Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nose > Complication Of Sinusitis > Flashcards

Complication Of Sinusitis Flashcards

1
Q

Complications are said to arise when infection spreads

A

spreads into or beyond the bony wall of the sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LOCAL COMPLICATIONS Sinusitis

A
  • MUCOCELE OF PARANASAL SINUSES AND MUCOUS RETENTION CYSTS

- OSTEOMYELITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

order of frequency sinuses commonly affected by mucocele

A

frontal, ethmoidal, maxillary and sphe- noidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

genesis of a mucocele

A
  • Chronic obstruction to sinus ostium ➡️ accumulation of secretions which slowly expand the sinus and destroy its bony walls.
  • obstruction of mucous gland duct ➡️Cystic dilatation of mucous gland of the sinus. In this case, wall of mucocele is surrounded by normal sinus mucosa. The contents of mucocele are sterile.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mucocele of the frontal sinus usually presents in the

A

superomedial quadrant of the orbit (90%) and displaces the eyeball forward, downward and laterally.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

swelling of Mucocele of the frontal sinus

A
  • cystic and nontender; egg-shell crackling may be elicited

- Sometimes, it presents as a cystic swelling in the forehead (10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patient’s complaints in Mucocele of the frontal sinus

A

headache, diplopia and proptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

in Mucocele of the frontal sinus Imaging of the frontal sinus usually reveals

A

clouding of the sinus with loss of scal- loped outline which is so typical of the normal frontal sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for Mucocele of the frontal sinus

A

frontoethmoidectomy with free drainage of frontal sinus into the middle meatus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mucocele of ethmoid sinuses

A
  • expansion of the medial wall of the orbit, displacing the eyeball forward and laterally.
  • bulge in the middle meatus of nose.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A mucocele of the ethmoid can be drained by an

A

intranasal operation, uncapping the ethmoidal bulge and establishing free drainage. Sometimes, it may require external ethmoid operation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mucous retention cyst of the maxillary sinus

A

retention cyst due to obstruction of the duct of seromuci- nous gland and usually does not cause bone erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical features of Mucous retention cyst of the maxillary sinus

A

asymptomatic

incidental finding on radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment for Mucous retention cyst of the maxillary sinus

A

No treatment is generally required for asymp- tomatic retention cysts as most of them regress spontane- ously over a period of time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mucocele of the maxillary sinus

A

complica- tion of chronic sinus inflammation when its ostium is blocked. The sinus fills with mucus and its bony walls get expanded due to expansile process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diagnostic tool for Mucocele of the maxillary sinus

A

CT scan and MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mucocele of sphenoid sinus or sphenoethmoidal mucocele

A

arises from slow expansion and destruction of sphenoid and poste- rior ethmoid sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical features of Mucocele of sphenoid sinus

A
  • superior orbital fissure syndrome
  • orbital apex syndrome
  • Exophthalmos
  • headache in the occiput or vertex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Superior orbital fissure syndrome

A

involvement of CN III, IV, VI and ophthalmic division of V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

orbital apex syndrome

A

superior orbital fissure syndrome with additional involve- ment of optic and maxillary division of trigeminal nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment for Mucocele of sphenoid sinus

A

external ethmoidec- tomy with sphenoidotomy

Anterior wall of the sphenoid sinus is removed, cyst wall uncapped and its fluid contents evacuated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pyocele

A

similar to mucocele but its contents are purulent. It can result from infection of a mucocele of any of the sinuses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Osteomyelitis is infection of

A

bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

osteitis is infection of

A

compact bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Osteomyelitis, following sinus infection, involves

A

either the maxilla or the frontal bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Osteomyelitis of the maxilla is more often seen in which age group

A

infants and children than adults because of the pres- ence of spongy bone in the anterior wall of the maxilla.

27
Q

Osteomyelitis of the maxilla the Infection may start in the

A

dental sac and then spread to the maxilla, but less often, it is primary infection of the maxillary sinus.

28
Q

Clinical features of Osteomyelitis of the maxilla

A

erythema, swelling of cheek, oedema of lower lid, purulent nasal discharge and fever. Subperiosteal abscess followed by fistulae may form in infraorbital region , alveolus or palate, or in zygoma. Sequestration of bone may occur.

29
Q

Treatment of Osteomyelitis of the maxilla

A

large doses of antibiotics, drainage of any abscess and removal of the sequestra

30
Q

Complications of Osteomyelitis of maxilla

A

damage to tempo- rary or permanent tooth-buds, maldevelopment of maxilla, oroantral fistula, persistently draining sinus or epiphora.

31
Q

Osteomyelitis of frontal bone is more often seen in

A

adults as frontal sinus is not developed in infants and children

32
Q

Osteomyelitis of frontal bone results from

A

acute infection of frontal sinus either directly or through the venous spread

It can also follow trauma or surgery of frontal sinus in the presence of acute infec- tion

33
Q

Pott’s puffy tumour

A

Pus form externally under the periosteum as soft doughy swelling

34
Q

Treatment Osteomyelitis of frontal bone

A
  • large doses of antibiotics, drainage of abscess and trephining of fron- tal sinus through its floor
  • removal of sequestra and necrotic bone by raising a scalp flap through a coronal incision
35
Q

ORBITAL COMPLICATIONS of SINUSITIS

A
  • Inflammatory oedema of lids
  • Subperiosteal abscess.
  • Orbital cellulitis.
  • Orbital abscess
  • Superior orbital fissure syndrome
  • Orbital apex syndrome
36
Q

Orbit and its contents are closely related to

A

ethmoid, frontal and maxillary sinuses

37
Q

Mc sinus causing orbital Complications of sinusitis

A

ethmoids as they are separated from the orbit only by a thin lamina of bone— lamina papyracea

Infection travels from these sinuses either by osteitis or as thrombophlebitic process of eth- moidal veins.

