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202: Theme 1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

the SCALP

A
  • Skin
  • Connective tissue
  • Aponeurotic tissue
  • Loose Connective Tissue
  • Pericranium
  • extends over the neurocranium
  • Innervation to the scalp is from the trigeminal nerve and spinal cutaneous nerves
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2
Q

Bones of the skull

A
  • the Neurocranium and the viscerocranium = 22 bones
  • Neurcroniaum bones
    • Occipital
    • 2 x temporal
    • 2x parietal
    • Sphneoid
    • ethmoid
    • frontal
  • Viscercranium
    • 2x nasal conchae
    • 2x nasal bones
    • 2x maxilla
    • 2x palatine bones
    • 2x zygomatic bones
    • 2x lacrimal bones
    • vomer
    • mandible
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3
Q

Foramina of the cranium

A

Cribiform: plate CN 1

Optic Canal: CN 2, Ophthalmic A

Superior Orbital Fissure: CN 3,4,6, 5 V1 (LFTSNIA)

Rotundum: CN5 V2

Ovale: CN 5 V3, AMMA

Spinosum: Middle Meningeal Artery

Lacerum: *Carotid Artery

Internal Acoustic Meatus: CN 7 and 8

Jugular foramen: CN 9, 10,11, IJV

Hypoglossal Canal: CN12

Magnum: Spinal Cord

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4
Q

Dura Mater

A
  • 2 layers of dura mater around the brain: create a sinus
    • endosteal layer: outer layer stops at the foreman magnum, only lines the skull
    • Meningeal layer around the brain and the skull
      • falx cerebri: separates cerebral hemispheres
      • tentorium cerebelli: separates the cerebellar hemisphere from the cerebral hemispheres
      • falx cerebelli- separates cerebellar hemispheres
  • supplied by CNX 5 (trigeminal), 10(vagus), C1-3 and sympathetic
  • blood supply is the middle meningeal artery​
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5
Q

Arachnoid Mater

A
  • thin avascular layer between the pia and the dura
  • loosely applied layer with projections
  • all structures passing to/ from brain pass through the subarachnoid space
  • Subarachnoid space contains cerebrospinal fluid produced by choroid plexus in brain ventricles
    • the CSF provides buoyancy for the brains
    • any excess CSG in the subarachnoid space goes to the arachnoid granulations which project into the superior sagittal sinus (the space between the two dura layers)
      • these granulations affect the transfer of CFS into the venous system
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6
Q

Pia Mater

A
  • very delicate vascular membrane: nourishes
  • closely invests brain following gyri/sulci
  • Cerebral arteries entering the brain carry a bit of the pia with it
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7
Q

Leptomengittis

A
  • infection and inflammation in the arachnoid and the pia mater
  • infection may enter the subarachnoid space and enter into the blood (septicemia)
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8
Q

Dural Sinuses

A
  • Sinuses sit between the dural folds.
  • Drained blood and CSF from the brain via cerebral veins.
  • Communicate with the veins of the skull and scalp.
  • Thick-walled endothelium. No Valves or smooth muscle.
  • Drain into the internal jugular vein.
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9
Q

Blood supply to the brain

A
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10
Q

Stroke

A

Occurs when the supply of blood to the brain is reduced or blocked completely, which prevents brain tissue from getting oxygen and nutrients.

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11
Q

Describe the embryological stage of the face

A
  • Development begins in week 4 and forms from 5 swellings.
    • Frontonasal
    • Maxillary X2
    • Mandibular X2
  • By week 5 two events;
    • Maxillary prominences enlarge in medial direction
    • Nasal placodes appear and form medial and lateral processes.
    • The medial nasal processes merge towards each other and form intermaxillary segment
    • The maxillary prominences fuse with the lateral and medial nasal processes to form the upper lip
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12
Q

What are the key muscles of the face and what are there roles

A
  • Occipitofrontalis- elevates eyebrows
  • Orbicularis oculi- closes eyelids
  • Orbicularis oris- closes mouth
  • Zygomaticus major- elevates labial commissure
  • Buccinator- compresses cheek
  • Platysma- depresses mandible against resistance, tenses
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13
Q

Innervation of the fascial muscles

A
  • Cutaneous innervation by the Trigeminal nerve (Cranial nerve 5)
  • All muscles of facial expression supplied by the Facial Nerve (Cranial nerve 7)
    • Sensory, Taste and a general motor and visceral motor nerve
    • Exits through:
      • the internal acoustic meatus
      • facial canal
      • stylomastoid foramen
    • Branches: Tempra facial and Vercofacial branch from the Posterior auricular nerve
      • Motor-Posterior auricular, temporal, zygomatic, buccal, marginal mandibular, cervical
      • Parasympathetic- branches: to pterygopalatine ganglion.
      • Taste- via chorda tympani via lingual nerve from anterior two thirds of tongue.
      • General sensory: skin over external auditory meatus.

