Learn About the Sinuses

4/1/2023 - 3/31/2026

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Online CME Assessment

Instructions for claiming CME Credit:

Complete the Assessment successfully
After successfully completing the assessment, you will be able to go to the OHS CME registration form.

Please Note

You must answer 25 out of the 35 questions correctly to qualify for credit.
You will get 5 attempts to complete the assessment correctly.

1) The paranasal sinuses are best described a...

a. The nasal air passages

b. The location of the smell nerves

c. Air spaces in the bones adjacent to the nasal airway

d. Fleshy structures in the airway

2) The Sinuses are named after...

a. German physicians from the 1800s

b. The cities they were discovered in

c. The name of the skull bone that they are contained by

d. Dental anatomy

3) In most people the largest sinus by volume is...

a. The frontal sinus

b. The maxillary sinus

c. The sphenoid sinus

d. The ethmoid sinuses

4) The sinus that is over your eyes and deep to your forehead is...

a. Thge sphenoid sinus

b. The ethmoid sinuses

c. The fontal sinus

d. The maxillary sinus

5) The farthest back sinus is the...

a. Regional sinus

b. Paranasal sinus

c. Sphenoid sinus

d. Oblique sinus

6) The sinuses have...

a. Large drainage openings relative to their size

b. Relatively small drainage openings

c. Drainage that occurs only at night

d. No need for drainage pathways in adults

7) The ethmoid sinuses are located...

a. Behind the nasal airway

b. Between the eyes and just below the brain

c. Immediately over the upper teeth

d. Around the tear ducts

8) True or false: The anterior ethmoid sinuses and the posterior ethmoid sinuses drain through the same pathway.

a. True

b. False

9) The most common and helpful type of radiologic study to evaluate the sinuses is...

a. MRI scan of the head

b. Coronal CT scan views

c. Submental vertex view

d. Lateral views

10) The primary function of the nasal airway is...

a. To provide clean moist air to the lungs

b. To supply mucous to the throat

c. To protect the delicate facial structures

d. To avoid bleeding

11) Airflow through the nose is most efficient when...

a. There is a large amount of space and turbulent airflow results

b. There is a thick coating of mucous on the surfaces

c. There is a narrow passage that encourages laminar airflow

d. The adenoids have been removed

12) The inferior turbinate is composed of...

a. Structures that are not part of the nasal cavity

b. A discreet bone and a thick vascular mucous membrane that can change size

c. Cartilage and olfactory nerve tissue

d. Lymph nodes and mucous glands

13) The farthest back portion of the nasal airway is called...

a. The cycloptic space

b. The nasopharynx and it is divided into left and right

c. The nasopharynx and it is not divided by the nasal septum

d. The parapharynx

14) The space under the inferor turbinate is called the inferior meatus. What drains into this space?

a. The maxillary sinus

b. The tear duct

c. The frontal sinus

d. The nasal gland

15) The middle turbinate is an important nasal structure. The middle turbinate functions as ...

a. A division between the left and right side of the nasal airway

b. An "awning" that protects the drainage from the frontal, maxillary, and anterior ethmoid sinueses

c. A structure that can change size dramatically and regulate airflow

d. An embryologic remnant with no known function

16) The uncinate process is an important anatomic structure that helps direct mucous flow from the maxillary sinus and sometimes from the frontal sinus, depending on the specific anatomy. It is ...

a. Under the middle turbinate

b. Inside of the frontal sinus

c. Formed from lymphatic tissue

d. Never present in adults

17) Mucous produced in the large maxillary sinus exits the sinus...

a. At the bottom of the sinus into the inferior meatus flowing by gravity

b. Directly into the nasal airway below the inferior turbinate

c. Out of a small hole at the top and medial aspect of the sinus, over the uncinate process, and then the mucous exits from under the middle turbinate

d. After mixing with the drainage from the posterior ethmoid cells

18) Mucous flow in the nasal cavity and sinuses is powered by...

a. Gravity

b. Airflow

c. Microscopic cilia on the mucous membrane cell surfaces

d. Static electricity

19) One of the most common problems that the nasal cavity and sinuses must deal with is the common cold. The average adult ...

