rhinitis-sinusitis Flashcards

1
Q

which sinus is present at birth

A

ethmoid

maxillary

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2
Q

when does frontal sinus develop

A

2nd year

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3
Q

when does spenoid sinus develop

A

3rd year

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4
Q

function of paranasal sinuses

A
Humidifying and warming inspired air
Regulation of intranasal pressure
Lightening the skull
Resonance
Absorbing shock
Contribute to facial growth
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5
Q

define acute, subacute, chronic

A

Acute stage – signs and symptoms may last (1-3) weeks
Subacute stage – 3weeks to 3 months
Chronic stage – lasting longer than 3 months
Recurrent episode – repetitive acute bouts of more than 4 bouts in a year

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6
Q

causative organisms in sinusitis viral

A

Viral - Rhinovirus , Reovirus , Myxovirus, Paramyxovirus , Coxsachivirus , ECHOvirus

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7
Q

causative organisms bacteria

A

Bacterial - Streptococcus pneumonia, Strept.haemolyticus, Staph. aureus, Haemophilus influenzae, Neiseria catarrhalis.

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8
Q

Mode of infection

A

Rhinogenic
Odontogenic
Haematogenic
Traumatic

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9
Q

pathophysiology of acute rhinosinusitis

A

inflammation leads to
increased vascular permeability and mucosal edema
impaired mucociliary function
increased mucus production

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10
Q

predisposing factors

A
Cold weather
Smoking and Fumes
Allergies
Nasal deformities
Nasal polyps
Cystic fibrosis
HIV infection
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11
Q

symptoms

A
  1. Headache, Fever, Malaise, Halitosis
  2. Nasal obstruction, Heaviness in the head,
  3. Rhinorrhoea - Mucoid - Mucopurulent - Haemorrhagic mucupurulent.
  4. Nasal irritation .
  5. Facial pains and tenderness
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12
Q

Localisation of pain in sinusitis

A

a, Maxillary - Frontal headache, Infra orbital pain.
b, Frontal - Frontal headache, Sopra orbital pain.
c, Ethmoid - Intra-canthal pain on the bridge of the nose.
d, Sphenoid - Occipital headache, Retro-ocular pain.

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13
Q

Investigations

A
  1. Radiological- X ray paranasal sinuses i. e. Water’s (Occipito-mental) view.
    Computerized tomography. (CT Scan).
  2. Haematological- Full blood count (FBC).
  3. Microbiology - Culture and Sensitivity test of Nasal swab .
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14
Q

Management of acute sinusitis

A
  1. Broad spectrum antibiotics.
  2. Analgesic / antipyretics .
  3. Nasal decongestant . a. Topical - b. Systemic-
  4. Steam inhalation with Menthol, or (TBC) Tincture of Benzoin Compound.
  5. Physiotherapy - Short wave therapy.
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15
Q

how does physiotherapy work?

A

Physiotherapycan assist in acute and especially in chronicsinusitisthrough means of reducing the inflammation in the linings, reducing the viscosity of the secretions and aiding in clearing the passages by increasing the rate of drainage from thesinuscavities.

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16
Q

which of the sinuses is more prone to inflammation

A

maxillary

since it drains against gravity

17
Q

microbes implicated in chronic sinusitis

A

bacteria

Gram negatives - Proteus vulgaris Pseudomonas aureginosa Escherechia coli.

Gram positives - Streptococcus spp. Staphylococcus aureus, Neiseria catarrhalis.

18
Q

most common inciting agent in chronic sinusitis

A

viral URI

19
Q

Pathogenesis of chronic sinusitis

A

Ostia obstruction creates increasingly hypoxic environment within sinus
Retention of secretion results in inflammation and bacterial infection
Secretion stagnate, obstruction increases, cilia and epithelial damage become more pronounced

20
Q

symptoms of chronic

A
  1. Offensive yellowish or greenish mucopurulent discharge .
  2. Nasal obstruction and Irritation.
  3. Discomfort ( Heaviness ) in the area of the involved sinus.
  4. Halitosis .
21
Q

management of chronic

A
  1. Medical -
  2. Surgical - a. Antral wash- out . b.Antral wash-out & Antrostomy. c. Radical antrostomy - Caldwell Luc Operation.
22
Q

instrument used in antral lavage

A

Lilwitz trocar and cannula

23
Q

difference between allergic and infective sinusitis

A

Nostril - Allergy is usually bilateral while infective sinusitis is usually unilateral.

Rhinorrhoea - Allergy is mucoid ( watery ) while infective sinusitis is mucopurulent.

Halitosis - eminent in infective sinusitis.

24
Q

Complications of sinusitis

A

Local- Fronto- ethmoidal mucocoele. Nasal and Antrochoanal polyps. Hypertrophic nasal turbinates. Epistaxis.

Distant- Pharyngitis, Tonsillitis, Laryngitis, Orbital cellulitis - abscess, Otitis media.

Intra-cranial-Meningitis, Cerebral abscess, Cavernous sinus thrombosis.

25
Q

characteristics of nasal polyps

A

mobile
soft
insensitive
painless

26
Q

mucocele

A

non-tender

27
Q

view usually used in radiographs of paranasal sinuses

A
Occipito-mental ( OM or Water’s ) view
Occipito-frontal  ( OF or Caldwell’s) view
Latero-lateral view
Oblique lateral view
Submentovertical ( SMV ) view
Verticomental view