62
How long do symptoms need to last in order to be bacterial sinusitis?
Greater than 7 days
63
Touchdown or slam dunk symptoms for sinusitis
Headache Facial pain Fever
64
In order to diagnose sinusitis you need 2+ of the following symptoms
``` Colored nasal drainage Poor response to decongestant Facial pain/Sinus pain Headache Biphasic illness which cold symptoms ```
65
Distinguishing Symptoms for Frontal Sinusitis
Pain when forehead over frontal sinuses is touched | Pain exacerbated by leaning forward
66
Distinguishing Symptoms of Ethmoid Sinusitis
Pain behind eyes, between eyes
67
Distinguishing Symptoms of Sphenoid Sinusitis
Pain behind the eyes
68
Distinguishing Symptoms of Maxillary Sinusitis
``` Upper jaw & teeth to ache Cheeks tender to touch Purulent drainage Nasal mucosa erythematous & swollen Presence of mucoid pus ```
69
Diagnostics of Sinusitis
Plain films CT scans MRI Sinus aspiration
70
Treatment of mild, recent onset sinusitis
``` Rest Plenty of fluids Gargle with warm salt water Throat sprays, lozenges Petroleum jelly Aspirin, Ibuprofen, or acetaminophen ```
71
Treatment for Bacterial Sinusitis
Amoxicillin (1st line) Augmentin Doxycycline Zithromax
72
Self Care Measure for Sinusitis
``` Adequate hydration Steamy shower Increase humidity in home Warm facial packs Analgesics Decongestants Saline irrigation lavage Saline drops/sprays Adequate rest Sleep with head of bed elevated Avoid cigarette smoke/dry, cool air ```
73
Complications of a Bacterial Sinusitis
``` Meningitis Epidural abscess Subdural empyema Brain abscess High fever CNS symptoms Orbital cellulitis Orbital abscess Cavernous sinus thrombosis Mucocele formation ```
74
Presentation of Allergic Rhinitis
``` Clear rhinorrhea Sneezing Tearing Eye irritation Pruritis Cough Bronchospasm Eczemetous dermatitis ```
75
Treatment of Allergic Rhinitis
Antihistamines Intranasal corticosteroids Antileukotrienes Immunotherapy
76
Define Nasal Airway Obstruction
Inability to inspire and expire through the nasal passage
77
Nasals Airway Obstruction
``` One or both nostrils Partial or complete block Always, intermittent Stable, worsening Impaired respiration, smell, and taste ```
78
Which population can nasal obstruction be life threatening?
Infants- obligate nose breathers
79
Differential Diagnosis for Nasal Airway Obstruction
``` Polyps Tumors Foreign bodies Septal deviations Trauma ```
80
Define Nasal Polyps
Intense inflammatory reaction of the sinonasal mucosa of unknown etiology
81
Polyps which block ______ can lead to chronic sinusitis?
Osteomeatal unit
82
Imaging to diagnose nasal polyps
Coronal sinus CT MRI Water's view X-ray
83
Treatment for Nasal Polyps
``` Topical steroids (1st line) Antihistamines Oral steroids Leukotriene inhibitors Intrapolyp steroid injections Surgical removal ```
84
Define Septal Deviation
Displacement of the nasal septum
85
How do you obtain a septal deviation?
Trauma Marfan syndrome Homocystinuria Ehlers-Danlos syndrome
86
Symptoms of Septal Deviation
``` Infections of the sinus Sleep apnea Snoring Change in smell Frequent sneezing Difficulty breathing ```
87
Treatment of Septal Deviation
Decongestants Anti-histamines Nasal spray Septoplasty
88
Define Septal Perforation
Hole or fissure in the nasal septum
89
Causes of Septal Perforation
Cocaine Nasal Sprays Piercing
90
Symptoms of Septal Perforation
Whistling when breathing Bloody discharge Nasal pressure Discomfort
91
Treatment of Septal Perforation
Usually heal without surgery

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