Head & Neck 8 Flashcards by Paras Marlowe

What are the major functions of the Nose and nasal cavity

Olfaction 
Route for isnpired air
Filters inspired air
Moistens and warms inspired air
Resonating chamber for speech

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Describe the structure of the external nose

Bone (nasal, lacrimal and maxiallry) and caritlage

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What is significant about the external nose bones?

Porne to fracutre in facial injuries

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What are the boundaries of the nasal csvity?

Medial wall = nasal septum

Lateral wall = conchae

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What is the nasal septum comprised of?

Septal cartilage
Perpendicular plate of ethmoid bone
Vomer bone

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What is a septal haematoma?

Trauma to nose buckles septum, shearing blood vessels allowing blood to accumulate between perichondrium and cartilage

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What is the saddle nose deformity?

Avascular necrosis of cartilaginous septum due to untreated septal haematoma

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What are the two main membranes of the nasal cavity?

Olfactory

Respiratory

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What is the function of the olfactory mucous membrane of the nasal cavity?

Olfaction

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What is the function of the respiratory mucous membrane of the nasal cavity?

Pseudostratified columnar ciliated epithelium FILTERS, HUMIDIFIES and WARMS

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How is the nasal cavity drained?

Paranasal sinuses 
Nasolacrimal duct (also drains eye)

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Which cranial nerve carries general sensation from the nasal cavity?

Trigeminal CN V

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What are nasal polyps?

Fleshy, benign swellings from nasal mucosa
Usually both sides
Pale/yellow or red and fleshy

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What are the symptoms of nasal polyps?

Blocked, runny nose
Post nasal drip
Decreased smell and taste

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What can unilateral polyps be an indicator for?

Tumour (+/- blood-tinged secretion)

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What is rhinitis?

Inflammation of the nasal mucosal lining

What causes rhinitis?

Simple acute infection i.e. cold

Allergic reactions

What are the symptoms of rhinitis?

Nasal congestion 
Rhinorrhoea
Sneezing 
Nasal irritation 
Postnasal drip

What feature of the nasal mucosa is key to the functions of warming and humidifying inspired air?

Rich blood supply BUT makes it prone to injury and bleeding

Describe the arterial supply to the nasal mucosa

Medial and lateral walls from opthalmic and maxillary arteries

What is the most common site of epistaxis?

Kiesselbach’s area - point of arterial anastomoses in anterior septum

How is teh nasal cavity drained?

Venously into cavernous sinus, facial vein and pterygoid plexus

What are the paranasal sinuses?

AIr filled spaces forming an extension of the nasal cavity

When do the paranasal sinuses appear?

After birth

What are the paranasal sinuses lined with?

Respiratory mucosa

How are the paranasal sinuses named?

According to bone in which they are found

What are the functions of the paranasal sinues?

Humidify, warm inspired air | Reduce weight of skull

How are the paranasal sinuses drained?

Via small channels (ostia) into nasal cavity (mostly middle meatus)

List some of the important anatomical relationships of the paranasal sinuses

Orbit Anterior cranial fossa Roots of upper teeth

What is acute sinusitis?

Inflammation of the lining of the sinuses lasting <4wks

What commonly causes acute sinusitis?

Infeciton, can be secondary to viral infection of nasal cavity Dental infection of upper teeth

How is acute sinusitis diagnosed?

``` Histroy + examination Non-resolved cold/flu Pyrexia Rhinorrhoea Headache/facial pain worse on leaning forward Blocked nose ```

What conditions can block ostia?

Nasal polyps | Deviated septum

How is acute sinusitis treated?

Usually self-limiting so only symptoms treated | e.g. nasal decongestants, analgesia. Antibiotics only if longer than a few weeks

What is the innervation of the antero-superior portion of the nasal cavity?

Opthalmic nerve CN Va

What is the innervation of the postero-inferior portion of the nasal cavity?

Maxillary nerve CN Vb

What nerve(s) innervate the paranasal sinuses?

All but maxillary = Opthalmic nerve CN Va

What is the innervation of the maxillary sinus?

Maxillary nerve CN Vb