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CP2 - ENT > Nose part 1 > Flashcards

Nose part 1 Flashcards

1
Q

Functions of the nose

A 
Breathing
Smell 
Humidifying + filtering air 
85% taste 
Defence against pathogens 
Equalisation + ventilation of middle ear 
Drainage of paranasal sinuses + NLD
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2
Q

Where are the nasal vestibular bodies

A

Inferior to the inf nasal turbinates

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3
Q

What is the upper 1/3 of the external nose made of?

A

Bone

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4
Q

What is the lower 2/3 of the external nose made of

A

Cartilage

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5
Q

What is the vestibule?

A

The nasal entrance

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6
Q

What is the nasal vestibule enclosed by?

A

Ala

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7
Q

What important pathologies are common at the vestibule

A

BCC/SCC

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8
Q

What bones form the nasal septum posteriorly (2)

A

Ethmoid

Vomer

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9
Q

What important structure does the nasal septum contain?

A

Little’s area

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10
Q

What structures drain into the middle meatus?

A

NLD

Sinuses

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11
Q

Why is the inferior turbinate blocked by autonomic control?

A

To prevent drying and allow regeneration

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12
Q

What structures do the nasal cavities end in?

A

Choanae

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13
Q

What is the line between the nasopharynx and oropharynx called?

A

Soft palate

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14
Q

Key features to ask about in a nose Hx (6)

A 
Obstruction 
Bleeding 
Pain 
Discharge 
Smell 
Snoring/OSA
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15
Q

Red flags nasal Hx

A 
Nasal bleeding 
Polyps
Neck lumps 
Numb face 
Eye Sx - unilateral , proptosis, Diplopia, eye displacement
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16
Q

Causes of nasal obstruction

A 
Infectious 
Allergy 
Developmental (septal deviation) 
Traumatic
Iatrogenic 
Drugs 
Neoplastics 
Inflamm/systemic disease
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17
Q

What is Rhinitis

A

Inflammation nasal lining

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18
Q

Common Sx rhinitis (4)

A

Nasal congestion
Rhinorrhoea
Post-nasal drip
Sneezing + irritation

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19
Q

Diagnosis of rhinorrhoea made by?

A 
Nasal Hx features + allergy test. 2+ of:: 
Blockage/congestion
Facial pain/P 
Decr smell 
Presence endoscopic features
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20
Q

What type of reaction is allergic rhinitis?

A

T1HS

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21
Q

causes of allergic rhinitis

A

Int - grass/pollen
Persistent - house dust mite, mould, cat/dog
Food allergen rhinitis

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22
Q

Signs allergic rhinitis (3)

A

Inflamed nasal turbinates + mucosa
Watery discharge
Gross turbinate hypertrophy

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23
Q

Mx allergic rhinitis

A

Avoid allergy

Dx (PO/TO anti H, Na cromoglycate spray)

24
Q

Secondary effects of infective rhinitis (2)

A

OM

Long standing rhinosinusitis

25
Q

Acute Sx infective rhinitis (4)

A

Systemic upset
Pyrexia
Rhinorrhoea
Pus

26
Q

Chronic Sx infective rhinitis

A

PN drip
Decr concentration
Facial pain

27
Q

Which non-allergic rhinitis is a diagnosis of exclusion?

A

Vasomotor

28
Q

What is medicamentosa due to?

A

Overuse of meds

29
Q

Mx medicamentosa

A

Stop decongestant
Steroids
Surgery

30
Q

What is atrophic rhintiis

A

Thickened secretions dry –> large crust + unpleasant odor

Req bleeding

31
Q

Mx atrophic rhinitis

A

Soften crust w/ steam inhal + glycerine

Surgically close

32
Q

Def acute rhinosinusitis

A

<4 w

33
Q

Def subacute rhinosinusitis

A

4-12w

34
Q

Def chronic rhinosinusitis

A

> 12w

35
Q

Where does the posterior ethmoid sinuses drain

A

superior meatus

36
Q

Which sinuses drain into the middle meatus

A

Ethmoid
Frontal
Maxillary

37
Q

Which sinus is most commonly affected by acute rhinosinusitis?

A

Maxillary

38
Q

Features acute rhinosinusitis

A

Severe unilateral pain over infected sinus
Malaise
Pyrexia

39
Q

Tx acute rhinosinusitis

A

Simple analgesia
Steam inhalation
>10days - nasal CCS
TO xylometolazine - 5 days max

40
Q

Who to Rx for surgery - rhinosinusitis (3)

A

Progressive pain
Headache
Focal neurology

41
Q

Chronic sinusitis

A

Longstanding mucosal inflammation leading to cystic polypoid changes
Swollen mucosa narrows ostia –> cycle

42
Q

Features of chronic sinusitis (4)

A

Usually painless
Hx sinogenic pain - exaccerbated during URTI
Purulent secretions

43
Q

DDx chronic sinusitis (3)

A

Midfacial segment pain
Migraine
Cluster headaches

44
Q

Tx chronic sinusitis

A

Beclomethasone 2m (take lying down)
BS Abx
Nasal douching
Surgery?

45
Q

Which sinusitis is life threatening?

A

Frontal

46
Q

PS frontal sinusitis

A

Tender forehead especially when percussed

Worse on bending over

47
Q

How can frontal sinusitis progress

A

into orbit –> blindness

Into cranial cavity –> abscess

48
Q

Tx frontal sinusitis

A

BS Abx

Decongestants

49
Q

Complications of rhinosinusitis (7)

A 
Pre-orbital cellulitis 
Mucoceles 
Meningitis 
Cavernous sinus thrombosis 
Brain abscess 
Extradural abscess 
Subdural abscess
50
Q

Which sinus does pre-orbital cellulitis come from

A

Ethmoidal

51
Q

Which is the most ocmmon rhinosinusitis complication?

A

pre-orbital cellulitis

52
Q

Tx pre-orbital cellulitis

A

High dose Abx

Obseve

53
Q

PS mucocoele (2)

A

Facial swelling

Changes to eye orientation

54
Q

Tx mucocele

A

Surgical drainage

55
Q

PS cavernous sinus thrombosis (6)

A 
Orbit swells 
Fever
Rigors 
Headache 
Change in consciousness 
CN III, IV, VI palsies
56
Q

Tx cavernous sinus thrombosis

A

High dose Abx

CP2 - ENT (13 decks)

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