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HNN > Anatomy Of The Nose, Nasal Cavity + Air Sinuses > Flashcards

Anatomy Of The Nose, Nasal Cavity + Air Sinuses Flashcards

1
Q

Functions of the nasal cavity

A
  • smelling
  • resonating chamber for speech
  • infection prevention/filter (mucous + cilia)
  • passage for air
  • humidification + warming of incoming air
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2
Q

Extent of the nasal cavity

A
  • entrance at nares (nostrils)
  • ends at choanae (posterior nasal aperture)
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3
Q

Regions of the nasal cavity

A

Vestibule
Respiratory region
Olfactory region

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4
Q

Nervous supply to the nasal cavity

A

Trigeminal nerve V:
Opthalamic branch Va
Maxillary branch Vb

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5
Q

What is nasal polyps?

A

Benign swelling of the nasal mucosa
Normally bilateral

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6
Q

Presentation of nasal polyps

A
  • nasal congestion
  • rhinorrhoea
  • hypo or anosmia
  • snoring
  • post nasal drip > cough
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7
Q

What is rhinitis?

A

Inflammation of the nasal mucosa

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8
Q

Symptoms of rhinitis

A
  • nasal congestion
  • rhinorrhoea
  • sneezing
  • post nasal drip
  • nasal irritation
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9
Q

Types of rhinitis

A

Infective
Allergic

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10
Q

What are the paranasal air sinuses?

A

Air filled spaces that are extensions of the nasal cavity

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11
Q

Functions of the paranasal air sinuses

A
  • Humidify + warm inspired air
  • Reduce weight of the skull
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12
Q

What epithelia lines the vestibule of the nasal cavity?

A

Keratinised stratified squamous epithelia

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13
Q

What bones make up the roof of the nasal cavity?

A

Nasal bone
Frontal bone
Ethmoid bone
Sphenoid bone

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14
Q

What bones make up the floor of the nasal cavity?

A

Maxilla
Palatine bone

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15
Q

Functions of the concha

A

Slows down air flow
Increases SA for humidification

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16
Q

Types of conchae

A

Superior
Middle
Inferior

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17
Q

What are the nasal conchae?

A
  • Bony plates located on the lateral wall of the cavity
  • Superior, middle + inferior conchae
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18
Q

What are the meatuses of the concha?

A
  • Three spaces located beneath the conchae
  • superior, middle + inferior meatuses
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19
Q

What makes up the medial wall of the nasal cavity?

A

Septal cartilage
Perpendicular plate of ethmoid bone
Vomer bone

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20
Q

What makes up the lateral wall of the nasal cavity?

A

Conchae

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21
Q

What is a septal haematoma?

A
  • due to trauma to cartilage > perichondrium is stripped off
  • can lead to avascular necrosis
  • causes saddle nose deformity
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22
Q

What causes saddle nose deformity?

A

Septal haematoma

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23
Q

Treatment of a septal haematoma

A
  • drainage (prevents infection
  • reattach perichondrium to re-establish blood slow
  • prophylactic antibitoics
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24
Q

When would you use an x ray with a patient with a nasal bone fracture?

A

If you suspect complications e.g cranial fossa fracture

25
Q

Blood supply to the nasal cavity

A
  • anterior + posterior ethmoidial arteries (from ophthalmic artery)
  • sphenopalatine artery (from maxillary artery)
  • greater palatine artery (from maxillary artery)
  • superior labial artery (from facial artery)
26
Q

What is Kiesselbach’s area?

A

Area of nose where 5 different blood vessels anastomose

27
Q

What is the Opthalamic artery a branch of?

A

Internal carotid artery

28
Q

Blood supply to the lateral wall of the nasal cavity

A

Anterior + posterior ethmoidal arteries
Sphenopalatine artery

29
Q

What is the maxillary artery a branch of?

A

External carotid artery

30
Q

A nose bleed involving which artery is more concerning?

A

Sphenopalatine artery

31
Q

What sinus is most commonly affected in sinusitis?

A

Maxillary sinus

32
Q

Demographic of nasal polyps

A

Men
>40 years old
Cystic fibrosis

33
Q

What is post nasal drip?
What can it cause?

