Anatomy Flashcards
What lies beneath the pterion?
Middle meningeal artery
Why is a blow to the pterion dangerous?
Can cause extradural haemorrhage as the pterion overlies the middle meningeal artery
Which nerve transmits through supraorbital notch?
Opthalmic nerve (CNV1)
What nerve transmits through the infraorbital foramen?
Maxillary nerve (CNV2)
What nerve transmits through the mental foramen?
Mandibular nerve (CNV3)
Which cervical vertebrae are typical?
C3-C6
Which cervical vertebrae are atypical and what are their names?
C1 Atlas
C2 Axis
C7 Vertebrae prominens
What is the atlanto-occipital joint and what is its function?
C1 and skull joint
Nodding
What is the joint of C1 and C2 called ant what is its function?
Lateral Atlanto axial joint
Rotation of the head (side to side)
What attaches to the spinous processes of the cervical vertebrae?
Ligamentum nuchae
What vertebrae level is the hyoid bone?
C3
Components of the carotid sheath (3)
Common carotid a
Internal jugular v
Vagus nerve
Muscles found in the superficial fascia of the neck and what is its function?
Platysma
Facial expression
What layer of fascia lies deep to the subcutaneous tissues?
Investing fascia
Fascia making up the carotid sheath
Boundaries with all three layers of deep cervical fascia - investing/pretracheal anteriorly, prevertberal posteriorly.
Path of the carotid sheath into the skull
Runs from aortic arch to foramen of carotid canal
Innervation of SCM
Accessory nerve
SCM function
Draws head forwards (bilaterally)
Tilts head towards ipsilateral shoulder
Turning face contralaterally (unilaterally)
What nerve does C3, C4 and C5 give rise to and what does it supply?
Phrenic nerve - supplies diaphragm
What nerve does C1, C2 and C3 give rise to and what does it supply?
Ansa cervicalis - innervates infrahyoid muscles
What nerve does C2 give rise to?
Lesser occipital nerve
What nerve does C2 and C3 give rise to ?
Great auricular, transverse cervical
What nerves do C3 and C4 give rise to?
Supraclavicular nerves
What triangle of the neck can the brachial plexus be seen in?
Omoclavicular triangle, within the posterior triangle of the neck
Which major vessels and nerves cross the SCM
EJV
Great auricular nerve
Transverse cervical nerve
Suprahyoid muscles
Mylohyoid
Geniohyoid
Stylohyoid
Digastric
Infrahydoid muscles
Sternothyroid
Sternohyoid
Thyrohyoid
Omohyoid
Which nerve gives rise to the nerve to mylohyoid?
Inferior alveolar nerve
What are 2 airway procedures and what are the anatomical landmarks for this procedure?
Cricothyrotomy - cricothyroid ligament
Tracheostomy - isthmus of the thyroid gland
Innervation of the carotid sinus?
Carotid sinus nerve from glossopharyngeal nerve
Where is the carotid sinus and what is its function?
Internal carotid artery, baroreceptors that regulate BP
What is Sibson’s fascia and what is its function?
Suprapleural membrane or fibrous connective tissue that acts as a barrier to prevent intrathoracic pressure changes
3 branches from aortic arch
Left subclavian
Left common carotid
Right brachicephalic
What muscle divides the subclavian artery into 3 parts?
Anterior scalene muscle
What are the branches of the first part of the subclavian artery?
Vertebral artery
Thyrocervical artery
Internal thoracic artery
What is the branch of the second part of the subclavian artery?
Costocervical artery
What is the branch of the third part of the subclavian artery?
Dorsal scapular artery
What are the 2 neurotransmitters released in the autonomic nervous system?
Acetylcholine
Noradrenaline
Where are the preganglionic neurons of the parasympathetic nervous system located?
Craniosacral: Spinal segments S2-S4
Cranial nerves (III VII IX X)
Where are the preganglionic neurons of the sympathetic nervous system located?
Thoracolumbar - spinal segments T1-L2 specifically in the lateral horn
What syndrome is caused by damage to the cervical part of the sympathetic trunk and list 3 signs of this syndrome
Horner’s syndrome
Constriction of pupil (miosis)
Drooping of superior eyelid (ptosis)
Anhydrosis
Why does the scalp have potential to spread infection?
Between the aponeurosis and pericranium there are potential spaces for accumulation of fluid (e.g. blood) or spread of infection
How do scalp infections spread to intracranial structures?
Via emissary veins
Why does the scalp bleed profusely when cut?
Arterial anastomoses are prevalent in the scalp and these lie superficially
With regards to lymphatic drainage of the skull. what nodes drain the scalp and external ear?
Parotid and mastoid nodes
What are the parts of the brainstem?
Midbrain
Pons
Medulla
What are the cranial meninges layers from innermost to outermost?
Pia mater
Arachnoid mater
Dura mater
What is the role of dura mater folds?
