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FRCOphth Part1 - paranasal sinuses > Paranasal Sinuses > Flashcards

Paranasal Sinuses Flashcards

1
Q

What are the paranasal sinuses?

A

Cavities in the interior of the maxilla, frontal, sphenoid, and ethmoid bones

They vary in size and shape among individuals and ages.

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2
Q

What is the primary function of the paranasal sinuses?

A

To act as resonators to the voice and reduce the weight of the skull

When blocked, the quality of the voice can change markedly.

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3
Q

How do the sinuses communicate with the nasal cavity?

A

Through relatively small apertures

This communication is essential for drainage and airflow.

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4
Q

What type of epithelium lines the paranasal sinuses?

A

Pseudostratified columnar ciliated epithelium

The cilia help move mucus into the nasal cavity.

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5
Q

What role does the cilia play in the sinuses?

A

Moves mucus into the nasal cavity

This action is crucial for maintaining sinus health.

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6
Q

Where are the maxillary sinuses located?

A

In the bodies of the maxillae

They are usually the largest of the paranasal sinuses.

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7
Q

Describe the shape of the maxillary sinuses.

A

Pyramid-shaped

The base forms part of the lateral wall of the nose.

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8
Q

What forms the roof of the maxillary sinus?

A

Orbital plate of the maxilla

It contains the infraorbital nerve and blood vessels.

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9
Q

How far below the floor of the nose does the floor of the maxillary sinus lie?

A

About 1.25 cm

This positioning is important for dental and sinus health.

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10
Q

What can cause conical projections on the floor of the maxillary sinus?

A

The apexes of the roots of the two premolar and three molar teeth

These projections can affect sinus health.

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11
Q

What structures are contained in the anterior wall of the maxillary sinus?

A

Canals for the anterior and middle superior alveolar nerves and blood vessels

These structures are branches of the infraorbital nerve.

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12
Q

What is the relationship of the posterior wall of the maxillary sinus?

A

Related to the infratemporal fossa

It contains the posterior superior alveolar nerves and blood vessels.

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13
Q

What bones contribute to the medial wall of the maxillary sinus?

A
  • Maxilla
  • Uncinate process of the ethmoid
  • Inferior concha
  • Vertical plate of the palatine bone

These contributions help define the sinus structure.

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14
Q

True or False: The maxillary sinuses are the smallest of the paranasal sinuses.

A

False

They are usually the largest paranasal sinuses.

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15
Q

Fill in the blank: The mucus produced by the glands moves into the nasal cavity by _______.

A

The action of the cilia of the lining epithelium

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16
Q

What is the maxillary sinus commonly indented by?

A

Bony ridges and septa

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17
Q

How may the maxillary sinus be divided?

A

Completely or incompletely into two parts

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18
Q

Where does the maxillary sinus communicate with the nose?

A

Through an opening in the superior part of its base. Pierces hiatus semilunaris

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19
Q

What pierces the in the maxillary sinus?

A

A single small opening or small openings

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20
Q

Into which part of the nose does the maxillary sinus discharge?

A

Middle meatus of the nose

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21
Q

What is the primary nerve supply for the area?

A

The area is supplied by the anterior and posterior superior alveolar branches of the infraorbital and maxillary arteries

This indicates the importance of these branches in providing sensory innervation.

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22
Q

From which arteries does the arterial supply originate?

A

Anterior and posterior superior alveolar branches of the infraorbital and maxillary arteries

These arteries are crucial for blood supply in the region.

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23
Q

How do the veins drain the maxillary sinus?

A

Veins drain through the ostium and join the venous plexuses in the nose

This drainage pathway is important for venous return.

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24
Q

What is the lymphatic drainage of the maxillary sinus?

A

Lymphatic vessels pass through the ostium and drain into the submandibular nodes

This indicates the lymphatic route involved in immune response.

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25
Q

Fill in the blank: The arterial supply is from the _______ and posterior superior alveolar branches.

A

anterior

This highlights the specific branches involved in the arterial supply.

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26
Q

True or False: The veins drain directly into the heart.

A

False

Veins drain into the venous plexuses in the nose before returning to the heart.

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27
Q

Where are the frontal sinuses located?

A

Within the frontal bone

The frontal sinuses are situated above the medial end of the eyebrows and extend backward into the medial part of the roof of the orbit.

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28
Q

What separates the two frontal sinuses?

A

A bony septum

The bony septum frequently deviates from the median plane.

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29
Q

What is the shape of the frontal sinuses?

A

Roughly triangular

The frontal sinuses extend upward and backward. Bony partitions divide them into a number of segments

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30
Q

How does the development of the frontal sinus vary among individuals?

A

It can be excessive, absent, or poorly developed

In some cases, one sinus may cross the midline or invade adjacent bones.

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31
Q

What is the relationship of the anterior wall of the frontal sinus?

A

Related to the skin of the forehead and the supraorbital and supratrochlear nerves

The anterior wall is thin and sensitive.

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32
Q

What structures does the posterior wall of the frontal sinus relate to?

A

The meninges and the frontal lobe of the cerebral hemisphere

This wall is also thin, making it significant in surgical considerations.

