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Block 4 > Anatomy [Week 3] > Flashcards

Anatomy [Week 3] Flashcards

1
Q

The primary position (of gaze) and long axis of orbit are _____ degrees apart. What is the implication of this?

A

23 degrees; must look off to the side in order to alight eyes with a muscle to test that muscle

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2
Q

Which 7 bones make up the orbit?

A
  1. frontal 2. zygomatic 3. maxilla 4. palatine 5. sphenoid 6. ethmoid 7. lacrimal
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3
Q

What foramen is in the lateral part of the orbit?

A

superior orbital fissure

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4
Q

What foramen is in the floor of the orbit?

A

inferior orbital fissure

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5
Q

Why when people break their nose, why is it that they can also get a black eye?

A

anastamoses between blood vessels in the “dangerous area”

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6
Q

Which two muscles in the eye are smooth (involuntary)?

A
  1. superior tarsal muscle 2. ciliary muscle
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7
Q

What are the 4 layers of the eye?

A
  1. skin/little fat 2. muscle 3. tarsal plates and orbital septum 4. conjunctiva
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8
Q

What are the SUPERIOR/INFERIOR CONJUNCTIVAL FORNIX?

A

where palpebral conjunctival (fascia layer), lining the eyelid, doubles back on itself to form the bulbar conjunctiva, lining the eye

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9
Q

What structure receives ducts of the lacrimal gland? (emptying)

A

the superior fornix

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10
Q

What are in the TARSAL PLATES?

A

-superior/inferior tarsals -levator palpebrae m. (CN III) -superior tarsal m (CN III) -tarsal glands

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11
Q

What do the TARSAL GLANDS do?

A

spreads oily layer to reduce evaporation over the eye; spreads when you blink

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12
Q

What are the 3 type of CONJUNCTIVITIS? What are the characteristics of each?

A
  1. viral = watery discharge and photophobia 2. bacterial = discharge of pus (pink eye) 3. allergic reaction = itching/redness/edema
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13
Q

How are TARSAL PLATES linked to bone of orbit?

A

via the medial and lateral palpebral ligaments

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14
Q

What are 3 characteristics of the lens of the eye?

A
  1. transparent, bicovex 2. made of lens fibers = cells that have eliminated all organelles and are crystalline 3. zonule fibers of zin connect lens to ciliary muscles (capsule)
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15
Q

What fills the anterior chamber of the eyeball?

A

aqueous humor (made by epithelium of the ciliary body)

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16
Q

What fills the posterior chamber of the eyeball?

A

vitreous humor, made up of liquid and glycoaminoglycans

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17
Q

When the ciliary muscles contract, the lens widens and focuses. What is this process called?

A

accommodation

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18
Q

If someone has CATARACTS, what is the clinical problem with the patient? What can be done to fix this problem?

A

-has a cloudy lens -surgery to remove lower part of lens and put in artificial lens

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19
Q

What is the SCLERA and what is its importance?

A

posterior 5/6 of eyeball (opaque, white) and it is where extra ocular muscles insert

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20
Q

Which structure has the most focusing capability?

A

CORNEA! (lens also has focusing capability, but not as much as cornea)

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21
Q

Name 3 characteristics of the CORNEA.

A
  1. major refractive structure for focusing 2. transparent 3. avascular
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22
Q

Why are CORNEA TRANSPLANTS rarely rejected?

A

because they are avascular!

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23
Q

What is the purpose of the CHOROID in the eye?

A

gives nutrients to the retina; it is highly pigmented

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24
Q

What is the most vulnerable area of the eye to mechanical torsion?

A

the origin of of the optic nerve on the back of the eye

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25
Q

Suppose a patient has an increase in CSF surrounding their eye. What will this due regarding the optic nerve?

A

-cause it to bulge out; can see upon clinical examination

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26
Q

What is GLAUCOMA?

A

glaucoma = too much pressure can block CN II can lead to blindness due to lack of drainage of aqueous humor

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27
Q

How is the DILATOR MUSCLE OF THE PUPIL arranged? What does it do?

A

-radially -dilates pupil

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28
Q

How is the SPHINCTER MUSCLE OF THE PUPIL arranged? What does it do?

A

-circumferentially arranged -close aperature

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29
Q

If you think of the lens of the eye as a trampoline, what are the springs and what is the frame?

