Anatomy Flashcards

1
Q

What lies beneath the pterion?

A

Middle meningeal artery

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2
Q

Why is a blow to the pterion dangerous?

A

Can cause extradural haemorrhage as the pterion overlies the middle meningeal artery

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3
Q

Which nerve transmits through supraorbital notch?

A

Opthalmic nerve (CNV1)

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4
Q

What nerve transmits through the infraorbital foramen?

A

Maxillary nerve (CNV2)

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5
Q

What nerve transmits through the mental foramen?

A

Mandibular nerve (CNV3)

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6
Q

Which cervical vertebrae are typical?

A

C3-C6

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7
Q

Which cervical vertebrae are atypical and what are their names?

A

C1 Atlas
C2 Axis
C7 Vertebrae prominens

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8
Q

What is the atlanto-occipital joint and what is its function?

A

C1 and skull joint
Nodding

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9
Q

What is the joint of C1 and C2 called ant what is its function?

A

Lateral Atlanto axial joint
Rotation of the head (side to side)

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10
Q

What attaches to the spinous processes of the cervical vertebrae?

A

Ligamentum nuchae

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11
Q

What vertebrae level is the hyoid bone?

A

C3

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12
Q

Components of the carotid sheath (3)

A

Common carotid a
Internal jugular v
Vagus nerve

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13
Q

Muscles found in the superficial fascia of the neck and what is its function?

A

Platysma
Facial expression

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14
Q

What layer of fascia lies deep to the subcutaneous tissues?

A

Investing fascia

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15
Q

Fascia making up the carotid sheath

A

Boundaries with all three layers of deep cervical fascia - investing/pretracheal anteriorly, prevertberal posteriorly.

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16
Q

Path of the carotid sheath into the skull

A

Runs from aortic arch to foramen of carotid canal

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17
Q

Innervation of SCM

A

Accessory nerve

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18
Q

SCM function

A

Draws head forwards (bilaterally)
Tilts head towards ipsilateral shoulder
Turning face contralaterally (unilaterally)

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19
Q

What nerve does C3, C4 and C5 give rise to and what does it supply?

A

Phrenic nerve - supplies diaphragm

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20
Q

What nerve does C1, C2 and C3 give rise to and what does it supply?

A

Ansa cervicalis - innervates infrahyoid muscles

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21
Q

What nerve does C2 give rise to?

A

Lesser occipital nerve

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22
Q

What nerve does C2 and C3 give rise to ?

A

Great auricular, transverse cervical

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23
Q

What nerves do C3 and C4 give rise to?

A

Supraclavicular nerves

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24
Q

What triangle of the neck can the brachial plexus be seen in?

