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Apuntes deApuntes deFisiologia Nasal, SistemaFisiologia Nasal, Sistemaolfativoolfativo
SeminariosClínica de Asma y
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Anatomy of the NoseThe external nose consists of paire nasal !ones an "pperan lo#er lateral cartila$es. %nternall&, the nasal sept"'
i(i es the nasal ca(it& into a ri$ht an left si e.
The lateral nasal #all consists of inferior an 'i let"r!inates an occasionall& a s"perior or s"pre'et"r!inate !one. The openin$ of the sin"ses also is fo"n"n er the 'i le t"r!inates on the lateral nasal #all.
The lacri'al s&ste' rains into the nasal ca(it& !elo# theanterior inferior aspect of the inferior t"r!inates.
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)(er(ie# Fisiología NasalTo "n erstan the ph&siolo$& of the nose, its f"nctions '"st !e"n erstoo . The nose ser(es as the onl& 'eans of !rin$in$#ar' h"'i ifie air into the l"n$s. %t is the pri'ar& or$an forfilterin$ o"t particles in inspire air, an it also ser(es to
pro(i e first*line i''"nolo$ic efense !& !rin$in$ inspire air
in contact #ith '"co"s*coate 'e'!ranes that containi''"no$lo!"lin + %$+-. %nspire air is !ro"$ht hi$h into thenasal ca(it& to co'e in contact #ith the olfactor& ner(es,there!& pro(i in$ the sense of s'ell, #hich is inti'atel&associate #ith the taste sensation. &sf"nction of an& of theses&ste's can lea to s&'pto's of nasal &sf"nction e$,con$estion, postnasal raina$e, facial press"re, hea aches,sin"s infections-.
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Nasal Airflow+ir flo#s s"periorl& into the nares, eter'ine !& its positionan the anterior nasal (al(e. The airstrea' then t"rns
posteriorl& approxi'atel& 90 an flo#s into thenasophar&nx. The airstrea' then t"rns inferiorl& 90 thro"$h
the phar&nx an lar&nx an flo#s into the trachea to#ar thel"n$s. The anterior nasal (al(e is locate 1.5*2 c' posteriorto the anterior nares an is the narro#est portion of the "pperair#a&. The narro# portion of the "pper air#a& allo#s closecontact !et#een the airstrea' an '"cosal s"rfaces.
"'i ification occ"rs !& e(aporation of 'oist"re fro' the'"cosal !lan et. +ir is h"'i ifie to 75*80 .
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“ o m!s di"cil es ver lo #ue esta delante de tuso$os%&' (oet)e
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ista en osc pica ,fosas nasal erecha. l t"r!inatoesta infla'a o le(e'ente, '"cosa pal i a,el t"r!inato(ien a ponerse en contacto con el septo
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AbnormalNasal Physiology
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To "n erstan the ph&siolo$& of the nose , its f"nctions '"st !e "n erstoo . The nose ser(es as the onl& 'eans of !rin$in$ #ar' h"'i ifie air into the l"n$s . %t is the pri'ar& or$an for filterin$ o"t particles in inspire air , an italso ser(es to pro(i e first*line i''"nolo$ic efense !&
!rin$in$ inspire air in contact #ith '"co"s*coate
'e'!ranes that contain i''"no$lo!"lin + %$+-. %nspire air is !ro"$ht hi$h into the nasal ca(it& to co'e incontact #ith the olfactor& ner(es, there!& pro(i in$ thesense of s'ell , #hich is inti'atel& associate #ith the tastesensation . &sf"nction of an& of these s&ste's can lea tos&'pto's of nasal &sf"nction e$, con$estion, postnasal
raina$e, facial press"re, hea aches, sin"s infections-.
