Anatomy (HEAD and Neck) Flashcards
1
Q
aponeurosis
A
central –> epicranial aponeurosis
anterior –> frontalis to skin of eyebrow and orbicularis oculi (temporal and zygomatic branches of CN VII)
posterior –> occipitalis to superior nuchal line (posterior auricular branch of CN VII)
2
Q
danger area of loose areolar connective tissue in scalp
A
potential vascular spread of infection as it contains emissary veins which connect cranial venous sinuses to extracranial veins
3
Q
emissary veins
A
communications which keep the blood pressure in the sinuses constant
4
Q
scalp wound bleeding
A
difficult to to stop as the arterial walls are attached to the fibrous septa in the connective tissue and are unable to contract/retract to allow blood clotting
5
Q
epicranial aponeurosis
A
keep the tension in wounds do it will not gape open
6
Q
extradural / epidural space
A
POTENTIAL space between inner aspect of skull bone and endosteal layer of dura mater
7
Q
subdural space
A
POTENTIAL space between dura and arachnoid mater
8
Q
subarachnoid space
A
ACTUAL space between arachnoid and pia mater
filled with CSF and contains blood vessels supplying the brain
9
Q
two layers of the dura mater
A
endosteal layer and meningeal layer
10
Q
extend through the foramen magnum and is continuous to the dura mater of the spinal cord
A
meningeal layer
11
Q
separated to form venous sinuses
A
endosteal layer and meningeal layer of the dura mater
12
Q
function of dura mater extensions
A
divide cranial cavity into subdivisions which restrict displacement of the brain associated with accel and decel
13
Q
attached to frontal crest and Crista Galli
A
falx cerebri
- sickle-shaped dura dividing the two cerebral hemispheres
14
Q
supports the occipital lobes
covers the upper surface of the cerebellum
roofs over the posterior cranial fossa
A
tentorium cerebelli
15
Q
attached to the internal occipital crest
divides the two CEREBELLAR hemsipheres
A
falx cerebelli
16
Q
roof of the sella turcica
A
diaphragma sella
17
Q
over the calvaria vs the cranial base
A
over the calvaria: fused layers of the dura can be easily stripped from the cranial bones vs firmly attached and difficult to separate in the cranial base
18
Q
dura mater NAV
A
N: trigeminal nerve and C1-C3
A: middle meningeal artery from maxillary artery
anterior meningeal artery from ophtalmic artey
posterior meningeal artery from occipital artery
all from external carotid artery
V: middle meningeal vein to pterygoid plexus
19
Q
avascular meninges
A
arachnoid mater
20
Q
filled with CSF
A
subarachnoid space
21
Q
arachnoid granulations
A
aggregations of arachnoid villi
22
Q
epidural space in the spinal cord
A
contains fibrofatty tissue and venous plexus
23
Q
shaken baby syndrome
A
occurs as a result of sudden deceleration
ex of subdural hematoma
24
Q
presents as a crescent shaped lesion in CR
from tearing of superior cerebral veins at their point of entry into the superior sagittal sinus
A
subdural hematoma
25
biconvex appearance in CT scan
| due to injury to meningeal arteries or veins
epidural hematoma
26
generally caused by rupture of the thin-walled lenticulostriate arteries (from the middle cerebral artery)
patient immediately loses consciousness and causes contralateral hemiplegia
involves corticobulbar and corticospinal fibers in the internal capsule
cerebral hemorrhage
27
appears as white on CT following sulcis
| suggests rupture of an artery in the _______
subarachnoid hematoma
| subarachnoid space
28
leptominingitis
confined in the subarachnoid space
29
tonsillar herniation causes ________________
cardiac and respiratory depression due to compresdion of medulla and upper cervical spinal cord
tonsils of the cerebellum herniate downward through the foramen magnum
30
caused by diffuse cerebral edema
| diencephalon (thalamus and hypothalamus) herniate through the tentorial notch
central herniation
31
uncal herniation
uncus of the temporal lobe herniate downward hence compressing the brainstem
32
unpaired bones of the neurocranium
frontal, occipital, ethmoid, sphenoid
33
paired bones of the neurocranium
temporal, parietal
34
paired bones of viscerocranium (facial)
