Anatomy - ENT Flashcards
What is the function of the ear canal/external auditory meatus?
Receives sound and transmits it medially towards the tympanic membrane
What is the function of the auricle?
Localises sound in different positions in space
Which nerve innervates the posterioinferior aspect of the outer ear?
Vagus
Which nerve innervates the anteriosuperior aspect of the outer ear?
Branch of V3
What portion of the external acoustic meatus is cartilagenous?
Lateral 1/3
What portion of the external acoustic meatus is bony?
Medial 2/3
What quadrant is the cone of light normally seen?
Antero-inferior quadrant
What are the margins of the middle ear?
Tympanic membrane to petrous part of temporal bone
What is the space above the tympanic membrane called?
Epitympanic recess
What does the epitympanic recess communicate with?
mastoid air cells
What is the function of the auditory/Eustachian tube?
Allows equilisation of pressure between the middle ear and the atmosphere
What structures does the auditory tube communicate with?
Middle ear communicates with auditory tube which connects to nasopharynx
In what direction does the auditory tube project?
anteroinferiorly to the nasopharynx
What is the clinical significance of a more horizontal auditory tube in infants?
Because auditory tube connects to the nasopharynx, bacteria from the nasopharynx can easily enter the middle ear. Since the auditory tube is more horizontal, it is more difficult for the bacteria to drain back into the nasal cavity
What is the clinical significance of inflammation in the middle ear?
Inflammation in the middle ear will impact the ossicles which transmit sound vibration and may impair hearing
Why can pain in the outer ear cause referred pain to the lower teeth?
The lower teeth are innervated by a branch of V3 and a portion of the outer ear is innervated by another branch of V3
What is the clinical significance of pressure build-up in the middle ear?
The pressure build-up may push the tympanic membrane out and therefore change the shape and concavity of the tympanic membrane. As a result, the cone of light will move to another quadrant
What are the 3 ossicles?
From lateral to medial:
Malleus
Incus
Stapes
Which ossicle attaches to the tympanic membrane?
Handle of the malleus
What is a protective mechanism to loud sounds?
Reflex contraction of the muscles which attach to the ossicles
Which muscle attaches to stapes and what is its innervation?
Stapedius innervated by CN VII (seventh for stapedius)
Which muscle attaches to malleus and what is its innervation?
Tensor tympani innervated by CN V (T for tensor and trigeminal)
What is the clinical significance of an acoustic neuroma situated near CN VII and VIII within the internal acoustic meatus?
The neuroma may compress CN VII causing inactivation of VII
As a result, the efferent arch of the reflex muscle contraction in the middle ear is obliterated.
Loud sounds may no longer be dampened and the hair cells within the inner ear may consequently be damaged by excessive energy transmission
What is the function of the round window?
It is an opening from the inner ear which allows the energy transmitted into the inner ear to be released back into the middle ear
Which nerve carries parasympathetic fibres to salivary glands and carries sensory info about taste from the tongue to the CNS?
Chorda tympani (branch of facial nerve)
What does chorda tympani transmit?
Carries parasympathetic fibres to salivary glands
Carries sensory info about taste from tongue to CNS
What is the promontory?
A bulge in the medial wall of the middle ear created by the basal turn of the cochlea
Where does the oval window lie in relation to the promontory?
Oval window is superior and posterior to the promontory
Where is the round window in relation so the promontory?
The round window is inferior and posterior to the promontory
Which vessel is close to the middle ear?
Internal carotid artery runs underneath the middle ear
What is the function of the bony labyrinth?
It transmits mechanical energy from vibration into the inner ear
Where are the sensory receptors for dynamic equilibrium (directional head movement) located?
Within the ampulla
What is the membranous labyrinth?
It is a closed sac filled with endolymph
Where are the sensory receptors for hearing located?
Within cochlear duct
Where are sensory receptors for static equilibrium (head position) located?
Within the utricle
Which bones form the bridge of the nose?
Nasal bones
What structures do the nasal bones articulate with?
Frontal bone and frontal process of maxilla
Which cartilage forms most of the boundaries of the nostril?
Alar cartilage
What is the function of the posterior nares?
Allows communication between the nasal cavity and other airways
Which structures complete the nasal septum?
Vomer, ethmoid bone and septal cartilage
Which structure allows communication between nasal cavity and other airways?
Posterior nares
What are possible consequences of a nose break involving the ethmoid bone?
- Bacteria from nasal cavity can spread to the meninges
- Blood may extend into the meninges and possibly involve the subarachnoid space
- Rhinorrhea
What are features of the medial wall of the nasal cavity?
-Olfactory area constitutes the top third of the cavity: contains
olfactory epithelium and primary afferent neurons
-Respiratory area constitutes pseudostratified columnar epithelium
-Lined by highly vascular mucous membrane
-Vestibule lined by skin and hair
What is the function of highly vascular mucous membranes in the nasal cavity?
- warms and humidifies air to prevent smooth muscle spasms
- mucous production
- lines most of nasal cavity except vestibule
What are features of the lateral wall of the nasal cavity?
- Turbinate bones (superior, middle and inferior concha)
- Vestibule
- Lined by highly vascular mucous membrane
What is the function of turbinate bones?
Produce turbulent air in order to increase air exposure to vascular mucosa
Which sinuses are innervated by V1 of trigeminal?
Frontal
Ethmoid
Sphenoid