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Boies > Chapter 10: Applied Anatomy and Physiology of the Nose > Flashcards

Chapter 10: Applied Anatomy and Physiology of the Nose Flashcards

1
Q
  1. Subserves the sense of smell
  2. Prepares inhales air for use in the lungs
  3. Furnishes the air resistance necessary for normal functioning of the lungs
  4. Exerts certain reflex effects upon the lungs
  5. Modifies speech
A

Nose

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2
Q

Midline structure projecting outward from the plane of the cheeks and upper lip

A

External nose

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3
Q

Division of external nose

A
  1. Bony vault: most superior, immobile
  2. Cartilaginous vault: slightly movable
  3. Nasal lobule: movable
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4
Q

External nasal skeletal structures

A
  1. Ascending processes of the maxillae
  2. Two nasal bones
    All supported by the nasal process of the frontal bone and a portion of the perpendicular plate of the ethmoid bone
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5
Q

Representing the portions of the embryologic medial maxillary process that engulfs the anterior premaxilla
Part of the external nose

A

Anterior nasal spine

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6
Q

Made up of the upper lateral cartilages
Fused with each other in the midline
Also fused with the upper margin of the quadrangular septal cartilage

A

Cartilaginous vault

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7
Q

Has its shape maintained by the lower lateral cartilages
Encloses the nasal vestibule
Medial: columella
Lateral: alae of the nose
Anterosuperior: nasal tip
Mobility is necessary for facial expression, sniffing and sneezing

A

Nasal lobule

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8
Q

Narrowest structure of the entire upper respiratory tract

A

Limen nasi (os internum)/ nasal valve of Mink

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9
Q

Soft tissue division between the internal and external nose

A

Inferior: pyriform crest with its skin cover
Medial: nasal septum
Superior and lateral: lower margin of the upper lateral cartilage

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10
Q

Extends from the os internum anteriorly to the posterior choana, which divides the nasal cavity from the nasopharynx

A

Internal nose

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11
Q

A bony structure which divides the organ into two noses

A

Nasal septum

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12
Q

Provides sinus ostia for the frontal, anterior ethmoid and maxillary sinuses

A

Hiatus semilunaris of the middle meatus

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13
Q

Empties into the inferior meatus anteriorly

A

Nasolacrimal duct

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14
Q

Drain into the superior meatus

A

Posterior ethmoid sinus cells

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15
Q

Drains into the sphenoethmoid recess

A

Sphenoid sinus

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16
Q

Skeletal portion of the septum is composed of

A

Anterior: septal cartilage (quadrangular)
Above: perpendicular plate of the ethmoid
Posterior: vomer and rostrum of the sphenoid
Below: ridge, comprising the crest of the maxillas and the crest of the palatines

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17
Q

Minor septal deformities rarely alter nasal air flow because of…

A

Turbinate compensation

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18
Q

All sinuses are lined with…

A

Modified respiratory epithelium

Capable of producing mucus and having cilia, of emptying. Into the nasal cavities

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19
Q

Most consistently present at birth

A

Rudimentary maxillary sinus or antrum

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20
Q

Histology of respiratory apparatus

A

Ciliated, pseudostratified columnar epithelium

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21
Q

Histology of the anterior ends of the turbinates and septal mucosa

A

Stratified squamous epithelium without cilia–an extension of the skim of the nasal vestibule

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22
Q

Along the main path of the inspiratory currents the cells become…

A

Columnar; cilia are short and slightly irregular

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23
Q

Cells of the middle and inferior meatuses, handling most of the expiratory flow path..