palatine, lacrimal, maxilla, nasal, inferior nasal concha, zygomatic
35
vomer
| mandible
unpaired bones of viscerocranium (facial)
36
point of meeting of frontal, parietal, squamous temporal, great wing of sphenoid
pterion
37
meeting point of lambdoid, parietomastoid, occipitomastoid
asterion
38
bregma came from _______________ which closes by ____
anterior fontanelle; 18 months
39
lambda came from ______ which closes by
posterior fontanelle; 1-2 months
40
important relations of the cavernous sinus
```
ICA , VI (passes through)
III, IV, V1, V2 (on the lateral walls)
pituitary gland
veins of the face (anteriorly)
petrosal sinuses (posteriorly)
```
41
trigeminal nerve
anterior division: muscles of mastication
| posterior division: sensory to the face and general sensation to anterior 2/3 of tongue
42
leaves the cranium through foramen rotundum (in the base of the greater wing of the sphenoid)
maxillary branch (V2) of the trigeminal nerve
43
three cutaneous branches of CN V2
zygomaticotemporal
zygomaticofacial
infraorbital nerve (through IOF)
44
largest branch of the trigeminal nerve
CN V3 (mandibular branch)
only branch that carries motor fibers (motor to MUSCLES OF MASTICATION)
somatic to anterior 2/3 of tongue
45
cutaneous nerves from ophthalmic branch of trigeminal
```
supraorbital
supratrochlear
external nasal nerve
infratrochlear nerve
lacrimal nerve (smallest branch)
```
46
cutaneous nerves from mandibular branch of trigeminal
auriculotemporal
buccal
mental
47
only branch of trigeminal nerve with motor fibers
mandibular branch
| MUSCLES OF MASTICATION
48
stylomastoid foramen
where facial nerve emerges
49
terminal branches of the facial nerve
```
temporal
zygomatic
buccal
mandibular
cervical
```
50
supplies taste fibers to the anterior 2/3 of the tongue
chorda tympani of CN VII
| contains secretomotor fibers to submandibular and sublingual gland
51
functions of facial nerve
1) motor to muscles of facial expression, stylohoid, posterior belly of digastric
2) special sensation to anterior 2/3 of tongue
3) prevents hyperacusis (dampening vibrations of stapes)
4) secretomotor to lacrimal, sublingual, and submandibular glands
5) common sensation to external ear
52
Bell palsy
paralysis of muscles on the affected side
drooping of corner of mouth, weakened lip muscles, paralysis of muscles of facial expression, dry mouth, hyperacusis, no tears, no special sensation
53
differentiating central vs peripheral nerve lesions
in central, forehead can still move/contract vs peripheral wherein entire affected side cannot move/contract
54
corneal blink reflex efferent
facial nerve (CN VII)
55
afferent of corneal blink reflex
CN V1 (nasociliary nerve)
56
treatment for Tic Douloureux
carbamazepine
57
sharp, stabbing pain over the areas innervated by cutaneous branches of CN V2 or CN V3
Trigeminal neuralgia (Tic Douloureux)
58
mental artery vs submental artery
submental: from facial artery
mental: from maxillary artery
59
arterial supply of face
branches of external carotid artery
facial artery (major)
superficial temporal artery
transverse facial artery - to the parotid gland, duct, masseter and skin of face
supraorbital and supratrochlear (from ophthalmic)
60
venous drainage of the face
facial vein and retromandibular vein
61
supraorbital vein + supratrochlear vein --> ______
| ----> _________ + anterior branch of retromandibular vein --> common facial vein ---> draining into IJV
angular vein ; facial vein
62
______+ __________ --> retromandibular vein
| posterior branch or retromandibular vein + posterior auricular branch --> draining into ______
superficial temporal vein + maxillary vein
| EJV
63
superficial lymph nodes of the head
```
ORB SSS
occipital
retroauricular parotid
buccal
submandibular
submental
superficial cervical
```
64
deep lymph nodes of the head
middle ear: retropharyngeal and upper deep cervical
nasal cavity and paranasal sinuses: submandibular, retropharyngeal, and upper deep cervical
tongue: submental, submandibular, and upper/lower cervical
larynx: upper/lower cervical
pharynx: retropharyngeal and upper/lower deep cervical
thyroid gland: lower deep cervical, prelaryngeal, pretracheal, paratracheal
note the pattern!
