Nose Flashcards
Rhinitis due to upper respiratory infection
Acute viral infection of upper respiratory tract
The common cold is also known as
Coryza
Rhinitis has increased risk in:
Kids, people with weakened resistance, and ovulating women
Differentiating Colds From Flu & Sinusitis
Colds: Milder symptoms that usually go way in less than 5 days
-Flu: More severe symptoms
-Sinusitis: Cause more face/head discomfort and usually lasts longer
Treatment of Rhinitis
Self-Care: Fluids, increased humidity, aerobic exercise, rest, chicken soup, zinc, echinacea, sterlile nasal saline, salt water, Acetaminophen or aspririn
-Adjustments and acupuncture
Complications of colds
-Middle ear infection
-Sinusitis
-Lower respiratory infection, especially bacterial
Allergic Rhinitis is also known as
Hay Fever
Allergic Rhinitis is caused by:
Hypersensitivity in the immune system: Use of antibiotics, lack of exposure to common allergens, allergic hypersensitivity
-Mediated IgE antibodies
Allergy symptoms
-Triggered by exposure to allergens
-Can be: Episodic, seasonal or perennial
-Can wax and wane
-Food allergies
Most common atopic (allergic) disorder
Allergic Rhinitis
Manifestations of Allergic Rhinitis
-Obvious: Itchy nose, eyes, palate
-Less obvious: Allergic salute, nasal polyps, tongue clucking
-Pale or bluish mucosa
Allergy Testing
-Skin tests: Most common
-RAST: ELISA/Allergen-specific IgE antibody
Treatment of Allergic Rhinitis
-Preventative: Avoid allergens, exercise indoors, take vitamin C, use HEPA/air quality filter or use mask
-Restorative: SCIT, SLIT, Chiro care, healthy living
-Therapeutic: Elimination diet, drugs
Vasomotor Rhinitis
Nasal congestion/obstruction not due to infection or allergic reaction
Vasomotor Rhinitis is usually triggered by:
-Irritants (smoke), dry air, changes in temp/AC, hormonal changes, anxiety, exercise, spicy foods, beer or wine
Treatment of Vasomotor Rhinitos
Avoid triggers, increase humidity, chiro adjustments, good nutrition, Drugs (decongestant sprays)
Postnasal drip
Mucus in the nose moving towards the oropharynx
Symptoms of Postnasal Drip
-Halking (snorting to clear mucus at back of throat), ticking in back of throat, coughing, hoarseness, sore throat, stuffy nose
Treatment of postnasal drip
Hydration/humidity, nasal saline, gargling with salt water, steam bath/sauna, exercise, chiro care
Diet for Postnasal drip
Decreased dairy, supplemental C and B vitamins
-Neti Pot
Bloody Nose is also called
Epistaxis
Recurrent or posterior nosebleeds can be a sign of:
Serious health problems: Hypertension, bleeding disorders, leukemia, tumors
Is a difference between blood from 1 nostril or 2?
