Olfaction

Question 1

referred pain: what nerves are involved? (ear, nose, sinuses) (2)

Answer 1

jacobson’s (9)

arnold’s (10)

Question 2

what to do before examining internal nose

Answer 2

decongest!

proetz and mecca positioning for full exposure of mucosa to decongestant

Question 3

t/f polyps shrink with decongestion and are painful when probed.

ano itsura nito

Answer 3

faaaaaaaalse

semi-translucent/pale/whitish

Question 4

maximum tenderness (percussed or pressed firmly)

sphenoid
frontal
ethmoid
maxillary

Answer 4

sphenoid
vertex

frontal
supero-medial roofs of orbital sockets

ethmoid
nasal bones between medial canthi

maxillary
incisive fossa area of cheeks

Question 5

visualize maxillary sinus

Answer 5

water’s

*face casette, orbitomeatal line angled 37 deg

Question 6

visualize frontal and ethmoid sinuses

Answer 6

caldwell

*face casette, orbitomeatal perpendicular, beam 15 deg caudally

Question 7

visualize sphenoid and ethmoid sinuses

Answer 7

submentovertical

*face away from casette
orbitomeatal parallel to casette

Question 8

visualize frontal and maxillary

Answer 8

lateral

Question 9

simplest form of allergy testing

another, more expensive test?

Answer 9

skin prick

RAST radio-allergosorbent (measures IgE)

*eosinophilia on nasal smears and blood = allergic rhinitis

Question 10

how to test mucociliary clearance?

Answer 10

place pellet/saccharin on inferior turbinate

taste in 20 mins!

Question 11

development of the nose (3)

Answer 11

preskeletal

chondrocranial

ossification

Question 12

nasal dermoids commonly located in? structure?

Answer 12

nasal dorsum

epithelial-lined cavities w skin appendages

Question 13

gliomas commonly located in? structure?

Answer 13

glabella level

unencapsulated glial cells outside CNS

Question 14

what are encephalocoeles

Answer 14

herniations of neural tissue through defects in skull

Question 15

excoriations of skin of nasal vestibule.

local causes? (3)
general causes? (3)
most common bacteria?

Answer 15

nose picking, coryza (allergy), collumelar dislocation

herpes simplex, zoster vesicles, eczema

staph

Question 16

nasal furunculosis commonly caused by?

Answer 16

s. aureus

* infection of hair follicle

Question 17

most common illness

Answer 17

common colds woooo

Question 18

allergic rhinitis is what kind of reaction?

Answer 18

type 1 hypersensitivity

*assoc w sinusitis, OM w effusion, bronchial asthma

Question 19

relation bet rhinitis and sinusitis?

Answer 19

sinus overflow obstruction -> bacterial colonization -> sinusitis (or chronic inflammation due to allergens -> sinusitis?)

Question 20

cardinal symptom of nasal polyps

Answer 20

progressive nasal obstruction

*rhinorrhea & recurrent sinusitis

Question 21

important sign for nasal foreign bodies

Answer 21

unilateral foul smelling discharge even after ab treatment

Question 22

most common anatomic abnormality (sa nose?); surgical emergency

treatment?

Answer 22

septal hematoma

incise and drain (to prevent infection, abscess formation, cartilage resorption, saddle-nose)

Question 23

most common type of facial fracture

Answer 23

nasal fracture

Question 24

kallman syndrome:

anosmia due to? (2)
what structure is absent?

Answer 24

failure of ontogenesis of olfactory structure, hypogonadism

vomeronasal organ is absent

Question 25

complication from brain surgery, subarachnoid hemorrhage which may lead to anosmia

Answer 25

damage to fila olfactoria

Question 26

toxic drugs (2) and chemicals (4)

Answer 26

aminoglycosides, formaldehyde alcohol nicotine organic solvents zinc sulfate

Question 27

nutritional deficiencies (3)

Answer 27

vitamin a thiamine zinc deficiencies