Limit the movement of the brain within the cavity
What lies beneath the lateral sulcus of the brain?
Insula
What is Broca’s area of the brain responsible for?
Speech production
What is Wernicke’s area of the brain responsible for?
Understanding speech
Hormones released by the pituitary gland
Growth hormone
Follicle stimulating hormone
Thyroid stimulating hormone
How do the lateral cerebral ventricles drain into the third ventricle?
Via interventricular foramen
How does the third cerebral ventricle drain into the fourth?
Via cerebral aqueduct
Sign of an anterior cerebral artery occlusion
Contralateral motor and sensory loss involving mainly leg and foot
Sign of a middle cerebral artery occlusion
Contralateral motor and sensory loss involving mainly the face and arm
Aphasia - difficulty with speech and language
Sign of posterior cerebral artery occlusion
Visual agnosia - inability to identify objects correctly
Sensory innervation of the angle of the mandible
Great auricular nerve (C2 C3)
CNVII facial nerve enters the skull vie the internal acoustic meatus, and exist via the stylomastoid foramen where it gives rise to which 2 branches?
Posterior auricular
Digastric
2 parts of orbicularis oculi muscle and their roles
Palpebral - involuntary or blinking reflex
Orbital - voluntarily or tightly closing
What muscle does the parotid duct pierce and where does it enter the mouth and secrete saliva?
Parotid duct lies over the masseter before reaching the buccinator and piercing it. It enters near the maxillary second molar
What muscle does the buccal fat pad lie over and what pierces it?
Buccinator
Parotid duct
Branches of the external carotid artery which supply the face
Maxillary - buccal, mental, infraorbital
Superficial temporal - transverse facial
Facial
What vein mainly drains the face and where to?
Facial vein to the IJV
Innervation of the parotid gland
Preganglionic - glossopharyngeal
Postganglionic - auriculotemporal (CNV3)
Innervation of the submandibular gland
Preganglionic - facial (chorda tympani)
Postganglionic - lingual (CNV3)
Innervation of the submandibular gland
Preganglionic - facial (chorda tympani)
Postganglionic - lingual (CNV3)
Innervation of the sublingual gland
Preganglionic - facial (chorda tympani)
Postganglionic - lingual (CNV3)
What nerve branches out of the facial nerve in the facial canal and what does it supply parasympathetic innervation to?
Greater petrosal nerve
Lacrimal and lingual glands
Most common idiopathic facial palsy and what does it present with?
Bell’s palsy
Inability to close eyelid
Drooping mouth
Viral infection which results in swelling of the parotid gland and what are 3 other symptoms?
Mumps
Fever
Headaches
Joint pain
Cerebral white matter
Corona radiata
A lesion affecting corticospinal fibres in the left side of the ventral pons impairs voluntary movement of the arm and the leg on which side? What clinical impact will this have?
Right side (contralateral)
Hemiplegia or paresis
Give an example of an upper motor neuron lesion and symptoms
Stroke
Spastic paralysis
Hyperreflexia
Hypertonia
Give an example of a lower motor neuron lesion and symptoms
Trauma or poliomyelitis
Flaccid paralysis
Hyporeflexia
Hypotonia
What type of joint is the TMJ?
Modified hinge (atypical) - synovial
What is the most common type of TMJ dislocation and how does the patient present?
Anterior dislocation
Open jaw unable to close
Origin, insertion, innervation and function of the temporalis muscle
Origin - temporal fossa and temporal fascia
Insertion - coronoid process of the mandible
Innervation - deep temporal nerves from CN V3
Function - elevation and retraction
Origin, insertion, innervation and function of the masseter
O - maxillary process of the zygomatic bone and arch
Insertion - ramus and angle of the mandible
Innervation - masseteric nerve from CNV3
Function - elevation and protrusion
Primary muscle involved in protrusion of the jaw
Lateral pterygoid
What is the origin, insertion, innervation and function of the medial pterygoid
Origin - medial surface of the later pterygoid plate (deep part) maxillary tuberosity
Insertion - medial aspect of the ramus and angle of the mandible
Innervation - nerve to medial pterygoid from CNV3
Function - lateral movement of the pterygoid
What is the origin, insertion, innervation and function of the lateral pterygoid?
Origin - greater wing of the sphenoid bone (upper head) lateral surface of the lateral pterygoid plate (lower head)
Insertion - pterygoid fovea
Innervation - nerve to lateral pterygoid from CNV3
Function - protrudes mandible and lateral movement
What muscle divides the maxillary artery into 3 parts?
Lateral pterygoid
What nerve passes postsynaptic parasympathetic secretomotor fibres to the parotid gland from the otic ganglion?
Auriculotemporal nerve from CNV3
Sensory innervation to the anterior 2/3rd of the tongue, floor of the mouth and lingual gingivae
Lingual nerve from CNV3
What supplies special sensory innervation (taste) to the anterior 2/3rd of the tongue?
Facial nerve via chorda tympani
What supplies sensory innervation to the posterior 1/3rd of the tongue?
Glossopharyngeal nerve
What main artery and venous plexus is located in the infratemporal region?
Maxillary artery
Pterygoid venous plexus
Where do upper motor neuron fibres of the corticobulbar tract pass through?
Genu of internal capsule
Where do the upper motor neuron fibres of the corticospinal tract pass through?
Posterior limb of internal capsule
Each upper motor neuron connects bilaterally to a cranial nerve nuclei in the corticobulbar tract. What are the 2 exceptions to this rule?
Facial nerve
Hypoglossal nerve
If a patient has drooping lower left face but can wrinkle his upper left forehead and all muscles on the right side what is the suspected lesion?
UMN lesion in the right side of the facial nerve of the corticobulbar tract
2 possible lesions causes patients tongue to protrude to the left
Lower left motor neuron lesion
Upper right motor neuron lesion of the hypoglossal nerve of the corticobulbar tract
Which vessel causes the groove on the parietal bone?
Middle meningeal artery
What does foramen rotundum transmit?
Maxillary nerve CNV2
What nerve is joined by chordae tympani nerve within the infratemporal fossa?
Lingual nerve
What is the sensory branch of the anterior division of the mandibular nerve?
Buccal nerve
Muscle originating from the infratemporal surface of greater wing of sphenoid bone
Upper head of the lateral pterygoid
What muscle attaches to the deep side of the ramus and into the angle of the mandible?
Medial pterygoid muscle
Which muscle protrudes the tongue?
Genioglossus
Nerve innervating the intrinsic muscles of the tongue
Hypoglossal nerve CNXII
What node drains the posterior of the tongue?
Superior deep cervical nodes
What node drains the maxillary sinus?
Submandibular node
87 year old woman has a fall and falls unconscious a couple of days after. Which vessel has ruptured and what type of haemorrhage is most likely?
Cerebral vein
Subdural haemorrhage
Pt comes in complaining of lack of sweating and drooping eyelid on right side. What is the diagnosis and what other signs are associated? What is the anatomical cause?
Horner’s syndrome
Constricted right pupil
Damage to cervical sympathetic trunk
When asking a pt to puff out their cheeks, which 2 branches of the facial nerve are tested?
Buccal nerve
Zygomatic nerve
What is modiolus and what is the dental significance?
Thick part in the angle of the mouth where middle fibres of the buccinator cross over
Have to be considered when making dentures
What nerve crosses anteriorly to the external and internal carotid artery?
Hypoglossal nerve
What nerve crosses posteriorly to the external and internal carotid artery?
Glossopharyngeal nerve
Patient had an infection of a maxillary tooth and is complaining of swollen eyes and fever. Which venous sinus has thrombosis and what other symptoms are seen in this?
Cavernous sinus thrombosis
A headache that feels worse when you lie or bend down
Rash that looks like small bruises or bleeding under the skin
A pt suffers from a brain aneurysm rupture which leads them to lose consciousness fast. What type of haemorrhage is suspected and what vessel is the cause of this?
Subarachnoid haemorrhage
Cerebral artery
What artery supplies the motor cortex?
Middle cerebral artery
What is the white matter area between the thalamus and lentiform nucleus that is a common site for strokes?
Internal capsule
What condition is caused by the overproduction of growth hormone by the pituitary gland?
Acromegaly
What two cerebral ventricles does the cerebral aqueduct connect?
Third and fourth
What structure makes CSF?
Choroid plexus
Drooping of the eyelid in Horner’s syndrome is caused by paralysis of which muscle?
Levator palpebrae superioris
Where does the submandibular duct open into the oral cavity?
Sublingual caruncle/papilla
What is the role of the buccinator during eating?
Press cheeks against molars
Move food to the occlusal surfaces of the teeth
What nerve is being tested when asking a patient to protrude their tongue?
Hypoglossal nerve
What carries parasympathetic secretomotor fibres to salivary glands in the tongue?
Internal laryngeal nerve (branch of vagus nerve)
Which salivary gland is arranged around the free edge of the mylohyoid muscle?
Submandibular gland
Which muscle retracts the mandible?
Temporalis
After an operation to remove stones in the submandibular duct, a pt reports the anterior 1/4 of the tongue is numb. What is the cause?
Damage to the lingual nerve which supplies general sensation to the anterior 2/3 of the tongue
Which muscle opens the mouth?
Lateral pterygoid
Bones making up the zygomatic arch
Temporal process of the zygomatic bone
Zygomatic process of the temporal bone
What is the anatomical basis of a pt having numb lower lip and tongue?
Damage to the mental nerve
2 structures that cross the submandibular gland
Facial vein
Marginal mandibular division of the facial nerve
Through what duct does most lymph of the body re-enter the vascular system? What is the exception?
Thoracic duct
Upper right quadrant which drains into right lymphatic duct
What node drains the parotd gland?
Deep parotid node
What node drains the pharynx, paranasal sinuses and nasal cavity?
Retropharyngeal nodes
What infections cause swelling of the submental nodes?
Epstein barr virus
Cytomegalovirus
Dental infections including periodontitis
What node drains the soft palate, oesophagus, trachea and thyroid gland?
Superior deep cervical nodes
What is a hard, painless lymph node generally indicative of?
Malignancy
What node drains the oral cavity and maxillary sinus?
Submandibular lymph nodes
When you have a cut to the lip why does it usually bleed from both sides?
The superior and inferior labial arteries anastomose across the midline
Which papillae of the tongue do not contain taste buds?
Filiform papillae
What vein is present on either side of the lingual frenulum?
Lingual vein
Where does the sublingual gland duct open?
Sublingual folds
What is the function of the intrinsic muscles of the tongue?
Change the shape and size of the tongue
What is the function of the extrinsic muscles of the tongue?
Protrude, elevate, retract and depress the tongue
What is the role of the genioglossus muscle?
Protrudes the tongue
What is the role of the hyoglossus muscle?
Depressing the sides of the tongue
What vessel enters the tongue between the hyoglossus and genioglossus muscles?
Lingual artery
What nerves enter the tongue on the external surface of the hyoglossus?
Hypoglossal and lingual
What is the function of the styloglossus muscle?
Elevate and retract the tongue
What is the motor innervation of the tongue and what is the exception?
All muscles of the tongue are supplied by the hypoglossal nerve except palatoglossus muscle which is supplied by the vagus nerve
What supplies the special sensory (taste) innervation of the posterior 1/3rd of the tongue?
Glossopharyngeal
What branch of the external carotid artery supplies the tongue?
Lingual artery
What two veins drain the tongue and to what vessel?
Deep lingual vein
Dorsal lingual vein
Both drain into the internal jugular vein
What two veins drain the tongue and to what vessel?
Deep lingual vein
Dorsal lingual vein
Both drain into the internal jugular vein
What nerve loops under the submandibular duct?
Lingual nerve
What are the secretions of each major salivary gland?
Parotid - mostly serous, some mucous
Submandibular - serous and mucous
Sublingual - mostly mucous, some serous
What is the arterial supply and venous drainage of the submandibular gland?
Submental artery and vein
What gland sits in the sublingual fossa of the mandible?
Sublingual gland
What is the arterial supply and venous drainage to the sublingual gland?
Sublingual and submental artery (branches of lingual and facial arteries respectively)
Submental vein to facial and lingual veins, similar to submandibular gland
What is the only major salivary gland that does not have a true fascia/fibrous capsule?
Sublingual gland
Parotid and submandibular have investing fascia surrounding them
Where is sympathetic innervation derived from in regards to main salivary glands?
Superior cervical ganglia
Nerve plexus on external carotid artery
What 2 nerves supply minor salivary glands?
Trigeminal and facial nerve
What nerve must be considered during thyroid surgery as it is usually damaged, and what does damage to this nerve cause?
Right recurrent laryngeal nerve
Hoarseness
Aphonia
At what level of the vertebrae does the common carotid artery bifurcate?
C3-C4
Action potentials form the carotid sinus and body go to which location of the brain?
Medulla
What is the carotid body and its role?
Small organ near the carotid sinus that had chemoreceptors
Regulates O2 CO2 pH and temperature
Innervation of the platysma muscle
Cervical branch of the facial nerve
What innervates the digastric muscle?
Anterior belly - nerve to mylohyoid (a branch of IAN)
Posterior belly - digastric nerve (from facial nerve)
What major lymphatic drainage channel begins in the abdomen ascending through the thoracic cavity and into the neck where it enter the venous system between the left internal jugular vein and the left subclavian artery?
Thoracic duct
What type of epithelium is the nasopharynx lined with?
Ciliated columnar with goblet cells
What connects nasopharynx and middle ear?
Pharyngotympanic tube/ Eustachian tube
How do you test for the accessory nerve?
Ask pt to turn head against resistance (SCM test)
Ask pt to shrug their shoulders against resistance (trapezius tests)
What are the two folds on either side of the palatine tonsils in the oropharynx?
Palatoglossal fold and palatopharyngeal fold
What epithelium lines the vocal fold?
Stratified squamous
What cranial nerve supplies sensory innervation to the pharynx?
Glossopharyngeal nerve
What nerve supplies the upper 3rd molar?
Posterior superior alveolar nerve
Where is the opening of the maxillary ostium in the nasal cavity?
Semilunar hiatus
If there is a laceration on the lower lip, what artery is the bleeding likely coming from?
Inferior labial artery
What nerve can be affected by chronic ear infection?
Vestibulocochlear nerve
What muscle stops the malleus from moving too much?
Tensor tympani muscle
What nerve goes through the incisive foramen?
Nasopalatine nerve
What nerve goes through foramen ovale?
Mandibular nerve (CNV3)
What nerve goes through the foramen rotundum?
Maxillary nerve (CNV3)
Pt complains of numbness of the pinna of the ear, what is likely to be the cuase?
Great auricular nerve
What cranial nerve supplies the larynx?
Vagus nerve
What is the importance of the mylohyoid line in the making of complete lower dentures?
It limits the extension of the lingual flange of the mandibular denture
What is the importance of the mylohyoid line in the making of complete lower dentures?
It limits the extension of the lingual flange of the mandibular denture
What is the vessel under the optic nerve?
Internal carotid artery
What nerve supplies the middle ear?
The auriculotemporal nerve (branch of CNV3) and vagus nerve (CNX)
What level of verterbrae is the larynx found?
C3-6
What is continuous with the oesophagus and what is continuous with the trachea?
Laryngopharynx is continuous with the oesophagus and larynx is continuous with the trachea
What type of cartilage are the laryngeal caritlages and what is the exception?
All hyaline except for the epiglottis which is elastic cartilage
What is the only complete ring of cartilage?
Cricoid cartilage
What connects the epiglottis to the hyoid bone?
Hyoepiglottic ligament
What cartilage lies posterior to the thyroid cartilage?
Arytenoid cartilage
What ligament and membrane spans the space between the thyroid cartilage and the hyoid?
Thyrohyoid membrane
Median thyrohyoid ligament
Lateral thyrohyoid ligament
What ligament and membrane spans the space between the thyroid cartilage and the hyoid?
Thyrohyoid membrane
Median thyrohyoid ligament
Lateral thyrohyoid ligament
What membrane spans from the arytenoid cartilage to thyroid cartilage to epiglottis?
Quadrangle membrane
What ligament forms the conus elasticus?
Cricothyroid ligament
What structure is on the superior free edge of the cricothyroid ligament?
Vocal ligament or true vocal folds
What is the opening between the vocal ligaments and folds called?
Rima glottidis
What structure is over the superior free edge of the quadrangular membrane?
Aryepiglottic fold
What structure is formed over the inferior free edge of the quadrangular membrane?
Vestibularl ligament or false vocal cord
What are the 3 functions of the intrinsic laryngeal muscles?
Open/close rima glottidis
Open/close laryngeal inlet
Alter the tension of true vocal cords
What is the only muscle that opens the rima glottidis?
Posterior cricoarytenoid muscle
What muscle lengthens vocal folds?
Cricothyroid muscle
What muscle shortens vocal folds?
Thyroarytenoid muscle
What muscle is responsible for closure of the laryngeal inlet?
Oblique arytenoid muscle
What provides motor nerve supply to the intrinsic muscles of the larynx and what is the exception?
Recurrent laryngeal nerve
Cricothyroid is supplied by the superior laryngeal nerve
What provides sensation above the vocal folds to the larynx?
Superior laryngeal nerve
What provides sensation below the vocal folds to the larynx?
Recurrent laryngeal nerve
Which cranial nerve provides motor and sensory innervation to the larynx?
Vagus nerve (CNX)
What is the muscle of the nose?
Nasalis
What is the muscle of the nose?
Nasalis
What is the connection between the nasal and oral cavity?
Incisive canal
What bones make up the nasal septum?
Perpendicular plate of ethmoid (superiorly) and vomer (inferiorly)
What cartilage makes up the nose?
Septal cartilage
Alar cartilage
Both hyaline cartilage
What projects the superior and middle chonchae into the nasal cavity?
Ethmoidal labyrinth
What nerve supplies the alae of the nose?
Maxillary nerve (CNV2)
What nerve supplies sensation to the tip of the nose?
Opthalmic nerve (CNV1)
What nerves supply the nasal cavity?
Olfactory nerve (CNI)
Opthalmic nerve (CNV1)
Maxillary nerve (CNV2)
What supplies parasympathetic innervation to the nasal cavity?
Preganglionic: greater petrosal nerve (Facial nerve CNVII)
Postganglionic - maxillary nerve (CNV2)
What supplies sympathetic innervation to the nasal cavity?
Superior cervical ganglion via the internal carotid plexus
What internal and external carotid artery branches supply the nasal cavity?
ECA - maxillary and facial artery
ICA - anterior and posterior ethmoidal arteries
Why is the anterior septal region a common area for nose bleeds?
Anterior and posterior ethmoidal arteries form many anastomoses in that region
What two vessels drain the nasal cavity?
Pterygoid plexus and facial vein
Where does the maxillary paranasal sinus drain?
Middle meatus at the semilunar hiatus
Where does the sphenoid paranasal sinus drain?
Sphenoethmoidal recess
What is the only paranasal sinus not to drain into a lateral wall?
Sphenoid sinus
What 2 sinuses drain into infundibulum in middle meatus?
Ethmoid and frontal
Why does toothache sensarion occur when there is infection in the maxillary sinus?
The innervation of maxillary teeth and the mucous membrane of the maxillary sinus are both superior alveolar nerves
What can the poor removal of a maxillary molar cause in relation to the maxillary sinus?
Oro antral communication
Explain the danger triangle of the face
Veins in the deep triangle of the face drain into the cavernous sinus.
Skin infections in this area can spread to intracranial infections
Which two veins join to form the external jugular vein?
Retromandibular vein
Posterior auricular vein
Innervation of the digastric muscle
Anterior belly - nerve to mylohyoid (from CNV3)
Posterior belly - digastric branch of the facial nerve
Main function of the suprahyoid muscles
Elevate the hyoid and larynx
Main function of the infrahyoid muscles
Depress and fix the hyoid
What runs in the mylohyoid groove and what nerve does it branch from?
Nerve to mylohyoid
Branches from the IAN before it enters the mandibular foramen
Innervation of the palatoglossus
Vagus nerve (CNX)
Stylopharyngeas innervation
Glossopharyngeal nerve
What innervates all of the pharyngeal muscles and what is the exception?
Vagus nerve
Stylopharyngeus is innervated by the glossopharyngeal nerve
Innervation of the carotid body
Glossopharyngeal nerve (carotid sinus branch)
What is the sympathetic innervation of the submandibular and sublingual glands?
Superior cervical ganglion
Nerve plexus on external carotid artery
Parasympathetic innervation of minor salivary glands above the oral fissure
Preganglionic - greater petrosal nerve (CNVII)
Postganglionic - palatine nerves
Parasympathetic innervation of minor salivary glands below the oral fissure
Preganglionic - chordae tympani (CNVII)
Postganglionic - lingual nerve (CNV3)
What nerve must you be careful of when doing a submandibular gland surgery?
Lingual nerve (CNV3)
Middle meningeal and inferior alveolar artery are branches of which artery?
Maxillary artery
Borders of the nasopharynx
Posterior of chonae
Superior of soft palate
Borders of the oropharynx
Superior of the soft palate
Superior of the epiglottis
Borders of the laryngopharynx
Superior of epiglottis
Inferior of cricoid cartilage
The larynx is continuous with what structure?
Trachea
The laryngopharynx is continuous with what structure?
Oesophagus
Phases of deglutition
Oral phase
Pharyngeal phase
Oesophageal phase
2 flat parts of the thyroid cartilage which form the laryngeal prominence
Thyroid lamina
The soft palate has no bony skeleton. What is it strengthened by?
Palatine aponeurosis
Innervation of the hard palate
Greater and nasopalatine nerve
Innervation of the soft palate
Lesser palatine nerve
What is the falx cerebri attached to anteriorly?
Crista galli
Which nerves pass through the jugular foramen?
CN IX, X, XI
Which nerves pass through the internal acoustic meatus?
CN VII, VIII
Which nerves pass through the superior orbital fissue?
CN III, IV, V1, VI
What nerve passes through the optic canal?
Optic nerve
What nerve passes through the hypoglossal canal?
Hypoglossal nerve
What can cause a rise in the intracranial pressure around the optic nerve cause?
Papillodema - swelling of the optic disc
What vessel can become occluded leading to painless temporary loss of vision and what is an example of this?
Central retinal artery
Amaurosis fugax
What are the visual implications of a pituitary gland tumour and what does the patient present with?
Bitemporal hemianopia - patients present with tunnel vision
The optic chiasm is superior and anterior to the pituitary gland therefore a tumour will cause an issue at the optic chiasm
What will a lesion to the optic tract on the left side cause?
Medial defect on the left eye
Lateral defect on the right eye
What is the recess between the eyeball and cornea called and what is secreted into the recess?
Conjunctival sac - tears are secreted into the recess
What nerves innervate the parasympathetic supply to the lacrimal gland?
Preganglionic - greater petrosal nerve (CNVII facial nerve)
Postganglionic - Zygomatic branch of the maxillary nerve (CNV2)
What nerves innervate the sympathetic supply to the lacrimal gland?
Superior cervical ganglion vie the internal carotid plexus
What muscle is responsible for elevating the upper eyelid?
Levator palpebrae superioris
What are the extraocular muscles?
Levator palpebrae
Medial rectus
Lateral rectus
Superior rectus
Inferior rectus
Superior oblique
Inferior oblique
Inferior oblique, inferior rectus, levator palpebrae, superior rectus and medial rectus innervation
Occulomotor nerve
Superior oblique innervation
Trochlear nerve
Lateral rectus innervation
Abducens nerve
Motor innervation of all extraocular muscles
Lateral rectus - CNVI abducens
Superior oblique - CNIV trochlear
Everything else - CNIII occulomotor
Which nerve is responsible for pupillary constriction?
