Term
| the external nose is a pyramidal structure composed of: |
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Definition
| skin, dorsal nasal bones and upper/lower lateral cartilages |
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Term
| one of the most common causes of nasal obstruction |
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Definition
| acquired deviation of the septum |
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Term
| reactions of turbinates to changes in temperatur, humidity & alergen exposure |
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Definition
| turbinates swell or cntract |
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Term
| where is the nasal pharnyx? |
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Definition
| posterior to the nasal cavity and superior to the soft palate & oropharnyx |
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Term
| what are the 2 most common reasons for physician consult in the US? |
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Definition
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Term
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Definition
| abnormal grey glistening masses filled with inflammatory material that form in the nasal cavity or sinuses |
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Term
| epidemiology of nasal polyps |
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Definition
10x more common in adults
affect males 2-4X more often than females
usually >20yrs |
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Term
| in adults nasal polyps are frequently associated with: |
|
Definition
chronic sinusitis
asthma
aspirin sensitivity |
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Term
| in children nasal polyps are most commonly assoc w.: |
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Definition
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Term
|
Definition
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Term
| 7 presentations of nasal polyps |
|
Definition
1. airway obstruction
2. watery anterior rhinorrhea, sneezing, postnasal drip
3. dull headaches
4. snoring
5. hyposmia/anosmia
6. chronic mouth breathing
7. change in quality of voice |
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Term
|
Definition
hyposmia - decreased ability to smell
anosmia - loss of smell |
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Term
| are polyps usually unilateral or bilateral? |
|
Definition
|
|
Term
| are polyps sensative to touch? |
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Definition
|
|
Term
| what is the mainstay treatment for nasal polyps? |
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Definition
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Term
| treatments for nasal polyps (3) |
|
Definition
1. steroidal nasal spray
2. polypectomy
3. sinus lavage may be helpful |
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Term
|
Definition
1. viral (most common)
2. allergic
3. vasomotor |
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Term
| which rhinitis is IgE mediated? |
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Definition
|
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Term
| 4 clinical presentations for allergic rhinitis |
|
Definition
rhinorrhea
2. nasal congestion
3. accompanied by eye irritation
4. enlarged, boggy, pale turbinates |
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|
Term
| ipratropium bromide nasal spray |
|
Definition
treatment for allergic rhinitis
anti-cholinergic med; inhibits mucus
also used as bronchodialator |
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Term
| 4 other treatment for allergic rhinitis |
|
Definition
antihistamines
decongestants
intranasal steroid sprays
saline nasal wash |
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Term
| when would you not want to perscribe a decongestant |
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Definition
| when pt has high BP - decoingestants are vsoconstrictors |
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Term
| define vasomotor rhinitis |
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Definition
| non-allergic rhinitis; similar symptoms different causes. |
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Term
| distinguis vasomotor from allergic rhinitis: |
|
Definition
| vasomotor: no nasal or occular itching, later age onset, post nasal drip, congestion is a promenent symptom |
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Term
| is vasomotor rhinitis seasonal or perennial? |
|
Definition
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|
Term
| vasomotor rhinitis pathophysiology: |
|
Definition
| exact mechanism is unknown; nonsecific stimuli act on autonomic nervous sys. |
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Term
| 3 treatments for vasomotor rhinitis: |
|
Definition
1. avoid triggers
2. nasal sprays (saline, steroids)
3. likely to need continued treatment |
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Term
|
Definition
|
|
Term
| which virus contributes up to half of viral rhinitises? |
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Definition
|
|
Term
| which cells are affected in viral rhinitis? |
|
Definition
| ciliated epithelial cells in nasal mucosa |
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Term
| name a significant complication fro viral rhinitis |
|
Definition
| secondary bacterial infection; bacterial adherence increases with viral infection |
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|
Term
| how does wet weather and chilling affect viral rhinitis? |
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Definition
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|
Term
| peak months of viral rhinitis: |
|
Definition
|
|
Term
| how ling is incubation phase of viral rhinitis? |
|
Definition
|
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Term
| symptoms of viral rhinitis peak at ____ days and persist as long as _____ _____: |
|
Definition
symptoms peak @ 3-5days
may persist as long as 2-3wks |
|
|
Term
| predominate method of transmission for viral rhinitis: |
|
Definition
|
|
Term
| 2 other methods of transmitting viral rhinitis: |
|
Definition
1. hand to hand to nose
2. cough/sneeze exposure |
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|
Term
| what is often the first symptom of viral rhinitis? |
|
Definition
|
|
Term
| fever is usually under ________ in viral rhinitis |
|
Definition
|
|
Term
| appearance of nasal concha in viral rhinitis: |
|
Definition
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|
Term
| 6 treatments for viral rhinitis: |
|
Definition
1. rest, fluids
2. water, juice, soup
3. acetomenophin or ibuprofen
4. cough supressant
5. decongestant (discouraged in children)
6. expectorant |
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|
Term
| 6 indications that viral rhinitis may require antibiotic: |
|
Definition
1. high fever (strep)
2. shortness of breath
3. ear pain
4. face tender to palpation
5. Hx and comorbidities
6. other unusual circumstances |
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|
Term
| 3 major signs of nasal foreign body: |
|
Definition
1. unilateral rhinorrhea
2. purulent pus
3. odor |
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|
Term
| 4 causes of nasal dryness: |
|
Definition
1. nose picker
2. overuse of nasal sprays
3. indoor heated air
4. vestibulitis |
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|
Term
|
Definition
|
|
Term
|
Definition
1. picking
2. dryness (most common)
3. medications (coumadin)
4. HTN
5. cocain use
6. systemic disorders (hepatitis)
7. neoplasms
8. Telangectasia (collection of capillaries) |
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|
Term
| anterior vs. posterior nose bleeds |
|
Definition
anterior: 95% of bleeds, direct pressure treatment
posterior: 5%, admit to hospital, consult ENT |
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|
Term
| 5 steps for nose bleed treatment: |
|
Definition
1. patient seated
2. leaning slightly forward
3. compression of nares x 15min
4. if bleeding continues, examine to determine bleeding site.
