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Neuro Exam 3 > Nasal cavity, paranasal sinuses > Flashcards

Nasal cavity, paranasal sinuses Flashcards

1
Q

what part of the respiratory tract does the nose make up? what makes up the nose?

what is the noses function?

A

A. The nose is the proximal most portion of the respiratory tract;

composed of external bony and cartilaginous nose and internal nasal cavities.

Functions to warm, humidify, and filter air as it passes into the respiratory tract.

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2
Q

what are paranasal sinuses ? what lines them
what bones are they found in?
what is their function

A

B. Paranasal sinuses are air-filled, epithelial-lined spaces

inside the frontal, sphenoidal, ethmoidal, and maxillary bones;

act to lighten the skull.

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3
Q

when do the sinuses form ?

A

C. The paranasal sinuses form post-natally as the epithelial-lined spaces excavate through surrounding bone.

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4
Q

what are the 4 paranasal sinuses

A

sphenoidal
ethmoidal
frontal
maxillary

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5
Q

where is the maxillary sinus

where does it drain?

what is it innervated by ?

A

within the maxillary bone
largest of the sinuses

drains to semilunar hiatus within middle nasal meatus (drains up!)

innervated by V2

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6
Q

what are the superior, medial, inferior, anterior/lateral, and posterior relationships of the maxillary sinus

A

a. Superior – orbit
b. Medial – nasal cavity
c. Inferior – maxillary teeth
d. Anterior and lateral – cheek
e. Posterior – pterygopalatine fossa

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7
Q

where is the frontal sinus

where does it open up into ?
innervated by?

A

within the frontal bone, superior to superciliary arches, nasal bones

open via frontonasal duct to semilunar hiatus within middle nasal meatus

innervated by V1

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8
Q

what are the superior/posterior and inferior relationships of the frontal sinus

A
  1. Relationships:
    a. Superior/Posterior – cranial cavity

b. Inferior – nasal cavity/orbit

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9
Q

where is the sphenoid sinus

where does it open

innervation

A

within the body of sphenoid bone

open to sphenoethmoidal recess

innervated by V2

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10
Q

where is the ethmoidal sinus

what are its components

innervated by what?

A

within the ethmoid bone

anterior, middle and posterior air cells

innervated by V1

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11
Q

what are the superior, medial/inferior, and lateral relationships of the ethmoidal sinuses

A

a. Superior – cranial cavity
b. Medial/inferior – nasal cavity
c. Lateral - orbit

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12
Q

where do the anterior ethmoidal air cells open to…

A

semilunar hiatus of middle nasal meatus

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13
Q

where do the middle air cells (ethmoidal) open to

A

ethmoid bulla

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14
Q

where do posterior ethmoidal air cells open?

A

superior nasal meatus

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15
Q

what is sinusitis

where are some sites of spread of infection from sinuses

A

infection/inflammation of the paranasal sinuses

translumination of the sinuses can be used to detect fluid levels within paranasal sinuses

can be complicated by spread to surrounding structures–> eye, optic nerve (optic neuritis), teeth, brain/meninges

maxillary teeth infection–> spread to maxillary air sinus

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16
Q

which sinus is most susceptible to infection? why

A

maxillary sinus

due to drainage.

The ostia of maxillary sinuses are located on the upper wall of the sinus. Thus, fluid has to completely fill the sinus before it can drain.

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17
Q

what are some potential problems in the central nervous system that can be caused by sinusitis

A 
meningitis 
subdural empyema 
epidural abscess
intracerebral abscess
cavernous sinus thrombosis
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18
Q

what is the external nose composed of? what bones… what cartilages

A

B. Composed of bony and cartilaginous structures

  1. Nasal, maxilla, frontal bones
  2. Nasal cartilages
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19
Q

what forms the roof of the nasal cavity

A

ethmoid bone (cribriform plate) mostly

frontal bone
sphenoid bone

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20
Q

what forms the lateral wall of the nasal cavity

A

ethmoid bone (superior and middle concha)

inferior concha

maxilla bone

palatine bone - perpendicular plate

lacrimal bone

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21
Q

what forms the floor of the nasal cavity

A 
palatine bone (posterior)
maxilla bone (anterior)
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22
Q

what forms the anterior wall of the nasal cavity

A

nasal cartilages, nasal bones

nares are the anterior openings to the nasal cavity

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23
Q

where do nares lead to and what does this area contain

A

lead to skin lined vestibule which contains vibrissae, hair cells which filter incoming air

