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Anatomy Flashcards

1
Q

what are the choanae

A

posterior nasal apertures. Closed off during swallowing by the soft palate meeting the superior constrictor muscle.

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2
Q

What are the 3 parts of the septum

A
  1. Perpendicular plate/extension of the ethmoid bone (where falx cerebri runs forward).
  2. Septum cartilage
  3. Vomer bone
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3
Q

Role of the conchae

A

Increase S.A. of nasal cavity so more efficient at heating and humidifying the air as it passes to the lungs.

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4
Q

What are the conchae made from

A

superior and middle part of ethmoid bone

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5
Q

What does the superior meatus drain

A

posterior ethmoidal sinus/cells

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6
Q

What does the middle meatus drain

A

Via the infundibulum = Frontal sinus.

Via the hiatus semilunaris = Anterior ethmoidal sinus/cells and maxillary sinuses.

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7
Q

What does the inferior meatus drain

A

nasolacrimal duct

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8
Q

Respiratory epithelium

A

Pseudostratified columnar ciliated epithelium + goblet cells

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9
Q

How does the mucoperiosteum act to warm air in the nasal cavity

A

Very rich in blood vessels which swell when increased blood flow and reduce the volume of nasal cavity so make it warmer.

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10
Q

Blood supply of nasal cavity

A

Ophthalmic artery = upper and front parts of midline septum.
Facial artery = upper hard palate and lower parts of the septum.
Maxillary artery = posterior septum and lateral wall.

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11
Q

Role of sinuses

A

Lighten skull weight and add resilience to the skull

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12
Q

Maxillary sinus

A

V thin bone b/w it and upper molars - careful when extracting to avoid fistulas.
High ostium so mucous accumulates before it can be cleared.

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13
Q

Frontal sinus

A

Drains above maxillary sinus in middle meatus = cross infection

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14
Q

Sphenoidal sinus

A

Drains into the sphenoethmoidal recess above the superior conchae.

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15
Q

Innervation of the nasal cavity

A

Infraorbital nerve = skin of the nose, lower eyelid, cheek, top lip.
Post-ganglionic fibers = glands, air sinuses, gingivae

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16
Q

Endothelial structure of the lymph ducts

A

Overlapping endothelial cells allow fluids to move in but not flow out.

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17
Q

What does the right lymphatic duct drain

A

The right side of the body, above the waist only.

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18
Q

What does the thoracic duct drain

A

All of the body apart from right side above the waist.

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19
Q

Where does the thoracic duct empty

A

Venous blood supply, between the left subclavian and jugular veins.

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20
Q

Superficial lymphatic vessels are found above which muscle

A

Sternocleidomastoid, and along external jugular.

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21
Q

Lymph nodes that drain into the deep cervical nodes

A

Pre-auricular, submental and submandibular node.

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22
Q

Lymph nodes that drain to the superficial nodes

A

Post-auricular and occipital node.

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23
Q

Face lymphatic nodes and areas they drain

A

Pre-auricular (drains eyelids, cheeks, and part of scalp)
Post-auricular (drains posterolateral scalp)
Submental (drains chin, tip of tongue, bottom lip, floor of mouth, incisors)
Submandibular (face, gingivae, teeth and tongue)
Occipital (posterior scalp and neck)

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24
Q

Which lymphatic nodes drain the scalp

A

Post-auricular, pre-auricular and occipital

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25
Q

Which lymphatic nodes drain the teeth

A

Submandibular (apart from incisors which are drained by the submental)

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26
Q

What is the midline raphe (tongue) and why is it important

A

Impervious lymph border at anterior 2/3 of tongue. Means cancer can’t spread from one side of tongue to the other through the lymph vessels. Deficient at tip and posterior 1/3 of tongue.

