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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
what makes up the medial wall of the nasal cavity
perpendicular plate of ethmoid bone vomer bone nasal cartilages
26
what is the problem with a deviated septum
it can be so severe that is affects breathing deviation can be corrected surgically
27
what does respiratory epithelium line ? what is its function
lines bulk of nasal cavity rich in blood vessels and mucous glands to warm air as it passes through the cavity
28
what does olfactory epithelium line
lines superior-posterior portion of cavity contains CN I
29
what is rhinitis
inflammation of the nasal mucosa
30
where can rhinitis infection spread to
anterior cranial fossa via cribriform plate nasopharynx middle ear via pharyngotympanic tube lacrimal apparatus and conjunctiva via nasolacrimal duct paranasal sinuses
31
what are meatusus and what are the 4 meatuses for the nasal cavity
openings of paranasal sinuses sphenoethmoidal recess superior, middle and inferior nasal meatus
32
sphenoethmoidal recess location opening for ?
a. Area posterior and superior to superior concha. | b. Contains opening for sphenoidal sinus.
33
superior nasal meatus location opening for?
beneath the superior concha contains opening for posterior ethmoidal sinus
34
middle nasal meatus location what two structures are contained in this area? what are the openings in this area from?
a. Beneath middle concha b. Contains bulla ethmoidalis and semilunar hiatus c. Contains openings for frontal, maxillary, anterior and middle ethmoidal sinuses.
35
inferior nasal meatus opening for?
beneath the inferior concha contains the opening for nasolacrimal duct
36
where does the sphenoid sinus drain
sphenoethmoidal recess
37
where does the frontal sinus drain
frontonasal duct to semilunar hiatus within middle nasal meatus
38
where does maxillary sinus drain
semilunar hiatus within middle nasal meatus.
39
where does anterior ethmoidal air cell drain to
semilunar hiatus within the middle nasal meatus
40
where does the middle ethmoidal air cells drain
ethmoid bulla within middle nasal meatus
41
where does the posterior ethmoidal air cells drain
superior nasal meatus
42
what two arteries are the main branches that supply the sinuses
internal and external carotids
43
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)
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
what are the branches off the exterrnal carotid artery that provide to the sinuses
sphenopalatine greater palatine facial artery
45
sphenopalatine artery provides what branches to sinuses?
terminal branch of the maxillary artery enters nasal cavity posteriorly via the sphenopalatine foramen provides posterior lateral nasal and septal branches
46
greater palatine artery supplies what?
its a branch off the maxillary artery enters nasal cavity via incisive canal provides nasal and septal branches
47
facial artery provides what branches to the sinuses and to what sinuses
septal branches from superior labial artery
48
what is kiesselbach's area? where is it
"little's" ``` anastomoses b/w greater palatine anterior ethmoidal sphenopalatine facial arteries ``` located on the anterior portion of the nasal septum
49
what is the venous drainage of the sinuses
submucosal venous plexus drains to maxillary, facial and ophthalmic vv's back to pterygoid plexus
50
what are the three nerves that provide innervation to the sinuses?
``` olfactory nerve (CN I) V1 and V2 (ophthalmic and maxillary) ```
51
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 ?
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
what is olfaction
the sensation of odors that results from the detection of odorous substances aerosolized in the environment.
53
where does the ophthalmic branch of CN V enter the orbit what do its branches provide and what component ?
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
what branches off the ophthalmic n (V1) are involved in innervating sinuses?
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
where does the maxillary branch of CN V enter? what do its branches provide
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
what are the branches off the maxillary nerve that are involved in innervating sinuses
``` infraorbital posterior superior alveolar pharyngeal n nasopalatine n posterior superior lateral nasal n posterior inferior lateral nasal n ```
57
infraorbital nerve off maxillary n. provides what sinuses?
a. Provides innervation to maxillary sinus. | b. Also supplies innervation to face, including lateral nose.
58
posterior superior alveolar provides what?
maxillary sinus
59
pharyngeal n off maxillary n. provides what?
courses through floor/medial wall of sphenoid sinus will provides sphenoid sinus
60
nasopalatine n. serves what?
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
posterior superior lateral nasal n. provides what/
a. Will enter nasal cavity via sphenopalatine foramen | b. Provides innervation to superior lateral nasal wall.
62
posterior inferior lateral nasal n. provides what
a. Enters nasal cavity via unnamed foramen | b. Provides innervation to inferior lateral nasal wall
63
where are the parasympathetic preganglionic cell bodies that supply the sinuses via what do the preganglionic parasympathetic fibers travel and where ?
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
what forms the nerve of the pterygoid canal
greater petrosal n. | deep petrosal n.
65
in what does the n. of the pterygoid canal travel and where is its destination
e. N. of pterygoid canal travels in pterygoid canal to the pterygopalatine fossa.
66
where are the parasympathetic postganglionic cell bodies for innervation to nasal cavities and paranasal sinuses
f. Postganglionic cell bodies – pterygopalatine ganglion
67
where do postganglionic fibers of parasympathetic innervation of nasal caviites travel and via what?
e. Postganglionic fibers travel with branches of V2 to distribute to the nasal cavities and paranasal sinuses.
68
what is the lymphatic drainage of the anterior portion of nasal cavities ? posterior portion?
1. Anterior portion drains along face to submandibular lymph nodes. 2. Posterior portion drains along pharynx to retropharyngeal lymph nodes.
69
where are the sympathetic preganglionic cell bodies to sinuses
T1-T4
70
postganglionic cell bodies of sympathetic innervation to sinuses?
superior cervical ganglion
71
postganglionic fibers of sympathetic innervation form what
c. Postganglionic fibers form the internal carotid nerve → deep petrosal n.
72
where do postganglionic fibers of sympathetic innervation to the sinuses distribute and via what
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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