Anatomy Flashcards
What are the pure sensory cranial nerves?
I, II, VIII
What are the mixed motor and sensory nerves?
V, VII, IX, X
What is the only nerve that doesn’t originate within the cranial cavity?
XI - Accessory nerve
What are the pure motor nerves?
III, IV, VI, XI, XII
Which nerves carry parasympathetic components?
III, VII, IX, X
What are the 4 peripheral sensory ganglia?
ciliary, pterygopalatine, otic, submandibular
What nerves supply each of the pharnygeal arches?
Arch 1 - V3
Arch 2 - VII
Arch 3 - IX
Arch 4&6 - X
Which nerves carry GVA components?
IX and X
What peripheral sensory ganglia carry the cell bodies of nerves IX and X?
inferior and superior sensory ganglia
How does sympathetic innervation get to the cranium?
pre-ganglionic sympathetic fibers leave the spinal cord T1-T2; course superiorly to the cervical chain ganglia; post-ganglionics form the peri-arterial carotid plexus; then branches to innervate targets
What foramen carries the optic nerve?
Optic canal
What runs in the optic canal?
optic nerve and ophthalmic branch of the ICA
Where does the vagus nerve exit the cranial cavity?
jugular foramen
What is the path of venous drainage from the eye?
cavernous - superior/inferior petrosal - sigmoid - IJV
What’s the path of venous drainage from the sagittal sinuses?
superior/inferior sagittal - straight - transverse - sigmoid - IJV
What are the attachments of the tentorium cerebelli?
Anterior: posterior clinoid process
Lateral: temporal bone
Posterior: occipital bone
What are the 4 dural partitions?
falx cerebri
tentorium cerebelli
falx cerebelli
diaphragma sellae
What’s the part of the skull that is vulnerable to injury and lies over the middle meningeal artery?
pterion
Through what foramen passes the middle meningeal artery?
foramen spinosum
What does the diaphragma sellae cover?
the pituitary
What pierces the diaphragma sellae?
the pituitary stalk
What 2 veins does the superior sagittal sinus communicate with?
emissary and diploic veins
What 2 veins communicate with the sigmoid sinus?
mastoid and condyloid emissary veins
How do the cavernous sinuses communicate with each other?
via intercavernous sinuses
With what does the cavernous sinuses communicate?
ophthalmic veins, pterygoid plexus (veins of the deep face), and superior/inferior petrosal sinuses
What nerves innervate the meninges?
- trigeminal nerve (all 3 branches)
- meningeal nerve branch off V3 enters via foramen spinosum
A dural sinus is formed from what layers of the dura mater?
periosteal dura and meningeal dura
What drains via arachnoid villi? and where do they drain?
- CSF
- into dural sinuses
What is the mental protuberance?
the chin of the mandible
What skull bone is the mastoid process part of?
temporal bone
What is the origin and attachment of the sternocleidomastoid musle?
from manubrium/clavicle to the mastoid process
What are the contents of the carotid sheath?
common carotid artery, internal jugular vein, vagus nerve
What are the borders of the thyroid gland?
lateral: carotid sheath post, SCM anterior
anterior: strap muscles
posterior: prevertebral fascia
medially: trachea and esophagus
What are the contents of the visceral or pre-tracheal fascia of the neck?
esophagus, trachea, thyroid
Where is the buccopharyngeal fascia located?
the posterior portion of the pretracheal fascia
How far does the retropharyngeal space extend?
base of the skull down into the thorax
What is the boundary between the anterior and posterior triangles?
sternocleidomastoid muscle
What are the borders of the anterior triangle?
superior: mandible
medial: midline
lateral: sternocleidomastoid
What are the borders of the posterior triangle?
medial: sternocleidomastoid
inferior: clavicle
lateral/posterior: trapezius
Where does the omohyoid muscle originate?
originates medial to suprascapular notch
What is the nerve point of the neck and what nerves branch here?
punctum nervosum; great auricular runs anterior to ear; lesser occipital runs posterior to ear; transverse cervical runs directly anterior
Where is the punctum nervosum located?
midpoint of the SCM
What set of cutaneous nerves forms in between the ventral ramus of C3 and C4, and where do they run?
Supraclaviculars: medial, intermediate, lateral; run down over the clavicle
The platysma is the muscle of…
facial expression
What is the major superficial vein of the neck and what 2 cutaneous veins from the head form it?
External jugular vein; retromandibular and posterior auricular vein
What are the 3 subdivisions of the anterior triangle?
muscular
carotid
submandibular
What are the borders of the muscular anterior triangle?
superior belly of omohyoid, SCM, and midline
What are the main contents of the muscular anterior triangle?
strap muscles and thyroid gland
What does the intermediate tendon of the omohyoid muscle attach to?
clavicle
Name the superficial and deep strap muscles.
superficial: sternohyoid and omohyoid
deep: sternothyroid and thyrohyoid
What are the lobes of the thyroid gland?
left and right, isthmus, and pyramidal (not always present)
What are the levels that supply the cervical plexus?
