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H and N > Anatomy & Physiology of Nose > Flashcards

Anatomy & Physiology of Nose Flashcards

1
Q

5 functions of the nose

A 
Airway passage
Immune barrier
Smell
Drainage and aeration of middle ear
Paranasal sinuses + nasolacrimal duct drain into nose
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2
Q

What does the nose do to inspired air

A

Warms + humidifies it

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3
Q

Why is nasal airway important for newborns (esp first 6 weeks) + what is the term that describes this

A

Because they mainly breathe through nose at the start

Babies are OBLIGATE NASAL BREATHERS - necessity to breathe through nose opposed to mouth

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4
Q

What is choanal atresia (2)

A

Congenital disorder where nasal passages are blocked by bone or soft tissue
Baby goes blue when they can’t breathe

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5
Q

How is the nose an immune barrier (3)

A

It contains nasal hairs to trap large particles
Contains goblet cells which secrete mucous to trap pathogens
Mucous contains antibodies and lysozymes

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6
Q

Epithelial lining of nasal mucosa (2)

  • anterior 1/3
  • posterior 2/3
A

Anterior 1/3 lined by stratified squamous epithelium

Posterior 2/3 lined by pseudostratified ciliated columnar epithelium

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7
Q

What does the anterior 1/3 of the nose contain

A

Nasal hairs to trap large particles

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8
Q

What does the posterior 2/3 of the nose contain (3)

A

Cilia - to move mucous
Goblet cells - secrete mucous
Mucous - to trap pathogens

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9
Q

Is mucous secreted in the nose acidic or alkaline + what effect does this have on pathogens

A

Alkaline - unfavourable for bacteria

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10
Q

Layers that make up mucous in the nose

A 
Thick gel layer on the bottom
Thin sol (watery) layer on top
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11
Q

What does mucous secreted in the nose contain (3)

A

IgA
IgE (for allergies)
Lysozymes - break down bacteria

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12
Q

What nerve allows smell + how does it get to nose

A 
Olfactory nerve (CN I)
Passes through foramina in cribriform plate at the roof of the nose
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13
Q

How is the middle ear drained and aired out

A

Via the Eustachian tube - links middle ear to nasopharynx to allow pressure in middle ear to equalise with atmospheric pressure

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14
Q

Function of paranasal sinuses (3)

A

Reservoir of warm air
Lighten the skull - because air is light
Act as ‘crumple zones’ - absorb trauma to face and protects brain
Vocal resonance

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15
Q

Components of external nose (describe top 1/3 and lower 2/3 components)

A

Top 1/3 is BONY = made of 2 nasal bones + frontal processes of maxilla

Lower 2/3 is CARTILAGINOUS = nasal septum centrally, upper lateral cartilages, lower lateral cartilages

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16
Q

Which is easier to fix - broken nasal bone or cartilage

A

Bone because you can move it back into position before they heal whereas it’s not easy to unbend broken/bent cartilage

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17
Q

What forms the midline/roof/walls (lateral)/floor of internal nose

A

Midline - nasal septum
Roof - skull base/ cribriform plate
Walls - turbinates
Floor - hard palate

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18
Q

Components of the nasal septum (3)

A

2 bones

  • vomer
  • perpendicular plate of ethmoid

Septal cartilage

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19
Q

Where does septal cartilage get its blood supply

A

From the mucosa overlying it so if mucosa gets separated from cartilage during trauma e.g. then it loses its blood supply and can necrose

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20
Q

What are turbinates + name them

A

Bony structures covered in soft tissue that protrude from the lateral wall of the inner nose

Super/middle/inferior

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21
Q

Function of turbinates (2)

A

Increase surface area of nasal cavity so more air can be humidified + warmed

Disrupt fast laminar air flow, making it slow and turbulent so air can spend longer in nasal cavity to be humidified

22
Q

What space is under each turbinate

A

A meatus

23
Q

What is the nasolacrimal duct + function + what meatus it drains into

A

Tear duct - drains tears secreted by lacrimal sac/gland into the nasal cavity via the inferior meatus