A

Omoclavicular triangle, within the posterior triangle of the neck

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25
Which major vessels and nerves cross the SCM
EJV Great auricular nerve Transverse cervical nerve
26
Suprahyoid muscles
Mylohyoid Geniohyoid Stylohyoid Digastric
27
Infrahydoid muscles
Sternothyroid Sternohyoid Thyrohyoid Omohyoid
28
Which nerve gives rise to the nerve to mylohyoid?
Inferior alveolar nerve
29
What are 2 airway procedures and what are the anatomical landmarks for this procedure?
Cricothyrotomy - cricothyroid ligament Tracheostomy - isthmus of the thyroid gland
30
Innervation of the carotid sinus?
Carotid sinus nerve from glossopharyngeal nerve
31
Where is the carotid sinus and what is its function?
Internal carotid artery, baroreceptors that regulate BP
32
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
33
3 branches from aortic arch
Left subclavian Left common carotid Right brachicephalic
34
What muscle divides the subclavian artery into 3 parts?
Anterior scalene muscle
35
What are the branches of the first part of the subclavian artery?
Vertebral artery Thyrocervical artery Internal thoracic artery
36
What is the branch of the second part of the subclavian artery?
Costocervical artery
37
What is the branch of the third part of the subclavian artery?
Dorsal scapular artery
38
What are the 2 neurotransmitters released in the autonomic nervous system?
Acetylcholine Noradrenaline
39
Where are the preganglionic neurons of the parasympathetic nervous system located?
Craniosacral: Spinal segments S2-S4 Cranial nerves (III VII IX X)
40
Where are the preganglionic neurons of the sympathetic nervous system located?
Thoracolumbar - spinal segments T1-L2 specifically in the lateral horn
41
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
42
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
43
How do scalp infections spread to intracranial structures?
Via emissary veins
44
Why does the scalp bleed profusely when cut?
Arterial anastomoses are prevalent in the scalp and these lie superficially
45
With regards to lymphatic drainage of the skull. what nodes drain the scalp and external ear?
Parotid and mastoid nodes
46
What are the parts of the brainstem?
Midbrain Pons Medulla
47
What are the cranial meninges layers from innermost to outermost?
Pia mater Arachnoid mater Dura mater
48
What is the role of dura mater folds?
Limit the movement of the brain within the cavity
49
What lies beneath the lateral sulcus of the brain?
Insula
50
What is Broca's area of the brain responsible for?
Speech production
51
What is Wernicke's area of the brain responsible for?
Understanding speech
52
Hormones released by the pituitary gland
Growth hormone Follicle stimulating hormone Thyroid stimulating hormone
53
How do the lateral cerebral ventricles drain into the third ventricle?
Via interventricular foramen
54
How does the third cerebral ventricle drain into the fourth?
Via cerebral aqueduct
55
Sign of an anterior cerebral artery occlusion
Contralateral motor and sensory loss involving mainly leg and foot
56
Sign of a middle cerebral artery occlusion
Contralateral motor and sensory loss involving mainly the face and arm Aphasia - difficulty with speech and language
57
Sign of posterior cerebral artery occlusion
Visual agnosia - inability to identify objects correctly
58
Sensory innervation of the angle of the mandible
Great auricular nerve (C2 C3)
59
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
60
2 parts of orbicularis oculi muscle and their roles
Palpebral - involuntary or blinking reflex Orbital - voluntarily or tightly closing
61
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
62
What muscle does the buccal fat pad lie over and what pierces it?
Buccinator Parotid duct
63
Branches of the external carotid artery which supply the face
Maxillary - buccal, mental, infraorbital Superficial temporal - transverse facial Facial
64
What vein mainly drains the face and where to?
Facial vein to the IJV
65
Innervation of the parotid gland
Preganglionic - glossopharyngeal Postganglionic - auriculotemporal (CNV3)
66
Innervation of the submandibular gland
Preganglionic - facial (chorda tympani) Postganglionic - lingual (CNV3)
66
Innervation of the submandibular gland
Preganglionic - facial (chorda tympani) Postganglionic - lingual (CNV3)
67
Innervation of the sublingual gland
Preganglionic - facial (chorda tympani) Postganglionic - lingual (CNV3)
68
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
69
Most common idiopathic facial palsy and what does it present with?