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27
Q

Which lymph node drains anterior 2/3 of tongue

A 
Directly = deep cervical nodes
Indirectly = submental and submandibular nodes
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28
Q

Which lymph nodes drain posterior 1/3 of tongue

A

the Jugulodigastric node of the deep cervical chain

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29
Q

Which lymph node drains tip of the tongue

A

Submental node then to jugulo-omohyoid node

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30
Q

Bones that make up the roof of the orbit

A

Frontal bone

Lesser wing of the sphenoid bone

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31
Q

Bones that make up the medial wall of the orbit

A

Lacrimal bone
Ethmoid bone
Maxilla bone
Body of the sphenoid bone

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32
Q

Bones that make up the lateral wall of the orbit

A

Zygomatic bone

Greater wing of the sphenoid bone

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33
Q

Bones that make up the floor of the orbit

A

Maxilla bone
Palatine bone
Zygomatic bone

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34
Q

Openings into the orbit

A

Superior orbital fissure
Optic canal
Inferior orbital fissure

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35
Q

What structures are in the superior orbital fissure

A

CN 3,4,5 (V1)

Superior ophthalmic vein

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36
Q

What structures are in the optic canal

A 
CN 2 (Optic nerve)
Ophthalmic artery
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37
Q

What structures are in the inferior orbital fissure

A 
CN 5 (V2)
Inferior ophthalmic vein
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38
Q

Where do all 4 rectus muscles originate from

A

Annulus of Zinn

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39
Q

What’s a blow-out fracture of the eye and how does it happen

A

When the force on globe > strength of bones so the globe breaks/bursts through the bony orbit.

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40
Q

What is proptosis

A

Forward displacement of the globe caused by any bleeding or growth in the orbit. Can cause compression of vessels and nerves here.

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41
Q

What is the role of the tarsal plate

A

Next to the globe, connective tissue which gives strength and structure.

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42
Q

Which muscles open the upper eyelid

A

Levator and Muller muscles

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43
Q

Which muscles close the upper eyelid

A

Orbicularis oculi

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44
Q

Which muscles open the lower eyelid

A

Lower Muller muscle

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45
Q

Which muscles close the lower eyelid

A

Orbicularis oculi

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46
Q

What glands are found in the orbit/globe

A

Meibomian glands - Sebaceous/secretes oil to stop tears evaporating and to lubricate.

Glands of Zeis - secrete oil onto lashes

Gland of Moll - Apocrine/sweat gland onto the skin.

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47
Q

What is the conjunctiva and its functions

A

Thin translucent mucous membrane over the globe.

Functions =

  1. Lubrication (goblets cells secrete mucous)
  2. Physical barrier - immunological defence.
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48
Q

Globe nerve innervations and their functions

A

CN II - sight, accomodation and pupil reflex
CN III - 4 extra-ocular muscles, upper levator muscle, iris muscles.
CN IV - superior oblique muscle
CN VI - lateral rectus muscle
CN VII - orbicularis oculi muscles, blink reflex

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49
Q

Action and innervation of the superior rectus muscle

A

CN III

Elevates

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50
Q

Action and innervation of the medial rectus muscle

A

CN III

Rotates globe medially

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51
Q

Action and innervation of the lateral rectus muscle

A

CN VI

Rotates globe laterally

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52
Q

Action and innervation of the inferior rectus muscle

A

CN III

Depresses

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53
Q

Action and innervation of superior oblique muscle

A

CN IV

Depresses and rotates the eye laterally

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54
Q

Action and innervation of inferior oblique muscle

A

CN III

Elevates and rotates the eye laterally

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55
Q

Movement of the arytenoids and how this affects phonation

A

Rotate around verticle axis: Inwards (adduction) and outwards (abduction).

Sliding: Medially (adduction) and laterally (abduction)

Tilting: Backwards (increase tension) and forwards (increase thickness, decrease tension).

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56
Q

Role of the conus elastus

A

Muscle covering the vocal folds and constrict the larynx vertically from the vocal folds to the cricoid.

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57
Q

Adduction definition

A

Closing

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58
Q

Abduction definition

A

Opening

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59
Q

Vocal folds open/close cycle

A
  1. –>F F, vocal folds open
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60
Q

What about the vocal folds affects pitch

A

Length
Tension
Thickness

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61
Q

How can the pitch of a voice be altered

A

Tilting arytenoids backward or forwards

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62
Q

What happens to overused vocal folds

A

Hemorrhaging or nodules/growths on them = lower quality of sound.