65
autonomic nerves on the head
SYMPATHETIC
- dilates pupil
- reduces secretion (lacrimal, nasal mucus gland)
- reduces secretion and more viscid (salivary gland)
PARASYMPATHETIC
- constricts pupil
- contract ciliary muscle to thicken lens
- increase secretion
- increase and more watery secretion (in salivary gland)
66
nucleus origin of oculomotor nerve
| parasympathetic ganglia
Edinger Westphal nucleus
| --> ciliary ganglion
67
facial nerve nucleus
| parasympathetic ganglia
lacrimal: pterygopalatine ganglion --> lacrimal gland and glands of the nose
superior salivatory: submandibular ganglion --> sublingual and submandibular gland
68
glossopharyngeal nucleus (parasympathetic ganglia)
inferior salivatory: otic ganglion --> parotid gland
69
mass of striated muscle that is covered with mucous membrane of the
anterior 2/3 : _____
posterior 1/3: ______
mouth; pharynx
70
superior attachment of the tongue
styloid process and soft palate
71
inferior attachment of the tongue
hyoid bone
| mandible
72
small nipple shaped projections on the anterior 2/3 of the tongue
lingual papillae
73
odd one out among the muscles of the tongue
palatoglossus (innervated by vagus)
| all others innervated by hypoglossal nerve
74
extrinsic muscles of the tongue
palatoglossus : elevation
styloglossus: retraction
hyoglossus: depression
genioglossus: protrusion
75
general sensation of the anterior 2/3 of tongue
CN V3 (lingual nerve) vs special sensation (chorda tympani)
76
special glands of the tongue
Salivary (Von Ebner glands): on vallate papillae
| Anterior lingual glands (of Nuhn and Blandin) under the tongue apex
77
orbital margins
superior: frontal bone
lateral: processes of the zygomatic and frontal bone
inferior: zygomatic and maxillary bone
medial: frontal bone and maxilla
78
orbital walls
roof: orbital plate of frontal bone and lesser wing of sphenoid
lateral: greater wing of sphenoid
inferior/floor: orbital plate of maxilla
medial: orbital plate of ethmoid bone
79
passes through the trochlea to insert in the sclera under the SR
superior oblique (intorsion)
80
nucleus of the oculomotor nerve
ventral part of the periacqueductal gray of the midbrain at the level of the SUPERIOR colliculus
81
abducens nerve nucleus
beneath the facial colliculus at the floor of the 4th ventricle
82
difference of nucleus of trochlear nerve vs oculomotor nerve
trochlear: ventral border of the periacqueductal gray at the level of INFERIOR colliculus (vs superior of CN III)
83
parietal lobe lesion
pie in the floor disorder
84
```
teMporal lobe (Meyer's loop)
(also called inferior optic radiation)
```
pie in the sky disorder
85
if in calcarine fissure lesion
with macular sparing
superior bank of calcarine fissure: inferior quadrantanopsia
inferior bank: superior quadrantanopsia
86
lesion in geniculocalcarine tract
contralateral homonymous hemianopsia
87
bitemporal non-homonymous hemianopsia
optic chiasm lesion
88
Bowman membrane vs Descemet membrane
layers of the cornea (avascular)
Bowman: epithelial basement membrane
Descemet: endothelial basement membrane
89
canal of Schlemm
drainage of aqueous humor
90
layers of the cornea
```
ABCDE
anterior epithelium
Bowman membrane
corneal stroma
Descemet membrane
endothelium
```
91
keratocytes vs keratinocytes
keratocytes: seen in corneal stroma
fibroblast-like cells
keratinocytes: keratin-secreting cells of the epidermis
92
middle vascular tunic (uvea)
iris
ciliary body
choroid
93
layer of retina that absorbs scattered light and forms blood-retina barrier
outer pigmented layer
94
sclera vs lens
lens: type IV collagen
sclera: type I collagen
95
Kiesselbach plexus
```
sphenopalatine artery (maxillary a)
greater palatine (maxillary a)
superior labial (facial a)
anterior ethmoidal (ophthalmic a)
```
96
ciliated pseudostratified columnar epithelium to clear debris and microbes
respiratory epithelium
97
goblet cells
secrete mucin
| with basal nuclei
98
function of columnar cells with apical microvilli
chemosensory receptors (brush cells)
99
small neuroendocrine cells secreting bioactive amines
Kulchitsky cells
100
olfactory epithelium
pseudostratified columnar epithelium
| lines superior concha at nasal cavity roof
101
olfactory neurons
bipolar neurons
102
length of external auditory meatus
2.5 cm
103
external 2/3 is cartilaginous, internal 1/3 is bony
external auditory meatus
104
labyrinth and lymph of inner ear
bony labyrinth: perilymph
| membranous labyrinth: endolymph
105
maculae
utricle
saccule
for linear acceleration in the membranous labyrinth
106
for angular acceleration (in the membranous labyrinth)
ampullae of semicircular canals
107
three parts of bony labyrinth
