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Head And Neck > Anatomy And Physiology Of The Nose > Flashcards

Anatomy And Physiology Of The Nose Flashcards

1
Q

What is the principal physiological function of the nose?

A

Humidify and warm inspired air

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2
Q

What can a blocked nose cause?

A

Dry mouth, disturbed sleep

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3
Q

What do tracheostomy/ Laryngectomy ‘patients need?

A

Humidifiers

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4
Q

What are other functions of the nasal airway?

A

Remove noxious particles from the air
Protects delicate distal lower respiratory tract

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5
Q

What is the olfaction?

A

Sense organ, housing the olfactory apparatus

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6
Q

What is the function of olfaction?

A

Smell substances for pleasure and defence purposes
Important role in protection from danger, such as fire
Central in forming positive and negative memories
Taste: while chewing, chemicals from food can activate olfactory receptors to identify food flavour

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7
Q

What can dysfunction in olfactory apparatus result in?

A

Poor quality of life

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8
Q

What is Choanal atresia?

A

Failed recanalization of the nasal fossae during foetal dvelopment

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9
Q

Why is choanal atresia an emergency?

A

Neonates are obligate nasal breathers, so will be unable to breathe

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10
Q

How is choanal atresia treated?

A

Surgical repair

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11
Q

How does the immune function of the nose work?

A

Mucus consists of compounds that are able to neutralise antigens (IgA and IgE).

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12
Q

What can affect the immune response of the nose ad why?

A

Smoking, reduces the number of cilia and change the mucous viscosity

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13
Q

How does the nose contribute to speech?

A

Nasal airflow modifies speech and produce nasal clicks or click consonants. Paranasal sinuses also contribute to viral resonance

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14
Q

What is nasal airflow like as it enters the nasal vestibule?

A

Laminar- no mixing of the different air layers at low velocity

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15
Q

Where does the velocity of air increase?

A

The nasal valve, narrowest site of upper respiratory tract

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16
Q

What type of airflow is observed at nasal valve?

A

Turbulent flow, with different layers swirling together.

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17
Q

What does the charge from laminar to turbulent flow allow?

A

The velocity to reduce, allowing prolonged contact with the nasal mucosa

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18
Q

What are paranasal sinuses?

A

Air filled, arise from the nasal cavit

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19
Q

What is the dorsum of the nose?

A

Surface between root of nose and tip

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20
Q

What is the opening of the nose called?

A

Nares

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21
Q

What are the opening of the nose separated by?

A

Columella

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22
Q

What is the nasal skeleton made up of?

A

Bony and cartilagenous components

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23
Q

What are the main cartlages?

A

Upper lateral cartilage
Lower lateral cartilage

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24
Q

What can nasal bone fracture result in?

A

Permanent deformity

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25
Q

Treatment for a nasal bone fracture?

A

Possible to correct before bone heals
Most often performed under local anaesthesia

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26
Q

What do yiu need to be aware of with nasal bone fracture?

A

Septal haematoma

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27
Q

What can cause a saddle nose deformity?

A

Nasal trauma - septal haematoma

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28
Q

What leads to a saddle nose deformity?

A

Can’t relate has no blood supply of its own
Relies on surrounding perichondrium
Haematoma results in ischaemia and necrosis of the septum
Support of the nose is lost

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29
Q

What is the vasculature of the skin of external nose?

A

Skin of external nose receives arterial supply from suratrochlear and dorsal nasal arteries and infra orbital artery

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30
Q

What is the vasculature of the septum and alar cartilages?

A

Angular artery and lateral nasal artery - both branches of the facial artery

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31
Q

What is the venous drainage of the external nose?

A

Facial vein and the internal jugular vein

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32
Q

What does highly anastomotic venous system of the nose allow?

A

Terograde preadolescent of infection to cavernous sinus via opthalmic veins

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33
Q

What can spread of infection to cavernous sinus be

A

Life and sight threatening

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34
Q

What can infection of cavernous sinus lead to?

A

Ptosis, chemosis, cranial nerve palsies
Sensory deficits of opthalmic and maxillary branches
Papilloedema, retinal haemorrhages, decreased visual acuity and blindness may occur
Fever, sepsis and tachycardia may be present
Headache with nuchal rigidity

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35
Q

What nerve is the innervation of external nose derived from?

A

Trigeminal nerve.

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36
Q

Describe the innervation of the external nose?

A

Infratroch;ear and external nasal nerves, branches of the opthalmic nerve, supply the skin of the dorsum of the nose, nasal alae and nasal vestibule
Lateral aspects of the nose are supplied by infra orbital nerve, a branch of the maxillary nerve
Motor innervation to the nasal muscles via the facial nerve

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37
Q

What muscle covers the dorsum of the nose>

A

Nasalis

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38
Q

What is the innervation of nasalis

A

Buccaneers branch of facial nerve

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39
Q

What is the action of nasalis?

A

Alar part: drepress ala laterally, dilates nostril
Transverse part: wrinkles skin of dorsum and nose

40
Q

What muscle occupies the glabella

A

Procerus

41
Q

What is the innervation of procerus

A

Temporal, lower zygomatic or buccaneers branches of facial nerve

42
Q

What is the action of procerus?

A

Depress medial ends of the eyebrows, wrinkles skin over glabella- creates facial expression of frowning or when exposed to bright lights or other eye irritants

43
Q

What separates the left and right nasal cavities?

A

Midline nasal septum

44
Q

What 3 parts is the nasal cavity split into?

