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Head and neck > ANKI HnN Anat 2 > Flashcards

ANKI HnN Anat 2 Flashcards

1
Q

Number of Spinal Vertebrae: […] Number of Spinal Cord: […] Which spinal cord arises above vertebrae column and which arises below?

A

Number of Spinal Vertebrae: 7,12,5,5,1 Number of Spinal Cord: 8,12,5,5,1 Which spinal cord arises above vertebrae column and which arises below? C1-C7 spinal cord arise from above the vertebrae column except C8 (below C7). All other spinal cords arise from below the vertebrae column.

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2
Q

Typical Cervical Vertebrae Features

A
  • Foramen Transversarium for vertebral artery, except C7 - Bifid spinous process
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3
Q

C1 atypical vertebrae name & features Name: […] Features: - […] - […]

A

C1 atypical vertebrae name & features Name: Atlas Features: - anterior facet for dens (AAJ) - superior facet for occipital condyle (AOJ)

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4
Q

C2 atypipcal vertebrae name & features Name: […] Unique Feature: - […]

A

C2 atypipcal vertebrae name & features Name: Axis Unique Feature: - Dens

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5
Q

C7 atypical vetebrae feature: […] Surface landmark: […]

A

C7 atypical vetebrae feature: has no foramen transversarium Surface landmark: first palpable C vertebrae due to ligaments covering C1-C6 vertebrae

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6
Q

Thoracic vertebrae features -[…] -[…]

A

Thoracic vertebrae features -heart shaped columnar bodies -spinous process long and sloping

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7
Q

Lumbar vertebrae features: - […] - […]

A

Lumbar vertebrae features: - kidney shape MASSIVE columnar bodies - short, blunt spinous process

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8
Q

What is Spina Bifida? […]

A

What is Spina Bifida? Neural arches fail to fuse in the midline during development, location indicated by tuft of hair or associated with herniation of meninges and/or spinal cord

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9
Q

Spine curvature From Cervical to Sacral, […], […], […], […].

A

Spine curvature From Cervical to Sacral, reverse C (1st degree), C (2nd degree), reverse C (1st degree), C (2nd degree).

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10
Q

What is Scoliosis, Kyphosis & Lordosis? Scoliosis: […] kyphosis: […] Lordosis: […]

A

What is Scoliosis, Kyphosis & Lordosis? Scoliosis: abnormal lateral curvature kyphosis: 1st degree T & S vertebrae concave anteriorly, decreases pulmonary capacity Lordosis: 2nd degree C & L vertebrae concave posteriorly, may be temporary in pregnancy & obesity

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11
Q

What is the main & supplementary arterial supply of the spine? Main: […] Supplementary: pos intercoastal art, lumbar art, sacral art

A

What is the main & supplementary arterial supply of the spine? Main: Vertebral art Supplementary: pos intercoastal art, lumbar art, sacral art

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12
Q

The spinal cord occupy the vertebral canal until […]. what is the embrological basis for Cauda Equina? […]

A

The spinal cord occupy the vertebral canal until L2. what is the embrological basis for Cauda Equina? Spinal cord occupies full length of vertebral canal in embryos, but vertebral growth outpaces spinal cord growth later. Hence spinal cord extends only to L2 (var: T12-L3). Cauda Equina are caudal spinal nerves that continue towards IV foramina lower than their levels of origin.

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13
Q

Explain Lumbar Puncture and the circumstances that it is not performed? […]

A

Explain Lumbar Puncture and the circumstances that it is not performed? Spinal cord can be accessed in midline between spinous processes, inf to L2 where there is no danger of damaging spinal cord. The needle will not hit the nerves because the nerves gives way. “Imagine you are holding up a noodle strand and trying to poke it with a chopstick.” – Prof Frank Voon Lumbar Puncture is for CSF withdra

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14
Q

Name the 3 cranial meninges and 4 meningeal spaces. Mnemonic: DAP […] Mater […] Mater […] Mater Epidural space: potential space btw […] & […] - Meningeal arteries travel in […] layer of dura Dural Venous Sinuses: normal space btw 2 layers of dura Subdural space: potential space between […] & […] Subarachnoid space: normal space btw […] & […] - This is where CSF, Circle of Willi

A

Name the 3 cranial meninges and 4 meningeal spaces. Mnemonic: DAP Dura Mater Arachnoid Mater Pia Mater Epidural space: potential space btw periosteal(endosteal) layer of dura & cranium - Meningeal arteries travel in periosteal layer of dura Dural Venous Sinuses: normal space btw 2 layers of dura Subdural space: potential space between dura & arachnoid Subarachnoid space: normal space btw arachnoid

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15
Q

Spinal cord arterial supply is by […]

A

Spinal cord arterial supply is by 1 ant 2 pos spinal art, anastomosis from vertebral art + segmental (radicular art) from walls of thorax, lumbar regions, etc

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16
Q

What is grey matter? What is white matter? explain their colours. […]

A

What is grey matter? What is white matter? explain their colours. Grey matter = neuron cell bodies organized in lamellae - Ventral horn: Motor neurons - Lateral horn: ANS neurons (T1-L2, S1-S2) = intermedio-lateral nucleus - Dorsal horn: Sensory neurons White matter = bundle of myelinated axons ( myelin appears white) forming descending and ascending tracts

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17
Q

Ventral Horn: […] Dorsal Horn: […] Dorsal root: […] Ventral root: […] Spinal nerve: […]

A

Ventral Horn: Motor neurons Dorsal Horn: Sensory neurons Dorsal root: contains dorsal root ganglion (pseudounipolar cell bodies of sensory neurons) Ventral root: motor neuron fibres leaving ventral horn Spinal nerve: union of ventral and dorsal roots, contains both motor and sensory neurons

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18
Q

Spinal Nerves split in to ant & pos rami Pos Rami SS: […] Ant Rami SS: […]

A

Spinal Nerves split in to ant & pos rami Pos Rami SS: Deep back muscles, overlying skin & synovial joints of vertebral column Ant Rami SS: Everything else. Often merge & split to form somatic and visceral plexuses

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19
Q

Muscle Reflex Arcs general pathway […]

A

Muscle Reflex Arcs general pathway - Receptor respond to stimulus, send impulse to CNS via afferent sensory neuron - May synapse in CNS: integration - Efferent motor neuron carry impulse to effector (e.g muscle contract) - Reciprocal innervation of antagonist/agonist muscle groups (e.g tapping quadriceps tendon results in hamstring relaxation)

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20
Q

Somatic (general) /special sensory (taste) pathway involves Distribution: Nerves - […] - […] - […] - […]

