·
9/10
people cpmplaining of sinusisits actually have rhinitis
Rhinitis-
inflammatory
state of the anterior nasal passages but not the sinuses. The common cold due
to allergies, viruses, hormones, bacteria. OTC sprays and decongestants may
give satisfactory response for viral and allergic reaction.
[FYI:
the nose produces 1-1.5 pints of mucous per day. Most of this goes down the
throat, smokers have more irritation and produce more mucous.
Epitaxis-nose
bleed
·
typically
due to nose picking or other trauma to kiesselbach’s plexus of the anterior
nasal septumà also due to: anemia, HTN,
infections.
·
If
the site of the bleed can not be found, than a consultation is needed as the
bleed is in the posterior nose which belongs to the external carotid system.
Therefore, serious problems can occur with tumor, aneurysm, etc.
Discharge:
due to
·
Clear:
allergies, hormones, adenoids, polyps, HTN, foreign object, neoplasm, asthma,
CSF
·
CSF:
typically post-trauma, leak from subarachnoid space
·
S&S:
intermittent discharge, when the head is flexed dries soft
·
Demonstrates
a halo due to glucose
·
Test
+ w/ glucose stick
·
Must
be treated in ER.
Vasomotor
rhinitis: 20-40 year old females especially
·
Predisposing
factor:
·
Stress[psycological,
endocrine, genetic, allergic]
·
Stimulation
of parasympathetics
·
Depression
of the sympathetics
·
Leading
to vasodialtion and subsequent secretion
·
Associated
w/ hormonal changes [puberty, menses, pregnancy, etc.]
·
Neurovascular
reaction
·
S&S
hypertrophic mucosa seen on post. Rhinoscopy
·
Profuse
watery discharge
·
¯ airway- unilateral or
bilateral
·
Swollen
turbinates, esp. the inferior
·
Deep
pink to dusky red mucosa due to vasodilation
·
Clear
with red streaks: CSF
·
Treatment
with vitamin C can help reduce stress cortisol levels
Atrophic
rhinitis: unknown etiology
·
S&S
copious ammounts of dry crusted material with dry nasal membranes and
turbinates
·