vestibule
semicircular canals
cochlea (upper: scala vestibula, lower: scala tympani)
108
organ of corti
organ of hearing
| 3 rows of outer hair cells and 1 row of inner hair cell attached to tectorial membrane
109
round window
high frequences: base
| low frequencies: apex
110
congenital megacolon/ Hirschsprung disease
squirt sign on DRE
failure of migration of neural crest cells due to RET mutation
does not have Meissner and Auerbach plexuses in the distal colon--> failure of peristalsis --> (usually cannot pass meconium within 48h of birth)
111
secondary brain vesicle giving rise to medulla
myelencephalon
112
neuroglial cells originate in the _____ except for ______ which originate from ______
ectoderm
microglia
mesoderm
113
oligodendrocyte vs Schwann cell
oligodendrocytes: CNS
forms myelin sheath around SEVERAL axons
Schwann cells: PNS
forms myelin sheath around a SINGLE axon
114
supratentorial level
```
cerebrum
basal ganglia
thalamus
hypothalamus
CN I, II
```
115
CN III to XII
cerebellum
brainstem (midbrain, pons, medulla oblongata)
infratentorial level
| below tentorium cerebelli but above foramen magnum
116
Wernicke / sensory aphasia
patient CANNOT understand
| Wernicke : Word Salad = non-sensical sentences
117
Broca / Motor aphasia
patient CAN understand but speech is slow and broken
| Broca : Broken speech = difficulty putting words together
118
Conduction aphasia
patient can understand and is fluent but difficulty repeating words
119
Global Aphasia
Wernicke and Broca
120
Gerstmann syndrome (MCA)
acalculia
agraphia
finger agnosia
left and right disorientation
121
Wernicke area
superior temporal gyrus
122
broca's area
inferior frontal gyrus
123
decussation of the corticospinal tract
lower medulla
124
corticobulbar decussation
above each relevant CN nuclei
125
VPL (ventral posterolateral nucleus)
spinothalamic tract
| through the dorsal column
126
thalamic infarction
Dejerine-Roussy syndrome
central pain syndrome
pure sensory loss without weakness of contralateral side
127
maintain coordination of limb movements and regulation of muscle tone
anterior lobe of cerebellum
128
anterior lobe of cerebellum
paleocerebellum
| spinocerebellum
129
posterior lobe of cerebellum
neocerebellum
| cerebrocerebellum
130
connected to cerebral cortex and coordinates voluntary movements
posterior lobe of cerebellum (cerebrocerebellum)
131
flocculonodular lobe of cerebellum
archicerebellum
| vestibulocerebellum
132
coordination of paraxial muscles involved in EQUILIBRIUM
vestibulocerebellum
133
posterior lobe syndrome
ataxia
dysmetria
dysdiadochokinesia
134
truncal ataxia
flocculonodular syndrome
135
foramina in cribriform plate of ethmoid bone
CN I
136
optic canal
CN II
ophthalmic artery
central artery/vein of retina
137
superior orbital fissure
CN III, IV, VI
frontal, lacrimal, nasociliary branches of CN V1
ophthalmic vein, superior
138
foramen rotundum
CN V2
139
foramen ovale
CN V3
| accessory meningeal artery
140
foramen spinosum
think MENINGEAL!
middle meningeal artery and vein
meningeal branch of CN V3
141
foramen lacerum
greater petrosal nerve
| on top is where ICA runs
142
internal acoustic meatus
CN VII, VIII
143
jugular foramen
CN IX, X, XI
sigmoid sinus to IJV
inferior petrosal sinus
posterior meningeal artery
144
hypoglossal canal
CN XII
145
foramen magnum
vertebral arteries
medulla
meninges
spinal root of CN XI
146
supraorbital foramen
supraorbital nerve, artery, and vein
| frontal nerve of CN V1
147
infraorbital foramen
infraorbital branch of CN V2
148
stylomastoid foramen
```
CN VII
stylomastoid artery (from posterior auricular)
```
149
mental foramen
adjacent to the root of 2nd premolar tooth
| transmits inferior alveolar nerve (mental nerve)
150
60-150 mmH2O
pressure of CSF
151
total volume of CSF
130-150 mL
152
Kernig sign
leg extension causes pain
| hips and Knees flexed
153
Brudzinski sign
passive flexion of head causes raising knees or hips in flexion
"Brud" - tatango sa brad
154
lumbar puncture (L3-L4 or L4-L5)
```
skin
superficial fascia
supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space
dura
arachnoid
subarachnoid space (where CSF is!)
```
155
chorea vs athetosis
chorea: jerking movement
athetosis: writhing movement
156
diplopia
ptosis
dilated and fixed pupil
CN III lesion
157
loss of corneal blink reflex
CN VII
158
loss of gag reflex
CN IX
159
dysarthria, dysphagia
CN X
160
white matter
myelinated axons
| deep in brain, peripheral in spinal cord
161
gray matter
cell bodies, glial cells
| peripheral in brain, deep in spinal cord
162
branches in the first part of subclavian
vertebral a
internal thoracic a
thyrocervical trunk
