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Head and Neck > Nasal Cavity > Flashcards

Nasal Cavity Flashcards

1
Q

what are the 3 regions in each nasal cavity

A

nasal vestibule, respiratory region, and olfactory region

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2
Q

what is the nasal vestibule region

A

small dilated space just internal to the external nose, lined by skin and contains hair follicles

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3
Q

what is the respiratory region

A

largest part of the nasal cavity, lined by respiratory epithelium and ciliated mucous cells

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4
Q

where is the olfactory region

A

at the apex of the nasal cavity, lined by olfactory epithelium (contains olfactory receptors)

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5
Q

what is olfaction

A

inspired air is passed through the olfactory region for smelling

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6
Q

how much mucus is produced per day

A

about 1 liter per day

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7
Q

where does the mucus normally drain

A

brushed towards the back of the throat by cilia and swallowed

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8
Q

what are alar cartilages

A

they form most of the nostrils

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9
Q

what is the fibroelastic tissue

A

forms the inferior-most parts of the nostrils

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10
Q

how many bones contribute to the skeletal framework of the nasal cavities

A

14 bones

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11
Q

what parts of the nasal cavity does the ethmoid contribute to

A

roof, lateral wall and medial wall of both nasal cavities

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12
Q

where are the ethmoidal labyrinths

A

two rectangular boxes, one on each side, united superiorly across the midline by the cribiform plate

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13
Q

what is the cribiform plate

A

a perforated sheet of bone at the apex of the nasal cavities, separates the cavities from the cranial cavity

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14
Q

where do the fibers of the olfactory nerve (CN 1) pass through into the nasal cavity

A

through the small perforations in the cirbiform plate

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15
Q

what is the perpendicular plate

A

vertical sheet of bone that forms the upper part of the nasal septum, descends from the midline of the cribiform plate

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16
Q

where is the orbital plate of the ethmoid bone

A

a lateral sheet of bone that is flat and forms part of the medial wall of the orbit

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17
Q

what 2 conchae are part of the ethmoid bone

A

the superior and middle (inferior is separate)

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18
Q

where are the ethmoidal bulla

A

inferior to the origin of the middle concha, forms a prominent bulge

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19
Q

what are some causes of CSF rhinorrhea

A

head trauma, complication of ear or nasal surgery, can be spontaneous, likely related to chronic elevated intracranial pressure

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20
Q

what are some symptoms of CSF rhinorrhea

A

salty post-nasal drainage, severe headache eased by intermittent, unilateral clear rhinorrhea

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21
Q

what is the treatment for CSF rhinorrhea

A

surgery (push protrusion back into cranial vault and fix bony defect), management of the high ICP (diuretics, lumbar peritoneal drain)

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22
Q

what is a complication of CSF rhinorrhea

A

meningitis

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23
Q

what is CSF rhinorrhea

A

occurs if the meninges are compromised and torn, the CSF leaks into the nasal cavity

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24
Q

what part of the nasal cavities does the sphenoid bone conrtibute to

A

most of the posterior part of the nasal cavities (houses the sphenoidal sinuses)

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25
Q

what bones form the choncae

A

sphenoid, vomer, and palatine bones

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26
Q

what part of the nasal cavities do the maxillae bones conrtibute to

A

most of the lateral and inferior parts (houses the maxillary sinuses)

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27
Q

what part of the nasal cavities does the frontal bone conrtibute to

A

small part of the roof (frontal sinuses housed here)

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28
Q

how many bones make up the lateral nasal wall

A

8 bones

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29
Q

what are the 8 bones of the lateral nasal wall

A

ethmoidal labyrinth, perpendicular plate of palatine bone, medial plate of pterygoid process of sphenoid bone, medial surfaces of lacrimal bones, inferior conchae, maxillae, frontal, and nasal bones

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30
Q

what makes up the nasal septum

A

septal nasal cartilage anteriorly, vomer, and the perpendicular plate of the ethmoid bone posteriorly

