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Respiratory > The Nasal Cavity, Paranasal Sinuses and Pharynx and its Clinical Anatomy > Flashcards

The Nasal Cavity, Paranasal Sinuses and Pharynx and its Clinical Anatomy Flashcards

1
Q

what nerve does sensation and pain temp touch to nasal cavity and sends off branches to lateral nasal wall and septum and to hard palate and the gums

A

maxillary nerve

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2
Q

what nerve is the lingual( chord tympani fibres-taste) nerve a branch of

A

mandibular nerve

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3
Q

4 main paranasal sinuses

A

Frontal sinus
Ethmoid sinus
Maxillary sinus
Sphenoid sinus

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4
Q

function of the nasal cavity

A

airway provision
warming and humidification of inspired air
filtering of large particulate matter
mucuous production, trapping and ciliary clearance
olfaction
drainage of paranasal sinuses

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5
Q

why is an infection more likely in infants than adults

A

tube connecting the nasal cavity and the ear is more horizontal so easier to move

sinus congestion and stuffiness can affect the pressure in your ears

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6
Q

what tube connects the middle ear to the nasopharynx

A

Eustachian tube

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7
Q

what are paranasal sinuses

A

air filled extensions of the nasal cavity

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8
Q

what type of cell lines each sinus

A

ciliated pseudo stratified epithelium with goblet cells

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9
Q

what does the nasal septum do

A

inside the nose and separated the two nostrils and nasal cavities

fibrocartilage and bone

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10
Q

nasal cavity is divided into right and left and each one has a roof, floor and ….

A

medial and lateral walls

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11
Q

The nasal cavity is the most superior part of the respiratory tract. It extends from the vestibule of the nose to the nasopharynx, and has three divisions- what are they

A

Vestibule – the area surrounding the anterior external opening to the nasal cavity.
Respiratory region – lined by a ciliated psudeostratified epithelium, interspersed with mucus-secreting goblet cells.
Olfactory region – located at the apex of the nasal cavity. It is lined by olfactory cells with olfactory receptors.

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12
Q

the nasal septum on the medial wall is made of what bones

A

Frontal, Ethmoid, sphenoid, maxilla, vomer and nasal bone

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13
Q

Lateral wall thrown into folds by 3 bony projections called concha(turbinates) which become cyclically engorged every 2-3 hours. this increases what

A

Increase the surface area of the nasal cavity, slow the flow of air to allow more time for heating/humidifying

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14
Q

The nasal bones are commonly fractured following trauma. Epistaxis (bleeding from the nose) is a common sequelae and sometimes patients require a MUA (manipulation under anaesthesia). The nasal septum is composed of bone and cartilage and deviations (bends) in the septum are common. A septal haematoma after nasal injury is a risk to the nasal airway and carries a potential for what

A

cartilage necrosis.

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15
Q

Septal cartilage relies on overlying perichondrium for its blood supply

A haematoma can lift the perichondrium away from the cartilage, starving it of its blood supply

If this is not drained quickly this can result in septal cartilage necrosis causing a what type of deformity to the external not e

A

saddle shaped

looks like huge skin bulges in nostril

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16
Q

Projecting out of the lateral walls of the nasal cavity are curved shelves of bone. They are called conchae (or turbinates).

what are the 3 concha

A

inferior

middle and superior

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17
Q

the conch project into the nasal cavity - creating 4 pathways for air to flow - these pathways are called what

A

meatuses

also there is the spheno-ethmodial recess

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18
Q

what is the function of the concha

A

increase SA of the nasal cavity
- increase amount of inspired air to come into contact with cavity walls - also make air slower so can be humidified

mucosa around the concha has vast blood supply so keeps it warm

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19
Q

which major arteries supply blood to nasal cavity

A

internal and external carotids

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20
Q

where is the mostly likely place in the nasal cavity for an epistaxis to occur

A

littles area/kisselbachs area
anterior third of the nasal cavity
due to local causes ( trauma) or systemic ( hypotension)