A

Somatic (general) /special sensory (taste) pathway involves Distribution: Nerves - Sensory Ganglion (primary sensory neurons) - Sensory Nucleus (secondary sensory neurons) - Thalamus (integration) - Sensory Cortex (Somatosensory)

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21
Q

Viscero-sensory pathway involves Distribution: Viscero-ceptors - […] - […] - […]

A

Viscero-sensory pathway involves Distribution: Viscero-ceptors - Sensory Ganglion (primary sensory neurons) - Sensory Nucleus (secondary sensory neurons) - Viscero-Centres for response/s

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22
Q

Somatic motor pathway Muscle supply: Nerves - […] - […]

A

Somatic motor pathway Muscle supply: Nerves - Lower Motor Neurons (Motor Nucleus) - Upper Motor Neurons

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23
Q

Viscero-motor (ANS) pathway Glands supply: Nerves - […]- […]

A

Viscero-motor (ANS) pathway Glands supply: Nerves - Pre-Ganglionic Neurons (autonomic Nucleus)- Post-Ganglionic Neurons (autonomic Ganglion)

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24
Q

Sympathetic output = […] - Supplies entire body through Sympathetic Chains Parasympathetic output = […]

A

Sympathetic output = thoraco -lumbar outflow. Remember as T1L2 outflow or T1 to where spinal cord ends (L2). - Supplies entire body through Sympathetic Chains Parasympathetic output = cranio-sacral outflow (CN3,7,9,10 + S2-S4) Unlike somatic motor, visceral (autonomic) motor requires 2 neurons to go from CNS to target organ. Pre is myelinated, post is not. - Sympathetic: Short pre long post - Para

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25
Q

All splanchnic nerves (greater, lesser, least, etc) are sympathetic except for […] (S2-S4, same level as pudendal n) which are parasympathetic.

A

All splanchnic nerves (greater, lesser, least, etc) are sympathetic except for pelvic splanchnic nerves (S2-S4, same level as pudendal n) which are parasympathetic.

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26
Q

Explain referred pain […]

A

Explain referred pain Referred pain is visceral pain that is perceived at a site that is not the site of origin. Theory used here is the convergence theory, where pain from viscera may be felt in the dermatome of the somatic nerve converging onto the same spinal segment because the brain cannot differentiate the source of the pain.

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27
Q

Ascending pathways Primary Neuron: […] Secondary Neuron: location differs but this is the one that […] (except […]) Tertiary Neuron: Thalamus for integration, projects to sensory cortex (post central gyrus)

A

Ascending pathways Primary Neuron: All at dorsal root ganglia Secondary Neuron: location differs but this is the one that decuss (except spinocerebellar because cerebellum lateral hemispheres does ipsilateral coordination of movements) Tertiary Neuron: Thalamus for integration, projects to sensory cortex (post central gyrus)

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28
Q

Name the 3 ascending pathways, their modality, secondary neuron location, and level of decussation […]

A

Name the 3 ascending pathways, their modality, secondary neuron location, and level of decussation

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29
Q

Name the descending (motor) pathways, function, origin & level of decussation - Most important motor pathway is the pyramidal tract, controlling mainly flexors - Extra-pyramidal tracts (postural pathways) influence muscle tone, posture and movement. They modify and influence the activities of the pyramidal system on LMN […]

A

Name the descending (motor) pathways, function, origin & level of decussation - Most important motor pathway is the pyramidal tract, controlling mainly flexors - Extra-pyramidal tracts (postural pathways) influence muscle tone, posture and movement. They modify and influence the activities of the pyramidal system on LMN

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30
Q

Weakness in a particular limb can arise from a lesion anywhere along the motor axis In LMN lesion - reflex arc is broken, hence no reflexes - ipsilateral (decussation happens before LMN neurons) - Denervative changes (muscle wasting, fasciculations) In UMN lesion - Higher level modulation of reflex arc is lost, hence brisk reflexes - Contralateral Hence the differential here is LMN lesion is […]

A

Weakness in a particular limb can arise from a lesion anywhere along the motor axis In LMN lesion - reflex arc is broken, hence no reflexes - ipsilateral (decussation happens before LMN neurons) - Denervative changes (muscle wasting, fasciculations) In UMN lesion - Higher level modulation of reflex arc is lost, hence brisk reflexes - Contralateral Hence the differential here is LMN lesion is no re

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31
Q

Pharyngeal/Branchial Apparatus development occurs around week […]

A

Pharyngeal/Branchial Apparatus development occurs around week 4

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32
Q

Pharyngeal arches appear as ridges on either side of the head & neck regions - Arches: bars of […] that gives muscles, vessels and skeleton - Pouches: […] diverticula from the gut, tends to become glands - Clefts: inward […] grooves

A

Pharyngeal arches appear as ridges on either side of the head & neck regions - Arches: bars of mesoderm that gives muscles, vessels and skeleton - Pouches: Endodermal diverticula from the gut, tends to become glands - Clefts: inward ectodermal grooves

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33
Q

Pharyngeal Arch Derivatives: 6 arches form but […] undergo regression, leaving 1,2,3,[…] Name the muscular derivatives and hence innervation of the 5 arches 1st PA (CN[…]) muscle derivatives: […] 2nd PA (CN[…]) muscle derivatives: […] 3rd PA(CN[…]) muscle derivatives: […] 4th PA(CN[…]) muscle derivatives: […] 5th PA(CN[…]) muscle derivatives: […]

A

Pharyngeal Arch Derivatives: 6 arches form but 5th arch undergo regression, leaving 1,2,3,4 & 6 Name the muscular derivatives and hence innervation of the 5 arches 1st PA (CN5) muscle derivatives: Muscles of mastication, + MATT (Mylohyoid, Ant belly of digastric m ,TVP, Tensor Tympani) 2nd PA (CN7) muscle derivatives: Muscles of Facial Expression + PSSP (Platysma, Stylohyoid, Stapedius, Pos belly

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34
Q

Derivative of Pouches: Due to obliteration of 5th arch, pouches 4 + 5 combine, so there are 4 pouches 1,2,3,4+5. Each pouch is divided into […] component Name the derivatives of the 4 pouches […]

A

Derivative of Pouches: Due to obliteration of 5th arch, pouches 4 + 5 combine, so there are 4 pouches 1,2,3,4+5. Each pouch is divided into dorsal and ventral component Name the derivatives of the 4 pouches

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35
Q

What are the 4 fascia (hence 4 compartments) of the neck? Name the components inside each compartment. Hint: cross section view […] in the carotid sheath, ICA is most medial. Platysma is inside the superficial fascia

