Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RLH MRCS > Anatomy pearls > Flashcards

Anatomy pearls Flashcards

1
Q

What is the distinguishing difference between CNIII and horners

A
  • Pupil:
    • CNIII - dilated, unopposed sympathetic (CNIII parasympathetic supply is lost)
    • Horner’s - constricted, unopposed parasympathetic,
  • CNIII: eye is down and out - unopposed superior oblique (trochlear) and lateral rectus (abducence)
  • Horner’s: ptosis, enophthalmus, anhydrosis, small pupil (miosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which nerve supplies sensation to the tongue?

A
  • Tase:
    • Glossopharyngeal IX - posterior 1/3rd
    • Corda tympani, branch of VII - anterior 2/3
  • Somatic sensation:
    • glossopharyngeal IX
    • Lingual nerve, branch of mandibular division of trigeminal Viii
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which nerve supplies motor sensation to the tongue?

A

XII, pharyngeal plexus of IX, X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the course of CN VII

A

VII (facial nerve) originated at junction between pons and medulla, crosses posterior cranial fossa, passing into temporal bone in the facial canal and exiting via the stylomastoid foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tell me about the trigeminal nerve?

A

3 branches: ophthalmic, maxillary, mandibular

sensation to the face + motor supply to muscles of mastication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you know about the cranial sutues?

A

Usually ossify 18-24mo

Before this time the fontanelles are open, they can be seen to bulge in times of increased ICP

when they fuse at birth = craniosyntosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the pterion?

A

junction of 4 bontes; frontal, parietal, temporal, sphenoidal

Middle meningeal artery runs behind the pterion - injury may damage this and result in extradural H’gge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the base of skull foramina?

A
  • Anterior cranial fossa:
    • cribriform plate - olfactory n, emissary veins and arteries
  • middle cranial fossa:
    • optic canal - optic nerve, 3 layers of dura, opthalmic artery and sympathetic
    • Superior orbital fissure - CN III, IV, VI, ophthalmic division of CNV, ophthalmic veins; sympathetic; br of middle meningeal & lacrimal arteries
    • Foramen rotundum; maxillary division of CN V
    • Foramen ovale - mandibular br of CN V, petrosal n, accesory meningeal art
    • F Spinosum - middle memningeal artery, meningeal br of mandibular n
    • F lacerum - artery and nerve of pterygoid canal, (via carotid canal - internal carotid art and n
  • posterior cranial fossa
    • F magnum - medulla oblongata surrounded by meninges, spinal roots of accessory n, vertebral arteries with surrounding sympathetic plexus, anterior and posterior spinal arteries, apical ligament of dens, tectoral membrane
    • Jugular F - IJV, CN IX, X, XI, inferior petrosal sinus
    • Hypoglossal canal - CN XII, meningeal br of ascending pharyngeal artery
    • Internal auditory meatus - CN VII, VIII, labyrinthine artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What passes through the foramen lacerum?

A

artery and nerve of pterygoid canal

The internal carotid artery passes from the carotid canal in the base of the skull, emerging and coursing superior to foramen lacerum as it exits the carotid canal. The internal carotid artery does not travel through foramen lacerum. The segment of the internal carotid artery that travels above foramen lacerum is called the lacerum segment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the boundaries of the middle cranial fossa?

A

Anterior = posterior margin of lesser wing, anterior clinoid process and anterior margin of chiasmatic groove of sphenoid

Posterior = crest of petrous temporal bone and dorsum sellae of sphenoid bone, squamous temportal bone, greater wings of sphenoid

Temporal lobe lies inside the middle cranial fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where can the pituitary gland be found?

A

Sella turcica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What passes through the foramen magnum?

A

Blood vessles - vertebral arteries, anterior and posterior splinal arteries

Nerves - spinal roots of accessory nerve, sympathetic plexus around the vertebral artery

Tissues - medulla, meninges, tectorial membrane, apical ligament of dens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What runs through the optic canal?

A

optic nerve, 3 laters of dural, opthalmic artery, sympathetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the contents of the jugular foramen?

A

IVJ, IX, X, XI, inferior petrosal sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the branches of the ICA?

A

no branches in the neck, intracranial -> middle cerebral and posterior communicating arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the cavernous sinus?

A

2 cavernous sinuses in the skull- each lying laterally on either side of the sella turcica

contain venous blood

draining the superficial middle cerebral, superior and inferior opthalmic veins & sphenoparietal sinuses

joined by the intercavernous sinuses and themselves drain into the superior and inferior petrosal sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the contents of the cavernous sinus?

A
  • ICA (with sympathetic plexus)
  • venous blood
  • CN VI
  • within the lateral wall: CNIII, CNIV, Va, Vb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does cav sinus thrombosis occur?

A
  • infections of the danger area of the face i.e. those drained via the facial and opthalmic veins - may spread into the cavernous sinus as the draining veins are valveles -> thrombosis
  • Sx: painful swelling of the eye, gradual loss of vision, CNIII, IV, V, VI palsies
  • infection spreads rapidly due to the intercavernous sinuses
  • DDx= CVA
19
Q

What are the 4 layers of deep cervical fascia?

A

carotid sheath

prevertebral fascia

pre-tracheal fascia

investing layer of deep cervical fascia - outer layer, deep to platysma

20
Q

What are the carotid sheath contents?

