You are on page 1of 52

Anatoma y Patologa Rinosinusal Sinusitis Sinusitis Crnica Anotaciones para El Estudio dela Rinitis Alergica Diagnstico Diferencial .

Revisin Dr. Juan Herrera Salazar Clnica de Asma y Alergia


1 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

NEW !

Apuntes de Anatomia radiolgica-clnica


Seminarios Clnica de Asma y Alergia I.parte
Lean las notas al pie de las diapositivas

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Dr. Juan Herrera Salazar


Foro Mdico Nicaragense Portales Mdicos Medbook Mi blog de Asma y Alergia

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Bibliografa
Atlas Netter II edicin.

Atlas Netter IV edicin Interactiva.


Atlas, Anatomy,Carmine de Clemente 3rd ed.. Gray s Anatomy Ed. Longman 1973. Allergy

Seminarios Anatoma Clnico Radiolgica Editor: 88825513 Tel. 22781169,22703359, Arlen D Meyers, 4

Mosby, Sthephen Holgate2002 Atlas de Alergia e Inmunologa Clnica Fireman Emedecine collection Nasal Cavity Anatomy, Physiology, and Anomalies on CT Scan Author: Belachew Tessema, MD; Chief
MD, MBA. Updated: Mar 29, 2011 13/04/2012

Bibliografa Emedecine
Nasal Physiology Author: Sanford M Archer, MD;

Chief Editor: Arlen D Meyers, MD, MBA more...


Olfactory System Anatomy Author: Amir

Vokshoor, MD; Chief Editor: Arlen D Meyers, MD, MBA more... Nasal Aerodynamics Author: Samuel J Lin, MD; Chief Editor: Arlen D Meyers, MD, MBA more...
Nasal Reconstruction

Author: Ali Sajjadian, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA more...
13/04/2012

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Lo ms dificil es ver lo que esta delante de tus ojos W.


Goethe

Seminarios Anatoma Clnico Radiolgica 6 Tel. 22781169,22703359, 88825513

13/04/2012

Anotaciones sobre la regin nasal

Seminarios Anatoma Clnico Radiolgica 7 Tel. 22781169,22703359, 88825513

13/04/2012

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Anatomia radiolgica

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Nombre con el indicador las estructuras

10

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Cuantos indicadores colocamos correctamente ?

11

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Radiografa Craneo Rx. . Lateral

12

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Nasal embriology
Neural Crest
Failure of these

13

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

carefully orchestrated events in early facial embryogenesis may result in multiple potential anomalies, including choanal atresia, medial or lateral nasal clefts, nasal aplasia, 13/04/2012 [1] and polyrrhinia.

Regin Nasal Esqueleto Vista Antero Lateral e Inferior

Netter

14

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Regin Nasal Vista Antero Lateral e inferior

15

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

16

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Cavidad nasal Estructura Osea Vista lateral

17

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

18

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

19

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Estructura Osea pared lateral de la cavidad nasal, reseccin parcial turbinatos

20

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Pared Lateral de la Cavidad Nasal

21

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Pared Lateral de la Cavidad Nasal

22

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Pared Lateral de la Cavidad Nasal. Reseccin de los Turbinatos Chonchae nasi

23

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Pared lateral de la cavidad nasal

24

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Esqueleto Nasal in situ.

25

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Esqueleto nasal in situ

Labels Netter MD
26 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

Vista de la Cavidad Nasal con el Especulum

27

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Vista de la cavidad nasal con el especulum

28

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Rinitis
Alrgica
Estacional Perenne Episdica Ocupacional

No alrgica
Infecciosa NARES Perenne no alrgica

vasomotora

Problemas

Gustativa

anatmicos
Sigamos el

estudio..
29 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

Otras Patologas Diagnstico Diferencial Rinitis


Anatmicas

Inmunolgicas Granulomatosas Infecciosas Wegener Policondritis Rinoscleroma

Tumores Hipertrofia

adenoides, cornetes Rinitis atrfica Mastocitosis. Ocupacionales, cromo,nickel,madera polvo de cuero


13/04/2012

30

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

Septo Nasal Estructura Osea y Cartilaginea.

