epistaxis

Question 1

mention the 2 main arteries supplying the nose

Answer 1

internal carotid
external carotid

Question 2

which divisions of the internal carotid artery supply the nose

Answer 2

internal carotid
|
ophthalmic artery
|
giving the anterior and posterior ethmoid

Question 3

which divisions of the external carotid artery supply the nose ?

Answer 3

facial which gives rise to the superior labial artery
and the maxillary artery which gives rise to the sphenopalatine artery and thee greater palatine artery

Question 4

what are the causes of epistaxis ?

Answer 4

local causes :
idiopathic ( commonest cause)
iatrogenic
inflammatory
trauma
neoplastic
Septal (deviated septum)

Question 5

what are the general causes that may cause epistaxis ?

Answer 5

cardiovascular
bleeding disorders
drugs such as aspirin
hepatic failure ( hypoprothrombinemia)
fever with vasculitis as with rheumatic fever of infective endocarditis

Question 6

what is the commonest cause of epistaxis ?

Answer 6

idiopathic

Question 7

what is thee most common cause of eepistaxis in children ?

Answer 7

trauma to little’s area (anastomosis in the anterior sector of the nose)

Question 8

what is the other name for little’s area ?

Answer 8

keisselbach plexus

Question 9

which arteries are included in the anastomosis of little’s area ?

Answer 9

anterior ethmoidal
greater palatine
superior labial of facial artery

Question 10

what is the most appropriate management for acute epistaxis ?

Answer 10

1st aid:
seating position
head slightly flexed and leaning forward
pinching the soft part of the nose
applying cold compresses on the forehead

Question 11

what are the points that must be assessed with a case of epistaxis ?

Answer 11

side
site
severity
Shock Signs

Question 12

what are the different types of management in cases of epistaxis ?

Answer 12

cauterization - after identification of the site
nasal packing - if the site cannot be localized and in cases of severe bleeding
surgical - if all previous measures failed

Question 13

what are the types of cauterization ?

Answer 13

1. chemical cautery:
   silver nitrate sticks
   chromic acid
2. electrical cautery

Question 14

when should nasal packing be used ?

Answer 14

if cauterization fails
if site cannot be identified
if there is severe bleeding

Question 15

what are the types of nasal packing ?

Answer 15

anterior (merocel)
posterior ( foley’s)

Question 16

when should a foley’s nasal packing be used ?

Answer 16

if the merocel is not sufficient or if the bleeding is posterior

Question 17

what procedures are done in the surgical approach of managing a case of epistaxis ?

Answer 17

used if all other measures failed
usually used for posterior bleeding
sphenopalatine artery ligation
anterior ethmoidal artery ligation

Question 18

what type of epistaxis occurs with general causes ?

Answer 18

posterior bleeding ( bleeding from woodruff’s area)

Question 19

what are the benign neoplasms that can cause epistaxis ?

Answer 19

hemangioma
angiofibroma