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ENT > Anatomy- Nasal cavities and Paranasal sinuses > Flashcards

Anatomy- Nasal cavities and Paranasal sinuses Flashcards

1
Q

what is the function of the nasal cavity

A

patent conduit for air to get to nasopharynx
filtres air of particulates (vibrissae= small hairs)
humidifies air (glands, goblet cells)
warms inspired air (blood)
sense of smell (olfactory epithelium- CN 1)

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2
Q

what cranial nerve for sense of smell

A

1- olfactory nerve

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3
Q

what is the ala

A

wing of the nose

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4
Q

what is the root of the nose

A

below the brow ride (monobrow)

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5
Q

what separates the nostrils

A

septum

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6
Q

what makes up the skeletal parts of the bone

A

base of nose made from nasal bones

nasal and ala cartilage make up the rest

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7
Q

what in the nose does the frontal bone and maxilla bone make

A

the nasal processes (when face developing)

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8
Q

where are the nasal bones

A

inbetween the frontal and maxilla bones

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9
Q

what forms the medial aspect of the orbit

A

the ethmoid bone

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10
Q

what bone makes up the boney part of the septum

A

perpendicular plates of the ethmoid bone and the vomer

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11
Q

what in nose does the ethmoid bone form

A

parts of the roof, lateral walls and septum of nasal cavity

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12
Q

where in the ethmoid bone does the olfactory nerve sit

A

in the central part (the cribiform plate)

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13
Q

where do you find dura in the ethmoid bone

A

in the crista galli

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14
Q

what makes up the paranasal sinuses

A

air cells in the lateral portions of the ethmoid bone

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15
Q

where in the ethmoid bone is the nasal cavity

A

between the middle concha, superior concha and the perpendicular plate

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16
Q

what bone forms the upper palate

A

maxilla

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17
Q

is the superior concha nigger/small than the middle and inferior concha

A

concha get bigger as you go down: superior smallest, inferior biggest

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18
Q

what is in the sphenoid sinus

A

were pituitary sits in sella turcica

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19
Q

what spilts the left and right nasal cavities

A

the vomer

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20
Q

what fractures can disrupt the cribiform plate of the ethmoid

A

le fort II and III (both have ethmoid involvement) and basillar skull fractures

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21
Q

what is anosmia

A

loss of smell

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22
Q

what are the complications of a fracture disrupting the cribiform plate

A

anosmia
facilitate the spread of infection
(basillar can cause CSF rhinorrhoea)

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23
Q

what is a le fort I fracture

A

floating palate- maxilla, vomer and palatine involved

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24
Q

what lines the nasal vestibule (chamber under ala/ nostrils)

A

stratified squamous epithelium (keratonised to non keratinised)

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25
Q

what lines the nasal cavity

A

inferior and medial concha= respiratory epithelium (pseudostratified columnar epithlium with goblet cells)

superior concha= olfactory epithelium (bipolar olfactory cells)

26
Q

what is olfaction

A

sense of smell

27
Q

what is the olfactory pathway

A

receptor cells in olfactory epithelium

pass up through cribiform plate (like hairs of a toothbrush)

synapse with olfactory bulb (ganglion)

neurones pass along olfactory tract

to temporal lobe and olfactory areas

28
Q

what cranial nerves dont go to the brainstem

A

1 and 2

29
Q

what is the innervation of the nasal cavity

A

somatic sensory

top half (tip of nose to superior sinus)= V1 (ophthalmic division of trigeminal) = anterior ethmoidal nerve

lower half (area sided by vomer and inferior sinus) = V2 (maxillary division)= nasopalatine nerve

30
Q

what is the anterior ethmoid nerve and where does it go

A

is a branch of the nasociliary nerve, a branch of CN V1

passes through the anterior ethmoidal foramen

31
Q

what is the nasopalatine nerve and where does it go

A

branch of CN V2

passes through the sphenopalatine foramen

32
Q

what do the anterior ethmoid and nasopalatine nerves sense

A

temp, pain and touch

33
Q

what is the blood supply to the face and nose

A

originates from internal and external carotids

internal carotid gives: opthalamic (supplies orbit)

ophthalmic gives anterior and posterior ethmoidal arteries

external carotid gives: maxillary artery (temporal branch), facial artery (under chin- goes to medial aspect of orbit)

maxillary artery gives sphenopalatine and greater palatine ateries

from facial artery comes superior labial artery, lateral nasal and septal branches

