5. Nasal cavity, paranasal sinuses and pharynx

Question 1

What is the function of the nasal conchae?

Answer 1

• to increase surface area of the nasal cavity.

Question 2

What is a septal haematoma?

Answer 2

• collection of blood between the perichondrium and nasal septal cartilage.
• dangerous bc prevents blood supply to the nasal septum.

Question 3

Which area of vasculature is epistaxis most likely to occur from?
What makes up this area?

Answer 3

• Little’s area.

- this is an anastomosis of the 5 blood vessels that supply the nasal septum.

Question 4

Why is epistaxis potentially very dangerous?

Answer 4

• bc the blood supply may originate from the internal or external carotid arteries which supply the brain and face.

Question 5

What are the boundaries of the danger triangle?

Answer 5

• bridge of nose and corners of mouth.

Question 6

Which nerve provides a) special sensory innervation and b) general sensory innervation to the nose?

Answer 6

a) olfactory nerves.

b) branches of the trigeminal nerve.

Question 7

Explain the clinical implications of fracturing the cribriform plate? (2)

Answer 7

• can lead to anosmia bc it will disrupt the olfactory nerve branches.
• also provides a pathway for CSF to leak into the nasal cavity causing CSF rhinorrhoea.

Question 8

Describe the cellular composition of the cells lining the paranasal sinuses.

Answer 8

• pseudo-stratified ciliated columnar epithelium with goblet cells.

Question 9

Name the 4 paranasal sinuses.
Which one of these sinuses does NOT drain into the nasal cavity?
Where does it drain into?

Answer 9

• ethmoidal.
• sphenoidal - this one doesn’t drain into the nasal cavity, it drains into the posterior roof.
• maxillary.
• frontal.

Question 10

Which paranasal sinus lies the most posteriorly in the skull?

Answer 10

• sphenoidal.

Question 11

Which paranasal sinus lies the most (a)superiorly and (b)inferiorly in the skull?

Answer 11

a) frontal.

b) maxillary.

Question 12

Which sinus is most likely affected during sinusistis?

Answer 12

• maxillary sinus.

Question 13

Briefly describe trans-sphenoidal surgery.

What is it typically used for?

Answer 13

• surgical tools are used to access the brain through the nose and through the sphenoid bone.
• typically used to remove pituitary gland tumours (adenomas).

Question 14

What is the function of the nasolacrimal duct?

Answer 14

• carries tears from the lacrimal sac of the eye to the nasal cavity.

Question 15

What is the function of the nasolacrimal gland?

Where does it drain into and via which structure?

Answer 15

• produces tears to protect and lubricate the eye.

- drains into the nasal cavity at the inferior meatus via the nasolacrimal duct.

Question 16

Where does the oropharynx lie?

Answer 16

• between the soft palate and superior border of the epiglottis.

Question 17

What does the oropharynx contain? (3)

Answer 17

• the tongue.
• lingual tonsils.
• palatine tonsils.

Question 18

Where does the laryngopharynx lie?

Answer 18

• between superior border of the epiglottis and inferior border of cricoid cartilage (C6).

Question 19

The muscles of the pharynx are divided into two groups: longitudinal and circular. Which muscles comprise the circular group of muscles?
What is the function of these muscles?

Answer 19

• the superior, inferior and middle constrictor muscles.

- to contract sequentially to squeeze the bolus down the oesophagus.

Question 20

What is the function of the longitudinal muscles of the pharynx?

Answer 20

• to shorten and widen the pharynx.

- to elevate the larynx during swallowing.

Question 21

Which nerve provides sensory innervation to the nasopharynx?

Answer 21

• pharyngeal branch of maxillary nerve (V2).

Question 22

Which tonsils does the nasopharynx contain?

Answer 22

• the adenoid tonsils.

Question 23

Explain the clinical implications of adenoid hypertrophy.

Answer 23

• blocks the nasopharynx leading to mouth breathing.

Question 24

Which nerve provides sensory innervation to the oropharynx?

Answer 24

• glossopharyngeal nerve via the pharyngeal plexus.

Question 25

What is quinsy?

Answer 25

• accumulation of pus behind the tonsils.

Question 26

Which nerve provides sensory innervation to the larygopharynx?

Answer 26

• vagus nerve.

Question 27

What is the piriform fossa and why is it clinically important?

Answer 27

• it is a recess on either side of the laryngeal orifice.

- it is an area where foreign objects could get lodged.