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We have said that the size and shape are evaluated nasal direct inspection looking at the face and nose in front and profile view.

should be noted:

• convexity or concavity of the nasal dorsum or bridge that is the apex of the bony pyramid
• width and projection of the tip (tip)
• deviation of the nose, si es por defecto óseo o cartilaginoso  
• forma de la columela
• alas nasales
• en visión basal (worm view) se examinan las alas,orificios nasales para ver asimetrías y si hay un desvio de tabique (septum nasal)
• tipo de piel de la punta nasal y alas nasales  si es fina, media o gruesa, la piel muy fina deja ver fácilmente a los cartílagos infrayacentes a la piel, lo contrario a la piel gruesa, sebaceous oil which is very subcutaneous tissue and cartilage belies that are underdeveloped and very thin, skin and tissue overlying dermofat leave no identifying particularly cartilage of the nasal tip (nose tip .)
• nasal tip (nose tip) in static and dynamic notice if it descends or not to smile or talk, guide us about the action of muscle depressor septi nasi descending (lower) the peak in cases of hypertrophy by increasing its force of contraction and what measures we take in this regard.

PALPATION NASAL (NOSE palpation)

the nose is taken as an aesthetic unit containing subunits

As the nose an aesthetic unit has its subunits are

Back up bone and cartilage below
sidewalls.
nasal tip (nose tip)
Wings
Columela
Triangles soft cartilage where there is extra skin and intranasal juxtaposed.


From a view basal (view worm) found the

C olumela ranging from nasal tip to the lip, attaching the lip on the top of the filter labial ( philtrum) and separating the nostrils (external nares ). His back is wider than the previous due to the divergence of the " medial crus" of the alar cartilages . The edge of the columella depends on the form and degree of divergence of these cartilages in lower portion is called here feet wing (wing feet).

PALPATION

With the patient standing or sitting is appropriate to the nasal palpation and adjoining areas:

starts at:

Back and side walls bone in nasal root in the nasofrontal angle to feel the thickness of the skin, if thin, thick, oily, dry and underlying bony structures.

Palpate the bony nasal dorsum , to feel in nasal root (radix ) and around the back bone if vertex of the bony pyramid is thin, thick, broad, deep, irregular or not, or if the nasofrontal angle is open or closed, if the frontal bone at its junction with the nasal bones is wide, it is sharp or not, if the nasal bones themselves and side walls formed by the upward apophysis the maxillae have a base open or closed and whether these side walls are symmetrical or uneven surfaces, bone spicules or poorly consolidated fault lines to walls lateral ventilation obstruct or compromise the aesthetic nasal . O lines to tangible and visible fractures at the base of the pyramid (SLEP ladder )

Or if there is a backup wide, flat or sharp edges (roof open ) product of a surgical fracture or not.

And we got to the junction (junction) or osteocartilaginous union of the nasal bones to the lateral cartilage.

cartilage Back

same maneuver is performed and checked whether or not the junction osteocartilaginous hump (dorsum convex, outstanding) in the nose area is very mobile.

Also if at the top and side walls of lateral cartilage (upper) are symmetrical or are sunken or protruding somewhere on their anatomy.

In the distal part of the lateral cartilage (above) can touch and sometimes see the septum (cartilaginous septum ) at its apex that lifts the skin as a store.

nasal tip (nose tip)

short: is the distal and the nose is formed by two alar cartilages on each side, Each cartilage has the following parts, the medial cross your foot wing , wing knee and lateral cross , both knees are the domus, which is one of the most important the nose from the point of view of a rhinoplasty , nasal tip.

The nasal tip (nose tip ) includes domus ( Alar dome ) is where you join both knees wing (genu wing ) the medial cross and lateral cross of the alar cartilages.

is simply the junction of the medial cross and cross lateral cartilage both (right and left) and is separated from the margin of the nostrils an area so triangular triangle known as soft (triangle soft ) .

On palpation, in fine leather leptorhines , we feel its consistency and elasticity curves

and up the groove interdomal ( space between wing both knees), and you still feeling inside in the vestibule (vestibulum ) we can easily continue to touch most of the lower edge of the lateral cross and clamping bidigital index inside the lobby and thumb out, and experience with the toe curve domus and feel even to the interdomal groove (sulcus interdomus ) separating the knees wing and medial cross .

Feeling the columella follow the entire length of the medial cross and its bifurcation or divergence of distal end showing the foot wing (wing feet) on the inside (medial) of the nasal floor.

