8. nose clinical (workbook)

Question 1

what forms the medial wall of the nasal cavity?

Answer 1

the nasal septum

Question 2

what does the nasal septum consist of?

Answer 2

perpendicular plate of the ethmoid bone
septal cartilage
vomer

Question 3

what does the cartilaginous portion of the septum rely on for blood supply?

Answer 3

overlying perichondrium (cartilage covering)

Question 4

what can affect the blood supply to the cartilaginous portion of the septum?

Answer 4

septal haematoma

Question 5

what happens in a septal haematoma?

Answer 5

blood collects in a space between the septum and its perichondrium, lifting the perichondrium off the cartilage, stripping away its blood supply

Question 6

what does the pressure of the accumulating blood in septal haematoma cause?

Answer 6

ischaemia of the cartilage

Question 7

how should you treat a septal haematoma?

Answer 7

drain away the blood

Question 8

if a septal haematoma is not recognised and drained in a timely fashion, what can it lead to?

Answer 8

irreversible necrosis of the cartilage

Question 9

what does irreversible necrosis of the cartilage lead to?

Answer 9

cosmetic distortion of the nose

Question 10

what is cosmetic distortion of the nose known as?

Answer 10

saddle deformity

Question 11

what is it important to do after any sort of nasal trauma?

Answer 11

important to inspect the nasal septum

Question 12

what is sinusitis?

Answer 12

inflammation of the lining of the sinuses

Question 13

when can sinusitis occur?

Answer 13

following a viral infection of the nasal mucosae (e.g. a cold)

Question 14

how can a viral infection of the nasal mucosae (e.g. a cold) lead to sinusitis?

Answer 14

spread to involve the sinus

Question 15

what does infection cause? (sinus infection)

Answer 15

mucosal oedema
impedance of ciliary function
increasing mucosal secretions

Question 16

what can be obstructed if mucosal oedema involves openings into the nasal cavity?

Answer 16

drainage from the sinuses

Question 17

what can lead to a stagnant pool collecting within the sinus?

Answer 17

drainage from sinuses obstructed AND

increased mucosal secretions

Question 18

what can a stagnant pool collecting within the sinus sometimes lead to?

Answer 18

sometimes become secondarily infected by bacteria

Question 19

what is the maxillary sinus sometimes called?

Answer 19

antrum

Question 20

what is the antrum particularly prone to?

Answer 20

infection

Question 21

why is the antrum particularly prone to infection?

Answer 21

because of the location of its opening high on the medial wall of the nasal cavity

Question 22

how can diagnosis of paranasal sinus infection be made?

Answer 22

on the basis of history AND clinical examination ALONE

Question 23

how do you treat most causes of paranasal sinus infections?

Answer 23

most are self-limiting

treated with simple analgesics

Question 24

when do most paranasal sinus infections start to improve?

Answer 24

within 1-2 weeks

Question 25

what may be required if a secondary bacterial infection is suspected?

Answer 25

a course of antibiotics

Question 26

what are complications from sinusitis?

Answer 26

infections in the air cells of the ethmoidal sinuses may break through the thin medial wall of the orbit

Question 27

what can result if infections in the air cells of the ethmoidal sinuses break through the thin medial wall of the orbit?

Answer 27

infection spreading first into the peri-orbital tissues and subsequently into the orbit

Question 28

what can an infection spreading first into the peri-orbital tissues and subsequently into the orbit lead to?

Answer 28

orbital cellitus

Question 29

what can an orbital cellitus lead to?

Answer 29

be potentially sight threatening

Question 30

why might infections into the orbit be potentially sight threatening?

Answer 30

may involve the optic nerve or even track back further to involve intracranial structures