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63
Q

Laryngeal muscles

A 
Transverse and oblique interarytenoids
Posterior cricoarytenoids
Lateral cricoarytenoids
Thyroarytenoids
Cricothyroids
Vocalis
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64
Q

Action of lateral cricoarytenoids

A

Forcefully adduct the arytenoids e.g. during speech

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65
Q

Action of the cricothyroid muscles

A

Act on the cricothyroid synovial joint to make the initial movements. Move cricoid up, tipping arytenoids backward and increasing tension in vocal folds.

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66
Q

Action of the vocalis muscles

A

Make fine adjustments. Pad out the vocal folds and move arytenoids forward, decreasing tension in vocal folds.

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67
Q

What nerves innervate the larynx

A

Recurrent laryngeal nerve and superior laryngeal nerve (branches off vagus nerve)

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68
Q

What does the superior laryngeal nerve supply

A

Motor to cricothyroid muscles

Sensory to mucosa above vocal folds

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69
Q

What happens if the superior laryngeal nerve is damaged

A

No cough reflex and hard to regulate pitch of voice.

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70
Q

What does the recurrent laryngeal nerve supply

A

Motor to all laryngeal musles apart from cricothyroid muscles (bilateral to interarytenoids)

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71
Q

What happens if the recurrent laryngeal nerve gets damaged

A

Harsh raspy voice bc vocal folds are tensed (due to cricothyroid muscles) and adducted (weak action from interarytenoids due to bilateral innervation)

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72
Q

Muscular tissue of pharynx

A

3 constrictor muscles (attached to the stylohyoid ligament) and 2 longitudinal muscles (palatopharyngeal and stylopharyngeal). Create a pressure wave to push food down into the stomach.

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73
Q

What are the 4 layers of tissue making up the pharyngeal wall

A
  1. Areolar CT (buccopharyngeal fascia containing nerve and venous plexus).
  2. Muscular tissue.
  3. Fibrous tissue (attaches pharynx to the base of the skull and medial pterygoid plates).
  4. Mucosa (respiratory = upper, remainder = SSE).
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74
Q

During swallowing, how does the mouth get closed off

A

Tongue moves up and meet hard palate

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75
Q

During swallowing, how does the nasal cavity get closed off

A
  1. Superior constrictor muscle moves down to meet the soft palate
  2. LVP and TVP move the soft palate up
  3. Uvula moves up
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76
Q

During swallowing, how does the laryngeal opening get closed off

A
  1. Hyoid bone and thyroid cartilage move up and forward (due to the action of geniohyoid and constrictor muscles) so epiglottis flops down and covers the opening.
  2. Arytenoid cartilages move forwards and medially (due to the action of the laryngeal muscles) to close of the glottis using the vocal folds.
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77
Q

CN I (5 points)

A
  1. Olfactory nerve
  2. Foramen = Cribriform plate of the ethmoid bone
  3. Enters = Nasal cavity
  4. Sensory
  5. Olfactory epithelium, allows for the sense of smell
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78
Q

CN II

A
  1. Optic nerve
  2. Foramen = optic foramen / canal
  3. Enters = orbit
  4. Sensory
  5. Retina (vision) and a part of the accommodation and pupil reflexes.
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79
Q

CN III

A
  1. Oculomotor
  2. Foramen = Superior orbital fissure
  3. Enters = Orbit
  4. Motor
  5. Target = eye and eyelid muscles internal and external.
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80
Q

CN IV

A
  1. Trochlear
  2. Foramen = Superior orbital fissure
  3. Enters = orbit
  4. Motor
  5. Target = superior oblique muscle of the eye
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81
Q

CN V1

A
  1. Opthlamic branch of trigeminal
  2. Foramen = Superior orbital fissure
  3. Region entered = orbit
  4. Sensory
  5. Skin and mucosa at and above orbit
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82
Q

CN V2

A
  1. Maxillary branch of Trigeminal
  2. Foramen = Foramen rotundum
  3. Target = Pterygopalatine fossa
  4. Sensory
  5. Skin and mucosa from orbit to mouth e.g. palate, nasal cavity.
83
Q

CN V3

A
  1. Mandibular division of Trigeminal
  2. Foramen = Foramen ovale
  3. Enters = Infratemporal fossa
  4. Mixed
  5. Targets = M to M of M and mylohyoid and other head/neck muscles. S to skin and mucosa from mouth to chin and anterior 2/3 of tongue.
84
Q

