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ENT > 1.2: Nasal Cavity/Paranasal Sinuses Anatomy > Flashcards

1.2: Nasal Cavity/Paranasal Sinuses Anatomy Flashcards

1
Q

Name the parts (A-I)?

A

A = Root B = Dorsum C = Tip D = Ala E = Nostril F = Septum G = Philtrum (of upper lip) H = Nasal Bone I = Nasal Cartilage

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2
Q

Why should you not use adrenaline containing anaesthetic around the nose?

A

The nose contains hyaline cartilage Cartilage is avascular, relies on skin for nutrients Adrenaline causes vasoconstriction May cause cartilage damage and necrosis

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3
Q

How many nasal cavities? How are they separated?

A

Two nasal cavities Separated by septum

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4
Q

What’s the most important bone for the nasal cavity?

A

Ethmoid

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5
Q

Name the bones of the face? A - G

A

A = Frontal Bone

B = Nasal Bone

C = Ethmoid Bone

D = Inferior Nasal Concha

E = Maxilla

F = Perpendicular plate of the ethmoid bone

G = The Vomer

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6
Q

What makes up the walls of the nasal cavities? - Roof? - Lateral Walls? - Septum?

A

Roof is the cribriform plate of the ethmoid bone and the crista galli

Lateral walls is the superior and middle concha

Septum is composed of the perpendicular plate of the ethmoid + the vomer

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7
Q

Describe Le Fort Fractures?

A

Le Fort 1 = Across the top of teeth, through maxillary bone

Le Fort 2 = Through maxillary bone and zygoma (pyramid)

Le Fort 3 = Splits bones of the face from bones of the cranium

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8
Q

Link between Le Fort Fractures and Ethmoid bone?

A

Le Fort 2 and Le Fort 3 fractures can disrupt the cribriform plate of the ethmoid bone. This may allow the spread of infection from nasal cavities/paranasal sinuses into anterior cranial fossa

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9
Q

Describe the median wall of the nasal cavity?

A

Mainly the septum This is composed of - Hyaline Cartilage - Vomer - Perpendicular plate of the ethmoid bone

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10
Q

Describe a septal haematoma and its importance?

A

A septal haematoma is a collection of blood in the septum. It must be drained to prevent avascular necrosis of the hyaline cartilage

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11
Q

Describe the nasal cavity roof?

A

Ethmoid Frontal Sphenoid

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12
Q

Describe the nasal cavity floor?

A

Much wider than the roof (think triangle) Formed by the palatine process of the maxilla and the palatine bone

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13
Q

Describe the lateral nasal wall?

A

Made up from concha, maxilla, palatine and sphenoid

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14
Q

Which part of the nose is covered in keratinised stratified squamous epithelium?

A

The first part of the nasal cavity (vestibule)

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15
Q

Which part of the nose is covered in respiratory epithelium?

A

Most of the nose

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16
Q

What is respiratory epithelium?

A

Contains mucous secreting goblet cells and cilia Provides moisture and protection

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17
Q

Where is Olfactory Mucosa found?

A

Right at the back of the nasal cavity

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18
Q

What is the function of the Olfactory Nerve?

A

Special Sensory - smell

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19
Q

Describe the path of the olfactory nerve?

A

Receptor cells in the olfactory mucosa pass through the cribriform plate of the ethmoid bone. These are the first neurones in the chain. The nerve fibres synapse in the olfactory bulb and make contact with the cell bodies of the 2nd neurones. The signal travels along the olfactory tract and ends in the temporal lobe - Receptor cells in olfactory mucosa - Passes through cribriform plate - Olfactory bulb to 2nd neurones - Olfactory Tract - Ends in Temporal Lobe

20
Q

Appreciate this picture of the right olfactory area (covered in olfactory mucosa, where smell is detected)

A

..

21
Q

What is the somatic sensory nerve supply of the nasal cavity?

A

The Trigeminal Nerve (CN V)

22
Q

Describe how the somatic sensory nerve supply to the nasal cavity works?

A

Nasal cavity is split into Anterosuperior and Posteroinferior CN V1 supplies anterosuperior (OPTHALAMIC) CN V2 supplies Posteroinferior (MAXILLARY) *INSERT PIC*

23
Q

Describe the blood supply to the nasal cavity? (NOT IN DETAIL)

A

The blood supply originates from both the internal and external carotid External: - Facial - Maxillary Internal: - Ophthalmic

24
Q

Describe blood supply to the nose IN DETAIL

A

Ophthalmic Artery - Comes from the internal carotid artery - Via anterior and posterior ethmoidal arteries Maxillary Artery - Comes from external carotid artery - Via Sphenopalatine and Greater Palatine Arteries Facial Artery - Comes from external carotid artery - Via Lateral Nasal Branch of Facial OR Septal Branch of Superior Labial Artery *PHOTO*

25
Q

Describe Little’s/Kiesselbach’s Area

A

This is the arterial anastomosis on the nasal septum. This is where 90% of nosebleeds occur

26
Q

What are the nasal conchae? Names?

