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nasal septum
bone and cartilage that seperates nasal cavities
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conchae
- bony turbinates
- 3 projections sup, inf, and middle
- incr surface area of nasal cavities
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paranasal sinuses
small air filled cavities lined w muc mem; drain into nose; frontal, maxillary, ethmoidal, and shenoidal
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how do we smell? 3
chemoreceptors (nasal cavities)-->impulses travels along cn1 (olfactory nerve)-->temporal lobe
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epitaxis control
- apply pressure to soft parts of nose for several minutes (10-15)
- pt seated (lessens fainting and decr bld flow)
- tilt head slightly forward
- breathe thru mouth
- ice pack to nose
- suck on ice
- emesis basin
- tissues
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profuse nose bleeding
- consult dr immediately
- cotton pedgets saturated w silver nitrate/epineprine/cocaine may be ordered w application of pressure and cold compresses
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continued profuse nose bleeding
pack nasal cavity w gauze for 24-72 hrs or cauterize blding areas
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post-op nasal surgery sign of hemorrhage
- frequent swallowing
- use flashlight look in back of throat
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nasopharynx*
upper portion behind nasal cavities
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oropharynx*
mid portion behind mouth
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laryngopharynx*
lower portion that opens into larynx
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strep throat
- streptococcal bacteria group A beta-hemolytic strep
- establishes in lymphoid tiss and produces abrupt onset
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s/s strep
sore throat, pain aggravated by swallowing/turning head, fever over 101, chills, ha, redness and edema, covered in yellow exudate, tender cervical nodes, sometimes rash
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rash with strep
r/o scarlet fever
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complications of strep**
rheumatic fever, nephritis
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strep tx
pcn drug of choice
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nsg management strep
vs, rest, mouth care, warn nss gargle, intermittent ice collar, humidification, anesthtic spray, monitor for complications
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t and a surgery
tonsils and adenoids removed bc of chronic inf, cont hypertrophy causing obstruction, repeated attacks of pur om, or hearing loss due to ser om
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post op t and a
- 1. observe for hemorrhage (immediately and pod 7-10) - freq swallowing*
- 2. throat color: black to green/grey to white to pink
- 3. freq vs (fever, shock)
- 4. position on side then semi fowlers
- 5. iv fluids and ff po
- **keep throat moist at all times***
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obstructive sleep apnea
- repetitive episodes of partial and complete airway obstruction
- tongue and soft palate fall backward blocking airway
- bldstream: co2 levels rise and o2 drops arousing pt
- cont thru sleep cycle, apneic episodes may last 10 sec and up to 300 per night
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osa common in
- obese men w short/thick neck
- increases w age
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s/s osa 9
- disrupted sleep pattern
- daytime sleepiness
- irritable
- personality changes
- ha
- effects memory and concentration
- htn
- arrythmias
- resp failure
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noisy sleep
loud snoring/snorting/gasping
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dx osa
- s/s
- abgs
- polysomnagraphy (sleep study)
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tx osa 6
- wt loss
- change in position
- acoid cns depressants
- pral appliance
- cpap and bipap
- surgery
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laryngeal ca
- over age 60
- 5x more in men
- increased risk w heavy smokers, chronic etoh users
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cordectomy/partial laryngectomy 5
- early stages esp true vocal cords
- 80% cure
- thyroid cart of larynx split midline of neck and diseased portion removed
- trach tube may be left for breathing
- does not perm eliminate voice
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total laryngectomy 4
- extrinsic tumor
- excises entire larynx, including thyroid cart, cricoid cart, hyoid, vocal cords, epiglott, 3+ trach rings
- modified or radical neck dissection
- perm trach
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throat sprays
nothing to eat/drink for 60 minutes bc throat anesthetized and gag relex inhibited
use tongue depressor to spray
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