Anatomy/Physiology - Nose/Sinus Flashcards
what is the functin of the nasal airway?
Warm and humidify inhaled air -Turbinates + Septum Laminar flow -Mucosal lining Humidification Sinuses – reservoir of warm humid air
Important for neonates
Obligate nasal breathers
Choanal atresia
what is the function of the immune barrier?
Specialised nasal mucosal lining
-First 1/3 stratified squamous epithelium
Nasal hairs- trap large particulates
-Posterior 2/3 pseudostratified columnar epithelium
Cilia
(1000 BPM) mucus travel 2.5cm/min
Goblet cells- sticky mucus traps pathogens
Mucus- IgA, IgE (allergies), Lysozymes, alkaline
Gel (thick) and Sol (watery) layer
what nerve contributes to the smell
olfactory nerve
where in the nose does smell come through
cribriform plate
what is the sinus function
Reservoir of warm humid air Lighten skull Crumple zones Vocal resonance Lined with same mucosa- Immune barrier
is the nose bone or cartilage?
1/3 bony and 2/3 cartilagenous
what are the external subunits of the external nasal anatomy
Columella
Tip + supratip
Dorsum
Nasion
Glabella
Glabella Tap
Chinese water torture
can bent cartilage go back to its normal position?
no cannot be easily unbent
what is the roof of the internal nasal anatomy called?
skullbase/cribriform plate
what are the walls of the internal nasal anatomy called?
turbinates
what is the floor of the internal nose called?
hard plates
what are some associated structures inside the nose called?
Paranasal sinuses
Orbits- Lamina papyracea
Eustacian tube
Adenoids
what is the bone and cartilage inside the septum called?
Septal cartilage
Vomer
Perpendicular plate of ethmoid
is the blood supply to the cartilage good? where does it come from?
poor supply
gets blood supply from mucose overlying it
what is septal haematoma?
Post trauma
Almost always bilateral
No blood supply to septum
Septum necroses
Leading to Perforation
Whistling
Bleeding
Needs to be drained ASAP
Perforations also caused by
Drugs
Digital trauma
what are turbinates?
bony scroll like projections from lateral wall of nose
what is the significance of turbinates being covered in erectile tissue?
day to day cycling
respond to temperature
what do nasolacrimal duct drain?
drainage pathway of lacrimal secretions (tears)
where does the nasolacrimal duct open?
under inferior turbinate
how many sinuses are there?
2 frontal, 2 maxilary, sphenoid and ethmoid
where is the frontal sinus?
behind eyebrows
where does frontal sinus drain into?
frontal recess
where does frontal sinus drain via?
middle meatus
what is the fronat sinus lateral to?
middle turbinate
where is the ethmoid sinuses?
honeycomb structure between eyes
where would an ethmoid sinus infection spread to?
orbit
what does the sphenoid sinus spread via?
Sphenoethmoidal recess
where odes the optic nerve run in comparison to the sphenoid?
above it
where does the pituaitry sit with respect to sphenoid sinus
posteriorly
where is the maxillary sinus?
behind each cheek
what does the maxillary sinus drain via
middle meatus
what does the Frontal, Anterior ethmoids, Maxillary drain via?
middle meatus
what does the posterior ethmoids drain via?
superior meatus
what does the sphenoid drain via?
Sphenoethmoidal recess
what does the nasolacrimal duct drain via?
ind=ferior meatus
what is the medical management of sinusitis?
Remove Allergic triggers \+/- antihistamines Treat infection Reduce inflammation Steroids (long term nasal spray)
what is the surgery for sinusitis
Remove polyps Open up sinus drainage pathways Risks: Damage lamina papyracea- orbital damage Damage to skull base- CSF leak and meningitis
where is the blood supply from that supplies the nose?
internal and external carotids
what is the nasal innervation?
Almost all Trigeminal Nerve (CNV)
V1 Ophthalmic
V2 Maxillary
what is the sensation internal and external?
Vidian nerve (greater petrosal from facial CNVII +deep petrosal)
Parasympathetic
Vasomotor Rhinitis/crocodile tears
Vidian neurectomy
