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Structures: Part Deux > LEC64: Nose and Paranasal Sinuses > Flashcards

LEC64: Nose and Paranasal Sinuses Flashcards

1
Q

identify important structures

A
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2
Q

where is the superior conchi

A
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3
Q

what are functions of nasal cavity? importance?

A

1) olfaction- for quality of life, not survival
2) respiration- matters for survival

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4
Q

what are macrosomatic animals

A

animals that use smell as primary sense- for detection of prey, spotting water resources, etc

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5
Q

nose’s general function re: air and inspiration?

A

nose prepares air - warms it to at or near body temperature - before it passes to lower respiratory tract

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6
Q

how much air does nose condition daily?

A

10,000-20,000 L of air daily

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7
Q

what is state of breathed air, what must happen to it?

A

air contains billions of infectious, allergenic, irritative, toxic materials

air must be filtered, neutralized, eliminated

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8
Q

identify:

root of nose, nasion, dorsum, margin, tip, ala, naris, columella

A
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9
Q

what is piriform aperature

A

border of nasal cavity, entry portal to upper respiratory system

looks like a pear

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10
Q

components of piriform aperature?

A

maxilla and nasal bones

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11
Q

where is nasal cavity proper?

A

inside piriform aperature

bony partition divides nasal cavity into 2

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12
Q

concha bullosa?

A

an inflated turbinate

normal unless impedes flow of air through nasal cavity- then problematic

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13
Q

how many turbinates?

A

3- superior, middle turbinate, inferior turbinate; in nasal cavity proper

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14
Q

what is the nasal septum?

A

perpendicular plate of the ethmoid

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15
Q

identify the bones

A

crista galli- anterior cranial fossa entry, connects to falx cerebra (orange/yellow at top)

PP: perpendicular plate of ethmoid, intrudes at midline

C: cartilagenous component

V: vomer

M: maxatine cavity- crest that arises above nasal cavity floor

P: palatine cavity- crest that arises above nasal cavity floor

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16
Q

what is this? how is it visualized? ID parts

A

nasal cavity wall, visualized by removing nasal septum

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17
Q

what must blood supply to nasal cavity pass through?

A

pterygomaxillary fissure

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18
Q

where is pterygopalatine ganglion? what is there with it?

A

through pterygopalatine fissure, in pterygopalatine fossa

find branches of CN V, trigeminal there also

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19
Q

what is maxillary artery? what is it a branch of? where does it travel through? where does it end up?

A

a terminal branch of external carotid a

goes through pterygomaxillary fissure, into pterygopalatine fossa, into sphenopalatine foramen, into nasal cavity proper

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20
Q

ID structures 10, 12

A

10: nasal septum, reflected superiorly
12: sphenopalatine artery - very thick!

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21
Q

what is arterial supply of nasal cavity wall?

A

1) maxillary branch of external carotid artery

1) postero-lateral superior branch of sphenopalatine a
2) postero-lateral middle branch of sphenopalatine a
3) postero-lateral **inferior **branch of sphenopalatine a

2) opthalmic branch of internal carotid artery

1) anterior ethmoidal** **branch of opthalmic a
2) posterior ethmoidal branch of opthalmic a

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22
Q

identify the arteries

A
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23
Q

where does greater palatine artery enter nasal cavity?

A

greater palatine foramen

hugs oral cavity

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24
Q

identify these holes

A

greater palatine foramen- where greater palatine a comes out, greater palatine nerve

lesser palatine foramen

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25
Q

where does greater palatine artery enter nasal cavity floor

A

incisive foramen

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26
Q

septal artery function?

A

facial artery branch

goes superiorly; connects w/ dorsal nasal artery at orbit

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27
Q

connection between a nasal and an eye-related artery?

A

external carotid > facial a > dorsal nasal a > opthalmic a

28
Q

describe all arteries of eye orbit

A
29
Q

“place of least resistance” principle?

A

ethmoidal arteries go through bone

surgeous can go through solid bone if have to, because if artery going thru bone by def’n, have osseus tunneling already, just have to snip to get pathologic site they want to access

30
Q

what is this

A

anterior and posterior ethmoid foramena, where ethmoid artery goes through ethmoid bone

31
Q

where do nasal bleeds occur?

A

little’s area

32
Q

major nervous contribution to nasal cavity?

A

branches of V2, maxillary a

33
Q

nasopalatine n location

A

hugs nasal septum

descends through incisive canal

sends branches to incisive dentition

34
Q

pterygopalatine ganglion sends branches where

A

nasal septum, wall

35
Q

branches of pterygopalatine ganglion in the nasal cavity are?