A

common carotid artery, IJV, with vagus in between

+ LN

embeded in the wall = ansa cervicalis

21
Q

What are the contents of pretracheal fascia?

A

thyroid gland, trachea, oesophagus

22
Q

what level does common carotid artery bifurfacte?

A

C4 -> internal and external carotid

surface marking - superior thyroid notch

23
Q

What are the branches of external carotid artery?

A

superior thyroid, ascending pharyngeal, lingual, fascial, occipital, posterior auricular, maxillary, superficial temporal

24
Q

what muscles are contained within the pre-vertebral fascia?

A

Scalenus anterior, medius, posterior

levator scapulae

splenius capitis

25
Q

What are the boundaries of the posterior triangle?

A

Anteriorly - posterior border of SCM

Posteriorly - anterior border of trapezius

Base - middle 3rd of clavicle

Roof = investing layer of deep cervical fascia

floor = prevertebral fascia

26
Q

What are the contents of the posterior triangle of the neck?

A
  • Vessels - subclavian artery (3rd part); transverse cervical, suprascapular, occipital arteries, transverse cervical, suprascapular & external cervical veins
  • Nerves - spinal root of accessory nerves and branches of brachial plexus, phrenic
  • muscle - omohyoid
  • LN
  • Surface marking of spinal bn of CNXI (accessory nerve) - at risk in op in post triangle of neck (1/3 way down SCM), (1/3 way up trapezius) -> weakness in both
27
Q
A
28
Q

Tell me about the anatomy of the thyroid

A

located below the thyroid cartilage with thyroid isthmus below cricoid cartilage invested in pretracheal fascia

attached to 2nd-4th tracheal rings

during development thyroid gland descends from foramen caecum (2/3rds along length of the tongue from the tip) to loop around beneath the hyoid bone

descent too far results in a retrosternal thyroid

incomplete descent, can lead to a lingual or pyramidal thyroid gland

or result in a thyroglossal duct cyst which can become infected

during removal the middle 1/3rd of the hypod bone should also be excised to prevent recurrence

29
Q

What is the blood supply of the thyroid?

A

Superior: superior thyroid artery, branch of external carotid artery

Middle/thyroid ima artery from brachiocephalic trunk

Inferior: inferior thyroid artery, thyrocervical trunk, off subclavian artery

30
Q

Venous drainage of the thyroid?

A

Superior and middle thyroid -> ipsilateral IJV

Inferior thryoid -> brachiocephalic vein

31
Q

How to perform a needle cricothyroid puncture?

A

emergency procedure

steril conditions as poss

locate cricothyroid membrane; thyroid notch - depression - cricothyroid cartilage

12/14 guage canula to syringe containing 1ml of air, inject air to displace skin plug,

remove needle, secure cannula in place

connect to O2 supply using Y connector -> jet insufflation

1 sec on, 4 sec off

ensure held on it’s way for definitive airway

32
Q
A

Thyrohyoid - depresses the hyoid and elevates the larynx

innervated by ansa cervicalis C1

33
Q
A
34
Q

What is the cause of a horse voice following total thyroidectomy?

A

Operative damage to Recurrent Laryngeal Nerve -> paralysis of ipsilateral cord -> horse voise

RLN runs close to interior thyroid artery

(ELN, external, @risk during ligation of superior thyroid artery)

Semon’s law dictates that if both RLN are damaged -> aiway compromise as both cords will lie in the midline

RLN -> all muscles of the larynx except cricothyroid (ELN, branch of SLN)

35
Q

How does damage to ELN present?

A

Change in the patient’s voice/lack of pitch

monotonous speach

cricothyroid -> increasing tension of the vocal cords -> higher pitch

36
Q

What is the sensory supply to the larynx?

A
  • Above vocal folds = internal laryngeal - branch of SLN*
  • Below vocal cords = branch of RLN*
  • ILN = sensation above vocal cords, br of SLN
  • ELN = cricothyroid muscle
  • RLN = sensation below vocal cords + muscles of larynx (except cricothyroid)
37
Q

What is the corresponding level and pharyngeal arch:

1) Hyoid bone
2) Thyroid cartilage
3) Cricoid cartilage

A

1) Hyoid bone - C3 - pharyngeal arch 4
2) Thyroid cartilage - C4 - pharyngeal arch 4
3) Cricoid cartilage - C6 - pharyngeal arch 6

38
Q

What muscle opens the vocal cords?

A

Posterior cricoarytenoids externally rotate the arytenoids opening the vocal cords

39
Q

What muscle closes the larynx when swallowing?

A

Lateral cricoarytenoids

40
Q

Tell me about the strap muscles

A

AKA infrahyoid muscles

innervated by parts of ansa cervicalis, except thyrohyoid = C1

sternothyroid, sternohyoid, theyrohyoid, omohyoid

Depress the hyoid bone and larynx during swallowing and speaking

Ansa cervicalis - loop of nerves C1-3 that forms part of the cervical plexus, superficial to internal jugular vein in carotid sheath

41
Q

Where are the parathyroids found?

A

Posterior aspect of the thyroid fland

2 on each side

blood supply = inferior thyroid artery = branch of thryocervical trunk = branch of sternoclavicular artery

Inferior parathyroids = 3rd branchial arch embryologicall (along with the thymus)

Superior parathyroids = 4th branchial arch

42
Q
A
43
Q

Sensory supply to the leg

A

RLH MRCS (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions