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Head and Neck > Nose & Sinus - Anatomy and Physiology > Flashcards

Nose & Sinus - Anatomy and Physiology Flashcards

1
Q

What is the primary nasal function?

A

To function as an airway in respiration.

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2
Q

Describe the sinonasal mucosa.

A

Respiratory ciliated columnar epithelium with goblet cells.

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3
Q

Why is nasal function so important in neonates?

A

Neonates are obligate nasal breathers.

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4
Q

What changes does the nasal passage carry out to the air coming in?

A
  • Warms the air
  • Humidification
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5
Q

What are some of the basic protective functions of the nasal passage?

A
  • Filtration of large particulate matter by coarse hairs (vibrisae) in the nasal vestibule.
  • Mucus production, trapping and ciliary clearance of particulate matter.
  • Immune protection
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6
Q

Smell is one of the other important functions of the nose. What is the medical terms?

A

Olfaction.

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7
Q

The nasal passage is also responsible for the drainage of what?

A
  • Drainage/aeration of the middle ear via Eustachian tube
  • Drainage of paranasal sinuses and nasolacrimal duct
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8
Q

What are the function of the sinuses?

A

Debated, but some thoughts are..

  • Help with vocal resonance
  • Decrease the weight of skull and facial bones
  • Act as buffer for trauma
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9
Q

How much of the external nose is bone vs cartilage?

A

• 1/3rd bony, 2/3rd cartilage

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10
Q

What are the structures which make up the external nose?

A

.

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11
Q

What is the name of the midline partition in the internal nose?

A

Nasal septum.

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12
Q

What form the lateral walls of the internal nose?

A

Turbinates

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13
Q

What froms the “roof” of the internal nose?

A

Cribiform plate

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14
Q

What is the name of the “floor” of the internal nose?

A

Hard palate

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15
Q

What are the associated structures of the internal nose?

A

Paranasal sinuses

Nasopharynx

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16
Q

What are the structures which make up the nasal septum?

A
  • Perpendicular plate of ethmoid bone.
  • Vomer bone
  • Septal Cartilage

(mainly)

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17
Q

What is the clinical relevance of the septum?

A

Deviation may occur. (this can be congenital or aquired)

Septal perforation and haematoma may occur.

18
Q

What are turbinates?

A
  • Bony scroll-like projections from lateral wall of nose.
19
Q

How many and what are the names of the turbinates? (also known as conchae)

A

3

  • Superior
  • Middle
  • Inferior
20
Q

What are the names of the air pathyways created by these bony projections?

A

These pathways are called meatuses.

21
Q

What is the clnincal relevance of the turbinates?

A
  • Usually the only clinical relevance is the inferior turbinate.
  • This can cause blockages due to inflammation or infection.
  • Usually this can be managed through the use of topical steroid sprays.
  • If the issue requires so there can be surgical management with turbinate reduction surgery.
22
Q

What are the paranasal sinuses?

A

Air cavities in the bones of the face.

23
Q

What are the names of the paranasal sinuses?

A
  • Frontal
  • Maxillary (x2)
  • Ethmoid (anterior and posterior)
  • Sphenoid
24
Q

What is the function of the Nasolacrimal duct and where does it drain?

A

The nasolacrimal duct acts to drain tears from the eye – it opens into the inferior meatus.

25
Q

Which sinuses drain into the middle meatus?

A

The frontal, maxillary and anterior ethmoidal sinuses open into the middle meatus.

26
Q

What sinuses drain into the superior meatus?

A

The posterior ethmoid and sphenoid sinuses drain into the superior meatus.

27
Q

What is the clinical relevance of knowing the associations between a sinus and where it drains?

A

Relevant in Rhinosinusitis, which reflects a concurrent inflammatory an dinfective process that affects the nasal passageway and contiguous para nasal sinuses.

28
Q

What are the 2 subtypes of rhinosinusitis?

A
  • Acute (bacteial) (less than 12 weeks)
  • Chronic (more than 12 weeks) - Allergic and Non Allergic, there may also be polyp formation.
29
Q

What is the importnat anatomical relation for the frontal and ethmoid sinuses?

A

Anterior cranial fossa

30
Q

What are the important anatomical relations of the maxillary sinus?

A

Orbits

31
Q

What are the important anatomical relations of the sphenoid sinus?

A

Optic nerve

Internal carotid artery

Cavernous sinus

32
Q

Why is it important to understand the the anatomical relations of the various sinuses in the head?

A

Spread of infections

  • Meningitis
  • Intracranial abscess
  • Orbital sepsis

Risks of Surgery

  • CSF leak
  • Oribital complications (worst case scenario - blindness)
33
Q

How is the blood supply of the nasal passage roughly divided?

A

Broadly divided into an anterior and posterior supply

34
Q

Outline the anterior blood supply in the nasal passage.

A

Derived from branches of internal carotid artery

  • Ophthalmic > Anterior/posterior ethmoid arteries
35
Q

Outline the posterior blood supply in the nasal passage.

A

Derived from branches of external carotid artery

  • Sphenopalantine
36
Q

What is Little’s Area?

A

Area in the anterior nose where there are lots of anastomoses between the supplying arteries.

37
Q

What is Epistaxis? What are the common causes?

A

Nose bleed

(occurs mostly from Little’s Area)

  • Trauma aka nose picking
  • Anticoagulants
  • Iatrogenic – surgery
  • Idiopathic
  • Hypertension
38
Q

What is the venous drainage of the nose?

A

The veins of the nose tend to follow the arteries. They drain into the pterygoid plexus, facial vein or cavernous sinus.

39
Q

Outline the innervation of the nose in terms of the “special innervation”.

A
  • Special sensory innervation refers to the ability of the nose to smell.
  • This is carried out by the olfactory nerves. The olfactory bulb, part of the brain, lies on the superior surface of the cribriform plate, above the nasal cavity.
  • Branches of the olfactory nerve run through the cribriform plate to provide special sensory innervation to the nose.
40
Q

Oultine the nerves involved in the general innervation of the nasal cavity.

A
  • General sensory innervation to the septum and lateral walls is delivered by the nasopalatine nerve (branch of maxillary nerve) and the nasociliary nerve (branch of the ophthalmic nerve).
  • Innervation to the external skin of the nose is supplied by the trigeminal nerve.

Head and Neck (13 decks)

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