Anatomy/physiology of nose

Question 1

What type of musoca is sinonasal mucosa

Answer 1

Ciliated columnar epithelium with goblet cells

Question 2

Drainage of the middle ear is via…..

Answer 2

The Eustachian tube

Question 3

Excess tears flow through the (a)……….. which drains into the (b)…………. to the nasal cavity

Answer 3

(a) nasolacrimal duct

(b) inferior nasal meatus

Question 4

Pushes mucosal lining away from the nasal septum and since the septum derives its vascular supply from the mucosal lining, can lead to septal perforation

Answer 4

septal haematoma

Question 5

Which is the most clinically relevant turbinate, and why

Answer 5

Inferior terbinate, is contained within the narrowest part of the nasal cavity, so swelling due to infection/inflammation is more likely to cause blockage

Question 6

IgE related inflammation of the nasal membranes

Answer 6

Allergic rhinitis

Question 7

Name the 4 sinuses:

Answer 7

Frontal, ethmoid, sphenoidal, maxillary

Question 8

Which sinuses drain into the middle meatus?

Answer 8

Frontal, maxilliary, anterior ethmoid

Question 9

Which sinuses drain into the superior meatus?

Answer 9

Posterior ethmoid, sphenoidal

Question 10

Inflammatory/infective process that affects nasal passageway and paranasal sinuses

Answer 10

Rhinosinusitis
(Acute = bacterial
Chronic = allergic or non allergic, with or without polyps)

Question 11

Prolapsed sinonasal mucosa

Answer 11

Nasal Polyps

Question 12

Infection can spread from sinus to internal cranial structures which are close, which areas are each sinus most closely related to?

Answer 12

Frontal/ethmoid - anterior cranial fossa
Maxillary - orbits
Sphenoid - optic nerve, internal carotid artery, cavernous sinus

Question 13

Which arteries supply blood to the nose?

Answer 13

Branches of the ophthalmic artery arising from the internal carotid artery and multiple branches of the external carotid artery

Question 14

Which area of the nose is most likely to bleed in epistaxis and why

Answer 14

Little’s area, also known as Hesselbach’s plexus, it is where arteries anastomose in the nose. (epistaxis = nose bleed)

Question 15

Describe the order of treatment for epistaxis

Answer 15

Simple first aid treatment first of all, having the patient put pressure on little’s area while tilting head downwards and hold firmly for 15 mins.
If nose still does not stop bleeding the next step would be silver nitrate or diathermy to cautorise the bleeding vessel.
If these options don’t work, nasal packs can be used