Anatomy - HNS Flashcards
What are the three main herniations you need to know
1) Subfalcine herniation 2) Uncal herniation 3) Tonsillar herniation
Which part of the brain herniates in a subfalcine herniation ?
Frontal lobe herniates under the falx cerebri This is not clinically significant
Which part of the brain herniates in an uncal herniation
The uncus of the temporal lobe herniates below the tentorium cerebelli and compresses the midbrain This can lead to loss of consciousness
Which part of the brain herniates in a Tonsillar herniation
The cerebellar tonsils move downward through the foramen magnum possibly causing compression of the medulla This can lead to cardiorespiratory arrest
Outline the drainage of CSF
The choroid plexi create CSF in each lateral ventricle Lateral ventricles->inter ventricular foramina ->the third ventricle ->cerebral aqueduct ->the fourth ventricle Then into the subarachnoid space
The internal carotid artery enters the cranium through which foramen?
Carotid canal
Lis the nerves (5) and artery that run through the cavernous sinus
CN3
CN4
Opthalmic and maxillar CN 51 CN52
CN6
Internal carotid
Anterior longitudinal ligament – covers and connects the anterior aspect of the vertebral bodies
Ligamentum flava – between vertebral arches
Posterior longitudinal ligament – runs within the vertebral canal on the posterior aspect of the vertebral bodies
Interspinous – between adjacent spinous processes
Supraspinous – between the tips of the spinous processes
Which ligament is often injured in whiplash injures
Anterior longitudinal
Describe the cough afferent and efferent pathways and what controls it
- Vagus afferents trigger inhalation ->
- Glottis closed and contracting abdominals
- >raised intra-thoracic pressure
- soft palate raised and tensed against posterior wall of pharynx by
- *-levator veli palantini CN X**
- *-superior constrictor, CN X**
- *-tensor veli palantini CN V3**
- -> abduction of vocal cords releasing intra-thoracic pressure through mouth
Name cranial nerves that have a parasympathetic function
Oculomotor III
Facial VII
Glossopharyngeal IX
Vagus X
What are the two small muscles of the ear and what are their actions?
Tensor tympani muscle (V3): Pulls the handle of the malleus medially. This tenses the tympanic membrane, reducing the force of vibrations in response to loud noises
Stapedius (VII): Pulls the stapes posteriorly to prevent excessive oscillation
Which nerve is the a fferent divions of the sneeze reflex?
V2
Which nerve is the a fferent divions of the cough reflex?
X
Which muslces depress the soft paalte agains the tongue in a sneeze?
Palatopharyngeus/palatoglossus (X)
Which muslces raise the soft palate against the posterior wall of the pharynx in a cough ?
Levator veli palatine (X),
Tensor veli palatine (V3),
Superior constrictor (X)
Name 6 functions of the facial nerve ?
Salivation: VII provides GVE fibres from the superior salivary nucleus destined for submandibular and sublingual salivary glands via the SUBMANDIBULAR ganglion
Lacrimation: VII provides GVE fibres from the superior salivary nucleus destined for LACRIMAL gland via PTERYGOPALATINE ganglion.
Facial expression; SVE fibres to facial muscles.
Tension on middle ear bones; innervation to stapedius
Taste; SVA fibres from anterior two thirds of tongue to the solitary nucleus via the geniculate ganglion
Mastication and swallowing: SVE fibres to the buccinator (mastication), raising larynx during swallowing, innervates stylohyoid and posterior belly of digastric
General sensation: To the external auditory meatus
Describe the major branches of the external carotid artery
Superior thyroid
Ascending Pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
What are the limits of the pharynx?
Sup: Base of skull
Inferior limit CV1
Which nerve innervates all the extrinsic muscles of the tongue and what is the exception?
hypoglossal nerve (XII)
EXCEPTION: Palatoglossus, innervated by the Vagus (X)
What are the 3 borders of the anterior triangle?
Anterior border of sternocleidomastoid
Midline
Inferior border of mandible
Muscles in the anterior triangle
The giant muscle, the platysma, covers the entire anterior of the neck in the superficial fascia
TOSS My Gravy Spoon Darling
Otherwise there are 2 main muscle groups:
Suprahyoid (x4)
above the hyoid bone – consist of the
- mylohyoid,
- geniohyoid
- stylohyoid,
- digastric.
Infrahyoid (x4)A.k.a strap muscles
below the hyoid bone –
- thyrohyoid muscles
- omohyoid,
- sternothyroid and
- sternohyoid,
Which muscles are both innervated by C1 fibres from the hypoglossal nerve
: The geniohyoid and the thyrohyoid
Borders of posterior triangle?
Posterior border of sternocleidomastoid
Anterior border of trapezius
Middle 1/3 clavicle
What is the contents of the posterior triangle of the neck?
4 vessels and 4 nerves
External + internal jugular veins
Subclavian arteries + subclavian veins
Trunks of brachial plexus
Spinal accessory
Phrenic nerve
Vagus nerve
What muscles does the Spinal accessory nerve innervate?
Innervates sternocleidomastoid and trapezius
indicate the landmarks for insertion of a central line into the internal jugular vein
Palpate common carotid
Go lateral and insert needle at 30 degree angle
Aim at apex of the triangle of the sternal and clavicular heads of the SCM
Direct towards nipple