A

These are scroll shaped bones that protrude from the lateral wall into the nasal cavity There are three - Superior - Middle - Inferior *PHOTO*

27
Q

Describe the difference between the conchae?

A

The superior and middle are part of the ethmoid The inferior is a bone on its own

28
Q

What are the functions of the conchae?

A
  • Increase surface area for gas exchange - Warm and humidify inhaled air - Trap bugs and particles
29
Q

What are the meatuses? Names?

A

Just below each conchae is a space/recess called an meatus - Sphenoethmoidal Recess - Superior Meatus - Middle Meatus - Inferior Meatus *PHOTO*

30
Q

Describe how to insert an NG tube?

A

Insert through the nostrils (avoid Little’s area) Pass below the inferior nasal concha Along the top of the hard and soft palate Down into the nasopharynx, oropharynx, laryngopharynx and down into the oesophagus

31
Q

How do you know an NG tube is correctly placed?

A

On X-RAY, it should go into the stomach If it goes into bronchi, it is incorrectly placed

32
Q

Complete the sentence: Right and left nasal cavities are divided by the.. This is composed of…

A

Divided by nasal septum Composed of perpendicular plate of the ethmoid bone, the vomer and hyaline cartilage

33
Q

Complete the sentence The lateral wall of both nasal cavities contains features: the superior, inferior and middle… The nasal roof is formed from… anteriorly and …. posteriorly

A

Nasal concha Roof is formed from nasal bones anteriorly and the cribriform plate of the ethmoid bone posteriorly

34
Q

What are Ostia? Function?

A

These are holes in the recesses and meatuses of the lateral nasal wall Their function is to allow for mucous drainage from the paranasal sinuses

35
Q

What are paranasal sinuses? Names?

A

These are air spaces within bones: - Frontal Sinuses (left and right, within frontal bone) - Maxillary Sinuses (Left and right, within maxillary bone, also called ANTRA) - Ethmoid Air Cells (Left and right, within ethmoid bone) - Sphenoid Sinuses (Sometimes one, sometimes two)

36
Q

Describe what is always occurring within the paranasal sinuses? What cells cause this?

A

The paranasal sinuses are lined with respiratory mucosa They are constantly secreting mucous

37
Q

Describe mucous drainage from paranasal sinuses?

A

Mucous drains via ostia in the lateral walls of the nasal cavity from the paranasal sinuses

38
Q

Where does the Sphenoid sinuses drain?

A

Sphenoethmoidal Recess

39
Q

Where do the Frontal sinuses drain?

A

Middle Meatuses

40
Q

Where do the Ethmoid Air Cells Drain?

A

Superior and Middle Meatuses

41
Q

Where do the Maxillary sinuses drain?

A

Middle Meatuses

42
Q

Why are ethmoids different..? *Remember using this*

A
  • Called air cells, not sinuses - Drain into both superior and middle
43
Q

Where do the lacrimal ducts drain?

A

These drain into the nasolacriminal duct then into the inferior meatus

44
Q

What is Sinusitis? - Length of time? - Causes?

A

This is inflammation of the mucosa of the paranasal sinuses. Can affect one or more paranasal sinuses. Can be acute, sub chronic or chronic (>12 weeks) Causes include allergy, infection, autoimmune issues Anything that affects cilia - smoking, cold air, pollution

45
Q

Describe the pain of Sinusitis? Innervation?

A

Sinusitis is painful Sensation is provided by V1 and V2 (Trigeminal - Ophthalmic and Maxillary) Pain may be referred to teeth

46
Q

Which is the most common sinusitis? Why?

A

Maxillary Sinus is the most common The maxillary sinuses drain into the middle meatus which is above the maxillary sinuses (they have to drain against gravity)

47
Q

Describe the link between teeth and sinusitis?

A

Extraction of a tooth can lead to a fistula (oro-antral fistula) Roots of the upper teeth spread into the maxillary sinus therefore infection can lead to sinusitis Maxillary sinusitis may present as toothache due to shared nerve supply (CN V). This is referred pain

ENT (17 decks)

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