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ENT > Anatomy; Nasal Cavity and Paranasal Sinuses > Flashcards

Anatomy; Nasal Cavity and Paranasal Sinuses Flashcards

1
Q

State the function of the nasal cavities

and describe how the anatomy/histology of the nasal cavities permits these functions

A
  1. Acts as a patent conduit for air to be transported to the nasopharynx
  2. Filters air of particulate material (vibrissae= small hairs)
  3. Humidifies air (glands)
  4. Warms inspired air in the nasal passage (blood)
  5. Sense of smell as air passes over the olfactory epithelium
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2
Q

Describe surface anatomy of the external nose

A
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3
Q

Describe the anatomy of the nasal cartilages

A

Note the careful mix of bone and cartilage; we need some control and movement over our nose. It’s a passage into the body.

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4
Q

Describe and identify the bony anatomy of the nasal cavities from a frontal external p.o.v.

A

Vomer is a tiny little triangular bone

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5
Q

Which parts of the nasal cavity does the ethmoid bone form?

A

The ethmoid bone forms parts of the:

  • roof
  • lateral walls
  • septum of the nasal cavity
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6
Q

Show roughly where the ethmoid bone is

A
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7
Q

Describe the ethmoid bone in detail

A
  • I think the olfactory nerve goes from nasal cavity up through cribiform plate
  • The vrest of crista galli gets some dura
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8
Q

Draw the lateral wall of the right nasal cavity

A
  • the concha increase in size from superior to inferior
  • palatine makes up part of hard palate
  • sphenoid sinus is where pituitary sits
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9
Q

Draw the medial wall of right nasal cavity

A
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10
Q

Explain how le fort fractures and basilar skull fracture can impact the nasal cavities

A
  • le fort II & III fractures and basilar skull fracture can:
    1. disrupt the cribiform plate of the ethmoid
    2. anosmia (loss of smell)
    3. also, can disrupt the paranasal sinuses
    4. facilitate spread of infection
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11
Q

List and describe the approximate locations of the 3 types of mucosa found in the nasal cavity

A
  • Nasal Vestibule
    • stratified squamous epithelium (keratinsed to non-keratinsed)
  • Nasal Cavity
    • respiratory epithelium
    • olfactory epithelium
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12
Q

Where can the olfactory bulb and tract be seen on the brain?

(possible spot Q.)

A
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13
Q

Describe how sense of smell works.

What household object can be used as a helpful metaphor?

A

CN I- Olfactory Nerves

  • special sensory

Olfactory Pathway

  1. Receptor cells in the olfactory epithelium
  2. Pass up through the cribifrom plate
  3. Synapse with olfactory bulb (ganglion)
  4. Then neurons pass along olfactory tract
  5. To temporal lobe and olfactory areas

A toothbrush!

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14
Q

Describe the somatic sensory innervation

A
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15
Q

Describe the areas of somatic sensory innervation and the associated nerves

A
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16
Q

Summarise the arterial blood supply to the face

A
17
Q

Summarise/draw the arterial blood supply to the lateral and medial walls of the nasal cavities

A
18
Q

Discuss the relevance of Kiesselbach’s area

A

Kiesselbach’s area is:

  • site where anastomosis occurs between the arterial contributions
  • located anterioinferiorly on nasal septum

often leads to epitaxis (nose bleed)

19
Q

Describe the conchae and meatuses/recess of the lateral wall of the nasal cavities

A

3 conchae project from the lateral nasal wall creating four recesses/meatuses

a) sphenoethmoidal recess

1. superior nasal concha (ethmoid bone)

b) superior meatus

2. middle nasal concha (ethmoid bone)

c) middle meatus

3. inferior nasal concha (own bone)

d) inferior meatus

Conchae increase in size as you go down

20
Q

Indicate which structure or sinus(es) drain their contents into each meatus/recess

A
  • a) Sphenoethmoidal recess*
  • sphenoid sinus

1. Superior meatus

  • posterior ethmoidal air cells

2. Middle meatus

  • semilunar hiatus:
    • frontal sinus
    • maxillary sinus
    • anterior ethmoidal air cells
  • ehtmoidal bulla
    • middle ethmoidal air cells

3. Inferior meatus

  • nasolacrimal duct
21
Q

Describe the anatomy of inserting a nasogastric tube

A
22
Q

What do clinicians call conchae?

A

Turbinates

because they cause turbulent airflow through the nasal cavity

23
Q

What is a benefit of turbulent airflow through the nasal cavity?

A

Increases opportunity for humidifying, warming and filtering

24
Q

What does this MRI show?

A

It shows engorgement of the nasal mucosa

  • this can impact air flow
  • one side will be engorgede and then change to the other side every 1-5 hours
  • due to erectile tissue (arteriovenous)
25
Q

List the bones that contain paranasal sinuses

A

Paranasal sinuses are found in:

  • frontal bone
  • ethmoid bone
  • maxilla
  • sphenoid
26
Q

Briefly discuss the anatomy of the paranasal sinuses

A

Paranasal sinuses are open spaces within bone

The human body has four bilateral pairs associated with the nasal cavity:

  • frontal sinuses
  • ethmoidal air cells
  • maxillary sinuses
  • sphenoid sinuses

Each sinus is lined with thin respiratory epithelium

27
Q

Summarise the anatomy of the lacrimal apparatus

A

Lacrimal fluid drains inferomedially to the nasolacrimal duct which drains to the inferior meatus

28
Q

What is sinusitis

A

Inflammation of the muscosa in 1/> of the paranasal sinuses

  • acute/sub chronic/chronic
29
Q

How does sinusitis happen?

A
  1. Cilia of the respiratory mucosa waft mucous towards ostia
  2. Viral URTI can cause swelling of mucosa, reducing diameter of ostia
  3. Sinuses can become filled with infected mucous
30
Q

Discuss the impact sinusitis could have on the local anatomy

A

When sinuses are filled with the infected mucous pressure builds

INcreased pressure in ethmoid can

break the medial wall of the orbit and impact the eye/spread infection to the optic nerve

31
Q

Discuss the relevant sensory innervation for sinusitis?

A

Sinusitis can be very painful

  • sensation is provided by CN V1 and CN V2
  • AND may be referred to teeth
32
Q

Explain the potential clinical consequences of the relatively high location of the ostium of the maxillary sinus

A

The ostium of maxillary sinus is located superiorly in relation to its cavity

  • :. cilia must work against gravity
  • maxillary sinus is predisposed to infection
33
Q

What is an oroantral fistula

A

An oroantral fistula is abnormal communication between maxillary sinus and tooth socket

34
Q
A

ENT (4 decks)

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