A

What are the 4 fascia (hence 4 compartments) of the neck? Name the components inside each compartment. Hint: cross section view Investing fascia: SCM, Trepezius (motor ss from CN11) Pre-tracheal fascia: Thyroid, Trachea, Esophagus Pre-vertebral fascia: Pre-vertebral muscles, Vertebral column Carotid sheath: CCA(ICA), IJC, CN10 in the carotid sheath, ICA is most medial. Platysma is inside the super

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36
Q

Neck anterior wall landmarks SCM: Divides […] C3: […] C4: […] -bifurcation of […], transition of pharynx to esophagus & larynx to trachea C6: lower border of […]

A

Neck anterior wall landmarks SCM: Divides ant/pos triangle C3: Hyoid Bone C4: Laryngeal Prominence, -bifurcation of common carotid, transition of pharynx to esophagus & larynx to trachea C6: lower border of Cricoid Cartilage

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37
Q

in Cricothyrotomy, wide-bore needle is inserted through […] which forms a soft depression between inf margin of thyroid cartilage and sup margin of cricoid cartilage

A

in Cricothyrotomy, wide-bore needle is inserted through cricothyroid ligament which forms a soft depression between inf margin of thyroid cartilage and sup margin of cricoid cartilage

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38
Q

Movements of the SCM Unilateral contraction: […] Bilateral contraction: […]

A

Movements of the SCM Unilateral contraction: tilt head towards same side, rotate head to opp side Bilateral contraction: tilt jaw up

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39
Q

Name the 4 infrahyoid muscles in the deep layer of the ant triangle of the neck & their innervation […]

A

Name the 4 infrahyoid muscles in the deep layer of the ant triangle of the neck & their innervation

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40
Q

Torticollis = […] If untreated: asymmetrical growth of face, cervical vertebrae become wedge-shape Caused by congenital defects: tearing of SCM during […] resulting in hematoma, fibrosis & shortening

A

Torticollis = Short SCM If untreated: asymmetrical growth of face, cervical vertebrae become wedge-shape Caused by congenital defects: tearing of SCM during difficult labour resulting in hematoma, fibrosis & shortening

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41
Q

Relations IN the carotid sheath [Lat] […] [Med] […] [Pos] […] Relations OF the carotid sheath [Ant] […] [Pos] […] [Med] […]

A

Relations IN the carotid sheath [Lat] Int Jugular vein (and deep cervical lymph nodes) [Med] Carotid art [Pos] Vagus n Relations OF the carotid sheath [Ant] Skin, fascia, SCM, omohyoid, parotid (int/ext carotid) [Pos] C4-7 transverse process, pre-vertebral muscles, cervical plexus, phrenic n [Med] Vascular compartment: Larynx, Pharynx, Trachea, Esophagus, Thyroid

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42
Q

Cutaneous branches of the cervical plexus emerge from […] (Nerve Point)

A

Cutaneous branches of the cervical plexus emerge from pos border of SCM (Nerve Point)

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43
Q

Ansa-Cervicalis lies on […] Supplies: […]

A

Ansa-Cervicalis lies on IJV Supplies: strap muscles, prevertebral muscles, levator scapulae

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44
Q

Ant rami of […] forms roots of the brachial plexus, which supplies the upper limb. Emerges between […], covered by pre-vertebra fascia & […] to int jugular vein of carotid sheath (nerves are large and converging) Descends inferolat, passing between 1st rib, clavicle & sup border of scapula to enter axilla

A

Ant rami of C5-T1 forms roots of the brachial plexus, which supplies the upper limb. Emerges between scalenus ant & medius, covered by pre-vertebra fascia & posterior to int jugular vein of carotid sheath (nerves are large and converging) Descends inferolat, passing between 1st rib, clavicle & sup border of scapula to enter axilla

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45
Q

CN11 (spinal) supplies motor innervation to […]

A

CN11 (spinal) supplies motor innervation to trapezius, SCM

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46
Q

Arrange apex of lung, scalenus ant, subclavian vein, art, phrenic nerve & brachial plexus from superficial to deep […]

A

Arrange apex of lung, scalenus ant, subclavian vein, art, phrenic nerve & brachial plexus from superficial to deep - Subclavian vein (not compressed by muscles) - Scalenus ant & phrenic nerve - Subclavian art - Brachial Plexus - Apex of Lung (pos to first part of subclavian art): beware of pneumothorax

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47
Q

Complications of central venous line catherization include […]

A

Complications of central venous line catherization include -Puncture apical pleura of apex of lung (pneumothorax) -Puncture subclavian art (haemothorax) -Phrenic n injury (diaphgram paralysis)

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48
Q

Cervical Sympathetic Trunk levels - Sup cervical ganglion: […] - Middle cervical ganglion: […] - Inf cervical ganglion: […]

A

Cervical Sympathetic Trunk levels - Sup cervical ganglion: C1 (immediately below skull) - Middle cervical ganglion: C6 (cricoid cartilage) - Inf cervical ganglion: C7

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49
Q

Phrenic n: pass btw […] (which means its on the scalenus ant), under prevertebral fascia

A

Phrenic n: pass btw subclavian vein and artery (which means its on the scalenus ant), under prevertebral fascia

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50
Q

Thyroid originates from […] The diverticulum is called […] The vestigial structure left behind is called […] Abnormality: ectopic thyroid gland on tongue is called […]

A

Thyroid originates from midline endodermal diverticulum behind 1st PA The diverticulum is called thyroglossal duct The vestigial structure left behind is called foramen of ceacum Abnormality: ectopic thyroid gland on tongue is called lingual thyroid

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51
Q

What are the layers of the scalp? Mnemonics: SCALP […]

A

What are the layers of the scalp? Mnemonics: SCALP S – Skin C – Connective Tissue (dense) A – Aponeurosis L – Loose connective Tissue P – Pericranium

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52
Q

Blood supply of the SCALP From ext carotid art: via […] From int carotid art: via […] Calvaria is supplied by […]

A

Blood supply of the SCALP From ext carotid art: via occipital, pos auricular & sup temporal art From int carotid art: via SOST art Calvaria is supplied by meningeal arteries

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53
Q

Muscles of facial expression and scrotum muscles are […] muscles Muscles of facial expression are derivatives of […]

A

Muscles of facial expression and scrotum muscles are subcutaneous muscles Muscles of facial expression are derivatives of 2nd PA (hence CN7)

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54
Q

Blood supply of the face is from […], a branch of […] Key feature is that it’s course is […]

A

“Blood supply of the face is from Facial Artery, a branch of ECA Key feature is that it’s course is ““Tortuous”””

