Trans 023 Basic sciences ENT Flashcards
What instruments do we use in anterior rhinoscopy?
Head light and nasal speculum
Structures that ‘ we check in lateral wall in anterior rhinoscopy
Nasal septum and turbinates
Bony projections that are covered by mucosa
Turbinates
Most prominent that we see in anterior rhinoscopy
Inferior turbinate
How to differentiate if it is a turbinate or a mass in anterior rhinoscopy?
Check for tenderness
check if its movable
administer decongestant
In unilateral polyp why does the pt presented with facial pain and thick nasal discharge?
your sinuses have drainage going into the nasal cavity. if there is a blockage there will be a secondary bacterial infection causing sinusitis.
what condition results from obstruction of the nasopharynx and nose that alters the tone of voice?
Rhinolalia clausa
Important functions of the nose?
- Respiratory passage: 2. Filtration: 3. Air-conditioning and humidification: 4. Vocal Resonance: 5. Nasal Reflex functions: 6. Nasal cavity serves as an outlet for lacrimal and sinus secretions 7. Olfaction
are hollow chambers that have foramina for draining into the nose. • They make the skull lighter
• Add resonance to the laryngeal voice • Act as shock absorbers to redistribute the forces of blunt trauma away from the orbit and so protect the eye.
SINUSES
• Embryology: does not appear until 5-6 years old
Not present at birth
Frontal
Volume of frontal sinus at adult?
• Volume at Adult: 4-7 ml by 12-20 years old
Drainage of frontal sinus?
• Drainage: frontal recess in anterior middle meatus
Vesssels of frontal sinus?
• Vasculature: supraorbital and supratrochlear arteries, ophthalmic (cavernous sinus) and supraorbital (anterior facial) veins
innervation frontal sinus?
• Innervation: supraorbital and supratrochlear nerves (V1)
plain film for frontal sinus?
lateral and Caldwell view
What is caldwell view?
View taken with nose and forehead touching the film and xray beam is projected 15 to 25 degree caudally
• Embryology: first to develop in utero, biphasic growth at 3 and 7-18 years old
Maxillary sinus
Volume of maxillary sinus?
typically 15 mL
largest paranasal sinus?
maxillary sinus
Drainage maxillary sinus?
Drainage: ethmoid infundibulum (middle meatus, 10-30% have accessory ostium)
Vasculature of maxillary sinus?
• Vasculature: maxillary and facial artery, maxillary vein
Innervation of maxillary sinus?
infraorbital nn (V2)
Plain film for maxillary sinus?
• Plain Film: Water’s view
What is waters view?
View is taken in such a way that the chin of the patient touch the film while Xray beam is projected from behind
your nose and chin are on the plate. The importance of this is in this position the petrous portion of your temporal bone is projected below the maxillary sinus and you would be able to see your maxillary sinus. what view?
water’s view
Sphenoid and posterior ethmoid drains into the
Superior Meatus. The rest is in the Middle Meatus.
• Embryology: 3-4 cells at birth (most developed paranasal sinus at birth)
Ethmoid sinus
Volume of ethmoid sinus?
Volume at Adult: 10-15 aerated cells, total volume of 2-3 ml (adult size at 12-15 years old)
drainage of ethmoid sinus?
Drainage: anterior cells drain into the ethmoid infundibulum, posterior cells drain into the spheno-ethmoid recess (superior meatus)
vasculature of ethmoid sinus?
• Vasculature: anterior and posterior ethmoid arteries (from ophthalmic artery), maxillary and ethmoid veins (cavernous sinus)
innervation of ethmoid sinus?
• Innervation: anterior and posterior ethmoidal nerves (from nasociliary nerve, V1)
Plain view for ethmoid sinus?
lateral and caldwell view
• Embryology: evagination of nasal mucosa into sphenoid bone • Volume at Adult: 0.5-8 ml (adult size at 12-18 years old)
sphenoid sinus
drainage of sphenoid sinus?
• Drainage: spheno-ethmoid recess in the superior meatus
vasculature of sphenoid sinus?
• Vasculature: sphenopalatine artery (from maxillary artery), maxillary vein (pterygoid plexus)
innervation of sphenopalatine sinus?
• Innervation: sphenopalatine nerve
plain film for sphenoid sinus?
• Plain Film: lateral and submentovertex (basal)
QUIZ: What is the paranasal sinus that is not present at birth?
frontal sinus
the nasal skeleton is consisted of?
• The external nasal skeleton consists of bone in the upper third (the nasal bones) and cartilage in the lower two-thirds.
most commonly fracutre bone of the face?
nasal bone
Common manifestation of nasal bone fracture is
swelling or inflammation and epistaxis
The nasal cavities are partitioned in the midline by the
nasal septum
The cartilage of the septum is dependent on what for its nutritional support
on the overlying adherent perichondrium
Separation of this layer (septal cartilage and perichondrium) by hematoma or abscess may result in?
in cartilage necrosis and a saddle nose cosmetic deformity
• The main artery of the nasal cavity is the
sphenopalatine branch of the maxillary artery
sphenopalatine branch of the maxillary artery anastomoses wiht?
- Palatine artery - Ethmoidal arteries - anterior and posterior - Labial artery
The lateral wall is thrown into folds by three bony projections:
the inferior, middle and superior turbinates
assymetrical vs symmetrical congestive response types?
- Asymmetrical Congestive Response (The Nasal Cycle): - Normal physiological congestion/decongestion cycle alternating between nasal sides every 2-7 hours
- Symmetrical Congestive Response: - Temporary bilateral congestion induced by exercise, changes in body position, hyperventilation, cold air, sulfur, histamine, and other irritants; lasts 15-30 minutes