Occulomotor
If pt presents with an eye that is turned downwards and outwards, drooping eyelid and a dilated pupil, what is the anatomical cause?
Oculomotor nerve damage
What are the layers of the eyeball from outermost in?
Sclera - fibrous layer (replaced by the cornea anteriorly)
Choroid - vascular layer
Retina
What separates the anterior and posterior chambers of the eye separated by and how do they communicate?
They are separated by the iris and communicate via the pupil
What muscle is found in the ciliary body of the eye and what does this body secrete?
Cilliaris muscle
Secretes aqueous humor
What drains aqueous humor and what happens if there is a build up of this fluid?
Scleral venous sinus drains the humor
If fluid builds up this will increase pressure which can cause glaucoma
What separates external and middle ear?
Tympanic membrane
What type of cartilage is the pinna/auricle?
Elastic
What supplies sensory innervation to the auricle/pinna?
Great auricular and auriculotemporal
What epithelium is the external acoustic meatus?
Stratified squamous epithelium
What are the roles of the tensor tympani and stapedius?
Dampen or resist movement of the ossicles
Protect the ear and tympanic membrane if there are loud sounds
Innervation of stapedius
Nerve to stapedius (facial nerve)
Innervation of the tensor tympani
Mandibular nerve (CNV3)
What ossicle is connected to the oval window/fenestra vestibuli?
Stapes
Why do resp. tract infections sometimes cause middle ear infections as well?
Pharyngotympanic tube connects the middle ear to the nasopharynx
What is the role of the pharyngotympanic tube?
Pressure equalisation between middle ear and atmosphere
Why is there a risk of infection between the middle ear and middle cranial fossa?
The roof of the bone between them is thin
What is otitis media?
Chronic ear infection caused by obstruction to the pharyngotympanic tube
What is glue ear and what group does it usually affect?
Otitis media with effusion - build up of a fluid in the middle ear behind the tympanic membrane
Tends to affect children
What does the bony labyrinth of the ear contain?
Cochlear
Vestibule
Semicircular canals
What is suspended in the bone labyrinth and is contained within the vestibulocochlear organ?
Membranous labyrinth
What is found in the otic capsule of the petrous part of the temporal bone?
Bony labyrinth
What type of fluid does the bony labyrinth and membranous labyrinth contain?
Bony labyrinth - perilypmh
Membranous labyrinth - endolymph
If a pt has signs of neural or conductive hearing loss what is likely to have been damaged?
Cochlear part of the vestibulocochlear nerve
If a pt has symptoms of nausea, vertigo, and ataxia, what is likely to have been damaged?
Vestibular part of the vestibocochlear nerve
What muscle dampens the malleus?
Tensor tympani
What muscle dampens the stapes?
Stapedius
What nerve innervates the external auditory meatus?
Auriculotemporal nerve (CNV3)
Which vessels pass close to the middle ear?
Internal carotid artery
Internal jugular vein
What innervates the levator veli palitini muscle?
Vagus nerve (CNX)
What innervates the tensor veli palitini muscle?
Trigeminal nerve (CNV)
What is the only muscle in the head innervated by the glossopharyngeal muscle?
Stylopharyngeus
What nerve is inferior and posterior to the inferior alveolar nerve and crosses the external carotid artery?
Hypoglossal nerve
The phrenic nerve always comes across the surface of which muscle?
Anterior scalene
Where would you find arachnoid granulations and what do they do?
In the sinuses
They reabsorb CSF and put it back into the venous system
What nerve innervates the stylohyoid muscle?
Facial nerve
What is the only cranial nerve to originate at the pons (excluding pons medulla border)?
Trigeminal CNV
What cranial nerves originate at the junction of the pons and medulla?
CN VI, VII, VIII
Abducens, facial, vestibulocochlear
What cranial nerves originate at the medulla?
CN IX, X, XI, XII
Glossopharyngeal, vagus, accessory, hypoglossal
Which cranial nerve originates in the cerebrum?
CNI olfactory
What cranial nerves originate in the midbrain?
CNIII, IV
Oculomotor, trochlear
What cranial nerves originate at the thalamus?
CNII Optic
What lobe of the brain is Broca’s area in?
Frontal
What lobe of the brain is Wernicke’s area in?
Temporal
What nodes does the oropharynx drain to?
Deep cervical nodes
What happens if the temporal branch of the facial nerve is damaged?
Inability to close eyelid
Drying of the cornea
What muscle of mastication is responsible for retraction?
Temporalis
What muscle of mastication lies deep to the zygomatic arch?
Temporalis
What provides sensory innervation to the mucosa of the larynx?
Superior and recurrent laryngeal nerves
What muscles closes the glottidis?
Transverse arytenoid muscle
What can be damaged during thyroid surgery and what are 2 symptoms caused by this?
Right recurrent laryngeal nerve
Hoarseness
Aphonia
What separates the intrinsic and extrinsic muscles of the tongue?
Sagittal septum
What anatomical landmark changes the name between subclavian to axillary artery/vein?
Lateral border of the first rib
What spinal nerves make up the brachial plexus?
C5-T1
What level vertebrae is the superior sympathetic ganglia found?
C1-C2
What ganglion lies below the foramen ovale?
Otic ganglion
What ganglion is found between lateral rectus and the optic nerve?
Ciliary ganglion
Where is CSF found?
Subarachnoid space between arachnoid and pia mater
Blood supply to the dura
Meningeal arteries
Where is the cerebral vein and artery found?
In the pia mater and subarachnoid space
Where do motor neurons exit the spinal cord?
Ventral root grey matter
Where do sensory neurons enter the spinal cord?
Dorsal root grey matter
Where are preganglionic neurons found in the spinal cord?
Lateral horn grey matter
Where do preganglionic sympathetic neurons exit the spinal cord from?
Ventral root grey matter
What divides the cerebellum into right and left hemispheres?
Vermis
What divides the cerebellum into anterior and posterior lobes?
Primary fissure
What is one function of the frontal lobe?
Problem solving
One function of the temporal lobe
Hearing
One function of the parietal lobe
Sensation
One function of the occipital lobe
Visual processing
What makes up the basal nuclei and what is its function?
Corpus Striatum (caudate nucleus and lentiform nucleus (globus pallidus and putamen))
Substantia Nigra
Subthalamic nucleus
Involved in motor control
What is the role of the hypothalamus?
Maintaining homeostasis
What connects the hypothalamus to the pituitary gland?
Infundibulum or pituitary stalk
What is the role of the ventricular system of the brain?
Protection of the brain
Produce and circulate CSF
What are the lateral ventricles separated by?
Septum pellucidum
Where does the spinal cord end?
L1-2
What muscle is responsible for elevating the eyebrows?
Frontalis
What embryological derivative do all muscles of mastication come from?
1st pharyngeal arch
What embryological derivative do all muscles of facial expression come from?
2nd pharyngeal arch
What is the only muscle to be derived from the 3rd pharyngeal arch?
Stylopharyngeus muscle
What nerve gives parasympathetic innervation to nasal and lacrimal glands?
Greater petrosal nerve (CNVII)
Why is an infection more painful in the parotid gland?
The swelling is contained within the fibrous capsule of the gland
At what level does the lateral corticospinal tract cross?
Pyramids of the medulla
At what level does the anterior corticospinal tract cross?
Spinal cord
What nerves sends sensory fibres to the TMJ?
Auriculotemporal nerve (CNV3)
If there is a lower motor neuron lesion to the facial nerve on the left side what will the patient present with?
Palsy on the whole left side of the face
What separates the oral cavity from the oropharynx?
Oropharyngeal isthmus
Innervation of geniohyoid muscle
C1 via hypoglossal nerve
What is the cartilage of the pharyngotympanic tube called?
Torus tubarius
What fold extends posterior and inferiorly to the torus tubarius?
Salpingopharyngeal fold
What epithelium is the oropharynx lined with?
Stratified squamous
What are common places fish bones get stuck?
Vallecula
Piriform recess
What is vulnerable to injury when a foreign object lodges in the piriform fossa?
Recurrent laryngeal nerve
What is Waldeyer’s ring?
Tonsillar ring of lymphoid tissue
If a pt is getting their pharyngeal tonsils removed what major nerve and vessel could be injured?
Glossopharyngeal nerve
Internal carotid artery
What muscle prevents air from being drawn into the stomach during inhalation and forms a sphincter around the upper oesophagus?
Cricopharyngeus
What is the primary role of pharyngeal constrictors?
Push food bolus to the oesophagus
What is the primary role of pharyngeal elevators?
Elevate the pharynx and larynx
What is the area where epistaxis most commonly occurs?
Anterior septal region
What paranasal sinus drains into the superior meatus?
Posterior cells of the ethmoidal sinus
What paranasal sinus drains into the ethmoidal bulla?
Middle cells of the ethmoidal sinus
A patient comes in with a sagging lower left eyelid, leakage of tears and dry eye. What is the anatomical cause of this?
Damage to the left facial nerve supplying the orbicularis oculi muscle
Where do tears drain after going through the nasolacrimal duct?
Inferior nasal meatus
What layer of the eyeball forms the ciliary body?
Choroid
What is the muscle responsible for pupillary constriction?
Sphincter pupillae
What is the muscle responsible for pupillary dilation?
Dilator pupillae
What produces earwax in the external ear?
Ceruminous glands
How is the mastoid connected to the middle ear and why is this clinically relevant?
Mastoid antrum
Middle ear infection can spread to the mastoid causing mastoiditis
Which part of the petrous part of the temporal bone does the bony labyrinth reside in?
Otic capsule