CN VI

A
  1. Abducens
  2. Foramen = Superior orbital fissure
  3. Enters = orbit
  4. Motor
  5. Target = lateral rectus muscle
85
Q

CN VII

A
  1. Facial
  2. Foramen = Internal acoustic meatus. Exits at stylomastoid foramen.
  3. Enters = Temporal bone
  4. Mixed
  5. M = muscles of facial expression and head/neck muscles. S = taste to anterior 2/3 of tongue
86
Q

CN VIII

A
  1. Vestibulocochlear
  2. Foramen = internal acoustic meatus
  3. Enters = Temporal bone
  4. Sensory
  5. Targets = balance and hearing
87
Q

CN IX

A
  1. Glossopharyngeal
  2. Foramen = Jugular foramen
  3. Enters = Middle ear/infratemporal fossa
  4. Mixed
  5. Targets = M to stylopharyngeus muscle and parotid gland. S to the pharynx, middle ear, auditory tube and taste to posterior 1/3 of the tongue
88
Q

CN X

A
  1. Vagus nerve
  2. Foramen = Jugular foramen
  3. Mixed
  4. M to pharynx, larynx, soft palate and thorax. S to larnx.
89
Q

CN XI

A
  1. Accessory nerve
  2. Foramen = jugular foramen / formamen magnum
  3. Enters = neck
  4. Motor
  5. Targets = sternocleidomastoid and trapezius muscles
90
Q

CN XII

A
  1. Hypoglossal nerve
  2. Foramen = Hypoglossal canal
  3. Enters = neck
  4. Motor
  5. All tongue muscles apart from palatoglossus (CN X)
91
Q

Damage to CN III (and test)

A

Diplopia, lateral squint and dilated pupils.

Test = see if the patient can follow pen across all visual fields.

92
Q

Damage to CN II

A

Damage to optic tract = complex visual loss
Damage at optic chiasm = loss of temporal fields
Damage to optic nerve = blindness in that eye

93
Q

Damage to CN VII

A

If after middle ear, taste and lacrimation are intact but facial expression lost on that side.

94
Q

What does the facial nerve supply + what are the branches

A

Branches = Temporal, Zygomatic, Buccal, Mandibular, Cervical.
Muscles = Zygomaticus, Buccinator, Frontalis, Orbicularis Oculi and Oris, Lip depressors and elevators.
Secretomotor nerves to Lacrimal, Submandibular and Sublingual glands.
Taste to anterior 2/3 of tongue (Chorda Tympani)

95
Q

Damage to CN VIII (and test)

A

Damage to cochlear or nerve = sensorineural hearing loss.
Test = high f tuning fork near the ear and if still not heard, on mastoid process. If only heard on mastoid process = conductive hearing loss only.

96
Q

What does CN IX supply

A 
M = stylopharyngeus and to the parotid gland
S = mucosa of the pharynx, posterior 1/3 of the tongue, middle ear and auditory tube.
97
Q

Damage to CN IX

A

No gag reflex

98
Q

What does CN X supply

A 
M = muscles of the pharynx (constrictor muscles and palatopharyngeus), larynx (and soft palate
S = mucosa of the larynx
99
Q

Damage to CN X (and test)

A

Damage to muscles of the palate (dysarthria/speaking problems), pharynx (dysphagia/problems swallowing) and larynx (dysphonia/problems making sounds).
Test = see if the patient can cough strongly and soft palate raises symmetrically when speaking.

100
Q

Testing CN XII

A

See if the patient can stick out tongue without it deviating to one side.

101
Q

3 things unique about the TMJ

A
  1. The R and L synovial joints are connecting by bone so move together.
  2. Articular surfaces of the joint are covered in fibrocartilage.
  3. Articular disc separates the cavity into 2.
102
Q

The ligaments found around the TMJ

A

Tempromandibular/ lateral ligament
Sphenomandibular ligament
Stylomandibular ligament

103
Q

Borders of the posterior triangle (neck)

A

Clavicle, posterior border of sternocleidomastoid and anterior border of trapezius

104
Q

Where does the external jugular vein drain blood from

A

Outside of skull, deep parts of face

105
Q

What can make the external jugular vein stand out

A

Valsalva’s maneuver (forced exhalation against resistance) and increased vena cava/central venous pressure e.g. due to right-sided heart failure.