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31
Q

what is a deviated septum

A

slightly crooked nasal septum

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32
Q

what causes a deviated septum

A

congenital, nasal fracture or through aging

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33
Q

what is the treatment for a deviated septum

A

severe deviations are repaired with septoplasty, decongestants, antihistamines

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34
Q

how many people have a deviated septum

A

about 80%

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35
Q

what are the symptoms of a deviated septum

A

obstruction of one or both nostrils, nasal congestion, epistaxis, snoring, chronic sinusitis

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36
Q

what percentages of facial fractures include the nasal bones

A

about 40%

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37
Q

what are the causes of a nasal fracture

A

injury from contact sports, physical fights, motor vehicle accidents, falls, accidental trauma

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38
Q

what are the symptoms of a nasal fracture

A

pain, tenderness, swelling, epitaxis, bruising around nose or eyes, crooked nose, difficulty breathing, rhinorrhea

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39
Q

what are some complications of a nasal fracture

A

deviated septum, cartilage fracture, septal hematoma

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40
Q

what are the treatments for a nasal fracture

A

icing for minor fractures, closed reduction, surgery

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41
Q

what bones make up the nasal cavity floor

A

horizontal plates of the palatine bones and the palatine processes of the maxillary bones

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42
Q

what bones make up the roof of the nasal cavity

A

cribiform plate of the ethmoid bone (frontal and nasal bones contribute small parts)

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43
Q

what 2 things pass through the cribiform plate

A

CN 1 exits the nasal cavity to the cranial cavity and the posterior ethmoidal vessels pass into the nasal cavity

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44
Q

what passes through the anterior ethmoidal canal

A

branch of ophthalmic nerve (V1): anterior ethmoidal nerve, arteries and vein

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45
Q

where is the anterior ethmoidal canal

A

small foramen between cribiform plate and surrounding bone

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46
Q

what is the foramen caecum

A

connection between nasal veins and superior sagittal sinus (midline between crista galli and frontal bone), nasal vein passes here

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47
Q

where is the sphenopalatine foramen

A

in the posteriorolateal wall of the superior nasal meatus

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48
Q

what structures pass through the sphenopalatine foramen

A

sphenopalatine branch of maxillary artery, nasopalatine nerve, superior nasal branches of the maxillary nerve (V2)

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49
Q

what is the communication route for the sphenopalatine foramen

A

between nasal cavity and pterygopalatine fossa

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50
Q

where is the incisive canal

A

in the floor of the nasal cavities (lateral to the nasal septum and posterosuperior to the root of the central incisor in the maxilla)

51
Q

where does the incisive canal open into

A

into the incisive fossa in the roof of the oral cavity

52
Q

what 2 things travel in the incisive canal

A

nasopalatine nerve and posterior septal branch of sphenopalatine artery

53
Q

what 3 things go through the nares

A

they allow small internal nasal branches of the infraorbital nerve (V2), alar and septal branches of superior labial artery (Facial) and small alar branches of lateral nasal artery to enter the nostrils

54
Q

how many paranasal sinuses are there

A

4- each named according to the bone where it is found

55
Q

how do the paranasal sinuses develop

A

as outgrowths from the nasal cavities and erode into the surrounding bones

56
Q

when do the paranasal sinuses grow

A

develop throughout childhood and grow throughout life- never stopping

57
Q

what lines the paranasal sinuses

A

respiratory mucosa, ciliated and mucus secreting and open into the nasal cavities

58
Q

where are the ethmoidal air cells located in the ethmoid bone

A

in the ethmoidal labyrinths, separated from the orbit by thin orbital plates (divided into anterior, middle, posterior)

59
Q

what is the largest paranasal sinus

A

the maxillary sinuses

60
Q

what do the nasal conchae do

A

increase the surface area of contact between tissues of the lateral wall and respired air, divide each nasal cavity into 4 air channels

61
Q

what are the 4 air channels that are created by the nasal conchae

A

inferior nasal meatus, middle nasal meatus, superior nasal meatus, and sphenoethmoidal recess

62
Q

where is the inferior nasal meatus

A

between the inferior concha and nasal floor- contains the opening of the nasolacrimal duct