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21
Q

what internal carotid branches supply the nasal cavity

A

anterior and posterior ethmoidal arteries branch of ophthalmic

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22
Q

what external carotid branches supply the nose

A

spehnopalatine
greater palatine
superior labial
lateral nasal

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23
Q

what can you use medically to stop a nose bleed

A

silver nitrate sticks

nasal tampons - building up pressure

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24
Q

where do the veins of the nose drain to

A

pterygoid plexus,
facial vein
cavernous sinus-danger triangle

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25
Q

in some individuals a few nasal veins join with the sagittal sinus ( dural venous sinus)- this could represent a potential pathway by which infection can spread from where to where

A

the nose into the cranial cavity

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26
Q

what is cavernous sinus thrombosis - life threatening

A

is the formation of a blood clot within the cavernous sinus, a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart.

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27
Q

symptoms of cavernous sinus thrombosis

A

a sharp and severe frontal headache, particularly around the eye.
swelling and bulging of the eye(s) and the surrounding tissues.
eye pain that’s often severe.
double vision

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28
Q

complications of cavernous sinus thrombosis

A

compress cranial nerves

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29
Q

the innervation of the nose can be functionally divided Ito special and general innervation.What is special innervation

A

ability to smell carried out by the olfactory nerves

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30
Q

what is general sensory innervation delivered to and by what nerves

A

the septum and lateral walls

nasopalatine nerve( branch of maxillary ) 
nasocillary nerve ( branch of ophthalmic nerve)
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31
Q

what nerve does the nasopalatine nerve come from

A

maxillary nerve

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32
Q

what nerve does the nasocillary nerve come from

A

ophthalmic nerve

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33
Q

innervation to the external skin of the nose is supplied by what nerve

A

trigeminal nerve

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34
Q

a fracture of the cribiform plate can occur as a result of nose trauma - what can a fractured cribiform plate can penetrate what and cause leakage of what

A

meningeal linings of the brain causing CSF to leak out

increasing the risk of meningitis , encephalitis and cerebral abscesses

glucose?

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35
Q

what other major structure can be damaged by a cribifrom plate injury

A

the olfactory bulb can be damaged irreversibly so patent will present with anosmia

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36
Q

the paranasal sinuses are named accordingly to the bone in which they are located in what are paranasal sinuses

A

air-filled spaces

37
Q

function of paranasal sinuses

A

lightening weight of head, support immune defence of nasal cavity, humidifying inspired air, increasing resonance of the voice.

38
Q

where do all the paranasal sinuses drain to

A

All drain inot the nasal cavity – openings on the roof and lateral walls.

39
Q

triangular shape. Drainage via frontonasal duct (opens at the semilunaris, within the middle meatus of the nasal cavity. Sensation via supraorbital nerve (ophthalmic nerve), anterior ethmoidal artery (internal carotid)
what sinus

A

frontal sinus

40
Q

open into nasal cavity in spheno-ethmoidal recess (supero-posterior to superiror cocha). Innervated by posterior ethmoidal nerve (ophthalmic nerve) and branches of maxillary nerve. Pharyngeal branches of maxillary arteries.

what sinus

A

sphenoid sinus

41
Q

what sinus - 3 on each side, anterior, middle and posterior. Anterior opens onto hiatus semilunaris (middle meatus), middle and posterior open onto lateral wall of superior meatus. Innervated by anterior and posterior ethmoidal branches of nasociliary nerve and maxillary nerve. Anterior and posterior ethmoidal arteries.

A

ethmoid sinus

42
Q

largest. Drain into the nasal cavity at the hiatus semilunaris underneath frontal sinus opening (drain against gravity)

what sinus

A

maxillary sinus

43
Q

as we know the paranasal sinuses drain into the nasal cavity - which sinuses open into the middle meatus

A

frontal
maxillary
anterior ethmoidal sinus ( middle ethmoidal into ethmoidal bulb and poster open at superior meatus)

44
Q

The only structure not to empty out onto the lateral walls of the nasal cavity is the …….. It drains onto the posterior roof.