Bell's palsy Inability to close eyelid Drooping mouth
70
Viral infection which results in swelling of the parotid gland and what are 3 other symptoms?
Mumps Fever Headaches Joint pain
71
Cerebral white matter
Corona radiata
72
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
73
Give an example of an upper motor neuron lesion and symptoms
Stroke Spastic paralysis Hyperreflexia Hypertonia
74
Give an example of a lower motor neuron lesion and symptoms
Trauma or poliomyelitis Flaccid paralysis Hyporeflexia Hypotonia
75
What type of joint is the TMJ?
Modified hinge (atypical) - synovial
76
What is the most common type of TMJ dislocation and how does the patient present?
Anterior dislocation Open jaw unable to close
77
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
78
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
79
Primary muscle involved in protrusion of the jaw
Lateral pterygoid
80
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
81
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
82
What muscle divides the maxillary artery into 3 parts?
Lateral pterygoid
83
What nerve passes postsynaptic parasympathetic secretomotor fibres to the parotid gland from the otic ganglion?
Auriculotemporal nerve from CNV3
84
Sensory innervation to the anterior 2/3rd of the tongue, floor of the mouth and lingual gingivae
Lingual nerve from CNV3
85
What supplies special sensory innervation (taste) to the anterior 2/3rd of the tongue?
Facial nerve via chorda tympani
86
What supplies sensory innervation to the posterior 1/3rd of the tongue?
Glossopharyngeal nerve
87
What main artery and venous plexus is located in the infratemporal region?
Maxillary artery Pterygoid venous plexus
88
Where do upper motor neuron fibres of the corticobulbar tract pass through?
Genu of internal capsule
89
Where do the upper motor neuron fibres of the corticospinal tract pass through?
Posterior limb of internal capsule
90
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
91
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
92
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
93
Which vessel causes the groove on the parietal bone?
Middle meningeal artery
94
What does foramen rotundum transmit?
Maxillary nerve CNV2
95
What nerve is joined by chordae tympani nerve within the infratemporal fossa?
Lingual nerve
96
What is the sensory branch of the anterior division of the mandibular nerve?
Buccal nerve
97
Muscle originating from the infratemporal surface of greater wing of sphenoid bone
Upper head of the lateral pterygoid
98
What muscle attaches to the deep side of the ramus and into the angle of the mandible?
Medial pterygoid muscle
99
Which muscle protrudes the tongue?
Genioglossus
100
Nerve innervating the intrinsic muscles of the tongue
Hypoglossal nerve CNXII
101
What node drains the posterior of the tongue?
Superior deep cervical nodes
102
What node drains the maxillary sinus?
Submandibular node
103
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
104
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
105
When asking a pt to puff out their cheeks, which 2 branches of the facial nerve are tested?
Buccal nerve Zygomatic nerve
106
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
107
What nerve crosses anteriorly to the external and internal carotid artery?
Hypoglossal nerve
108
What nerve crosses posteriorly to the external and internal carotid artery?
Glossopharyngeal nerve
109
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
110
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
111
What artery supplies the motor cortex?
Middle cerebral artery
112
What is the white matter area between the thalamus and lentiform nucleus that is a common site for strokes?
Internal capsule
113
What condition is caused by the overproduction of growth hormone by the pituitary gland?
Acromegaly
114
What two cerebral ventricles does the cerebral aqueduct connect?
Third and fourth
115
What structure makes CSF?
Choroid plexus
116
Drooping of the eyelid in Horner's syndrome is caused by paralysis of which muscle?
Levator palpebrae superioris
117
Where does the submandibular duct open into the oral cavity?
Sublingual caruncle/papilla
118
What is the role of the buccinator during eating?
Press cheeks against molars Move food to the occlusal surfaces of the teeth
119
What nerve is being tested when asking a patient to protrude their tongue?
Hypoglossal nerve
120
What carries parasympathetic secretomotor fibres to salivary glands in the tongue?
Internal laryngeal nerve (branch of vagus nerve)
121