Suprapunta (supratip area)

is the area where they join the distal part of the lateral cartilages, the upper edge and vertex of cartilaginous septum (septum) and proximal edges (above) of the alar cartilages forming a "V". This triangular-shaped area called the triangle weak (weak triangle)

The weak or weak triangle triangle

is called well as the septal angle maintains, supports the back area between the diverging medial cross and holds it up by ligamentos.

 La cruz lateral de los alares en la zona de la suprapunta ( supratip area ) en su divergencia forma una zona triangular donde el ángulo septal se entalla, cabe en el vértice de esa "V".

En muchas narices, esa zona de la punta solo es soportada por el ángulo septal que muchas veces se palpa y estas estructuras se mantienen juntas y sostenidas entre si por el Ligamento suspensorio de la punta (Suspensory ligament of the tip).

To check whether the nasal tip ( nose tip) is well supported or not, makes the following maneuver, push down and back, and observe, if the move was easy and did not offer much resistance and the return of the tip was no natural place to stop almost instantaneous pressure indicates that , the point needs a good support (cartilage) to hold and prevent it from falling post-surgery.

nostrils

Palpation checks and l thickness of the skin is very thick and oily in platyrhine and mestizos with little or no cartilage palpable round nasal tip, thick bulbous tissue dermofat, short columella and nostrils flatten.

mesorhine In (Eastern) her nose is smaller, round tip, nasal lobe lower and wider than leptorhines .

leptorhines In as we have said can be felt and even see the outline of nasal tip cartilages , your nostrils are vertical and oblique.

REVIEW Endonasal
(endonasal EXAMINATION)

With the patient lying down and the chin lifted discussed in view and observe the basal diameter nostril and eye, raising a finger tip can check:

• diversion nasal septum (septal cartilage or bone)
• perforated septum
• constrained internal nasal valve

• hypertrophied inferior turbinate or middle,
• congestive nasal mucosa, red
• anomaly of position of the alar and triangular cartilage (above) or the bridge
• nasal obstruction, to prove there is a simple test that involves occluding one nostril and listen and appreciate the passage of air breathing through the other nostril.
• nasal speculum and good light: is introduced to review and confirm all the above intranasal structures and perform a preoperative clinical diagnosis.

have any questions, requested to ray examination, CT or resonance imaging (MRI) or videoendoscopy diagnostic and assistance of a specialist, especially one Otolaryngologist (ENT)

; PHOTOS

routine with a good camera, taking pictures of front, left and right profile, right and left anterior oblique and basal (worm view). Used to assess changes in the short, medium and long term certified with photos taken in the immediate postoperative period, mediate and long term.

IMAGE SOFTWARE

With this software can display the photos taken at the / patient, the changes will be made with rhinoplasty and displayed on a large screen for a good display and discuss them for a reasonable consensus on the outcome.
We must remember that these images are two dimensional and that the face and nose have 3 dimensions (height, width and depth).

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patient was asked to go for cosmetic rhinoplasty what bothers you most of your nose and you could answer the following: "My .... or "My ......

is thick nasal tip ---------------------------------- --------------- I finest



nose is down ----------- -------------------------------------------- concerns nasal tip, want to lift the tip


nasal tip is biased ---------------- ------------------------- part of the tip is higher or lower


Back nasal is very thin ---------------- ----------------------------- refer to a very narrow nasal bridge


Nose is very broad, referring to his nose bridge bone ---- I finest


nose has a high back (pronounced hump), referring to the cartilaginous dorsum --- ----------------------------------------------- I straight or slightly incurved not very curved, not concave.


nose is skewed, ---------------------------------- ------------ -refers to the nasal bones themselves or the area of \u200b\u200bthe triangular area of \u200b\u200bthe supra-tip (supratip).


nose is up ----------------------------------- ------------ concerns very rotated nasal tip upward


Nose is down again and I have a ball , A ball (sic) here, referring to the area the suprapunta (supratip)


nostrils are very wide, open -------------- ------------ the finest I


nostrils (nares) are very open ------------- ------- I want the most closed


nostrils are down


nostrils close, collapse to inspire


Wings are thick nasal


nose is too long --------------- Long ---------------------------------- Pinocchio nose or nose


Nose is very short -------------------------------------------- Short nose -----


Nose is very small


nose is very straight ------------------------------------------------- refers to the nasal profile straight, no curves, no concavity in the back


nose seems divided on the tip ------------------ Bifid nose -------------


breathing is not right --------------- ------------------------- relates to a septum deviated
------------------------- --------------- to turbinate hypertrophy
----------------------------------- ----- an internal nasal valve surgery constrición by previous are diagnosed with intranasal examination.




very ugly scar ---------------------------- ------------------- concerns of exorinoplastia columellar scar


nose is a disaster ------- --------------------------------------- referred to surgery / previous surgeries.


