Session 7 - Group work

Question 1

What are the functions of the

turbinates?

Answer 1

• Reduce speed of air flow by making turbulent
• Dry air is humified
• Air is temperature regulated to within 1* body
• Debris is filtered

Question 2

What anatomical features facillitate the action of the turbinates?

Answer 2

Increase in cross sectional area of nasal cavity reduced flow through it
- Narrow nostril -> Wide cavity

Question 3

What is the structure of the
nasal mucosa and explain why it was
it found to be red and swollen?

Answer 3

Redness- due to highly vascularity,
supplied from branches of both the
internal & external carotid arteries

• Moist – lined by respiratory epithelium
Serous & mucus secretions

Swollen - due to inflammation of the
mucous membrane

Question 4

What cells line the nasal mucosa?

Answer 4

ciliated pseudostratified columnar epithelium (with

goblet cells)

Question 5

Explain why this patient (with inflammation of nasal mucosa) has
copious nasal discharges?

Answer 5

Inflammatory reactions of tissues can 
lead to increased tissue fluid leakage 
from the circulation. This is known as 
extravasation. In the nose, 
extravasation of tissue fluids is also 
accompanied by increased mucous 
secretion, etc. This is the explanation 
for the copious nasal discharges in 
this case.

Question 6

Explain the underlying causes of

headaches & facial pain.

Answer 6

Blocked nasal passages; 
discharge of secretions from 
the sinuses interrupted; 
stuffy feeling; irritation of 
the mucosa; 

• Nerves supplying the nasal
cavity & sinuses also supply
intracranial structures (the
meninges, in patricular)

Question 7

Where is the opening of the maxillary air sinus in the nasal cavity? Why is this a cause of nasal disorder?

Answer 7

Its opening is high up on the medial wall of the
maxilla. During maxillary congestion, its opening
is obstructed thereby affecting its drainage

Question 8

What differences are there between the Eustachian tube of a child
and that of an adult and how does this help explain the

Answer 8

In the adult, the tube has a downward
vertical path to the nasopharynx from the
middle ear, thus allowing mucous secretions
to drain freely. In children, however, not
only is the tube relatively narrow, but also
lies almost horizontal making drainage
difficult. Near its opening in the
nasopharynx, is the pharyngeal tonsil (or
adenoid). Any enlargement of this
lymphoid mass will obstruct the drainage
from the tube. Chronic obstruction causes
a collection of sticky mucus on the middle
ear (glue ear) that readily becomes
infected by bacterial growth. As the
incidence of upper respiratory tract
infection is high in children, the frequency
of middle ear infection in children is
therefore unsurprisingly also high.

Question 9

7 Why might a child with recurrent ear infections

benefit from an adenoidectomy?

Answer 9

Adenoids are a mass of lymphoid tissue
situated at the very back of the nose, in the
roof of the nasopharynx

• An enlarged pharyngeal tonsil in a child will
most certainly to lead to blockage of the
auditory tube, leading to recurrent ear
infections.

• Thus, its removal may improve mucus drainage
of the tympanic cavity, thereby reducing the
number of middle ear infections.

Question 10

What is responsible for the change in the shape of the
face of a child during the time of the eruption of the
permanent teeth and subsequent during puberty?

Answer 10

Rapid growth of the face during infancy and early childhood coincides
with the eruption of primary teeth. These changes are more marked
after the secondary teeth erupt after 5 – 6 years. Enlargement of the
frontal and facial regions is associated with the increase in the size of
the paranasal sinuses; growth of the sinuses is responsible for the
alteration in the shape of the face.

Question 11

Why should a patient complaining about toothache be asked

about recent upper respiratory tract infections?

Answer 11

The floor of the maxillary sinus lies adjacent to the roots and alveolar
processes of the upper teeth (pre-molar & molars). Pain from infection
in the maxillary sinus, due to upper respiratory tract infection, is quite
indistinguishable from that of dental origin because the teeth &
maxillary sinus are both innervated by the maxillary branch of the
trigeminal nerve.

Question 12

Why is it possible for the infection in the

frontal sinus to drain into the maxillary sinus?

Answer 12

The drainage of the 
frontal paranasal sinus is 
by gravity to the middle 
meatus. The ostium of 
the maxillary paranasal 
sinus which opens into 
this area is located as 
such for infection in the 
frontal sinus to drain 
straight down into the 
maxillary sinus