a. Stops getting colds in adolescence

b. Only catches colds in the winter

c. Gets 2 colds per year on average

d. Becomes resistant to the common cold after being vaccinated

20) Viral infections can enter the nasal cavity through the mucous membranes of the eye

a. True

b. False

21) True or false: Viral infections do not involve the sinuses, they only cause swelling in the nasal airway itself

a. True

b. False

22) When the term sinusitis is used by a health are provider, it usually implies that the causitive agent is...

a. Viral infection, which is the most common type of sinusitis

b. Bacterial is generally implied and antibiotics are usually prescribed

c. Allergic, which is the most severe type of sinusitis

d. Fungal

23) Most cases of acute bacterial sinusitis will resolve without medication

a. True

b. False

24) A viral sinus infection can lead to a bacterial sinus infection because...

a. Viruses will eventually mutate into resistant bacteria if left untreated

b. When antibiotics are mistakenly used to treat a viral infection bacterial superinfection develops

c. Viral infections are not a known cause of bacterial sinus infections

d. Swelling and pooling of secretions provides a hospitable environment for a bacterial infection to develop

25) At some point it may become clear that antibiotics, decongestants, steroids, and time will not clear a sinus infection. Only then is it appropriate to...

a. Treat the infection with homeopathic medications

b. Consider testing for allergies

c. Consider some type of surgical procedure to address the chronic sinusitis

d. Increase the frequency of saline irrigations

26) In general, sinus surgery for chronic bacterial sinusitis is designed to...

a. Instill antibiotics into the infected sinus

b. Scrape away the sinus walls and place packing

c. Open an obstructed sinus drainage pathway to restore drainage

d. Document failure of antibiotics

27) In addition to traditional endoscopic sinus surgery techniques which remove obstructing tissue, balloon sinus surgery can be used to...

a. Leave a balloon filled with antibiotics in the sinus cavity

b. Forcefully dilate the sinus opening by crushing obstructing tissues out of the way

c. Create new unnatured drainage pathways

d. Decompress the arterial supply to a sinus

28) Nasal polyps are....

a. Inflammatory regions of focal swelling

b. Almost always a single structure, rarely are they many in number

c. Never seen at the level of the nostril

d. Unaffected by oral steroids

29) On physical exam what structure is commonly mistaken for a nasal polyp?

a. The nasal septum

b. An enlarged inferior turbinate or prominent middle turbinate

c. The vibrissae

d. Purulent drainage from the sphenoid sinus

30) A common cause of nasal airway obstruction is a deviation of the nasal septum. Deviations of the nasal septum are...

a. Never related to birth trauma

b. Always in the very front of the septum

c. A known risk factor for nasal cancer

d. Often present with no clear history of trauma

31) One category of deviated nasal septum is called a 'septal spur'. In addition to obstructing the nasal airwy, septal spurs can cause...

a. Lymphoma

b. Osteoporosis

c. Referred pain syndromes

d. Contralateral edema

32) When a deviated septum causes problems that do not respond to medications, it can be appropriate to correct the deviation. In most cases a septal repair begins by...

a. Forcefully pushing the septum towards the midline

b. Removing the maxillary crest

c. Elevating the mucous membrane to access the deviated bone and cartilage

d. Puncturing the septum with a canula

33) Once the nasal septum is repaired and returned to the midline, the turbinates may present a new problem. This problem is best described and addressed with the following statement.

a. The turbinates may need to be inverted because of paradoxical airflow

b. The turbinates are rarely involved when airflow is restricted by a septal deviation

c. The turbinates may have enlarged to fill the concavity of the deviation over time and may need to be reduced to create symmetric airflow after a septoplasty

d. Medicare will not allow a turbinate reduction at the same sitting as a septoplasty

34) A very common procedure to improve the nasal airway is called a turbinate reduction. In genaral a turbinat reduction is performed on...

a. The superior turbinate

b. The middle turbinate

c. The inferior turbinate

d. The prime turbinate

35) Nasal packing is generally used, in the context of sinus surgery to...

a. Apply antibiotics to the surgical site

b. To ensure that patients return for a post operative visit

c. To apply pressure to surrounding tissues to reduce post operative bleeding

d. To prevent airflow