38
Q

Inflammatory oedema of lids

A

only reactionary.

There is no erythema or tenderness of the lids which characterises lid abscess. It involves only preseptal space, i.e. lies in front of orbital septum. Eyeball movements and vision are normal. Generally, upper lid is swollen in frontal, lower lid in maxillary, and both upper and lower lids in ethmoid sinusitis.

39
Q

Subperiosteal abscess

A

Pus collects outside the bone under the periosteum. A subperiosteal abscess from ethmoids forms on the medial wall of orbit and displaces the eyeball forward, downward and laterally; from the frontal sinus, abscess is situated just above and behind the medial canthus and displaces the eyeball downwards and laterally; from the maxillary sinus, abscess forms in the floor of the orbit and displaces the eyeball upwards and for wards.

40
Q

Orbital cellulitis.

A

When pus breaks through the perios- teum and finds its way into the orbit, it spreads between the orbital fat, extraocular muscles, vessels and nerves. Clinical features will include oedema of lids, exophthal- mos, chemosis of conjunctiva and restricted movements of the eye ball. Vision is affected causing partial or total loss which is sometimes permanent. Patient may run high fever. Orbital cellulitis is potentially dangerous because of the risk of meningitis and cavernous sinus thrombos

41
Q

Orbital abscess

A

Intraorbital abscess usually forms along lamina papyracea or the floor of frontal sinus. Clinical picture is similar to that of orbital cellulitis. Diagnosis can be easily made by CT scan or ultrasound of the orbit. Treatment is i.v. antibiotics and drainage of the abscess and that of the sinus (ethmoidectomy or trephination of frontal sinus).

42
Q

Superior orbital fissure syndrome

A

Infection of sphenoid sinus can rarely affect structures of superior orbital fis- sure. Symptoms consist of deep orbital pain, frontal headache and progressive paralysis of CN VI, III and IV, in that order.

43
Q

Orbital apex syndrome

A

It is superior orbital fissure syn- drome with additional involvement of the optic nerve and maxillary division of the trigeminal (V2)

44
Q

INTRACRANIAL COMPLICATIONS

Of sinusitis

A
  1. Meningitis and encephalitis 2. Extradural abscess
  2. Subdural abscess
  3. Brain abscess
  4. Cavernous sinus thrombosis.
45
Q

Infection of which sinus cause INTRACRANIAL COMPLICATIONS

A

Frontal, ethmoid and sphenoid sinuses are closely related to anterior cranial fossa

46
Q

CAVERNOUS SINUS THROMBOSIS Aetiology

A

Infection of paranasal sinuses, particularly those of ethmoid and sphenoid and less commonly the frontal, and orbital complications from these sinus infections can cause thrombophlebitis of the cavernous sinus

The valveless nature of the veins connecting the cavernous sinus causes easy spread of infection.

47
Q

Furuncle and septal abscess - source and route - cavernous sinus thrombosis

A

Nose and danger area of face

Pharyngeal plexus

48
Q

Orbital cellulites or abscess source and route - cavernous sinus thrombosis

A

Ethmoid sinuses

Ophthalmic veins

49
Q

Sinusitis source and route - cavernous sinus thrombosis

A

Sphenoid sinus

Direct

50
Q

Sinusitis and osteomyelitis of frontal bone source and route - cavernous sinus thrombosis

A

Frontal sinus

Supraorbital and ophthalmic veins

51
Q

Cellulitis and abscess of orbit route - cavernous sinus thrombosis

A

Ophthalmic veins

52
Q

Abscess of upper lid route for - cavernous sinus thrombosis

A

Angular vein and ophthalmic veins

53
Q

Acute tonsillitis or peritonsillar abscess source and route - cavernous sinus thrombosis

A

Pharynx

Pharyngeal plexus

54
Q

Petrositis source and route - cavernous sinus thrombosis

A

Ear

Petrosal venous sinuses

55
Q

Differences between orbital cellulitis and cavernous sinus thrombosis

A

Refer book

56
Q

Clinical features of cavernous sinus thrombophle- bitis

A
  • abrupt Onset of with chills and rigors
  • Eyelids get swollen with chemosis and proptosis of eyebal
  • Cranial nerves III, IV and VI which are related to the sinus get involved individually and sequentially causing total oph- thalmoplegia.
  • Pupil becomes dilated and fixed, optic disc shows congestion and oedema with diminution of vision.
  • Sensation in the distribution of V1 (ophthalmic division of CN V) is diminished.
57
Q

CSF is usually———— cavernous sinus thrombophle- bitis

A

normal

58
Q

DD for cavernous sinus thrombosis

A

orbital cellulitis

CT scan is useful for this.

59
Q

Treatment of cavernous sinus thrombosis

A

i.v. antibiotics and attention to the focus of infection, drainage of infected ethmoid or sphenoid sinus. Blood culture should be taken before starting antibiotic therapy. Role of anticoagulants is not clear.

60
Q

IV. DESCENDING INFECTIONS of Sinusitis

A
  • Otitis media (acute or chronic).
  • Pharyngitis and tonsillitis.
  • Persistent laryngitis and tracheobronchitis
61
Q

indicative of chronic sinusitis.

A

Hypertrophy of lateral lym-

phoid bands behind the posterior pillars (lateral phar- yngitis)

62
Q

DESCENDING INFECTIONS Chronic sinusitis may also cause

A

recurrent tonsillitis or granular phar yngitis.

63
Q

FOCAL INFECTIONS

A

polyarthritis, tenosy- novitis, fibrositis and certain skin diseases may respond to elimination of infection in the sinuses.

Nose (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions