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BDS3 - BAMS > Anatomy 1 & 2 > Flashcards

Anatomy 1 & 2 Flashcards

1
Q

skeleton of the head and neck
components

A
  • skull
  • cervical vertebrae
  • hyoid bone
  • ossicles of the ear (6)
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2
Q

how many bones of head and neck

A
  • 22
  • NOT including ossicles of ear
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3
Q

individual bones joined by

A
  • sutures
  • fibrous joints
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4
Q

movement of skull only occurs at

A
  • TMJ
  • atlanto-occipital joint
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5
Q

skull function

A
  • protective case for delicate structures
  • provides attachment for muscles
  • provides framework for the head
  • gives us identity as backbone of our facial features
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6
Q

types of bone

A
  • flat
  • irregular
  • pneumatised
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7
Q

flat, smooth bones formed by

A

intramembrenous ossification

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8
Q

irregular bones formed by

A

intramembrenous ossification

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9
Q

pneumatised bones? and examples

A
  • bones with air spaces/air cells/sinuses
  • frontal, temporal, sphenoid and ethmoid
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10
Q

pneumatised bones function

A
  • provides a resonance space for our voice
  • reduces overall weight of the skull
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11
Q

didivisions of the skull

A
  • neurocranium:further divided to calvaria and cranial base
  • viscerocranium
  • mandible separate bone from two parts
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12
Q

bones of the neurocranium

A
  • 8 bones
  • 4singular bones: frontal, occipital, sphenoid, ethmoid
  • 2 paired: parietal, temporal
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13
Q

Identify structures scored out

A
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14
Q

zygomatic arch formed between

A
  • temporal process of zygomatic bone
  • zygomatic process of temporal bone
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15
Q

deep to zygomatic arch is

A
  • infratemporal fossa
  • contains muscular and neurovascular structures
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16
Q

mastoid and styloid process are

A
  • easily broken
  • when not stabilised by muscle attachments
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17
Q

attachment site for temporalis and temporal fascia

A
  • temporal fossa
  • superior and inferior temporal lines
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18
Q

temporal fossa
superior and posterior borders

A
  • superior temporal line
  • inferior temporal line
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19
Q

temporal fossa
anterior border

A
  • frontal process of zygomatic bone
  • zygomatic process of frontal bone
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20
Q

temporal fossa
inferior border and what does floor include

A
  • infratemporal crest
  • deep to zygomatic arch
  • floor includes pterion
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21
Q

vertex

A
  • superior part of neurocranium
  • inferior border is the orbitomeatal or frankfort horizontal plane
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22
Q

Identify structures scored out

A
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23
Q

Identify structures scored out

A
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24
Q

what is the inion

A
  • most prominent point of the external occipital protuberance
  • greek for back of the head
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25
asterion
* star shaped junction of three sutures * between occipital, temporal and parietal bones
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nasion
* where frontonasal and internasal sutures meet and the glabella
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pterion
* H shaped junction of sutures * frontal, parietal,temporal and greater wing of sphenoid bone * vulnerable to injury
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pterion vulnerability
* overlies anterior branch of middle meningeal artery * fracture @ pterion can lead to rupture * can lead to extradural haematoma (between skull and dura) * if untreated will exert pressure on brain
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views of the skull
* norma lateralis * norma verticalis * norma frontalis * norma basalis * norma occipitalis
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what is a wormian bone
* small islands of bone within a cranial suture * also known as sutural/accessory bones
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where is a wormian bone most commonly observed
in the lamdoid suture
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where is inion located and what does it lie between
* located inferiorly to the external occipital protruberance * between the superior and inferior nuchal lines where the nuchal ligament attaches
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suture
* type of fibrous joint * limited or no movement
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fontanelle
* fibrous membrane that are soft spots in the skull * fuse in post-natal life to form sutures
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key fontanelles
* anterior * posterior * sphenoidal * mastoid
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when do anterior and post fontanelles fuse
* anterior around 18 months * posterior under 1 year
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what is the piriform aperature
* anterior nasal opening of the cranium * pear shaped
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bony nasal septum formed by
* ethmoid superiorly * vomer inferiorly
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orbit formed by
* frontal bone * sphenoid bone * zygomatic bone * maxilla * lacrimal bone * ethmoid bone
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paranasal sinuses names/location
* frontal sinuses * ethmoidal cells * maxillary sinuses * also found in temporal and sphenoid bone
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names of foramen/canal seen norma basalis
* carotid canal * jugular foramen * foramen magnum * foramen spinosum * foramen ovale * greater and lesser palatine foramen * incisive fossa
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structures that pass through foramen magnum
* spinal cord * meninges * vertebral and spinal arteries * spinal root of accessory nerve CNXI
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what is the foramen lacerum
* artefact of dry bone * in life it is closed by cartilage * ICA and sympathetic and venous plexuses pass horizontally across it
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how many cervical vertebrae and which are irregular
* 7 vertebrae * C1, C2 and C7 irregular
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ligamentum nuchae
* ligament which attaches external occipital protruberance on nuchal lines and foramen magnum to spinous process of the cervical vertebrae * continuous with supraspinal ligament
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ligamentum nuchae function
* supports head * resists flexion * attachment point for muscles of the head and neck
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C1 C2 and C7 names
* C1 atlis * C2 axis * C7 vertebra prominens
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only cervical vertebrae have
foramen transversium
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foramen transversium contain
* vertebral BV * C7 the vertebral artery does not pass
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C7 unique features
* spinous process not bifid * known as vertebra prominens)
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C1 unique features
* anterior arch and posterior tubercle * no body * no spinous process= tubercle * facets articulate with occipital condyles of skull/dens
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C2 unique features
* dens extending from body * also called odontoid process * large articular facets on which the atlas rotates
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cervical vertebrae key joints
* atlanto-occipital joint * atlanto-axial joint
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atlanto-occipital joint allows
flexion and extension (nodding)
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lateral atlanto-axial joint allows
* rotation of head (side to side movements)
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alar ligament
* prevents excessive rotation of head and neck * connects dens to occipital condyles
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hyoid bone function
* helps to keep the airway open * connects oral cavity with pharynx posteriorly and larynx inferiorly
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What is this
Wormion bone
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neck boundaries
* superior boundary: base of skull and inferior border of mandible * inferior border: top of sternum, clavicle, acromion (anterior) and c7 (posterior)
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neck compartments
* visceral compartment * vascular compartment * vertebral compartmentn
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whats in visceral compartment
* trachea * oesophagus * thyroid * parathyroid
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fascia of neck function
* surrounds compartments * provides containment and protection of structures * provides slipperiness that allpw structures to slide over each other
73
what is superficial fascia
* fatty connective tissue * contains cutaneous nerves, BV, lymphatics * contains the platysma muscle anterolaterally
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superficial fascia location
* between dermis and investing fascia * connects to mandible and facial muscles * continuous with superficial fascia of thorax
75
what is deep fascia
* connective tissue * gives protection and support to contents * three layers: investing, prevertebral, pretrachea * forma carotid sheath
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investing layer of deep fascia
