Disorder of Nose and Sinus Flashcards
Consequences of impaired olfaction (ability to perceive smell)
- impaired sense of taste
- leads to nutritional deficiencies
- impairs social interactions
- depression
- may be dangerous (tumors, alzheimer’s, parkinson’s, neuro disorders)
Define:
- anosmia
- hyposomia
- dysosmia
- -parosmia
- -phantosmia
- -agnosia
- anosmia: inability to detect odors
- hyposomia:decreased ability to detect odors
- dysosmia:distorted identification of smell
–parosmia:altered perception of smell in the presence of
an odor, usually unpleasant
–phantosmia:perception of smell without an odor present
–agnosia:inability to classify or contrast odors, although able to detect odors
What are the three most common causes of primary olfactory deficits?
nasal and/or sinus disease
prior viral upper resp infection
head trauma
Congenital causes of anosmia
Causes of dysosmia
Causes of parosmia and hyposmia
Anosmia
- midline facial abnormalities (cleft palate)
- neurosensory hearing loss
Dysosmia
- nasal and paranasal sinus disease (most common)
- head trauma
- URI
- medications
- exposure to toxins
Parosmia and Hyposmia
- AGING and neurodegenerative processes
- nasal obstruction
- URI
- head/facial trauma
- central olfactory damage
The nose contains cilia that are less than a cm in length and beat at a frequency of 1000 cycle/min. True or false?
Truuuuue
-there is also a mucous blanket that is important in preventing infection and subsequent problems
Rhitinis
- defined as
- caused by
Defined as
-inflammation of the nasal mucosa
Cuased by
- infection (viral, bacterial, fungal)
- allergy
- environmental irritants
- medications (rhinitis medicamentosa-afrin abuse)
- hormonal changes
- chronic inflammatory disease
- other undefined mechanisms (vasomotor rhinitis)
Rhinitis
-presentation
Presentation
- nasal congestion
- rhinorrhea/discharge
- epistaxis
- pain (nasal, sinus, pharyngeal, dental)
What is an upper respiratory infection?
How many URIs do the following age groups typically get per year?
- preschool children
- kindergarten
- school age
- adolescents/adults
URI/infectious rhinitis/the common cold
- inflammation of the nasal passages commonly due to any number of respiratory viruses
- vast majority are self treatable
- preschool children: 6-10/year
- kindergarten: 12/year
- school age: 7/year
- adolescents/adults: 2-4/year
Infectious rhinitis/the cold/URI
-presentation
Presentation
- pharyngitis (usually first sx)
- nasal congestion, rhinorrhea, obstruction
- sneezing
- facial and/or ear pressure
- loss of smell/taste
- cough (mucous drainage)
- hoarseness (mucous coating larynx)
- HA
- Malaise
- fever greater than 100F/37.7C
Infectious rhinitis/the common cold/URI
Cause
Cause
- weather
- exercise, diet, enlarged tonsils/adenoids
- psychological stressors
- allergic disorders
- VIRAL *** (more than 200 strains of viruses can cause URI)
- -rhinoviruses (80%)
- -coronaviruses
- -adenoviruses
-40% of cases have an unknow etiology
What are the viruses that can causes a more severe Infectious rhinitis/the cold/URI?
orthomyxovirus (influenza A and B)
Paramyxovirus (parainfluenza)
Echoviruses
Respiratory syncytial virus
Enteroviruses (polio)
Coxsackieviruses (heart muscle)
Infectious rhinitis/the cold/URI
Treatment
- rest
- drink plenty of fluids (think mucous)
- gargle with warm salt water
- Use throat sprays, lozenges
- petroleum jelly for sore nose
- aspirin, ibuprofen, or acetaminophen for HA and fever
- reassurance (usual course is 6-10 day)
- discontinue tobacco and alcohol use
*Never use aspirin for Ha or fever in children..Reyes Syndrome (N/v/liver inflammation/progressive mental changes)
- Antihistamines (benadryl, zyrtec)
- NSAIDs
- -relieve fever, myalgias, HA
- -“the way to go with the common cold”
- Decongestants (sudafed/pseudoephedrine, afrin is a decongestant but you don’t use it for the common cold)
- -SE: narrow angle closure glaucoma, HTN, CAD
Infectious rhinitis/the cold/URI
-Possible complications
Complications
- Lower resp tract infection (bronchitis, pneumonia)
- bronchial hyperreactivity (reactive airway)
- exacerbation of chronic lung diseases (asthma, COPD)
- otitis media (bacterial)
- acute sinusitis (bacterial)
- rhinitis medicamentosa
Sinusitis
- Definition
- Causes
- classifications
- -acute rhinosinusitis
- -subacute rhinosinusitis
- -chronic rhinosinusitis
- -recurrent acute rhinosinusitis
Definition
-inflammatory or infectious processes in the paranasal sinuses (air pockets on either side of and behind the nose
Causes
- bacteria
- Viruses (most common)
- Fungi
- possibly allergies
Classifications
- -acute rhinosinusitis:sx last less than 4 weeks
- -subacute rhinosinusitis: sx for 4-12 weeks
- -chronic rhinosinusitis:sx persist greater than 12 weeks
- -recurrent acute rhinosinusitis:4 or more episodes per year, with interim sx resolution
Sinusitis
- Patho
- 3 factors crucial for the normal physiologic functioning of the sinuses
- predisposing factors for reccurent sinus infections
Patho
- the most important element in the development of sinusitis is the osteomeatal complex of the outflow tracts of all the sinuses into the nose, but most importantly the maxillary and ethmoid sinuses
- obstruction may occur causing sinusitis of the sinuses
3 factors crucial for the normal physiologic functioning of the sinuses
- Patency of the osteomeatal unit (OMU)
- normal mucociliary transport
- normal quantity and quality of secretions
Predisposing Factors
- anatomical irregularities
- infections
- allergies
- polyps
- hormones
- environment
- foreign bodies
- cystic fibrosis
