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Assessing Nose and Sinuses2

Thank you for the assessment. I have documented the normal findings and any deviations noted.

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Hannah Vuelta
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267 views36 pages

Assessing Nose and Sinuses2

Thank you for the assessment. I have documented the normal findings and any deviations noted.

Uploaded by

Hannah Vuelta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Assessing The

Nose and Sinuses


Prepared by: Alfrey J. Corpuz, RN
Anatomy and Physiology
Nose
- the nose consists of the external or outer nose and the
nasal fossae, or internal nose.
- assessment of the nose includes inspection and
palpation

Functions:
• Breathing
• Air conditioning/Humidification of inspired air
• Protection of lower airway
• Olfaction
• Resonating chamber for sound waves
Anatomy and Physiology
Anatomy and Physiology
Outer Nose
 is made up of bone and cartilage and is divided internally
into two fossae by the nasal septum, and externally by the
columella.

 Nostrils or Nares
- anterior openings into the nasal fossae
- its function is to passageway for air the nasal cavities so it
can be purifiedand sent to the next parts
 Ala Nasi
- lateral extended wing portion external of the nose
- gives shape of the nostril
Anatomy and Physiology
 Turbinates
- are sausage shaped
structure made of thin
bone covered by spongy
mucous membranes
Functions:
• warm the air we breath
• humidify this air as it
passes
• the mucous layer assist
in filtering particles such
as dust and pollen
Anatomy and Physiology
 Vibrissae-The hairs growing in the vestibule of the
nose.
 Cilia-Microscopic hair like projection from certain
epithelial cells.
 Membranes containing such cells are known as
ciliated membranes.
 Nasal Mucosa-appears redder than oral mucosa
because of the rich blood supply present to warm
the inhaled air.
 Septum- divide the nasal cavity medially into two slit
like airpassages.
Anatomy and Physiology
 Kiesselbach's plexus
- is a vascular area on
the nasal septum, and a
common site for
nosebleeds (epistaxis).
Anatomy and Physiology
 Olfactory Receptors
- located in the upper
parts of the nasal cavity
- the chemical
component of odors binds
with the receptors,
causing nerve impulses to
be transmitted to the
olfactory cortex, located
in the base of the frontal
lobe
Anatomy and Physiology
Sinuses
- are connected system of hallow cavities in
the skull
- also refers to the paranasal sinuses, air-
filled lined with mucous membranes
- lightened the weightof the skull and add
resonance to the quality of the voice
Anatomy and Physiology
Modes of Examination:
Inspection and Palpation
Preparation
1. Assemble equipment.
 Nasal Speculum
 Flashlight/Penlight
Performance
1. Prior performing the procedure,
introduce yourself and verify the clients;
identity using agency protocol. Explain
to the client what you are going to do,
whi it is necessary, and how he or she
can cooperate. Discuss how the result
will be used in lanning further care or
treatments.
Procedure
2. Perform hand hygiene, and
observe appropriate infection
control procedure.
Procedure
3. Provide for client privacy.
Procedure
4. Inquire if the client has any history of the
following:
 Allergies
 Difficulty breathing through the nose
 Sinus infections
 Injurinesto nose or face
 Nosebleeds
 Medications taken
 Changes in sense of smell
Procedure
5. Position the client
comfortably-seated, if possible.
Assessment
Nose
6. Inspect the external nose for any deviationsin shape, size, or
color and flaring or discharges from nares.

Normal Finding Deviations from Normal


Symmetric and straight Asymmetry

No discharge or flaring Discharges from nares

Uniform color Localized areas of redness or


presence of skin lesion
Assessment
Nose
7. Lightly palpate the external nose to determine any areas of
tenderness, massess, and displacements of bone and
cartilage.

Normal Finding Deviations from Normal


 No tender; No lesion  Tenderness on palpation; Presence of
lesions
Assessment
Nose
8. Determine patency of both nasal cavities.
 Ask the client to close the mouth, exert pressure on
one naris, and breath through the opposite naris.
Repeat the procedure to assess patency of the
opposite naris.
Normal Finding Deviations from Normal
 Air moves freely as  Air movement is restricted in one or
the client breaths both nares
through the nares
Assessment
Nose
9. Inspect the nasal cavities using a flashlight or nasal
speculum.
 Hold the speculum in your right hand to inspect the
client’s left nostril and your right hand to inspect the
client’s right nostril.
 Tip the client’s back head.
 Facing the client, insert tip of the closed speculum
(blades together) about 1 cm up to the point at
which the blade widens. Care must be taken to
avoid pressure on the sensitive nasal septum.
Assessment
Nose
 Stabilize the speculum with your index finger against
the side of the nose. Use the other hand to posisition
and then hold the light.
 Open speculum as much as possible and inspect
the floor of the nose (vestibule), the anterior portior
of the septum, the middle meatus, and the middle
turbunates. The posterior turbunateis rarely visualize
because of its position.
 Inspect the lining of the nares and the integrity and
the position of th nasal septum.
Assessment
Nose
10. Observe for the presence of redness, sweeling,
growths, and discharges.

Normal Finding Deviations from Normal


 Mucosa pink  Mucosa red, edematous

Clear, watery discharge Abnormal discharge (e.g., pus)

 No lesions Presence of lesion (e.g., polyps)


Assessment
Nose
11. Inspect the nasal septum between the nasal
chambers.

Normal Finding Deviations from Normal


 Nasal septum intact and in  Septum deviated to the right
middle or to the left
Abnormal Findings associated with Nose:

Deviated Septum
- a nasal septum that
is “pushed” to one
side
- caused by trauma
to the face and
nasal area
Abnormal Findings associated with Nose:
Occluded nasal cavity
- foreign bodies may be
present, especialy in
children
- trauma may include
nasal edema, sinus
infection may produce
copious discharge, an
adenoid may be so large
that it occludes the nasal
cavity
Abnormal Findings associated with Nose:
Rhinitis
- an inflammation of the nasal
mucosa
- nasal mucosa is red and swollen
with copious clear, watery
discharge
- occurance of common colds
(coryza) when there is an acute
onset symptoms
- discharge may become purulent
if a secondary bacterial infection
develops
Abnormal Findings associated with Nose:

Nasal polyps
- smooth, round
masses that are
pale and shiny
protruning from the
middle meatus
Abnormal Findings associated with Nose:

Nosebleed(Epistaxis)
- causes are: dry air,
when nasal
membranes dry out
they are more
susceptible to bleed
and infection; nose
picking
- Kiesselbach's plexus
Abnormal Findings associated with Nose:
Nursing Management/Intervention:
• Sit upright and lean forward (reduces the blood
pressure in the veins of nose; will avoid
swallowing the blood which can irritate the
stomach)
• Pinch nose (sends pressure to the bleeding point
on the nasal septum and oftern stop flow of
blood)
Assessment
Facial Sinuses
12. Palpate the maxillary and frontal sinuses for
tenderness.

Normal Finding Deviations from Normal


 Not tender  Tenderness in one or more
sinuses
Abnormal Findings associated with Sinus:
Sinusitis
- pain and tenderness at
the site
- due to viral, bacterial, or
allergic process that cause
inflammation of the
mucous membranes and
obstruction of the
draigane pathways
Assessment
13. Document findings in the client record.

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