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ENT > Anatomy of embryology and the ear > Flashcards

Anatomy of embryology and the ear Flashcards

1
Q

When do the pharyngeal arches develop?

A

Arch 1 - day 22
Arch 2 and 3 - day 24
Arch 4 and 6 - day 29

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2
Q

What are the 3 components of the pharyngeal apparatus?

A

Core pharyngeal arch - mesenchymal tissue
External pharyngeal cleft - ectoderm
Internal pharyngeal pouch - endoderm

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3
Q

What is contained within each pharyngeal arch?

A

Mesenchyme derived from the paraxial and lateral plate mesoderm
Neural crest cells
Cranial nerve
Artery

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4
Q

What does the mesenchyme of the pharyngeal arch create?

A

Musculature of the face

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5
Q

What does the neural crest cells of the pharyngeal arch create?

A

Skeletal components of face

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6
Q

What does the cranial nerve component of the pharyngeal arch create?

A

Innervation (sensory or motor)

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7
Q

What nerve supplies the 1st pharyngeal arch?

A

Trigeminal - mainly maxillary and mandibular

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8
Q

What nerve supplies the 2nd pharyngeal arch?

A

Facial nerve

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9
Q

What nerve supplies the 3rd pharyngeal arch?

A

Glossopharyngeal nerve

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10
Q

What nerve supplies the 4th and 6th pharyngeal arch?

A

Vagus nerve:
Arch 4 - superior laryngeal
Arch 6 - recurrent laryngeal

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11
Q

What skeletal processes does the 1st pharyngeal arch form?

A 
Maxilla
Zygoma
Squamous portion of the temporal bone
Mandibular process forms meckel's cartilage
Incus and malleus
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12
Q

What muscles and nerves does the 1st arch form?

A 
All musculature V3:
Muscles of mastication
Anterior belly of digastric
Mylohyoid
Tensor tympani
Tensor veli palatini
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13
Q

What is the sensory supply to the face?

A

V1
V2
V3

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14
Q

What skeletal structures does the 2nd pharyngeal arch form?

A 
Reichert's cartilage: 
Stapes
Styloid process of temporal
Stylohyoid ligament
Lesser horn of hyoid
Upper part of hyoid body
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15
Q

What muscles and nerves does the 2nd arch form?

A 
All musculature supplied by CN V||:
Muscles of facial expression 
Posterior belly of digastric
Stylohyoid
Stapedius
Auricular muscles
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16
Q

What skeletal components does the 3rd pharyngeal arch form?

A

Greater horn

Lower part of hyoid bone

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17
Q

What muscles and nerves does the 3rd arch form?

A

Musculature supplied by CN |X:
Stylopharyngeus
Longitudinal pharyngeal muscle

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18
Q

What skeletal components does the 4th and 6th arch form?

A

Laryngeal cartilages - thyroid and cricoid cartilage

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19
Q

What muscles and nerve does the 4th arch form?

A

Superior laryngeal nerve:
Cricothyroid
Levator veli palatini
Pharyngeal constrictors

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20
Q

What muscles and nerves does the 6th arch form?

A

Recurrent laryngeal nerve:

Intrinsic laryngeal musculature

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21
Q

What does the 1st cleft form?

A

External acoustic meatus

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22
Q

What do the 2nd -4th cleft form?

A

Cervical sinus

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23
Q

What does the 1st pharyngeal pouch form?

A

Middle ear
Tympanic membrane
Eustahcian tube

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24
Q

What does the 2nd pharyngeal pouch form?

A

Palatine tonsil

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25
Q

What does the 3rd pharyngeal pouch form?

A

Inferior parathyroid gland

Thymus

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26
Q

What does the 4th pharyngeal pouch form?

A

Superior parathyroid gland

Thyroid gland/ C cells

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27
Q

What structure does the thyroid gland originate from?

A

Foramen cecum

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28
Q

What is included in the inner ear?

A

Balance - semicircular canals

Hearing - organ of corti

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29
Q

What is included in the middle ear?

A

Tympanic cavity

Ossicles - mastus, incus and stapes

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30
Q

What is included in the external ear?

A

External auditory meatus

Auricle

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31
Q

What does the utricular portion of the inner ear give rise to?

A

Semicircular canals

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32
Q

What does the saccular portion of the inner ear give rise to?

A

Cochlear

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33
Q

What is formed within the crista ampullaris?

A

Sensory cells for balance

Vestibular fibres of CN V|||

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34
Q

When does the cochlear duct spiral?

A

Between weeks 6-8

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35
Q

What is included within the organ of corti?

A

Hair cells

Auditory nerve fibres

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36
Q

What structures surround the cochlear duct?