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24
Q

what is the posterior wall of the nasal cavity

A

open to nasopharynx via choanae

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25
Q

what makes up the medial wall of the nasal cavity

A

perpendicular plate of ethmoid bone

vomer bone

nasal cartilages

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26
Q

what is the problem with a deviated septum

A

it can be so severe that is affects breathing

deviation can be corrected surgically

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27
Q

what does respiratory epithelium line ?

what is its function

A

lines bulk of nasal cavity

rich in blood vessels and mucous glands to warm air as it passes through the cavity

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28
Q

what does olfactory epithelium line

A

lines superior-posterior portion of cavity

contains CN I

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29
Q

what is rhinitis

A

inflammation of the nasal mucosa

30
Q

where can rhinitis infection spread to

A

anterior cranial fossa via cribriform plate

nasopharynx

middle ear via pharyngotympanic tube

lacrimal apparatus and conjunctiva via nasolacrimal duct

paranasal sinuses

31
Q

what are meatusus and what are the 4 meatuses for the nasal cavity

A

openings of paranasal sinuses

sphenoethmoidal recess
superior, middle and inferior nasal meatus

32
Q

sphenoethmoidal recess
location
opening for ?

A

a. Area posterior and superior to superior concha.

b. Contains opening for sphenoidal sinus.

33
Q

superior nasal meatus
location

opening for?

A

beneath the superior concha

contains opening for posterior ethmoidal sinus

34
Q

middle nasal meatus
location

what two structures are contained in this area?

what are the openings in this area from?

A

a. Beneath middle concha
b. Contains bulla ethmoidalis and semilunar hiatus
c. Contains openings for frontal, maxillary, anterior and middle ethmoidal sinuses.

35
Q

inferior nasal meatus

opening for?

A

beneath the inferior concha

contains the opening for nasolacrimal duct

36
Q

where does the sphenoid sinus drain

A

sphenoethmoidal recess

37
Q

where does the frontal sinus drain

A

frontonasal duct to semilunar hiatus within middle nasal meatus

38
Q

where does maxillary sinus drain

A

semilunar hiatus within middle nasal meatus.

39
Q

where does anterior ethmoidal air cell drain to

A

semilunar hiatus within the middle nasal meatus

40
Q

where does the middle ethmoidal air cells drain

A

ethmoid bulla within middle nasal meatus

41
Q

where does the posterior ethmoidal air cells drain

A

superior nasal meatus

42
Q

what two arteries are the main branches that supply the sinuses

A

internal and external carotids

43
Q

what are the branches off the internal carotid that supply the sinuses, where do they course, and which areas do they provide to (4 main things)

A

anterior and posterior ethmoidal

branches off the ophthalmic which is off the internal carotid

course through ethmoidal air cells and enter roof of nasal cavity

1provide lateral nasal branches
2provide septal branches to nasal cavity

3provide ethmoid sinuses

4 provide external nose

44
Q

what are the branches off the exterrnal carotid artery that provide to the sinuses

A

sphenopalatine
greater palatine
facial artery

45
Q

sphenopalatine artery provides what branches to sinuses?

A

terminal branch of the maxillary artery

enters nasal cavity posteriorly via the sphenopalatine foramen

provides posterior lateral nasal and septal branches

46
Q

greater palatine artery supplies what?

A

its a branch off the maxillary artery

enters nasal cavity via incisive canal

provides nasal and septal branches

47
Q

facial artery provides what branches to the sinuses and to what sinuses

A

septal branches from superior labial artery

48
Q

what is kiesselbach’s area? where is it

A

“little’s”

anastomoses b/w 
greater palatine
anterior ethmoidal 
sphenopalatine 
facial arteries

located on the anterior portion of the nasal septum

49
Q

what is the venous drainage of the sinuses

A

submucosal venous plexus drains to maxillary, facial and ophthalmic vv’s back to pterygoid plexus

50
Q

what are the three nerves that provide innervation to the sinuses?

A 
olfactory  nerve (CN I)
V1 and V2 (ophthalmic and maxillary)
51
Q

olfactory nerve components for sinuses? what portion of the sinuses do they provide

where are the bipolar neurons that compose CNI ?

where do the fiber processes of CNI pass through and where do they synapse

what is the olfactory bulb an extension of ?

A

SVA
provide to the olfactory area of the nasal cavity

The bipolar neurons that compose CN I are located in the superior portion of the nasal cavity epithelium.

d. The fiber processes of CN I pass through the cribriform plate of the ethmoid bone to synapse in the olfactory bulb of the brain (2nd order neurons)
e. The olfactory bulb is an extension of the forebrain (telencephalon); thus CN I synapses directly within the forebrain.