* surrounds neck completely * deep to subcutaneous tissue * encloses SCM and trapezius, parotid and submandibular glands
77
fascia investing infrahyoid muscles
* sometimes counted as part of investing fascia * sometimes as muscular part of pretracheal layer
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pretracheal layer of deep fascia
* thin layer limited to anterior part of neck * encloses trachea, oesophagus and thyroid gland etc * encloses infrahyoid muscles and separates them from trachea and thyroid * forms pulley for intermediate tendon of digastrid...suspending the hyoid
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pretracheal layer pierced by
thyroid vessels
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prevertebral layer of deep fascia
* surrounds vertebral column and pre and post vertebral muscles * scalenes, longus colli and longus capitus * cervical parts of sympathetic trunk embedded * pierced by branches of cervical plexus
81
carotid sheath and contents
* has boundaries with all three layers off deep cervical fascia * runs from foramen of carotid canal to aortic arch...potential pathway for spread of infection * surrounds CCA, ICA, IJV, CNX * also contains deep cervical lymph nodes
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posterior triangle boundaries
* anterior: post border of SCM * posterior: anterior border of trapezius * inferior: middle 3rd clavicle * apex: superior nuchal line of occipital bone
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posterior triangle subdivisions
* occipital triangle * omoclavicular/subclavian triangle * divided by inferior belly of omohyoid
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roof and floor of posterior triangle
* roof: investing fascia, platysma, superficial fascia and skin * floor: prevertebral fascia surrounding muscles at floor of triangle...splenus capitus, levator scapulae, scalenes
85
sternocleidomastoid origin and insertion
* origin: sternal head from manubrium, clavicular head from medial 3rd of clavicle * insertion: lateral surface of mastoid process and lateral half of superior nuchal line
86
SCM Innervation
* spinal accessory nerve CN XI * also C2,C3 nerves for pain and proprioception
87
SCM actions
* draws head forward (bilaterally) elevation of chin * tilts head towards ipsilateral shoulder so ear approaches shoulder * acts as accessory muscle during respiration by elevating clavicle and manubrium
88
SCM test
* head is turned to opposite side against resistence (hand against chin) * can be seen and palpated if normal
89
trapezius origin and insertion
* origin: superior nuchal line, external occipital protruberance, ligamentum nuchae and C7-T12 * insertion: lateral 3rd of clavicle, acromion and spine of scapula
90
trapezius innervation and action
* spinal accessory nerve CN XI * assists in rotating scapula, elevate, adduct and depress scapula
91
trapezius to test
* shoulder shrugged against resistence * if acting normally superiod border can be seen and palpated * if trapezius is paralised shoulder droops
92
what is the cervical plexus
* nerve loops formed between anterior rami of c1-c4 * branches of plexus arise from loops
93
cervixal plexus muscular branches
* phrenic nerve c3,4,5 * ansa cervicalis c1,2,3 * branches to prevertebral and vertebral muscles
94
cervical plexus cutaneous branches
* c2 lesser occipital nerves * c2,3 greater auricular and transverse cervical nerves * c3,4 supraclavicular nerves
95
ansa cervicalis
* nerve loop from anterior rami of C1,2,3 (cervical plexus) * innervated infrahyoid muscles except thyrohyoid
96
posterior triangle vasculature
* external jugular vein runs accross SCM and drains to subclavian * posterior external jugular vein runs alongside anterior border of trapezius
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posterior triangle contents that cross SCM
* external jugular vein * greater auricular nerve * transverse cervical nerve
98
posterior triangle contents that cross triangle
* spinal accessory nerve * external jugular vein * transverse cervical artery and vein * lesser occipital nerve
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anterior triangle borders
* inferior borner of mandible superiorly * anterior border of SCM posteriorly * midline of neck anteriorly
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anterior triangle roof and floor
* roof: deep investing fascia around muscles * floor: pretracheal fascia and carotid sheath
109
anterior triangle subdivisions
* submandibular/digastric * submental * carotid * muscular/omotracheal
110
submandibular triangle contains
* submandibular gland * lymph nodes * parts of hypoglossal nerve CNXII * mylohyiod nerve * parts of facial artery and vein pass through it
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submental triangle contains
* submental lympth nodes * small veins which unite to form anterior jugular vein
112
carotid triangle contains
* parts of thyroid gland, larynx and pharynx * deep cervical lymph nodes * carotid sheath and its contents * branches of cervical plexus * superior root of ansa cervicalis * parts of CNXI and CNXII
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muscular/omotracheal triangle contains
* sternohyoid * sternothyroid * larger part of thyroid and parathyroid glands
114
suprahyoid muscles
* mylohyoid * digastric * stylohyoid * geniohyoid
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mylohyoid separated by
mylohyoid raphe
116
geniohyoid position
* similar position to digastric * deep to the structures * inserts directly into the hyoid
117
infrahyoid muscles
* sternohyoid * omohyoid * sternothyroid * thyrohyoid
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mylohyoid originates/inserts/action
* originates at mylohyoid line on mandible * inserts into body of hyoid and fibres of opposite mylohyoid * elevates the hyoid bone and floor of mouth, reinforces the floor of the oral cavity
119
digastric originates/inserts/action
* anterior belly originates at digastric fossa on mandible * posterior belly originates at mastoid notch on mastoid process * insert at intermediate tendon at hyoid which attaches to hyoid by a fascial sling * anterior belly raises hyoiod and opens mouth by lowering mandible * post belly elevates and retracts hyoid bone
120
suprahyoid muscles function
* elevate hyoid to fascilitate swallowing * elevate larynx for tone production * constitute substance of floor of mouth
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mylohyoid and digastric innervation
* mylohyoid by CNV3 inferior alveolar branch called nerve to mylohyiod * digastric muscle anterior belly by nerve to mylohyoid * post belly by digastric branch of facial nerve
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infrahyoid muscles function
* depress or fix hyoid bone * anchor hyoid, sternum, clavicle, scapula * provides attachment site for suprahyoid muscles
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sternohyoid originates/inserts/action/innervation