`

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14
Q

The Parotid glands place in the face

A
  • largest of the three salivary glands in the head and is superficial to the muscles in the face
  • Parotid duct leaves gland at anterior edge and passes towards the corner of the mouth but turns deep through buccinator.
  • The parotid duct opens into oral cavity at upper second molar tooth.
  • The retromandibular vein and external carotid artery run through it.
  • Facial nerve passes through the parotid gland.
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15
Q

Muscles responsible for mastication (chewing)

A
  • Temporalis- elevation, retraction
  • Masseter- elevation
  • Medial Pterygoid- elevation, side to side
  • Lateral Pterygoid- protrusion and depression
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16
Q

Innervation of the mastication muscles

A
  • supplied by the motor nerve of V3
    • the Mandibular branch of the trigeminal nerve
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17
Q

Cranial NErve 5

A
  • the Trigeminal Nerve
    • it’s a somatic and somatic motor to derivatives of the 1st pharyngeal arch
  • It has three main divisions
    • Ophthalmic (V1): exits through the Superior orbital fissure
    • Maxillary (V2): exits through the Foramen Rotundum
    • Mandibular (V3): exits through the Foramen Ovale
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18
Q

Explain the Ophthalmic Nerve V1

A
  • Type: Sensory fibres skin, mucous membranes, conjunctiva, front of head and nose
  • Path: Branches into lacrimal, nasociliary, frontal
  • Exit: Superior Orbital Fissure
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19
Q

Explain the Maxillary Nerve V2

A
  • Type: Sensory fibres dura, nasal, upper cheek, lip, teeth
  • Path: Enters pterygopalatine fossa, gives off branches to the pterygopalatine ganglion, through the inferior orbital fissure.
  • Exit: Foramen rotundum
  • Branches: Infraorbital, zygomatic, superior alveolar.
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20
Q

Explain the Mandibular Nerve V3

A
  • Type: Mixed, sensory, lower face, lip, teeth. Motor to muscles of mastication
  • Exit: Foramen Ovale
  • Branches:
    • Sensory-auriculotemporal, buccal, lingual, inferior alveolar, mental
    • Motor- temporalis, masseter, medial and lateral pterygoids, nerve to mylohyoid
    • Parasympathetic (hitchhiking)- to salivary glands
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21
Q

The Temporal and infratemporal fossa

A
  • The temporal fossa is a fan-shaped space that is located on the lateral surface of the skull.
  • The temporal fossa contains: temporalis muscle, branches of V2
  • The infratemporal fossa is inferior to the temporal fossa.
  • The infratemporal fossa contains: medial and lateral pterygoids, maxillary artery, V3, branches of the facial nerve, glossopharyngeal nerve and pterygoid plexus of veins.
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22
Q

Describe the arterial supply to the face

A

arterial supply from the external carotid artery

  • Lingual
  • Facial
  • Maxiallry
  • Superficial temporal

in this order

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23
Q

Venous drainage of the face

A
  • the facial vein drains the majority of the face, starting near the eye
  • the facial vein passes inferiorly and drains into the internal jugular vein
  • the superficial temporal vein drains into the external jugular vein
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24
Q

Draw out this image

A
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25
Q

Overview of the tongue

A
  • The tongue is divided into an anterior two thirds (oral) and a posterior third (pharyngeal), demarked by a V shaped sulcus (terminal sulcus)
  • Papillae cover the tongue and all except filiform have taste buds on their surface.
  • Undersurface contains medial fold (frenulum) which internally separates the right and left sides of the tongue.
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26
Q

Muscles of the tongue

A
  • Intrinsic muscle: creates precise movement for speech, eating and swallowing.
  • Extrinsic:
    • ​Genioglossus: depresses and protrudes the tongue
    • Hyoglossus: depresses tongue
    • Styloglossus: retracts tongue
    • Patalglossus: elevates back tongue and depresses soft palate
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27
Q

Innervation and supply of the tongue

A

Supply

  • supplied by the lingual arteries and drained by the lingual veins

Innervation: Motor

  • Hypoglossal nerve (CN12)
    • general motor for the whole tongue apart from the palatoglossus
  • Vagus (CN10)
    • provides innervation to the palatoglossus

