[1] Epistaxis Flashcards
What is epistaxis more commonly known as?
A nosebleed
What is epistaxis?
Bleeding from the nasal cavity and/or nasopharynx
What sort of age distribution does epistaxis have?
Bimodal
When are nosebleeds most common?
In the young and the old
Why does the nasal cavity bleed profusely?
The mucosa has a rich blood supply that can easily be ruptured
What is blood supply rupture associated with?
Trauma or can be spontaneous
What are the two types of nosebleeds?
- Anterior
- Posterior
Which type of nosebleed is most common?
Anterior
What area of the nasal cavity to anterior nosebleeds start in?
Little’s area
What is found within Little’s area?
Kiesselbach’s plexus
What is Kiesselbach’s plexus?
A richly vascular area
Bleeding from what causes posterior nosebleeds?
Woodruff’s plexus
What is Woodruff’s plexus?
A venous plexus
Where is Woodruff’s plexus found?
In the posterior part of the inferior meatus
How are posterior nosebleeds different from anterior nosebleeds in presentation?
- Prolonged
- Both nostrils
- More blood in the mouth
Which type of nosebleed is more difficult to control?
Posterior
What are the most common causes of nose bleeding?
- Nose picking
- Blunt trauma
- Insertion of foreign body
When is bleeding more likely?
When there is inflammation and thinning of the nasal tissues
What factors can cause thinning and inflammation?
- Relative humidity
- Respiratory tract infection
- Chronic sinusitis
- Rhinitis
- Environmental irritants
- Nasal oxygen
When should investigation of epistaxis causes be considered?
When they are recurrent and do not respond to home therapies
What are the categories of rare underlying causes of epistaxis?
- Coagulopathy
- Inflammatory
- Medications/drugs
- Neoplasia
- Trauma
- Vascular malformation
What coagulopathies can cause epistaxis?
- Thrombocytopenia
- Leukaemia
- Haemophilia
- HIV
- Chronic liver disease
What inflammatory causes lead to epistaxis?
- Granulomatosis with polyangiitis
- SLE
What medication can cause nosebleeds?
Anticoagulation