Nose ---------------------------------- I do not like -------------- not know what they dislike.


nose was operated on 2, 3 or more times and I hate ---- Psychic Nose is a patient with BDD


not Nose I like anything, so I ---------------------------- show a photo of your favorite artist nose


nose is very straight, is attached to my forehead ---------------------- refers to a Greek profile.


All these reported situations can occur individually or all together and be perfectly real, verifiable inspection in nasal or not verifiable.
After this come the general examination of the face and nose, forehead and review face and nose, in profile

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The aesthetic rhinoplasty is surgery used to improve the shape of the nose giving it a harmonic with preservation of its functions, other reasons may be: straighten a crooked nose to improve breathing is difficult , correct a depression of the nasal dorsum or correct distortions caused by a traumatic, surgical or an adaptation of a previous rhinoplasty, in this case is called secondary rhinoplasty or even tertiary, etc.

Initial Consultation

The patient comes to the plastic surgeon to solve a problem surgically nasal aesthetic and functional, observable or not.

rigor initial questions are:

• Do you feel healthy?

• If you had or have suffered trauma skull, face or nose or was operated specifically above the nose or other anatomic area

• Breathing is good or not

• have recurrent nosebleeds

• or allergic rhinitis (and if used chronically nasal drops for it)

• or sinusitis

• or asthma

• or frequent headaches or migraines and improves spontaneously with or without medication / hospitalization

• or anosmia (smell little or almost nothing)

• Consultation with ENT or allergist regularly

• have systemic disorder, a general enfemedad

• Diabetes

• Hypertension

• Make physical activity and supports it without problems or feel tired easily

• His wounds coagulate faster and the resulting scar takes time evolution normal

• regularly are medical sedatives, antidepressants, antipsychotics, hypnotics or anti-inflammatory analgesics aspirin, Corticosteroids, diclofenac, etc. or other nonsteroidal antitinflamatorios

• received or receives any anticoagulant

• take herbs or natural medicines such as ginkgo biloba or other

• Allergy to antibiotics

• Allergy local or general anesthetic

• Do you smoke, drink alcohol, narcotics?

• When was the last time you conducted a medical check-up, an electrocardiogram or echocardiogram, or ultrasound or computed tomography or magnetic resonanacia study (MRI) or a nasal or videoendoscopy sinuses, a chest X-ray or laboratory analysis of blood and urine. Other tests and what was the reason and if you received treatment?

• regular consultations especialistas o médicos generalistas  y los motivos

• Internación hospitalaria, por qué motivo y por cuánto tiempo

Preguntas dirigidas al motivo de consulta.

La nariz

La paciente acude al cirujano plástico para resolver su problematica nasal  quirúrgicamente with cosmetic and reconstructive purposes , that could be real or fictitious, looking in most cases a resolution to this distorted body image that causes disturbances in self-esteem and social relationships in their optimal social environment.

The vast majority of the / operators report that their life has changed "after rhinoplasty and it was worth the investment. These are people in which their expectations are realistic to understand that surgery is its scope and limitations.

Listen to the patient and his desire to capture and cooperation in the outcome is important to note the psychological reaction that can occur to a greater or lesser problem solved or not surgery , if he persists in magnifying the situation and there in the doctor-patient-flowing dialogue and understanding of risk / benefit result, it is better to discontinue the intervention because , is requesting surgery impossible or unpredictable outcome.

A successful outcome is one that meets the patient and the surgeon, and limiting .

Some patients ask to change your facial structure, there are cases where this is feasible, but in others the plastic surgeon is best qualified by experience to decide which is what can be achieved or not and what is best for the patient .

The ideal patient would is very concerned that a great deformity or its anxiety or worry is proportional to their problem other hand, there are those / these where his concern is exaggerated more than the degree of defect and that their expectation for the outcome beyond what surgery can offer for aesthetic improvement.

If the level of experience and skill required for a rhinoplasty exceeds the capacity of plastic surgeon must send it to another colleague who possesses the required skills to solve the case whenever possible, feasible.

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bony structures of the nose

own nose bones

are a couple bones together in the midline nasal spine supported in the frontal and lateral the or ascending frontal process of maxilla. The side walls of the nose are formed by the bones themselves from the nose and the ascending apophysis of both maxillae.