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Tests of
Nasal Physiology
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0i liografía medecine
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Nasal )ysiology Aut)or5 Sanford 6 Arc)er, 678C)ief ditor5 Arlen 7 6eyers, 67, 60A more'''
9lfactory System Anatomy Aut)or5 Amir:o;s)oor, 678 C)ief ditor5 Arlen 7 6eyers, 67,60A more'''Nasal Aerodynamics Aut)or5 Samuel < in, 678C)ief ditor5 Arlen 7 6eyers, 67, 60A more'''
Nasal =econstruction Aut)or5 Ali Sa$$adian, 67,FACS8 C)ief ditor5 Arlen 7 6eyers, 67, 60Amore'''
http://emedicine.medscape.com/article/874771-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/876456-overviewhttp://emedicine.medscape.com/article/876456-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/874771-overview
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Aparato 9lfativo Anatomía
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Anatomía del aparatoolfativo
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9lfactory pit)elium9lfactory Nerve and t)e Cri riform late9lfactory 0ul
9lfactory >ract and Central at)?aysCentral ro$ectionsClinical CorrelationClinical valuation
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http://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overview
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Olfactory Nerve and the Cribriform Plate
The s'all, "n'&elinate axons of the olfactor& receptor cellsfor' the fine fi!ers of the first cranial ner(e an tra(el centrall&to#ar the ipsilateral olfactor& !"l! to 'a e contact #ith thesecon *or er ne"rons.Con "ction (elocities are extre'el& slo#, an s"pport is
pro(i e in !"n les !& a sin$le ch#ann cell. +s pre(io"sl&'entione , the tri$e'inal ner(e cranial ner(e - sen s fi!ers tothe olfactor& epitheli"' to etect ca"stic che'icals, s"ch asa''onia.The cri!rifor' plate of the eth'oi !one, separate at the'i line !& the crista $alli, contains '"ltiple s'all fora'inathro"$h #hich the olfactor& ner(e fi!ers, or fila olfactoria,tra(erse. ract"re of the cri!rifor' plate in tra"'atic settin$s can
isr"pt these fine fi!ers an lea to olfactor& &sf"nction .
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Olfactory lb
http://physiologyofsensationandperception.wikispaces.com/file/view/Olfactory.jpg/355186034/Olfactory.jpghttp://physiologyofsensationandperception.wikispaces.com/file/view/Olfactory.jpg/355186034/Olfactory.jpg
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Olfactory Tract and Central Pathways
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% path#a&s flashcar
http://www.google.com.ni/imgres?imgurl=http://www.ncbi.nlm.nih.gov/books/NBK10982/bin/ch15f1.jpg&imgrefurl=http://www.cram.com/cards/pathways-3037177&h=633&w=694&sz=273&tbnid=37rVUd4zbEW5nM:&tbnh=94&tbnw=103&zoom=1&usg=__4kNREo-xdf3n-6gmW_aYciPN4Io=&docid=iT7n9f8UwlhShM&sa=X&ei=o5dlUvKeB4Pa9QSDiIHYAw&ved=0CFgQ9QEhttp://www.google.com.ni/imgres?imgurl=http://www.ncbi.nlm.nih.gov/books/NBK10982/bin/ch15f1.jpg&imgrefurl=http://www.cram.com/cards/pathways-3037177&h=633&w=694&sz=273&tbnid=37rVUd4zbEW5nM:&tbnh=94&tbnw=103&zoom=1&usg=__4kNREo-xdf3n-6gmW_aYciPN4Io=&docid=iT7n9f8UwlhShM&sa=X&ei=o5dlUvKeB4Pa9QSDiIHYAw&ved=0CFgQ9QE
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Fisiología Nasal
Tests of Nasal Physiologystos e@!menes incluyen estudios 5
Flu$o nasalFunci n ciliar9lfato'
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=inomanometria=)inomanometría cuanti"ca el Bu$o a reonasal durante respiraci n nasal e@clusiva'D Nasal resistance measurementEAcoustic r)inometry'
=)inomanometry and acoustic r)inometry cane used clinically to evaluate nasal patency in a
num er of situations' it)er test may e usedfor a general evaluation of nasal airBo? and to
compare premor id conditions ?it) c)angest)at may occur after medical or surgicalt)erapy' Additionally, t)ese tests can comparenasal passages for medical or surgical planning'
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9tros e@amenes=adiologic imaging ?it) C> or 6= also canassess t)e crossGsectional area of nasalpassages Dsee t)e e6edicine articleC> Scan, Nasal Cavity E'
>)e sacc)arin test evaluates ciliaryfunction y measuring t)e time it ta;es fora drop of sacc)arin to e tasted in t)e ac;of t)e t)roat ?)en applied to t)e anteriortip of t)e inferior tur inate'
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http://emedicine.medscape.com/article/875126-overviewhttp://emedicine.medscape.com/article/875126-overview
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9tros e@amenes olfatoHniversity of ennsylvania Smell
denti"cation >est DH S >Ees el test delolfato m!s conocido''>)e H S > is a 4/Gitem scratc)GandGsniItest and is )ig)ly validated y age and se@'=ecent researc) into e@)aled nitric o@idesuggests t)at in t)e future, t)esemeasurements may prove valua le as nonGinvasive o $ective tools for t)e assessmentand management of normal nasalp)ysiology and nasal and sinus disorders ' J3K
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Anomalías de la "siologíanasal
Nitric o@ideo# ) concentrations #ere reporte in certainiseases, s"ch as pri'ar& ciliar& &s inesia, c&stic
fi!rosis, an ac"te an chronic 'axillar& sin"sitis,#hereas hi$h concentrations #ere etecte in"pper air#a& infection, aller$ic rhinitis, an nasal
pol&posis.