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33
Q

What is the relationship of the floor of the frontal sinus?

A

Related to the orbit and the nose

The floor is critical for the sinus’s drainage and communication.

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34
Q

How does the frontal sinus communicate with the nose?

A

Through the frontonasal duct or the ethmoidal infundibulum

These structures open into the hiatus semilunaris in the middle meatus.

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35
Q

What supplies the mucous membrane of the frontal sinus?

A

A branch from the supraorbital nerve

This occurs as the nerve passes through the supraorbital notch or foramen.

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36
Q

What arteries supply blood to the frontal sinus?

A

Supraorbital and anterior ethmoidal arteries

These arteries are vital for the sinus’s vascularization.

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37
Q

Where do the veins draining the frontal sinus empty?

A

Into the venous plexuses of the nose and the supraorbital vein

This drainage is important for maintaining sinus health.

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38
Q

Where do the lymphatic vessels from the frontal sinus drain?

A

Into the submandibular nodes

This drainage pathway is crucial for immune response.

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39
Q

Where do the lymphatic vessels drain?

A

Into the submandibular nodes

This refers to the lymphatic drainage system associated with the head and neck.

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40
Q

What bone houses the sphenoidal sinuses?

A

Sphenoid bone

The sphenoidal sinuses are located within the body of the sphenoid bone.

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41
Q

What is a unique characteristic of sphenoidal sinuses?

A

They vary most in their extent and development among air sinuses

Sphenoidal sinuses can differ significantly between individuals.

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42
Q

What structures may the sphenoidal sinus extend into?

A

Pterygoid processes or greater wing of sphenoid

In some individuals, the sphenoidal sinus can encroach on the basilar part of the occipital bone.

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43
Q

What separates the two sphenoidal sinuses?

A

Vertical median septum

This septum is often deviated to one side of the midline.

44
Q

What is a common asymmetry found in sphenoidal sinuses?

A

One sinus is often much larger than the other

This size difference can lead to one sinus extending across the midline.

45
Q

What is located anteriorly to the sphenoidal sinus?

A

Nasal cavity and ethmoidal sinuses

The anterior wall of the sphenoidal sinus is in close relation to these structures.

46
Q

What is located posteriorly to the sphenoidal sinus?

A

Posterior cranial fossa and pons

The posterior wall of the sphenoidal sinus faces these structures.

47
Q

What lies laterally to the sphenoidal sinus?

A

Cavernous sinus

The cavernous sinus contains the internal carotid artery and the abducent nerve.

48
Q

What is the superior relation of the sphenoidal sinus?

A

Hypophysis cerebri, optic nerves, and optic chiasma

This indicates the sinus’s proximity to key neurological structures.

49
Q

What is the inferior relation of the sphenoidal sinus?

A

Nasopharynx and pterygoid canal

This highlights the sinus’s anatomical connections below it.

50
Q

Where does the sphenoidal sinus open into?

A

Nasal cavity into the sphenoethmoidal recess

This opening occurs above the superior concha.

51
Q

What supplies the mucous membrane of the sphenoidal sinus?

A

Posterior ethmoidal nerves and orbital branches of the pterygopalatine ganglion

These nerves provide sensory innervation to the sinus.

52
Q

What is the arterial supply for the sphenoidal sinus?

A

Posterior ethmoidal arteries

These arteries provide the necessary blood supply to the sinus.

53
Q

Where do the veins from the sphenoidal sinus drain?

A

Into the posterior ethmoidal veins

This drainage is part of the venous return from the sinus.

54
Q

Where do the lymphatic vessels from the sphenoidal sinus drain?

A

Into the retropharyngeal nodes

This indicates the lymphatic drainage pathway from the sinus.

55
Q

What do the ethmoidal sinuses consist of?

A

A honeycomb of air cells

These cells lie within the ethmoid bone.

56
Q

What do the lymphatic vessels of the anterior and middle groups of ethmoidal air cells drain into?

A

Submandibular nodes

57
Q

What do the lymphatic vessels of the posterior group of ethmoidal air cells drain into?

A

Retropharyngeal nodes

58
Q

What are the ethmoidal sinuses composed of?

A

A honeycomb of air cells

59
Q

Where are the ethmoidal sinuses located?

A

Within the ethmoid bone between the nose and the orbit

60
Q

How many air cells can the ethmoidal sinuses have?

A

As few as 3 or as many as 18

61
Q

What are the three groups of ethmoidal air cells?

A

Anterior, middle, and posterior

62
Q

What structures are superiorly related to the ethmoidal sinuses?

A

Anterior cranial fossa, meninges, and frontal lobe

63
Q

What structure lies inferiorly to the ethmoidal sinuses?

A

The nose

64
Q

What is the lateral relation of the ethmoidal sinuses?

A

Orbital cavity

65
Q

What separates the ethmoidal sinuses from adjacent structures?

A

Paper-thin bone

66
Q

What can infection of the ethmoidal sinuses easily spread to?

A

The orbit, causing orbital cellulitis

67
Q

How do the anterior group of air cells communicate with the nose?