Which salivary gland is arranged around the free edge of the mylohyoid muscle?
Submandibular gland
122
Which muscle retracts the mandible?
Temporalis
123
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
124
Which muscle opens the mouth?
Lateral pterygoid
125
Bones making up the zygomatic arch
Temporal process of the zygomatic bone Zygomatic process of the temporal bone
126
What is the anatomical basis of a pt having numb lower lip and tongue?
Damage to the mental nerve
127
2 structures that cross the submandibular gland
Facial vein Marginal mandibular division of the facial nerve
128
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
129
What node drains the parotd gland?
Deep parotid node
130
What node drains the pharynx, paranasal sinuses and nasal cavity?
Retropharyngeal nodes
131
What infections cause swelling of the submental nodes?
Epstein barr virus Cytomegalovirus Dental infections including periodontitis
132
What node drains the soft palate, oesophagus, trachea and thyroid gland?
Superior deep cervical nodes
133
What is a hard, painless lymph node generally indicative of?
Malignancy
134
What node drains the oral cavity and maxillary sinus?
Submandibular lymph nodes
135
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
136
Which papillae of the tongue do not contain taste buds?
Filiform papillae
137
What vein is present on either side of the lingual frenulum?
Lingual vein
138
Where does the sublingual gland duct open?
Sublingual folds
139
What is the function of the intrinsic muscles of the tongue?
Change the shape and size of the tongue
140
What is the function of the extrinsic muscles of the tongue?
Protrude, elevate, retract and depress the tongue
141
What is the role of the genioglossus muscle?
Protrudes the tongue
142
What is the role of the hyoglossus muscle?
Depressing the sides of the tongue
143
What vessel enters the tongue between the hyoglossus and genioglossus muscles?
Lingual artery
144
What nerves enter the tongue on the external surface of the hyoglossus?
Hypoglossal and lingual
145
What is the function of the styloglossus muscle?
Elevate and retract the tongue
146
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
147
What supplies the special sensory (taste) innervation of the posterior 1/3rd of the tongue?
Glossopharyngeal
148
What branch of the external carotid artery supplies the tongue?
Lingual artery
149
What two veins drain the tongue and to what vessel?
Deep lingual vein Dorsal lingual vein Both drain into the internal jugular vein
149
What two veins drain the tongue and to what vessel?
Deep lingual vein Dorsal lingual vein Both drain into the internal jugular vein
150
What nerve loops under the submandibular duct?
Lingual nerve
151
What are the secretions of each major salivary gland?
Parotid - mostly serous, some mucous Submandibular - serous and mucous Sublingual - mostly mucous, some serous
152
What is the arterial supply and venous drainage of the submandibular gland?
Submental artery and vein
153
What gland sits in the sublingual fossa of the mandible?
Sublingual gland
154
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
155
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
156
Where is sympathetic innervation derived from in regards to main salivary glands?
Superior cervical ganglia Nerve plexus on external carotid artery
157
What 2 nerves supply minor salivary glands?
Trigeminal and facial nerve
158
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
159
At what level of the vertebrae does the common carotid artery bifurcate?
C3-C4
160
Action potentials form the carotid sinus and body go to which location of the brain?
Medulla
161
What is the carotid body and its role?
Small organ near the carotid sinus that had chemoreceptors Regulates O2 CO2 pH and temperature
162
Innervation of the platysma muscle
Cervical branch of the facial nerve
163
What innervates the digastric muscle?
Anterior belly - nerve to mylohyoid (a branch of IAN) Posterior belly - digastric nerve (from facial nerve)
164
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
165
What type of epithelium is the nasopharynx lined with?
Ciliated columnar with goblet cells
166
What connects nasopharynx and middle ear?
Pharyngotympanic tube/ Eustachian tube
167
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)
168
What are the two folds on either side of the palatine tonsils in the oropharynx?
Palatoglossal fold and palatopharyngeal fold
169
What epithelium lines the vocal fold?
Stratified squamous
170
What cranial nerve supplies sensory innervation to the pharynx?