63
Q

where is the middle nasal meatus

A

between the inferior and middle concha

64
Q

what does the middle nasal meatus contain

A

the ethmoidal bulla and the hiatus semilunaris (ostium of the maxillary sinus)

65
Q

where is the superior nasal meatus

A

between the middle and superior concha

66
Q

where are the sphenoethmoidal recess

A

between the superior concha and the nasal roof

67
Q

what does the sphenoethmoidal recess contain

A

the opening of the sphenoidal sinus

68
Q

where does the frontal sinus drain into

A

into the lateral wall of the middle meatus via the frontonasal duct (penetrates the ethmoidal labyrinth and enters anterosuperior part of hiatus semilunaris)

69
Q

where do the anterior ethmoidal cells open into

A

the frontonasal duct or anterior part of hiatus semilunaris

70
Q

where do the middle ethmoidal cells open into

A

the ethmoidal bulla

71
Q

where do the posterior ethmoidal cells open into

A

superior meatus

72
Q

where does the maxillary sinus drain into

A

the center of the hiatus semilunaris

73
Q

where does the sphenoidal sinus drain into

A

into the roof of the cavity via apertures on the posterior wall of the sphenoethoidal recess

74
Q

what is the function of the sphenoidal and frontal sinuses in carnivores

A

smell

75
Q

what may be the function of the maxillary sinuses

A

phonation (resonance), conservation of heat, lightening of skull

76
Q

what may be the function of the ethmoidal air cells

A

reduction of olfactory area of nasal cavities

77
Q

what is rhinitis

A

irritation and inflammation of the mucous membrane inside the nose

78
Q

what are some symptoms of rhinitis

A

stuffy or runny nose, postnasal drop

79
Q

what are some triggers of rhinitis

A

environmental, weather changes, viral infections, alcohol, NSAID’s, hypertension medications, sedatives, antidepressants, oral contraceptives, decongestant sprays, stress, and hormone changes

80
Q

what are 3 complications of rhinitis

A

nasal polyps, chronic sinusitis, and middle ear infections

81
Q

what are some treatments for rhinitis

A

nasal rinses, humidifiers, oral decongestants, saline or antihistamine nasal sprays

82
Q

what is sinusitis

A

swollen sinus mucosa that blocks off routes of drainage

83
Q

what is acute sinusitis

A

usually a cold that becomes bacterial infection, resolves within a month

84
Q

what is chronic sinustitis

A

allergies, pollutants, injuries, biofilms - cause 3/4 cases

85
Q

what are symptoms of sinusitis

A

purulent rhinorrhea (green/yellow discharge), nasal congestion, facial pain, fever, feeling of facial “fulness”, worsens with bending over, aching teeth, sore throat, ear pain

86
Q

what are 3 treatments for sinusitis

A

anti-inflammatories, antibiotics, or surgery

87
Q

what is a complication of sinusitis

A

can be life-threatening

88
Q

where are 4 routes of infection from the nasal cavities

A

infection can reach the anterior cranial fossa (via cribriform plate) the nasopharynx and retropharyngeal space, middle ear (via pharyngotympanic tube) and the orbit (nasolacrimal duct)

89
Q

what are 2 routes of infection from the sphenoidal sinus

A

pituitary fossa and cavernous sinus

90
Q

what is a route of infection from the ethmoidal sinus

A

to the orbit

91
Q

what 3 sinuses can cause infection in the cranial cavity (meningitis or intracranial abcesses)

A

frontal, ethmoidal and sphenoidal sinuses

92
Q

what is functional endoscopic sinus surgery (FESS)

A

preferred method for treating chronic sinusitis- natural drainage channels of paranasal sinuses are enlarged

93
Q

what is transnasal transsphenoidal surgery (TNTS)

A

preferred method for removing pituitary tumors or cysts

94
Q

what is the general afferent of the nasal cavities

A

trigeminal nerve (CN 5)

95
Q

what general afferents innervate the anterior region of the nasal cavities

A

branches of V1 ophthalmic: anterior lateral, septal, and external nasal branches of anterior ethmoidal nerve