A

Grow long and evenly spaced cilia

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24
Q

Sources of the mucous blanket, are found in proportion to the thickness of the lamina propia

A

Secretion-producing glands and goblet cells

Very viscous and sticky mucous blanket catches dust, inspissated foreign bodies and bacteria

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25
Q

Are found in the mucous blanket and give further protection against pthogens

A

Lysozyme

Immunoglobulin A

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26
Q

The mucous blanket in the nose is renewed about…

A

3-4 times an hour

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27
Q

5-7 microns in length
Located on the end plates of the surface cells in the epithelium
Work almost automatically

A

Cilia

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28
Q

Built up of two single central microtubules surrounded by 9 pairs of microtubules, all enclosed within the thin fragile, trilaminar cell membrane

A

Cilia

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29
Q

Each stroke has a powerful, rapid phase in the direction of flow with the cilium straight and stiff, followed by a slower phase recovery during which the cilium bends

A

Cilia movement/stroking

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30
Q

Olfactory pseudostratified columnar epithelium is composed of 3 cell types

A
  1. Olfactory bipolar nerve cells
  2. Sustentacular, supporting cells (most numerous)
  3. Few, small basal cells (stem cells for the sustentacular cells)
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31
Q

Represents the only portion of the CNS that reaches the body’s surface

A

Olfactory bipolar neurons

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32
Q

Provide lateral support
Represent a means of intraepithelial ionic communication via their junctional complexes with the olfactory bipolar neurons

A

Sustentacular cells

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33
Q

Tiny outpouchings of the cell membrane

Incease the surface area

A

Microvilli

34
Q

Supplies the conchae, meatus and septum

A

Sphenopalatine branch of the internal maxillary artery

35
Q

Supply the ethmoidal and frontal sinuses and the roof of the nose

A

Anterior and posterior ethmoidal branches of the ophthalmic artery

36
Q

Supply the maxillary sinus

A

Branch of the superior labial artery

Infraorbital and alveolar branches of the internal maxillary artery

37
Q

Venous drainage

A
  1. Ophthalmic
  2. Anterior facial
  3. Sphenopalatine veins
38
Q

The nose has a rich supply of lymphatics occurring in an…

A

Anterior network

Posterior network

39
Q

Small and drains along the facial vessels to the neck

Serve the most anterior portion of the nose–the vestibule and the preturbinal area

A

Anterior network of lymphatics

40
Q

Serves the majority of the nasal anatomy, joining 3 main channels in the posterior area of the nose–superior, middle and inferior channels

A

Posterior network of lymphatics

41
Q

From the middle and superior turbinates and that portion of the nasal wall
Pass above the ET and empty into the retropharyngeal lymph nodes

A

Superior group

42
Q

Passing below the ET

Drain the inferior turbinate, inferior meatus and a portion of the floor and go to the jugular chain of lymph nodes

A

Middle group

43
Q

From septum and part of the floor of the nose

Pass through the lymph nodes along the internal jugular vessels

A

Inferior group

44
Q

To control the diameters of veins and arteries in the nose as well as mucous production

A

Sphenopalatine ganglion

45
Q

Nerve supply

A
  1. 1st CN for olfaction
  2. Ophthalmic and maxillary divisions of the trigeminal nerve (sensory afferent impulses)
  3. Facial nerve (movement of the respiratory muscles of the externa, nose
  4. ANS
46
Q

Theories about olfaction

A
  1. Chemical theory

2. Undulation theory

47
Q

Particles of odorous substances are distributed by diffusion throughout the air and cause a chemical reaction when they reach the olfactory epithelium

A

Chemical theory

48
Q

Waves of energy similar to light impinge upon the olfactory nerve endings

A

Undulation theory

49
Q

Conveys air through the upper and lower respiratory tract to the alveoli of the lung in sufficient volume, with sufficient pressure, moisture, warmth and cleanliness, to assure optimal conditions for oxygen uptake, and in the reverse process optimal elimination of carbon dioxide brought to the alveoli by the blood stream

A

Act of breathing

50
Q

Changes in air pressure which take place inside the nose during the respiratory cycle have been measured using

A

Rhinomanometry

51
Q

Air pressure changes inside the nose are minimal and normally are not greater than 10 to 15 mm H2O

A

Quiet respiration

52
Q

Provides more than 50% of normal respiratory resistance

A

Nose

53
Q

Narrowings in the vestibular segment of the nose

A
  1. Between the posterior aspect of the upper lateral cartilage and the nasal septum (increased narrowing may cause symptomatic airway obstruction)
  2. At the bony piriform aperture
54
Q