Innervation: Sensory

  • Chordia timpani (from CN7 facial nerve via the lingual nerveV3)
    • provides taste to the anterior 2/3 of the tongue
  • Lingula Nerve (V3)
    • provides sensation to anterior 2/3 of the tongue
  • Glossopharyngeal (CN9)
    • provides taste and general sensation to the posterior 1/3
28
Q

Give an overview of Cranial Nerve 9: Glossopharyngeal

A
  • Sensory (somatic), special sensory (taste), motor and visceral
  • Exits through the Jugular Foramen
  • Provides innervation to-
    • Sensory- posterior 1/3 tongue, oropharynx
    • Taste- posterior 1/3 tongue
    • Motor- stylopharyngeus
    • Visceral to the parotid gland to stimulate secretion to aid digestion.
  • other salivary glands innervated via facial nerve (CN7)
29
Q

Give an overview of Cranial Nerve 12: Hypoglossal

A
  • provides motor function to intrinsic and extrinsic muscles of the tongue (save palatoglossus)
  • exits through the hypoglossal canal: this is just lateral of the Foramen Magnum
30
Q

Give an overview of the framework of the larynx

A
  • Provides a protective sphincter for the air passages and produces phonation, made up of cartilages:
    • Thyroid, Cricoid, Arytenoid, Cuneiform, Corniculate and Epiglottis
  • Contains ligaments, most important:
    • Vestibular and the Vocal ligament.
31
Q

Give the innervation and supply of the larynx

A
  • Nerve supply: sensory and motor from the vagus, via the superior laryngeal branch and recurrent laryngeal branch.
  • Blood supply: upper half by the superior thyroid artery and lower half by inferior thyroid artery
32
Q

Give an overview of the Pharynx

A
  • the most posterior part of the neck, situated behind the nasal cavity and the larynx.
  • It’s a funnel-shaped tube with three sections:
  • Nasopharynx
  • Laryngopharynx
  • Oropharynx
  • Muscles consist of three constrictors: Superior, Middle and Inferior
    • also the stylopharyngeus
33
Q

Innervation of the Pharynx

A
  • Motor supply via vagus, EXCEPTstylopharyngeus which is through CN9
  • Sensory supply via V2, CN 9, CN10
34
Q

Give an overview of Cranial Nerve: Vagus

A
  • Provides Sensory, taste, visceral sensory, motor and visceral motor
  • Path: rootlets from medulla, through jugular foramen continues in carotid sheath, branches into head and thorax
  • Exit: Jugular foramen
  • Innervations
    • Sensory- from larynx, dura mater
    • Taste- epiglottis and pharynx
    • Visceral sensory- aortic bodies, aortic arch chemoreceptors, bronchi, heart, lungs, midgut and foregut
    • Motor- palatoglossus, muscles of pharynx and larynx
    • Visceral motor- as part of parasympathetic to smooth muscle in glands in pharynx, larynx, thoracic viscera, foregut and midgut.
35
Q

Give an overview of the neck Fascia

A
  • The deep fascia of the neck creates three important layers
    • Pretracheal fascia- Pink
    • Prevertebral fascia- Blue
    • Investing fascia- Green
      • Important as reduces the spread of infection
      • Enables structures to move past each other in movement and swallowing etc
  • Carotid sheath (Red) blends with the pretracheal and prevertebral fascia. It contains the
    • Common and internal carotid arteries.
    • Internal jugular vein.
    • Vagus nerve (CN 10).
    • Some deep cercal lymph nodes.
    • Carotid sinus nerve
36
Q

Identify the surface anatomy of the Neck

  • the triangles
A
  • The neck is divided into the anterior and lateral/posterior compartment by the presence of the sternocleidomastoid muscle.
  • The anterior compartment is further subdivided into three paired triangles and one unpaired;
    • the unpaired submental triangle,
    • the paired submandibular, carotid and muscular triangle.
  • The posterior compartment is bounded posteriorly by the trapezius muscle and is divided into two triangles by the presence of the posterior belly of omohyoid into:
    • the large occipital triangle
    • the smaller omoclavicular triangle.
37
Q

Muscles and contents of the Anterior triangle

A
  • Submandibular triangle bounded by: anterior and posterior bellies of digastric.
    • Contains: the submandibular gland, facial artery and vein.
  • Submental triangle bounded by: digastric.
    • Contains lymph nodes.
  • Muscular triangle bounded by: omohyoid, Supraclavicular Muscles SCM
    • Contains supra and infrahyoid muscles
  • Carotid triangle bounded by: omohyoid, stylohyoid, digastric, SCM.
    • Contains: common carotid artery, IJV, hypoglossal nerve, vagus nerve, accessory nerve.
38
Q

Give details of the muscles of the muscular triangle

A

Suprahyoid muscles

  • Stylohyoid, digastric, mylohyoid and geniohyoid
  • Innervation:
    • Facial nerve for the stylohyoid and posterior belly of digastric.
    • Mylohyoid by CN 5 and
    • Geniohyoid by CN 12

Infrahyoid muscles

  • Omohyoid, sternohyoid, thyrohyoid, and sternothyroid
  • Innervation: C1-C3 of ansa cervicalis
39
Q

Muscles and contents of the posterior triangle?

A
  • Posterior triangle contains: Subclavian artery, EJV, Brachial plexus, CN 11, Cervical plexus
  • Occipital triangle bounded by: SCM, trapezius and omohyoid.
  • Supraclavicular triangle bounded by: clavicular head of SCM, clavicle and omohyoid
40
Q

Describe arterial supply of the neck and throat

A
  • Brachiocephalic ÷ Common carotid ÷ Internal and external carotids
  • External carotid ÷ 6 branches to supply the neck and head
    • Superior thyroid,
    • Ascending pharyngeal,
    • Lingual,
    • Facial,
    • Maxillary,
    • Superficial temporal
  • Subclavian arteries supplied by the inferior thyroid
  • Internal carotid forms no branches until it’s inside skull
41
Q

Describe the Venous Drainage of the face and neck

A
  • The Internal jugular vein (IJV) drains the brain, face, cervical viscera and neck muscles.
  • External jugular vein
  • Anterior jugular vein
42
Q

Give an Overview of Cranial Nerve 11: Accessory

A
  • Motor to Sternocleidomastoid and Trapezius.
  • Exit: Jugular foramen.
43
Q

Give an Overview of Cranial Nerve 8: Vestibulaochlear Nerve

A
  • Type: Sensory, special somatic afferent for hearing, equilibrium and motion.
  • Path: Divides into Vestibular and Cochlear Nerves.
  • Exit: Internal acoustic meatus.
44
Q

Give an Overview of the Cervical Plexus

A
  • Roots of cervical plexus C1-C4 lies anterior to Levator scapulae.
  • The cervical plexus provides cutaneous branches and deep motor branches (ansa cervicalis and phrenic nerve)
45
Q

Give an Overview of the Brachial Plexus

A
  • Roots of the brachial plexus C5-T1 appear between the anterior and middle scalene muscles.
  • Five rami unite to form the three trunks of the brachial plexus
  • Supply cutaneous and motor to the upper limb.
46
Q

What are the 12 Cranial Nerves?

A
  1. Olfactory: Smell.
  2. Optic: Sensory nerve of vision it is more correctly called a brain tract.
  3. Oculomotor: innervates four of the extrinsic eye muscles—muscles that move the eyeball in the orbit.
  4. Trochlear: innervates an extrinsic eye muscle that hooks through a pulley-shaped ligament in the orbit.
  5. Trigeminal: The trigeminal nerve provides general sensory innervation to the face and motor innervation to the chewing muscles.
  6. Abducens: innervates the muscle that abducts the eyeball (turns the eye laterally).
  7. Facial: This nerve innervates the muscles of facial expression as well as other structures.
  8. Vestibulocochlear: sensory nerve of hearing and equilibrium/ balance
  9. Glossopharyngeal: innervates structures in the tongue and pharynx,
  10. Vagus: this nerve “wanders” beyond the head into the thorax and abdomen.
  11. Accessory: carries motor innervation to the trapezius and sternocleidomastoid muscles.
  12. Hypoglossal: The name hypoglossal means “below the tongue.” This nerve runs inferior to the tongue and innervates the tongue muscles.
47
Q

Give an overview of the structure of the Nose

A
  • Bones: comprised of paired Nasal bones, Maxillae, Frontal bone and Septum.
  • Cartilages: comprised of 3 main lateral nasal cartilage, major alar cartilage and septal cartilage• Septum divides the chamber into two cavities
  • Internal surface: lateral wall has three projections; superior, middle and inferior conchae
  • Nasal cavity opens into the nasopharynx
48
Q

Give an overview of the innervation and supply of the nose

A
  • Supplied arterial branches from ophthalmic and maxillary.
  • Nerve supply from the olfactory nerve, ophthalmic( V1) and maxillary (V2)
49
Q

Give an Overview of Cranial Nerve 1: Olfactory

A
  • Special sensory afferent nerve
  • Exits through the Cribiform Plate
50
Q

Explain Olfaction

A
  • Olfaction is aided by the airflow through the nasal cavity
  • Conchae help warm and moisten the air
  • Olfaction receptors are in the epithelium lining the roof and walls,
  • The epithelium secretes a mucus fluid, odoriferous gases are dissolved into the fluid and then detected by the olfactory nerves
51
Q

Explain the purpose and organisation of the Paranasal sinuses

A
  • Paranasal sinuses are air filled extensions of the nasal cavity
  • Paired Frontal sinuses in frontal bone that drain through frontonasal duct.
  • Ethmoidal cells (sinuses) are invaginations in the ethmoid bone and drain into middle meatus (if anterior, or middle) or superior meatus (if posterior).
  • Sphenoidal sinuses in sphenoid bone that drain into spheno-ethmoidal recess.
  • Paired Maxillary sinuses in maxilla drain into middle meatus.
52
Q

7 of them

Name the bones that make up the Orbit

A

Frontal, Maxilla, Ethmoidal, Lacrimal, Sphenoidal, Temporal-zygomatic, Nasal

53
Q

What are the three layers of the eye?

A
  • Outer fibrous- Sclera and Cornea
  • Vascular- Iris
  • Inner- Retina
54
Q

Give an Overview of Cranial Nerve 2: Optic

A
  • Special afferent – sensory
  • Exit from the Optic canal

Special Embryology: Optic stalk grows out and lens vesicle grows in

55
Q

What are the Extraocular muscles that control eye movement?

  • and how does the movement occur?
A
  • Levator Palpebrae, Superior Oblique, Superior Rectus, Medial Rectus, Lateral Rectus, Inferior Rectus, Inferior Oblique
  • movement occurs around 3 axes: vertical, transverse and anterioposterior
56
Q

Give an Overview of the Cranial Nerve 3: Oculomotor

A
  • Somatic Motor (general somatic efferent) to extraocular muscles and general visceral efferent-parasympathetic via short ciliary nerves to the ciliary body and sphincter pupillae.
    • doesn’t provide motor supply to the superior oblique and lateral rectus
  • exits through the Superior orbital fissure​
57
Q

Give an Overview of Cranial Nerve 4: Trochlear

A
  • Somatic Motor (general somatic efferent) to Superior Oblique
  • Found on the posterior view of the pons
  • Exits through Superior orbital fissure
58
Q

Give an Overview of Cranial Nerve 6: Abducent

A
  • Somatic Motor (general somatic efferent) to Lateral Rectus
  • Found in the pons at the floor of the fourth ventricles, at the same level as the facial colliculus
  • Exit: Superior orbital fissure
59
Q

What are clinical considerations related to the motor function caused by cranial nerves?

A
  • Inability of specific eye movements (CN 3, 4, 6),
    • Dilated pupil (CN 3),
    • Ptosis (CN 3),
    • Abnormal pupil reflex (CN 3)
  • example of lesion:
    • CN 3 – Aneurysm of cerebral a.
    • CN 4 – Arbital fracture
    • CN 6 – Cavernous sinus lesion
60
Q

Describe how crying is able to take place

  • lacrimal apparatus
  • innervation
A
  • Lacrimal apparatus consists of lacrimal glands
    • Orbital
    • Palpebral
    • secretes lacrimal fluid which passes across the eye and into the lacrimal papilla, lacrimal sac and to the inferior meatus via the nasolacrimal duct.
  • Innervation
    • Parasympathetic: Secretomotor (via facial nerve CN7)
    • Sympathetic: Vasoconstrictive (superior cervical ganglion, via internal carotid)
61
Q

Describe the parasympathetic supply of the lacrimal gland

62
Q

Give an overview of the Nerve supply of the Orbit

A
  • CN2, 3, 4, V1 (5), 6, 7
  • Sympathetic: stimulates dilator pupillae to let more light in.
  • Parasympathetic: stimulates constrictor pupillae to let less light in.
63
Q

What is the arterial supply of the Orbit?

A
  • Ophthalmic Artery
  • Infraorbital artery
  • Central artery
64
Q

Give an Overview of Cranial Nerve 5: Trigeminal

A
  • Somatic (general sensory) and somatic motor to derivatives of 1st pharyngeal arch.
  • Three divisions-
    • Ophthalmic- V1
    • Maxillary- V2
    • Mandibular- V3
  • Exits through the
    • V1: Superior orbital fissure
    • V2: Foramen Rotundum
    • V3: Foramen Ovale
65
Q

Give an Overview of V1- the Ophthalmic branch

A
  • Sensory fibres skin, mucous membranes, conjunctiva, front of head and nose
  • Branches into the lacrimal, nasociliary, frontal
  • Exits through the Superior Orbital Fissure

202: Theme 1 (14 decks)

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