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29 Cards in this Set
- Front
- Back
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What structure is NOT derived from the ethmoturbinals?
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inferior turbinate.
(derived from the maxilloturbinal) |
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The maxillary sinus undergoes 2 periods of rapid growth: first ____________ and then __________
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first 3 years of life
between ages 7 and 12 |
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Which sinuses not not present at birth?
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only the frontal
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Ethmoids reach adult size by age ____
Sphenoids reach adult size by age ____ Frontals develop into the ______ |
12
12-15 into the 20s |
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Where is Woodruff's plexus located?
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posterior 1 cm of the nasal floor and inferior meatus
Under inferior turbinate where SPA anastomoses with pharyngeal artery |
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The sphenopalatine artery divides into the
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lateral nasal artery (supplies nasal side wall) and posterior septal nasal artery (goes over sphenoid face)
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Describe the parasympathetic pathway of the nasal cavity
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superior salivatory nucleus
nervus intermedius GSPN vidian nerve synapse at sphenopalatine ganglion post-ganglionic travels with branches of sphenopalatine nerve |
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Describe the sympathetic pathway of the nasal cavity
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thoracic spinal nerve (T1-T2) synapses at
superior cervical ganglion post-ganglionic fibers travel with carotid deep petrosal nerve (joins GSPN to make vidian) traverse sphenopalatine ganglion without synapsing distributed via trigeminal fibers |
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Primary parasympathetic neurotransmitters?
Primary sympathetic neurotransmitters? |
Acetyelcholine
VIP norepinephrine neuropeptide Y |
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List mediators that vasodilate
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Substance P
Prostaglandin E3 Histamine Bradykinin |
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Choanal atresia occurs 1 in 8000 births.
____ female to male ratio _____ side more commonly involved |
2:1
right |
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What is the classic presentation of bilateral atresia?
Unilateral atresia? |
cyclic cyanosis relieved by crying
detected later in childhood, unilateral purulent discharge |
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How do you diagnose atresia?
How do you manage it? |
inability to pass 6 or 8 Fr catheter 5.5 cm from alar rim. CT will show widened vomer width.
oropharyngeal airway, McGovern nipple, intubation |
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What syndromes are associated with atresia?
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CHARGE
Apert Crouzon Treacher-Collins |
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What are 3 approaches for atresia repair?
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1. transnasal puncture of atretic plate
2. transpalatal repair (palatal flap breakdown, fistula, cross bite, palate deformity) 3. endoscopic approach with powered instruments (avoids midpalate suture and deformities |
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What presents with a nasal pit and tuft of hair?
What is it comprise of? |
nasal dermoid
ectodermal and mesodermal elements |
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What percent of gliomas have an intercranial connection?
What does it look like clinically? |
20%
firm, non-tender, non compressible, overlying telangiectasias gray/purple polyp arising from lateral aspect of the nose |
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Where are each of these cysts located?
1. Globulomaxillary cyst 2. Nasoalveolar cyst 3. Nasopalatine duct cyst 4. Thornwaldt cyst 5. Rathke pouch cyst |
1. between lateral incisor and canine
2. anterior pyriform aperture 3. midline palate, 4th-6th decade 4. high nasopharynx between longus capitus muscles 5. within sella turcica, women 5th-6th decade |
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What syndrome is characterized by congenital loss of smell?
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Kallman's disease
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What marker is used to test Wegener's?
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c ANCA
vasculitic phase 90% positive granulomatous phase 65% positive remission phase 30% positive |
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What is lupus pernio?
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chronic violaceous lesion of the nose/cheeks/ears associated with sarcoid
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Histologic finding in Rhinoscleroma?
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Mikulicz cells
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What is lupus pernio?
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chronic violaceous lesion of the nose/cheeks/ears associated with sarcoid
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What do S. aureus strains that cause toxic shock syndrome make?
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enterotoxin B or C/TSS toxin1
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Why is a paradoxical middle turbinate clinically significant?
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can narrow the middle meatus
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Anterior third of skull base has a saggital insertion into the skull base. Middle third inserts onto the ___________
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lamina paprycea
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Osteomas of the sinuses are most commonly found in the _______ sinus.
What syndrome is associated with skull osteomas? |
frontal sinus
Garnder's syndrome -- colonic polyps, skull osteomas, soft tissue tumors |
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What is the mechanism of aspirin sensitivity?
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NSAIDs block prostaglandin production which shunts the pathway to leukotriene production
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What should you suspect if you see nasal polyps in a child?
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cystic fibrosis
associated with 7q31 |
