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ENT SOH > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Which structure gives rise to the cupid’s bow?

A

Philtrum

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2
Q

From which part of the nasal cavity to we get sense of smell?

A

Olfactory epithelium

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3
Q

Nasal septum - anterior component

A

Hyaline cartilage

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4
Q

Nasal septum - posterior compartment

A

Bony

  • perpendicular place of ethmoid bone (superiorly)
  • vomer (inferiorly)
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5
Q

What divides the nasal cavity from the anterior cranial fossa?

A

Cribiform plate of ethmoid bone

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6
Q

Where is the crista galli of the ethmoid located?

A

medially and superiorly.

Superior to the nasal septum

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7
Q

Which conchae are part of the ethmoid bone?

A

Superior and middle

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8
Q

Where are the conchae located?

A

In the lateral wall of the nasal cavity

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9
Q

Function of conchae?

A

They create turbulence of the nasal cavity which ultimately creates better gas exchange

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10
Q

Where are the meatuses in relation to the conchae?

A

The space under each concha where the paranasal sinuses drain into

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11
Q

What are paranasal sinuses?

A

Extensions of the nasal cavities which aim to make the skull lighter

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12
Q

Name the 4 paranasal sinuses

A

Frontal sinus (2)
Maxillary sinus - antra (2)
Ethmoidal air cells (2)
Sphenoid sinus (2)

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13
Q

Where do frontal sinuses drain to?

A

Middle meatus

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14
Q

Where do maxillary sinuses drain to?

A

Middle meatus

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15
Q

Where do ethmoidal air cells drain to?

A

Anterior and middle drain into middle meatus

Posterior drains into superior meatus

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16
Q

Where do sphenoid sinuses drain to?

A

Sphenoethmoidal recess

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17
Q

What drains into the inferior meatus?

A

Nasolacrimal duct

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18
Q

3 types of mucosa in the nasal cavities

A

Keratinised stratified squamous epithelium
Respiratory epithelium
Olfactory mucosa

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19
Q

Keratinised stratified squamous epithelium in the nasal cavities

A

Located at the entrance of the nostril

The verbose hairs here start to filter foreign objects out of the air that you are breathing in

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20
Q

Respiratory epithelium in nasal cavities

A 
This makes up the majority of the nasal cavity mucosa 
Columnar, glandular 
Warms the air 
Humidifies the air 
Secretes mucous 
Traps foreign bodies
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21
Q

Special sensory nerve supply to the nasal cavities (e.g. for smell)?

A

CN I (olfactory)

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22
Q

Where does CN 1 leave the brain?

A

Cribriform plate of ethmoid bone

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23
Q

Somatic nerve supply to the nasal cavities (e.g. for ho, cold, touch, pain)?

A

CNV1 (ophthalmic division) supplies anterosuperiorly

CNV2 (maxillary division) supplies posteroinferiorly

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24
Q

Which arteries does blood supply to the nasal cavities originate from?

A

External and internal carotid arteries

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25
Q

Branching of internal carotid artery which supplies the nasal cavities

A

Internal carotid artery ->
Ophthalmic artery ->
Anterior and Posterior ethmoidal artery -> supplies the medial and lateral walls of the nasal cavity

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26
Q

Branching of external carotid artery which supplies the nasal cavities

A

External carotid artery -> facial artery and maxillary artery

Facial artery -> lateral and septal branch

Maxillary artery -> sphenopalatine artery (lateral and medial walls), greater palatine (medial wall only)

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27
Q

What is Kiesselbach’s area

A

The anastamotic site of the nasal arteries in the nasal septum.
It is the most common site of epistaxis (nosebleed)

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28
Q

NG tube is passed through the SUPERIOR/INFERIOR aspect of the nasal cavity

A

Inferior

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29
Q

How do you ensure an NG tube has been correctly inserted into a patient?

A

X-ray

- NG tube should remain in the midline down to the level of the diaphragm and the tip should be seen in the diaphragm

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30
Q

Temporal bone 2 parts

A

Squamous (flat)

Petrous (stony/rocky)

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31
Q

What is the pterion

A

H shaped structure connecting 4 bones of the skull

It is the thinnest part of the skull

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32
Q

Which 4 bones does the pterion connect?

A

Temporal
Frontal
Parietal
Sphenoid

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33
Q

Which CN exit at the anterior cranial fossa ?

A

CN I

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34
Q

Which CN exit at the middle cranial fossa ?

A

CN II, CN III, CN IV, CNV1,V2,V3, CN VI

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35
Q

Which CN exit at the posterior cranial fossa ?

A

CN VII, CN VIII, CN IX, CN X, CN XI, CN XII

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36
Q

External ear

A

Collects sound and processes sound waves to the tympanic membrane

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37
Q

What are the 2 sections of the external ear

A

Auricle

External acoustic meatus

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38
Q

External ear: Auricle - function

A

Captures and transmits sound to the external acoustic meatus

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39
Q

External ear: Auricle - structure

A

Helix - outer curvature of ear
Tragus
Lobe - ear piercing site

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40
Q

External ear: Auricle - innervation

A

Mainly C2, C3 spinal nerve

CN VII - just posterior to tragus

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41
Q

External ear: EAM - function

A

Tube which extends to the tympanic membrane

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42
Q

External ear: EAM - innervation

A

CN V3 - superior part of EAM

CN X - inferior part of EAM

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43
Q

External ear: EAM - shape (adult vs children)

A

Adult: Curved
Child: short and straight

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44
Q

Middle ear - function

A

Amplifies and conducts sound waves (by transmitting vibrations) to the inner ear

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45
Q

Middle ear - which type of mucosa is present

A

Change from squamous epithelium -> columnar glandular mucosa

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46
Q

Middle ear: tympanic membrane

A

The connection between the external and middle ear

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47
Q

Middle ear: tympanic membrane - innervation

A

External surface:
CN V3 - most of tympanic membrane
CN X - inferior part of tympanic membrane

Internal surface
CN IX

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48
Q

Middle ear: tympanic membrane - umbo

A

ost inwardly depressed part of tympanic membrane

Created from handle of malleus

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49
Q

Middle ear: tympanic membrane - what is the thick part called?

A

Pars tensa

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50
Q

Middle ear: tympanic membrane - what is the thin part called?

A

Pars flaccida

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51
Q

Middle ear: tympanic cavity

A

Medial to tympanic membrane

Contains most of the bones of the middle ear

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52
Q

Middle ear: epitympanic recess

A

Superior to tympanic membrane

Near mastoid air cells

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53
Q

Middle ear: What are the bones of the middle ear called?

A

Auditory ossicles

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54
Q

Middle ear: name the 3 bones which link the tympanic membrane to the oval window

A

Malleus
Incus
Stapes (looks like a horses stirrup)

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55
Q

What is the smallest bone in the human body

A

Stapes

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56
Q

Middle ear: how do the auditory ossicles articulate with each other?

A

Synovial joints

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57
Q

Middle ear: aditus

A

The doorway from the epitympanic recess -> mastoid antrum

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58
Q

Where are mastoid air cells located

A

Posterior to epitympanic recess

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59
Q

Internal ear: location

A

From the oval window to the internal acoustic meatus (IAM)

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60
Q

Internal ear: function

A

Maintain balance

Convert mechanical signals from middle ear into electrical signals which transfer info to the auditory pathway of the brain

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61
Q

Internal ear: innervation

A

CN VIII (vestibulocochlear nerve)
2 parts
- vestibular nerve (balance)
- cochlear nerve (hearing)

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62
Q

Internal ear: bony labyrinth

A 
A series of bony cavities 
Composed of:
- cochela
- vestibule 
- 3 semicircular canals 
All of these structures contain perilymph fluid
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63
Q

Internal ear: bony labyrinth - vestibule

A

In the middle of the bony labyrinth. Communicates with cochlea (anteriorly) and semicircular canals (posteriorly)

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64
Q

Internal ear: bony labyrinth - cochlea

A

Looks like a snails shell
Contains cochlea duct (responsible for hearing)
If it is unrolled you can visualise the basilar membrane

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65
Q

Internal ear: semicircular canals

A

Anterior, lateral, posterior

Contains semicircular ducts (responsible for balance)

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66
Q

Internal ear: Membranous labyrinth

A

Continuous system of sacs and ducts which is suspended within the bony labyrinth.
Filled with endolymph
Surrounded by perilymph of bony labyrinth

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67
Q

At the apex of the cochlea (most internal turn) you hear high/low frequency sound

