Anatomy-Nasal Cavity & Sinuses Flashcards
What structures make up the nasal septum?
Vomer, septal cartilage and perpendicular plate of ethmoid bone.
Which nasal concha is most often affected by pollen allergies?
The inferior concha. It is the 1st and main concha that sees airflow.
Which bones are often the bone someone refers to when they have a broken nose?
The conchae. These are very thin, eggshell-like bones that can break easier than other bones around them.
What structures are commonly seen in pediatric patients that cause unilateral blockage of airflow through the nose?
Pharyngeal tonsils and choana
What are the structures indicated below? Where do they all drain?
1) Frontal sinus 2) Ethmoid sinus 3) Maxillary sinus. These all drain to the middle meatus
What structure is indicated below?
Sphenoid sinus. Note that it sits directly below the pituitary fossa.
Why do people need a kleenex when they cry?
The nasolacrimal duct drains into the inferior concha, this area gets more fluid from the eyes when you cry.
Obstruction of what region in the nasal cavity will cause the most significant sinusitis?
Hiatus semilunar. The frontal, anterior ethmoidal and maxillary sinuses all drain through this region.
Where does the sphenoid sinus drain through?
Sphenoethmoidal recess
A 12 year old boy presents with vision loss, eye pain and swelling of the orbits. CT is shown below. What condition would make this an ENT’s problem?
Orbital cellulitis from spread from ethmoid sinusitis. These sinuses sit right next to the orbit
Where does the posterior ethmoidal sinus drain through?
Superior meatus
When a patient presents with nosebleeds, what blood vessels do you hope they are coming from?
Those from the external carotid system (sphenopalatine, palatine and labial arteries). If they come from the internal carotid (anterior/posterior ethmoidal, then they are much more difficult to treat)
What are the general sensory nerves that supply the nasal cavity and sinuses?
V1 and V2. Sphenopalatine provides autonomic. CN I provides special sensory.
Why do anticholinergics often give you a dry nose?
The parasympathetic nerves from the pterygopalatine ganglion and the ciliary ganglion are responsible for producing mucus secretions.
Why shouldn’t you send a 2 year old to the ENT with sinusitis?
The ethmoid, sphenoid and frontal sinuses don’t even develop until after birth. The maxillary sinus is just a tiny little thing when you are born.
What is your diagnosis in this patient who has difficulty breathing?
Choanal atresia. It is a developmental birth defect. Note the bony structures obstructing the choana.
What is your diagnosis in this patient who has difficulty breathing?
Allergic rhinitis. Note how the inferior turbinate is bulging and purple with lots of mucus secretions.
What is your diagnosis in this patient who has difficulty breathing?
Deviated nasal septum. Note the normal turbinate on the right, with the nasal septum jutting out on the left.
When do you worry about a patient with a broken nasal bone?
Only if it looks weird, otherwise you can leave it alone.
35 year old woman presents with pain and pressure in her cheeks near her nose. Endoscopy is shown below. What is your diagnosis?
Sinusitis. Note how the patient’s right maxillary sinus is completely obstructed.
What are nasal polyps a sign of? How might patients present?
Chronic inflammation (cystic fibrosis in children). Patients may present with terrible sinus pain from sinus drainage blockade by the polyp.
