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ENT Week 1 2017/18 > 2: Anatomy 1 - nose > Flashcards

2: Anatomy 1 - nose Flashcards

1
Q

From superior to inferior, name the parts of the external nose.

A

Root (between eyebrows)

Dorsum (the bridge of the nose)

Apex (tip of the nose)

Septum (separates the right and left nasal cavities)

Philtrum (indentation in the midline, just superior to the upper lip)

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2
Q

Which bone forms the bridge of the nose?

A

Nasal bone

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3
Q

What are the sides of the nose found on either side of the apex?

A

Ala

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4
Q

What is the technical name for the nostrils?

A

Nares

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5
Q

Which two bones make up the nasal septum?

A

Perpendicular plate of the ethmoid bone

Vomer

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6
Q

Apart from the vomer, which bone forms the superior part of the nasal septum?

A

Ethmoid bone

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7
Q

What are the two important structures of the roof of the nasal cavity?

Which bone do they belong to?

A

Cribriform plate

Crista galli

Both part of the ethmoid bone

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8
Q

In which cranial fossa are the cribriform plate and crista galli found?

A

Anterior cranial fossa

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9
Q

Which ganglia of CN I sit on the cribriform plate of the ethmoid bone and are separated by the crista galli?

A

Olfactory bulbs

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10
Q

Which structures of the ethmoid bone are found on the lateral wall of the nasal cavities?

A

Orbital plates

Superior and middle conchae

Ethmoidal air cells

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11
Q

Which part of the ethmoid bone separates the nasal cavity from the bony orbit?

A

Orbital plate

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12
Q

Which of the three conchae are part of the ethmoid bone?

A

Superior and middle conchae

Inferior conchae is its own thing

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13
Q

Which particular part of the ethmoid bone makes up the nasal septum?

A

Perpendicular plate

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14
Q

Is the nasal septum always found in the midline?

A

No

Slightly deviated in most people

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15
Q

Which type of fracture can damage the cribriform plate of the ethmoid bone?

Which types specifically?

A

Le Fort fracture

II & III

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16
Q

Why can Type II & III Le Fort fractures cause meningeal infections?

A

Transmission of bacteria from

nasal cavity and paranasal sinuses

to

anterior cranial fossa

via damaged cribriform plate

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17
Q

The conchae are found on the (medial / lateral) sides of the nasal cavities.

A

lateral sides

medial side is quite featureless

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18
Q

Which bone joins with the maxilla to form the hard palate at the floor of the nasal cavity?

A

Palatine bone

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19
Q

Which parts of the sphenoid bone act as insertions for the medial and lateral pterygoids and is found near the nasal cavity?

A

Pterygoid plates

(remember medial CLOSES the jaw and lateral OPENS it)

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20
Q

The cribriform plate is shaped like a sieve - why?

A

Allows passage of CN I (olfactory nerve)

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21
Q

The ethmoid air cells form one of the paranasal ___.

A

paranasal sinuses

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22
Q

Is the inferior concha part of the ethmoid bone?

A

No

Superior and middle concha ARE

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23
Q

The stratified squamous epithelium at the anterior part of the nasal cavity is ___.

What does this achieve?

A

keratinised

Stops foreign stuff getting into the nasal cavities

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24
Q

Most of the nasal cavity is lined with respiratory epithelium.

What is this specifically?

A

CILIATED PSEUDOSTRATIFIED COLUMNAR epithelium with GOBLET CELLS

Don’t forget this

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25
Q

What kind of epithelium is found at the superolateral part of the nasal cavity?

A

Olfactory epithelium

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26
Q

Where is olfactory epithelium found?

What is its function?

A

Superolateral nasal cavity

Sense of smell

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27
Q

Which cranial nerve is responsible for smell?

A

CN I

Olfactory nerve

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28
Q

Which structures do the nerve fibres for CN I pass into once they have gotten up through the cribriform plate?

A

Olfactory bulbs

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29
Q

What type of fibres are found in CN I?

A

Special sensory

(Optic nerve is also special sensory because sight is one of the special senses)

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30
Q

Nerve fibres for CN I pass through which part of the ethmoid bone?

A

Cribriform plate

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31
Q

Where are the receptors for CN I found?

A

Olfactory epithelium

Superolateral parts of nasal cavities

32
Q

From the olfactory bulbs, CN I fibres travel to the temporal lobes via which structures?

A

Olfactory tracts

33
Q

Are cranial nerves part of the CNS?

A

No

CNS is brain and spinal cord only

Cranial nerves are technically peripheral nerves (part of PNS)

34
Q

Which cranial nerves give off the somatic sensory supply for the

a) anterosuperior
b) posteroinferior

parts of the nasal cavity?

A

a) CN V1

b) CN V2

35
Q

Which divisions of the trigeminal nerve supply the upper and lower nasal cavities?

A

a) CN V1 - ophthalmic division

b) CN V2 - maxillary division

36
Q

Which parts of the nasal cavity are supplied by

a) CN V2
b) CN V1?

A

a) Posteroinferior

b) Anterosuperior

37
Q

Which major arteries of the neck give off the vessels supplying the nose?

A

External carotid artery

Internal carotid artery

38
Q

Which arteries branch off the

a) external carotid artery
b) internal carotid artery

to supply the nose?

A

a) Facial artery and Maxillary artery

b) Ophthalmic artery

39
Q

Which two arteries come off the ophthalmic artery (which comes off internal carotid) to supply the superior part of the nasal cavity?

A

Anterior ethmoidal artery

Posterior ethmoidal artery

40
Q

Which artery do the anterior and posterior ethmoidal arteries come off to supply the nasal cavity?