Glossopharyngeal nerve
171
What nerve supplies the upper 3rd molar?
Posterior superior alveolar nerve
172
Where is the opening of the maxillary ostium in the nasal cavity?
Semilunar hiatus
173
If there is a laceration on the lower lip, what artery is the bleeding likely coming from?
Inferior labial artery
174
What nerve can be affected by chronic ear infection?
Vestibulocochlear nerve
175
What muscle stops the malleus from moving too much?
Tensor tympani muscle
176
What nerve goes through the incisive foramen?
Nasopalatine nerve
177
What nerve goes through foramen ovale?
Mandibular nerve (CNV3)
178
What nerve goes through the foramen rotundum?
Maxillary nerve (CNV3)
179
Pt complains of numbness of the pinna of the ear, what is likely to be the cuase?
Great auricular nerve
180
What cranial nerve supplies the larynx?
Vagus nerve
181
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
182
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
183
What is the vessel under the optic nerve?
Internal carotid artery
184
What nerve supplies the middle ear?
The auriculotemporal nerve (branch of CNV3) and vagus nerve (CNX)
185
What level of verterbrae is the larynx found?
C3-6
186
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
187
What type of cartilage are the laryngeal caritlages and what is the exception?
All hyaline except for the epiglottis which is elastic cartilage
188
What is the only complete ring of cartilage?
Cricoid cartilage
189
What connects the epiglottis to the hyoid bone?
Hyoepiglottic ligament
190
What cartilage lies posterior to the thyroid cartilage?
Arytenoid cartilage
191
What ligament and membrane spans the space between the thyroid cartilage and the hyoid?
Thyrohyoid membrane Median thyrohyoid ligament Lateral thyrohyoid ligament
192
What ligament and membrane spans the space between the thyroid cartilage and the hyoid?
Thyrohyoid membrane Median thyrohyoid ligament Lateral thyrohyoid ligament
193
What membrane spans from the arytenoid cartilage to thyroid cartilage to epiglottis?
Quadrangle membrane
194
What ligament forms the conus elasticus?
Cricothyroid ligament
195
What structure is on the superior free edge of the cricothyroid ligament?
Vocal ligament or true vocal folds
196
What is the opening between the vocal ligaments and folds called?
Rima glottidis
197
What structure is over the superior free edge of the quadrangular membrane?
Aryepiglottic fold
198
What structure is formed over the inferior free edge of the quadrangular membrane?
Vestibularl ligament or false vocal cord
199
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
200
What is the only muscle that opens the rima glottidis?
Posterior cricoarytenoid muscle
201
What muscle lengthens vocal folds?
Cricothyroid muscle
202
What muscle shortens vocal folds?
Thyroarytenoid muscle
203
What muscle is responsible for closure of the laryngeal inlet?
Oblique arytenoid muscle
204
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
205
What provides sensation above the vocal folds to the larynx?
Superior laryngeal nerve
206
What provides sensation below the vocal folds to the larynx?
Recurrent laryngeal nerve
207
Which cranial nerve provides motor and sensory innervation to the larynx?
Vagus nerve (CNX)
208
What is the muscle of the nose?
Nasalis
209
What is the muscle of the nose?
Nasalis
210
What is the connection between the nasal and oral cavity?
Incisive canal
211
What bones make up the nasal septum?
Perpendicular plate of ethmoid (superiorly) and vomer (inferiorly)
212
What cartilage makes up the nose?
Septal cartilage Alar cartilage Both hyaline cartilage
213
What projects the superior and middle chonchae into the nasal cavity?
Ethmoidal labyrinth
214
What nerve supplies the alae of the nose?
Maxillary nerve (CNV2)
215
What nerve supplies sensation to the tip of the nose?
Opthalmic nerve (CNV1)
216
What nerves supply the nasal cavity?
Olfactory nerve (CNI) Opthalmic nerve (CNV1) Maxillary nerve (CNV2)
217
What supplies parasympathetic innervation to the nasal cavity?
Preganglionic: greater petrosal nerve (Facial nerve CNVII) Postganglionic - maxillary nerve (CNV2)
218
What supplies sympathetic innervation to the nasal cavity?
Superior cervical ganglion via the internal carotid plexus
219
What internal and external carotid artery branches supply the nasal cavity?
ECA - maxillary and facial artery ICA - anterior and posterior ethmoidal arteries
220
Why is the anterior septal region a common area for nose bleeds?
Anterior and posterior ethmoidal arteries form many anastomoses in that region
221