A

sphenoid sinus

45
Q

in addition to the paranasal sinuses what other things drain into the nasal cavity

A 
nasolacrimal duct (a groove formed by the lacrimal bone and frontal process of the maxilla) 
auditory( Eustachian tube)
46
Q

the nasolacrimal duct acts to drain tears from the eyes what meatus does it open into

A

inferior

47
Q

the Eustachian tube opens into the nasopharynx at the level of the inferior meatus what is its function

A

it allows the middle ear to equalise with atmospheric air pressure

As the auditory tube connects the middle ear and upper respiratory tract, it is a path by which infection can spread from the upper respiratory tract to the ear. Infection of the auditory tube causes swelling of the mucous linings, and the tube becomes blocked. This results in diminished hearing.

48
Q

Sinusitis

A

As the paranasal sinuses are continuous with the nasal cavity, an upper respiratory tract infection can spread to the sinuses.

Infection of the sinuses causes inflammation (particularly pain and swelling) of the mucosa, and is known as sinusitis. pansinusitis( more than one)

49
Q

the maxillary nerve supplies both the maxillary sinus and maxillary teeth and so inflammation of the sinus can present with what

A

toothache

50
Q

what nerve innervates the sphenoid sinus

and where does it get its blood supply from

A

posterior ethmoid nerve

maxillary arteries

51
Q

If someone has a pituitary adenoma - what is the surgery of choice

A

endoscopic trans-sphenoidal surgery- way to accessory pituitary gland through this sinus ( hypophyseal fossa)

Avoid the need for craniotomy for a mid-line structure.

52
Q

why is the maxillary sinus most commonly affected by sinusitis

A

uphill drainage against gravity so commonly infected

53
Q

the lacrimal gland produces lacrimal fluid which does what

A

protects and lubricates the eye

54
Q

what is the pharynx

A

Muscular tube that connects the nasal and oral cavities with the larynx and oesophagus

55
Q

where does the pharynx begin and end

A

Begins at the base of the skull and ends at the cricoid cartilage (C6)

56
Q

3 divisions of the pharynx

A

Nasopharynx
Oropharynx
Laryngopharynx

57
Q

middle ear effusion

A

Middle ear effusion is a build-up of fluid in the space behind your child’s eardrum

blockage of the tube during ear infection

58
Q

what area is the nasopharynx

A

base of the skull to the soft palate

Communicates with middle ear cleft via eustachian tube (unwinds when yawning/chewing to allow air in middle ear to maintain atm pressure).

59
Q

oropharynx goes from where

A

soft palate ( uvula) to the level of the epiglottis

60
Q

blood supply of the oropharynx

A

Rich blood supply from lingual, facial and ascending pharyngeal branches of the external carotid artery.

61
Q

laryngopharynx runs from where

A

tip of the epiglottis to th eoesphagis at the level of c6

62
Q

which muscle marks the transition into the oesophagus

A

cricopharyngeus

prevent the reflux of foods from the esophagus into the throat, the cricopharyngeus remains contracted and tight at most times.

63
Q

where the larynx bulges into the pharynx is called the piriform fossa - is this the most common place for sharp ingested foreign bodies such as fish bones to lodge

A

true

64
Q

All muscles of the pharynx are innervated by vagus nerve except stylopharyngeus which is innervated by what nerve

A

by glossopharyngeal nerve.

65
Q

true or false

Rich blood supply from lingual, facial and ascending pharyngeal branches of the external carotid artery.

