Ear, nose & throat · UKMLA & AKT
Epistaxis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise epistaxis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Little's area (Kiesselbach's plexus) - anteromedial nasal septum; source of ~95% of nosebleeds
- Fed by four arteries: anterior ethmoid, sphenopalatine, greater palatine, superior labial
- Mucosa here is thin, highly vascular, and exposed to trauma/turbulent airflow - explains why bleeding can be brisk
- Posterior epistaxis - less common; suggested by bilateral or oral bleeding; associated with atherosclerosis and anticoagulation in older patients
Anterior nasal septum (Little's area) is the most likely source in the vast majority of epistaxis cases - including in anticoagulated patients without nasal pathology.
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