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ENT SB > Anatomy > Flashcards

Anatomy Flashcards

1
Q

what is the thinnest part of the skull

A

the pterion

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2
Q

what are the two parts of the temporal bone

A

petrous part

squamous part

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3
Q

what is contained in the anterior cranial fossa

A

frontal, ethmoid and spehnoid

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4
Q

what is contained in the middle cranial fossa

A

sphenoid and temporal

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5
Q

what is contained in the posterior cranial fossa

A

temporal and occipital

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6
Q

what is the only cranial nerve to run through the anterior fossa

A

CNI

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7
Q

what nerves could be damaged in pathology of the internal acoustic meatus

A

CN VII and VIII

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8
Q

what are the 3 parts of the ear and what are there boundaries

A

external ear

  • auricle to tympanic membrane
  • via external acoustic meatus

middle ear

  • tympanic membrane to oval window
  • also eustachian tube

internal ear
- oval window to internal acoustic meatus

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9
Q

what are the functions of the 3 parts of the ear

A

external
- collect and conveys sound waves to tympanic membrane

middle
- amplifies and conducts sound waves to the internal ear

internal
- converts special sensory information; into fluid waves, then APs, conducts APs to brain.

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10
Q

why is anaesthetic contained adrenaline not used on external ear

A

avascular

nutrients from skin

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11
Q

what is the external acoustic meatus/ear canal lined with

A

skin

- ceruminous glands that produce earwax

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12
Q

what are the lymph nodes surrounding the ear

A

parotid (pre-auricular)

mastoid (post-auricular)

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13
Q

how is the auricle pulled in otoscopic examination

A

posteroinferiorly in children

posterosuperiorly in adults

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14
Q

what is the nerve supply of the tympanic membrane

A

external surface - CN V3

internal surface - CN IX

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15
Q

what does CNIX, the glossopharyngeal nerve provide sensory innervation to

A 
middle ear cavity
eustachian tube
nasopharynx
oropharynx
tonsils
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16
Q

what does the eustachian tube connect

A

middle ear cavity to nasopharynx

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17
Q

laryngopharynx nerve supply

A

CN X

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18
Q

what are the 3 bones of the middle ear cavity called the auditory ossicles

A

Malleus
Incus
Stapes

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19
Q

what does the base of the stapes fit into

A

the oval window i.e. internal ear

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20
Q

what foramen in the base of the skull does CN VII run through

A

internal acoustic meatus

stylomastoid foramen

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21
Q

what is the course of the facial nerve through the petrous temporal bone

A 
internal acoustic meatus
>>
facial canal
>>
stylomastoid foramen
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22
Q

what is chorda tympani

A
  • branch of CN VII
  • supply to taste buds of anterior 2/3rds of tongue
  • parasymp supply to submandibular and sublingual salivary glands
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23
Q

what is the function of the stapedius

A

reduces stapes movement to protect internal ear from excessive noise

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24
Q

what does chorda tympani connect with

A

lingual nerve branch of CN V3

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25
Q

what are the muscles of facial expression

A

frontalis
orbicularis oculi
elevators of lips
orbicularis oris

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26
Q

how can we test muscles of facial expression and motor function of CN VII

A

frown
close eyes tightly
smile
puff out cheeks

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27
Q

what are the two parts of CN VIII, the vestibulocohlear nerve

A

the cochlear nerve (hearing)

the vestibular nerve (balance)

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28
Q

what is the apex of the spiral of the cochlea called

A

cupula

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29
Q

what are the 3 semi-circular canals called

A

anterior
lateral
posterior

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30
Q

what is contained in the cochlear duct and the semi-circular canals

A

cochlear duct - cochlear nerve

semi-circular canals - vestibular nerve

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31
Q

what tuning fork is used to test hearing

A

512 Hz tuning fork

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32
Q

how is sound transmitted

A

1 - Sound waves make tympanic membrane vibrate
2 -Vibrations transmitted through ossicles
3 -Base of stapes vibrates in oval window
4 - Vibration of stapes creates pressure waves in perilymph
5 - Hair cells in the cochlea are moved, neurotransmitter is released, Aps stimulated and conveyed to brain by cochlear nerve
6 - Pressure waves descend and become vibrations again
7 - Pressure waves are dampened at the round window

