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Biomed > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the main structures in the neck

A

Hyoid bone
Thyroid cartilage
Cricothyroid membrane
Cricoid cartilage - only complete ring of cartilage in respiratory tract
Tracheal rings

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2
Q

3 muscles of the neck

A

Strenocleidous mastoid
Trapezius
Digastric

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3
Q

What are Atlas and Axis

A

Cervical vertibraes (C1 & C2). The skull is on top of atlas and its articulations allow you to nodd your head.

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4
Q

Structures in a typical Cervical Vertibrae

A

Transverse foramen
Vertebral foramen
Spinous process

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5
Q

What is a tracheostomy and how is it done

A

It establishes an emergency airway
An incision in made through skin and cricothyroid membrane - tracheostomy tube is inserted into trachea.
Only useful if blockage is above where you make the hole

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6
Q

What are satures and when are they formed

A

the connections between the bones of the skull. They aren’t fused during birth to allow the skull to compress when coming through birth canal

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7
Q

what is proprioception

A

The bodies ability to sense movement, and make sure you don’t over do it. e.g. over open mouth

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8
Q

Muscles of mastication functions

A

Superficial=
Temporalis - closes mouth, moves jaw post (back)
Masseter - closes mouth, chewing
Deep =
lateral pterygoid - protrusion of mandible (moves jaw forward), unilateral action (jaw side to side)
Medial pterygoid - elevation of mandible (jaw close)

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9
Q

Which cranial nerve innervates the muscles of mastication

A

CN V - Trigeminal - V3 - mandibular

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10
Q

Which CN innervates muscles of facial expression

A

VII - facial

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11
Q

7 muscles of facial expression and their functions

A

Frontalis - forehead muscle
Orbicularis Occuli - eyes close
Orbicularis Oris - lips closed or pursed
Lip elevator
Lip depressor
Zygomatic - contracts to smile
Buccinator - cheek muscle - used when playing wind instrument, breatfeeding and to push bolus into oral cavity to stop it staying in cheeks

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12
Q

what is venous drainage

A

route deoxygenated blood takes going back to lungs

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13
Q

What is TMJ
What is it formed by
What does it do

A

TMJ = Temporomandibular joint (jaw/ear)
Formed by temporal bone and mandibular condyle
Allows mouth to open and close

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14
Q

Actions TMJ can do

A

Rotate - only a bit
Slide - head of condyle moves from glenoid cavity to articular eminence

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15
Q

Ligaments of TMJ

A

Temporomandibular
Stylomandibular
Sphenomandibular

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16
Q

What to do if TMJ dislocates

A

It can dislocate anteriorly (forwards)
Clinician apply downward and backward pressure on molars - may require muscle relaxants

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17
Q

What are the muscles of the hyoid bone called

A

Suprahyoid (above)
Infrahyoid (below)
contract together stabilising hyoid

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18
Q

What are the functions of the larynx

A

1 - protects lower respiratory tract by preventing inhalation of food or liquids
2 - generates speech by vocal folds vibrating

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19
Q

Key structures within the larynx

A

Hyoid bone
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilage
Epiglottis
Cricothyroid joint

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20
Q

What happens at the cricoarytenoid joint

A

the arytenoid cartilage moves backwards, altering length, tension and thickness of vocal folds

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21
Q

What are the arytenoids

A

Cartilages in larynx essential for production of vocal sound, and help form the cricoarytenoid joints

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22
Q

3 possible movements at the cricoarytenoid joints

A

Sliding apart/together
Rotating inwards/outwards
Tilt forwards/backwards

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23
Q

Are vocal folds open or closed normally

A

Open to allow air through - closed during swallowing, o&c during speech

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24
Q

adduct means

A

close

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25
Q

abduct means

A

open

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26
Q

What are the names and functions of the muscles of the arytenoids

A

Transverse arytenoid, oblique arytenoid and lateral criocoarytenoid all ADDUCT VFs
Posterior criocoarytenoid is the ONLY ABDUCTOR

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27
Q

what are the requirements for phonation

A

Closed VF to raise subglottal pressure until it is greater than the closing force, which forces VF’s open. Sound can only be produced when VF’s are tensed. When air rushes past tensed VF’s they will vibrate and make a sound

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28
Q

3 variables in VF that affect pitch

A

Length
Tension
Thickness
You cannot change one without changing the others - elastic band

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29
Q

What is the name of the branches of Vagus (CN X)

A

Superior Laryngeal Nerve (SLN)
Recurrent Laryngeal Nerve (RLN)

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30
Q

What is superior laryngeal nerve (SLN) sensory and motor to
What is RLN motor to

A

Sensory to - mucosa of larynx
Motor to - cricothyroid muscles
RLN is motor to all other muscles in larynx

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31
Q

What happens if SLN is damaged

A

Loss of sensation in the larynx which initiates cough reflex = increase risk of inhalation of food
No motor innervation to cricothyroid muscles = difficulty regulating pitch