31

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

32

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Cartilagos nasal variaciones anatmicas


In some individuals,

33

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

evidence of a scroll may exist, that is, an outcurving of the lower borders of the upper lateral cartilages and an incurving of the cephalic borders of the alar cartilages. Several variations exist, as depicted 13/04/2012 below.

34

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Pared Medial de la Cavidad Nasal Septo Nasal

35

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Vasos sanguineos
Carotide interna Nariz externa: ramos Carotide externa

de la arteria facial , arteria angular


Plexo de Kiesselbach Area de Little

Venas comunican con el seno cavernosovenas con ausencia de valvulas ver adelante infecciones y trombosis
36 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

Estructura de la nariz

Structure

External nasal anatomy

Regarding the lateral nasal wall

The first image below depicts

37

the external nasal anatomy. Nasal subunits include the dorsum, sidewalls, hemilobules, alae, soft triangles, and columella.[2] Ethnic influences can result in different appearances of the nose,[3] as follows: Caucasian, leptorrhine; African American, platyrrhine; Hispanic, paraleptorrhine; and Asian, subplatyrrhine. The external valve is a variable area dependent on the size, shape, and strength of the lower lateral cartilage. Nasal anatomy.Internal nasal anatomy The septum is a midline bony and cartilaginous structure that Seminarios Anatoma Clnico Radiolgica Tel. divides the nose into 2 similar 22781169,22703359, 88825513 halves.

and paranasal sinuses, the superior, middle, and inferior concha form corresponding superior, middle, and inferior meatus on the lateral nasal wall. The superior meatus is the drainage area for the posterior ethmoid cells and the sphenoid sinus. The middle meatus provides drainage of anterior ethmoid and the maxillary and frontal sinuses. The inferior meatus provides drainage of the nasolacrimal duct.[2] The internal nasal valve involves the area bounded by upper lateral cartilage, septum, nasal floor, and anterior head of the inferior turbinate. This makes up the narrowest portion of the nasal airway in the leptorrhine nose. Generally, an 13/04/2012 angle wider than 15 is needed in this area. The width of the

Tejidos Blandos de la Nariz


The subunits include

the dorsal nasal segment, lateral nasal wall segments, the hemilobule segment, soft tissue triangle segments, the alar segments and the columellar segment

38

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

La importancia de los Tejidos Blandos. Salut Allergique Rinitis Alrgica


Factores de Riesgo

Historia Fam. Atopia IgE > 100 UI/mL

Alergnos caseros

animales, Acaro. Pruebas cutaneas +


Socio Econmico
39 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

Unidades estticas de la Nariz

Dorso nasal Pliegue nasal alar


Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

crease Punta nasal, nasal tip Soft triangle Ala nasal Columella
13/04/2012

40

Arteria Maxilar Distribucin orbito -maxilar

41

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Arteria Maxilar Distribucin Naso-Palatina

42

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Irrigacin del Septo Nasal Levantado.

43

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Nervios de la cavidad Nasal

44

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Distribucin de la mucosa olfativa

45

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Nervios de la Cavidad Nasal Septum

Nervio Palatino Mayor .. jhs


46 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

47

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

48

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Ramas oftlmica y maxilares, V1, V2

49

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

50

Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513

13/04/2012

Rinitis Alrgica
Escuela Trabajo

Dificultades

cognitivas Tratamiento 1era generacin antihistamnicos


Priming effect.
51 Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513 13/04/2012

Nasal Cavity Anatomy, Physiology, and Anomalies on CT Scan


Imagenologia Because most nasal cavity imaging for chronic sinusitis is

52

currently performed with computed tomography, this article concentrates on CT anatomy. Understanding the anatomy of the nasal cavity and its anomalies is important because it leads to an understanding of imaging anatomy, which is needed to plan the surgical approach. Common anatomic variations are also discussed. Readers are urged to review anatomic texts before reading this article. The following image is an example of CT scanning of the nasal cavity. CT scan, nasal cavity. Normal anterior ostiomeatal complex anatomy. The anatomy of the ethmoid infundibulum and the uncinate process is demonstrated here. Sinusitis, Chronic. Seminarios Anatoma Clnico Radiolgica Tel. Sinusitis, Acute. 13/04/2012 22781169,22703359, 88825513

You might also like