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55
Q

Danger Triangle (upper lips to bridge of nose) Connection between venous drainage of the face and venous sinuses of the cranium is through - […] - […]

A

Danger Triangle (upper lips to bridge of nose) Connection between venous drainage of the face and venous sinuses of the cranium is through - ophthalmic veins to cavernous sinus - infra-orbital & deep facial veins to pterygoid venous plexus

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56
Q

Somatic sensory supply of CN5 is demarcated by […]

A

Somatic sensory supply of CN5 is demarcated by Vertex-Ear-Chin line If you got a knee jerk reaction and answered within 1s, NYK is proud of u :)

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57
Q

Corticobulbar tract to muscles on lower face receive only […] UMN influence CN7 UMN lesion: paralysis of […] CN7 LMN lesion: paralysis of […]

A

Corticobulbar tract to muscles on lower face receive only contralateral UMN influence CN7 UMN lesion: paralysis of lower half of contralateral face CN7 LMN lesion: paralysis of both upper and lower half of ipsilateral face i.e lower face contralateral UMN influence, upper face bilateral UMN influence

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58
Q

Innervation of parotid gland is from CN[…] –> […] nerve –> […] ganglion –> hitchhike […]

A

Innervation of parotid gland is from CN9 –> lesser petrosal nerve –> otic ganglion –> hitchhike audiculotemporal n of CN V3

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59
Q

Parotid duct makes sharp turn at […] to empty secretion into […]

A

Parotid duct makes sharp turn at anterior border of masseter muscle to empty secretion into parotid papilla

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60
Q

Travelling within parotid gland (from superficial to deep) are […], […], […] which are easily damaged during surgery on parotid gland

A

Travelling within parotid gland (from superficial to deep) are CN7, Retromandibular Vein, ECA which are easily damaged during surgery on parotid gland

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61
Q

Outline the origin, course, supply of the Common Carotid Artery Origin: -R Common Carotid from […] behind R sternoclavicular joint -L Common Carotid directly from […] Course: -run upward in […] from sternoclavicular joint, under […] border of SCM -no branches given off, bifurcate at […] Supply: -All structures in […] -except […] which is supplied by […] system Extra: Carotid pulse

A

Outline the origin, course, supply of the Common Carotid Artery Origin: -R Common Carotid from brachiocephalic art behind R sternoclavicular joint -L Common Carotid directly from arch of aorta Course: -run upward in carotid sheath from sternoclavicular joint, under anterior border of SCM -no branches given off, bifurcate at C4 level (upper border of thyroid cartilage) Supply: -All structures in he

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62
Q

Outline the origin, course and supply of the External Carotid Artery Origin: -terminal branch of […] Course: -ascend […] upon emerging from […] border of SCM -initially […]then […] to ICA (and hence carotid sheath) -gives 6 branches including sup thyroid art (inf thyroid art from subclavian art), lingual art, facial art, etc -terminates in […] by bifurcating into […] & […] Supply:

A

Outline the origin, course and supply of the External Carotid Artery Origin: -terminal branch of common carotid artery after bifurcation at C4 Course: -ascend superficially upon emerging from ant border of SCM -initially medialthen pos/lat to ICA (and hence carotid sheath) -gives 6 branches including sup thyroid art (inf thyroid art from subclavian art), lingual art, facial art, etc -terminates in

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63
Q

Outline the origin, course and supply of the Internal Carotid Artery Origin: -terminal branch of […] after bifurcation at C4 Course: -ascend in neck within […] deep to parotid gland -pass through […] in petrous temporal bone -travel […] cavernous sinus (no communication) -gives out […] & […] branches -bifurcates and terminates as […] & […] Supply: […]

A

Outline the origin, course and supply of the Internal Carotid Artery Origin: -terminal branch of Common Carotid Artery after bifurcation at C4 Course: -ascend in neck within carotid sheath deep to parotid gland -pass through carotid canal in petrous temporal bone -travel thruough cavernous sinus (no communication) -gives out opthalmic art & posterior communicating art (Circle of Willis) branches -

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64
Q

Carotid sheath surface marking is from […] to point midway between […] and […]

A

Carotid sheath surface marking is from sternoclavicular joint to point midway between tip of mastoid process and angle of mandible

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65
Q

Outline the origin, course and drainage of the Internal Jugular Vein Origin: -IJV is the continuation of […] Course: -Descends in the neck through […] -joins […] behind medial end of clavicle to form […] Drainage: -drains […] Extra: -if you dk IJV origin its ggwp…. -IJV catheterization is btw sternal & clavicular heads of SCM -recall that thoracic duct (L) and right lymphatic duct drai

A

Outline the origin, course and drainage of the Internal Jugular Vein Origin: -IJV is the continuation of sigmoid sinus which leaves posterior cranial fossa through the jugular foramen (along w CN9,10,11) Course: -Descends in the neck through carotid sheath (together with ICA, CN10, deep cervical lymph nodes) -joins subclavian vein behind medial end of clavicle to form brachiocephalic vein Drainage

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66
Q

Neck lymphatic drainage general pathway Superficial tissues: […] –> […] –> […] Deep tissues: […] –> […]

A

Neck lymphatic drainage general pathway Superficial tissues: Superficial Cervical Nodes –> Deep Cervical Nodes –> Jugular Lymphatic Trunks (R lymphatic duct & L thoracic duct) Deep tissues: Deep Cervical Nodes –> Jugular Lymphatic Trunks (R lymphatic duct & L thoracic duct)

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67
Q

The convergence of the frontal, occipital, temporal and greater wing of sphenoid wing is called […]. This is the thinnest part of the skull, and fractures punctures the […] artery, resulting in […] haemorrhage

A

The convergence of the frontal, occipital, temporal and greater wing of sphenoid wing is called Pterion. This is the thinnest part of the skull, and fractures punctures the middle meningeal artery, resulting in extradural haemorrhage

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68
Q

Name the 3 cranial fossa, their respective openings and contents that passes through (1 card ta it all!!!) […] cranial fossa: -contains frontal lobes -Cribriform plate of ethmoid (CN1) […] cranial fossa: -bounded by lesser wing of sphenoid & petrous temporal bone -contain temporal lobes -[…] contains pituitary gland -[…] -[…] -[…] […] cranial fossa: -contain hindbrain (cerebellum, po

A

Name the 3 cranial fossa, their respective openings and contents that passes through (1 card ta it all!!!) Anterior cranial fossa: -contains frontal lobes -Cribriform plate of ethmoid (CN1) Middle cranial fossa: -bounded by lesser wing of sphenoid & petrous temporal bone -contain temporal lobes -hypophyseal fossa/sella turcica (turkish saddle) contains pituitary gland -Optic canal (CN2) -SOF/Foram

