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When does aeration of the frontal sinus begin?
Age 4-5 years, continues into the late teens
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What percentage of the population has a unilateral frontal sinus?
10%
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At what age can the maxillary sinuses be visualized on CT?
Age 4-5 months
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The is fully formed by the 5th week gestation and goes on to develop into the floor of the nose/palate.
Oronasal membrane
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What are the nasal anatomic subunits?
- nasal dorsum
- nasal sidewalls
- nasal tip
- alar lobules
- depressions of the supra-alar facets
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Which muscles elevate the nose?
- Procerus
- Levator labii superioris alaeque nasi
- Anomalous nasi muscles
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Which muscles depress the nose?
- Alar nasalis
- Depressor septi nasi muscles
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What are the other muscles of the nose (the compressor and dilators)?
- Transverse nasalis
- Compressor narium minor
- Dilator naris anterior muscles
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What is the narrowest portion of the nasal cavity?
Nasal valve
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What is the nasal valve?
The angle between the caudal quadrangular cartilage and the distal upper lateral cartilages
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What is the only septal component that is paired?
The vomer, which may be bilaminar owing to its dual embryonic origin
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What makes up the superior portion of the bony nasal septum?
Perpendicular plate of the ethmoid
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What are the major tip support mechanisms?
- Contour, size, and strength of the lateral crura
- Attachment of the medial crural footplate to the caudal septum
- Attachment of the caudal edge of the upper lateral cartilages to the cephalic border of the alar cartilages
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What are the minor tip support mechanisms?
- Nasal tip ligamentous aponeurosis
- Cartilaginous septum
- Nasal spine
- Strength and resilience of the medial crura
- Thickness of tip skin and subcutaneous tissue
- Supportive strength of the alar sidewalls
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What are the major anatomic features that determine tip projection?
- Thickness and character of tip skin
- Shape and strength of alar cartilages
- Length of infratip lobule and columella
- Anatomy of the quadrangular cartilage (esp the anterior septal angle)
- Size of the nasal spine and premaxilla
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What type of epithelium lines the nasal cavity?
Ciliated pseudostratified epithelium
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What neuropeptide is thought to be a mediator of pain in the nose and paranasal sinuses?
Substance P
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What are odorous substances made of?
Either gases or volatile liquids
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How is sensory epithelium of the olfactory system different from the surrounding respiratory epithelium?
Both have cilia, but the cilia of the olfactory epithelium do not beat synchronously
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What are Bowman's glands?
They secrete mucus and yellow pigment in the olfactory epithelium. The odorant must dissolve in this layer of mucus to reach the sensory receptors.
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How are the receptor cells in the olfactory system different from those of the ear, eye, and tongue?
They are bipolar nerve cells (others are specialized epithelial cells)
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Unlike the taste pathway to the cerebral cortex, the olfactory pathway does not relay in the . The olfactory nerve terminates in the and sends axons via the olfactory tract to the piriform cortex, the periamygdaloid area, and the .
- Thalamus
- Olfactory bulb
- Olfactory tubercle
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What is the most common cause of taste loss?
Olfactory dysfunction
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What is dysosmia?
Perception of an unpleasant odor
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What is phantosmia?
Perception of an odor in the absence of a stimulus
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What is parosmia?
Distorted perception of an odor
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Where does the nasolacrimal duct lie in relation to the osmium of the maxillary sinus?
3-6mm anteriorly
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The majority of posterior ethmoid cells empty into which meatus?
Superior meatus
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What percent of the population has a supreme nasal concha?
60%
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What are the 5 basal or ground lamella of the paranasal sinuses?
- Uncinate process
- Bulla ethmoidalis
- Basal lamella of the middle turbinate
- Lamella of the superior turbinate
- Lamella of the supreme turbinate (if present)
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What structure separates the anterior and posterior ethmoid complexes?
Basal lamella of the middle turbinate
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Where does the natural ostium of the maxillary sinus empty?
Ethmoid infundibulum
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What is the most posterior part of the middle turbinate attached to?
Crista ethmoidalis of the perpendicular process of the palatine bone
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Where does the anterior portion of the middle turbinate most often attach superiorly?
Laterally onto the lamina papyracea (may also attach to the skull base)
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What is an agger nasi cell?
- Pneumatized area of the lateral nasal wall immediately anterior and superior to the insertion of the middle turbinate.
- The most anterior ethmoid air cell
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What problem can an enlarged agger nasi cell cause?
Narrowing of the frontal recess
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What is the term for a persistent, nonpneumatized second basal lamella?
Torus ethmoidalis/lateralis
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What is the term for a pneumatized second basal lamella?
Bulla ethmoidalis
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What is the most posterior aspect of the anterior ethmoids?
Retrobullar recess
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When may the suprabullar recess extend into the retrobullar recess?
If the posterior wall of the bulla lamella is not in contact with the basal lamella of the middle turbinate
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What is another name for the retrobullar recess?
Sinus lateralis
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What does the retrobullar recess drain into?
hiatus semilunaris superior
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What recess does the suprabullar recess open into?
Frontal recess; anteriorly is is separated from the recess by the bulla lamella
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What are the borders of the ethmoid infundibulum?
- Medially, the uncinate process
- Laterally, the lamina papyracea and frontal process of the maxilla
- Posteriorly, the ethmoid bulla
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Into what does the ethmoid infundibulum drain posteriorly?
Hiatus semilunaris inferior
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Where does the maxillary sinus ostium lie in relation to the ethmoid infundibulum?
At the floor and lateral aspect of the infundibulum, between its middle and posterior 1/3
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Where is the anterior ethmoid artery found intranasally?
Anterior to the vertical portion of the basal lamella, immediately below the skull base, and posterior to the frontal recess
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What is the distance from the posterior ethmoid artery to the optic foramen?
5-10mm
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Which table of the frontal sinus is thinner?
Posterior
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Where is the natural ostium of the fontal sinus?
The posteromedial aspect of the sinus floor
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What is the frontal recess?
The drainage pathway from the frontal sinus to the nasal cavity
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What forms the anterior boundary of the frontal recess?
The posterior wall of the agger nasi and frontoethmoid cells, if present
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What structures form the posterior boundary of the frontal recess?
The ethmoid bullae, suprabullar space, anterior skull base, and anterior ethmoid artery; frontal bulla cell
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