Nosebleeds and Sinsuitis

Question 1

Identify the structures of the external nose

Answer 1

Question 2

Identify the bones of the nasal cavity

Answer 2

Question 3

Which bones make up the bony part of the nasal septum?

Answer 3

Ethmoid and vomer

Question 4

What parts of the ethmoid make up the roof of the nasal cavity?

Answer 4

Cribriform plate and crista galli

Question 5

What parts of the ethmoid make up the lateral wall of the nasal cavity?

Answer 5

Superior and middle conchae

Question 6

What part of the ethmoid contributes to the septum?

Answer 6

Perpendicular plate

Question 7

Which Le Fort fractures can disrupt the cribiform plate?

Answer 7

II and III

Question 8

The conchae of the nasal cavity are found on the medial/lateral wall

Answer 8

Lateral

Question 9

Which of the conchae is a bone in itself?

Answer 9

Inferior conchae

Question 10

Identify which epithelium/mucosa corresponds to which number

Answer 10

1 - keratinised stratified squamous epithelium

2 - respiratory epithelium

3 - olfactory mucosa

Question 11

Which cranial nerve is responsible for detecting smell?

Answer 11

Olfactory nerve (CN I)

Question 12

The receptor cells of the olfactory nerve pass through which structure?

Answer 12

Cribiform plate

Question 13

Somatic sensory supply to the nasal cavity comes from which nerves?

Answer 13

CN V1 (anterosuperiorly)

CN V2 (posteroinferiorly)

Question 14

What are the main arteries supplying the nose?

Answer 14

Facial

Maxillary

Ophthalmic

Question 15

What branches of the ophthalmic artery supply the nasal cavity?

Answer 15

Anterior and posterior ethmoidal arteries

Question 16

What branches of the maxillary artery supply the nasal cavity?

Answer 16

Sphenopalatine and greater palatine

Question 17

What branches of the facial artery supply the nasal cavity?

Answer 17

Lateral nasal

Septal branch of superior labial

Question 18

Identify the area highlighted and explain its clinical significance

Answer 18

Kiesselbach’s (Little’s) area - commonest site of epistaxis (nosebleeds)

Question 19

What is the function of conchae?

Answer 19

Create turbulent air flow

Question 20

Identify the meatuses and conchae in the image shown

Answer 20

Question 21

When confirming placement of an NG tube, how far should the tip of the tube be beyond the GOJ?

Answer 21

10cm

Question 22

What are the four groups of paranasal sinuses?

Answer 22

Frontal sinuses

Maxillary sinuses

Ethmoid air cells

Sphenoidal sinuses

Question 23

What do paranasal sinuses secrete and where is it drained?

Answer 23

Secrete mucous which drain via ostia into nasal cavity

Question 24

Which sinuses drain into the middle meatus?

Answer 24

Frontal

Maxillary

Anterior and middle ethmoidal cells

Question 25

What paranasal sinus drains into the sphenoethmoidal recess?

Answer 25

Sphenoidal sinus

Question 26

What paranasal sinus drains into the superior meatus?

Answer 26

Posterior ethmoidal cells

Question 27

What is drained into the inferior meatus?

Answer 27

Lacrimal fluid

Question 28

What is sinusitis?

Answer 28

Inflammation of the mucosa of paranasal sinuses

Question 29

Which nerves provide the sensation of sinusitis?

Answer 29

CN V1 and V2

Question 30

Why is the maxillary sinus most likely to become inflamed?

Answer 30

As its ostia is locatated superiorly and so mucous has to drain against gravity

Question 31

What teeth can grow into maxillae and spread an infection causing sinusitis?

Answer 31

Molar teeth