A

Scala vestibuli

Scala tympani

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37
Q

What is the function of the nasal cavity?

A

Acts as a patent conduit to be transported to the nasopharynx
Filters air of particulate material (vibrissae - small hairs)
Humidifies air (glands)
Warms inspired air in the nasal passage (blood)
Sense of smell as air passes over the olfactor epithelium

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38
Q

What is included in the external nose?

A 
Root
Dorsum
Tip (V1 sensory, hutchinson's sign)
Ala
Nares
Septum 
Philtrum
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39
Q

What are the bones of the nose?

A 
Frontal bone - superior nasal processes
Maxilla - inferior nasal processes
Nasal bone
Vomer
Perpendicular plate of the ethmoid bone
Inferior nasal concha
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40
Q

What does the ethmoid bone form in the nasal cavity?

A

Perpendicular plate - septum
Superior and middle concha
Air cells
Crista galli of cribriform plate where the olfactory axons travel through

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41
Q

What forms the septum?

A

Perpendicular plate of the ethmoid bone

Septal cartilage

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42
Q

What can occur as a result of a le fort 2 or 3 fracture?

A

Disrupt the cribriform plate of the ethmoid resulting in ansomia, disruption of paranasal sinuses and faciliates the spread of infection

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43
Q

What mucosa is contained within the nasal vestibule?

A

Stratified squamous epithelium

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44
Q

What mucosa is contained within the nasal cavity?

A

Superiorly - olfactory epithelium at the superior concha

Inferior and medial concha is made from respiratory epithelium (ciliated pseudostratified columnar epithelium)

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45
Q

What is the olfactory pathway?

A

Receptor cells in the olfactory epithelium
Pass up through the cribriform plate
Synapse with the olfactory bulb
Neurones pass along olfactory tract
Pass to temporal lobe and olfactory areas

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46
Q

What nerve supplies the superior and anterior portion of the nasal cavity extending to the tip of the nose?

A

Ophthalmic division of the trigeminal nerve

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47
Q

What nerve supplies the inferior and posterior portion of the nasal cavity - covering the teeth?

A

Maxillary division of the trigeminal nerve

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48
Q

What layer is the neural crest derived from?

A

Ectoderm

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49
Q

What branch of V1 provides innervation to the nasal cavity?

A

Anterior ethmoidal nerve which is a branch of the nasociliary nerve
Passes through the anterior ethmoidal foramen

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50
Q

What branch of V2 provides innervation to the nasal cavity?

A

Nasopalatine nerve which passes through the sphenopalatine foramen

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51
Q

What is the blood supply to the face?

A

Ophthalmic artery from the ICA
Maxillary artery from ECA
Facial artery from the ECA
Superior labial artery from the facial artery

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52
Q

What arteries form kiesselbacks area?

A 
Lateral nasal artery (facial artery)
Greater palatine (maxillary artery)
Anterior ethmoidal (ophthalmic)
Posterior ethmoidal (ophthalmic)
Sphenopalatine (maxillary) 
Septal branch (facial)
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53
Q

What can occur with trauma to kiesselbachs area?

A

Epitaxis

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54
Q

Where is kiesselbachs area found?

A

Anteroinferorly on nasal septum

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55
Q

What are the 3 nasal conchas that project from the lateral nasal wall?

A

Superior nasal concha (ethmoid)
Middle nasal concha (ethmoid)
Inferior nasal concha (own bone)

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56
Q

What areas lie between the concha?

A

Sphenoethmoidal recess above the superior concha
Superior meatus between superior and middle
Middle meatus between middle and inferior
Inferior meatus below the inferior concha

57
Q

What sensory nerve supply is the inferior nasal concha?

A

CN V2

58
Q

Where does the eustachian tube open in the throat?

A

Lateral wall of the nasopharynx

59
Q

Describe airflow and the nasal cycle?

A

Conchae are referred to as turbinates as they cause turbulent flow through the nasal cavity
They increase opportunity for humidifying, warning and filtering

60
Q

Why will the nasal concha engorge?

A

Erectile tissue

61
Q

What is a paranasal sinus?

A

Open space within the bone

62
Q

What are the 4 different paranasal sinuses?

A

Frontal sinus
Ethmoidal air cells
Maxillary sinus
Sphenoidal sinus

63
Q

What lines the paranasal sinuses?

A

Respiratory epithelium - ciliated pseudostratified columnar epithelium with goblet cells

64
Q

What drains into the sphenoethmoidal recess?

A

Sphenoid sinus

65
Q

What drains into the superior meatus?