C1-C4
What is the ansa cervicalis?
nerve loop between branch from C1 and branch from C2/C3 that innervates the strap muscles
The hypoglossal nerve travels with…
the ansa cervicalis
What is the only strap muscle not innervated by the ansa cervicalis, and what innervates it?
the thyrohyoid, and it’s innervated by C1 which travels with the hypoglossa nerve
What nerve comes mainly from C4 but also has contributions from C3 and C5?
phrenic nerve
What are the boundaries of the carotid triangle?
lateral: SCM
inferior: superior belly of omohyoid
superior: posterior belly of ac
At what level does the common carotid branch into internal and external?
upper level of thyroid cartilage, @C4
Which of common, external, and internal have branches in the neck, and how many?
External carotid only–8 branches
What cartilage makes the Adam’s apple?
thyroid cartilage, especially the laryngeal prominence
What suspends the larynx from the hyoid bone?
the thyrohyoid membrane
What ligament extends inferiorly from the thyroid cartilage and to where?
the cricothyroid ligament, attaches to the cricoid cartilage
Where does the median cricothyroid ligament run?
anterior midline between thyroid and cricoid cartilage
What are the arytenoids?
bilateral pyramidal cartilages that sit behind the trachea and above the cricoid
What do the corniculate and cuneiform cartilages support?
arytenoid cartilages and wall of the laryngeal vestibule, resp.
What is the epiglottis?
cartilage attached to the posterior thyroid and base of the tongue; closes off airway during swallowing
What does the Superior laryngeal nerve innervate?
inlet, vestibule, and ventricle&saccule of larynx
What structures are located in the laryngeal inlet?
epiglottis mucosa, aryepiglottic fold, and interarytenoid notch mucosa
In what region is the conus elasticus found?
glottic space
What does the ventricle & saccule contain?
muscosa (lining ventricle) and sacculus
What does the inferior laryngeal nerve innervate?
infraepiglottic space
What does the vestibule contain?
mucosa of quadrangular membrane and vestibular fold
What nerve innervates the intrinsic muscles of the larynx?
Vagus nerve: superior laryngeal nerve branch
What are the intrinsic muscles of the larynx?
cricothyroid, posterior cricoarytenoid, lateral cricoarytenoid, thyroarytenoid, transverse arytenoid, oblique arytenoid, and vocalis
What are the functions of the intrinsic muscles of the larynx?
adjust tension in vocal ligaments, open/close the rima glottidis, control inner vestibule, facilitate closing of laryngeal inlet
What is the mucosa folded over the arytenoid cartilage called?
interarytenoid fold
What are the piriform recesses?
located on either side of the epiglottis
What is the vestibular fold?
one of two folds within the larynx, above the ventricle and vocal fold
What is the interarytenoid gap?
the midline space in between the arytenoid cartilages
What runs through the piriform recess?
the internal branch of the superior laryngeal nerve
The thyroid cartilage comes together anteriorly to…
the anterior junction of the right and left vocal folds
Where is the ventricle located?
in between the vestibular fold and the vocal fold
Where does the conus elasticus originate and attach?
originates from the arch of the arytenoid cartilage laterally and inserts on the vocal ligament medially
Which laryngeal folds/ligaments come together during speaking/singing?
only the vocal folds, not the vestibular folds (unless you’re a Tuban throat singer)
What is the axis of movement of the arytenoids?
look up in the podcast
How far down does the infraglottic space extend?
to the inferior border of the cricoid cartilage
What does the superior laryngeal nerve innervate?
internal: sensory, taste, PS motor
external: cricothyroid muscle
What muscle, when it contracts, produces a high pitched sound?
cricothyroid muscle; pulls the cricoid cartilage downward and stretches the vocal ligaments to make a higher pitched sound
What muscle is responsible for adduction and abduction of the vocal folds?
lateral cricoarytenoid = adduction
posterior cricoarytenoid = abduction
What does the aryepiglottic muscle do?
draws aryepiglottic folds together
What does the thyroepiglottic do?
draws the epiglottis downward
What are the 5 characteristics of epiglottic function on the voice?
- level of adduction
- thickness of vocal folds
- length of vocal folds
- tension on vocal folds
- breath
What is the rima glottidis?
the space between the vocal folds; bigger when the folds are abducted
How does the internal branch of the superior laryngeal nerve get into the larynx?
through a space piercing the thyrohyoid membrane
What functional components does the internal branch of the superior laryngeal nerve have?