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69
Q

In the middle cranal fossa, ICA can be found associated with CN[…]

A

In the middle cranal fossa, ICA can be found associated with CN2

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70
Q

The two layers of the Dura mater are […] & […]. The layer that extends through foramen magnum to form dura of spinal cord is the […]

A

The two layers of the Dura mater are Endosteal/Periosteal layer & Meningeal layer. The layer that extends through foramen magnum to form dura of spinal cord is the Meningeal layer (i.e spinal cord no endosteal layer)

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71
Q

Name the 3 septa formed by the meningeal layer of the dura mater and its main function -[…] -[…] -[…] Main function is to […]

A

Name the 3 septa formed by the meningeal layer of the dura mater and its main function -Falx Cerebri -Falx Cerebelli -Tentorium Cerebelli Main function is to resist rotatory displacement of the brain (TL;DR stability)

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72
Q

CSF drains into the dural venous sinuses via […]

A

CSF drains into the dural venous sinuses via arachnoid granulations/villi

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73
Q

Dura is innervated by meningeal branches from […] Falx(s) are all innervated by […] Literally nobody knows but now u know hehe….

A

Dura is innervated by meningeal branches from CN V1,V2,V3, 10 & C2-3 Falx(s) are all innervated by CN V1 Literally nobody knows but now u know hehe…. Clinical: Dural headaches Dura is sensitive to pain even though brain itself is not (reason why in neurosurgery after you get past it, patient can be awake and playing violin while the surgeon works away at removing the brain tumour) - Caused by di

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74
Q

Name the 3 types of brain haemorrhages and identify the cause. - […] - […] - […] Note the presentation of these haemorrhages on radiography.

A

Name the 3 types of brain haemorrhages and identify the cause. - Extradural, torn MMA - Subdural, torn sup cerebral veins (crossing of cerebral vein to enter DVS) - Subarachnoid, cerebral artery aneurysms (blood spills directly into subarachnoid space & CSF) Note the presentation of these haemorrhages on radiography.

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75
Q

Dural Venous Sinuses. Imagine drawing out the sinuses and connecting them as you answer. […] runs in the upper border of falx cerebri - Receive sup cerebral veins - Cont. w venous lacunae […] runs in inf concave border of falx cerebri - Union of ISS & Great Cerebral Vein of Galen forms the […] […] runs in falx cerebelli against occipital bone, communicates inferiorly with vertebral veins p

A

Dural Venous Sinuses. Imagine drawing out the sinuses and connecting them as you answer. Superior sagittal sinus (I affectionately calls it SSS) runs in the upper border of falx cerebri - Receive sup cerebral veins - Cont. w venous lacunae Inferior sagittal sinus (ISS) runs in inf concave border of falx cerebri - Union of ISS & Great Cerebral Vein of Galen forms the straight sinus (StS) Occipital

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76
Q

Cavernous sinus (CS) is drained by -[…]: from CS via anterolat margin of tentorium cerebelli to TS -[…]: drains inferiorly to junction of SS & IJV Recall CS communicates w pterygoid plexus, triangle of danger.

A

Cavernous sinus (CS) is drained by -Sup Petrosal Sinus: from CS via anterolat margin of tentorium cerebelli to TS -Inf Petrosal Sinus: drains inferiorly to junction of SS & IJV Recall CS communicates w pterygoid plexus, triangle of danger.

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77
Q

Structures & relations of the Cavernous Sinus Structures inside the CS: - Thru sinus: […], […], […] - In lat wall: CN[…],[…],[…],[…] Relations of CS & pituitary - [Ant] […] - [Lat] […] - [Pos] […] - [Sup] […] - [Med] […] - [Inf] […]

A

Structures & relations of the Cavernous Sinus Structures inside the CS: - Thru sinus: ICA, sympathetic plexus, CN6 - In lat wall: CN3,4,V1,V2 Relations of CS & pituitary - [Ant] SOF - [Lat] Foramen R, Foramen.O, Trigeminal Ganglion - [Pos] F. Lacerum - [Sup] Optic Chiasma - [Med] Pituitary gland (in Sella Turnica) - [Inf] Nasal cavity, sphenoid sinus

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78
Q

Enlarged pituitary gland causes […]

A

Enlarged pituitary gland causes bitemporal hemianopia “If you see the slides I showed you during prelab, 3 of our 20 silent mentors had pituitary enlargement. What will that cause? Yes (???)”– Prof Ng Yee Kong

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79
Q

Brain Embryology. Name the primary vesicles, secondary vesicles and derivatives of the neural tube […]

A

Brain Embryology. Name the primary vesicles, secondary vesicles and derivatives of the neural tube Need to know? idk man. At least secondary vesicle? Know the names for MCQ.

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80
Q

Name the 4 lobes of the brain (dont tell me u dont know) and the 2 fissure 3 sulcus that divides them. 4 lobes of the brain […] - L/R separated by […] - […] divides F & P (identify as most consistent parallel fold) - […] divides P & T - […] (must see from medial aspect) divide P & O - […] subdivides the occipital lobe

A

Name the 4 lobes of the brain (dont tell me u dont know) and the 2 fissure 3 sulcus that divides them. 4 lobes of the brain (F, P, T, O) - L/R separated by longitudinal fissure/falx cerebri - Central sulcus divides F & P (identify as most consistent parallel fold) - Lateral fissure divides P & T - Parieto-occipital sulcus (must see from medial aspect) divide P & O - Calcarine sulcus subdivides the

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81
Q

The white matter connecting two brain hemispheres is called […]

A

The white matter connecting two brain hemispheres is called Corpus Callosum (CC)

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82
Q

The […] lies on either side of the 3rd ventricle of the brain

A

The thalamus lies on either side of the 3rd ventricle of the brain

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83
Q

Cerebral cortex grey matter layers - Layer […] thicker in sensory cortex (ascending tracts ST, DLMC, SC) - Layer […] thicker in motor cortex (descending tracts CS/pyramidal, CB)

A

Cerebral cortex grey matter layers - Layer 4 thicker in sensory cortex (ascending tracts ST, DLMC, SC) - Layer 5 thicker in motor cortex (descending tracts CS/pyramidal, CB)

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84
Q

Where are the somatic sensory areas in the cerebral cortex? - Primary somato-sensory cortex (SC1): […] (A1,2,3) –> receives input from […] of the thalamus - Secondary somato-sensory cortex (SC2)/Somesthetic Association Area: […] (A5) –> multimodal columns provide […] (identify 3D object without held in hand looking at it)

