Nasal Anatomy and Physiology

Question 1

What are the functions of the nose?

Answer 1

Respiration 
Humidification of air
Flitration of large particulate matter by course hairs in nasal vestibule 
Mucus production 
Immune protection 
Olfaction
Drainage/aeration of middle ear, paranasal sinuses and lacrimal duct 
Voice modification

Question 2

What type of cells comprise the nasal epithelium?

Answer 2

Respiratory ciliated columnar epithelium with goblet cells

Question 3

What is the function of sinuses?

Answer 3

Vocal resonance
Decrease the weight of the skull and facial bones
Act as a buffer for trauma

Question 4

What is the glabella?

Answer 4

The area between the eyebrows

Question 5

What is the composition of the external nose?

Answer 5

1/3 bony 2/3 cartilage

Frontal processes of the maxilla and the nasal part of the frontal bones

Question 6

Why must a deviated of the nose be fixed asap?

Answer 6

Manipulation must occur before a bony callous has formed

Question 7

What comprises the internal nose?

Answer 7

Turbinates (lateral walls)
Cribriform plate (roof) 
Hard palate (floor)

Question 8

What structures are associated with the internal nose?

Answer 8

Paranasal sinuses

Nasopharynx

Question 9

What are the causes of septum deviation?

Answer 9

Congenital

Acquired (almost always through trauma)

Question 10

What other clinical problems may occur in relation to the septum?

Answer 10

Septal haematoma

Septal perforation

Question 11

What is the treatment for septal haematoma?

Answer 11

Excision and drainage

Question 12

What are the 3 different types of turbinates?

Answer 12

Inferior
Middle
Superior

Question 13

What are the causes of nasal blockage?

Answer 13

Infection
Inflammation
Foreign body

Question 14

How are nasal blockages usually managed?

Answer 14

Topical steroid sprays

Surgically with turbinate reduction surgery?

Question 15

What are the different types of paranasal sinuses?

Answer 15

Frontal
Maxillary x2
Ethmoid (ant and post)
Sphenoid

Question 16

What drains into the inferior meatus?

Answer 16

Nasolacrimal duct

Question 17

What drains into the middle meatus?

Answer 17

Frontal
Maxillary
Anterior ethmoid

Question 18

What drains into the superior meatus?

Answer 18

Posterior ethmoid

Sphenoid

Question 19

What is rhinosinusitis?

Answer 19

Concurrent inflammatory and infective process that affects the nasal passageways and contiguous para nasal sinuses

Question 20

What are the different forms of rhinosinusitis?

Answer 20

Acute (bacterial)

Chronic ( allergic, non allergic with polyps or non allergic without polyps)

Question 21

What are polyps?

Answer 21

Prolapsed mucosa

Question 22

What is the relevance of the location of the frontal and ethmoid sinuses?

Answer 22

Close to the anterior cranial fossa

Question 23

What is the relevance of the location of the maxillary sinus?

Answer 23

Close to the orbits

Question 24

What is the relevance of the location of the sphenoid sinus?

Answer 24

Close to the optic nerve, internal carotid artery and cavernous sinus

Question 25

Why are the locations of the sinuses clinically important?

Answer 25

Spread of infections ( meningitis, intracranial abscess, orbital sepsis)

Question 26

What are the risks of sinus surgery?

Answer 26

``` CSF leak Orbital complications (worst case scenario of blindness) ```

Question 27

How is orbital cellulitis treated?

Answer 27

Aggressive IV antibiotics. Ct determines severity before considering surgery

Question 28

Where do the adenoids sit in childhood?

Answer 28

Nasopharynx

Question 29

Where is the anterior blood supply of the nose derived from?

Answer 29

Branches of the internal carotid artery | Ophthalmic > ant/post ethmoid arteries

Question 30

Where is the posterior blood supply of the nose derived from?

Answer 30

Branches of the external carotid artery | Sphenopalatine

Question 31

What is the area in the nose where most of the arteries will anastomose?

Answer 31

Little's area

Question 32

What is the clinical significance of Little's area?

Answer 32

Epistaxis commonly occurs here

Question 33

What are common causes of epistaxis

Answer 33

``` Trauma Anticoagulants (warfarin) Iatrogenic (surgery) Idiopathic Hypertension ```

Question 34

What are the causes of olfactory dysfunction?

Answer 34

Rhinosinusitis Post oral anosmia Trauma