A

Vestibule
Respiratory region
Olfactory region

45
Q

What is the vestibule

A

entrance to cavity, lineed hair bearing skin

46
Q

What is the respiratory region?

A

Lined by ciliates pseudostratified epithelium, with mucous secreting goblet cells

47
Q

What is the olfactory region?

A

At the apex of the nasal cavity. Lined by olfactory cells with olfactory receptors

48
Q

What makes up the nasal septum

A

Quadrangular cartilage
Perpendicular plate of ethmoid
Vomer
Maxillary crest
Palatine bone

49
Q

What are the paired bony projection from the lateral nasal wall?

A

Superior turbinate
Middle turbinate
Inferior turbinate

50
Q

What does the presence of turbinates produce?

A

Meati

51
Q

What does the rich vascular supply of the internal nose allow?

A

Allow humidification and warmin of inspired air

52
Q

Branches of what arteries supply the internal nose?

A

ICA and ECA

53
Q

What branches of the ICA supply the internal nose?

A

Anterior ethmoidal artery
Posterior ethmoidal artery

54
Q

What branches of the ECA supply the internal nose?

A

Sphenopalatine artery
Greater palatine artery
Superior labial artery
Lateral nasal arteries

55
Q

What are paranasal sinuses lined by?

A

Respiratory epithelium

56
Q

What are the four paired sinuses?

A

Frontal
Ethmoidal
Sphenoid
Maxillary

57
Q

Where do the frontal sinuses drain into?

A

Via the frontonasal duct into the hiatus semilunaris, within the middle meatus of the nasal cavity

58
Q

What is sensation to the frontal sinus supplied by?

A

Supraorbital nerve

59
Q

What is the arterial supply for frontal sinus?

A

Anterior ethmoidal artery

60
Q

Where does the sphenoid sinus drain to?

A

Via sphenoethmoidal recess, supero-posterior to the superior turbinate

61
Q

what is the sphenoid sinus innervated by?

A

Posterior ethmoidal nerve

62
Q

What is arterial supply to sphenoid sinus?

A

Sphenopalatine and posterior ethmoidal artery

63
Q

What is trans-sphenoid surgery most often uses for?

A

Pituitary adenoma (also possible in other skull base tumours)

64
Q

What is the advantage of trans-sphenoidal surgery?

A

Avoids transcranial approach

65
Q

Who is trans-sphenoidal surgery a joint procedure between?

A

ENT and neurosurgery

66
Q

What is transphenoidal surgery in close proximity to?

A

Internal carotid artery

67
Q

What does a CSF leak require

A

Repair

68
Q

Where does the maxillary sinus drain to?

A

Via Ostia at hiatus semilunaris, underneath the frontal sinus opening

69
Q

What is maxillary sinus innervated by?

A

Superior alveolar nerves and greater palatine nerve

70
Q

What is the arterial supply of the maxillary sinus?

A

Branches of facial and maxillary arteries

71
Q

How many ethmoidal sinuses are there?

A

2- anterior and posterior

72
Q

Where does the anterior ethmoidal sinus open into?

A

Hiatus semilunaris, middle meatus via ethmoid bulla

73
Q

Where does the posterior ethmoidal sinus open into?

A

Lateral wall of the superior meatus

74
Q

What is the ethmoidal sinuses innervated by?

A

Anterior and posterior ethmoidal branches of the nasociliary nerve and the maxillary nerve

75
Q

What is the arterial supply of the ethmoidal sinuses?

A

Anterior and posterior ethmoidal arteries

76
Q

What is orbital cellulitis caused by?

A

Acute spread of infection from ethmoid or frontal sinuses

77
Q

What clinical signs differentiate orbital cellulitis from pre-septal cellulitis?

A

Portosis, chemosis
Ophthalmopegia
Painful eye movement
Decreased visual acuity/ loss of colour vision

78
Q

What is the treatment for orbital cellulitis?

A

Requires IV antib, nasal decongestants, CT scan +/- surgical drainage

79
Q

What does the sphenoid sinus drain via?

A

The sphenoethmoidal recess

80
Q

What does the posterior ethmoid drain via?

A

The lateral wall of the superior meatus

81
Q

What does the anterior ethmoid, frontal and maxillary sinus drain via?

A

Ostiomeatal complex in the middle meatus

82
Q

Where does the nasolacrimal duct open into?

A

Inferior meatus

83
Q

What does blockage of ostiomeatal complex lead to?

A

Sinusitis

84
Q

What is sinusitis?

A

Inflammation of lining of the sinus

85
Q

How long does sinusitis occur for to be acute

A

<3 months

86
Q

What causes acute sinusitis?

A

Viral origin

87
Q

How long does sinusitis occur for to be chronic?

A

> 3 months

88
Q

What can chronic sinusitis occur with?

A

Polyposis

89
Q

What can chronic sinusitis cause?

A

Nasal obstruction
Chronic nasal discharge
Affect on smell

90
Q

What can happen to static mucus?

A

Infection

91
Q

What is the nasopharynx?

A

Area posterior to nasal choanae, extending down the soft palate

92
Q

What is the contents of the nasopharynx?

A

Adenoids and tubal tonsils - lymphoid tissue, make up part of waldayers ring
Eustachian tube opening

93
Q

What can obstruct Eustachian tubes?

A

Enlarged adenoids or post nasal space masses

94
Q

What may glue ear require?

A

Adenoidectomy and insertion of grommets

95
Q

What may unilateral glue ear indicate?

A

Nasopharyngeal mass

Head And Neck (9 decks)

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