106
Q

The infrahyoid muscles

A

Thyrohyoid
Omohyoid (inferior and superior bellies)
Sternothyroid
Sternohyoid

107
Q

Innervation of the infrahyoid muscles

A

Ansa Cervicalis from Cervical spinal nerves 1-3

108
Q

Function of the infrahyoids

A

Depress the larynx and hyoid bone after swallowing

109
Q

What does the carotid sheath contain

A

internal jugular vein
Common Carotid artery
Vagus nerve

110
Q

What does the superior thyroid artery supply and what does it branch off

A

Branches off the eternal carotid and supplies the superior anterior aspect of the thyorid

111
Q

What does the inferior thyroid artery supply and what does it branch off

A

Branches off the thyrocervical artery (from the subclavian) and supplies the inferior posterior aspect.

112
Q

Why are tumours in the thyroid area v dangerous

A

Because they can compress the oesophagus or trachea

113
Q

Borders of the anterior triangle (neck)

A

Anterior side of sternocleidomastoid, mandible and midline of neck.

114
Q

What does the ansa cervicalis supply and which nerves does it branch off

A

Supplies the infrahyoid muscles and geniohyoid.

Branches of the cervical spinal nerves 1-3 (part of the cervical plexus)

115
Q

Main branches of CN V1

A

Frontal branch
Lacrimal branch
Nasociliary branch

116
Q

Main branches of the cervical plexus and which nerves is it made up of

A

Made from Cervical spinal nerves 1-4
Main motor branches = ansa cervicalis and phrenic nerve (C3,4,5 keep the diaphragm alive)
Sensory branches = auricle nerve, transverse cervical nerves.

117
Q

How to do an emergency cricothyroid stab/tracheotomy

A

Incision between the thyroid and cricoid cartilages and insert a tube.

118
Q

What are the suprahyoid muscles

A

Mylohyoid muscle
Geniohyoid muscle
Stylohyoid muscle
Digastric muscle (anterior and posterior bellies)

119
Q

The action of the suprahyoid muscles

A

Elevate the hyoid bone during swallowing.

120
Q

Borders of the submandibular triangle

A

Anterior belly and posterior belly of digastric muscle and mandible.

121
Q

Anatomy of the submandibular gland and its duct

A

Deep part hooks around posterior margin of the mylohyoid muscle.
Secretions travel in Wharton’s duct

122
Q

Branches of the external carotid artery

A 
Some attendings like freaking out potential medical students.
SALFOPMS
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior Auricular
Maxillary
Superficial temporal
123
Q

Damage to the cervical sympathetic chain

A

Drooping of eyelid, no sweating/flush skin, constricted pupil = Horner’s syndrome

124
Q

What is the modiolus

A

Place at the corner of the mouth where 8 muscles meet.

125
Q

What are the branches of the facial nerve and which branches supply the muscles of facial expression.

A 
Temporal - frontal, orbicularis oculi
Zygomatic - orbicularis oculi
Buccal - buccinator, orbicularis oris, zygomaticus
Mandibular - mentalis
Cervical
126
Q

The action of Masseter/ the deep and superficial part features

A

Closes mouth by elevating jaw. Has many origins so can retract and protrude jaw too. Deep part is more muscular and more for closing (verticle fibres). Superficial is more tendonous (for opening). Diff angels so the max force can be exerted through the whole range of movements.

127
Q

Action of Temporalis

A

Closes jaw by elevating and retracting mandible. Weaker action than masseter.

128
Q

Action of the Lateral Pterygoid

A

Opens mouth by protruding jaw - moves articular disc and condyle forward

129
Q

Action of the Medial Pterygoid

A

Closes mouth by elevating jaw. Also protrudes jaw.

130
Q

Origin of the buccal nerve, its path and what it supplies

A

From V3
Pierces masseter but doesnt supply it and enters mouth
Sensory to lower buccal and gingival mucosa.
Motor to lower temporalis and pterygoid muscles.

131
Q

What does the mylohyoid nerve branch off and what does it supply?