A

springs = zonule fibers of zin frame = ciliary muscle

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30
Q

When the lens is slack, what kind of focus are you doing?

A

close

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31
Q

When the lens is pulled tight, what kind of focus are you doing?

A

distance

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32
Q

Where is the LACRIMAL GLAND located?

A

superiolaterally in lacrimal fossa

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33
Q

Describe the path of tears from the lacrimal gland to the pharynx.

A

Palpebral part of lacrimal gland–>excretory ducts–>medial/inferior on cornea–>lacrimal lake–>lacrimal caruncle–>lacrimal canaliculi (with lacrimal papillae)–>lacrimal sac—>nasolacrimal duct–>inferior nasal meatus–>nasal cavity–>PHARYNX!

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34
Q

Which two arteries pierce the ethmoid bone near the superior oblique fissure?

A

anterior/posterior ethmoidal arteries

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35
Q

Which vessels are involved in the anastamosis between the internal and external carotid arteries?

A

ECA–>facial—>angular—>Ant. ethmoidal/post ethmoidal arteries–>opthalmic artery—>ICA

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36
Q

Name 7 branches of the OPHTHALMIC ARTERY.

A
  1. central artery of retina 2. lacrimal a. 3. supraorbital a. 4. supratrochlear a. 5. dorsal nasal a. 6. post. ethmoidal a. 7. ant. ethmoidal a.
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37
Q

Which artery pierces the optic nerve and supplies the retina?

A

CENTRAL ARTERY OF THE RETINA

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38
Q

Which foramen does the OPHTHALMIC ARTERY travel?

A

optic canal (with optic nerve)

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39
Q

What are the 3 main veins of the orbit?

A
  1. central v. of the retina 2. superior ophthalmic v. (goes through sup. orbital fissure) 3. inferior opthalmic v. (goes through inf. orb. fissure)
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40
Q

Where do the superior/inferior opthalmic veins drain? Why is this significant?

A

pterygoid plexus–>cavernous sinus; sig. for infections (danger triangle!)

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41
Q

Describe the route of the OPTIC NERVE.

A

[sensory = vision] from retinal ganglion—>pierces sclera medial to posterior pole of eyeball—>exits orbit through optic canal of sphenoid to form optic chiasm (medial nerves cross to contralateral side)–>optic tracts terminate in lateral geniculate nucleus (in thalamus)—>to cortex

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42
Q

What does injury to optic nerve cause?

A

visual field defects

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43
Q

Describe the route of GVA of CN V1.

A

from sensory receptors (pain, temperature, pressure, etc.)—>through superior orbital fissure—>cavernous sinus—>neuron cell bodies in trigeminal ganglion–>sensory nucleus of cortex/spinal nucleus of CN V

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44
Q

Which branches of CN V1 are important (3)? Where are they located??

A

1.Lacrimal n. 2. Frontal n. = supratrochlear, supraorbital, n. to frontal sinus 3. Nasociliary n. = ant/post ethmoidal, infratrochlear, meningeal, long/short ciliary) -Located on top of levator palpebrae superioris/lateral rectus muscle; superior aspect of eye

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45
Q

Describe the GSE (motor) innervations of the muscles of the orbital region. Which foramen do they travel from the brainstem?

A

-CN III = all muscles except: 1. CN IV = superior oblique m. 2. CN VI = lateral rectus m. -superior orbital fissure

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46
Q

What structures receive GVE (PNS) innervation in the orbit?

A
  1. Lacrimal gland 2. Sphincter pupillae and ciliary m. 3. Dilator pupillae and superior tarsal m.
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47
Q

Describe the path of PNS innervation of the lacrimal gland.

A

superior salivary nucleus—>travels with VII to —>geniculate ganglion (NO synapse)—>travels with greater petrosal n. through pterygopalatine fossa, joins with deep petrosal to form nerve of pterygoid canal—>PTERYGOPALATINE GANGLION (SYNAPSE!!!!)—>travels with zygomaticotemporal n./lacrimal n.—>Lacrimal gland (secrete tears)

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48
Q

Describe the SNS innervation of the LACRIMAL GLAND.

A

lateral horn of spinal cord—>ventral root/spinal nerve/ventral ramus/white ramus communicantes–>SUPERIOR CERVICAL GANGLION (SYNAPSE!!!)–> internal carotid n., deep petrosal n. thru carotid canal/joins greater petrosal n (PNS)—>nerve of pterygoid canal —>lacrimal n.—>Lacrimal gland (vasoconstricts BVs)

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49
Q

Describe the GVE (PNS) route of the SPHINCTER PUPILLAE/CILIARY MUSCLES.