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32
Q

How can RLN get damaged

A

During thyroid operations as it runs close to thyroid
Lung pathology

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33
Q

What are the conditions required for phonation, and what is it used for

A

Used for vowels and voiced consonants
conditions
1 = Flow of air from lungs = energy in system
2 = Adduction of vocal folds to build subglottal pressure
3 = Tension of VF to allow for vibration
If conditions are met VF vibrate according to Aerodynamic-Myoelastic Theory

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34
Q

What is the Aerodynamic-Myoelastic Theory

A

As VF’s close, subglottal pressure is raised. When this overcomes the adducting forces, they are forced open, causing subglottal pressure to fall so VF adduct again
This aided by Bernoulli effect

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35
Q

How do VF’s open and close

A

From bottom up - bottom will start vibrating out of phase with the top causing them to open

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36
Q

What are the names of the 3 muscles that alter the length, tension and thickness of Vocal Folds

A

Criocothyriod
Thyroarytenoid
Vocalis

37
Q

Function of criocothyroid muscle

A

Lengthens VF’s by rotating and sliding

38
Q

Function of Thyroarytenoid muscle

A

Shorten and thickens VF’s
Makes refined changes in length/tension

39
Q

Function of Vocalis

A

Shorten and thicken VF’s
Refined changes to length/tension

40
Q

How do criocothyroid and vocalis muscles work together

A

Contract isometrically which alters tension without changing length of VF’s

41
Q

What can affect the quality of the voice

A

Infections/inflammatory conditions e.g laryngitis
Benign/malignant growths
Occupational demands (strong adduction leads to trauma)
Drug effects - antidepressants/psychotics affect neuro-muscular control. Decongestants produce rebound effect - when drug wears off there’s excess production of mucus causing thickening of VF’s

42
Q

What are the 3 phases of swallowing and are they a reflex or voluntary

A

1) Oral phase (includes oral preparatory) - V
2) Pharyngeal phase - R
3) Oesophageal phase - R

43
Q

Describe the oral preparatory phase of swallowing

A

Food is prepared by mastication and mixing with saliva. The consistency of the food is monitored by sensory receptors in the oral mucosa

44
Q

Describe the oral phase of swallowing

A

The bolus is pushed to the back by raising the tongue to the palate. The tongue is lowered to form a shute pushing the bolus to the oropharynx.

45
Q

What must occur for the oral phase of swallowing to be completed

A

mouth closed
soft palate elevated to stop food entering nasal pharynx
respiration suspended to stop food entering larynx

46
Q

What are the trigger points in the oral cavity and what do they initiate

A

TP = palatoglossal arches & posterior pharyngeal walls
Initiate = pharyngeal contraction & reflex actions to protect airway

47
Q

Describe the pharyngeal phase of swallowing

A

The bolus passes through pharynx by contraction of constrictor muscles

48
Q

How is the airway protected during the pharyngeal stage of swallowing

A

Respiration suspended
Larynx elevated by supra hyoid muscle
Narrowing of laryngeal entrance to prevent inhalation
Strong adduction of VF’s
Cough reflex in place in case food enters larynx

49
Q

Describe Oesophayeal phase

A

Bolus passes through oesophagus to stomach.

50
Q

What happens during a cough reflex

A

Initiated by CN X
Diaphragm and intercostal muscles contract
VF’s adduct and glottis closes to increase pressure

51
Q

What happens during a gag reflex

A

Mouth is opened and post part of tongue is elevated to expel the material
Soft palate elevated to stop material entering nasopharynx

52
Q

What are the nerves involved in swallowing

A

Sensory = V, IX
Motor = V3, VII, X, XII

53
Q

What are the 3 possible causes of dysphagia

A
  1. obstructive
  2. neurogenic
  3. xerostomia
54
Q

What causes neurogenic dysphagia

A

Interference with neuro muscular mechanics of swallowing by neuromuscular disease e.g stroke, parkinsons, motor neurone

55
Q

What are 3 problems dysphagia causes

A

Malnutrition/dehydration
Social problems (embarrassment)
Aspiration into respiratory tract

56
Q

What are the 4 types of swallowing assessments

A

Sips of water- timing of swallow and size of sips
Check to see if patient coughs, chokes or has ‘wet voice’ after drinking
Fiber-optic Endoscopic Evaluation of Swallowing (FEES)
Video fluoroscopy (VFS)

57
Q

Name the 3 sections of the pharynx and where they are

A

Nasopharynx - behind nose to soft palate
Oropharynx - soft palate to epiglottis
Laryngopharynx - epiglottis to cricoid cartilage

58
Q

What are the 2 groups of muscles in the pharynx

A

Constrictor muscles
Longitudinal muscles

59
Q

What are the names and function of the constrictor muscles

A

Superior, Middle, Inferior constrictors
Function = propel food through the pharynx

