Anatomy Flashcards
Nasal cartilage is what type of cartilage
Hyaline
What are structures A & B?
A = Inferior nasal concha
B = Vomer
What makes the roof of the nasal cavity?
Cribiform plate of ethmoid
Label the structures
A: Crista galli
B: Superior concha
C: Middle concha
D: Orbital plate
What makes up the septum?
Perpindicular plate of ethmoid + vomer
Which LeFort fractures can disrupt the cribiform plate of the ethmoid?
II & III
Label the structures of the nasal cavity. Which wall of the (right) nasal cavity is this?
Lateral wall.
A = Nasal bone
B: Palatine bone
C: Superior concha
D: Middle concha
E: Inferior concha
What side of the nasal cavity is this? Label the structures
Medial wall
A: Perpindicular plate of ethmoid
B: Vomer
What types of mucosa are present at 1, 2 and 3?
1 = Keratinised squamous
2 = Respiratory
3 = olfactory
Where does CN I pass through into the nose?
Cribiform plate of ethmoid bone
CN I enters the brain at which lobe?
Temporal lobe
Which nerves are responsible for sensation in the areas A + B?
A = CN V1
B = CN V2
Label the arteries
A: Internal carotid
B: External carotid
C: Facial
D: Maxillary
E: Ophthalmic
Which 3 main arteries contribute to the nasal blood supply?
Ophthalmic (ethmoidal), maxillary (sphenopalatine) and facial (greater palatine)
Where is Little’s Area?
Nasal septum
The superior/ middle concha are part of what bone
Ethmoid
How should an NG tube be confirmed placed correctly?
CXR.
Tip of NG tube visible, 10cm beyond GOJ, below diaphragm.
Describe the sinuses & how many of each there are
1) Frontal bone with 2
2) 2 maxillae each with 2 sets
3) Sphenoidal with 2
4) Ethmoid 2 sets of ethmoidal air cells
Where does the frontal sinus drain?
Middle meatus
Where do the ethmoidal air cells drain into?
Superior and middle meatus
Where does the sphenoidal sinus drain to?
Spheno-ethmoidal recess
Where does the maxillary sinus drain to?
Middle meatus
Where does the lacrimal fluid drain to?
Inferior meatus
Which CN is responsible for sensing sinusitis pain?
CN V1 and V2 (can be referred to teeth)
Which sinus is most predisposed to infection?
Maxillary
Why might maxillary sinusitis present with toothache?
Shared innervation by CN V of the maxillary sinus & upper/ lower dental arches.
Which specific part of CN V innervates the sinuses?
CN V2 is maxillary
All others are CN V1
Which bone contaisn the hearings of organ and balance?
Temporal bone
The pterion is the squamous/ petrous part of the temporal bone?
Squamous
Label the base of skull features
A: Zygomatic process of the temporal bone
B: Styloid process
C: Stylomastoid foramen
D: Mastoid process
E: Palatine bone
Label the foramens
A: Cribiform plate of the ethmoid bone
B: Optic canal
C: Foramen rotundum
D: Foramen ovale
E: Carotid canal
F: Internal Acoustic Meatus
G: Jugular foramen
H: Hypoglossal
(not labelled is superior orbital fissure)
What is the external ear?
Auricle to tympanic membrane (extrernal acoustic meatus)
What is the middle ear?
Tympanic membrane to the oval window
What is the inner ear
Oval window to internal acoustic meatus
Label the nerves
A: Facial
B: CN V3
C: CN X
Where does the ear-lobe drain to (lymphatics)?
Superficial cervical lymph nodes
The external ear is mostly cartilage/ bone?
The superficial 1/3 cartilage, deep 2/3rd bone (petrous part)
Which glands produce earwax?
Ceruminous
Label this otoscopy
A: Umbo
B: Pars tensa
How should the EAM be straightened in an adult?
Pull posterior and superiorly
How should the EAM be straightened in a child?
Posterior and inferiorly
Which CN supplies the tympanic membrane?
CN V3
What CN supplies the middle-ear?
CN IX (Glossopharyngeal)
Which nerve innervates the eustachian tube/ tonsils?
CN IX
The joints of the ossicles are what type of joint
Synovial
Label these structures of the middle ear
A: Malleus
B: Incus
C: Stapes
D: Footplate of the stapes
E: Hammer of the malleus
F: Eustachian tube
The eustachian tube connects the middle ear to where
Nasopharynx
What CN supplies the nasopharynx/ oropharynx?
CN IX
Which CN supplies the larynopharynx?
CN X
Why does tonsilitis mimic earache?
Both are supplied by CN IX (glossopharyngeal).
Which nerve passes through the middle ear cavity?
CN VII (through the internal acoustic meatus)
Which nerve supplies the stapes muscle?
Facial
Label the parts of the middle ear
A: Aditus
B: Prominence formed by the LATERAL semicircular canal of the ear
C: Facial nerve (not labelled is the internal acoustic meatus)
D: Prominence formed by the cochlea
E: Stylomastoid process
F: Tympanic membrane (inner)
Where does the CNS enter the brain?
Brainstem (junction between pons and medulla)
Taste sensation of the anterior 2/3rd of the tongue is supplied by which nerve?
Chord typmani (branch of CN VII)
CN VII exits at the petrous/ squamous part of the temporal bone?