A

edinger-westphal nucleus—>with CN III—>CILIARY GANGLION (SYNAPSE!!!)–>short ciliary nn (V1)—>spincter pupillae/ciliary m. contract

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50
Q

Describe the SNS route of the DILATOR PUPILLAE/SUPERIOR TARSAL MUSCLES.

A

Spinal cord (lateral horn)–>SUPERIOR CERVICAL GANGLION (SYNAPSE!!!)–>via int. carotid plexus/ciliary ganglion/long ciliary nn (V1)–>dilator pupillae/superior tarsal mm.

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51
Q

What will an injury to CNS III (including SNS) look like?

A

-person cannot open eyelid (ptosis) -pupil will be pinpoint (miosis)

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52
Q

What does the SUPERIOR LEVATOR PALPEBRAL m. do? Which CN does this?

A

raise upper eyelid; CN III

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53
Q

What does the MEDIAL RECTUS m. do? Which CN does this?

A

turn eyeball medially (adduction); CN III

54
Q

What does the LATERAL RECTUS m. do? Which CN does this?

A

turn eyeball laterally (ABduction); CN VI

55
Q

What does the SUPERIOR RECTUS m. do? Which CN does this?

A

ADduction, elevation, intorsion of eyeball; CN III

56
Q

What does the INFERIOR RECTUS m. do? Which CN does this?

A

ADduction, depression, extorsion; CN III

57
Q

What does the SUPERIOR OBLIQUE m. do? Which CN does this?

A

aBduction, depression (LOOK DOWN), intorsion; CN IV

58
Q

What does the INFERIOR OBLIQUE m. do? Which CN does this?

A

aBduction, elevation (LOOK UP), extorsion; CN III

59
Q

You tell someone to look to their right and up. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R = superior rectus L = inferior oblique

60
Q

You tell someone to look to their left and up. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R = inferior oblique L = superior rectus

61
Q

You tell someone to look to their right and down. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R = inferior rectus L = superior oblique

62
Q

You tell someone to look to their left and down. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R = superior oblique L = inferior rectus

63
Q

You tell someone to look to their right. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R = lateral rectus L = medial rectus

64
Q

You tell someone to look to their left. Which muscle are you testing on their RIGHT eyeball? LEFT eyeball?

A

R= medial rectus L = lateral rectus

65
Q

A patient comes in and cannot open his right eyelid nor can he look straight with his pupil–it is off to the lateral side of his face. Which nerve is injured?

A

CN III (superior levator palpebral m. and medial rectus)

66
Q

You ask a patient to look straight at you and her left eye is looking medially. Which nerve is damaged?

A

CN VI (lateral rectus) = ABDUCENT PALSY

67
Q

A patient comes into the ophthalmologist complaining of diplopia (double vision). It is worse when he tilts his head to the left and better when he tilts it to the right. What is your diagnosis?

A

left superior oblique muscle atrophy (CN IV palsy!!); too much extorsion/not enough intorsion

68
Q

What is HORNER’S SYNDROME?

A

injury to SNS fibers: miosis, ptosis, anhidrosis (lack of sweating), erythematosis (blushing of skin–>blood vessels open)

69
Q

What happens when there is an injury to the PNS fibers with CN III?

A

-pupil dilation (sphincter cili can’t contract) -loss of accommodation to light reflex (ciliary m. cannot contract–>focus only near)

70
Q

You ask a patient to follow your finger with his eyes. You slowly go toward his nose but he cannot ADduct his eye or look down. Which nerve/muscle is injured?

A

CN IV; superior oblique m.

71
Q

The NASAL CAVITY extends from the ______ to the ______ , where it opens into the nasopharynx

A

-external nares -choanae

72
Q

The ORAL CAVITY is the ____ part of the alimentary tract, the oral _____ and oral _____ proper.

A

-first -vestibule -cavity

73
Q

Name the 3 divisions of the pharynx.

A
  1. nasopharynx 2. oropharynx 3. laryngopharynx
74
Q

The LARYNX functions in ______; and connects the ______ with the ______.

