Nose/Sinus Flashcards
Functions of the Nose? [9]
- Airway for respiration
- Warming & Humidifying air
- Filtering out large particles
- Immune function
- Olfaction
- Drains paranasal sinuses & nasolacrimal duct
- Drains/aerates middle ear via eustachian tube
- Voice Modification
- Pheromone Detection via Vomeronasal organ (of Jacobson) (in animals)
Who is most in need of the nose for respiration? [1]
Neonates, they are obligate nasal breathers.
Describe the epithelium of the nasal cavity? [3]
The sinonasal mucosa is the same as most of the resp. tract. [1]
Ciliated Pseudostratified Columnar Epithelium [1] with Goblet Cells [1]
How does the nose filter out particles? [2]
Coarse hairs (Vibrisae) in the nasal vestibule [1] catch large particles. Smaller ones are caught in mucous and cleared by the cilia [1]
What is the eustachian tube? [3]
Connects nasopharynx and middle ear [1], to aerate/equalise pressure in the middle ear. [1]
Normally its closed but opens on positive pressure or swallowing [1]
What is the nasolacrimal duct? [2]
Carries excess tears from the lacrimal sac to the nasal cavity. [1]
The reason your nose runs when you cry or you can taste eyedrops.
Also known as tear duct [1]
What is the function of sinuses? [3]
Debated but we think:
- Help with vocal resonance
- Decrease weight of skull bones
- Buffer for Trauma
What are the sections of the external nose? (Locate on self) [6]
Glabella Nasion Dorsum Supratip Tip Collumnella
What are the bony sections of the external nose? [2]
The frontal process of the maxilla and the nasal bones.
What are the borders of the internal nose? [4]
Midline, lateral, roof, floor
Midline - Nasal Septum
Laterally - Turbinates
Roof - Cribriform plate of ethmoid bone
Floor - Hard palate (maxilla and palatine bones)
What structures are associated with the internal nose? [2]
The paranasal sinuses
Nasopharynx
What is a turbinate? [1]
What is meatus [1]
A bony scroll like projection from the internal lateral wall of the nose. [1]
There are 3:
- Sup
- Middle
- Inf
Each is associated with its respective meatus which drains the sinuses
Clinical relevance of inner nose [4]
- Septal deviation
- Septal perforation
- Septal haematoma
- Nasal blockage due to inflamed turbinates
How does a septal perforation occur? [2]
Pressure on the blood supply to the septum due to infection, trauma etc. [1]
This leads to necrosis and break down of cartilage leading to perforation. [1]
How would we treat inflamed turbinates? [2]
Topical steroid treatment
Or Turbinate reduction surgery
List the sinuses in the face? [4]
Frontal
2x Maxillary
Ant/Post Ethmoid
Sphenoid
What is drained through the inferior meatus? [1]
Excess tears from the eye (lacrimal sac) along the nasolacrimal.
What is drained by the middle meatus? [4]
- Frontal Sinuses
- Maxillarly Sinuses
- Anterior Ethmoid Sinus
- Middle Ethmoid Sinus
What is drained by the superior meatus? [1]
- Posterior Ethmoid sinus
Rhinosinusitis
- Definition [2]
Rhinosinusitis
- Concurrent inflammation and infection [1] of the nasal passage and paranasal sinuses. [1]
- Acutely its probably bacterial
- Chronic it may be allergic or non-allergic
- Non-allergic comes with or without polyps
What are the anatomical relations of the frontal/ethmoid sinuses? [1]
Anterior Cranial Fossa
What are the anatomical relations of the maxillary sinus? [1]
The orbits
What are the anatomical relations of the sphenoid sinus? [1]
- Optic Nerve
- ICA
- Cavernous Sinus
What are the clinical relevance of the anatomical relations of the sinuses? [4]
Spread of infection E.g.:
- Meningitis
- Intracranial Abscess
- Orbital Sepsis
Risks from surgery E.g.:
- Orbital complications from sinus surgery
Explain the nasal blood supply? Anterior [3] Posterior [3]
Anterior of the nose:
ICA -> Opthalmic Art -> Ant/Post Ethmoid Art.
Posterior of the nose:
ECA -> Maxillary -> sphenopalatine
Define epistaxis [1]
Where does it occur most commonly [1]
Causes [5]
Epistaxis:
(acute haemorrhage from the nose)
Usually occurs in little’s area (anterior of nasal cavity)
Caused by:
- Trauma
- Anticoagulants
- Iatrogenic (surgery)
- Idiopathic
- Hypertension
Explain the nervous innervation of the nose? [3]
Most of the nasal cavity is supplied by the pterygopalatine ganglion at the back of the cavity. [1]
It in turn is mainly facial nerve with some maxillary (Trigeminal V2) involvement… [1]
The olfactory bulb inserts fibres through the roof of the nasal cavity and inserts directly into the forebrain. [1]
Clinical relevance of the nose nerves? [3]
Olfactory dysfunction can occur due to rhinosinusitis, post-viral anosmia (loss of smell) or trauma.
What drains the sphenoid sinus? [1]
The spheno-ethmoid recess