60
Q

What are the names and function of the Longitudinal muscles

A

Stylopharyngeus
Salpingopharyngeus
Palatalpharygeus
Function = elevate, shorten and widen larynx during swallowing

61
Q

What kind of tissue are tonsils made of and what does it do

A

Lymphoid tissue - protective to GI + respiratory tracts by lymphocytes producing anti-bodies in response to bacteria + toxins. The tonsils will enlarge if there is an infection

62
Q

What are the 4 groups of tonsillar tissues and where are they situated

A

1) Palatine - between palatoglossal arches + palatopharyngeal arches
2) Pharyngeal (adenoid) - posterior wall of nasopharynx
3) Lingual - under muscosa of post 1/3 tongue
4) Tubal - auditory tube (not always present)

63
Q

Enlarged adenoids (pharyngeal) can cause…

A

Sinisitus, middle ear infections, sleep apnea
Distort nasal speech sounds like m,n,ng
Interfere with soft palate elevation

64
Q

What are the names of the 3 layers of the cranial meninges

A

Dura Mater
Arachnoid Mater
Pia Mater

65
Q

What are the names of the two layers within the Dura Mater

A

Outer - endosteal layer - tightly bound to the cranium
Inner - Meningeal layer

66
Q

What are Dural Folds

A

Dural folds are created when the inner layer extends into the cranium. They provide stabilisation and support to the brain

67
Q

Describe the arachnoid mater

A

It covers the brain and creates a smooth surface but doesn’t go into folds
Subarachnoid space lies between the arachnoid and pia mater, but fibres extend between them to bridge the gap

68
Q

Describe the Pia Mater

A

Thin layer covering brain, extends into every fold

69
Q

What are the names of the two cranial spaces

A

Extradural
Subarachnoid

70
Q

What is extradural space and how is it created

A

‘potential’ space between dura mater and cranium, occurring due to trauma. When the meningeal arteries in the endosteal are ruptured they bleed into the extradural space creating increased intra-cranial pressure -coning

71
Q

What is subarachnoid space

A

‘real’ space between arachnoid and pia mater. It is large so any haemorrhages take time to spread symptoms take 24-48 hours to occur.

72
Q

What does subarachnoid space contain

A

Cerebrospinal fluid (CSF) - filled with anti-bodies and nutrients
Arteries to the brain
Veins from the brain

73
Q

What are true end arteries

A

arteries that supple a specific area and there is no alternative blood supply

74
Q

What is the fancy name for a stroke

A

Cerebrovascular accident (CVA)

75
Q

What are the names for the 2 types of stroke

A

Ischemic
Haemorrhagic

76
Q

What causes an Ischemic stroke

A

a blood clot that blocks the flow of blood

77
Q

What causes a Haemorrhagic stroke

A

A burst blood vessel (aneurysm) or trauma
Excessive bleeding in an area causes loss of function

78
Q

What are the consequences of an Ischemic stroke

A

Brain function lost in areas where blood supply is permanently absent

79
Q

What are the consequences of a haemorrhagic stroke

A

short term effects worse than long term effects. Function may return as the mass of hematoma decreases.

80
Q

What is the circle of Willis

A

connects the internal carotid arteries with the vertebrobasilar system via communicating arteries.
It can act as an alternative blood supply, but is only complete for 60% of people

81
Q

What are the 3 types of papillae

A

circumvallate - contain taste buds
filliform - no taste buds, gives tongue rough appearance allowing for increased friction for pushing food around the mouth
fungiform - contain taste buds

82
Q

What are the two types of tongue muscles and what are their functions and attachments

A

Extrinsic - attach to the skull - change position of tongue
Intrinsic - within tongue - change shape of tongue

83
Q

Name the extrinsic tongue muscles and their function

A

Palatoglossus - elevates tongue/depresses soft palate
Styloglossus - retracts tongue and elevates sides
Genioglossus - Lots of actions e.g. protrude, flatten
Hyoglossus - depresses tongue and sides

84
Q

What nerve are the extrinsic muscles innervated by

A

CN XII except palatalglossus

85
Q

Name the intrinsic tongue muscles and their function

A

superior longitudinal - shortens and curls apex up
Inferior longitudinal - shortens and curls apex down
Transverse - narrows and lengthens
Vertical - broadens and flattens

86
Q

Where is the alveolar ridge

A

just behind front teeth - important for forming alveolar consonants

87
Q

What are the ridges in the hard palate called

A

rugae - provides friction as food is pushed around oral cavity

88
Q

Name the muscles of the soft palate and their functions

A

Levator veli palatini - elevates
Tensor veli palatini - tenses
Palatoglossus - depresses
Palatopharyngeus - depresses

89
Q

What CN are the muscles of the soft palate innervated by

A

All innervated by X except TVP which is innervated by V3

Biomed (4 decks)

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