A

-phonation -oropharynx -trachea

75
Q

You find someone on the ground unconscious. After assessing the situation and asking someone nearby to call for help, you _______ by _________.

A

-assess the airway -tilting head back

76
Q

What to help someone in a hospital for aspirating, you can place breathing tubes in two places. What are they?

A
  1. nasopharyngeal airway 2. oropharyngeal airway
77
Q

A 27yo obese male comes into the clinic with exertional dyspnea. What is causing this?

A

Due to resistance in airway because of constriction; too much fat pressing on airway to accommodate extra physical activity

78
Q

The openings of the _____ are at the second upper molar tooth.

A

PAROTID GLAND

79
Q

Where is the submandibular tract opening?

A

lateral to frenulum, under the tongue

80
Q

What is the ORAL CAVITY proper bound by?

A

teeth, gums, palate/floor of mouth; from oropharynx to oropharyngeal isthmus.

81
Q

What is the Mallampati score?

A

used to predict the ease of intubation

82
Q

Name the 4 classes of Mallampati scores:

A

Class I = soft palate uvula fauces pillars visible

Class II = soft palate, uvula, fauces visible

Class III = soft palate, base of uvula visible

Class IV = only hard palate visible

83
Q

Where are the palatine glands?

A

on the hard and soft palates!

84
Q

In the CN V2 nerve on the hard palate, the ______ innervates the inscisors/canine, the _____ innervates 2 premolars-1/2 molar and _____ innervates 2 1/2 molars.

A
  • anterio superior alveolar
  • middle superior alveolar
  • posterior superior alveolar
85
Q

The _______ and _______ come of the Maxillary nerve (V2) to innervate the hard and soft palates, respectively.

A
  • greater palatine nerve
  • lesser palatine nerve
86
Q

What 4 muscles make up the soft palate? Which are on top? Which are on bottom?

A
  1. levatory veli palatini = top
  2. tensor veli palatini = top
  3. palatoglossus = bottom
  4. palatopharyngeus = bottom
87
Q

The ________ hooks under the ______ in the soft palate in order to contract the top of the soft palate.

A

tensor veli palatini

pterygoid hamulus

88
Q

The _____ is in the anterior midline of the hard palate.

A

incisive fossa

89
Q

Label the structures the black lines are pointing to:

A

top = incisive fossa

bottom left = horizontal plate of palatine bone

bottom right (top) = greater palatine fossa

bottom right (bottom) = lesser palatine fossa

90
Q

The tongue has 3 parts. Name them.

A
  1. root
  2. body
  3. apex
91
Q

Where is the choana?

A

behind the nasal turbinates proximal to nasopharyngeal cavity

92
Q

The body of the tongue has ______ on its surface.

A

papillae

93
Q

The root of the tongue contains the _______, _____ and _______

A

sulcus terminalus, foramen cecum and lingual tonsil

94
Q

The tonge is attached to the ______ [4 things] by extrinsic muscles.

A
  1. mandible
  2. hyoid bone
  3. styloid process
  4. palate
95
Q

Name these muscles (innervated by CN X). Which muscle is missing? What is that muscle innervated by?

A

18 = styloglossus

19 = hyoglossus

20 = genioglossus

missing = palatoglossus (CN XII)

96
Q

In terms of taste, what is the yellow area innervated by? The blue? The red?

A

yellow = CN IX

blue = chorda tympani (CN VII), lingual n.

red = CN X (internal laryngeal n)

97
Q

CN IX gives motor innervation to the ______ and _____of the tongue, and taste/sensation to the _____ of the tongue.

A
  • stylopharyngeus m.
  • middle constrictor m.
  • posterior 1/3
98
Q

CN X gives motor innervation to the ______ and _____ of the oral cavity, and sensory information from the _____ , _____ and _____.

A
  • soft palate (except tensor veli palatini)
  • laryngeal muscles for phonation
  • inferior pharynx
  • larynx
  • epiglottis
99
Q

Which artery branches off the lingual artery and supplies the glad associated with the inferior part of the tongue? How about the posterior part of the tongue?

A
  • sublingual artery (sublingual gland)
  • deep lingual artery
100
Q

The lingual nerve innervates the tongue from the _______ part.

A

inferior

101
Q

______ muscles alter the tongue’s shape whereas _____ muscles alter its position.

A
  • intrinsic
  • extrinsic
102
Q

The picture on the left is lateral. The one on the right is a coronal section. Name these structures.