* originates at post surface of sternoclavicular joint and manubrium * inserts into body of hyoid medially * depresses hyoid after swallowing * innervated by anterior rami of C1 to C3 through ansal cervicalis
124
omohyoid originates/inserts/action/innervation
* superior belly originates at intermediate tendon and inserts onto hyoid bone laterally * inferior belly originates at scapula and inserts into intermediate tendon * intermediate tendon attaches to clavicle via fascial sling * depresses and fixes the hyoid * innervated by anterior rami C1 to C3 through ansa cervicalis
125
thyrohyoid originates/inserts/action/innervation
* originates at thyroid cartilage * inserts into greater horn and body of hyoid * depresses the hyoid, can raise larynx when hyoid fixed * innervated by anterior rami of C1 which run with CNXII
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sternothyroid originates/inserts/action/innervation
* originates at manubrium * inserts into thyroid cartilage * draws the larynx downwards * innervated by anterior rami of C1 to C3 through the ansa cervicalis
127
what is pyrimidal lobe of thyroid gland
remnant of embryonic thyroglossal duct
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thyroid arterial supply
* superior thyroid artery (1st branch of ECA) * inferior thyroid artery (branch of thyrocervical trunk from subclavian)
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thryoid venous drainage
* superior thyroid vein into IJV * middle thyroid vein into IJV * inferior thyroid vein into brachiocephalic
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thyroid ima artery
* approx 10% have this additional artery * small, unpaired * usually arises from brachiocephalic trunk * ascends on anterior surface of trachea so consider during tracheostomy as potential source of bleeding
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thyroid and parathyroid gland implications for neck surgery
* anatomical relationship to recurrent laryngeal nerves from CNX * potential damage to nerve especially RRLN * symptoms of injury include hoarseness or aphonia
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emergency surgical airway types
* cricothyrotomy emergency procedure where needle passed through cricothyroid ligament * tracheostromy is surgical airway insertion of tube between 1-2nd or 2-4th tracheal rings
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carotid triangle bound by
* superior belly of omohyoid * posterior belly of digastric * anterior border of SCM
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structures surrounded by carotid sheath
* common carotid artery * internal carotid artery * part of ECA * internal jugular vein * vagus nerve CNX
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where does carotid sheath run from/to
aortic arch to foramen of carotid canal
143
common carotid artery branches from
* brachiocephalic trunk on right * directly from aortic arch on left
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carotid sinus location/contains/innervation
* dilation at bifurcation of CCA in wall of ICA * contains baroreceptors which moniter blood pressure and sensitive to stretch * innervated by CNIX via carotid sinus nerve and CNX
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carotid body location/contains/innervation
* small organ at bifurcation of CCA near carotid sinus * contains chemoreceptors which monitor blood O2, CO2 and pH and temp * innervated by CNIX via carotid sinus nerve and CNX
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exceptions to blood suply external to cranium
* ECA supplies most structures external to cranium * orbit and part of forehead and scalp are major exception as supplied by supra-orbital artery
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at what level does CCA bifurcate
* C3/4 * superior border of thyroid cartilage
148
external carotid artery branches (pneumonic)
* some anatomists like freaking out poor medical students * Superior thyroid * Ascending pharyngeal * Lingual * Facial * Occipital * Posterior auricular * Maxillary * Superficial temporal
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terminating branches of ECA
* maxillary * superficial temporal * embedded in parotid gland when divides
150
middle meningeal artery origin and course
* branches off maxillary artery which is ECA * enters cranium through foramen spinosum in sphenoid bone * part of artery is region of pterion
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internal jugular vein is continuation of and where does it exit skull
* continuation of sigmoid sinus in post cranial fossa * exits via jugular foramen
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veins draining into IJV
* inferior petrosal sinus * pharyngeal * occipital * facial * lingual * superior thyroid * middle thyroid
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inferior end of IJV
* dilates to form inferior bulb * has a bicuspid valve * permits blood flow to heart * prevents backflow which might occur if standing upside down or increased intrathoracic pressure
154
veins draining into EJV
* posterior external jugular * transverse cervical * suprascapular * anterior jugular * mainly drains scalp and face beginning near mandibular angle
155
EJV superficial to/covered by/parallel with
* superficial to SCM * covered by platysma, superficial fascia and skin * lies parallel with greater auricular nerve
156
CNVII neck enters via and supply/main trunks
* enters through stylomastoid foramen * 5 main branches * temporal * zygomatic * buccal * mandibular * cervical innervates platysma muscle * digastric branch supplies digatric muscle * also supplies stylohyoid
157
CNIX in neck enters via and supply
* exits via jugular foramen and travels between IJV and ICA * most travels forward to oral cavity...tongue and pharynx * some branches to carotid sinus and body
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nerves to emerge through jugular foramen
* CNIX CNX CNXI
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CNX in neck enters via/supplies
* exits jugular foramen * travels within carotid sheath * motor branch to pharynx * branch to carotid body and sinus * recurrent laryngeal nerve near to SA/arch of aorta which damage leads to voice hoarseness or aphonia
160
CNXI in neck emerges from and supplies
* exits the jugular foramen * descends to post triangle of neck * innervates SCM and trapezius
161
CNXII in neck emerges from and supplies
* exits hypoglossal canal * crosses ICA and ECA on its way to oral cavity * supplies intrinsic muscles of tongue and 4/5 extrinsic muscles * gives off superior root of ansa servicalis * branch to geniohyoid
162
main nerves in neck other than CN
* transverse cervical (anterior rami C2/3) * ansa cervicalis (anterior rami C1-3) innervates infrahyoid muscles * cervical plexus (anterior rami C1, C2-4) to infrahyoid muscles, diaphragm, skin of anterior/lateral neck * brachial plexus (C5-T1) * phrenic nerve * cervical part of sympathetic trunk (3 ganglia)
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