Epistaxis pathophysiology: Difference between revisions
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'''Editor in Chief''':''':''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]]. {{AE}} [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]]{{Jose}} | '''Editor in Chief''':''':''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]]. {{AE}} [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]]{{Jose}} | ||
==Overview== | ==Overview== | ||
Nosebleeding occurs due to tears in the [[mucosal]] lining and the many small [[blood vessels]] it contains. Fragility or injury may cause the tears, while [[inflammation]], [[coagulation]] problems and other disorders may make the [[injury]] more difficult to repair. In some patients, rupture of nasal [[blood vessels]] is spontaneous. | |||
==Pathophysiology== | ==Pathophysiology== | ||
Different causes tear vessels of nose plexuses and | Different causes tear [[vessels]] of the nose plexuses and lead to [[epistaxis]]:<ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2=Fix|first2=Megan Leigh|title=Epistaxis|journal=Emergency Medicine Clinics of North America|volume=37|issue=1|year=2019|pages=29–39|issn=07338627|doi=10.1016/j.emc.2018.09.005}}</ref> | ||
*Epistaxis results from | *[[Epistaxis]] results from tears in the nasal mucosal lining, which contains many small [[blood vessels]]. It can be started by [[trauma]], nasal picking, [[coagulopathies]], and [[tumors]]. | ||
*There is not enough evidence that [[hypertension]] is a [[risk factor]] for [[epistaxis]]. The | *There is not enough evidence that [[hypertension]] is a [[risk factor]] for [[epistaxis]]. The technique of lowering [[blood pressure]] to control and prevent [[epistaxis]] remains controversial. | ||
*Anterior epistaxis is more common, and source of this bleeding is usually Kiesselbach's plexus. | *[[Anterior]] [[epistaxis]] is more common, and the source of this [[bleeding]] is usually [[Kiesselbach's plexus]]. | ||
*Posterior bleeding is less common and harder to stop, and source of this bleeding is usually Woodruff's plexus. Bleeding from this plexus may cause aspiration and | *[[Posterior]] [[bleeding]] is less common and harder to stop, and the source of this [[bleeding]] is usually Woodruff's plexus. [[Bleeding]] from this [[plexus]] may cause [[aspiration]] and lead to [[bleeding]] with [[coughing]] and [[hemoptysis]], as it generates a greater flow of blood. Posterior bleeding can compromise the airway if blood leaks into the [[posterior]] [[pharynx]].<ref name="pmid28613768">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28613768 | doi= | pmc= | url= }} </ref> | ||
'''Location of the Kiesselbach's and Woodruff's plexus'''<ref name="pmid31620565">{{cite journal| author=Moon S| title=Comprehensive understanding of vascular anatomy for endovascular treatment of intractable oronasal bleeding. | journal=Yeungnam Univ J Med | year= 2018 | volume= 35 | issue= 1 | pages= 7-16 | pmid=31620565 | doi=10.12701/yujm.2018.35.1.7 | pmc=6784680 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31620565 }} </ref> | '''Location of the Kiesselbach's and Woodruff's plexus'''<ref name="pmid31620565">{{cite journal| author=Moon S| title=Comprehensive understanding of vascular anatomy for endovascular treatment of intractable oronasal bleeding. | journal=Yeungnam Univ J Med | year= 2018 | volume= 35 | issue= 1 | pages= 7-16 | pmid=31620565 | doi=10.12701/yujm.2018.35.1.7 | pmc=6784680 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31620565 }} </ref> | ||
<br> | <br> | ||
[[File:Kiesselbach.png|400px|thumb| | [[File:Kiesselbach.png|400px|thumb|center|]] | ||
<br> | <br> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category: | [[Category:Up-To-Date] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category:Rhinology]] | [[Category:Rhinology]] | ||
[[Category:First aid]] | [[Category:First aid]] | ||
[[Category:Injuries]] | [[Category:Injuries]] | ||
Latest revision as of 20:47, 11 January 2021
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Editor in Chief:: C. Michael Gibson, M.S., M.D.. Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.José Eduardo Riceto Loyola Junior, M.D.[1]
Overview
Nosebleeding occurs due to tears in the mucosal lining and the many small blood vessels it contains. Fragility or injury may cause the tears, while inflammation, coagulation problems and other disorders may make the injury more difficult to repair. In some patients, rupture of nasal blood vessels is spontaneous.
Pathophysiology
Different causes tear vessels of the nose plexuses and lead to epistaxis:[1]
- Epistaxis results from tears in the nasal mucosal lining, which contains many small blood vessels. It can be started by trauma, nasal picking, coagulopathies, and tumors.
- There is not enough evidence that hypertension is a risk factor for epistaxis. The technique of lowering blood pressure to control and prevent epistaxis remains controversial.
- Anterior epistaxis is more common, and the source of this bleeding is usually Kiesselbach's plexus.
- Posterior bleeding is less common and harder to stop, and the source of this bleeding is usually Woodruff's plexus. Bleeding from this plexus may cause aspiration and lead to bleeding with coughing and hemoptysis, as it generates a greater flow of blood. Posterior bleeding can compromise the airway if blood leaks into the posterior pharynx.[2]
Location of the Kiesselbach's and Woodruff's plexus[3]
References
- ↑ Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
- ↑ "StatPearls". 2020. PMID 28613768.
- ↑ Moon S (2018). "Comprehensive understanding of vascular anatomy for endovascular treatment of intractable oronasal bleeding". Yeungnam Univ J Med. 35 (1): 7–16. doi:10.12701/yujm.2018.35.1.7. PMC 6784680 Check
|pmc=value (help). PMID 31620565.
[[Category:Up-To-Date]