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33
Q

what cannot be used near nasal cartilage

A

adrenaline-containing local anaesthetics

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34
Q

what part of the ethmoid bone contributes to the roof

A

cribriform plate and crista galli

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35
Q

what part of the ethmoid bone contributes to the septum

A

perpendicular plate of ethmoid

rest is made up by the VOMER

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36
Q

what type of fracture can disrupt the cribriform plate and why is this an issue

A

Le Fort II and III

- danger of infection spreading to the anterior cranial fossa

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37
Q

what is the olfactory bulb

A

ganglion of CN I

cell bodies of 2nd neurones

38
Q

where do the receptor cells of CN I pass through

A

cribriform plate of ethmoid bone

39
Q

what is the nerve supply of the nasal cavity

A

Ophthalmic (CN V1)
anterosuperiorly

Maxillary (CN V2)
posteroinferiorly

40
Q

what is the blood supply of the nasal cavity

A

External

  • facial
  • maxillary

Internal
- ophthalmic

41
Q

what is Kiesselbach’s Area and why is it clinically important

A

anastomosis of all the arterial blood supply of the nasal cavity

common site for nosebleeds/epistaxis

42
Q

what are the conchae of the nasal cavities

A

superior (of ethmoid)
middle (of ethmoid)
inferior

43
Q

what are meatuses

A

spaces under each concha

44
Q

what is the only meatus not under a concha

A

sphenoethmoidal

45
Q

what is the nerve supply of the inferior conchae

A

CN V1

46
Q

what are the cavities mainly lined by

A

respiratory epithelium

- pseudostratified columnar with cilia and goblet (mucous-secreting) cells

47
Q

what do ‘holes’ in the meatus allow

A

drainage of mucous from the paranasal sinuses

48
Q

what are the paranasal sinuses

A

frontal sinuses
ethmoidal (air) cells
maxillary sinuses
sphenoid sinus

49
Q

what are sinuses lined by

A

mucous-secreting respiratory mucosa

50
Q

what are the functions of sinuses

A

mucous drains into nasal cavities via ostia in the lateral walls of the nasal cavities

51
Q

where does the frontal sinuses drain into and what also does

A

middle meatus

maxillary sinus

52
Q

where do ethmoidal cells drain into

A

superior and middle meatus

53
Q

what drains into the sphenoethmoidal recess

A

sphenoidal sinus

54
Q

what drains into the inferior meatus

A

lacrimal gland via the nasolacrimal duct

55
Q

what provides the painful sensation in sinusitis and where may the pain be referred

A

CN V1 and V2

Teeth

56
Q

why is the maxillary sinuses predisposed to inflammation

A

maxillary sinus ostia being located superiorly

mucous has to drain against gravity

57
Q

where in the mouth is the opening for the submandibular salivary glands

A

under the tongue

58
Q

where does the parotid duct sit

A

crosses masseter

pierces medially through buccinator

59
Q

where does the parotid gland come out in the mouth

A

upper back molars

60
Q

what is the muscle of the floor of the mouth

A

mylohyoid

61
Q

what supplies the sublingual and submandibular gland

A

CN VII

62
Q

what is the nerve supply of the anterior 2/3rds of the tongue

A

general sensory = CN V3

special sensory = CN VII

63
Q

what is the nerve supply of the posterior 1/3rd of the tongue

A

general and sensory supply = CN IX

64
Q

what is the origin of the thyroid gland

A

foramen caecum

65
Q

what are the 4 extrinsic muscles of the tongue

A

palatoglossus
styloglossus
hyoglossus
genioglossus

66
Q

what does CN XII sit in in the occipital bone

A

hypoglossal canal

67
Q

how can CN XII be tested

A

ask patient to stick out tongue

68
Q

what are the muscles of the soft palate and what is their function

A

levator veli palatini - lifts the soft palate towards the base of the skull

tensor veli palatini - tenses the soft palate

palatoglossus - depresses the palate towards the tongue or vice versa

palatopharyngeus - a longitudinal muscle of the pharynx - attaches between the palate and the larynx

musculus uvulae

69
Q

what is the nerve supply of the muscles of the soft palate

A

all CN X apart from tensor veil palatini - CN V3

70
Q

how can CN X and CN V3 be tested

A

ask the patient to say ‘Aaahh’

71
Q

what innervates the pharynx

A

CN X

72
Q

what protects the pharynx

A

Waldeyer’s (defensive) ring of lymphoid tissue

73
Q

what is enclosed in pre tracheal fascia

A 
the strap muscles
thyroid gland
trachea & larynx  
oesophagus & pharynx
recurrent laryngeal nerves
74
Q

where is the larynx

A

between C4 and C6

75
Q

what level is the hyoid bone

A

C3

76
Q

when can vertebra begin to be palpated

A

C7

77
Q

what what level does the larynx become the trachea

A

C6

78
Q

what is the name of the membrane that connects the hyoid to the thyroid cartilage

A

thyrohyoid membrane

79
Q

what is the name of the membrane that connects the thyroid cartilage to the cricoid cartilage

A

cricothyroid membrane

80
Q

what is the only cartilage to make a complete ring around the larynx

A

cricoid cartilage

81
Q

what is the name of the back of the cricoid cartilage

A

lamina

82
Q

where do vocal cords attach to

A

thyroid cartilage

vocal process of arytenoid cartilages

83
Q

what is the space between vocal cords called

A

rima glottidis

84
Q

what is the mucosa of the larynx

A

mainly respiratory epithelium:

EXCEPT for the VOCAL CORDS stratified squamous epithelium

85
Q

what are the false and true vocal cords

A

F - superior of vocal cords
- vestibular folds

T - inferior of vocal cords
- vocal folds

86
Q

nerve supply of larynx

A

CN X

Superior to vocal fold = superior laryngeal branches of CN X

Vocal fold and inferior = recurrent laryngeal branches of CN X

87
Q

what are the role of cricothyroid muscles

A

tense the vocal cords

88
Q

role of thyro-arytenoid muscles

A

relax vocal cords

pull the arytenoid cartilages towards the thyroid cartilage

89
Q

role of lateral circa-arythenoid muscles

A

adduct the vocal cords

rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline

90
Q

role of the arytenoid muscles

A

adduct the vocal cords

91
Q

role of posterior circa-arythenoid muscles

A

abduct the vocal cords

widens the rima glottidis

92
Q

how can the vagus nerve be tested

A

ask patient to swallow small sip of water
listen to patient speak
ask patient to cough

ENT SB (9 decks)

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