GSA (mucosa), GVE (PS), SA (taste)
When does the recurrent laryngeal nerve become the inferior laryngeal nerve?
once it passes the cricothyroid joint
What is the vascular supply of the larynx?
laryngeal branches off inferior thyroid artery; branches of the superior laryngeal artery
What are the borders of the posterior triangle?
anterior/medial: SCM
posterior: trapezius
inferior: clavicle
The vagus nerve runs in the neck between…
esophagus and trachea
What are the 3 scalene muscle?
anterior, middle, and posterior
Where do the scalenes originate and insert?
transverse cervical processes; first and second rib
Which vertebra has a transverse foramen but no artery in it?
C7
What lies in the scalene triangle?
phrenic nerve, brachial plexus and subclavian artery
What lies anterior to the scalene triangle?
subclavian vein
What is thoracic outlet syndrome?
compression of the brachial plexus and subclavian artery, related to tension in the scalenes/scalene triangle
What are the branches of the subclavian artery?
Vertebral artery, internal thoracic artery, thyrocervical trunk, costocervical trunk, and dorsal scapular
What are the branches of the thyrocervical trunk?
- inferior thyroid
- ascending cervical
- transverse cervical
- suprascapular
What are the branches of the costocervical trunk?
- highest intercostal
- deep cervical
Where does the vertebral artery enter the cranial cavity?
foramen magnum
What does the inferior thyroid artery supply, and how does it travel there?
lower pole of thyroid gland; travels posteriorly to the carotid sheath, ascending on the anterior scalene muscle
What does the ascending cervical artery supply?
anterior scalene and some other neck muscles
What does the transverse cervical artery supply?
trapezius muscle
What ties down the phrenic nerve on the anterior surface of the anterior scalene?
the suprascapular and transverse cervical arteries
Where does the dorsal scapular artery travel through?
it’s variable but usually it goes posterior underneath levator scapulae and rhomboids, weaving through brachial plexus on the way
Where does the accessory nerve run in relation to SCM and trapezius?
bottome of the superior 1/3 of SCM and superior border of the inferior 1/3 of trapezius
The shape of the atlanto-occipital joint allows for what movement?
nodding
What forms the axis for rotational movement of the head?
dens
What happens when both SCMs contract?
neck flexes
if the accessory nerve is affected on the right side, what movements would be affected
- shoulder elevation (trapezius)
- chin elevation and contralateral rotation (SCM)
What nerve follows the ICA?
internal carotid nerve
What forms the superior cervical ganglion?
C1-4
What forms the middle cervical ganglion?
C5-6
What do C7-8 and T1 form?
stellate ganglion or cervicothroacic ganglion
What ganglion lies near the vertebral artery?
parasympathetic ganglion
What is the deep cervical chain?
lymph nodes running along the jugular vein
What is the jugular digastric node?
lymph node in the neck that is swollen and palpable when sick
Where do the lymphatic nodes of the neck empty into?
the lymphatic trunk, which joins the thoracic duct, as it enters the subclavian/IJV junction
From which cervical segment comes phrenic nerve?
C5
What cervical segments give rise to the long thoracic nerve?
C5-6-7
Where does the pharynx run from and to?
from base of the skull to C6
What is the sphenoid bone and what are its important landmarks?
the bat-shaped bone; pterygoid process and hamulus; lesser wing and anterior clinoid process in front; medial and lateral pterygoid plates on the inferior surface
Where is the pterygomandibular raphe?
within the mouth, it extends from the hamulus to the mandible
The cavity of the pharynx is divided into what 3 divisions?
nasopharynx
oropharynx
laryngopharynx
What nerves are in the pharyngeal plexus?
- GVE/PS from vagus(X)
- GVE/S from cervical sympathetic ganglia
- GSA from glossopharyngeal(XI)
What are the structural layers of the pharyngeal wall?
mucosa; submucosa or pharyngobasilar fascia; muscular; buccopharyngeal fascia
What is the orientation of the muscle layers surrounding the pharynx?
longitudinal muscles internal
circumferential layers external
(opposite of GI tube)
In what region of the pharynx are the buccopharyngeal and pharyngobasilar fascia the only support layers, any why?
in the uppermost pharynx; because there is no muscle layer here
What parts of the temporal bone do the pharyngeal muscles utilize?
the stylohyoid ligament and styloid process
What part of the temporal bone makes up the majority of the temporal fossa?
squamous part of temporal bone
Which part of the temporal bone extends anteriorly?
zygomatic process
What are the 2 major processes of the temporal bone and which direction do they extend?
mastoid process and styloid process, both extend inferiorly
The mastoid process is the origin for what muscles?