68
Q

At the bottom of the cochlea you hear high/low frequency sound

69
Q

Internal ear: Membranous labyrinth - Cochlear duct

A

Situated within the cochlea

It is the organ of hearing

70
Q

Where is the organ of corti located

A

Basilar membrane

71
Q

Internal ear: Membranous labyrinth - saccule

A

Membranous sac located in the vestibule

Receives the cochlear duct

72
Q

Internal ear: Membranous labyrinth - utricle

A

Membranous sac located in the vestibule

Receives the 3 semicircular ducts

73
Q

Internal ear: Membranous labyrinth - semicircular ducts

A

Located within semicircular canals

Processes balance

74
Q

Summary of sound transmission in the ear

A
  1. Sound waves travel along EAM and make the tympanic membrane vibrate
  2. Vibrations are transmitted through ossicles to the oval window
  3. Vibration of oval window creates pressure waves in perilymph
  4. Hair cells in cochlea are moved, neurotransmitter is released, AP’s are stimulated and conveyed to the brain via cochlear nerve
75
Q

What is the eustachian tube

A

Connects the tympanic cavity (middle ear) to the lateral wall of the nasopharynx.

76
Q

Eustachian tube common nerve supply

77
Q

Eustachian tube - function

A

Conroe’s the pressure within the middle ear, making it equal with the air pressure outside the body

78
Q

Which 2 muscles open and raise the eustachian tube?

A

Tensor Veli Palatine

Levator Palatine

79
Q

Where does CN VIII connect with the brainstem?

A

Junction between pons and medulla

80
Q

Functions of CN VIII

A

Hearing and balance

81
Q

Where does CN VII connect with the brainstem?

A

Junction between pons and medulla

82
Q

What does CN VII supply

A

Muscles of facial expression
Special sensory to taste buds
Parasympathetic innervation to sublingual and submandibular glands
Parasympathetic to lacrimal gland

83
Q

Chorda tympani

A

Branch of CN VII
Passes over tympanic membrane
Carries special sensory fibres to anterior 2/3rds of tongue (taste buds)
Carries parasympathetic motor supply to submandibular and sublingual salivary glands

84
Q

Which nerve does chords tympani ‘hitch a ride’ on ?

85
Q

Muscles of facial expression - frontalis action

A

Wrinkling forehead

Raising eyebrows

86
Q

Muscles of facial expression - orbicularis oculi action

A

Screwing eyes shut

87
Q

Muscles of facial expression - orbicularis iris action

A

Prevents drooling

88
Q

Which structures are located in the pre-tracheal fascia? (5)

A 
Larynx and trachea 
Pharynx and oesophagus 
Strap muscles 
Thyroid gland 
Recurrent laryngeal nervs
89
Q

Larynx location (vertebral levels)

90
Q

Where is the hyoid bone located (vertebral level)

91
Q

What vertebral level is cricoid cartilage located?

92
Q

How is aspiration prevented when eating food?

A

Pharynx lifts the larynx up and raises it towards the mandible.
Epiglottis covers larynx to prevent food from entering lung

93
Q

What is the body’s response if something IS aspirated?

A

Cough reflex

- vocal cords produce a strong jet of air to move the foreign object

94
Q

Epiglottis - which type of cartilage is it?

A

Elastic (as it moves)

95
Q

Epiglottis - function

A

flaps over and covers the larynx when food is being swallowed to prevent aspiration

96
Q

Thyroid cartilage features

A

Superior horn

Inferior horn - articulates with cricothyroid joint

97
Q

Cricoid cartilage

A

The only real component of the cartilage that is a full ring
(thin anteriorly, thick posteriorly)

98
Q

Arytenoid cartilage - location

99
Q

Arytenoid cartilage - function

A

Important for movement of vocal cords

100
Q

Cricothyroid joint

A

Articulation of inferior horn of thyroid cartilage with posterior aspect of cricoid cartilage

101
Q

Cricothyroid joint - function

A

Allows the thyroid to move forwards and backwards which changes the dynamics of the vocal cords

102
Q

When does a vocal ligament become a vocal cord?