-Blood from one nostril: Ok
-Blood from 2: Check further
Kids usually have _____ nosebleeds
Anterior
Bloody nose are more common in:
Older adults
Anterior Nosebleed
-MC type of nosebleed
-Usually just one nostril (Posterior is both)
-Damaged vessels near the surface of the anterior nasal septum (Kiesselbach’s plexus)
Causes of Anterior nosebleeds
-Overuse of topical decongestants/corticosteroids, anticoagulant meds
-Also: picking nose, cold/dry air or high altitudes, fractured nose
Treatment of Anterior Bleed
Patient sits or stands, tipping head forward a bit to prevent blood from going down throat
-Pinch soft part of nose for 10-15 minutes while clot forms
-Petroleum jelly can help
Posterior Nosebleeds
-Less common but often more serious
-Large vessel in inner nose breaks (both nostrils)
-Can be due to hypertension, use of oral anticoagulants, leukemia or tumors
Medical Diagnosis and treatment
-May require nasal endoscopy, MRI, CT
-Also: Evaluate BP, INR, CBC
Prevention of nosebleeds
Don’t pick, use nasal saline, humidify the air/hydrate the body, adjust blood thinner dose, control blood pressure, stop using topical nasal steroids
Kids with recurrent nosebleeds could have:
Juvenile nasopharyngeal angiofibroma
Broken nose can lead to:
Permenent deformity, chronic nasal obstruction, recurrent sinusitis
Care of broken noses
-Dont adjust an acute broken nose
-Prevent future damage
-Let swelling go down
-Rhinoplasty (Nose Job-Cosmetic)
Deviated Septum can involve:
the bony septum or the soft tissue of the septum
Deviated septum treatment
Seroplasty, Septal Hematoma
Sinusitis
Swelling & inflammation of the sinus cavirties around the nose, leading to impaired sinus drainage
Symptoms of sinusitis
-Nasal obstruction
-Throbbing facial pain, pressure, facial swelling
-Fatigue, malaise
Acute sinusitis is commonly caused by
Common cold viruses
Acute sinusitis causes increased risk in patients w/:
Allergies or asthma, nasal polyps or tumors, or deviated septum
Chronic sinusitis
Same as acute sinusitis, but consider underlying structural problems and polyps
Diagnosis of Sinusitis
-SNOT-16 exam: Decreased nasal patency
-MD: Nasal endoscopy, allergy testing, imaging
Treatment of sinusitis
SNOT-16 to assess baseline & preferably natural care
-Chiro care
-Warm compress
-Rest/Sleep
-Fluids…
-OTC: Nasal decongestants, analgesics
Sinusitis Supplements
Vitamin C,D, fish oil, probiotics
Anosmia
Loss of sense of smell
Anosmia is often due to:
Disorders that lead to nasal obstruction: Allergies, Upper respiratory infections, sinusitis, deviated septum, nasal polyps)
-Use of Zicam nasal spray
Treatment of anosmia
Treat the cause of nasal obstruction
Rosacea
A chronic, inflammatory disease that affects the skin of the nose, cheeks, chin and sometimes eyes
Rosacea: Signs/Symptoms
-Redness, pimples, thickened skin
-Self-consciousness, loss of self esteem, depression
-Common pattern on cheeks, forehead, chin
Triggers of Rosacea
Heat, exercise, sunlight/wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, long term use of topical steroids on the face
Treatment of Rosacea
Skin hygeine, healthy living habits, chiro care, acup, massage therapy, medical care
Rhinophyma
Occurs in some people who have rosacea
-Thickened skin, bulbous appearance
Treatment of Rhinophyma
Rhinoplasty
Sleep Apnea
Interruption of breathing during sleep
Types of sleep apnea
Obstructive Sleep Apnea: More common-closure of upper airway & cessation of airflow
-Central sleep apnea: Much less common-complete absence of breathing effort (nervous system abnormality)
Most common patient with sleep apnea is
Older, overweight male
Factors that increase risk of sleep apnea
-Male (2:1), overweight, excess tissue in nose or throat; big tongue, post-menopausal female, use of alcohol/sedatives before bed, chronic nasal obstruction, COPD, sleeping on back
Snoring and Obstructive Sleep Apnea
-Virtually 100% of people with OSA snore
-Not all people who snore have OSA
-Snoring is exacerbated by: Alcohol, sleeping on back, extreme fatigue
OSA: Obstruction of airflow leads to these primary signs and symptoms
-Increased ventilatory effort
-Sympathetic response
-CNS sleep cycle disruption
Secondary Symptoms of OSA
-Daytime sleepiness
-Fatigue
-Morning headache
-History of frequent car accidents
-Others: Night sweating, restless sleep
OSAL Secondary Symptoms and signs
-Personality changes, bad behaviour and decreased performance at work, school, family and relationship problems, hypertension and/or arrythmias
Diagnosis of Sleep Apnea
-Suspicious symptoms
-Positive Epworth Sleepiness Score (+15 points)
-Hypertension
-Audio or video evidence of snoring
-Polysomnography (sleep diagnosis)
Treatment of Sleep Apnea
*CPAP therapy: Most common
-Weight loss
-Elimination of alcohol/sedatives before bed
-Oral orthotics
-Nasal strips
-Surgery
-Chiro adjustments
-Allergy treatments
-Acupuncture and/or oriental medicine