A

Through openings into the ethmoidal infundibulum or the frontonasal duct

68
Q

Where does the middle group of air cells open into?

A

The middle meatus of the nose

69
Q

Where does the posterior group of air cells open into?

A

The superior meatus of the nose

70
Q

What supplies the ethmoidal air cells with nerves?

A

Anterior and posterior ethmoidal nerves and orbital branches of the pterygopalatine ganglion

71
Q

What is the arterial supply of the ethmoidal air cells?

A

Anterior and posterior ethmoidal arteries and sphenopalatine artery

72
Q

True or False: The venous drainage of the ethmoidal air cells corresponds to the arterial supply.

A

True

73
Q

What are the paranasal sinuses?

A

Diverticula from the nasal mucosa

74
Q

At what stage are paranasal sinuses present at birth?

A

Rudimentary or absent

75
Q

When do the paranasal sinuses rapidly increase in size?

A

At the eruption of permanent teeth and puberty

76
Q

What is sinusitis?

A

Infection of the paranasal sinuses

77
Q

What can cause maxillary sinusitis?

A

Extension from an apical dental abscess

78
Q

Why is the maxillary sinus particularly susceptible to infection?

A

Drainage orifice is near the roof of the sinus

79
Q

How does fluid accumulation affect sinus drainage?

A

The sinus must fill with fluid before it can effectively drain

80
Q

Where does the frontal sinus drain?

A

Into the hiatus semilunaris

81
Q

What is the relationship between frontal sinusitis and maxillary sinusitis?

A

A patient with frontal sinusitis nearly always has maxillary sinusitis

82
Q

What is the commonest cause of orbital cellulitis?

A

Ethmoidal sinusitis

83
Q

Why can infection spread easily from ethmoidal sinusitis?

A

The medial wall of the orbit is paper-thin

84
Q

What is the drainage site for the maxillary sinus?

A

Middle meatus through hiatus semilunaris

85
Q

What is the drainage site for the frontal sinus?

A

Middle meatus via frontonasal duct or ethmoidal infundibulum

86
Q

What is the drainage site for the sphenoidal sinuses?

A

Sphenoethmoidal recess

87
Q

What is the drainage site for the anterior group of ethmoidal sinuses?

A

Middle meatus via ethmoidal infundibulum or frontonasal duct

88
Q

What is the drainage site for the middle group of ethmoidal sinuses?

A

Middle meatus on or above bulla ethmoidalis

89
Q

What is the drainage site for the posterior group of ethmoidal sinuses?

A

Superior meatus

90
Q

When do maxillary and sphenoidal sinuses become fully formed?

A

In adolescence

91
Q

Fill in the blank: The maxillary and sphenoidal sinuses are usually present in _______ form at birth.

A

Rudimentary

92
Q

How can the maxillary sinus be clinically examined?

A

By pressing one’s finger against the anterior wall of the maxilla below the inferior orbital margin

93
Q

What may increased sensitivity over the infraorbital nerve indicate?

A

Potential issues with the maxillary sinus

94
Q

How can inflammation in the maxillary sinus be detected?

A

Using a flashlight to check for inflammatory exudate in a darkened room

95
Q

Where is the frontal sinus examined?

A

By pressing upward beneath the medial end of the superior orbital margin

96
Q

How can the ethmoidal sinuses be palpated?

A

By pressing medially against the medial wall of the orbit

97
Q

What nerves innervate the maxillary sinus?

A
  • Infraorbital nerve
  • Anterior superior alveolar nerve
  • Middle superior alveolar nerve
  • Posterior superior alveolar nerve
98
Q

Where does pain from the maxillary sinus refer to?

A
  • Upper jaw
  • Teeth
  • Skin of the cheek
99
Q

What nerve innervates the frontal sinus?

A

Supraorbital nerve

100
Q

What areas may experience referred pain due to frontal sinusitis?

A

Skin of the forehead and scalp as far back as the vertex

101
Q

What can happen if the bony boundaries of the optic canal are invaded by sphenoidal or ethmoidal sinuses?

A

Spread of infection to the optic nerve, causing retrobulbar neuritis

102
Q

What risks are associated with surgical intrusion in chronic sinusitis treatment?

A

Damage to orbital contents or the optic nerve

103
Q

What can a severe blow to the eye cause in relation to the maxillary sinus?

A

The floor of the orbit may buckle downward into the maxillary sinus

104
Q

What additional symptoms may occur due to damage from a blow-out fracture?

A
  • Diplopia
  • Loss of sensation to the cheek
  • Loss of sensation to the upper lip
105
Q

What type of trauma can cause inward buckling of the ethmoid bone?

A

Trauma to the eye, often negligible

106
Q

What is a potential result of an ethmoidal fracture?

A

Expansion of the orbit’s volume and enophthalmos

107
Q

The medial wall/base of the maxillary sinus is formed by…

A

Maxilla, unicate process of ethmoid, inferior concha (WHICH IS A SEPARATE BONE), vertical plate of palatine bone

FRCOphth Part1 - paranasal sinuses (1 decks)

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