A

When mucosa is aded :

Ligament + Mucosa = cord

103
Q

True vocal cords

A

Lower folds of tissue in the larynx
Movement of true vocal cords impacts sound
The space between the true VCs is the rima glottidis

104
Q

False vocal cords (vestibular fold)

A

Folds of tissue found above true vocal cords in the larynx

Located superolaterally to the true vocal cords

105
Q

Intrinsic muscles of larynx - location

A

Between cartilages

106
Q

Intrinsic muscles of larynx - function

A

Cause movement of vocal cords

107
Q

Intrinsic muscles of larynx - cricothyroid muscle

A

Tensor - tenses vocal ligament

Stretches (lengthens) the VC to produce a higher pitch (high voice)

108
Q

Intrinsic muscles of larynx - cricothyroid muscle (attachments)

A

Anterolateral cricoid cartilage -> inferior horn of thyroid cartilage

109
Q

Intrinsic muscles of larynx - thyroarytenoid muscle (vocalis muscle)

A

Relaxor - relaxes vocal ligament
Brings the VC together to produce a lower pitch (low voice)
Placed just next to true vocal cords

110
Q

Intrinsic muscles of larynx -thyroarytenoid muscle (attachments)

A

Posterior thyroid cartilage -> anterior arytenoid cartilage

111
Q

Intrinsic muscles of larynx - lateral circo-arytenoid muscle

A

Adductors - brings vocal ligaments together which narrows rim glottidis and means less air will be able to cross
This makes the voice quieter

112
Q

Intrinsic muscles of larynx - lateral circo-arytenoid muscles (attachments)

A

Muscular process of arytenoid -> anterior cricoid cartilage

113
Q

Intrinsic muscles of larynx - arytenoid muscles

A

Adductors - brings the vocal ligaments closer together

which narrows rima glottidis and makes the voice quieter

114
Q

Intrinsic muscles of larynx - arytenoid muscles (attachments)

A

One arytenoid cartilage to another cricoid cartilage

looks like a scottish flag

115
Q

Intrinsic muscles of the larynx - posterior crico-arytenoid muscles

A

Abductors - spreads VCs further apart which widens rima glottidis
Makes voice louder

116
Q

Intrinsic muscles of larynx - posterior crico-arytenoid muscles (attachments)

A

Posterior cricoid cartilage -> muscular process of arytenoid cartilage

117
Q

______ is a relaxor and makes the voice HIGHER/LOWER pitch

A

Thyroarytenoid

Lower

118
Q

______ is a tensor and makes the voice HIGER/LOWER pitch

A

Cricothyroid muscle

Higher

119
Q

______ and ______ are adductors and make the voice LOUDER/QUIETER

A

Lateral crico-arytenoid muscle
Arytenoid muscle
Quieter

120
Q

______ is an abductor and makes the voice LOUDER/QUIETER

A

Posterior crico-arytenoid muscle

Louder

121
Q

At the level of the circathyroid joint, the left recurrent laryngeal nerve becomes the ______ nerve

A

Inferior laryngeal nerve

122
Q

______ nerve supplies all of the muscles of the larynx apart from the cricothyroid muscle

A

Inferior laryngeal nerve

123
Q

The cricothyroid muscle is supplied by ______ nerve

A

External laryngeal nerve

124
Q

Which nerve supplies sensory innervation to the mucosa above the vocal folds?

A

Internal laryngeal nerve

125
Q

Which nerve supplies sensory innervation to the mucosa below the vocal folds

A

Inferior laryngeal nerve

126
Q

How does the voice make sound

A

When subglotal pressure threshold is reached then air crosses the VC’s causing a vibration (from inferior -> superior).
This produces a sound in the larynx

127
Q

Production of oral sounds

A

Tense soft palate (CN V3) and elevate soft palate (CN X). This closes off the entrance into the nasopharynx and allows a direct stream of air through the oral cavity

128
Q

Production of nasal sounds

A

Tense soft palate (CNV3) and descend soft palate (CNX) to close off the entrance into the oropharynx and allow a stream of air directed through nasal cavities
Produces “m”, “n” and “ing” sounds

129
Q

The soft palate is anterior/posterior to the hard palate ?

130
Q

Name 3 muscles of the floor of the mouth

A

Mylohyoid
Geniohyoid
Anterior belly of digastric

131
Q

What is the frenelum of the tongue ?

A

Thin dangly part seen when you put the tongue towards the roof of the mouth

132
Q

3 major salivary glands and their nerve supply

A

Parotid gland - CN IX
Submandibular gland - CN VII
Sublingual gland - CN VII

133
Q

Parotid gland location

A

Superficial to masseter muscle
Parotid duct crosses the masseter and pierces medially through the buccinator and then opens on the buccal mucosa at upper 2nd molar

134
Q

Parotid gland is palpable - true or false?