52
Q

what is olfaction

A

the sensation of odors that results from the detection of odorous substances aerosolized in the environment.

53
Q

where does the ophthalmic branch of CN V enter the orbit

what do its branches provide and what component ?

A

a. The ophthalmic branch of CN V enters the orbit via the superior orbital fissure;

several branches will then provide GSA innervation to the nose and sinuses

(to the anterior portion of the nasal cavity;
ethmoidal sinus,
and frontal sinus).

54
Q

what branches off the ophthalmic n (V1) are involved in innervating sinuses?

A

supraorbital and supratrochlear
–> frontal sinus

posterior ethmoidal
–> ethmoid sinus

anterior ethmoidal

  • -> ethmoidal air cells
  • -> septal branches to anterior nasal cavity
  • -> lateral branches to anterior lateral wall of nasal cavity
  • -> external nasal branch to dorsum of nose
55
Q

where does the maxillary branch of CN V enter?

what do its branches provide

A

pterygopalatine fossa via foramen rotundum

several branches provide GSA innervation to the nose and sinuses (most of the nasal cavity, maxillary sinus, and sphenoid sinus)

56
Q

what are the branches off the maxillary nerve that are involved in innervating sinuses

A 
infraorbital 
posterior superior alveolar 
pharyngeal n
nasopalatine  n 
posterior superior lateral nasal n
posterior inferior lateral nasal n
57
Q

infraorbital nerve off maxillary n. provides what sinuses?

A

a. Provides innervation to maxillary sinus.

b. Also supplies innervation to face, including lateral nose.

58
Q

posterior superior alveolar provides what?

A

maxillary sinus

59
Q

pharyngeal n off maxillary n. provides what?

A

courses through floor/medial wall of sphenoid sinus

will provides sphenoid sinus

60
Q

nasopalatine n. serves what?

A

main nerve to septum

a. Enters nasal cavity via sphenopalatine foramen and will provide the majority of innervation to the nasal septum.
b. Continues to hard palate via incisive foramen.

61
Q

posterior superior lateral nasal n. provides what/

A

a. Will enter nasal cavity via sphenopalatine foramen

b. Provides innervation to superior lateral nasal wall.

62
Q

posterior inferior lateral nasal n. provides what

A

a. Enters nasal cavity via unnamed foramen

b. Provides innervation to inferior lateral nasal wall

63
Q

where are the parasympathetic preganglionic cell bodies that supply the sinuses

via what do the preganglionic parasympathetic fibers travel and where ?

A

salivatory nucleus in braistem

preganglionic fibers travel with facial n.

c. Facial n provides greater petrosal branch which exits temporal bone via the hiatus for the greater petrosal n.
d. Now in the middle cranial fossa, the greater petrosal nerve joins the deep petrosal nerve to form the nerve of the pterygoid canal.

64
Q

what forms the nerve of the pterygoid canal

A

greater petrosal n.

deep petrosal n.

65
Q

in what does the n. of the pterygoid canal travel and where is its destination

A

e. N. of pterygoid canal travels in pterygoid canal to the pterygopalatine fossa.

66
Q

where are the parasympathetic postganglionic cell bodies for innervation to nasal cavities and paranasal sinuses

A

f. Postganglionic cell bodies – pterygopalatine ganglion

67
Q

where do postganglionic fibers of parasympathetic innervation of nasal caviites travel and via what?

A

e. Postganglionic fibers travel with branches of V2 to distribute to the nasal cavities and paranasal sinuses.

68
Q

what is the lymphatic drainage of the anterior portion of nasal cavities ?

posterior portion?

A
  1. Anterior portion drains along face to submandibular lymph nodes.
  2. Posterior portion drains along pharynx to retropharyngeal lymph nodes.
69
Q

where are the sympathetic preganglionic cell bodies to sinuses

A

T1-T4

70
Q

postganglionic cell bodies of sympathetic innervation to sinuses?

A

superior cervical ganglion

71
Q

postganglionic fibers of sympathetic innervation form what

A

c. Postganglionic fibers form the internal carotid nerve → deep petrosal n.

72
Q

where do postganglionic fibers of sympathetic innervation to the sinuses distribute and via what

A

e. Postganglionic fibers travel with branches of V2 to distribute to the nasal cavities and paranasal sinuses.

Neuro Exam 3 (12 decks)

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