A

Branch off V3, inferior alveolar nerve.

Supplies mylohyoid muscle and anterior belly of digastric muscle.

132
Q

Order of branching off V3

A 
Mandibular nerve
Buccal nerve (with branches to M of M)
Auriculotemporal nerve
Lingual nerve (with Chorda Tympani)
Inferior alveolar nerve (with mylohyoid, inferior dental and mental nerve branches)
133
Q

What does the inferior alveolar artery supply and what does it branch off.

A

Mandible, chin, lower teeth, mylohyoid muscle

134
Q

What nerves can be found at level of bifurcation of common carotid into external and internal

A

Hypoglossal and Glossopharyngeal

135
Q

What happens at the germinal centres of lymph nodes

A

Cells proliferate and mutate and differentiate

136
Q

What are the 4 types of tonsils and type of epithelium.

A 
Lingual tonsils (SSE)
Palatine tonsils (SSE)
Adenoids (Respiratory epithelium)
Tubal tonsils (respiratory epithelium)
137
Q

What does the internal carotid artery supply

A

Goes directly to the brain

138
Q

What vessel runs over the sternocleidomastoid muscle

A

External jugular vein

139
Q

What is the role of the thyroid Isthmus

A

Connects the 2 lobes of the thyroid

140
Q

What is the shape of the thyroid cartilage

A

A ring, incomplete posteriorly. Articulates w the cricoid cartilage anteriorly inferiorly.

141
Q

What is the shape of the cricoid cartilage

A

Complete ring, bigger and flatter posteriorly.

142
Q

Features of cervical vertebrae

A

Tranverse foramen
Bifid spinous process
Small body

143
Q

Masseter

A

Origin = Zygomatic arch and process
Insert = Ramus, angle of the mandible and lateral surface of the coronoid process.
Action = elevates mandible (has many origins so can also protrude and retract mandible).
CN V3.

144
Q

Temporalis

A

Origin = Temporal fossa
Insert = Coronoid process (down to retromolar fossa)
Action = Elevates and retracts mandible
CN V3.

145
Q

Lateral Pterygoid

A

Origin = Lateral surface of lateral pterygoid plate
Insert = Articular disc and neck of condyle
Action = Protrudes mandible so opens the mouth.
CN V3

146
Q

Medial Pterygoid

A

Origin = Medial surface of lateral pterygoid
Insert = Inner surface of angle of mandible
Action = Elevates mandible and protrudes.
CN V3

147
Q

Jaw movements

A

Biting/insicing = Protrude jaw so incisors meet
Mastication = Depress mandible via infra and suprahyoid muscles. Lateral and medial excursion to allow cuspal contact.
Speaking
Limits of movements when yawning.

148
Q

Lateral Excursion of mandible

A
  1. Lateral pterygoid on balancing side contracts to move mandible to working side.
  2. Temporalis on working side contracts so working side moves back slightly and balancing side moves medially.
149
Q

TMJ movements

A 
Some rotation around the axis of the condyle
Anterior movement (condylar guidance) onto the articular eminence.
150
Q

Role of the articular disc

A
  1. Joins lateral pterygoid to the lateral joint surface
  2. Pulled forward by lateral pterygoid when the condyle moves forward onto the articular eminence so packs the joint and stabilizes it.
151
Q

TMJ dislocation and how to fix it

A

When the condyle overshoots the articular eminence. Can only happen anteriorly (there’s bone medially and the lateral pterygoid muscle laterally).
Can be fixed by applying downwards and backward force onto the mandible (needs to be done quickly or using muscle relaxants to stop them spasming or locking the jaw in place).

152
Q

TMJ dysfunction

A

Mostly due to over-closing e.g. grinding teeth.

153
Q

Meningeal Arteries - origin, foramen, location, supply

A

Branch off the maxillary artery (from the external carotid)
Foramen spinosum
Located in the extradural space and they mostly supply the cranium bones.

154
Q

The Mater’s

A

Dura Mater
Arachnoid Mater
Pia Mater

155
Q

About the dura mater

A

One layer tightly bound to the cranium and one to the arachnoid mater.
Venous sinuses can be found here.
Creates the dural folds.

