Hmmm.
My friend has an HP Pavilion Elite m9250f (has Q6700). I was doing some maintenance (wouldn't boot, video card fried, replaced it), and decided to check the temps. 70C idle, 86C running Prime95. Problem. Took off the fan, and sitting on top of the heat sink was so much dust you could hardly see the heat sink. Took off the heat sink, cleaned, reseated with AS5, now 40C/70C (what I was expecting).
The heatsink fins did not look aerodynamically designed for inflow - it had hard square edges (which seems like it would encourage dust buildup). Which lead me to think about this question and wind up here.
I think a HSF could intentionally be designed for outflow, not inflow. And I'm wondering if that's what I was dealing with. Directly above the HSF, in the side of the case, it's perforated. Is this to get hot air out of the system, or to get cool air into the system and over the processor (and blow warm air over everything else)?
The dust buildup, non-aerodynamic nature of the top of the heatsink, and case perforations lead me to suspect this may have been an outflow design.
If anyone can definitively answer this, I'd appreciate it.