A

Where are the somatic sensory areas in the cerebral cortex? - Primary somato-sensory cortex (SC1): post-central gyrus (A1,2,3) –> receives input from ventral posterior nucleus (VPL/VPM) of the thalamus - Secondary somato-sensory cortex (SC2)/Somesthetic Association Area: posterior to SC1 (A5) –> multimodal columns provide stereognosis (identify 3D object without held in hand looking at it)

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85
Q

Where are the somatic motor areas in the cerebral cortex? - Primary motor cortex (MC1): […] (A4) –> Gives rise to pyrimidal tract - Secondary motor cortex (MC2) is subdivided into […] (A6, […]) & […] (A6, […]) between primary and frontal gyri –> […] for motor intention, […] for motor planning

A

Where are the somatic motor areas in the cerebral cortex? - Primary motor cortex (MC1): pre-central gyrus (A4) –> Gives rise to pyrimidal tract - Secondary motor cortex (MC2) is subdivided into Pre-Motor Cortex (PMC) (A6, lat) & Supplementary Motor Area (SMA) (A6, med) between primary and frontal gyri –> PMC for motor intention, SMA for motor planning

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86
Q

Sensory and motor homunculus show the area of representation of body areas in the cerebral cortex: -Medial cortex: […] -Lateral cortex: […]

A

Sensory and motor homunculus show the area of representation of body areas in the cerebral cortex: -Medial cortex: Lower body (Supplied by ACA) -Lateral cortex: Upper body (Supplied by MCA)

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87
Q

Where are the visual areas in the cerebral cortex? - Primary Visual cortex (VC1): […] (A17) - Visual Association Area (VC2): […] –> motion, colour, shape Form & colour (what) continues into cortex on the underside of the T lobe […] Spatial relationships & motion (where) continue to the posterior parietal lobe […]

A

Where are the visual areas in the cerebral cortex? - Primary Visual cortex (VC1): both banks of calcarine sulcus in occipital lobe (A17) - Visual Association Area (VC2): surrounding VC1 (A17,18) –> motion, colour, shape Form & colour (what) continues into cortex on the underside of the T lobe (Ventral Visual Pathway) Spatial relationships & motion (where) continue to the posterior parietal lobe (

88
Q

Where are the hearing & speech areas in the cerebral cortex? - Primary auditory area (AC1) at […] - […] speech area (sensory speech) surrounds the […] - […] speech area (motor speech) at […]

A

Where are the hearing & speech areas in the cerebral cortex? - Primary auditory area (AC1) at superior temporal gyrus - Wernicke’s speech area (sensory speech) surrounds the primary auditory area - Broca’s speech area (motor speech) at inf frontal gyrus, above lateral fissure

89
Q

Aphasia = disturbed language function. Normal function requires both sensory and motor speech area connected by Arcuate Fasciculus, mostly on dominant hemisphere. Presentation of speech lesions: - Wernicke’s (sensory speech) –> […] - Broca’s (motor speech) –> […]

A

Aphasia = disturbed language function. Normal function requires both sensory and motor speech area connected by Arcuate Fasciculus, mostly on dominant hemisphere. Presentation of speech lesions: - Wernicke’s (sensory speech) –> Receptive aphasia (difficulty in understanding spoken word) - Broca’s (motor speech) –> Expressive aphasia (difficulty in speaking & writing)

90
Q

Pre-Frontal Cortex (PFC) is found infront of […] It is uniquely large in human brain, concerned with the highest brain functions such as […]

A

Pre-Frontal Cortex (PFC) is found infront of PMA It is uniquely large in human brain, concerned with the highest brain functions such as decision making, abstract thinking, social behaviour, foresight

91
Q

Frontal Eye Field (FEF) (A8) is located infront of […] and is responsible for […]

A

Frontal Eye Field (FEF) (A8) is located infront of SMA/PMC and is responsible for conjugate movement of eye

92
Q

The number to remember which CN arise from which part of the brainstem is […]

A

The number to remember which CN arise from which part of the brainstem is 2,2,1,3,4

93
Q

The 3 lobes of the cerebellum are […], […] and […] The 4 anatomical subdivisions of the cerebellum are […], […], […] & […]

A

The 3 lobes of the cerebellum are anterior lobe, posterior lobe and flocculo-nodular lobe The 4 anatomical subdivisions of the cerebellum are Vermis (SC), Para-Vermal Zone (SC), Lateral Hemisphere (CC) & Flocculo-nodular (VC)

94
Q

Name the 3 functional subdivisions of the cerebellum, their functions and location. […]: Function: […] Location: […] […] Function: […] Location: […] […] Function: […] Location: […]

A

Name the 3 functional subdivisions of the cerebellum, their functions and location. Spino-cerebellum SC: Function: muscle tone Location: Vermis, Para-vermal Cerebro-cerebellum CC: Function: ipsilateral coordination Location: Lateral Hemisphere Vestibulo-cerebellum VC: Function: equilibrium Location: Flocculo-nodular lobe

95
Q

“Complex of motor symptoms in cerebellar dysfunction is called ““[…]””. Cerebellar dysfunction presents […]laterally Dysequilibrium - Pt unsteady in standing position, show considerable swaying - Staggering and tendency to fall on when walking Dystonia - Loss in resistance normally offered by muscles to passive manipulation Dyssynergia - Loss of coordinated muscle movement - Inability to arres

A

“Complex of motor symptoms in cerebellar dysfunction is called ““Ataxia””. Cerebellar dysfunction presents ipsilaterally Dysequilibrium - Pt unsteady in standing position, show considerable swaying - Staggering and tendency to fall on when walking Dystonia - Loss in resistance normally offered by muscles to passive manipulation Dyssynergia - Loss of coordinated muscle movement - Inability to arres

96
Q

Damage to basal ganglia causes problems concerning speech, movement & posture. The combination of these symptoms is called […]

A

Damage to basal ganglia causes problems concerning speech, movement & posture. The combination of these symptoms is called parkinsonism Substentia nigra is a basal nuclei btw.