A

Posterior ethmoidal air cells

66
Q

What drains into the middle meatus?

A

Semilunar hiatus
Frontal sinus
Maxillary sinus
Anterior ethmoidal air cells

67
Q

What drains into the inferior meatus?

A

Nasolacrimal duct

68
Q

What is sinusitis?

A

Inflammation of the mucosa in one or more of the paranasal sinuses

69
Q

Why does sinusitis occur?

A

Cilia of resp mucosa wafts mucous towards the ostia

In a viral URTI , there can be swelling reducing the diameter of the osta causing infected mucous to build up

70
Q

What can occur if the ethmoid bone breaks?

A

Increased pressure can cause a rupture of the ethmoid bone breaking into the medial wall of the orbit impacting the eye/ optic nerve

71
Q

Why can sinusitis cause referred pain to the teeth?

A

Sensation provided by CN V1 and V2 may be referred to the teeth

72
Q

What sinus is predisposed to infection?

A

Maxillary sinus because the ostium is located superiorly and medially in relation to its cavity to the cilia must work against gravity

73
Q

What is an oroantral fistula?

A

Communication between maxillary sinus and tooth socket

Tooth infection can lead to sinus infections if the roots pierce upwards into maxillary sinus

74
Q

What different parts of the ear are responsible for hearing and balance?

A

Hearing - auditory system

Balance - vestibular system

75
Q

What is the pterion?

A

H shaped suture which contains the frontal, parietal, temporal and sphenoid bones
THINNEST PART OF SKULL

76
Q

What part of the temporal bone forms the ear?

A

Petrous part

77
Q

What forms the squamous part of the frontal bone?

A

1st pharyngeal arch from neural crest cells

78
Q

What arch forms the styloid process?

A

2nd

79
Q

What can occur with rupture to the pterion?

A

Epidural haemorrhage

80
Q

Through which does the facial nerve exit the temporal bone?

A

Stylomastoid foramen

81
Q

What bones are in the anterior cranial fossa?

A

Frontal

Cribriform plate of ethmoid

82
Q

What bones form the middle cranial fossa?

A

Parietal and sphenoid bones

83
Q

What bones form the posterior cranial fossa?

A

Parietal and occipital

84
Q

What CN exits via cribriform plate of ethmoid bone?

A

Olfactory

85
Q

What CN exits via optic canal?

A

Optic nerve

86
Q

What CN’s exit via superior orbital fissure?

A

Oculomotor, Trochlear, V1 and abducens

87
Q

What CN’s exit via formen rotundum?

A

V2

88
Q

What CN’s exit via foramen ovale?

A

V3

89
Q

What CN’s exit via the internal acoustic meatus?

A

Facial nerve
Vestibulocochlear nerve
Also labyrinthine artery and vein

90
Q

What CN’s exit via the jugular foramen?

A

Glossopharyngeal
Vagus
Spinal accessory

91
Q

What CN exits via the hypoglossal canal?

A

Hypoglossal canal

92
Q

What does the facial nerve do?

A 
Motor to muscles of facial expression 
Motor to stapedius
Taste to anterior 2/3rd of tongue
Secretomotor to salivary glands (except parotid which is glossopharyngeal) and lacrimal gland
General sensation of external ear
93
Q

What does the vestibulocochlear nerve do?

A

Balance

Hearing

94
Q

What is the labyrinthine artery?

A

Branch of anterior inferior cerebellar artery from circle of willis

95
Q

What is the anatomical division of the external ear?

A

Auricle to tympanic membrane
Via external acoustic meatus
Collects and conveys sound waves to tympanic membrane

96
Q

What is the anatomical division of the middle ear?

A

Tympanic membrane to oval window
Eustachian tube
Amplifies and conducts sounds waves to internal ear

97
Q

What is the anatomical division of the internal ear?

A

Oval window to internal acoustic meatus
Converts special sensory info:
into fluid waves then APs then conducts these APs to the brain

98
Q

What forms the skeleton of the external ear?

A

Petoral temporal bone
Elastic cartilage - neural crest cells
Avascular - nutrients from skin

99
Q

What forms the ear canal

A

Begins at external acoustic meatus
Composed of 1/3rd catilage and 2/3rds bone
Lined by skin
Produces ear wax

100
Q

What gland produces earwax?

A

Ceruminous glands

101
Q

What nerve supplies the pinna?

A

C2,3 spinal nerves

Tiny bit facial nerve

102
Q

What nerve supplies the superior parts of the external acoustic meatus and the majority of the tympanic membrane?

A

CN V3 (1st pharyngeal arch)

103
Q

What nerve supplies the inferior parts of the external acoustic meatus and a small part of the tympanic membrane?

