Nasal Cavity, sinuses, nasopharynx

Question 1

List the surface anatomy markers of the nose from top to bottom

Answer 1

Bridge/root of nose
Dorsum nasi
apex of nose
ala of nose
naris
Philtrum

Question 2

List 4 functions of the nose

Answer 2

1. respiratory - warms and humidifies inspired air
2. immune - traps and removes pathogens/particulates from inspired air
3. olfactory - responsible for sense of smell
4. drainage- acts as a drainage system from paranasal sinuses and lacrimal ducts

Question 3

What are the 3 regions of the nasal cavity and what are their cell types?

Answer 3

1. olfactory region - olfactory mucosa
2. respiratory region - ciliated pseudo stratified epithelium & goblet cells
3. Vestibule - keratinized stratified squamous epithelium

Question 4

what 3 structures make up the nasal septum

Answer 4

Perpendicular extension of the ethmoid plate, vomer and
septum cartilage

Question 5

List the 3 nasal conchae and what do they form?

Answer 5

Superior nasal conchae
Middle nasal conchae
Inferior nasal conchae

Question 6

What is the function of the nasal conchae?

Answer 6

Projections of the lateral walls of the nasal cavity - they form pathways (called meatuses) for air to flow through the nasal cavity.

Question 7

what is the perforated part of the ethmoid bone called?

Answer 7

Cribriform plate - holes to allow the olfactory nerves to pass

Question 8

Where does the blood supply to the nasal cavity come from?

Answer 8

Branches of the internal carotid arteries

Question 9

Name two structures that drain into the nasal cavity?

Answer 9

Nasolacrimal duct
+
Paranasal sinuses

Question 10

Name the 4 paranasal sinuses

Answer 10

1. Maxillary sinus
2. Sphenoid sinus
3. Ethmoid sinus
4. Frontal sinus

Question 11

Give 4 functions of the paranasal sinuses

Answer 11

1. Decrease weight of skull
2. immune defence
3. produces mucous for tissues of the nasal cavity
4. helps warm & humidify inhaled air

Question 12

What is the sella turcica

Answer 12

Saddle shaped depression in the sphenoid bone that houses the pituitary gland.

Question 13

List the 4 muscles of mastication

Answer 13

1. Temporalis
2. Masseter
3. medial pterygoid
4. lateral pterygoid

Question 14

Where is the nasopharynx located

Answer 14

behind the nasal cavity above the soft palate

Question 15

What is the important location within the nasopharynx

Answer 15

Fossa of rosenmuller (pharyngeal recess) - contains the retropharyngeal nodes

Question 16

What lymphoid tissue is present in the nasopharynx?

Answer 16

Pharyngeal tonsils

Question 17

What is the first lymph node involved in nasopharynx cancer

Answer 17

Retropharyngeal lymph node and if it is more than 1cm in diameter this is not normal.

Question 18

What type of cartilage is the nasal cartilage

Answer 18

hyaline

Question 19

List the nasal cartilages:

Answer 19

1. nasal septum cartilage
   2.Upper lateral cartilage (L+R)
2. Major Alar cartilage (Lateral crus and medial crus)
3. Minor alar cartilage

Question 20

What is the name of the recess that connects the sphenoid sinus to the nasal cavity?

Answer 20

Spenoethmoidal recess

Question 21

What is the most common histology of nasal tumours?

Answer 21

Squamous cell carcinoma

Question 22

List 6 signs and symptoms of nasal related cancer

Answer 22

1.permanently blocked nose
2.rhinorrhea (runny nose)
3.nosebleeds
4.trismus (locked jaw)
5. Pain in the face
6. Loss of sense of smell

Question 23

List 3 ways nasal cancer may be clinically investigated:

Answer 23

1. physical examination of neck, nose, throat, mouth
2. nasoendoscopy/biopsy/FNA of neck nodes
3. imaging scan CT/MRI/X-ray

Question 24

What is the name of lymph node removal in the neck?

Answer 24

Radical neck dissection

Question 25

Which nasal cancer is usually unsuitable for surgery and why?

Answer 25

Nasopharynx cancer - difficult to resect from this location

Question 26

Give 3 risk factors of nasal cancer:

Answer 26

1. Industrial/occupational exposure (dust,metals,chemicals)
2. Smoking
3. HPV

Question 27

Describe the tumour types of the TNM staging system

Answer 27

T0- no signs of tumour, just abnormal cells present
T1- small and have not spread
T2- spread to surrounding tissue
T3- spread further into surrounding tissue
T4- spread into nearby bones, nerves, tissues of the skull

Question 28

What are the 3 main treatment types for nasal cancers?

Answer 28

Surgery - 1st line of treatment if tumour is resectable and has not spread. may include neck dissection.

Radiotherapy - usually given after surgery to treat microscopic spread/prophylactic purpose. May be given to treat neck nodes if didn’t have removal.

Chemotherapy - usually given if nasal cancer has spread or come back after initial treatment

Question 29

In what circumstances can radiotherapy be given to treat nasal cancer?

Answer 29

1. Adjuvantly post surgery - treat microscopic spread, prevent disease from returning (with or without chemo)
2. On its own if surgery is unsuitable (with or without chemo)

Question 30

What is the chemotherapy drug most commonly used to treat nasal cancer?

Answer 30

Cisplatin

Question 31

What treatment type is rarely used for nasal cancer?

Answer 31

Immunotherapies

Question 32

In which sinus is cancer most likely to develop?

Answer 32

Maxillary