135
Q

Submandibular gland location

A

Duct is deep to the mucosa of the floor of the mouth and opens on the sublingual papillae

136
Q

Submandibular gland is palpable - true or false?

137
Q

Sublingual gland location

A

Deep to the mucosa of the floor of the mouth

138
Q

Sublingual gland is palpable - true or false?

139
Q

Anterior 2/3rds of tongue innervation

A

General sensory - CN V3

Special sensory - CN VII

140
Q

Posterior 1/3rd of tongue innervation

A

General and sensory supply - CN IX

141
Q

What is the foramen caecum (in the tongue)

A

Division between the anterior and posterior portions of the tongue

142
Q

Name 4 papillae

A

Filliform
Fungiform
Vallate
Folate

143
Q

Which papillae doesn’t have taste buds

144
Q

Name the 4 skeletal extrinsic tongue muscles and their nerve supply

A

Palatoglossus - CN X
Styloglossus - CN XII
Hyoglossus - CN XII
Genioglossus - CN XII

145
Q

Hypoglossal nerve - route

A

Passes through the hypoglossal canal in the posterior cranial fossa.
Descends in the neck lateral to the carotid sheath.
Passes towards the lateral aspect of the tongue and supplies most tongue muscles

146
Q

CN XII clinical testing

A

Ask patient to stick tongue out

If both CN XII are functioning properly, tip of tongue remains in midline position

147
Q

CN XII - unilateral CN XII damage findings

A

Tongue will point towards the side of the injured nerve

- if right CN XII deficit then tongue will point to the right

148
Q

Blood supply of the tongue

A

Lingual artery (branch of external carotid artery)

149
Q

Where is the palatine tonsil located?

A

In the space between the arches of the soft palate

150
Q

Which bones are located in the hard palate

A

Palatine bones

151
Q

Soft palate - function

A

Stops food entering nose when swallowing

152
Q

5 pairs of muscles of soft palate

A 
Levator veli palatine
Tensor veli palatine 
Palatoglossus 
Palatopharyngeus 
Musculus uvulae
153
Q

Soft palate muscles: Levator veli palatine (function, nerve supply)

A

Lifts soft palate towards base of skull

CN X

154
Q

Soft palate muscles: Tensor veli palatine (function, nerve supply)

A

Tenses the soft palate

CN V3

155
Q

Soft palate muscles: palatoglossus (function, nerve supply)

A

Forms the first arch of the soft palate

CN X

156
Q

Soft palate muscles: palatopharyngeus (function, nerve supply)

A

Pulls the soft palate down

CN X

157
Q

Soft palate muscles: musculus uvulae

A

Uvulae, dangles down from the back

158
Q

CN V3 and CN X soft palate clinical testing

A

Get patient to say “ahhhh” and open mouth wide

If the nerves are functioning normally then the uvula should lift straight up in the midline

159
Q

CN V3 and CN X soft palate clinical testing - unilateral nerve pathology

A

The uvulae will be pulled AWAY from the non-functioning side (towards the opposite side of damage)
eg: if there is damage to the right CN X or CN V3 then the uvula will be pulled towards the left side

160
Q

Constrictor muscles of the pharynx are innervated by which CN ?

161
Q

Longitudinal muscles of the pharynx (3)

A

Stylopharyngeus
Salpingeopharyngeus
Palatopharyngeus

162
Q

Innervation of the longitudinal muscles of the pharynx

A

Stylopharyngeus - CN IX
Salpingeopharyngeus - CN X
Palatopharyngeus - CN X

163
Q

What is waldeyer’s ring of lymphoid tissue?

A

Defence ring around the larynx/pharynx which prevents infection from getting into GI or resp tract

164
Q

3 main tonsils involved in waldeyer’s ring of lymphoid tissue

A

Palatine tonsil
Lingual tonsil - in mucosa of posterior 1/3rd of tongue
Pharyngeal tonsil “adenoid” - in the mucosa of the roof of the nasopharynx

165
Q

Regional lymph nodes

A

They first receive the lymph that has drained from a given structure

166
Q

What is the only part of the oral cavity that drains to submental lymph nodes first

A

tip of the tongue

167
Q

Which lymph node drains the palatine tonsil

A

jugulo-digastric node

ENT SOH (9 decks)

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