A

Vagus nerve - can refer to pharynx

104
Q

Where does everything in front of the ear (lateral surface of superior half) drain to?

A

Parotid lymph nodes

105
Q

Where does the auricle drain to?

A

Superficial cervical lymph nodes

106
Q

Where does everything behind the ear (cranial surface of superior hald) drain to?

A

Mastoid lymph

107
Q

Where does all of the ear eventually drain to?

A

Deep cervical lymph nodes at the carotid sheath

Then the thoracic duct or right lymph duct at venous angles

108
Q

What does an otoscopic exam look at?

A

EAM and tympanic membrane - pars flaccida, cone of light, the pars tensa and the umbo (depressed part)

109
Q

What is the difference when examining the ear in children and adults?

A

Children - posteroinferorly

Adults - posterosuperiorly

110
Q

What supplies the external surface of the tympanic membrane?

A

CN V3

111
Q

What supplies the internal surface of the tympanic membrane?

A

CN |X

112
Q

What does the glossopharyngeal nerve provide sensory innervation to?

A 
Middle ear cavity
Eustachian tube
Nasopharynx
Oropharynx
Tonsils
113
Q

What bones are contained within the middle ear?

A

Malleus
Incus
Stapes

114
Q

What muscles are contained within the middle ear?

A

Stapedius - facial nerve

Tensor tympani - V3

115
Q

What type of joints are between the bones of the middle ear?

A

Synovial joints

116
Q

What is the epitympanic recess?

A

Superior to the tympanic membrane

117
Q

What bone connects to the oval window?

A

Stapes

118
Q

What makes up the walls of the tympanic cavity?

A 
Roof - tegmental wall 
Floor - jugular wall
Lateral - membranous
Medial - labyrinthine 
Posterior - mastoid 
Anterior - carotid
119
Q

What is the aditus?

A

Doorway into the mastoid antrum from the epitympanic recess

120
Q

Why can tonsillitis or pharyngitis mimic earache?

A

Common sensory nerve supply - CN |X

121
Q

Where does the facial nerve originate from?

A

Brainstem at the pontomedullary unction

122
Q

What does the chorda tympani (branch of facial nerve) supply?

A

Taste buds of 2/3rds of tongue

Parasymp to submandibular and sublingual salivary glands

123
Q

What is the function of the stapedius?

A

Recues stapes movement to protect the internal ear from excessive noise

124
Q

What is the facial canal?

A

Connects the internal acoustic meatus to the stylomastoid foramen in the petrous temporal bone

125
Q

How can the muscles of facial expression be tested?

A

Frown - frontalis
Close eyes tightly - orbicularis oculi
Smile - elevators of lips
Maintain puffed out cheeks - orbicularis oris

126
Q

What are the 2 parts of the vestibulocochlear nerve?

A

Cochlear nerve - hearing

Vestibular nerve - balance

127
Q

What is contained within the otic capsule?

A

Bony labyrinth filled with perilymph

Suspended within the perilymph of the labyrinth is the communicating sacs and ducts which contain endolymph

128
Q

How many semicircular canals are there?

A

3 - superior, lateral and posterior

129
Q

How many turns are there in cochlea?

A

Cupula (apex)

2 turns

130
Q

What does the perilymph communicate with?

A

CSF

131
Q

What is the cochlear duct?

A

Long balloon like structure within the cochlear filled with endolymph - APs conducted to brainstem in the cochlear nerve

132
Q

What are the semicircular ducts?

A

inter-linked balloon like structures within the semicircular canals filled with endolymph
APs conducted to brainstem via vestibular nerve

133
Q

What are hair cells stimulated by?

A

Movement of endolymph

134
Q

What is a cluster of hair cells called?

A

Maculae

135
Q

What do semicircular ducts detect?

A

Angular movement change

136
Q

What doe the utricle and saccules detect?

A

Linear movement change:
Utricle - horizontal - car sickness
Saccule - vertical

137
Q

Describe sound transmission?

A

Sound waves make tympanic membrane vibrate
Vibrations transmitted through ossicles
Base of stapes vibrate in oval window
Vibration of stapes creates pressure waves in perilymph
Hair cells in cochlea moved (endolymph), APs stimulated and conveyed to brain via cochlear nerve
Pressure waves descend and become vibrations again
Pressure waves dampened at round window

138
Q

What is the organ of corti?

A

REceptor cells that detect auditory stimuli that is located on the basilar membrane of the cochlear dut

139
Q

What are the 2 parts of the cochlear duct?

A

Scala vestibuli - sound in

Scala tympani - sound out

ENT (20 decks)

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