Venous drainage via the pharyngeal venous plexus, which drains into the internal jugular vein

A

true

66
Q

what type of cells line the nasopharynx

A

ciliated pseudostratified columnar epithelium

67
Q

what nerve innervates the nasopharynx

A

pharyngeal branch of maxillary nerve (V2)

68
Q

what tube connects the nasopharynx to the middle ear

A

Eustachian tube

69
Q

the adenoids are lymphoid tissue that increase in size secondary to infection and enlargement can obstruct the Eustachian tube leading to what in children

A

glue ear

in adults need to be investigated

70
Q

adenoid hypertrophy can block the nasopharynx resulting in what

A

mouth breathing

71
Q

glue ear

A

adhesive otitis, is a condition that occurs when the middle part of your ear fills with fluid. This part of the ear is located behind the eardrum. The fluid can become thick and sticky, like glue. Overtime, glue ear is likely to lead to a middle ear infection.- bulging ears

symptoms include temporal hearing loss and earache or ear pain

72
Q

what does the oropharynx contain

A

posterior 1/3 of the tongue
lingual tonsils
palatine tonsils

73
Q

what nerve innervates the oropharynx

A

glossopharyngeal nerve - sensory

74
Q

tonsillitis and symptoms

A

infection and inflammation of the tonsils

swollen tonsils
sore throat
difficulty swallowing
tender lymph nodes on the side of the neck

75
Q

what is quinsy

A

complication of tonsillitis - collection of pus that develops between th back on one of the tonsils and wall of the throat known as an abcess
normally a complication of bacterial tonsillitis

symtpms
dysphargia - dribble as can’t swallow
trismus - hot potato voice
can obstruct airway and needs drainage

76
Q

what is the ring of lymphoid tissue in the pharynx called

A

waldeyers ring of lymphoid tissue

77
Q

Piriform fossa is a deep recess anterolateral to the larynx (on each side). Sharp ingested foreign bodies may lodge here

true or false

A

true

78
Q

what innervates the laryngopahrynx

A

sensory innervation by vagus nerve via internal branch of superior laryngeal nerve.

79
Q

pharyngeal pouch is what

A

Potential gap between the upper oblique fibres (thyropharyngeus) and lower transverse fibres (cricopharyngeus) of inferior constrictor
muscle
The submucosa and mucosa of the pharynx may herniate into this space forming a pouch.

80
Q

symptoms of pharyngeal pouch

A

This causes halitosis( bad breath) , dysphagia and cachexia( extreme weight loss and muscle wasting)

81
Q

if the pharyngeal pouch spills into the larynx what can it cause

A

aspiration

82
Q

3 phases of swallowing (Deglutition )

A

1 – voluntary chewing and pushing food bolus into oropharynx
2 – involuntary – soft palate seals off nasopharynx, larynx elevated and pulled forward, widens pharynx
3 – involuntary – sequential contraction of pharyngeal constrictors causes peristalsis into oesophagus for semi-solid or solid material. Liquids may shoot down oesophagus passively.

83
Q

a food bolus is a semi solid mass of food - constrictor muscles have to contract to push food down the oespahgus - by what process does this go by

A

peristalsis

  • also bowel movements
84
Q

the lacrimal nerve is a branch of what nerve

A

ophthalmic nerve

85
Q

the small perforations in the cirbiform plate allows fibres of what nerve to enter and exit

A

olfactory nerve

86
Q

at the level of the superior meatus the sphenopalatine foramen is located. This hole allows communication between the nasal cavity and the the pterygopalatine fossa. what travels through here

A

sphenopalatine artery

nasopalatine and superior nasal nerves

87
Q

a child bites ic cream ands gets brain freeze - what region is going to be the source of this pain

A

maxillary sinus - nerves to maxillary teeth run in mucosa of the sinus walls and are sensitive to cold

88
Q

acute sinusitis symptoms or signs

A

nasal blockage or nasal discharge
facial pain/pressure - he ache or loss of smell
altered speech indicating nasal obstruction
tenderness and swelling or redness over the cheekbone and perioribial areas
cough
symptoms over more than 10 days - bacterial - severe local pain and fever over 38degreees

Respiratory (22 decks)

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