The nasal bones are quadrangular, thick, hard top, reinforced by frontal nasal spine, thin and wide at the bottom. The ascending apophysis are thick on top and a rear face with the lacrimal the lacrimal groove , and are thinner at the bottom and here are the edges of the pit piriform is lower limit of the lateral nasal wall.

osteo-cartilaginous structures of the nose

cartilaginous structures of the nose

lateral cartilage or triangular or more

are two structures, one pair, attached to the nasal bones from above, ascending apophysis on the sides and the septal cartilage in the midline. Flow at the edges are overlapped by alar cartilages at the level of the internal nasal valve . Diverge in the lower third of septum and form the internal nasal valve .

nasal septum

average structure divides the nasal cavity into two chambers, lateral canals . The septum or septum is formed by the bony septum (perpendicular plate of ethmoid , vomer , nasal crest of maxilla and the nasal crest of palatine bone ), the cartilaginous septum is a square sheet that forms the greater part of the septum in its caudal part. The septal angle is immediately Ariba the alar cartilages in an area called supratip or suprapunta .

The lower part of cartilaginous septum is attached to the vomer and premaxillary wings. Its caudal border is separated from the columella mucocutaneous juxtaposed two layers that form the membranous septum or subseptum .

The cephalic portion septal is attached to the cephalic part of lateral cartilage and extends a few mm under the nasal bones equal distance as do lateral cartilage and is supported by a bony groove Held nasal bones. The dorsal edge septum undergoes a change in its width and configuration to the nasal bones , splits into "Y" forming a groove supraseptal between the branches of the "Y".

The back edge of the septum is attached to the perpendicular plate of ethmoid .

function nasal septum

package supporting the pyramid right nasal and allows nasal physiology are the ventilatory and phonatory olfactory.

lateral cartilage and the bony pyramid

The cephalic part the lateral cartilage ends below the nasal bones themselves above the septum an extension of 8-10 mm, has an oval shape. United by dense connective tissue.

alar cartilage or less

pair structure, which is forming cartilaginous framework of the nasal tip - nose tip -. Each unit has two parts: a " medial crus" and "lateral crus" joined together united in the most prominent Nasal tip called dome or domus, the medial cross curves downwards to form part of the columella , these branches of the medial cross at the bottom end and diverge and there is call it foot wing or foot of the cross medial . Each medial crus is closely attached to the skin of the columella

The lateral portion of the lateral cross is attached to the edge of the piriform aperture through the cartilage accessories.

accessory cartilage or sesamoid

are small, are among the lateral cartilage and alar cartilages .

support cartilage and ligaments

suspensory ligament of the nasal tip : joins the septal angle The distal part of the triangle, in which diverge suprapunta the medial crus and the lateral cross of alar cartilages.

fibrous connections : between bottom and distal lateral cartilage with the upper and distal lateral crus .

Pilar piriform : of cartilage accessories y la the raw side pyriform aperture.

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NEWS PAGES AND OTHER INTERESTING ADDRESSES

On the next page you will find a very attractive presentation of the issues we care about Plato. There is a very attractive historical setting and friendly, graphic reproductions of drawings, illustrations, diagrams, etc. In the last pages you will find a graphic schemes to visually understand the correlation between ethics and politics platonic.

That you take advantage.
http://sofronisco.blogspot.es/img/tema4platon.pdf


In this one page, from the same portal from which you can reach the point on Lledó-Plato already know (see my blogs "), you will find well-structured reference work on the doctrine and the figure of Thomas Aquinas.

May you continue to take advantage.
http://www.xtec.cat/ ~ jortiz15/aquino.htm


A page designed and executed pretty well comes from the IES Bachiller Sabuco, Albacete. Not match all the issues, as you will see, with the agenda of Andalusia. But that match, as well as Aristotle offered from this page are fine.

That you further advantage.
http://bachiller.sabuco.com/filosofia/hfilosofia/index.htm

Una página dotada con bastantes instrumentos, entre ellos un diccionario de Filosofía. Está bastante bien presentada, y los contenidos son de calidad.
http://www.e-torredebabel.com/Historia-de-la-filosofia/Historia-de-la-Filosofia.htm

En esta otra dirección encontraréis una relación de los textos aprobados para la convocatoria 2010-2011. Desde ella también se puede acceder a las pruebas para otras materias (no todas, pero sí las comunes y muchas otras de modalidad).
http://www.juntadeandalucia.es/innovacioncienciayempresa/sguit/paginas/distrito/examenes_sel_m25/