A

superior, middle, and inferior postero-lateral nasal branches

36
Q

4 sinuses?

A

frontal

sphenoidal

maxillary

ethmoidal

37
Q

roles of sinuses?

A

1) architectural: reduce cranial weight, shock absorption, accomodate growth, replace functionless bone
2) physiological: produce fluid for humidification, ventilation, secrete mucus, air conditioning, shock absorption, impart resonance to voice, aid in respiratory function
3) evolutionary residuals: had a fxn once that’s no longer needed

38
Q

identify frontal and maxillary sinuses. should they be a/symmetrical?

A

frontal: asymmetric
maxillary: symmetric

39
Q

which paranasal sinus develops first, embryologically?

A

maxillary sinus

begins as bud along inferoalteral surface of ethmoid portion of nasal capsule

day 65

40
Q

borders of maxillary sinus?

A

roof: floor of orbit
floor: dental roots

41
Q

embryologic cell type of nasal cavity cells?

A

mesenchymal cells

42
Q

what element of vault grows uniquely in humans only?

A

maxilla grows vertically

43
Q

how does maxillary sinus grow?

A

medial > lateral

44
Q

when do molar teeth erupt?

A

6 yrs old: 1st moral erupts

12 yrs old: 2nd moral erupts

17-25 yrs old: 3rd molar erupts

45
Q

where is maxillary sinus floor re: nasal cavity floor?

A

in fetus, maxillary sinus floor is above level of floor of nasal cavity

in grown person, maxillary sinus floor is below the level of the nasal cavity floor

46
Q

where do V2 branches go re: paransal sinuses?

A

V2 branches hug around maxillary sinus

47
Q

autonomic innervation to lacrimal gland?

A

presynaptic: greater petrosal n., of VII, to pterygopalatine ganglion
postsynaptic: zygomatic n., lacrimal n.

distribution root: V1, V2

48
Q

autonomic innervation to mucous glands, nasal cavity, nasopharynx, palate?

A

presynaptic: VII via greater petrosal n.
ganglion: pterygopalatine
postsynaptic: branches of V2

49
Q

what is within sinus wall epithelium that is the target for GVEs?

A

respiratory epithelial lining has serous glands, mucous glands, goblet cells

this is postganglionic GVE target

50
Q

descrbe path of greater petrosal n > target glands

A

preganglionic parasympathetic fibers exit from midbrain

enter internal acoustic meatus

at GENICULATE BEND, greater petrosal n goes thru pterygoid canal

synapses at pterygopalatine ganglion

rides w/ V2 to get to target glands

51
Q

what is middle conchi

A

middle turbinate w/ epithelial lining

52
Q

what are 3, 5, 7?

A

3, inferior turbinate

5, middle turbinate

7, suprior turbinate

53
Q

lamina papyracea?

A

paper thin part of ethmoid bone

where ethmoid sinus air cells are

each air cell has an opening

are unique to individuals

54
Q

what is norm for frontal sinus morphology?

A

asymmetric

55
Q

what lines sinuses?

A

respiratory epithelium

they produce fluid, which must drain

56
Q

identify hiatus semilunaris

A

anterior face of ethmoid bullop, sliver that is posterior bone of ulcinate process

57
Q

what space is entered from the hiatus semilunaris?

A

ethmoid infindibulum

is the receptical space for frontal, maxillary, ethmoid inner sinuses

58
Q

components of middle turbinate?

A

horizontal, vertical, superior components

so attachment to middle turbinate is in 3 dimenstions, very solid

59
Q

3 categories of sphenoid sinus?

A

1) conchal - tiny
2) pre-sellar - neumitization remains in front of sella turcica
3) post-sellar - neumitization grows beyond sella turcica

60
Q

what leaves an imprint on walls of sphenoid sinus?

A

optic nerve

61
Q

what is wrong with this pt?

A

papilloma in R eye, affecting his abducens

cannot abduct eye

62
Q

how does infection get to middle ear from sinus?

A

via eustachian tube

63
Q

how do lacrimal tears travel and where do they drain?

A

lacrimal tears bathe the occular globe from superolaterally > inferomedially

drain into **inferior meatus **

64
Q

what drains into middle meatus?

A

frontal, maxillary, anterior ethmoid sinuses

65
Q

what drains into superior meatus?

A

sphenoid, posterior ethmoid sinuses

66
Q

what drains into inferior meatus?

A

lacrimal tears

67
Q

what is unique about sphenoid sinus drainage?

A

sphenoid drains into superior meatus

but must go through posterior ethmodi sinus to get to superior meatus

all other sinuses have direct route of drainage to their meatus

Structures: Part Deux (36 decks)

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