97
Q

Name the ventricles of the brain and the communicating channels between ventricles […] in the cerebral hemispheres - Body (P lobe), frontal horn, occipital horn, temporal horn - Opens through […] into 3rd ventricle […]: slit-like cavity btw R & L diencephalon - Drains via (cerebral) […] to 4th Ventricle […]: in pos pons & medulla, extending infero-posteriorly - Continuous with central ca

A

Name the ventricles of the brain and the communicating channels between ventricles 2 Lateral Ventricles in the cerebral hemispheres - Body (P lobe), frontal horn, occipital horn, temporal horn - Opens through interventricular foramen into 3rd ventricle 3rd Ventricle: slit-like cavity btw R & L diencephalon - Drains via (cerebral) aqueduct of Sylvius to 4th Ventricle 4th Ventricle: in pos pons & me

98
Q

Bell’s Palsy is a […] lesion that can be caused by - Inflammation of facial nerve (e.g. viral neuritis) especially at […] foramen - Temporal bone fracture, wounds (superficial hence vulnerable), birth injury LMN lesion causes […] paralysis of facial muscles (both upper and lower face)

A

Bell’s Palsy is a CN7 LMN lesion that can be caused by - Inflammation of facial nerve (e.g. viral neuritis) especially at stylomastoid foramen - Temporal bone fracture, wounds (superficial hence vulnerable), birth injury LMN lesion causes ipsilateral paralysis of facial muscles (both upper and lower face) If lesion occurs before these fibres exit, may also result in -Ipsilateral hyperacusis: overs

99
Q

CSF is secreted by […] in each ventricle (vascular pia mater covered by […] epithelium) Outline the circulation of CSF and its eventual drainage into the dural venous sinuses CSF leaves[…]–>[…]–>[…]–>[…]–>[…]–> enter[…] via[…] –> reabsorbed into venous system via[…]–> Protrude through meningeal layer of dura into dural venous sinuse, usually at […] and […]

A

CSF is secreted by choroid plexus in each ventricle (vascular pia mater covered by cuboidal epithelium) Outline the circulation of CSF and its eventual drainage into the dural venous sinuses CSF leaves lateral ventricle –> interventricular foramina (of Monroe) –> 3rd ventricle –> aqueduct of Sylvius –> 4th ventricle –> enter subarachnoid space via 2L1M (2 Luschka, 1Magendie) –> reabsorbed in

100
Q

Intra-cranial pressure depends on the balance between CSF secretion and reabsorption. Abnormal accumulation of CSF in the ventricles of the brain = […] Causes include - […] - […] - […]

A

Intra-cranial pressure depends on the balance between CSF secretion and reabsorption. Abnormal accumulation of CSF in the ventricles of the brain = Hydrocephalus Causes include - Blockage of CSF outflow, usually in cerebral aqueduct (tumour, infection) - Interference with drainage into DVS (e.g. blocked arachnoid granulations after haemorrhage) - Overproduction of CSF Hydrocephalus results in vent

101
Q

The blood supply of the brain is 80% from […] (anterior circulation) & 20% from […] (posterior circulation)

A

The blood supply of the brain is 80% from internal carotid system (anterior circulation) & 20% from vertebrobasilar system (posterior circulation)

102
Q

The cerebral arterial circle on ventral surface of brain, in subarachnoid space is called […]. It’s function is to provide […]

A

The cerebral arterial circle on ventral surface of brain, in subarachnoid space is called Circle of Willis . It’s function is to provide anastomosis & collateral circulation in the brain [Ant to pos] ant communicating art, ACA,ICA, pos communicating art, PCA “Not everyone has a complete Circle of Willis, but if you do, you are lucky and less likely to get stroke ” Prof Ai Peng Tan

103
Q

Rupture of Berry Aneurysms in the Circle of Willis causes […].

A

Rupture of Berry Aneurysms in the Circle of Willis causes subarachnoid haemorrhage.

104
Q

Blood supply of the cerebral cortex is by […], […] & […]

A

Blood supply of the cerebral cortex is by ACA, MCA & PCA

105
Q

Blood supply to cerebellum is from the […] system

A

Blood supply to cerebellum is from the vertebralbasilar system - Sup cerebellar: also SS pons, sup cerebellar peduncle, tectum of midbrain - Ant inf cerebellar: also SS part of pons (cochlear nuclei) - Pos inf cerebellar: also SS lat medulla, inf vermis, 4th ventricle choroid plexus - Pontine art

106
Q

The labyrinthine artery is a branch of […]

A

The labyrinthine artery is a branch of basilar artery

107
Q

The […] prevents macromolecules from passing between vascular system and the CNS

A

The BBB prevents macromolecules from passing between vascular system and the CNS Exception: BBB leaky at hypothalamus to allow hypothalamus to sense level of circulating hormones. Other exceptions include pineal gland, area postrema & median eminence

108
Q

CNS capillary endothelial cells (BBB) are unlike somatic tissue endothelial cells with fenestrations. Name the 3 differences that contributes to the BBB. - […] - […] - […]

A

CNS capillary endothelial cells (BBB) are unlike somatic tissue endothelial cells with fenestrations. Name the 3 differences that contributes to the BBB. - Tight Junction - Basement Membrane - Astrocytic foot process Astrocytes transport glucose actively into CSF, water soluble substances blocked (e.g. plasma proteins, macromolecules), lipid soluble substances cross. These are implications for dru

109
Q

BBB breakdown can be caused by: - […] - […] - […] - […]

A

BBB breakdown can be caused by: - Hypertension –> BP > power of arterioles to control –> cerebral oedema - Infection –> leukocyte migration - Osmotic challenge (sometimes on purpose) - Severe hypercapnia (due to arteriolar muscle relaxation)

110
Q

12 Cranial Nerve CHINESE mnemonic: 1[…]2[…]3[…]，4[…]5[…]6[…]，7[…]8[…]9[…]，10[…]1[…][…]全

A

12 Cranial Nerve CHINESE mnemonic: 1嗅2视3动眼，4滑5叉6外展，7面8听9舌咽，10迷1副舌下全

111
Q

12 Cranial Nerve somatic sensory/motor function mnemonic: […] […]

A

12 Cranial Nerve somatic sensory/motor function mnemonic: Some say marry money, but my brother says big brains matter more S: sensory (olfactory nerve - CN I) S: sensory (optic nerve - CN II) M: motor (oculomotor nerve - CN III) M: motor (trochlear nerve - CN IV) B: both (trigeminal nerve - CN V) M: motor (abducens nerve - CN VI) B: both (facial nerve - CN VII) S: sensory (vestibulocochlear nerve

112
Q

12 Cranial Nerve special sensory nerves: Pure special sensory: […] Has special sensory: […]

A

12 Cranial Nerve special sensory nerves: Pure special sensory: CN1,2,8 Has special sensory: CN7,9,10 Note that smell is the only sensation that DOES NOT pass through the thalamus

