(Figure 9) Structure of nose
1, nasal root 2, nasal bridge 3, nasal tip
4. Anterior nostril 5. Nose backward
6, nasolabial groove 7, alar
(2) The front part of the nasal cavity is called the nasal vestibule, which has nasal hair and abundant sweat glands and sebaceous glands, and is prone to furuncle. The top of nasal cavity is a part of the bottom of anterior cranial fossa, which is thin and closely connected with dura mater, through which olfactory nerve passes. Inside the nose is the nasal septum, and there is a rich vascular network in front. The surface of the lateral wall of the nasal cavity is irregular, and there are three vertical downward protrusions, which are called upper turbinate, middle turbinate and lower turbinate respectively. The space below each turbinate is called nasal meatus, that is, upper, middle and lower nasal meatus. The gap between the middle turbinate and the nasal septum is called the common nasal meatus. The lower nasal meatus has an opening of nasolacrimal duct, the middle nasal meatus has an opening of frontal sinus, anterior ethmoid sinus and maxillary sinus, and the upper nasal meatus has an opening of posterior ethmoid sinus and sphenoid sinus. (Figure 10) 1- frontal sinus 2- superior turbinate 3- superior nasal meatus
4- Middle meatus 5- Middle turbinate 6- Inferior turbinate
7- inferior nasal meatus 8- nasal vestibule 9- sphenoid sinus
10- eustachian tube protrusion 1 1- eustachian tube pharynx
(3) There are four pairs of sinuses, namely frontal sinus, ethmoid sinus, maxillary sinus and sphenoid sinus.
① Frontal sinus: located in the lower part of frontal bone, the posterior wall is a thin bone plate separated from the anterior cranial fossa, and the bottom wall is equivalent to the upper angle of the orbit, which is very thin. In acute frontal sinusitis, there is obvious tenderness here.
② ethmoid sinus: located in ethmoid bone between the orbit and the external upper part of nasal cavity, it consists of a very thin small bone plate, which is divided into two groups. The outer and inner sides of the orbit are paper templates as thin as paper, so ethmoid sinus or orbital inflammation can infect each other.
③ Maxillary sinus: It lives in the maxilla and is the largest pair of sinuses, with an average volume of about 13 ml. The opening position of maxillary sinus is high, which is not conducive to drainage, so it is more inflamed than other sinuses.
④ Sphenoid sinus: located in the sphenoid bone above the nasal cavity, its top, outer wall and posterior wall are separated from the middle cranial fossa and the posterior cranial fossa by bone plates, which are closely related to the orbital apex, so sphenoid sinusitis can cause optic neuropathy. acne rosacea
Also known as rose acne, it is more common in middle-aged and elderly people. The lesions showed diffuse flushing in the middle part of the face, accompanied by papules, pustules and telangiectasia. The etiology is not completely clear, which may be caused by the imbalance of facial blood vessels and motor nerves and the long-term expansion of capillaries on the basis of sebum overflow.
[Clinical manifestations]
1. The initial damage is temporary erythema, and then it persists with telangiectasia. Since then, papules have appeared in batches on the basis of erythema, and some have become pustules, purulent papules and nodules. In severe cases, local tissue thickens and rhinoplasty is formed.
2. Skin lesions occur on the face, especially on the nose and its sides.
3. Irritating food, gastrointestinal dysfunction and endocrine disorders can all induce this disease.
[diagnosis]
1. According to the clinical characteristics of the disease, it can be diagnosed.
2. It needs to be differentiated from acne vulgaris in adolescence. In addition to facial lesions, the chest and back are often invaded, often accompanied by blackheads, and the nose is often inviolable.
[Prevention and Care]
1. The diet should be light, eat more fresh vegetables, and avoid spicy food such as spicy food, wine and strong tea.
1. Keep a good mood and avoid excessive emotional fluctuations.
3. Wash your face with warm water to avoid the stimulation of too cold, too hot and unclean items.
1, nasal mucosal swelling or edema: when the vascular lesions of nasal mucosa are mainly microvascular dilatation and permeability increase, they show pale edema; when the vascular lesions of nasal mucosa are mainly venules and cavernous sinus dilatation, they show swelling. Nasal mucosal swelling or edema is one of the main causes of nasal congestion. Nasal polyps are the result of severe nasal mucosa and long-term swelling and edema. Nasal mucosa droops, forming nasal polyps. It is mainly located in the middle nasal meatus and middle turbinate. Because of its deep location, it is difficult to find it during inspection. Therefore, before the nasal polyps in the middle nasal meatus and middle turbinate can be clearly seen, decongestants must be used to shrink the swollen nasal mucosa. Nasal polyps can be single or multiple, which can be seen in unilateral nasal cavity or bilateral nasal cavity. Nasal polyps are more common in perennial allergic rhinitis. Because hay fever has a certain seasonality, the longest is no more than 6 months, so nasal polyps are rare.
2. Increased nasal mucus: The nature of nasal mucus is serous (watery), serous mucinous or mucinous (sticky white); Yellow and purulent nasal secretions are more common in sinusitis and chronic rhinitis, and allergic rhinitis accompanied by bacterial or viral infection can also occur. Nasal secretions often exist in the common nasal passage (between the inferior turbinate and the nasal septum) and the nasal floor, which are easy to be found during examination. Because of the long-term increase of nasal secretions in children, it often irritates the skin around the nasal vestibule and anterior nostril, leading to nasal vestibulitis and skin inflammation outside the nose, which is characterized by skin congestion, exudation, scabbing and small cracks.
3. Scales, nasal secretions, bacteria and allergens accumulate in the nasal cavity. Scab is also called booger. Many nasal diseases can lead to scab. In fact, as long as there is a runny nose, runny nose and pus, the secretion will reach the nasal outlet. If it is dried, plus dust and bacteria, it will scab. Due to the large increase of nasal secretions, the yellow secretions are thick and the nasal cilia swing abnormally, which makes it difficult to discharge from the nasal cavity; Because of abnormal nasal cilia movement and nasal mucus secretion, bacteria and allergens can not be excreted in time. These are also important reasons for nasal congestion.
This state of rhinitis nose can lead to a variety of symptoms:
1, rhinitis nasal mucosa tissue swelling or edema, scabbing, plus purulent secretions or watery secretions too much, hindering the circulation of air in the nasal cavity, so it will cause nasal congestion (of course, nasal polyps, turbinate hypertrophy, nasal septum deviation cause nasal congestion, this situation is best surgery);
2. The insensitivity of the sense of smell is also because these things prevent the airflow from reaching the olfactory region in the upper part of the nasal cavity, so that the olfactory nerve cannot touch the airflow;
3. The accumulation of bacteria and allergens in the nasal cavity and watery secretions will stimulate nerves, causing itchy nose and sneezing;
4. The accumulation of bacteria and allergens in the nasal cavity will make the glands secrete too much, forming a large number of nasal mucus flowing out from the front of the nose;
5, rhinitis nasal mucosa tissue swelling or edema, scabbing, plus purulent secretions or excessive watery secretions blocked the opening of the sinus, causing negative pressure in the sinus and causing headache;
6. Bacteria, allergens and purulent secretions accumulate in the nasal cavity, which makes the inflammation continue to develop and worsen, and can spread to other adjacent organs, causing complications.