CLINICAL QUESTIONS

Question 1

A patient comes to you with an anterior nose bleed. You remember from medical school that anterior nose bleeds are from arteries in "Kiesselbach's Area." Which of the following would be the least likely artery to hemorrhage in the anterior nose bleed?
Ethmoidal A. 
Sphenopalatine A. 
superior labial A.
Greater Palatine A.
Lateral Nasal A.

Answer 1

Lateral Nasal A.

Question 2

Which of the following nerves are the sensory innervation of the Frontal Sinus?
V1, V2 
V1
Trigeminal nerve 
Facial expression nerve

Answer 2

V1
Front Sinus is Innervated by supraorbital branches of ophthalmic division (V1) – pain due to frontal sinusitis Ethmoidal Sinus is innervated by anterior & posterior ethmoidal branches of nasociliary n (V1) & orbital branches of V2 Maxillary Sinus is Innervated by V2 Sphenoidal Sinus is Innervated by branches of V1 & V2

Question 3

The nasal septum is formed by all the following EXCEPT: 
perpendicular plate 
septal cartilage 
vomer 
hard palate

Answer 3

hard palate

Question 4

You are to perform surgery on a patient that has a pituitary tumor. through what sinus will you be able to access the pituitary tumor?
maxillary 
frontal 
sphenoidal 
ethmoidal

Answer 4

Sphenoidal.

Question 5

A patient comes into your clinic complaining of pressure in the maxillary sinus area. You turn out the lights and shine a penlight over the maxillary sinus area. If the sinus is filled with mucus, what will you see?

Answer 5

sinus will remain dark.
Aeration of frontal or maxillary sinuses can be evaluated w/ a penlight in a dark room:
If air-filled, the light will produce a pink glow
If the sinus is fluid or tumor filled it will remain dark

Question 6

A patient presents to you with a blockage in the semilunar hiatus, which of the following sinuses will still be able to drain?

Answer 6

Sphenoidal Sinus.
The only sinus that don’t drain in through the semilunar hiatus are the Posterior Portion of Ethmoidal Sinus and the Sphenoidal Sinus.

Sphenoidal Sinus drains through the spheno-ethmoidal recess

Posterior Portion of Ethmoidal Sinus drains into the Superior Nasal Meatus

Question 7

Which of the following arteries reach the nasal cavity through the Incisive Canal?

Answer 7

Greater Palatine A.

Question 8

Which of the following sinuses does not drain well gravitationally in an upright position and may cause tooth ache?

Answer 8

Maxillary sinus

Question 9

Which of the following portions of the ethmoidal sinus does not drain into the Middle Nasal Meatus?

Answer 9

Posterior portion of ethmoid sinus.

Posterior portion of the Ethmoidal Sinus drains into the Superior Nasal Meatus

Question 10

A mother brings her newborn baby into your clinic because of a sinus infection. Which of the following is most likely the paranasal sinus infected?
frontal 
ethmoidal 
sphenoidal 
maxillary

Answer 10

Maxillary sinus.
The Maxillary Sinus is the only sinus developed by birth. The Frontal, Ethmoidal, and Sphenoidal Sinus develop by 2 years of age.