What two vessels drain the nasal cavity?
Pterygoid plexus and facial vein
222
Where does the maxillary paranasal sinus drain?
Middle meatus at the semilunar hiatus
223
Where does the sphenoid paranasal sinus drain?
Sphenoethmoidal recess
224
What is the only paranasal sinus not to drain into a lateral wall?
Sphenoid sinus
225
What 2 sinuses drain into infundibulum in middle meatus?
Ethmoid and frontal
226
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
227
What can the poor removal of a maxillary molar cause in relation to the maxillary sinus?
Oro antral communication
228
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
229
Which two veins join to form the external jugular vein?
Retromandibular vein Posterior auricular vein
230
Innervation of the digastric muscle
Anterior belly - nerve to mylohyoid (from CNV3) Posterior belly - digastric branch of the facial nerve
231
Main function of the suprahyoid muscles
Elevate the hyoid and larynx
232
Main function of the infrahyoid muscles
Depress and fix the hyoid
233
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
234
Innervation of the palatoglossus
Vagus nerve (CNX)
235
Stylopharyngeas innervation
Glossopharyngeal nerve
236
What innervates all of the pharyngeal muscles and what is the exception?
Vagus nerve Stylopharyngeus is innervated by the glossopharyngeal nerve
237
Innervation of the carotid body
Glossopharyngeal nerve (carotid sinus branch)
238
What is the sympathetic innervation of the submandibular and sublingual glands?
Superior cervical ganglion Nerve plexus on external carotid artery
239
Parasympathetic innervation of minor salivary glands above the oral fissure
Preganglionic - greater petrosal nerve (CNVII) Postganglionic - palatine nerves
240
Parasympathetic innervation of minor salivary glands below the oral fissure
Preganglionic - chordae tympani (CNVII) Postganglionic - lingual nerve (CNV3)
241
What nerve must you be careful of when doing a submandibular gland surgery?
Lingual nerve (CNV3)
242
Middle meningeal and inferior alveolar artery are branches of which artery?
Maxillary artery
243
Borders of the nasopharynx
Posterior of chonae Superior of soft palate
244
Borders of the oropharynx
Superior of the soft palate Superior of the epiglottis
245
Borders of the laryngopharynx
Superior of epiglottis Inferior of cricoid cartilage
246
The larynx is continuous with what structure?
Trachea
247
The laryngopharynx is continuous with what structure?
Oesophagus
248
Phases of deglutition
Oral phase Pharyngeal phase Oesophageal phase
249
2 flat parts of the thyroid cartilage which form the laryngeal prominence
Thyroid lamina
250
The soft palate has no bony skeleton. What is it strengthened by?
Palatine aponeurosis
251
Innervation of the hard palate
Greater and nasopalatine nerve
252
Innervation of the soft palate
Lesser palatine nerve
253
What is the falx cerebri attached to anteriorly?
Crista galli
254
Which nerves pass through the jugular foramen?
CN IX, X, XI
255
Which nerves pass through the internal acoustic meatus?
CN VII, VIII
256
Which nerves pass through the superior orbital fissue?
CN III, IV, V1, VI
257
What nerve passes through the optic canal?
Optic nerve
258
What nerve passes through the hypoglossal canal?
Hypoglossal nerve
259
What can cause a rise in the intracranial pressure around the optic nerve cause?
Papillodema - swelling of the optic disc
260
What vessel can become occluded leading to painless temporary loss of vision and what is an example of this?
Central retinal artery Amaurosis fugax
261
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
262
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
263
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
264
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)
265
What nerves innervate the sympathetic supply to the lacrimal gland?
Superior cervical ganglion vie the internal carotid plexus
266
What muscle is responsible for elevating the upper eyelid?
Levator palpebrae superioris
267
What are the extraocular muscles?
Levator palpebrae Medial rectus Lateral rectus Superior rectus Inferior rectus Superior oblique Inferior oblique
268
Inferior oblique, inferior rectus, levator palpebrae, superior rectus and medial rectus innervation
Occulomotor nerve
269
Superior oblique innervation
Trochlear nerve
270
Lateral rectus innervation
Abducens nerve
271
Motor innervation of all extraocular muscles
Lateral rectus - CNVI abducens Superior oblique - CNIV trochlear Everything else - CNIII occulomotor
272
Which nerve is responsible for pupillary constriction?
Occulomotor
273