96
Q

where does the posterior ethmoidal nerve go

A

ends in the ethmoidal air cells, does not pass through nasal cavity

97
Q

what general afferents innervate the posterior region of the nasal cavity

A

branches of V2- maxillary: nasopalatine and posterior lateral nasal branches of pterygopalatine ganglion, internal nasal branches of infraorbital nerve and nasal branch of anterior superior alveolar nerve

98
Q

what are the special afferents carried by

A

olfactory nerve CN 1

99
Q

what is the visceral efferent innervation of the glands in the mucosa of the nasal cavity and paranasal sinuses

A

the greater petrosal branch of the facial nerve (7)

100
Q

where do the visceral efferents synapse and how are they distributed

A

in the pterygopalatine ganglion and are distributed in general afferent branches of the maxillary nerve V2

101
Q

how do the sympathetic fibers reach the nasal cavities

A

from the superior cervical ganglion along blood vessels (anterior region) or through internal carotid plexus and deep petrosal nerve (posterior region)

102
Q

what does the sympathetic innervation do

A

involved with regulating blood flow in nasal mucosa

103
Q

what nerve carries general afferents from the frontal sinus

A

branches of the supraorbital nerve (V1)

104
Q

what 3 nerves carry general afferents from the ethmoidal air cells

A

anterior and posterior ethmoidal branches of the nasociliary nerve (V1) and orbital branches from pterygopalatine ganglion

105
Q

what 2 nerves carry general afferents from the maxillary sinus

A

infraorbital and alveolar branches of maxillary V2

106
Q

what 2 nerves carry general afferents from the sphenoidal sinuses

A

posterior ethmoidal branch of the ophthalmic nerve V1 and orbital branches from pterygopalatine ganglion

107
Q

what 2 branches of the external carotid supply the nasal cavity

A

maxillary artery and facial artery

108
Q

what is the branch of the internal carotid artery that supplies the nasal cavity

A

the opthalmic branch

109
Q

what are the 2 branches of the maxillary artery that supply the nasal cavity

A

sphenopalatine artery- largest vessel in nasal cavity (posterior lateral nasal branches and posterior septal branches) and greater palatine artery

110
Q

what are the 2 branches of the facial artery that supply the nasal cavity

A

superior labial artery (alar and septal branches) and lateral nasal artery (alar branches)

111
Q

what are the 2 branches of the ophthalmic artery that supply the nasal cavity

A

anterior ethmoidal artery (septal, anterior lateral nasal, ext nasal branches) and posterior ethmoidal artery (septal branch)

112
Q

where does the sphenopalatine artery travel

A

leaves the pterygopalatine fossa and through sphenopalatine foramen and onto lateral wall of nasal cavity

113
Q

what is Kiesselbach’s plexus

A

an extensive anastomose on anterior part of nasal septum between branches of greater palatine (through incisive canal), sphenopalatine, superior labial, and anterior ethmoidal arteries

114
Q

what is epistaxis

A

nose bleeds- kiesselbach’s plexus is close to surface for anterior nasal septum bleeds

115
Q

what is the blood supply to the frontal sinus

A

branches of the anterior ethmoidal arteries

116
Q

what is the blood supply to the maxillary sinus

A

branches from the infraorbital and superior alveolar branches of the maxillary arteries

117
Q

what is the blood supply to the ethmoidal air cells

A

branches of anterior and posterior ethmoidal arteries

118
Q

what is the blood supply to the sphenoidal sinus

A

pharyngeal branches of maxillary sinus

119
Q

where do veins that pass with branches that originate from the maxillary sinus drain into

A

the pterygoid plexus of vein in the infratemporal fossa

120
Q

where do veins from the anterior regions of the nasal cavity drain

A

join the facial vein

121
Q

where do veins that travel with the anterior and posterior ethmoidal veins drain into

A

tributaries of the superior ophthalmic vein = cavernous sinus on either side of hypophyseal fossa

122
Q

what arteries would cause a post nasal septum epitaxis

A

sphenopalatine arteries

123
Q

where does the nasal vein travel

A

passes superiorly through foramen caecum in frontal bone anterior to crista galli and joins anterior end of the superior sagittal sinus

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