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Anatomy > Nasal cavity, paranasal sinuses and pharynx and its clinical anatomy > Flashcards

Nasal cavity, paranasal sinuses and pharynx and its clinical anatomy Flashcards

1
Q

role of nose

A 
olfaction - smell
respiration
filtration of dust
humidification and warmth
reception and elimination of secretions
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2
Q

external nose

A 
mostly cartilage
nares - nostrils
bounded by alae
skin extends into vestibule
has hairs for filtration
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3
Q

bones of the external nose

A

nasal
maxillary
frontal
septum

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4
Q

cartilage of external nose

A

5 main parts

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5
Q

what makes up the septum?

A

ethmoid bone
vomer bone
cartilage
maxilla and palatine bones nasal crests

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6
Q

walls of nose

A

floor, roof, medial and lateral walls

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7
Q

Nasal cavity

A

divided by septum, entry through nares, exit to nasopharynx (choanae)
Lined by mucosa
except vestibule
continuous with pharynx and paranasal sinuses, lacrimal sac and conjunctiva
olfactory area - superior 1/3

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8
Q

role of conchae/ turbinates

A

increased surface area for heat exchange

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9
Q

nasal meatus

A

recess underneath conchae
common nasal meatus - nasal passageway
mucosa can swell blocking passages

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10
Q

paranasal sinuses

A

air filled extensions of nasal cavity
named by the bones which they occupy
maxillary and sphenoidal small at birth, others develop later
can be hyperaerated

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11
Q

vasculature of nasal cavity

A 
5 sources
superior 3 have septal and lateral branches
Kiesselbach area 
external nose 
submucosal venous plexus
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12
Q

venous drainage of the external nose

A

opthalmic veins
cavernous sinus
pterygoid plexus
facial vein

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13
Q

nerve supply of external nose

A

maxillary and opthalmic branches
most of external nose by V1
olfactory nerve

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14
Q

sphenoid sinus

A

only thin bone separating from optic nerves and chiasm. Pituitary gland, internal carotid arteries and cavernous sinus
trans-sphenoidal surgery

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15
Q

Maxillary sinus

A

forms wall of nasal cavity and floor of orbit
posterior molar teeth can project into
drains via maxillary ostium into semilunar hiatus of middle meatus
most commonly infected - uphill drainage

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16
Q

ethmoidal sinus

A

direct passage to anterior cranial fossa through cribriform plate
infection can spread from ethmoiditis
fracture of cribriform plate can lead to CSF rhinorrhoea
similar to otorrhoea
can test glucose content - highly unreliable
beta-2-transferrin
single best test - high sensitivity and specificity
no localising information though - use imaging .

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17
Q

otorrhoea

A

discharge from the ear from ear canal or middle ear

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18
Q

nasal and facial fractures

A

common

causing septal deviation

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19
Q

rhinitis

A

Urticaria and allergy
sinusitis
infection can spread intracranially

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20
Q

nasopharynx to middle ear

A

eustachian tube

21
Q

Pharynx

A

part of upper aerodigestive tract
cranial base to oesphagus
there are 3 parts

22
Q

what are the 3 parts of the pharynx?

A

nasopharynx
oropharynx
laryngopharynx

23
Q

nasopharynx

A

respiratory function
from nasal choanae to soft palate
eustachian tube orifice

24
Q

oropharynx

A

digestive function

soft palate to base of tongue

25
Q

laryngopharynx

A

epiglottis to oesophagus

26
Q

Pharyngeal muscle

A

longitudinal muscle internal to circular layer

opposite to rest of alimentary tract

27
Q

external circular layer

A 
pharyngeal constrictors
superior 
middle
inferior 
inferior has sphincteric function 
involuntary sequential contraction to propel food bolus
28
Q

nerve supply of external circular layer of pharynx

A

pharyngeal nerve plexus from vagus, glossopharyngeal and sympathetic cervical ganglia
gaps between the muscles allows passage of nerves and arteries

29
Q

internal longitudinal layer of pharynx

A

palatopharyngeus
stylopharyngeus
salpingopharyngeus
they elevate the larynx and shorten and widen the pharynx during swallowing and speaking

30
Q

swallowing

A

deglutition

3 phases

31
Q

what are the phases of swallowing

A
  1. voluntary chewing and pushing into oropharynx
  2. involuntary soft palate seals off nasopharynx, larynx elevates, widens pharynx
  3. involuntary - sequential contraction of pharyngeal constrictors causes peristalsis into oesophagus
32
Q

tonsilar ring

A

pharyngeal tonsils -
tubal tonsil
palatine tonsils -

33
Q

tonsils

A

aggregated lymphoid tissue

34
Q

Pharyngeal tonsils

A

adenoid on roof and posterior wall of nasopharynx

35
Q

Tubal tonsils

A
  • near eustachian tube orifice
36
Q

palatine tonsils

A

each side of oropharynx between palatine arches

37
Q

lingual tonsils

A

posterior part of tongue

38
Q

vessels

A

tonsilar branch of facial artery and others
ascending and descending palatine, lingual, ascending pharyngeal
large paratonsilar vein to pharyngeal venous plexus
highly vascular can bleed a lot during or after surgery

39
Q

lymphatic drainage of tonsils

A

tonsilar lymphatic vessels to juugulodigastric cervical lymph node

40
Q

Nervous supply of tonsils

A 
pharyngeal plexus
vagus - motor
glossopharyngeal - sensory 
some nasopharyngeal sensation from maxillary branch of trigeminal nerve 
gag reflex
41
Q

what muscles of the pharynx are innervated by the vagus nerve

A

all muscles of pharynx and soft palate except stylopharyngeus and tensor velipalatini
some motor to inferior constrictor from external and recurrent laryngeal branches

42
Q

Eustachian tube

A

more horizontal in children
can be associated with middle ear infections
more difficult to equalise so painful during air travel

43
Q

ear cancer

A

nasopharyngeal mass/ cancer in adults can lead to middle ear obstruction

44
Q

foreign body

A

usually in piriform fossa
lateral to laryngeal opening
can damage internal and recurrent laryngeal nerves deep to here

45
Q

pharyngeal pouch

A 
zenker diverticulum 
outpouching of hypopharynx just superior to upper oesophageal spchincter
between 2 parts of inferior constrictor
killian dehiscence
pulsion pseudo diverticulum
46
Q

what can happen in the pharyngeal pouch?

A 
trapped food and liquid
dysphagia
halitosis
regurgitation
cough
aspiration
infection
47
Q

orbital plate of ethmoid bone

A

fractures easily due to thin bone

48
Q

infection

A

can spread from ethmoid fracture upwards but CSF moves down

49
Q

epiglottis

A

start of larynx

Anatomy (16 decks)

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