Nasal cavity, paranasal sinuses & ear Flashcards by Jessica Hardy

What are the boundaries of the nasal cavity?

Nares to choanae

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What are the nasal choanae?

Two oval openings at back of nasal cavity that take you into the nasopharynx

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What type of epithelium is the nasal cavity lined with?

Respiratory type epithelium - pseudostratified ciliated

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How many concha are there and what are the names?

3 - superior, middle & inferior

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What is the meatus?

The area between the concha

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What are the functions of the nasal cavity?

Filter air - concha create turbulent air flow – air is forced against nasal mucosa (goblet cells produce mucus) – trap particulate matter
Warm & moisten air – highly vascularised mucosa – air warms up as it spins against it
Cavity & paranasal sinuses produce resonance in voice
Receptor for sense of smell

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What is CSF rhinorrhoea?

Trauma to the nose can fracture the cribriform plate in the ethmoid, damaging the dura + arachnoid, causing CSF to leak out the nose

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What is the area called where multiple arteries anastomose in the nasal cavity?

Little areas/Kiesselbach plexus

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What is the nasolacrimal duct?

Drains tear fluid from medial eyelid to the inferior meatus

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What are the 4 paranasal air sinuses & where do they sit?

Frontal - in frontal bone
Ethmoid - air cavity between nasal cavity & orbit
Maxillary - in cheek
Sphenoid - midline

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What epithelium line sinuses?

Respiratory mucosal epithelium

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How does mucous drain from sinuses?

With gravity, except maxillary sinus

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What drains into the sphenoethmoid recess?

Sphenoid sinus

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What drains into the hiatus semilunaris?

Frontal, maxillary & most of ethmoid

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What is peri-orbital cellulitis?

Orbital plate is a very thin piece of bone - ethmoid sinusitis can spread as soft tissue infection to the orbit

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What is the sensory innervation of the nasal cavity?

Trigeminal -

CNVa - tissues around the eye
CNVb - maxillary
CNVc - mandibular division

Also CNI - olfactory

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What is the sensory innervation of the sinuses?

All from CNVa apart from maxillary from CNVb

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What is the pinna of the ear?

The outer structure formed from cartilage & freshy lobule

What is the external acoustic meastus

Leads to tympanic membrane

When performing otoscopy, what would you do differently in adults compared to children?

In adults - pull ear postero-superiorly

In children - pull ear postero-inferiorly - tube not fully devloped

What are the 3 layers of the tympanic membrane & the innervations?

Skin (CNVc + X)
Mesoderm
Respiratory mucosa (CNIX)

When performing otoscopy, where would you expect the cone of light to shine on the tympanic membrane?

Antero-inferiorly

Towards bottom right in R ear

Is the tympanic membrane concave or convex normally?

Concave

What does CNVIII vestibulocochlear nerve innervate & what are its function?

Vestibular system & cochlear.

Hearing, balance, eye movement in relation to head

What is the sensory innervation of the ear?

- Back - CN II + III - Front - CNVc - Also CN VII + X

Pain can be referred to the ear from what regions and via which nerves?

- CNVc - manible, teeth | - CNX - laryngopharynx, larynx, cardiac

What structures are in the middle ear?

Ossicles & eustacian tube

What are the 3 bones of the ossicles?

Stapes, incus & malleus

What is the function of the ossicles?

Conduct vibrations of tympanic membrane to oval window – amplifies signal so you can hear quiet sounds

What type of joints are in the ossicles?

Synovial joints

What are the two muscles to control oscillatory range & what do they do?

- Tensor tympani - Contracts & tenses tympanic membrane – reduce how loud sound is - Stapedius - stop stapes from moving so much to reduce sound

What is hyperacusis?

CNVII lesion damages innervation to stapedius - sound is too loud

What is the function of the eustacian/auditory/ pharyngotympanic tube?

- Equalise pressure during swallowing | - Drain mucus of middle ear

What is the suprameatal triangle?

Access point for mastoid/tympanic antrum (drill through temporal bone)

What is mastoiditis?

Ear infections can track into mastoid air cells (in mastoid process – another sinus). Can be extreme and erode through bone + skin

How is the eustacian tube opened when swallowing?

- Tensor veli palatini - Levator palatini - Salpingopharyngeus

What is the cochlear of the inner ear responsible for?

Converting vibrations into neural signals | Vibrations transmitted to perilymph via vestibular membrane

What is acute otitis media?

Infection spread from nasopharynx to middle ear. | Pain & swelling of tympanic membrane.

What is glue ear (secretory otitis media)?

Blockage of eustacian tube - persistant mucoid accumulation --> conductive hearing loss

What happens in auricular sinus?

Can be quiescent or become infected, form cysts or discharge

What nerve is being tested in the Rinne's & Weber's test?

CNVIII - testing cochlear component

What is Rinne's test?

Hold tuning fork on mastoid process until stop hearing it and then hold to external acoustic meatus (EAM). Air conduction should be better than bone conduction. Conductive deafness - no sound heard at EAM

What is Weber's test?

Hold tuning fork on forehead. Conductive deafness - sound loudest in affected ear. Sensorineural deafness - sound loudest in normal ear