Nose - part 2 Flashcards
Which 2 aa from ICA end up in nose
Anterior ethmoidal
Posterior ethmoidal
What are the 4 aa from the ECA that end up in the nose?
Sphenopalatine (main)
Sup labial
Lat nasal
Greater palatine
Where do nosebleeds usually arise from?
Little’s area
Causes of nosebleeds (7)
Trauma Infection Inflammation Neoplastic Decr platelet function Congenital - HHT Cocaine use
Key Hx points nosebleed
Unilateral predominance Ant/post Frequency Pain Drunk Incr BP NSAIDs Volume Co-morbidities Antecedents Mx technique Smoker Nut allergy
Significant co-morbidities in nasal Hx (5)
HTN Cardiac problems Anticoagulation use Previous nasal surgery Clotting disorder
1st aid Mx nosebleed
Site forward
Pink fleshy bit of nose for 10mins
Avoid swallowing + ice pack
Cauterising nosebleed
1:200,000 adrenaline + AgNO4 stick 1-2s
Do feeder vessel before main one
Dab clean w/ naseptin
Next step for nosebleed if cautery fails
Nasal packing (ant/ then post)
leave for 24-48hrs
+ prophylactic Abx
Negative of nasal packing
Very uncomfortable
Last resort nose bleed?
SPA ligation
What needs to be ruled out during a nose fracture Hx?
Facial injury
C spine injury
Head injury
Mx of septal haematoma
Drain asap
ABx to prevent 2’ infection
Mx nose fracture
Send home
Review in 5-7 days if v swollen
Manipulate under GA/LA at under 2 w
Mx of septal deviation
Removal cartilage and reposition cartilage surgically