SCM and posterior digastric muscles
What bone landmarks lie between the mastoid and zygomatic processes?
external acoustic meatus and mandibular fossa
What is the most lateral portion of the sphenoid bone?
the greater wing
Where is the pterygoid process?
lateral base of the sphenoid bone, deep to the mandible and zygomatic arch
The hamulus is a process of which bone and section?
the sphenoid bone, and medial pterygoid plate
What are the origins of the superior constrictor muscle?
inferior medial pterygoid plate, pterygoid hamulus, and pterygomandibular raphe,
What are the origins of the middle constrictor muscle?
inferior stylohyoid, and the lesser and greater horns of hyoid bone
What are the origins of the inferior constrictor muscle?
oblique line of the thyroid cartilage, cricoid cartilage, and arcus tendineus
What is a common insertion point of all the constrictor muscles, and where is it located?
pharyngeal raphe in the posterior midline of the pharynx
Where does the pharyngeal raphe run?
pharyngeal tubercle superiorly (anterior to foramen magnum) to blend inferiorly with the muscles of the esophagus
What is the primary function of the palatopharyngeal sphincter?
to constrict and close off the nasopharynx during swallowing
Where does the stylopharyngeus muscle extend?
from the styloid process to the thyroid cartilage, internally to the constrictor muscles
What is the importance of the cricopharyngeus muscle?
it is the upper esophageal sphincter, keeps stomach contents contained; potential site for diverticulum; makes eructation
What are the 3 longitudinal muscles of the pharynx?
- stylopharyngeus
- salpingopharyngeus
- palatopharyngeus
What is the main function of the longitudinal muscles of the pharynx?
To raise the larynx and wall of pharynx during swallowing
What passes between the middle and inferior constrictor muscles?
the internal branch of the superior pharyngeal nerve, as well as the superior pharyngeal artery
What passes superiorly to the superior constrictor?
part of auditory tube, levator veli palatini, ascending palatine of facial artery, palatine branch of asc. pharyngeal artery
What passes between the superior and middle constrictor muscles?
the stylopharyngeus muscle, glossopharyngeal nerve, and the lingual artery
What passes below the inferior constrictor muscle?
the recurrent laryngeal nerve as well as the laryngeal branch of the inferior thyroid artery
What’s the cricopharyngeus?
circular muscle that lies at the bottom of the inferior constrictor and serves as the UES
Where are the choanae located?
opening from nasal cavity to nasopharynx posteriorly, between the conka, which are the curved bones
What is the torus tubarius?
the opening to the auditory tube which runs from the middle ear to the nasopharynx
What is the salpingopharyngeal fold?
fold that extends downward from the torus tubarius; there’s the muscle underneath
What’s the dingle-dangle thing in the back of your mouth?
uvula
Is the palatopharyngeal fold superior or inferior to the salpingopharyngeal fold?
inferior
The pharyngoepiglottic fold covers what muscle as it runs where to where and through what?
stylopharyngeus, as it runs styloid process to thyroid cartilage through the gap between superior and middle constrictor muscles
What are the side borders of the piriform recess?
thyroid cartilage laterally and cricoid cartilage medially
What is the first branch of cranial nerve IX and what does it carry?
tympanic nerve, carrying PS fibers to the otic ganglion (to parotid gland) and GSA from tympanic cavity
Describe the superior and inferior sensory ganglia.
they are a set of paired ganglia for each nerves IX and X
What nerve innervates the stylopharyngeus muscle?
IX, glossopharyngeal; a brachiomeric muscle
Cranial nerve IX afferents carry sensation from what?
posterior 1/3 of tongue–both SA and GSA
What innervates the wall of the upper 2/3 of pharynx?
pharyngeal branches of CNIX (GSA)
GVA fibers to carotid sinus are carried by which nerve?
CN IX
What receptor types are found in the carotid sinus?
baroreceptors, GVA
Inferiorly, around C2, what nerves travel in the carotid sheath?
9, 10, and 12
Where is the levator veli palatini located?
base of the lumen of the auditory tube
The tonsils are located anteriorly and posteriorly to what mucosal folds?
palatopharyngeal and palatoglossal
What is the posterior boundary of the oral cavity?
palatoglossal fold
What folds form “little valleys” on either side of the base of the tongue?
lateral and medial glossoepiglottic folds
What arteries contribute to the pharynx?
- inferior thyroid artery and its pharyngeal branches
- ascending pharyngeal artery from medial ECA
- facial artery
- lingual artery
- maxillary artery
In which part of the pharynx do the digestive and respiratory tracts cross?
oropharynx
What are the tonsillar pillars?
mucosal folds of the oropharynx overlying the palatopharyngeal (post) and palatoglossus (ant) muscles, with palatine tonsils in-between
What is the junction between the oral cavity and oropharynx?
palatoglossal fold
What muscle lies deep to the palatoepiglottic fold?
stylopharyngeus muscle