5. anterior packing |
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|
Term
| 4 drug types for nose bleed treatments: |
|
Definition
1. topical nasal decongestant(vasoconstrict)
2. topical cocain (vasoconstrict)
3. lidocain (vasoconstrict)
4. silver nitrate cautery - for visualized anterior bleed |
|
|
Term
| 3 types of anterior packing: |
|
Definition
vasoline coated gause
nasal tampon or sponge
epistaxis catheter/baloon |
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|
Term
| anterior packing follow up 4 points: |
|
Definition
1. keep packing moistened with saling
2. antibiotics
3. RTC in 3-5 for packing removeal
4. must tell pt not to pick nose |
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|
Term
| 2 indicated lab tests assoc w posterior nasal bleed |
|
Definition
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|
Term
| posterior packing procedure 5 points: |
|
Definition
1. immediate ORL consult or ER packing
2. add anterior gauze pack
3. admit for observation
4. oxygen; ck airway frequently
5. pain medication |
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|
Term
| post epistaxis 48hour precautions: (6) |
|
Definition
1.don't blow nose
2. lubricant (if no pack)
3. no hot or spicy foods
4. avoid straining/vigorous exercise
5. keep head above heart
6. no picking |
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|
Term
| pathophysiology og sinusitis: |
|
Definition
| inflammation of membranse lining the sinus blocks drainage tract, mucus secretions accumulate and become secondarily infected |
|
|
Term
| 4 organisms assoc w sinusitis: |
|
Definition
1. S. pneumo
2. H. influ
3. S. aureus
4. M. cat |
|
|
Term
| 7 factors that increase risks for sinusitis: |
|
Definition
1. frequent URI
2. asthma
3. diabetes
4. smoking
5. immunocompramised
6. nasal polyps
7. cystic fibrosis |
|
|
Term
| where is ostium located in maxillary sinuses? |
|
Definition
|
|
Term
| define recuring sinusitis: |
|
Definition
| >3 acute episodes in a year |
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|
Term
|
Definition
| infection lasting 7-30days |
|
|
Term
| define subacute sinusitis |
|
Definition
|
|
Term
|
Definition
| symptoms persist longer than 90d |
|
|
Term
| which sinus is most commonly infected? |
|
Definition
|
|
Term
| define transillumination of maxillary sinus |
|
Definition
| light shone through maxillary sinus & visible inside mouth if sinuses clear |
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|
Term
| 5 acute sinusitis treatments: |
|
Definition
1. increase fluids and humidify
2. saline spray
3. decongestants (oral/spray)
4. antibiotics
5. NO ANTIHISTAMINES |
|
|
Term
| define sinus series:4 views: |
|
Definition
radiographs of the sinuses
1. water's
2. Caldwell's
3. Submental
4. Lateral |
|
|
Term
| indications for sinus series: |
|
Definition
| when concerned about: mucocele comlications of chronic sinusitis, bony damage, or malignancy |
|
|
Term
| checklist for sinus radiographs 4: |
|
Definition
1. thickened lining
2. opacification
3. air/fluid levels
4. check bony margins to ro malignancy |
|
|
Term
| 4 acute sinusitis emergencies: |
|
Definition
1. frontal infection
2. sphenoid
3. possible schock
4. radiograph shows air-fluid level |
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|
Term
|
Definition
|
|
Term
| two sinuses commonly indicated in chronic sinusitis: |
|
Definition
|
|
Term
| treatment for chronic sinusitis may include: |
|
Definition
| surgery, steroids, referal |
|
|
Term
| 2 conditions assoc w fungal infections: |
|
Definition
| immunocomprimised & diabetes |
|
|
Term
| which occupation is at greater risk for malignancies of paranasal sinuses |
|
Definition
|
|
Term
| 3 presentations of malignancies in paranasal sinuses: |
|
Definition
1. persistent facial/dental pain
2. nasal obstruction
3. epistaxiis |
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