34
Q

what is kiesselsbacks area

A

site where anastomisis occurs between arterial contributions

located anteroinferiorly on nasal septum

35
Q

what is epitaxis

A

a nose bleed

36
Q

where do nose bleeds usually originate from

A

kiessebachs area (input from high pressure arteries)

37
Q

what feeds into kiesselbachs area

A

Anterior and posterior ethmoidal are branches of the ophthalmic (ICA) which travel through the air cells
Sphenopalatine artery passes through the sphenopalatine foramen gives off a descending palatine which goes towards the greater palatine artery
Superior labial artery gives off the septal branch
Lateral nasal artery comes off the facial artery

38
Q

what are the parts of the lateral nasal wall

A 
sphenoethmoidal recess 
superior nasal concha (ethmoid bone)
superior meatus
middle nasal concha (ethmoid bone)
middle meatus
inferior nasal concha (own bone)
inferior meatus
39
Q

what is a meatus

A

spaces below each concha

40
Q

what is the path of a nasogastric tube

A

past septum (watch for epitaxis)
past inferior nasal concha (pain from V2)
over hard palate and past soft palate
past
The opening of the eustachian/auditory/ pharyngotympanic tube (from the middle ear) in the lateral wall of the nasopharynx
when reach pharynx will need anaesthetic do stop gagging
oropharynx
laryngopharynx
oesophagus

41
Q

what are turbinates

A

e.g. nasal conchae

cause turbulent airflow through the nasal cavity increasing the opportunity for humidifying, warming and filtering

42
Q

what can impact nasal air flow

A

engorgement of the nasal mucosa

43
Q

what causes nasal engorgement

A 
erectile tissue (anteriovenous) (swelling of the mucosa)
one side will be engorged for 1-5 hours then switch to other side
44
Q

what are the paranasal sinuses

A 
open spaces within bone
in the nasal cavity:
-frontal sinuses
-ethmoidal air cells 
-maxillary sinuses 
-maxillary sinuses 
-sphenoid sinuses
45
Q

what lines each paranasal sinus

A

respiratory epithelium (cilliated pseudostratified columnar epithelium with goblet cells)

46
Q

what does the maxillary (para)sinus form

A

floor of orbit and lateral wall of nose and upper dental arch

47
Q

where does the sphenoid sinus drain to

A

sphenoethmoidal recess

48
Q

where do the posterior ethmoid air cells drain to

A

superior meatus

49
Q

where do the frontal and maxillary sinuses and anterior ethmoidal air cells drain to

A

semilunar hiatus of the middle meatus (created by the curvature of the ethmiodal bulla)

50
Q

where do the middle ethmoidal air cells drain to

A

ethmoidal bulla

51
Q

where does the nasal lacrimal duct drain to

A

inferior meatus

52
Q

what is below the superior meatus

A

the posterior ethmoidal air cells

53
Q

where is the ethmoidal bulla

A

in the middle meatus

54
Q

where does lacrimal fluid drain into the nose

A

the nasolacrimal duct which drains to the inferior meatus

55
Q

what is sinusitis

A

inflammation of the mucosa in 1 or more of the paranasal sinuses
can be acute, sub chronic or chronic

56
Q

where do the cilia waft mucous towards

A

the ostia

57
Q

what cause sinusitis

A

Viral URTI can cause swelling of mucosa, reducing diameter of ostia (where mucous is swept towards)

Sinuses can become filled with infected mucous and pressure builds

58
Q

when can sinusitis cause spread of infection to which nerve

A

if there is a break in the medial wall of the orbit then infection in sinuses can spread to optic nerve

59
Q

where in sinusitis can pain be referred to

A

the teeth

60
Q

what sinus is predisposed to infection and why

A

Maxillary sinus is predisposed to infection

Ostium of maxillary sinus is location superior in relation to its cavity (drains into middle meatus)

Cilia must work against gravity

61
Q

what is an oro-antral fistula

A

communication between maxillary sinus and tooth socket

62
Q

what are the complications of an oro-antral fistula

A

(usually caused by tooth extraction)

tooth infection can case sinus infections

sinus infections can present as tooth ache due to referred pain

ENT (27 decks)

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