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B MRCS JS > Anatomy HNS > Flashcards

Anatomy HNS Flashcards

1
Q

Where does the internal carotid enter the cranium?

A

Common carotid bifurcates at C3/4

Internal carotid is identified as posterior branch

Enters cranium through carotid canal in petrous temporal bone

Divided into 7 segments

Travels through petrous part of temporal bone

Runs behind petrotemporal ligament

Through cavernous sinus

Emerges medial to anterior clinoid process

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2
Q

How many anatomical parts of the internal carotid are there?

A

7 total

  • Cervical
  • Petrous
  • Lacerum
  • Cavernous
  • Clinoid
  • Ophthalmic
  • Communicating
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3
Q

What branches are given off by petrous part of ICA?

A
  • Carticotympanic artery
  • Artery of pterygoid canal
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4
Q

What branches are given off by cavernous part of ICA?

A
  • Inferolateral trunk
  • Meningohypophyseal artery
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5
Q

What branch is given off prior to bifurcation into anterior cerebral and middle cerebral?

A
  • Anterior choroidal artery
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6
Q

Branches of internal carotid outside of skull?

A

None

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7
Q
A

Image of the ICA

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8
Q

What is the blood supply to the cerebellum

A

Superior cerebellar artery > Basilar

Anterior inferior cerebellar artery > Basilar

Posterior inferior cerebellar artery > Vertebral

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9
Q

Draw the Circle of Willis

A
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10
Q

Carotid digital subtraction angiogram lateral view. Identify ACA, MCA, ICA

A
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11
Q

Carotid angiogram AP view: Identify ICA, ACA, MCA

A
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12
Q

Bones of the orbit

A
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13
Q

Label the following:

A
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14
Q

What are the branches of the basilar artery?

A
  • Anterior inferior cerebellar artery
  • Labyrinthine
  • Pontine branches
  • Superior cerebellar
  • Posterior cerebral
  • Posterior communicating
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15
Q

What structures are supplied by basilar?

A
  • Cerebellum (AICA, SCA)
  • Pons
  • Middle ear
  • Occipital lobe
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16
Q

Outline the course of the vertebral artery

A
  • First branch of the subclavian artery
  • Ascends in foramen transversarium of C6 > C1
  • Here it is accompanied by vertebral veins and sympathetic nerves
  • Passes posteriorly behind lateral mass of axis
  • Turns medially over posterior arch
  • Pierces atlanto-occipital membrane, dura and arachnoid
  • Ascends on anterior aspect of medulla
  • Forms basilar artery at lower border of pons
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17
Q

Outline flow of blood from superior sagittal sinus to the internal jugular

A

Superior sagittal (falx cerebri) > confluence > transverse (tentorium cerebelli) > sigmoid + inferior petrosal > internal jugular

18
Q

Where is the straight sinus? Primary contribution?

A
  • Junction between falx cerebri and tentorium cerebelli
  • Formed by:
  • Great cerebral vein of Galen
  • Inferior sagittal sinus
  • Right and left basal veins
19
Q

Image of the venous system of the head

A
20
Q

What forms the internal jugular? Where does it exit? What exits with it?

A
  • Sigmoid sinus and inferior petrosal sinus
  • Jugular foramen (posterior cranial fossa)
  • Accompanied by:
  • CNIX
  • CNX
  • CNXI
21
Q

What are diplopic veins? What do they drain?

A
  • Valveless intraosseous veins
  • Drain blood from cranium > dural venous sinuses via emissary veins
  • Conduit for infection
22
Q

What is drained by dural venous sinuses?

A
  • Brain parenchyma > cerebral veins
  • Cranium > diplopic veins
  • CSF > Arachnoid granulations
23
Q

How does infection spread from face to cavernous sinus?

A
  • Direct communication between facial vein and cavernous sinus
  • Via inferior ophthalmic vein
24
Q

What is the danger area for infection spreading into cavernous sinus?

A
  • Triangle bounded by nasal bridge and labial commissures
25
Q

Label the following:

A
26
Q

Outline flow of CSF

A
  • Ventricles lined by ependymal cells (glial cell) which form Choroid Plexus
  • 70% CSF produced by choroid plexus
  • 30% produced directly by ependymal cells lining ventricles

- Two lateral ventricles > Interventricular foramen of Monro > Third ventricle > Cerebral Aqueduct > Fourth ventricle > Foramen of Magendie (middle) OR Foramen of Luschka (lateral)

  • Circulates in subarachnoid space
  • Drained into dural venous sinuses by arachnoid granulations
27
Q

Identify: Central sulcus, pre-central gyrus, post-central gyrus, lateral sulcus (sylvian fissure)

A
28
Q

What area is located in pre-central gyrus?

A
  • Primary motor cortex
  • Broadmann area 4
29
Q

What area is the post-central gyrus?

A
  • Primary somatosensory cortex
  • Broadmann area 3/1/2
30
Q

T1 vs T2 weighted MRI?

A
31
Q

Gross anatomy of cerebellum?

A
  • Posterior fossa
  • Anterior: separated from pons by 4th ventricle
  • Superior: separated from occipital lobe by tentorium cerebelli
  • Two hemispheres connected via vermis
32
Q

What is an Arnold Chiari malformation?

A
  • Downward displacement of cerebellar tonsils through foramen magnum
  • Associated hydrocephalous + lumbar myelomeningocele
  • CSF leakage (myelomeningocele)
  • Hypoplasticposteriorfossa
  • Cerebellartonsilherniation
33
Q

What are the layers of the scalp?

A
  • Skin
  • Connective tissue (dense)
  • Aponeurosis (galea)
  • Loose connective tissue (areolar, blood vessels)
  • Periosteum
34
Q

Why do scalp lacerations bleed profusely?

A
  • Scalp vessels adherent to dense connective tissue→ prevents vasoconstriction
  • High collateralisation with lots of feeder vessels
  • Pull of occipitofrontalis prevents closure of bleeding vessel and surrounding skin
35
Q

Which layer raised during scalp surgery?

A
  • Loose connective tissue (areolar)
36
Q

Outline sensory innervation to scalp

A
37
Q

Outline blood supply to scalp

A

Branches of external carotid:

  • Superficial temporal
  • Occipital
  • Posterior auricular
38
Q

Describe the layers of meninges

A

DURA

  • Periosteal layer and meningeal layer
  • Dural venous sinuses between these two layers
  • Only meningeal layer present in vertebral column

ARACHNOID

  • Avascular with no innervation (thin, spiderlike)
  • CSF flows in subarachnoid space
  • Projections into dura = arachnoid granulations = CSF resorption into dural venous sinuses

PIA

  • Highly vascularised
  • Tighly adherent to brain
39
Q

Identify falx cerebri and tentorium cerebelli

A
40
Q

What are the attachments of the falx cerebri?

A
  • Anterior: Crista gali of ethmoid
  • Posterior: Occipital protuberance and tentorium cerebelli
41
Q
A

B MRCS JS (1 decks)

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