Petrous
Chord tympani is a branch of which nerve, specifically what part?
CN V3
Which nerve exits foramen ovale?
CN V3
Which nerve supplies secretomotor innervation to the salivary glands (sublingual)?
CN VII
The otic capsule resides within which bone
Temporal bone
What’s the “outer” layer of fluid in the bony labyrinth?
Perilymph
What fluid is suspended within the otic capsule?
Endolymph
Label the otic capsule
A: Cupula (of cochlea)
B: Oval window
C: Round window
D: Anterior canal
E: Lateral canal
F: Posterior canal
Where do CN VII and VIII combine?
Internal acoustic meatus
Loss of general sensation of auricle, just posterior to the tragus, is likely to be what
CN VII (mandibular division)
Is the parotid gland normally palpable?
No
Which gland is normally palpable?
Submandibular
Which salivary duct pierces the buccinator?
Parotid
Which salivary duct opens in the sublingual papilla?
Submandibular duct
Where does the parotid duct insert into the mouth?
Buccal mucosa
The parotid gland is superficial/ deep to the masseter?
Superficial
Which CN supplies the sublingual salivary gland?
CN VII (parasympathetic)
The parotid gland is innervated by which CN?
CN IX
Which CN supplies general sensation of the anterior 2/3rd of tongue?
CN V3
Which CN supplies taste information on the anterior 2/3rd of tongue?
CN VII
Which CN supplies general AND taste information from the posterior 1/3rd of tongue?
CN IX
Pyramidal lobe of thyroid most often comes from what lobe?
Right
What are the 4 muscles of the tongue
Palatoglossus
Stylogossus
Hyoglossus
Genioglussus
Where does CN XII exit the skull?
Hypoglossal canal
If there is damage to one of the CN XII’s, where will the tongue point?
TOWARD the side of the injured nerve
Which artery supplies the tongue? What is this a branch of?
Lingual artery
External carotid artery
The skeletal muscles of the soft palate are all supplied by which CN?
CN X (vagus)
EXCEPT tensor veli palatini which is CN V3
How can CN X and CN V3 be tested?
Ask patient to open and say “aaah”
Which CN innervates palatopharyngeus & salpingopharyngeus?
CN X
Which CN innervates stylopharyngeus?
CN IX
Where do the palatine tonsils lymph drain to?
Jugulo-digastric node
The superficial cervical nodes are placed along which structure?
External jugular vein
The deep cervical nodes are placed along which structure?
Internal jugular vein
Label these tongue muscles
A: Genioglossus
B: Hypoglossus
C: Styloglossus
D: Palatoglossus
Label these tongue structures
A: Hypoglossal nerve
B: External carotid
C: Lingual artery
Pretracheal fascia includes what
Strap muscles, thyroid gland, oesophagus and larynx, trachea, recurrent laryngeal nerves
The larynx is located between which vertebral levels?
C4-C6
Should the mastoid process be palpable normally?
Yes
Should the transverse process of all the cervical vertebrae be palpable?
Yes (NOT spinous process - C7 is first one)
Label the larynx cartilages
A: Hyoid bone
B: Epiglottis
C: Laryngeal prominence
D: Cricoid cartilage
E: 1st tracheal ring
F: Cricothyroid joint
G: Inferior horn of the thyroid
H: Superior horn of thyroid cartilage
I: Thyrohoid membrane
Label these structurs of the deeper larynx
A: Epiglottis
B: Arytenoid
C: Vocal process of arytenoid
D: Muscular process of arytenoid
Pushing against the cricoid cartilage will press it against what structure? What will this ensure?
Will push oesophagus against the C6 vertebral body, ensuring the oesophagus is closed and the trachea is open
Label the features of the larynx
A: False vocal cord
B: True vocal cord
C: Infra-glottic cavity
D: Laryngeal ventricle
E: Laryngel vestibule
Where do the false vocal cords connect?
Arytenoid cartilage to the epiglottis
Label this laryngoscopy
A: False vocal cord
B: True vocal cord
C: Rima glottidis
D: Epiglottis
All the larynx muscles are innervated by which CN?
CN X
Tension of the vocal cords produces what effect on sound?
Increased pitch
Relaxation of the vocal cords produces what effect on sound?
Decreased pitch
Adduction of the vocal cords produces what effect on sound?
Quiet speech
Abduction of the vocal cords produces what effect on sound?
Loud sound
The cricothyroid muscles do what
Tense the larynx (increase pitch)
The thyroarteynoid muscles of the larynx do what
Relax vocal cords - decrease pich
The lateral crico-thyroid muscles have what effect on voice/ vocal cords?
Adducts cords / makes voice quieter
The arytenoid muscles of the larynx have what effect on vocal cords/ sound?
Adductors - make voice quieter
What are the larynx abductor muscles?
Posterior thyroid muscles (make voice louder)
Supra-glottic tumours will drain to which lymph nodes
Superior DEEP cervical nodes
Sub-glottic tumours will drain to which nodes?
Paratracheal nodes
T/F: Glottic/ vocal cord tumours tend to metastaise.
False - tend to stay on cords.
Which nerve supplies all intrinsic larynx muscles EXCEPT cricothyroid?
Inferior laryngeal nerve
(cricothyroid is external laryngeal nerve)