No es nada frecuente reconocer la enorme debt incurred by the thought, science and Western philosophy with Eastern traditions and Semitic (Arabic and Hebrew). But without names such as Avicenna, Averroes, and many others Abentofail our philosophical and scientific legacy would not be so complex and rich as it actually is. This blog is attempted, and largely achieved, do something for the repair of such injsticia. Highly recommended.
http://unviajeespiritual.blogspot.com/

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Review of a fragment of Republic-VII

Plato, Republic, Book VII, 511c-511d (Version Conrado Eggers Lan)
understand, but not enough, because I think you have in mind an enormous task: to distinguish what you want as real and intelligible is studied by science dialectic , stating that it is clearer than that studied by the so-called 'arts', for which the assumptions are principles. And that students are forced to study by means of discursive thought , but not by the senses. But due to not making progress towards a first test but from assumptions, you seem to have no intelligence about them albeit with intelligible principle. And I think you call ` discursive thought 'the mental state of the surveyors and the like, but the` intelligence', as if the ` discursive thought 'was something between opinion and intelligence.

C o m e n t a r i o

Once placed the text in its historical context we proceeded to highlight some of the terms that we understand may have a greater interest in both express with clarity some of the ideas characteristic of the Platonic doctrine. In this case, given the epistemological nature of text, are those terms that allow us to more confidently refer to some of the most characteristic elements of the Platonic theory of knowledge (I could not be otherwise since in such a short text could hardly find terms from which we can reflect to the full knowledge of the doctrine of Plato, that is, moreover, a very complex doctrine).

We believe these terms

good they could be those of 'understood', 'science of dialectics' (very similar to the first in the text and in the Platonic doctrine), and the term' discursive thought. " The latter, 'discursive thought' appears three times, while the term 'understood', while directly related to the term 'intelligence' (that is intelligible that of which you can have intelligence) appears four. We think it is interesting to note that these terms are referred to as such, ie as terms in one hand and in the same sentence that distinguishes each other. Specifically one in which Plato writes "I think you call` discursive thought 'the mental state of the surveyors and the like, but the `intelligence' ." This would justify those single quotes that appear in the text by the translator's decision. In any case it is interesting to note how in that sentence in which these two terms appear as intended by the author is separate or distinguish the 'discursive thought' the fact of intelligence seen in a more general. This should not be construed as an attempt to oppose each other, if anything to distinguish them as the 'discursive thought' in the Platonic doctrine does not exhaust the possible knowledge or "intelligence" that could be reality, but is only one phase of it: a phase in which the formal (as eidetic) begins to highlight. We believe that when Plato writes that the 'discursive thought' is referable " the mental state of the surveyors and the like " which is trying to do is make it clearer with this example, the formal (eidetic) that this stage of knowledge. In another previous sentence, we also see quite clearly intended to distinguish this 'discursive thought' other upstream (and lower scope) of knowledge. We refer the sentence in which the purpose of the principles (not the 'assumptions' that are only beginning to call 'art') Plato writes that "those who study are forced to study by means of discursive thought, but senses not. " So that discursive thought is the beginning of this phase epistemic more rigorous and reliable knowledge that will leave behind those other times false beliefs (eikasía) or only probable conjectures (pistis) to get into the higher stages of knowledge those which lead us to the truth: dianoia (discursive thinking), and finally and as noesis horizon or contemplating the eide.

Despite its shortness this text is very dense and rich in nuances. Hardly have time now to refer to another term that we meant to be particularly interesting in relation to the Platonic epistemology: the 'science of dialectics. " We had pointed out the relationship between the content of the terms' inteligible'-'inteligencia 'and the term' science of dialectics. " The explanation of this relationship can not be found explicitly in the text, but in Plato's doctrine in its epistemological aspect: is dialectical any time when there is a move towards knowledge, having now some denial (which is exceeded, the thing that intelligence is not resigned: the false assumptions) and some claim (what is said , if only as a goal: the knowledge of the truth from the approach to the principles on which it is claimed).

This dialectical character is permeating the entire text under discussion, as the highlight of the same idea, in our opinion, is that knowledge is a process, that this process approach to the principles is the ultimate goal and that " distinguish what's real intelligible "are things that are constituted as objects of our knowledge is the ultimate goal for our ability to reason.

To conclude our analysis we can say that, despite its shortness, are present in it a short but important set of proposals epistemological order. Namely: that the science of the dialectic is interested in making intelligible realities, at first, can not seem (to not appear 'understandable'); that this progress of reason to the inteligilidad plays a major role that 'discursive thought' That dianoia , and that this involves a process of alienation of opinions and, perhaps, of the principles established in earlier phases of this development (sensitive phase) and an approach to the eidetic dimension of reality, the closest to the truth.