A
  • mucous drips from nose +accumulates in the back of the throat > irritation
  • chronic cough
34
Q

What is a worrying presentation if a patient has nasal polyps?
Why?

A
  • unilateral
  • bloody discharge
  • potentially nasal cancer
35
Q

What can cause allergic rhinitis ?

A

Hay fever
Pets
Dust

36
Q

Which blood vessels anastomose at Kiesselbach’s area?

A
  • anteior + posterior ethmoidal arteries
  • sphenopalatine artery
  • greater palatine artery
  • superior labial artery
37
Q

What type of epithelia lines the paranasal air sinuses?

A

Respiratory mucosa
Ciliated pseudostratified columnar epithelia

38
Q

List the paranasal sinuses

A

Frontal sinus
Ethmoid sinus
Sphenoid sinus
Maxillary sinus

39
Q

Sensory innervation to the paranasal air sinuses

A
  • ophthalmic nerve Va: frontal, ethmoidal + sphenoid sinus
  • maxillary nerve Vb: maxillary sinus
40
Q

What does the middle meatus drain?

A

Frontal sinus
Maxillary sinus
Anterior + middle ethmoid sinus

41
Q

What does the interior meatus drain?

A

Nasolacrimal duct
(Reason why your nose gets blocked when crying)

42
Q

Cause of acute sinusitis

A

Viral URTI spreading to sinuses

43
Q

What time period is classified as acute sinusitis?

A

< 12 weeks

44
Q

Pathophysiology of acute sinusitis

A
  • inflammation of respiratory mucosa > swelling, reduced cilia movement + ^ secretions
  • ostia becomes blocked
  • fluid builds up in sinus
    (can develop secondary bacterial infection 0.5-2%)
45
Q

Treatment of acute sinusitis

A
  • analgesia
  • anti-pyrexia
  • high dose steroid nasal spray for 14 days e.g. mometasone
  • backup antibiotics if doesn’t resolve - phenoxymethylpenicillin
46
Q

Treatment of chronic sinusitis (>12 weeks)

A
  • saline nasal irrigation
  • steroid nasal sprays or drops - mometasone
  • functional endoscopic sinus surgery
47
Q

Diagnosis of acute sinusitis

A
  • based on history + exam
  • recent UTRI
  • blocked nose
  • rhinorrhoea
  • pyrexia
  • headache (worsens on leaning forward)
48
Q

When would you suspect a patient has acute bacterial sinusitis?

A
  • symptoms >10 days without improvement
  • discoloured purulent nasal discharge
  • high fever
  • severe local pain
  • symptoms worsen after an initial improvement
49
Q

What organisms commonly cause acute bacterial sinusitis?

A

Streptococcus pneumonia
Haemophilus influenzae
Moraxella catarrhalis

50
Q

Where are most sources of bleeds in epistaxis from?

A

Keisselbach’s area
(Anterior bleed)

51
Q

Where are posterior bleeds in epistaxis from?

A

Sphenopalatine artery

52
Q

Special sensory innervation of the nose

A

Olfactory nerve

53
Q

What are predisposing factors to nosebleeds?

A
  • age: children or older age
  • dry air
  • high altitudes
  • allergies
  • blood thinning medications
  • recreational drugs
54
Q

Managment of epistaxis
In order to
(If first fails, move onto next)

A
  • direct pressure
  • cautery (silver nitrate stick)
  • anterior packing
  • posterior packing +/- surgical innervation
55
Q

Why is sinusitis most common in the maxillary sinus?

A

Ostia high up > harder to drain

56
Q

What arteries supply both the medial + lateral wall of the nasal cavity?
Which only supply the medial?

A

Both:
- anterior + posterior ethmoidal arteries
- sphenopalatine artery

Medial only:
- greater palatine artery
- superior labial artery

57
Q

Presentation of acute sinusitis

A
  • Blocked nose
  • Rhinorrhoea
  • Pyrexia
  • Headache which worsens on leaning forwards
58
Q

Outline the structures involved in the drainage of tears

A
  • lacrimal gland produces
    .
  • lacrimal punctum
  • lacrimal canaliculi
  • lacrimal sac
  • nasolacrimal duct
  • nasal cavity

HNN (24 decks)

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