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ESA 4 - Head and Neck > Nose and Paranasal sinuses > Flashcards

Nose and Paranasal sinuses Flashcards

1
Q

What are the functions of the nose?

A

Olfaction (smell)
Respiration
Filter and humidify
Drain & eliminate paranasal sinus and nasolacrimal duct secretions

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2
Q

Briefly describe the external nose.

A

Provides opening into nasal cavity

Bony and (predominantly) cartilaginous components

Nostrils bounded laterally by alae

Skin covering nose extends into the vestibule

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3
Q

List the bones that constitute the external nose.

A

Nasal bone
Frontal process of maxilla
(Lacrimal bone?)

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4
Q

List the cartilage of the external nose.

A 
Septal cartilage
   - Lateral process of septal cartilage
   - Superior margin of septal cartilage
Major alar cartilage
Minor alar cartilage
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5
Q

What is the most common facial fracture?

A

Nasal fracture

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6
Q

Tell me a little bit about nasal fractures.

A

Most common facial fracture
History of force to the face
Deformity
Complications include septal haematoma

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7
Q

What are the openings to the nasal cavity called?

A

Nares

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8
Q

What are the passage ways from the nasal cavity to the nasopharynx called?

A

Choanae

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9
Q

What bones contribute to the skeleton of the nose?

A 
Frontal
Nasal
Ethmoid (plus its perpendicular plate)
Sphenoid
Vomer
Palatine process of maxilla
Horizontal process of palatine bone
Inferior concha
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10
Q

What are the lateral walls of the nasal cavity?

A 
Conchae (a.k.a. turbinates) (creates 5 passages within cavity - 1 unpaired and 3 paired) (made from ethmoid bone)
Openings into the nasal cavity
- Draining
   - Sinuses
   - Lacrimal apparatus
   - Middle ear
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11
Q

What are on the medial walls (septum) of the nasal cavity?

A

Bony part - ethmoid bone

Cartilaginous part

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12
Q

What re the passages of the naval cavity called?

A

Sphenoidal recess
Superior meatus
Middle meatus
Inferior meatus

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13
Q

Describe the ethmoidal bone.

A

It has a perpendicular plate in the centre with a cribriform plate at the top
Cribriform plate has lots of holes - for olfaction
Two Ethmoidal labyrinths (air cells) joined by the cribriform plate
The cribriform plate has the crista galli on top
Crista galli anchors falx cerebri
Infundibulum - a groove penetrating ethmoidal labyrinth and drains frontal sinus

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14
Q

What are the openings inside the nasal cavity?

A

Cribriform plate - olfaction
Sphenopalatine foramen
Incisive foramen - nerve and artery exchange (to mouth)
Foramen cecum - nasal veins to superior sagittal sinus
(some individuals)

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15
Q

Give an overview of the blood supply of the nasal cavity.

A 
Facial artery (external carotid artery)
   - Brachial superior labial artery
Maxillary artery (external carotid artery)
   - Sphenopalatine artery
   - Greater palatine artery
Ophthalmic artery (internal carotid artery)
   - Anterior ethmoidal artery
   - Posterior ethmoidal artery
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16
Q

What is the clinical significance to nasal blood supply?

A

An area of anastomoses:
- Kiesselbach’s plexus - (a.k.a. Little’s area)
So any damage can lead to epistaxis (nose bleed)

17
Q

Give an overview of the venous drainage of the nasal cavity

A

Drains to:

  • Cavernous sinus
  • Facial vein
  • Pterygoid plexus
18
Q

Name some deformities of the nose and nasal cavity.

A 
Nasal septum deviation
   - Congenital / acquired
   - Narrowing / obstruction
Nasal septum necrosis
   - Injury to nasal septum
   - Saddle nose deformity
19
Q

Give an overview of the innervation of the nasal cavity.

A

Special sensory innervation
- CN I: Olfactory Nerve
General sensory innervation to septum and lateral walls
- Ophthalmic (CN V1) and Maxillary (CN V2)
Posterior inferior of nasal cavity
- Maxillary nerve
- Nasopalatine nerve (septum) & branches greater
palatine nerve to lateral wall
Anterior superior of nasal cavity
- Ophthalmic nerve
- Branches of nasociliary nerve

20
Q

Give an overview of the innervation of the external nose.

A 
Infraorbital nerve (CN V2)
External nasal nerve (CN V1)
21
Q

What is the epithelium of the respiratory region of the nasal cavity?

A

Pseudostratified columnar ciliated, with goblet cells

22
Q

What is the epithelium of the olfactory region of the nasal cavity?

A

Olfactory cells with olfactory receptors

23
Q

What are the paranasal sinuses?

A

Paired, mucous membrane lined out-pocketings of the nasal cavity, draining into the nasal cavity

Maxillary
Frontal
Sphenoid
Ethmoid

24
Q

What is the function of the paranasal sinuses?

A

Unknown
May contribute to conditioning of inspired air

Reduce weight of skull

25
Q

Describe the maxillary sinus.

A 
Roof = floor of orbit
Floor = alveolar part of maxilla
Posteriorly = pterygopalatine & infratemporal fossae

Present at birth, enlarging from about 8yrs
Opens into middle meatus

26
Q

Describe the frontal sinus.

A

Not present at birth
Variable in size

Related to anterior cranial fossa and the orbit
Drains into the middle meatus through the frontonasal duct

27
Q

Describe the sphenoid sinus

A

Small at birth, enlarging after puberty

Related to:

  • Pituitary fossa & middle cranial fossa
  • Cavernous sinus and inferior carotid artery
  • Posterior cranial fossa & pons
  • Roof of nasopharynx
28
Q

Describe the ethmoidal sinus.

A

Ethmoid air cells between orbit and nasal cavity

Anterior cells
 - Middle meatus via infundibulum
Middle cells
 - Bulla
   - Directly into middle meatus
Posterior cells
 - Superior meatus
29
Q

What is the clinical importance of the nasal cavities and the spread of infection?

A

Infection can spread to:

  • Anterior cranial fossa
  • Middle ear
  • Paranasal sinuses
  • Lacrimal apparatus & conjunctiva
30
Q

What is rhinitis?

A 
Inflammation of the nasal mucosa
- Leading to swelling & increased volume of
  secretion
Causes include:
- Infective (viral)
- Allergic
- Nasal polyps
31
Q

Tell me abut nasal polyps.

A

Prevalence ~2-4%
Might be linked to chronic rhinosinusitis
Grow close to the ostiomeatal complex of the nasopharynx

Nasal obstruction
- Snoring/obstructive sleep apnoea

32
Q

What is sinusitis?

A

Inflammation of the mucosal lining of the sinuses

Acute: 7 - 30 days
Sub-acute: 4-12 weeks
Chronic: >90 days

Infection

  • Viral with secondary bacterial infection
  • S pneumonia & H influenzae

ESA 4 - Head and Neck (16 decks)

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