12. Head & neck I

Question 1

What is the anterior nasal septum made of?

Answer 1

Nasal/septal cartilage (hyaline cartilage)

Question 2

What bones constitute the posterior nasal septum?

Answer 2

1) perpendicular plate of ethmoid bone (at the top of which is the cribriform plate)
2) vomer bone

the maxilla and palatine bones also contribute to the posterior nasal septum

Question 3

Label this diagram

Answer 3

Question 4

What is the name of the opening of the nostrils?

Answer 4

Nasal recess

Question 5

What is the name of the back of the nasal cavity?

Answer 5

Nasal Choanae (choanae are the posterior ends of the nasal cavity and are like passages)

Question 6

From which bone do the superior and middle nasal conchae/turbinates arise?

Answer 6

Ethmoid bone

Question 7

From which bone does the inferior nasal choncha/turbinate arise?

Answer 7

Maxillary bone

Question 8

What is the function of the nasal chonchae/turbinates?

Answer 8

To cause the air to flow in a turbulent manner, warming it up and humidifying it as well as trapping any foreign particles that enter nose in order to stop them entering airways.

Nasal chonchae/turbinates are covered in mucus to aid this function.

Question 9

What is the name of the space between nasal chonchae/turbinates?

Answer 9

Meatus

hence there is a superior, middle and inferior meatus

Question 10

Label this image

Answer 10

Question 11

Which paranasal sinus has lots of little air cells?

Answer 11

Ethmoid sinus, consisting of many ethmoidal air cells

Question 12

What kind of epithelium lines the paranasal sinuses?

Answer 12

Pseudostratified ciliated columnar epithelium

contain mucus-producing goblet cells which moves across the cilia along with trapped foreign particles and pathogens

Question 13

Which sinus is the most posterior of the paranasal sinuses?

Answer 13

Sphenoid sinus

Question 14

Label this image

Answer 14

Question 15

Label this diagram.

What kind of cross-section is it?

Answer 15

Coronal

Question 16

What exactly is the role of the paransal sinuses?

Answer 16

Previously believed to be involved in resonance of sound, lightening the skull and olfaction however, currently these are not confirmed so, for now, it is believed the paranasal sinuses do not really have an exact function.

Question 17

Which paranasal sinuses drain into the semilunar hiatus?

Answer 17

Maxillary, Frontal and Anterior ethmoidal air cells

semilunar hiatus is a groove in the middle meatus

Question 18

How do paranasal sinuses drain?

Answer 18

via channels called infundibula and then out through ostia

Question 19

Which paranasal sinuses drain into the ethmoidal bulla?

Answer 19

The middle ethmoidal air cells. Ethmoidal bulla is a prominence of the middle meatus

Question 20

Which paranasal sinuses drain into the superior meatus?

Answer 20

the posterior ethmoidal air cells

Question 21

which paranasal sinuses drain into the spheno-ethmoidal recess and what is this recess?

Answer 21

The sphenoid sinuses drain into the spheno-ethmoidal recess.

Spheno-ethmoidal recess is a small space superior to the superior chonchae.

Question 22

What opens into the inferior meatus?

Answer 22

Nasolacrimal duct

Question 23

Why does the nose start to run when we cry?

Answer 23

Because nasolacrimal duct opens into the inferior meatus

Question 24

Which paranasal sinuses get their blood supply from a branch of the external carotid artery?

Answer 24

Maxillary sinuses (via the maxillary branch of the external carotid artery)

Question 25

Which paranasal sinuses get their blood supply via a branch of the internal carotid artery?

Answer 25

Frontal, Ethmoidal and Sphenoid via the ophthalmic artery

Question 26

What is the maxillary nerve a branch of?

Answer 26

It is the second branch of the trigeminal nerve (CN V).

The maxillary division (V2) gives off alveolar branches which innervate the teeth. Hence why a sinus infection can cause toothache (referred pain)

Question 27

Why is obstruction of the maxillary sinuses common?

Answer 27

They drain superiorly into the nasal cavity via a vertical/diagonal canal

Hence foreign particles get trapped and can cause infections

When such infections occur they cause inflammation of mucosal layer which gets swollen and blocks the passage

Question 28

What is endoscopic maxillary sinus surgery/ functional endoscopic sinus surgery?

Answer 28

Surgical removal of the uncinate process which contributes part of the medial wall of the maxillary sinus.

This is done in order to expose the infundibulum and enlarge passage between the nasal cavity and the maxillary sinus

Question 29

What structure is at the top of the ethmoid bone?

Answer 29

Crista galli (crest)

Question 30

What is the function of the perpendicular plate of the ethmoid bone?

Answer 30

superior nasal septum

Question 31

where do the superior and middle nasal chonchae/turbinates come from?

Answer 31

ethmoid bone

Question 32

Where is the opening of the eustachian tube?

Answer 32

Nasopharynx (C1-C2)

Question 33

Where is the adenoid/pharyngeal tonsil?

Answer 33

Nasopharynx

Question 34

Where are the palatine and lingual tonsils located?

Answer 34

Oropharynx (C2-C3)

Question 35

what are the boundaries of the laryngopharynx?

Answer 35

located at C4-C5/6

Bounded by epiglottis superiorly and inferior portion of the cricoid cartilage inferiorly (C6)

continuous inferiorly with the oesophagus.

Laryngopharynx contains middle and inferior pharyngeal constrictors

Question 36

Boundaries of oropharynx

Answer 36

soft palate to epiglottis

contains posterior 1/3 of tongue, lingual tonsils, palatine tonsils and superior constrictor muscle

oropharynx is involved in the voluntary and involuntary phases of swallowing

Question 37

Boundaries of nasopharynx

Answer 37

nasal choanae to soft palate (and C1)

lined in respiratory epithelium, conditions inspired air and propagates it to the larynx

Question 38

what is the function of the pharyngeal longitudinal muscles?

Answer 38

widen and shorten the pharynx and elevate the larynx during swallowing

elevation of larynx during swallowing is important in order to move the epiglottis and seal the airway

Question 39

what is the function of the circular constrictor muscles?

Answer 39

Constrict the pharynx in order to transport bolus of food to oesophagus.

Run from the nasopharynx to the esophagus.

Question 40

What are the laryngeal muscles innervated by?

Answer 40

Mostly vagus nerve (CN X) apart from stylopharyngeus (glossopharyngeal nerve CN IX)

Question 41

What separates the nasopharynx from the oropharynx?

Answer 41

uvula (at tip of soft palate)

Question 42

when do we call the laryngeal tonsils ‘adenoids’?

Answer 42

When they are inflammed

Question 43

What are the three longitudinal pharyngeal muscles?

Answer 43

Palatopharyngeus

Stylopharyngeus

Salpingopharyngeus (innervated ‘by’ CN IX the glossopharyngeal nerve)

Question 44

Other than widening and shortening the pharynx/ elevating larynx during swallowing, what is another function of salpingopharyngeus muscle?

Answer 44

Opens up the eustachian tube to equalise pressure inside the middle ear

Question 45

Are the muscles of the pharynx voluntary or involuntary?

Answer 45

Involuntary striated muscle serving for deglutition (swallowing)

Question 46

Which bones are part of the neurocranium?

Answer 46

1. Frontal bone
2. Sphenoid bone
3. Ethmoid bone
4. Occipital bone
5. Temporal bone
6. Parietal bone

Question 47

What is another name for the eustachian tube?

Answer 47

the pharyngotympanic tube

infections can spread from nasopharynx into the ear

Question 48

What are the tonsils in the nasopharynx and oropharynx known as collectively?

Answer 48

Waldeyer’s ring of lymphatic tissue