Assessing Nose and Sinuses Anatomy of the Nose • External Structures – Bridge – Tip – Nostrils – Vestibule • Internal Structures – Mucous Membranes – Hard Palate, Soft Palate – Turbinates Septum – Posterior Pharynx – Opening of Eustachian Tube Nose and Sinuses • Functions: – Identification of Odors – Air Passage – Humidification, Warming, and Filtering Air – Resonance of Speech – Drainage of Sinuses Assessing the Nose and Sinuses • Inquire if the client has any history of the following: • Allergies • Difficulty of breathing through the nose • Sinus infections • Injuries to nose or face • Nosebleeds
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• Medications taken • Changes in the sense of smell Inspect the external nose for any deviations in shape, size, or color and flaring or discharge from the nares Lightly palpate the external nose Determine the patency of both nasal cavities >Air moves freely as the client breathes through the nares. Inspect the nasal cavities using a flashlight or a nasal speculum >Observe for the presence of redness, swelling, growths and discharge. Inspect the nasal septum between the nasal chambers
Assessing Facial Sinuses Sinuses: • Frontal • Ethmoid • Sphenoid • Maxillary
• Palpate the maxillary and frontal sinuses for tenderness
Lifespan Considerations • Infants: • A speculum is usually not necessary to examine the septum, turbinates, and septum Children • A speculum is not necessary, it might cause the child to be apprehensive • Cough and runny nose are the most common signs of sinusitis in preadolescent children Elders • The sense of smell Markedly diminishes • Nosebleeds may result from hypertensive diseases or other arterial vessel changes