anat/physio/patho 2 Flashcards
Name the 3 middle ear bones
Malleus, incus, stapes
What test should I conduct if I suspect that patient has a CN 8 palsy affecting their balance?
Romberg’s test - test for proprioception & balance
** How do I identify vagus nerve palsy?
Uvula deviation AWAY from affected side.
Vagus nerve innervates the muscles of the soft palate, in particular, the levator palatini elevates the soft palate.
When functioning normally, both sides of the levator palatini contract to lift the soft palate evenly. This gives rise to an equal level uvula.
Lesion of vagus nerve -> paralysis of the levator veli palatini muscle on one side -> failure of soft palate to elevate
Unopposed pull of soft palate towards the unaffected side -> deviation of the uvula AWAY from affected side
Differentiate between the 2 palsies causing uvula and tongue deviation
Uvula deviation:
- AWAY from affected side
- vagus nerve palsy
Tongue deviation:
- TOWARDS affected side
- hypoglossal nerve palsy
Name the 2 nuclei in the thalamus where visual and auditory information synapses
Visual -> lateral geniculate nucleus
Auditory -> medial geniculate nucleus
What branch of the ophthalmic nerve sits on top of the levator palpebrae superioris?
Frontal nerve
Which branch of trigeminal is the only one to have a motor component?
Mandibular, V3
All the muscles of the tongue is supplied by the _ nerve EXCEPT the muscle _ which is supplied by the _ nerve
Hypoglossal (CN 12), palatoglossus, vagus (CN 10)
All the muscles of the soft palate is supplied by the _ nerve EXCEPT the muscle _ which is supplied by the _ nerve
Vagus (CN 10), tensor veli palatini, mandibular (CN V3)
All the muscles of the pharynx is supplied by the _ nerve EXCEPT the muscle _ which is supplied by the _ nerve
Vagus (CN 10), stylopharyngeus, glossopharyngeal (CN 9)
In a thyroidectomy, what are the 3 vessels I am worried about affecting?
- Superior thyroid artery <-> external laryngeal nerve -> cricothyroid muscle -> high pitched sounds
- Inferior thyroid artery <-> recurrent laryngeal nerve -> posterior cricoarytenoid muscle -> abducts the vocal folds
- Cervical sympathetic trunk -> loss of sympathetic function to head and neck region -> ptosis, miosis, anhidrosis
What are the 2 key branches of the cervical plexus?
- Phrenic nerve
- Anas cervicalis -> innervation of the strap muscles (omohyoid, sternohyoid and sternothyroid) EXCEPT thyrohyoid (CN 12)
Which 2 veins combine to form the external jugular vein? How does the EJV relate to the SCM and describe its trajectory to becoming the brachiocephalic vein.
Posterior auricular vein + retromandibular vein -> external jugular vein
EJV crosses the SCM anteriorly -> subclavian vein
Subclavian (right and left) + internal jugular vein (right and left) -> (right and left) brachiocephalic vein -> superior vena cava
Name the 5 broad groups of muscles in the face & scalp
- Muscles of mastication (CN V3)
- Muscles of facial expression (CN VII)
- Muscles of the cheek - buccinator
- Orbicularis oris (mouth) & oculi (eye)
- Muscles of the scalp - occipital & occipitofrontal (forehead)
Name the deep and superficial muscles of the neck.
Deep: strap muscles (omohyoid - superior & inferior belly, sternohyoid, thyrohyoid, sternothyroid)
Superficial: platysma
Name the infra and supra hyoid muscles
Infra: strap muscles - omohyoid - superior & inferior belly, sternohyoid, thyrohyoid, sternothyroid
Supra: geniohyoid, mylohyoid, digastric (anterior & posterior), stylohyoid
State which nerves innervate the anterior and posterior belly of digastric, as well as the superior and inferior belly of omohyoid
Anterior belly of digastric: nerve to mylohyoid
Posterior belly of digastric: CN VII
Superior & inferior belly of omohyoid: anas cervicalis (C1-C4)
Between which 2 muscles does the brachial plexus lie within?
Anterior and middle scalene muscles of the neck
Name the 2 types of orbicularis oculi muscle
- Palpebral - close eye gently
- Orbital - close eye tightly
Name the layers of the scalp and name which layer is the most vascular
Skin
Connective tissue (dense)
Aponeurosis
Loose connective tissue (**Most vascular layer)
Pericranium
Describe the sensory innervation to the face
Anterior to vertex ear chin line: Trigeminal nerve
Posterior: branches of superficial cervical plexus
Name the 3 sutures of the skull and roughly where they are
Anterior left to right: coronal
Posterior (occipital region) left to right: lambdoid
Anterior to posterior: sagittal
The pterion is the junction between which 4 boenes?
Frontal
Parietal
Sphenoid (greater wing)
Temporal
What is the needle looking bone of the skull near the ear canal and what is the other closely related bony part where many muscles attach to?
Needle: styloid process
Point of muscular attachment: mastoid process