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Head and Neck > Lecture 13 - Nose and paranasal sinuses > Flashcards

Lecture 13 - Nose and paranasal sinuses Flashcards

1
Q

Functions of the nose

A
  • Smell
  • Route for inspired air
  • Filters inspired air - raps particles in nasal hair and mucous
  • Turbulent air flow
  • Humidifies and moistens inspired air
  • Resonating chamber for speech
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2
Q

Nasal cavity lining

A

Psuedostratified columnar cells with goblet cells

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3
Q

Vestibule

A

Anterior part of nose before conchae lined with skin containing sebaceous and sweat glands and nasal hair.

Filters inspire air

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4
Q

Boundaries of the nasal cavity

A

Roof - anterior crania fossa where the cribriform plate is

Floor - Hard palate

Lateral walls - conchae on ethmoid bone

Medial - nasal septum of the ethmoid bone and septal cartilage

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5
Q

Conchae

A

Bony projections on the lateral wall of the nasal cavity covered by respiratory mucosa

  • Superior
  • Middle
  • Inferior
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6
Q

Meatuses

A

Gaps between conchae

  • superior
  • middle
  • inferior
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7
Q

Runny nose

A

Nose runs due to tears running into the nasal cavity from the lacrimal ducts

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8
Q

Openings under the meatuses

A

Allow drainage of the paranasal air sinuses especially under the middle meatus

Drainage of nasolarimal duct into the nasal cavity

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9
Q

Septal haematoma

A

Septal cartilage is avascular and receives blood from the septal perichondrium

  1. Trauma can cause damage to the perichondrium
  2. Tear blood vessels
  3. Blood accumulates sub-perichondrium forming a septal haematoma
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10
Q

Saddle nose deformity

A

Untreated septal haematoma leads to avascular necrosis of septum cartilage

Get saddling of nasal dorsum

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11
Q

Complication of septal haemoatoma

A

Can get infection in the haematoma forming a septal abscess

Increasing chance of avascular necrosis

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12
Q

Innervation to nose and nasal cavity

A

General sensation - trigeminal nerve

Va - vestibule
Vb - conchae and nasopharynx

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13
Q

Olfactory mucous membrane

A

Contains olfactory receptor neurones - CN I

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14
Q

Respiratory mucous membrane

A

Psuedostratified columnar ciliated epithelium rinch in goblet cells

  • Filters - mucous and cilia
  • Humidifies - watery secretions
  • Warms - vascular
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15
Q

Nasal polyp

A

Benign fleshy accumulation of respiratory mucosa

  • Normally bilateral
  • Commonly seen in under 40 yr olds

Symptoms:

  • Decreased smell and taste
  • Blocked nose and watery rhinorroea
  • Yellow or pale lump in nasal cavity, felshy and reddened
  • Post nasal drip
  • Tickly cough as polyp drips into nasopharynx onto larynx

More concerning if unilateral or blood secretions as may be tumour

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16
Q

Rhinitis

A

Inflammation of the nasal mucosal lining

Causes:

  • rhinorroea
  • sneezing
  • post-nasal dripping
  • nasal congestion
  • nasal irritation
17
Q

Common causes of rhinitis

A

Simple acute infective rhinitis - viral e.g. common cold

Allergen e.g. pollen or house dust

18
Q

Epitaxis

A

Nose bleed

19
Q

Blood supply to nasal cavity

A

From opthalmic (ethmoidal) and maxillary artery (sphenopalatine and greater palatine)

Anastomose in anterior septum in Kiesselbach’s plexus

20
Q

Venous drainage of nasal cavity

A

Pterygoid venous plexus

Cavernous sinus

Facial vein

21
Q

Paranasal air sinuses

A

Air filled spaces that are extensions of the nasal cavity lines with respiratory mucosa - ciliated and secrete mucous

22
Q

4 Paranasal air sinuses

A

Frontal
Ethmoidal
Sphenoid
Maxillary

23
Q

Roleof paranasal air sinuses

A
  • Warm and humidify inspired air

- Reduce weight of skull

24
Q

Ostia

A

Small channels that allow the drainage of the paranasal air sinuses into a meatus of the nasal cavity

25
Q

Sinusistis

A

Inflammation of the mucosal lining of the paranasal air sinuses and nasal cavity due to infection

Maxillary most commonly affected

26
Q

Innervation of the paranasal air sinuses

A

Trigeminal nerve

Frontal, ethmoidal and sphenois - Va

Maxillary - Vb

27
Q

Presentation of acute sinisitis

A 
Blocked nose
Rhinorrhoea
Pyrexia
Recent URTI
Headache and facial pain
28
Q

Pathophysiology of acute sinisitis

A
  1. Primary infection causes decreases cilia function, oedema of the mucosa and ostia and increased nasal secretions
  2. Drainage from sinus impeded
  3. Stagnant secretions in sinus - breeding ground for bacteria
29
Q

Why is the maxillary sinus most commonly affected?

A

Drainage is higher up into the nasal cavity so needs to work against gravity

30
Q

COmmon bacteria in acute sinistis

A

Strep pneumoniae
Haemophilus influenzae
Moraxella Catarrhalis

Head and Neck (15 decks)

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