156
Q

About the arachnoid mater

A

Covers the pia mater. Has extensions which run into the pia mater through the subarachnoid space.

157
Q

About the pia mater

A

Thin layer, very tightly associated with the brain.

158
Q

Dural folds and their functions

A

Stabilise and support the brain.
Falx Cerebri = Between the cerebrum hemispheres
Falx Cerebelli = Between the cerebellum hemispheres
Tentorium Cerebelli = between the cerebrum and cerebellum hemisphere.

159
Q

Extradural space and consequences of a haemorrage here

A

A potential space above the Dura Mater containing the meningeal arteries.
As the dura mater is v tightly associated with the cranium, a hemorrhage here can’t spread so causes a localized coning and increase in intracranial pressure. This can force the brain down and put pressure on the brain stem = v dangerous.

160
Q

Subarachnoid space and consequeces of a haemorrage here

A

A real space, containing brain arteries, nerves and CSF (which reduces the brains apparant weight and cusions it).
Slower raise in intracranial pressure as the fluid can spread so less dangerous.

161
Q

Venous drainage of the cranium

A

Venous blood drains into venous sinuses which follow the path of the dural folds and eventually drain into the internal jugular vein.

162
Q

How do the venous sinuses connect to deep and superficial veins?

A

Via the orbit, pterygoid and pharyngeal venous plexuses and the emissary veins.

163
Q

What are emissary veins and what problems are associated with them?

A

Veins that exit the cranium into the nasal sinuses. Have no valves so blood and infections can travel up the brain too.

164
Q

Role of the Circle of Willis

A

Connects the internal carotid and vertobrobasilar systems.

Provides an alternative blood supply if there’s damage in one of the other vessels.

165
Q

What does the anterior cerebral artery supply and what happens if it gets damaged?

A

Supplies the medial part of the frontal lobe.

Damage = Loss of M and S function to opposite leg.

166
Q

What does the middle cerebral artery supply and what happens if it gets damaged?

A

Supplies the lateral part of the hemisphere (apart from occipital lobe)
Damage = Loss of M and S function to opposite arm and side of the face (and speech).

167
Q

What does the posterior cerebral artery supply and what happens if it gets damaged?

A

Supplied the medial and inferior part of the occipital and temporal lobe and visual cortex.
Damage = Blindness one 1 side of visual field.

168
Q

Different types of strokes

A

Ischemic and hemorrhagic stroke

169
Q

Ischemic stroke

A

A blocked brain artery. Brain function lost after the point of blockage.

170
Q

Hemorrhagic stroke

A

Trauma, aneurysm etc can cause a tear in a brain artery (blood is toxic to brain tissue). Short-term effects are normally worse than long-term effects and function can return as mass of blood clot decreases.

171
Q

Functions/benefits of CSF

A

Cushions and protects the brain.
Lightens the apparent weight of the brain.
Carries nutrients and hormones to the brain.
Takes metabolic waste products away from the brain.

172
Q

Embryology time frame

A

Pre embryonic stage = 0-2.5 weeks
Embryonic stage = 2.5-8 weeks
Fetal stage = 8 weeks - 9 months

173
Q

Post fertilization/early embryonic events

A

Gastrulation
Neurulation
Development of the pharyngeal arches

174
Q

Gastrulation

A

Epiblast and hypoblast totipotent cells in the inner cell mass (surrounded by placental cells).
Epiblast cells move down and invaginate, pushing the hypoblast cells out the way.
3 embryonic/germ layers = Ectoderm, mesoderm and endoderm.

175
Q

Neurulation

A
  1. Another germ layer = Ectomesderm (derived from ectoderm but has properties of mesoderm)
  2. Ectoderm thickens in the middle to form the neural plate.
  3. Crease along the axis of the neural plate
  4. Neural folds/plate move together and fuse = neural tube
  5. The merged neural folds separate from neural tube = neural crest/epidermis.
  6. Neural crest cells move to mesoderm and differentiate into diff types of cells.
176
Q

The fate of the 4 embryonic germ layers

A 
Ectoderm = Hair, the epidermis.
Mesoderm = Skeleton, muscles
Endoderm = Epithelium
Ectomesoderm = CNS, PNS
177
Q

The 4 (out of 6) embryonic pharyngeal arches all contain ?

