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14. Head and Neck > 7. The Nose > Flashcards

7. The Nose Flashcards

1
Q

What is the external nose?

A

The visible portion that projects from the face made of bony and cartilaginous components and is the opening into the nasal cavity.

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2
Q

What are the nostrils bounded laterally by?

A

Alae.

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3
Q

What is the supporting skeleton of the nose composed of?

A

Bone: nasal bones, maxillae frontal processes, frontal bone (nasal part and nasal spine).
Hyaline cartilage: 2 lateral cartilages, 2 alar cartilages, 1 septal cartilage.

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4
Q

What is the nasal septum made of?

A

Anterior portion - cartilage
Middle portion - perpendicular plate of ethmoid bone
Posterior portion - vomer

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5
Q

What is the hard palate made of inferiorly?

A

Palatine and maxillary bones, separates the nasal and oral cavities.

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6
Q

What is a complication of a nasal fracture?

A

Septal haematoma.

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7
Q

What is the nasal cavity made up of?

A

Nostrils, chonchae (terbinates) in the lateral wall which create five passages within the cavity, and mucosal lining (except vestibule which has skin) which is continuous with areas draining into the cavity.

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8
Q

What are the three nasal conchae?

A

Superior, middle, and inferior. They are scroll-like structures that offer a vast surface area for heat exchange.

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9
Q

Where are the nasal conchae?

A

They curve inferiormedially, hanging like short curtains from the lateral wall of the nasal cavity.

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10
Q

Which is the largest nasal conchae?

A

The inferior one, it is the broadest and formed by an independent bone (inferior concha).

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11
Q

What are the middle and superior conchae from?

A

They are medial processus of the ethmoid bone.

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12
Q

What divides the nasal cavity into five passages?

A

The recess/nasal meatus that underlies each terbinate.

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13
Q

Where is the sphenoethmoidal recess and what does it receive opening of?

A

It is superoposterior to the superior concha and receives opening of the sphenoidal sinus.

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14
Q

What is the purpose of the sphenoethmoidal recess?

A

Olfaction by its modified lining epithelium of mucous membrane.

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15
Q

How does olfaction work?

A

Axonal processes of the olfactory cell pass through the cribriform plate and penetrate the meninges before entering the olfactory bulb.

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16
Q

What runs through the cribriform plate?

A

The olfactory nerve (CN I), can be damaged in fractures -> CSF leakage and anosmia.

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17
Q

What are the opening of the nasal cavity?

A

Cribriform plate, sphenopalatine foramen, incisive foramen, foramen cecum.

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18
Q

What is the blood supply of the nasal cavity?

A

Branches of the opthalmic artery (branch of internal carotid) and of the maxillary and facial arteries (branches of external carotid).

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19
Q

What is Kiesselbach/Little’s area?

A

Anterior part of the nasal septum that is rich in capillaries and all arteries supplying the septum anastomose. Site of nose bleeds.

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20
Q

What is epistaxis?

A

Bleeding from the nose due to local or systemic cause.

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21
Q

What causes epistaxis?

A

Anterior bleeds in 90% of cases but sphenopalatine artery in posterior bleeds.

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22
Q

What is the venous drainage of the nose?

A

Rich submucosal venous plexus, deep to nasal mucosa, drains into: cavernous sinus, facial vein, pterygoid plexus.

23
Q

What is the special sensory innervation of the nose?

A

Olfactory nerve (CN I).

24
Q

What is the general sensory innervation of the nose?

A

Posteroinferior nasal mucosa - maxillary division of trigeminal nerve (CN V2), nasopalatine nerve.
Anterosuperior nasal mucosa - opthalmic division of trigeminal nerve (CN V1), anterior and posterior ethmoidal nerves.
External nose - external nasal nerve (CN V1), infraorbital nerve (CN V2).

25
Q

What is the epithelium of the nasal cavity?

A

Respiratory region: pseudostratified columnar ciliated with goblet cells.
Olfactory region: olfactory cells with olfactory receptors.

26
Q

What are paranasal sinuses?