24
Q

What causes septal haematoma + how it’s formed

A

Trauma to the nose damaging the mucosa and pulling it away from the septum so disrupting blood supply to the septum –> blood leaks from the injured blood vessels in the mucosa –> blood collects between the mucosal lining and the septum

25
Q

Immediate treatment for septal haematoma

A

Drainage then squash mucosa back down to the cartilage of the septum so it can get blood supply back

26
Q

Name the paranasal sinuses + how many of each

A 
2 frontal sinuses
2 maxillary sinuses
1 sphenoid sinus
1 anterior ethmoid sinus (air cells)
1 posterior ethmoid sinus (air cells)
27
Q

What drains into the middle meatus (3)

A

Frontal sinuses, maxillary sinuses and anterior ethmoid air cells

28
Q

What can you present with if your frontal sinuses are blocked

A

Potts puffy - large bump on forehead

29
Q

What drains into the superior meatus (1)

A

Posterior ethmoid air cells

30
Q

What does the sphenoid sinus drain into (1) + describe the location of the thing it drains into

A

Sphenoethmoidal recess - on the posterior roof of the nasal cavity unlike the others which drain onto the lateral walls of the nasal cavity

31
Q

How are the ethmoid sinuses different to the other paranasal air sinuses

A

They’re a collection of air cells between the eyes instead of being one single continuous air space

32
Q

What is the ground lamella

A

The bony structure created where the middle turbinate turns at the back of the nose to attach to the lateral nasal wall, separating the anterior and posterior ethmoid sinuses

33
Q

Which sinus drains anterior to the ground lamella

A

Anterior ethmoid

34
Q

Which sinus drains posterior to the ground lamella

A

Posterior ethmoid

35
Q

What drains into the inferior meatus (1)

A

Nasolacrimal duct

36
Q

What is the lamina papyracea

A

Paper thin bone forming medial wall of the orbit (eye socket) and the lateral surface of the ethmoid air cells

37
Q

How can orbital sinusitis arise

A

Infection can spread from the ethmoid air cells through the lamina papyracea into the orbit

38
Q

What is sinusitis

A

Swelling of the sinuses due to infection or allergies

39
Q

Treatment of sinusitis (5)

A

Remove allergy trigger
Antihistamines
Treat infection - with antibiotics
Steroids (long term steroid nasal spray)

Surgery - to remove polyps (in chronic sinusitis)

40
Q

Blood supply to the nose (5)

  • branches of ECA
  • branches of ICA (2)
A

Branches of the ECA:
Sphenopalatine a - MAJOR one
Greater palatine a
Superior labial a

Branches of ICA:
Anterior ethmoidal a
Posterior ethmoidal a

41
Q

Sphenopalatine artery supplying the nose is a branch of what branch of the ECA

A

Maxillary a

42
Q

Anterior and posterior ethmoidal arteries are a branch of what branch of the ICA

A

Ophthalmic a

43
Q

A nose bleed coming from higher up the nose is likely due to which 2 arteries

A

Anterior and posterior ethmoidal arteries

44
Q

What is the kiesselbach’s area (little’s area)

A

Area in the anteroinferior part of the nasal septum where 4 arteries anastomose to form the kiesselbach’s plexus

45
Q

Clinical relevance of keisselbach’s area

A

Most common site for epistaxis

46
Q

General sensory and special sensory innervation of the nose

A

General sensory - CN V1 + V2

Special sensory - CN I

47
Q

What structures are at the back of the nasal cavity in the nasopharynx

A

Adenoids

48
Q

Clinical problems in the middle ear could be due to a primary problem where? (think Eustachian tube)

A

Back of nose because Eustachian tube opens into nasopharynx

49
Q

What is the fossa of rosenmuller

A

A space/depression behind the Eustachian tube opening in the nasopharynx

50
Q

What sits in the fossa of rosenmuller in the post nasal space

A

Node of rouvier (lymph node)

51
Q

What can cause blue ear

A

If node of rouvier is enlarged, it can compress the Eustachian tube

H and N (14 decks)

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