A

Ophthalmic artery

41
Q

Which two arteries come off the maxillary artery to supply the posteroinferior part of the nasal cavity?

A

Sphenopalatine artery

Greater palatine artery

42
Q

Which artery do the sphenopalatine and greater palatine arteries come off of to supply the nasal cavity?

A

Maxillary artery

43
Q

Which artery comes off the facial artery to supply the anterior part of the nasal cavity?

A

Lateral nasal branch of facial artery

44
Q

Which arteries come off

a) maxillary artery
b) facial artery
c) ophthalmic artery

to supply the nasal cavity?

A

a) Sphenopalatine and greater palatine arteries

b) Lateral nasal branch

c) Anterior and posterior ethmoidal arteries

45
Q

What is Kiesselbach’s area?

A

Arterial anastomosis in nasal cavity

46
Q

Is Kiesselbach’s area found on the lateral wall or the nasal septum?

A

Nasal septum

47
Q

Kiesselbach’s area is a common site for what?

What is a situation where you may cause this yourself?

A

Epistaxis (nosebleeds)

NG tube insertion

So you want to guide it laterally at first to avoid the anastomosis on the nasal septum (medial)

48
Q

What two types of structure are found on the lateral wall of the nasal cavity?

A

Conchae

Meatuses

49
Q

What is a concha?

What is their function?

A

Ridge in wall of nasal cavity

Increase surface area of respiratory epithelium so blood vessels, glands can warm and humidify it

50
Q

What is a meatus?

A

Inferior space created by each concha

51
Q

What are the three important conchae in the nasal cavity?

Which side of the cavity are they found on?

A

Superior, middle and inferior conchae

Lateral wall

52
Q

What are the four important meatuses found in the nasal cavity?

A

Sphenoethmoidal recess

Superior meatus

Middle meatus

Inferior meatus

53
Q

Which opening is found on the lateral wall of the nasopharynx?

A

Eustachian tube

communication between middle ear and nasopharynx

54
Q

Hard palate is found (anteriorly / posteriorly).

Soft palate… “”

A

Hard palate is anterior

Soft palate is posterior

55
Q

Which cranial nerve are you going to give sensation to when you insert an NG tube?

What do you need to avoid?

What is the path of the NG tube into the stomach?

A

CN V2 - maxillary division (inferoposterior)

Kiesselbach’s area (in case you cause an epistaxis)

Nasal cavity > Nasopharynx > Oropharynx > Laryngopharynx > Oesophagus > Stomach

56
Q

To be confident that it’s in the stomach, how far past the gastroesophageal junction should the NG tube be?

A

10cm

57
Q

What allows you to smell air as it passes through the nasal cavity?

A

Olfactory epithelium

58
Q

Every bone around the nose has what kind of spaces in it?

A

Paranasal sinuses

59
Q

What is the function of paranasal sinuses?

A

Dunno really

but makes your head lighter, might trap infectious stuff and flush it out

60
Q

What type of epithelium lines the paranasal sinuses?

What does it secrete?

A

Respiratory epithelium

Mucus via goblet cells

61
Q

Which sinuses are associated with the

a) frontal bone
b) maxilla
c) ethmoid bone
d) sphenoid bone?

A

a) 2 frontal sinuses

b) 2 maxillary sinuses (called antra)

c) 2 sets of ethmoidal air cells

d) 2 sphenoid sinuses

62
Q

What holes are found in the lateral wall of the nasal cavity and allow mucus to drain from the paranasal sinuses?

A

Ostia

(each one is called a sinus ostium)

63
Q

Where does the sphenoid sinus drain?

A

Sphenoethmoidal recess

64
Q

Where do the ethmoidal air cells drain?

A

Superior and inferior meatuses

65
Q

Where does the frontal sinus drain?

A

Middle meatus

66
Q

Where do the antra drain?

A

Middle meatus

67
Q

Where do the nasolacrimal ducts drain?

A

Inferior meatus

(only thing draining into inferior meatus is lacrimal fluid)

68
Q

Where do the

a) nasolacrimal ducts
b) sphenoid sinuses
c) frontal sinuses
d) ethmoidal air cells
e) maxillary sinuses / antra

drain?

A

a) Inferior meatus (only structure which drains here)

b) Sphenoethmoidal recess

c) Middle meatus

d) Superior and middle meatuses

e) Middle meatus

69
Q

Why do you get a runny nose when you cry?

A

Increased drainage of lacrimal fluid through inferior meatus

Which then comes out your nose

70
Q

What is sinusitis?

A

Inflammation of the respiratory epithelium lining the sinuses

71
Q

What are some causes of sinusitis (think VINDICATE)?

A

Infection

Inflammation

Autoimmune (including allergy)

72
Q

The problem in sinusitis usually revolves around the failure of mucus drainage through what?

A

Ostia

73
Q

If the ostia of sinuses are closed off, what accumulates in the sinuses?

A

Mucus +/- infection

74
Q

What cranial nerves supply the somatic sensory fibres which will be stimulated in sinusitis?

A

CN V1 and V2

75
Q

Where may sinusitis pain be referred?

Why?

A

Teeth

because teeth are also supplied by CN V1 and V2

76
Q

Why are the maxillary sinuses / antra more likely to become inflamed than other sinuses?

A

Ostia is superior

So mucus has to drain against gravity

77
Q

What spaces can be connected by a fistula following dental surgery?

A

Oral cavity and maxillary sinus

ENT Week 1 2017/18 (10 decks)

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