A

Air-filled extensions of the respiratory part of the nasal cavity into cranial bones.

27
Q

What are the four paranasal sinuses?

A

Frontal, ethmoidal, sphenoidal, maxillary.

28
Q

Where are the frontal sinuses?

A

Right and left sinuses are between the outer and inner tables of the frontal bone, posterior to the superciliary arches and the root of the nose.

29
Q

What are frontal sinuses detectable?

A

By the age of 7, not there at birth.

30
Q

Where do the frontal sinuses drain?

A

Through a frontonasal duct into ethmoidal infundibulum, which opens into the semilunar hiatus of the middle nasal recess.

31
Q

What are ethmoidal cells/sinuses?

A

Small invaginations of the mucous membrane of the middle and superior nasal recess into the ethmoid bone.

32
Q

When are ethmoidal sinuses visible on plain radiographs?

A

After the age of 2.

33
Q

What do the ethmoidal sinuses drain?

A

Anterior drain directly or indirectly into the middle nasal recess through ethmoidal infundibulum.
Middle open directly into middle nasal recess.
Posterior open directly into superior nasal recess.

34
Q

Where are the sphenoidal sinuses?

A

In the body of the sphenoid and may extend into the wings of the bone.

35
Q

Where do the sphenoidal sinuses drain?

A

Into the sphenoethmoidal recess.

36
Q

What are the largest paranasal sinuses?

A

Maxillary sinuses.

37
Q

Where are the maxillary sinuses?

A

In the bodies of the maxillae.

38
Q

Where do maxillary sinuses drain?

A

By one or more openings, maxillary ostia into middle nasal recess by semilunar hiatus.

39
Q

Where can infections of the nasal cavity spread to and how?

A

Anterior cranial fossa via cribriform plate of ethmoid bone.
Paranasal sinuses via openings into nasal cavity.
Lacrimal apparatus and conjunctiva via opening of nasolacrimal duct.
Middle ear via pharyngotympanic tube.

40
Q

What is rhinitis?

A

Inflammation of the nasal mucosa -> swelling and increased secretion.

41
Q

What causes rhinitis?

A

Infective (viral): adenovirus, rhinovirus, respiratory syncytial virus (RSV).
Allergic.
Nasal polyps.

42
Q

Where do nasal polyps grow?

A

Close to ostiomeatal complex of the nasoparynx.

43
Q

What are nasal polyps linked with?

A

Chronic rhinosinusitis, nasal obstruction -> snoring/obstructive sleep apnoea.

44
Q

What is sinusitis?

A

Inflammation of the mucosal lining of the sinuses.

45
Q

How are cases of sinusitis classified into acute, sub-acute, chronic, and infection?

A

Acute 7-30 days, sub-acute 4 to 12 weeks, chronic >90 days.

46
Q

What causes sinusitis?

A

Infection, viral with secondary bacterial infection by Streptococcus pneumoniae, or Haemophillus influenzae.

47
Q

What is an ethmoidal sinus air cell infection?

A

Infection that has gone through medial wall of the orbit, close to optic canal so affects optic nerve (CN II) and opthalmic artery causing visual disorders.

48
Q

What is maxillary sinus infection from?

A

Mucus membrane of sinus is congested so ostia are obstructed and sinuses can’t drain when head is erect unless they’re full.

49
Q

What are maxillary teeth?

A

The three maxillary molar teeth that are close to the floor of the maxillary sinus.

50
Q

When may infection occur with maxillary teeth?

A

In their removal, some root may be driven superior into maxillary sinus so there is communication made between the oral cavity and maxillary sinus which may be a route of infection spread.

51
Q

How does inflammation of the mucosa of the maxillary sinus present?

A

Sensation of toothache in the molar teeth.

52
Q

What can cause nasal septum deviation?

A

Birth injury, or trauma in adolescence and adulthood.

53
Q

What are possible consequences of nasal septum deviation?

A

Makes contact with lateral wall of nasal cavity and obstructs breathing or exacerbates snoring.

14. Head and Neck (11 decks)

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