Applied Anatomy - Nose Flashcards
What is acute sinusitis ?
Symptomatic inflammation of the paranasal sinuses.
Often triggered by a viral upper respiratory tract infection (for example, rhinovirus, RSV, parainfluenza, or influenza) or bacterial
Typical presentation (triad for diagnosis)
Triad for diagnosis: nasal obstruction, facial pain & reduction/loss of the sense of smell
Treatment includes
- reassurance
- hydration
- saftey netting
- if > 10 days consider nasal steroids
What is allergic rhinitis ?
What is the treatment for it ?
Inflammation of nasal mucous membrane
Most common chronic disease in childhood
Characterised by an IgE-mediated inflammation of the nasal mucosa following exposure to allergens
1 in 5 adults (UK population)
Seasonal/hay fever, perennial and/or occupational
Common in atopic pts
Symptoms
Sneezing, nasal congestion or post-nasal drip, watery eyes, redness, itchiness, swelling
Often worse on waking and bilateral
Management
Education and avoidance of allergen
Antihistamines- Good for sneezing and nasal discharge
Nasal (PRN relief, do not use <5yrs old)
Oral (take regularly, OD, non-drowsy type recommended e.g. cetirizine or loratidine, can be used from age 2+)
Steroids
What is epistaxis ?
What area does the bleeding usually come from ?
How to manage ?
Nose bleed
Majority of the bleed comes from Little’s area at the anterior nasal septum (80-95%), which contains the Kiesselbach plexus of vessels.
Management
Assess patient’s vital signs, ABCDE
Ask patient to sit up and lean forward
Pinch the soft part of the nose firmly for 10-15 minutes
Consider applying medications (Naseptin) to prevent crusting
If bleeding does not stop after 10–15 minutes of nasal pressure, consider:
Nasal cautery — if the bleeding point can be seen and the procedure can be tolerated (for example in adults and older children, but not younger children).
Nasal packing — if nasal cautery is ineffective or the bleeding point cannot be seen.
Admit patient for observation.