A
103
Q

Name these structures:

A

9 = hyoid bone

10 = mylohyoid m.

11 = geniohyoid m.

104
Q

What are the 3 salivary glands and where are they located?

A

Parotid = in cheek; duct exits through opening near 2nd molar

Sublingual = under the tongue; multiple ducts exiting distal-lateral to the frenulum, lining the floor of the oral cavity

Submandibular = under the mandible; ducts (2) exit proximal-lateral to frenulum

105
Q

Name the green structure.

A

Submandibular duct

106
Q

Name the top nerve and associated ganglion, bottom nerve and green structure.

A

lingual n. and submandibular ganagion (ANS)

hypoglossal

submandibular duct

107
Q

Name the 4 functions of the salivary glands.

A
  1. keeps mouth moist
  2. lubricates food
  3. begins digestion
  4. cleans
108
Q

What is the muscle posterior to the mylohyoid? What is it innervated by?

A

genioglossus m.; CN XII

109
Q

What are the 4 stages of swallowing?

A

Stage 1 = bolus in oral cavity

Stage 2 = bolus conveyed into oropharynx

Stage 3 = bolus extends into laryngopharynx

Stage 4 = bolus penetrates opened pharyngoesophageal segment

110
Q

The nose has a ____ and _____ framework.

A

bone; cartilage

111
Q

The septum is made up of _______ [3].

A
  1. perpendicular plate of ethmoid
  2. septal cartilage
  3. vomer
112
Q

Label the pink sections of the nose.

A

Top to bottom:

  • frontal sinus
  • superior nasal concha
  • sphenoidal sinus
  • middle nasal concha
  • inferior nasal concha
  • torus tubarius
113
Q

Most influenza activity is ______.

A

widespread

114
Q

Name the structures between the nasal chochae, begining with the most rostral.

A

superior meatus, middle meatus, inferior meatus

115
Q

What is wrong with this image?

A

deviated septum due to drainage complaints (notice grayish part in right meatuses = fluid)

116
Q

What structure is this?

A

cribriform plate

117
Q

The _____ and _______ of the nose are part of the ethmoid bone.

A

superior nasal concha

middle nasal concha

118
Q

Name the nerves shown.

A

olfactory tract, olfactory bulb, CN I, maxillary nerve V2 (in sphenopalatine foramen), nerve of pterygoid canal (vidian), lesser/greater palatine nerves and pterygopalatine ganglion

119
Q

What is the name of the artery, coming of the maxillarly artery that dives into a foramen than comes out to form the angular artery?

A

infraorbital artery

120
Q

What is the name of the artery that branches off the maxillary artery and dives into a foramen?

A

superior alvolar arteries (into alveolar foramen)

121
Q

The ________ artery in the nasal region makes an anastamotic connection with the _______ arteries in the hard palate region.

A

sphenopalatine

(from descending greater palatine artery) left/right greater palatine

122
Q

The function of paranasal sinuses are to _______. Name the 4 paranasal sinuses.

A

make your head lighter

  1. frontal
  2. maxillary
  3. ethmoidal
  4. sphenoid
123
Q

What does this person present with, clinically?

A

sinusitis (in maxillary sinus) and stuffed nose

124
Q

Why when we cry do our noses get stuffy? Which structure is responsible?

A

The nasolacrimal duct (meant to drain tears coming from lacrimal sac into nasal cavity)

125
Q

The _______ are right under the supeior meatus.

A

posterior ethmoid air cells

126
Q

The _____ makes up part of the middle meatus and opens to ethmoid air cells. The ____ is another part of the middle meatus and opens to the frontal/maxillary sinuses.

A

bulla ethmoidalis

hiatus semilunars

127
Q

The inferior meatus opens to the ________ of the nasolacrimal duct.

A

ostium

128
Q

What is the FAUCES?

A

the passage from the mouth to the pharynx

129
Q

Label structures.

A

1 = frontal sinus

2 = maxillary sinus

3 = ethmoidal sinus

4 = sphenoid sinus

130
Q

Label the pterygopalatine structures:

A
131
Q

What is the vallecula of the oral cavity?

A

depression just behind the root of the tongue between the folds in the throat. These depressions serve as “spit traps”; saliva is temporarily held in the valleculae to prevent initiation of the swallowing reflex

Block 4 (10 decks)

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