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
274
What are the layers of the eyeball from outermost in?
Sclera - fibrous layer (replaced by the cornea anteriorly) Choroid - vascular layer Retina
275
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
276
What muscle is found in the ciliary body of the eye and what does this body secrete?
Cilliaris muscle Secretes aqueous humor
277
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
278
What separates external and middle ear?
Tympanic membrane
279
What type of cartilage is the pinna/auricle?
Elastic
280
What supplies sensory innervation to the auricle/pinna?
Great auricular and auriculotemporal
281
What epithelium is the external acoustic meatus?
Stratified squamous epithelium
282
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
283
Innervation of stapedius
Nerve to stapedius (facial nerve)
284
Innervation of the tensor tympani
Mandibular nerve (CNV3)
285
What ossicle is connected to the oval window/fenestra vestibuli?
Stapes
286
Why do resp. tract infections sometimes cause middle ear infections as well?
Pharyngotympanic tube connects the middle ear to the nasopharynx
287
What is the role of the pharyngotympanic tube?
Pressure equalisation between middle ear and atmosphere
288
Why is there a risk of infection between the middle ear and middle cranial fossa?
The roof of the bone between them is thin
289
What is otitis media?
Chronic ear infection caused by obstruction to the pharyngotympanic tube
290
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
291
What does the bony labyrinth of the ear contain?
Cochlear Vestibule Semicircular canals
292
What is suspended in the bone labyrinth and is contained within the vestibulocochlear organ?
Membranous labyrinth
293
What is found in the otic capsule of the petrous part of the temporal bone?
Bony labyrinth
294
What type of fluid does the bony labyrinth and membranous labyrinth contain?
Bony labyrinth - perilypmh Membranous labyrinth - endolymph
295
If a pt has signs of neural or conductive hearing loss what is likely to have been damaged?
Cochlear part of the vestibulocochlear nerve
296
If a pt has symptoms of nausea, vertigo, and ataxia, what is likely to have been damaged?
Vestibular part of the vestibocochlear nerve
297
What muscle dampens the malleus?
Tensor tympani
298
What muscle dampens the stapes?
Stapedius
299
What nerve innervates the external auditory meatus?
Auriculotemporal nerve (CNV3)
300
Which vessels pass close to the middle ear?
Internal carotid artery Internal jugular vein
301
What innervates the levator veli palitini muscle?
Vagus nerve (CNX)
302
What innervates the tensor veli palitini muscle?
Trigeminal nerve (CNV)
303
What is the only muscle in the head innervated by the glossopharyngeal muscle?
Stylopharyngeus
304
What nerve is inferior and posterior to the inferior alveolar nerve and crosses the external carotid artery?
Hypoglossal nerve
305
The phrenic nerve always comes across the surface of which muscle?
Anterior scalene
306
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
307
What nerve innervates the stylohyoid muscle?
Facial nerve
308
What is the only cranial nerve to originate at the pons (excluding pons medulla border)?
Trigeminal CNV
309
What cranial nerves originate at the junction of the pons and medulla?
CN VI, VII, VIII Abducens, facial, vestibulocochlear
310
What cranial nerves originate at the medulla?
CN IX, X, XI, XII Glossopharyngeal, vagus, accessory, hypoglossal
311
Which cranial nerve originates in the cerebrum?
CNI olfactory
312
What cranial nerves originate in the midbrain?
CNIII, IV Oculomotor, trochlear
313
What cranial nerves originate at the thalamus?
CNII Optic
314
What lobe of the brain is Broca's area in?
Frontal
315
What lobe of the brain is Wernicke's area in?
Temporal
316
What nodes does the oropharynx drain to?
Deep cervical nodes
317
What happens if the temporal branch of the facial nerve is damaged?
Inability to close eyelid Drying of the cornea
318
What muscle of mastication is responsible for retraction?
Temporalis
319
What muscle of mastication lies deep to the zygomatic arch?
Temporalis
320
What provides sensory innervation to the mucosa of the larynx?
Superior and recurrent laryngeal nerves
321
What muscles closes the glottidis?
Transverse arytenoid muscle
322
What can be damaged during thyroid surgery and what are 2 symptoms caused by this?
Right recurrent laryngeal nerve Hoarseness Aphonia
323
What separates the intrinsic and extrinsic muscles of the tongue?
Sagittal septum
324
