8. nose clinical (workbook) Flashcards
what forms the medial wall of the nasal cavity?
the nasal septum
what does the nasal septum consist of?
perpendicular plate of the ethmoid bone
septal cartilage
vomer
what does the cartilaginous portion of the septum rely on for blood supply?
overlying perichondrium (cartilage covering)
what can affect the blood supply to the cartilaginous portion of the septum?
septal haematoma
what happens in a septal haematoma?
blood collects in a space between the septum and its perichondrium, lifting the perichondrium off the cartilage, stripping away its blood supply
what does the pressure of the accumulating blood in septal haematoma cause?
ischaemia of the cartilage
how should you treat a septal haematoma?
drain away the blood
if a septal haematoma is not recognised and drained in a timely fashion, what can it lead to?
irreversible necrosis of the cartilage
what does irreversible necrosis of the cartilage lead to?
cosmetic distortion of the nose
what is cosmetic distortion of the nose known as?
saddle deformity
what is it important to do after any sort of nasal trauma?
important to inspect the nasal septum
what is sinusitis?
inflammation of the lining of the sinuses
when can sinusitis occur?
following a viral infection of the nasal mucosae (e.g. a cold)
how can a viral infection of the nasal mucosae (e.g. a cold) lead to sinusitis?
spread to involve the sinus
what does infection cause? (sinus infection)
mucosal oedema
impedance of ciliary function
increasing mucosal secretions
what can be obstructed if mucosal oedema involves openings into the nasal cavity?
drainage from the sinuses
what can lead to a stagnant pool collecting within the sinus?
drainage from sinuses obstructed AND
increased mucosal secretions
what can a stagnant pool collecting within the sinus sometimes lead to?
sometimes become secondarily infected by bacteria
what is the maxillary sinus sometimes called?
antrum
what is the antrum particularly prone to?
infection
why is the antrum particularly prone to infection?
because of the location of its opening high on the medial wall of the nasal cavity
how can diagnosis of paranasal sinus infection be made?
on the basis of history AND clinical examination ALONE
how do you treat most causes of paranasal sinus infections?
most are self-limiting
treated with simple analgesics
when do most paranasal sinus infections start to improve?
within 1-2 weeks
what may be required if a secondary bacterial infection is suspected?
a course of antibiotics
what are complications from sinusitis?
infections in the air cells of the ethmoidal sinuses may break through the thin medial wall of the orbit
what can result if infections in the air cells of the ethmoidal sinuses break through the thin medial wall of the orbit?
infection spreading first into the peri-orbital tissues and subsequently into the orbit
what can an infection spreading first into the peri-orbital tissues and subsequently into the orbit lead to?
orbital cellitus
what can an orbital cellitus lead to?
be potentially sight threatening
why might infections into the orbit be potentially sight threatening?
may involve the optic nerve or even track back further to involve intracranial structures