A

Arch bone/cartilage
Arch muscle
Arch cranial nerve
Arch artery

178
Q

Embryonic pharyngeal arch 1

A

CN V
Muscles of mastication
Meckel’s cartilage (= mandible, malleus and incus)

179
Q

Embryonic pharyngeal arch 2

A

CN VII
Muscles of facial expression
Styloid process, part of the hyoid bone, Stapes

180
Q

Embryonic pharyngeal arch 3

A

CN IX
Stylopharyngeus
Hyoid bone

181
Q

Embryonic pharyngeal arch 4

A

CN X
Laryngeal and soft palate muscles
Laryngeal cartilages

182
Q

Laryngeal muscles and their innervation

A 
Interarytenoids
Posterior cricoarytenoid
Lateral cricoarytenoid
Cricothyroid
Thyroarytenoids
Vocalis
All supplied by CN X (recurrent and superior laryngeal nerves)
183
Q

Interarytenoids

A

Adduct the vocal folds

Recurrent laryngeal

184
Q

Thyroarytenoids

A

Move the arytenoids forward, relaxing the vocal folds. Makes the initial movements.
Recurrent laryngeal

185
Q

Posterior cricoarytenoids

A

Abduct the vocal folds

Recurrent laryngeal

186
Q

Cricothyroid

A

Acts on the cricothyroid synovial joint to move the cricoid up so it tilts the arytenoids backward and tenses the vocal folds.
Superior laryngeal.

187
Q

Vocalis

A

Pads out the vocal folds and moves the arytenoids forward, relaxing the vocal folds.
Recurrent laryngeal

188
Q

What does the recurrent laryngeal nerve innervate

A

M to all the laryngeal muscles (apart from cricothyroid)

189
Q

What does the superior laryngeal nerve innervate

A

M to the cricothyroid muscle.

S to laryngeal mucosa up to the vocal folds.

190
Q

What are the pharyngeal muscles and their innervation?

A

Superior, middle and inferior constrictor muscles (CN X/pharyngeal plexus)
Stylopharyngeus (CN IX)
Palatopharyngeus (CN X/pharyngeal plexus)

191
Q

What are the soft palate muscles and their innervation

A

LVP (CN X)
TVP (CN V3)
Palatoglossus (CN X)
Palatopharyngeus (CN X)

192
Q

The action of the soft palate muscles

A

Palatoglossus/pharyngeus elevate the pharynx and larynx.

LVP and TVP elevate and tense the soft palate.

193
Q

Muscles of the tongue and their innervations.

A 
Extrinsic:
Palatoglossus
Genioglossus
Styloglossus
Hyoglossus

Intrinsic:
Superior longitudinal
Inferior longitudinal
Transverse
Verticle

All supplied by CN Xii apart from palatoglossus (CN X)

194
Q

Palatoglossus

A

Elevates the posterior tongue / depresses the soft palate.

195
Q

Styloglossus

A

retract the tongue and elevates the sides

196
Q

Hyoglossus

A

Depresses the tongue and sides of the tongue and retract tongue

197
Q

Genioglossus

A

Many actions e.g. protrusion and depression

198
Q

Inferior and superior longitudinal tongue muscle action

A

Curl apex of tongue down (inferior) / up (superior)

199
Q

Transverse tongue muscle action

A

Narrow and increase the depth of tongue.

200
Q

Verticle tongue muscle action

A

Flatten and lengthen the tongue.

201
Q

Attachments of the constrictor muscles

A

All attach to the pharyngeal raphe at the midline.
Superior = pharyngeal tubercule
Middle = stylohyoid ligament/hyoid bone
Inferior = thyroid cartilage

202
Q

Venous drainage of the brain

A

Via the sinuses and then to the internal jugular vein.

Superior sagittal sinus
Inferior sagittal sinus
Straight sinus, transverse sinus, sigmoid sinus

203
Q

Ventricles in the brain

A 
Lateral ventricle (main big one)
3rd and 4th ventricles (joined by the aqueduct)
204
Q

Type III la forte fracture complications

A

Can disrupt cranial floor so the brain is open to the outside via nose so can get infected.

Den104 (8 decks)

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