What anatomical landmark changes the name between subclavian to axillary artery/vein?
Lateral border of the first rib
325
What spinal nerves make up the brachial plexus?
C5-T1
326
What level vertebrae is the superior sympathetic ganglia found?
C1-C2
327
What ganglion lies below the foramen ovale?
Otic ganglion
328
What ganglion is found between lateral rectus and the optic nerve?
Ciliary ganglion
329
Where is CSF found?
Subarachnoid space between arachnoid and pia mater
330
Blood supply to the dura
Meningeal arteries
331
Where is the cerebral vein and artery found?
In the pia mater and subarachnoid space
332
Where do motor neurons exit the spinal cord?
Ventral root grey matter
333
Where do sensory neurons enter the spinal cord?
Dorsal root grey matter
334
Where are preganglionic neurons found in the spinal cord?
Lateral horn grey matter
335
Where do preganglionic sympathetic neurons exit the spinal cord from?
Ventral root grey matter
336
What divides the cerebellum into right and left hemispheres?
Vermis
337
What divides the cerebellum into anterior and posterior lobes?
Primary fissure
338
What is one function of the frontal lobe?
Problem solving
339
One function of the temporal lobe
Hearing
340
One function of the parietal lobe
Sensation
341
One function of the occipital lobe
Visual processing
342
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
343
What is the role of the hypothalamus?
Maintaining homeostasis
344
What connects the hypothalamus to the pituitary gland?
Infundibulum or pituitary stalk
345
What is the role of the ventricular system of the brain?
Protection of the brain Produce and circulate CSF
346
What are the lateral ventricles separated by?
Septum pellucidum
347
Where does the spinal cord end?
L1-2
348
What muscle is responsible for elevating the eyebrows?
Frontalis
349
What embryological derivative do all muscles of mastication come from?
1st pharyngeal arch
350
What embryological derivative do all muscles of facial expression come from?
2nd pharyngeal arch
351
What is the only muscle to be derived from the 3rd pharyngeal arch?
Stylopharyngeus muscle
352
What nerve gives parasympathetic innervation to nasal and lacrimal glands?
Greater petrosal nerve (CNVII)
353
Why is an infection more painful in the parotid gland?
The swelling is contained within the fibrous capsule of the gland
354
At what level does the lateral corticospinal tract cross?
Pyramids of the medulla
355
At what level does the anterior corticospinal tract cross?
Spinal cord
356
What nerves sends sensory fibres to the TMJ?
Auriculotemporal nerve (CNV3)
357
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
358
What separates the oral cavity from the oropharynx?
Oropharyngeal isthmus
359
Innervation of geniohyoid muscle
C1 via hypoglossal nerve
360
What is the cartilage of the pharyngotympanic tube called?
Torus tubarius
361
What fold extends posterior and inferiorly to the torus tubarius?
Salpingopharyngeal fold
362
What epithelium is the oropharynx lined with?
Stratified squamous
363
What are common places fish bones get stuck?
Vallecula Piriform recess
364
What is vulnerable to injury when a foreign object lodges in the piriform fossa?
Recurrent laryngeal nerve
365
What is Waldeyer's ring?
Tonsillar ring of lymphoid tissue
366
If a pt is getting their pharyngeal tonsils removed what major nerve and vessel could be injured?
Glossopharyngeal nerve Internal carotid artery
367
What muscle prevents air from being drawn into the stomach during inhalation and forms a sphincter around the upper oesophagus?
Cricopharyngeus
368
What is the primary role of pharyngeal constrictors?
Push food bolus to the oesophagus
369
What is the primary role of pharyngeal elevators?
Elevate the pharynx and larynx
370
What is the area where epistaxis most commonly occurs?
Anterior septal region
371
What paranasal sinus drains into the superior meatus?
Posterior cells of the ethmoidal sinus
372
What paranasal sinus drains into the ethmoidal bulla?
Middle cells of the ethmoidal sinus
373
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
374
Where do tears drain after going through the nasolacrimal duct?
Inferior nasal meatus
375
What layer of the eyeball forms the ciliary body?
Choroid
376
What is the muscle responsible for pupillary constriction?
Sphincter pupillae
377
What is the muscle responsible for pupillary dilation?
Dilator pupillae
378
What produces earwax in the external ear?
Ceruminous glands
379
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
380
Which part of the petrous part of the temporal bone does the bony labyrinth reside in?
Otic capsule