Session 7: the nose Flashcards
What are the functions of the turbinates?
They disrupt the laminar flow of air causing turbulence and slowing of the air. They are 3 curved shelves of bone covered in mucousal membrane and increase SA. Increases time for air to be humidified and any particulate matter to be filtered by cilia and mucus.
What is the histological classification of the nasal mucosa and why was it red and swollen
Ciliated pseudostratified columnar epithelium with goblet cells. Nasal cavity lining is continuous with the lining of the paranasal sinuses.
red and swollen because the nasal cavity is inflamed and inflammatory markers cause an increase in capillary permeability and cause vasodilation therefore more red and swollen
a patient with a history of recurrent headaches and facial pain and red swollen nasal mucosa over the turbinates. Why does she have copious postnasal discharge?
inflammation of the mucosal membrane will lead to a increase in mucus production and there will be increased leakage of tissue fluid from the inflamed tissues
Explain the underlying causes of the headaches and facial pain
Branches of the trigeminal nerve provide sensory innervation to the nasal cavity and sinuses. Inflammation in this area will cause pain felt in this area. The trigeminal nerve carries sensory information from other parts of the head (the meninges, paranasal sinuses,) so pain may be perceived as a headache.
where is the opening of the maxillary air sinus in the nasal cavity and why is its anatomy a cause of nasal disorder?
The opening of the sinus is high up on the medial wall on the maxilla and gravity is unable to assist in the natural drainage of the sinus when in upright position.
There more susceptible to problems with drainage especially if there is mucosal congestion.
Why might a child with recurrent ear infections benefit from an adenoidectomy?
due to the adenoids proximity to the opening of the Eustachian tube they can become enlarged and block the tube causing problems with ventilation and drainage of the middle ear therefore recurrent middle ear infections may occur.
What is responsible for the change in the shape of a childs face around the time of eruption of permanent teeth and subsequently during puberty?
Enlargement of the frontal and facial regions is associated with the increase in size of the paranasal sinuses. At birth the paranasal sinuses are rudimentary or even absent.
Why should a patient complaining of toothache be asked about recent upper resp tract infections?
An upper resp tract infection may precede and cause inflammation/infection of the mucosa of the maxillary sinus.
Sensory innervation of the maxillary sinus mucosa is provided by infra-orbital nerve and alveolar nerves (branches of V3). These provide innervation to the skin of the cheek, upper jaw and teeth therefore can be difficult toe accurately determine where the pain is from.
Why is it possible for the infection in the frontal sinus to drain into the maxillary sinus?
Drainage of the frontal paranasal sinus is by gravity into the middle meatus. The ostium of the maxillary sinus also opens up into the middle meatus and is inferior to the frontal sinus ostium.
therefore infection in the frontal sinus can potentially drain straight down into the maxillary sinus.
