A patient reports frontal face pain, chronic runny nose, and headaches. The patient has a history of sinusitis. In assessing this patient, what two sinuses should be palpated for tenderness?

Paranasal sinuses are air-filled cavities within the cranium lined with ciliated epithelium that provide resonance and lighten the skull. Acute or chronic sinusitis involves inflammatory edema and mucus accumulation, leading to increased intrasinus pressure and focal pain. Only the superficial cavities are accessible for physical examination to detect localized tenderness during palpation. A. Maxillary and frontal: These are the only two sets of sinuses accessible to physical examination. The nurse palpates the frontal sinuses by pressing up and under the eyebrows and the maxillary sinuses by pressing over the cheekbones. Tenderness in these specific locations correlates with the patient's report of frontal face pain and chronic rhinitis. B. Ethmoid and sphenoid: These sinuses are located deep within the skull and cannot be palpated or percussed during a standard physical assessment. Inflammation in these areas often causes deep-seated headaches or retro-orbital pain but does not manifest as superficial tenderness. Assessment of these structures requires advanced imaging like computed tomography. C. Frontal and sphenoid: While the frontal sinuses are easily palpated superior to the orbits, the sphenoid sinuses are situated too deep in the sphenoid bone for manual assessment. A report of frontal pain justifies frontal palpation, but the sphenoid component of this choice makes the combination incorrect for a physical exam. D. Maxillary and ethmoid: The maxillary sinuses are readily assessed inferior to the orbits on the malar eminence. However, the ethmoid sinuses are located between the orbits and are not accessible to the nurse's touch. This makes the choice only partially correct for the clinical palpation technique used in practice.