Air conditioning

A

During the brief time that air traverses the horizontal portion of the nasal passage, 16-20 times a minute in normal respiration, the inspired air is warmed (or cooled) to near body temperature and its relative humidity is brought to near 100%

55
Q

Play a role in air filtration

A

Hair or vibrissae of the skin-lined nasal vestibule

56
Q

Air purification

A

Foreign body is either expectorated or carried by mucociliary transport to the stomach for sterilization by gastric secretions
Soluble gases are also removed from the air as it passes through the nose
The greater the water solubility of the gas, the more completely it is removed by the nasal mucosa
Carbon monoxide and hydrocarbons have a very low solubility and thus pass straight through the lungs

57
Q

A highly viscid, continuous sheet of secretion which exceeds into all of the spaces and angles of the nose, sinuses, ET, pharynx and the entire bronchial tree

A

Nasal epithelium with its mucous blanket

58
Q

Rich in glycoprotein, more viscid, with a tensile strength that allows the cilia’s stiff forward motion to keep the blanket moving posteriorly in a continuous stream

A

Upper layer thin mucous blanket

59
Q

More serous, providing a little hindrance to the bending, ciliary recovery stroke

A

Lower, periciliary layer of mucous blanket

60
Q

Mucous blanket is renewed by the submucosal glands…

A

2-3 times an hour

61
Q

Is created by the pulling action of the cilia on the mucous blanket when any of the chambers is blocked by mucous plug
This may result in intense sinus pain as the plug clears the ostium and as the mucous plug moves down the auditory canal, may cause atelectasis of the TM

A

Negative pressure

62
Q

Compromised by extreme drying

A

Effective ciliary action

63
Q

Transfer heat, normally warms inspired and cools expired air and humidifies the inspired air with more than a liter of moisture each day

A

Nasal mucus

64
Q

Determined by neural stimulation of the seromucous submucosal glands in the nasal lining

A

Degree of moisture in the mucous blanket

65
Q

Changes in response to changes in the physical properties of the inspired air

A

Anterior third of the nasal chamber

66
Q

Becomes transitional or squamous and no cilia are observed
The mucous blanket in this region becomes more viscid and movement is achieved only through the pulling transmitted along the mucous blanket from still-ciliated areas located posteriorly

A

Anterior portion of the tubinates (inferior turbinates)

67
Q

Direction of mucous streaming in the nose…

A

Backward

68
Q

Direction of flow on the septum…

A

Back and somewhat downward toward the floor

69
Q

Direction of the flow on the floor…

A

Back with a tendency to flow under the inferior turbinate into the inferior meatus

70
Q

Flow of mucous on the medial aspect of the turbinates…

A

Back and downward, passing under the inferior margin into the corresponding meatus

71
Q

Area that collects most of the airborne contaminants

A

Anterior third of the nose

72
Q

Direction of the flow in the sinuses…

A

Spiral

73
Q

Barrier to allergens, viruses and bacteria

A

Mucous blanket

74
Q

Immunoglobulins in the nasal mucosa

A

IgG, IgA, IgE

75
Q

Occurs when an inhaled allergen comes into contact with the IgE antibodies to that antigen which are fixed to nasal mucosal and submucosal mast cells, generating and releasing inflammatory mediators that produce characteristic nasal mucosal changes

A

Allergic rhinitis

76
Q

Dependent upon nasal breathing

A

Normal pulmonary physiology

77
Q

Dependent upon nasopulmonary reflexes that also cause changes in total pulmonary resistance and perfusion

A

Bronchial tone

78
Q

Process in speech production

A
  1. Lungs acting as a power source
  2. Larynx acting as a sound generator
  3. Structures in the head and neck acting as articulators to change the basic laryngeal sounds into understandable speech
79
Q

Results when velopharyngeal insufficiency allows too many sounds to resonate in the nasal spaces
Eg. Unrepaired soft palate cleft

A

Hypernasality

80
Q

Result when sounds that normally resonate in the nasal spaces are prevented from doing so
Eg. URTI, adenoid hypertrophy, nasal tumor

A

Hyponasality

Boies (27 decks)

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