nose and sinus Flashcards
what physical exams are used for nose?
Nasal illuminator or otoscope to examine vestibule and turbinates
What exam for the sinus?
palpate or percuss, or transilluminate
anosimia
loss of sense of smell
when should loss of sense of smell be of concern
if its on one side, accopanied by behavioral or vision changes
what neurological conditions often have loss of sense of smell
alzheimers and parkinsons
what is epistaxis
nose bleed
two types of nose bleeds
anterior or posterior
Which nose bleed is more dangerous
posterior woodruffs plexus because its more difficult to stop
which nose bleed is more common in children
anterior with kiesselbach plexus.
what is the risk factor for anterior nose bleed
nose picking, low temps, dry air, acute rhinitis,
what are the risk factors for posterior nose bleed
HTN, liver disease, alcholism, cocaine use
what should be a concideration when there are nose bleeds.
bleeding disorders, cancer and anemia
what is rhinitis
inflammation of the mucus membranes of nose with stuffy, obsrcted runny nose.
what are the three types of rhinitis
acute, allergic and attrophic
how are the symptoms /signs of acute and allergic rhinitis different
acute has watery profuce discharge, with low feaver, and allergic ususall as ichy watery eyes and nose.
what rhinitis causes crease above nose and black eyes
allergic rhinitis
which rhinitis has the pale red mucosa
allergic rhinitis
what antigen triggers allergic rhinitis
IgE and esinophils will show up.
What is atrophic rhinitis?
for an unknown cause, nasal mucosa goes to stratified squamous, its atrophying.
signs and symptoms of atrophic rhinitis
painful , foul smelling, loss or sensitive smell, nasal congestion.
upon PE what does atrophic rhinitis show?
dry shiny membranes with atrophy of tissures. Crusts bleed when removed
What is the non allergic, non infectious syndrom cause by parasympathetic dominance?
vasomotor rhinitis
signs and symptoms of vasomortor rhinitis?
like allergic, rhinorrhea, sneezing, puritus, congestion. It can change sides
what would trigger vasomortor rhinitis
emotions, cold air, spicy food, smoke, perfume, weather
PE of vasomortor rhinitus?
swollen inferior nasal turbinates, with dark red bluish mucosa
what are the signs of cocane use?
constant runny nose when affected, congested when not and chronic sore throat
PE with cocane use
chemical burns or septal porforation
What are the 4 bilateral rhinitis?
vasomotor , acute, atrophic, allergic
What are the 4 unilateral rhinitis?
trauma, choanal atresia, foreign body and neoplasm
what is a polyp
soft pedunculated lesion in nasal mucosa
what are polyps linked to
chronic inflammation, ANS dysfunction, chronic infection, and genetics,
who is more likely to have polyps
men who are over 40
what conditons are associated with multibe benign polyps
allergic fungal sinusitis, allergic rhinitis, cyctic fibrosis
what are the signs of polyps?
none to obstruction, postnasal drainage, headaches, snoring and epistaxis
why are nasal septum abscesses dangerous although rare
can lead to cavernous sinus thrombosus - clots
what has a large bulbous reddened nose ?
rhinophyma
what can make rinophyma worse
alcholism and its associated with untreated acne rosacea
who is more likely to have rhinophyma and why is it a concern?
men and it has a psychological tol
what causes rhinosinusitis?
viral, bacterial and fungal
what predesposes one t orhinosinusitus
decongestants, fatigue, dental,gi probles, foreign bodies, food sensitivities
two types of rhinosinusitis
acute suppurative and chronic suppurative
what ane the symptom difference between the two rhinosinusitis
acute is obvous and lasts 1-3 weeks but chronic is subtle
symptons of rhinosinusitus acute
nasal congestion, purulent drainage, facial paoin with headache feaver if bacterial
symptoms of chronic rhinosinusitus
facial pain and feaver absent, with nasal stuffines, dental pain sore throat stuffy ears.
PE for acute rhinosinusitus
purulent secretion middle meatus, completely opaque sinus
PE for chronic rhinosinusitus
tenderness with palpation,
what should you check for when chencing for chronic rhinosinusitus
dental carries, nasal obstruction, conjuntival congestion, extra ocular movements.
what are some serous complications from rhinosinusitus
orbital/periorbital cellulitus and cavernous sinus thrombosis
orbital/periorbital cellulitus is what?
edema, pain when moving eye, very sick
what is cavernous sinus thrombosis
50 percent mortality, with high fever, chills, ocular Palsy 3,4,6 death within days.
upper airway cough syndrome looks like what
cough, halitosis, frequent spitting and throat clearing, post nasal drip.
for what syndrom would you find cobbelstoning of orthopharyngeal mucosa
upperairway cough syndrome.
