Sinuses & Rhinitis

Question 1

Antrum of Highmore

Answer 1

Aka Maxillary sinus

Question 2

Floor of maxillary sinus ?

Answer 2

Alveolar Process of Maxilla
Related to 2nd premolar & 1st Molar

Question 3

Ethmoidal cell present below orbit ?

Answer 3

Haller cell

(HELL is below the eye)

Question 4

Ethmoidal cell present most anteriorly ?

Answer 4

Agger Nasi

Can at times almost invade n pneumatize uncinate

Question 5

Posterior Ethmoidal cell present near Optic ?

Answer 5

Onodi cell

Question 6

Sinuses at Birth ?

Answer 6

” ME till im 15”

Maxillary and Ethmoidal

Both Complete by 12 to 15 yrs

Question 7

Last to develop & Last to complete

Answer 7

Frontal

2nd yr of life ethamoidal cells grow into frontal bone

Finishes by 18yrs

Question 8

Frontal

visible on xray by ?

Q2 no idea of question

Answer 8

8th yr

12th yr

Question 9

Sphenoid sinuses develop by ?

Answer 9

Small sac present at birth

Develops by 5th yr

Question 10

Cavernous sinus

Answer 10

Inside:
6.
Carotic plexus
ICA

Lateral wall - 3,4,V1 V2
Roof optic nerve

Question 11

Tras sphenoidal Hypophysectomy deals with Sella types

Answer 11

Sella 90% > presellar 9% > cochal 1%

Question 12

Bulla ethamoidalis is situated behind ?

Answer 12

Uncinate process

Question 13

Aggar nasi communicates with ?
Situated where ?

Answer 13

Frontal sinus

Its situated just anterior to middle turbinate

Question 14

Pnumatization of what leads to choncha bullosa ?

Answer 14

Middle turbinate

Drains into frontal or aggar nasi

Question 15

Haller cells

Answer 15

At roof of maxillary sinus

Below choncha bullosa
Impeds maxillary drainage

Question 16

Posterior ethamoidal air cell ?

Answer 16

Onodi cell

Post by spehnoid sinus or 1.5cm superior to it

IMPORTANT BECAUSE OF ITS OPTIC NERVE RELATION

Question 17

Post 2/3rd of nose nerve ?

Answer 17

Sphenopalantine nerve

Septum and lateral wall

Question 18

Nerve supplying Anterior Nd superior (lateral wall and septum)

Answer 18

Anterior ethamoidal nerve

Question 19

Forceps used for Antral Lavage

Answer 19

Lich-twitz trochar and cannula

1.5- 2 cm from ant end of inferior turbinate

Question 20

Causes of Primary Atropic Rhinitis

Answer 20

Hereditary Factors
Endocrine Disturbances
Racial
Nutritional (Deficiency A, D & iron )
Infective - Klebsiella ozaenae Diptherods Proteus vulgaris E. coli
Autoimmune

Question 21

Treatment of Atropic Rhinitis

Answer 21

ATROPI IN YOUNG GIRLS

Antibiotic spray - Kemicetine
Teflon past submucosal inj
Remove Crust
Ostradiol spray
P- K iodine
Irrigation

Insertion of fat,bone etc

Youngs

Question 22

Rhinitis sicca

Answer 22

Dry dusty
Ant 1/3rd crusting
Squamous metaplasia from ciliary col
& atrophy of seromucinous glands

Question 23

Rhinitis Caseosa

Answer 23

U/l
Males
Cheesy material
Cronic sinusitis

Sinus mucosa becomes granulomatous
Bony sinus wall destroyed

Prognosis good

Question 24

Rhinoscleroma caused by

Answer 24

Klebsiella rhinoscleroma

Question 25

Stages of Rhinosocleroma

Answer 25

Atropic - resembles atropic rhinitis Granulomatous (subdermal infilteration ext nose and upper lip - woody- painless - non ulcerative) Cicatrial - stenosis, distortion and adhesion

Question 26

Biopsy of Rhinoscleroma shows

Answer 26

Infilteration of submucosa Mikulicz cells (pronounced as Mi-ku-lich) - Large foamy cells with central nucleus & vaculated cytoplasm containing bacili Russel bodies - homo esosinophilic inclusion Bodies in plasma cells

Question 27

Rx of Rhinoscleroma

Answer 27

Streptomycin and tetracycline for 4- 6 weeks upto a month

Question 28

Youngs sx vrs Modified

Answer 28

Young's- Atropic Rhinitis nostril closed by flap Modified - 3mm opening @ centre

Question 29

North India + Tapir/Hebra Nose + Atropic rhinitis

Answer 29

Rhinoscleroma

Question 30

Strawberry masss +PONDS + Tamil Nadu+ skin + bleeding mass studded with white dots

Answer 30

RHINOSPORIDIOSIS Leafy and polypoidal mass

Question 31

Cause of rhinosporidiosis

Answer 31

Rhinosporidium seebri

Question 32

Uniquness of mucormycosis

Answer 32

Can invade arteries and cause endothelial damage and thrombosis

Question 33

Wegner's granulomatosis

Answer 33

Blood stain nasal discharge Persistent cold & destruction of nose C ANCA and VASCULTITS Haemoptysis Xray cavity lesion Kidney- red cast albumin

Question 34

T cell lymphoma aka

Answer 34

Midline malignancy Polymorphic reticulosis

Question 35

T cell lymphoma uniqueness

Answer 35

Rapid ONE SIDE destruction from nose till maxilla Angiocentric and angioinvasive NO systemic involment and no vasculitis Rx Radi/chemo

Question 36

Nasal myiasis caused by ?

Answer 36

Chryosma flies

Question 37

Kemicetine antiozaena solution contains

Answer 37

Chloromycetin aka chloramphenicol Oestrodiol Vit D2

Question 38

Nasal myiasis rx

Answer 38

Chloroform water + oil Nasal douche for crusting Mosquito net to prevent further fly contact