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Ophthalmology & ENT > Nose > Flashcards

Nose Flashcards

1
Q

What is rhinosinusitis? What types are there?

A

Inflammation of the nose and paranasal sinuses

Acute
Chronic with polyps
Chronic without polyps
Allergic

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2
Q

Diagnostic criteria of rhinosinusitis?

A

At least 2 of these symptoms

  • nasal blockage, congestion
  • nasal discharge
  • facial pain
  • reduced sense of smell
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3
Q

What is acute rhinosinusitis?

Which bugs?

A

The common cold

Rhinovirus
Coronavirus
RSV
Parainfluenza

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4
Q

Management of acute rhinosinusitis?

A

Self-limiting

If no improvement after 5 days you can prescribe intranasal corticosteroids

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5
Q

List the sinuses in the face? And vaguely describe where they are?
Draw a diagram?

A

Frontal sinuses: above eyes

Ethmoid sinuses: in corner of eyes, either side of nose

Maxillary sinuses: either side of nose

Sphenoid sinuses: right at the back of the nose

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6
Q

What is the function of the sinuses?

Describe their structure?

A

Air filled cavities in the bones around the nose

They’re lined with ciliated mucosa which sweep mucus into the nostrils

They also lighten the skull and improve sound of voice

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7
Q

What is a nasal polyp?

A

A swelling/growth of the nasal or sinus mucosa which prolapses into the nasal cavity

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8
Q

What causes nasal polyps?

A

Long term inflammation of the nose and sinuses

Chronic rhinosinusitis, 
Asthma
Cystic fibrosis
Allergic rhinitis
Aspirin sensitivity
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9
Q

Pathophysiology of nasal polyps?

How does aspirin sensitivity cause nasal polyps?

A

Unknown, but it is due to chronic inflammation

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10
Q

How does aspirin sensitivity present?

Why?

A

Aspirin sensitivity polyps are due to metabolism of arachidonic acid

Cause asthma like symptoms like wheezing and nasal polyp formation

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11
Q

Presentation of chronic rhinosinusitis?

A 
Watery anterior rhinorrhoea
Sneezing
Purulent post-nasal drip
Nasal obstruction
Sinusitis
Mouth breathing
Snoring
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12
Q

Where do nasal polyps usually arise?

A

Middle meatus
Bilateral

Sometimes maxillary antrum and nasopharynx

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13
Q

What’s the structure of the nose?

Draw a picture?

A

Nostrils are known as nares

Inside there are three turbinates (inferior, middle and superior) which are small thin shell-form bones

These extend backwards

Various drainage points of the sinuses are hidden under the turbinates

At back of nasal cavity is the opening to the eustachian tube

Above nasal cavity is the frontal sinus

At the back (above opening to E tube) is the sphenoid sinus

Below nasal cavity is hard and soft palate, below which is the oral cavity

The nasal septum separates both sides

http://ent4students.blogspot.co.uk/2012/12/nose-anatomy.html

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14
Q

Management of chronic rhinosinusitis?

A

Intranasal corticosteroids
Nasal saline irrigation

Consider long term abx if obvious infection and no improvement after 4 weeks

Remove polyps

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15
Q

What causes chronic rhinosinusitis?

A 
Allergic
Infections
Foreign body
CSF leak after head injury
Pregnancy
HIV, TB
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16
Q

What’s the differential diagnosis of nasal congestion in children?

A 
Acute or chronic rhinosinusitis
Allergic rhinosinusitis
Large adenoids
Tumour (angiofibroma)
Foreign body
17
Q

What’s the differential diagnosis of nasal congestion in adults?

A 
Acute or chronic rhinosinusitis
Allergic rhinosinusitis
Deviated nasal septum
Granuloma (TB, granulomatosis)
Tricyclics
18
Q

Management of allergic rhinosinusitis?

A 
Avoid allergen
Nasal saline irrigation
Intranasal corticosteroid
Oral prednisolone
Immunotherapy
Allergy vaccine
19
Q

What are adenoids? Where are they?

A

Superior most tonsils

Found right at the back of the nasal cavity, in the roof of the nasopharynx

20
Q

When do adenoids become problem?

A

They enlarge up to the age of 5-7

They are supposed to shrink after school age

Sometimes they can become so big they can obstruct or even block airflow through nasal passages

Causing mouth breathing, snoring and sleep apnoea

21
Q

What are:

  • adenoid hypertrophy
  • adenoid facies?
A

AH: enlargement of adenoids (enlargement of size of cells)

AF: when AH causes atypical appearance of the face

22
Q

N

A

elongated face, mouth breathing, short upper lip, prominent incisors, high arched palate

23
Q

How to manage epistaxis?

A
  1. ABCDE
  2. Pressure to lower part of nose
  3. Lidocaine spray or adrenaline soaked cotton wool (to cause vasoconstriction)
  4. Cautery with silver nitrate
  5. Anterior nasal pack
  6. Posterior nasal pack?
24
Q

Two types of epistaxis?

A

Anterior

Posterior

25
Q

Blood supply causing anterior epistaxis?

A

Little’s area

Where many arteries in area meet

Ophthalmology & ENT (14 decks)

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