Nose Flashcards
What is more common in epistaxis; anterior or posterior?
Where does anterior epistaxis occur?
Anterior = 90%
Anterior bleeds occur in Kiesselbach’s plexus
What is the most common cause of nose bleeds in young people?
What are some other causes of epistaxis?
Most common = Trauma Coagulation or platelet disorders Vascular lesions Nasal tumours Foreign body Infection
What are some causes of epistaxis in the elderly?
What role does HTN play?
Age-related mucosal atrophy
Mucosal drying (long time in air conditioned room)
HTN increases severity but is NOT a cause
Where is Little’s area? What is contained there?
Anterioinferior part of nasal septum
Regions of mucosa
What 4 arteries form Kiesselbach’s plexus?
Great palatine
Anterior ethmoid
Sphenopalatine
Superior labial
What artery is common damaged in posterior epistaxis?
What is the underlying pathology?
Sphenoid-palatine artery
Atherosclerosis
What are techniques to control epistaxis?
Pinching of alae (cartilaginous nose) Cautery Anterior nasal packing (rapid rhino) Posterior nasal packing (need admission re: dislodgement) Balloon catheter Endoscopic ligation
What does watery/mucoid discharge indicate?
What does mucopurulent discharge indicate?
What does serosanguinous (yellow with blood) indicate?
What does bloody indicate?
Watery/mucoid = Viral, allergic, vasomotor, CSF leak "halo sign" with blood in middle Mucopurulent = bacterial or foreign body Serosanguinous = neoplasia Bloody = trauma, neoplasia, bleeding disorder, vasculitis
What type of epithelium lines the nasal cavity?
What type of epithelium lines the nasopharynx?
Stratified squamous & respiratory-type pseudo-stratified columnar epithelium Stratified squamous (inferior anterior & posterior, anterolateral walls) & respiratory-type pseudo-stratified columnar epithelium (nasal concha & roof of posterior wall
What are the two types of mucosa in the nasal cavity?
Is there lymphoid tissue?
Respiratory = Schneiderian membrane
Olfactory = superior 1/3 of nasal septum, superior turbinate & cribriform plate
NO
Where do all of the sinuses drain into?
Where is this located?
What sinus-related bone is damaged in base of skull fractures?
Osteomeatal
Middle meatus
Ethmoid
How is sinusitis classified ?
Acute = <4wk Sub-acute = 4-8wks Chronic = >8-12wks
What is the pathogenesis of sinusitis?
What causes the pain in maxillary sinusitis?
Ostial obstruction or dysfunctional cilia permit stagnant mucous -> infection
Negative pressure
What are 3 causes of ostial obstruction? E.g. Of each
Inflammation = URTI or allergy Mechanical = septal deviation, turbinate hypertrophy, polyps Immune = granulomatosis with polyangiitis (GPA), lymphoma
