Trans 54 and 55 Paranasal and Nose Flashcards
(29 cards)
in the nose, Upper 1/3 consists of bones which are (3)
while lower 1/3 is composed of?
2 nasal bones
Frontal process of maxilla
Nasal notch of frontal bone
Cartilage
lower lateral cartilage + nasal septal cartilage =
ALA
superior and middle turbinates are part of _________ bone
inferior turbinate is __________ bone
Ethmoid bone;
separate bone
lining epithelium of Upper 1/3 of the nasal cavity?
• Upper 1/3 – olfactory epithelium
Specialized sensory epithelium. Same epithelium with respiratory but without goblet cells. It starts from the superior turbinate.
lining epithelium of lower 2/3 of nasal cavity
Lower 2/3 pseudostratified columnar ciliated epithelium
With goblet cells also with respiratory epithelium
lining epithelium of the vestibule
Vestibule – stratified squamous keratinizing epithelium
lining epithelium of the sinuses?
cuboidal ciliated
located at the antero-inferior part of the septum which is a confluence of arteries.
Kiesselbach’s plexus or Little’s area
No opening • Usually located at the bony-cartilaginous junction of the nasal dorsum • Contain all elements of skin: hair, sweat glands, sebaceous glands, connective tissue • Non-compressible, non-pulsatile • Diagnosis: o CT Scan • Treatment: o Surgical excision
NASAL DERMOID CYST
• Connected to the CNS
• Frequently associated with other midline fusion defects (cleft lip, cleft palate)
• Extracranial herniation of meninges and brain
• Bluish, compressible, pulsatile
(+) Furstenberg’s sign
Diagnosis:
o CT Scan “for confirmation – connection with the brain
• Treatment:
o Surgery
Nasal encephalocele
enlargement on compression of the jugular
(+) Furstenberg’s sign
• Solid • Non-compressible, non-pulsatile gray or purple mass • (-) Furstenberg’s sign • Diagnosis: o CT Scan
Nasal Glioma
acute vs chronic rhinosinusitis?
acute vs chronic rhinosinusitis?
• Acute rhinosinusitis:
o >10 days, <12 weeks with complete resolution of symptoms
• Chronic rhinosinusitis:
o >12 weeks without complete resolution of symptoms
Etiology: most of the time, bacterial sinusitis follows after a course of viral sinusitis. Typical pathogens include
o Streptococcus pneumonia
o Haemophilus influenza
o Moraxella catarrhalis
o Staphylococcus aureus
o PE ▪ Anterior Rhinoscopy/Nasal endoscopy: • pale, bluish-grey, • boggy turbinates • minimal to profuse, watery to mucoid nasal discharge
what disease entity?
ALLERGIC RHINITIS
Pharmacotherapy for Allergic Rhinitis
▪ Antihistamines: for early phase reaction
E.g. loratadine, cetirizine
Blocks histamine receptors
▪ Pseudoephedrine: for decongestion
▪ Intranasal corticosteroids: for early and late phase reaction.
What type of non allergic rhinitis?
- Patient usually have no history of allergens, and there are no signs of infection
- Symptoms may be exacerbated by temperature changes, strong odors, stress, and exposure to variety of irritants.
Vasomotor rhinitis
- Usually caused by Upper Respiratory viral infection
- Tends to resolve after infection run its course
- Nasal discharge is clear or mucopurulent, rather than watery
what form of non allergic rhinitis?
Infectious rhinitis
- Experienced only in workplace
- Thought to result from exposure irritants
- May present with concomitant occupational asthma
What form of non allergic rhinitis?
Occupational rhinitis
- Associated with hormonal imbalance and hypothyroidism
- Most common during puberty, menstruation, pregnancy and with use of hormonal therapies
what type of non allergic rhinitis?
Hormonal rhinitis
- Many drug types have been implicated
- A subtype, rhinitis medicamentosa, is caused by prolonged use of topical decongestants
what type of non allergic rhinitis?
Drug-induced rhinitis
Usually occurs after ingesting hot or spicy foods or alcohol
• Characterized by profuse watery rhinorrhea
what type of non allergic rhinitis?
Gustatory rhinitis
NARES vs BENARES? (non allergic rhinitis with esonophilia syndrome; blood eosinophilia nares)
- NARES: nasal smears show >5% to >20% eosinophils;
- BENARES: No nasal eosinophilia but elevated serum eosinophil levels
- NARES: estimated to account for 20% of rhinitis diagnoses
- NARES/BENARES: Patients at high risk of developing aspirin sensitivity, nasal polyps, sinusitis, and asthma