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l septo nasal
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7esviaci n delSepto
Fisiología de las desviaciones del SeptoNasalL
Factor predisponenteL' SinusitisL:er el papel de las alergiasL
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Estructura Osea y
Cartilaginea.
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Nervios de la CavidadNasal Septum
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Nervio alatino 6ayor L'' $)s
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7istri uci n de la mucosaolfativa
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Correlaciones ClMnicas
Anosmia G A sence of smell sensationyposmia G 7ecreased sensation
7ysosmia G 7istortion of smell sensationCacosmia G Sensation of a ad or foul smellarosmia G Sensation of smell in t)e
a sence of appropriate stimulus
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Síndromes ClínicasOallmann syndrome Die, )ypogonadism ?it)anosmiaE Foster Oennedy syndrome Die, papilledema,unilateral anosmia, and optic atrop)yusually associated ?it) an olfactory groovemeningiomaE' artial comple@ epilepsy ?it) a mesialtemporal focus includes an aura of foulGsmelling odors Dtermed uncinate "tsE t)atoccur efore seiPure onset, emp)asiPingpresumed origination at t)e uncus'
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Sindromes clínicas9lfactory dysfunction isassociated ?it) early
ar;inson disease and?it) ot)erneurodegenerativedisorders, suc) asAlP)eimer disease and
untington c)orea' J3KAnassociation also e@ists
et?een a normalolfactory identi"cationand o sessiveGcompulsive disorder' J4K
ead trauma leading tofracture of t)e cri riform platemay cause cere rospinal BuidDCSFE r)inorr)ea and apotential for meningitis'
aranasal sinus endoscopy
may lead to violation of t)ecri riform plate and potentialinfectious complications'9lfactory structures also can
e in$ured duringcraniotomies involving t)e
anterior cranial ase or fromsu arac)noid )emorr)age,?)ic) may disrupt t)e "ne" ers of t)e olfactory nerve'
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i#uidos Cere ro spinal=inorrea li#uido claro
romptly complete evaluation and treatment ofclear r)inorr)ea in t)e patient in ?)om lea;age ofCSF is suspected' nitial testing of Buid for glucosesuggests CSF ut is not con"rmatory' resence of
eta transferrin is a more sensitive indicator of CSFr)inorr)ea' Computed tomograp)y DC>E scanning?it) cisternograp)y or radionuclide scans can eused to detect t)e site of CSF lea;age from t)eanterior cranial fossa' =epair of lea;s at t)e level
of t)e cri riform plate may e ac)ieved from t)eintracranial approac), intranasal DendoscopicEapproac), or ot), depending on t)e nature of t)edefect'
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http://emedicine.medscape.com/article/861126-overviewhttp://emedicine.medscape.com/article/861126-overview
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=amas oft!lmica y ma@ilares,:1, :2
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Thetrigemina
l nerveinnervate
s theposterior
nasalcavity to
detectnoxiousstimuli.
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Gracias
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(racias por la oportunidad
7esde la Clínica de Asma y Alergia6anagua , Nicaragua' >el 22 -11+.,
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