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ENT > Rhinology > Flashcards

Rhinology Flashcards

1
Q

What/where is Little’s area?

A 
Antero-inferior nasal septum
4 anastomoses (90% epistaxis originates from here)
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2
Q

What type of tissue covers the turbinate bones?

A

Mucoperiostium

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3
Q

Which structure(s) drain into the middle meatus? (3)

A

Maxillary, frontal + anterior ethmoid

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4
Q

Which structure(s) drain into the inferior meatus?

A

Nasolacrimal duct

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5
Q

Which structure(s) drain into the superior meatus? (2)

A

Sphenoid + posterior ethmoid

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6
Q

What is the name of the structure where the 2 nasal cavities meet?

A

Choanae

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7
Q

What are the different types of rhinitis? (8)

A

Allergic: seasonal + perennial

Non-allergic: infective, vasomotor, hormonal, old age, medicamentosa, atrophic

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8
Q

How is rhino sinusitis diagnosed?

A 
Inflamm of nose / sinuses with ≥2 of:
Congestion
Anosmia
Anterior/post-nasal discharge
Facial pain

AND

Endoscopy findings of meatus obstruction or oedema/discharge (e.g. polyps)
OR
CT mucosal changes

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9
Q

What pathogens may cause infective rhinitis?

A

Usually viral URTI
OR
TB, syphillis, Klebsiella (scleroma)

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10
Q

What would be seen O/E in allergic rhinitis? (3)

A

Allergy symps: vasc congestion/ oedema/ rhinorrhoea/ irritation

Damp
Pale nasal linings
Swollen oedematous turbinates

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11
Q

What treatment for allergic rhinitis? (4)

+ what other type of rhinitis is treated the same

A

Allergen avoidance
Nasal douche
Antihistamines
Steroid spray

Same as treatment fir vasomotor (when failed to test +ve for any allergens)

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12
Q

List some provoking factors for epistaxis? (6)

A 
Trauma
NSAIDs
Anticoagulants
Clotting disorders
Hypertension
URTIs
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13
Q

What general first aid measures should be done for epistaxis?

A

Press fleshy part (not bridge)
Sit forward
Ice pack on nasal bridge

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14
Q

How is severe epistaxis managed (resuscitation)? (3 steps)

A 
Assess blood loss (BP, IV access, FBC/G&S/Crossmatch)
Examine for point of bleeding (use 5% cocaine)
Nasal cautery (+ packing if fails)
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15
Q

What must NOT be done when surgically managing a deviated nasal septum?

A

Removal of anterior/dorsal septum

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16
Q

What 3 things must be considered when managing injury of external nasal skeleton?

When/what is done to treat it?

A

? Legal action
? cervical/head/facial injury
? Septal haematoma

Manipulation under GA if resp blockage / bothers pt

17
Q

Describe the physiology behind infective/allergic sinusitis

Describe the physiological changes that occur as a consequence of chronic sinusitis

A

Causes ↓ ciliary function
→ oedema of nasal/sinus opening mucosa + ↑ nasal secretions

Cystic/polypoid changes in sinuses
Swollen mucosa further narrow ostia

18
Q

What pathogens involved in chronic sinusitis?

A

Streptococcus / haemophilus

19
Q

How is sinusitis Dx / managed?

A

Hx/Ex + XRay/CT

Decongestants (e.g. ephedrine)
Abx/analgesics
If fails → aspiration / washout

20
Q

List the complications of acute sinusitis (Face Cavities Infected with Phlegmy Mucus)

A 
Frontal sinusitis
Chronic sinusitis
Intracranial complications 
Peri-Orbital cellulitis
Mucocoeles (late complication)
21
Q

What intracranial complications can occur from sinusitis?

A

Meningitis
Cavernous sinus thrombosis
Brain abscess
Extra-dural abscess (secondary to frontal sinusitis)
Subdural abscess (secondary to frontal sinusitis)

22
Q

How are most complications of sinusitis managed?

A

High-dose/broad spec Abx

± surgical drainage (neuro drainage if brain abscess)

23
Q

What is vasomotor rhinitis?

What are some of the triggers? (3)

A

Same as allergic (+ same Tx) but failed to test +ve for any allergens

Climate (sudden change in temp)
Alcohol
Emotional

24
Q

What is rhinitis medicamentosa?

A

Acquired sensitivity of nasal lining in response to prolonged use of topical decongestants

25
Q

What is atrophic rhinitis?
What symptoms? (3)
How treated (3)

A

Rare (more LEDCs)
Abnormal patency of nostril + loss of ciliated epithelium

Crust / Odour / Bleeding (thickened secretions)

Nasal toilet / Steam inhalation / Surgical closure of nostril

26
Q

What symptoms seen in mucoceles?

A

Late complication

Asymp unless infection / face swelling

ENT (6 decks)

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