113
Q

12 Cranial Nerves parasympathetic nerves: […]

A

12 Cranial Nerves parasympathetic nerves: CN3,7,9,10

114
Q

CN3 supplies parasympathetic innervation to […] & […] Pre-ganglionic ganglion: […] Post-ganglionic ganglion: […] CN3 parasympathetic post-ganglionic fibres emerge ciliary ganglion as […]

A

CN3 supplies parasympathetic innervation to sphincter pupillae & ciliary muscle Pre-ganglionic ganglion: Edinger-Westpal nuc Post-ganglionic ganglion: Ciliary ganglion CN3 parasympathetic post-ganglionic fibres emerge ciliary ganglion as short ciliary nerve Note that long ciliary nerve carries sympathetic from superior cervical trunk

115
Q

CNs generally receive bilateral UMN influence except CN[…]

A

CNs generally receive bilateral UMN influence except CN7 Exception: CN7 fibres to lower face only receive contralateral UMN input Exception: CN7 receives bilateral input but contralateral is dominant Clinical: Lesion of brain UMN not significantly seen except in lower face and tongue

116
Q

All extraoccular muscles are supplied by CN3 except […]

A

All extraoccular muscles are supplied by CN3 except SO4 LR6

117
Q

All muscles of facial expression are supplied by CN[…]

A

All muscles of facial expression are supplied by CN7

118
Q

Stapedius is a derivative of the […] pharyngeal arch and is hence supplied by CN[…]

A

Stapedius is a derivative of the 2nd pharyngeal arch and is hence supplied by CN7

119
Q

All muscles of mastication are derivatives from the […] pharygeal arch and is hence innervated by CN […]

A

All muscles of mastication are derivatives from the 1st pharygeal arch and is hence innervated by CN V3

120
Q

Tensor Tympani & Tensor Palitini are derivatives of the […] pharyngeal arch and hence is innervated by CN […]

A

Tensor Tympani & Tensor Palitini are derivatives of the 1st pharyngeal arch and hence is innervated by CN V3

121
Q

All muscles of the palate is supplied by the […] except […]

A

All muscles of the palate is supplied by the Pharyngeal Plexus (CN10) except TVP (CN V3)

122
Q

All muscles of the tongue is supplied by […] except […]

A

All muscles of the tongue is supplied by CN12 except PG (Pharyngeal Plexus/CN10)

123
Q

All muscles of the pharynx is supplied by […] except […]

A

All muscles of the pharynx is supplied by CN10 except stylopharyngeus (CN9)

124
Q

All muscles of the larynx are supplied by […] except […]

A

All muscles of the larynx are supplied by Recurrent laryngeal of CN10 except cricothyroid (ext laryngeal of CN10)

125
Q

CN1 pathway: […] –> […] –> […]

A

CN1 pathway: Olfactory tract –> olfactory bulb –> olfactory cortex in forebrain

126
Q

Outline the course of CN2 (try drawing out) […] cells –> […] –> optic nerve fibres enter optic canal and middle cranial cavity –> […] –> […]–> […] –> […] –> […] @ banks of calcarine sulcus of occipital lobe Collaterals to midbrain for visual reflexes are given off by […]

A

Outline the course of CN2 (try drawing out) Retinal ganglion cells –> optic disc –> optic nerve fibres enter optic canal and middle cranial cavity –> optic chiasma (hemi decussation) –> optic tract–> Lateral Geniculate Nucleus (LGN) of thalamus –> optic radiation (note Meyer’s Loop) –> Visual cortex @ banks of calcarine sulcus of occipital lobe Collaterals to midbrain for visual reflexes ar

127
Q

The somatic motor nuclei of CN3 is called […], supplying […] CN3 also supplies parasympathetics to […] & […] Outline the course of CN3: Originate from […] –> […] –> […]

A

The somatic motor nuclei of CN3 is called Occulomotor Nuc, supplying all EOM except SO4 LR6 CN3 also supplies parasympathetics to sphincter pupillae & ciliary body Outline the course of CN3: Originate from midbrain at level of superior colliculus –> lat wall of cavernous sinus (CN3,4,V1,V2) –> Superior orbital fissure Rmb fight or flight = eye open big big so dilator pupillae is sympathetic (ss

128
Q

CN3 lesion results in paralysis of […]. Clinical signs: - […] - […] - […] - […]

A

CN3 lesion results in paralysis of all EOM except SO4 LR6. Clinical signs: - Ptosis due to impaired LPS - Pupil dilation, unreactive to pupillary light reflex (CN3 supplies sphincter pupillae which is parasympathetic) - Lat deviation of affected side due to unopposed lat rectus - Diplopia (double vision) present for all CN3,4,6 lesions when looking towards affected side –> one eye can look but th

129
Q

All cranial nerves exit anterior to the brainstem except CN[…] which exits posterioly (hence only CN to innervate contralateral structures) Outline the course of CN4: Originate from […] –> […]–> […] –> […]

A

All cranial nerves exit anterior to the brainstem except CN4 which exits posterioly (hence only CN to innervate contralateral structures) Outline the course of CN4: Originate from Midbrain at level of inferor colliculus –> middle cranial fossa–> lateral wall of cavernous sinus (3,4,V1,V2) –> superior orbital fissure

130
Q

CN4 lesion results in paralysis of […] Clinical signs: - […] - […] - […]

A

CN4 lesion results in paralysis of SO4 Clinical signs: - Elevation of eye on forward gaze due to unopposed IO - Elevation increased with head tilting towards the affected side - Diplopia (double vision) present for all CN3,4,6 lesions when looking towards affected side à one eye can look but the other cannot

131
Q

The somatic motor nuclei of CN6 is called […], supplying […] Outline the course of CN6: Originate from […] –> […] –> […] –> […]

A

The somatic motor nuclei of CN6 is called Abducens Nuc, supplying LR6 Outline the course of CN6: Originate from Pontomedullary junction (CN6,7,8) –> Middle cranial fossa –> passes through cavernous sinus (ICA, CN6) –> Superior Orbital Fissure (CN3,4,V1,6)

132
Q

CN6 lesion results in paralysis of […] Clinical signs: - […] - […] - […]

A

CN6 lesion results in paralysis of LR6 Clinical signs: - Eye cannot abd - Add at rest due to unopposed MR - Diplopia (double vision) present for all CN3,4,6 lesions when looking towards affected side –> one eye can look but the other cannot

133
Q

CN11 (spinal) supplies […] & […]

A

CN11 (spinal) supplies SCM & Trapezius

134
Q

Outline the course of CN12: Originate from […] –> […] –> between […] to reach tongue

A

Outline the course of CN12: Originate from Medulla Oblongata –> Hypoglossal canal –> between mylohyoid & hyoglossus to reach tongue

135
Q

CN5 divisions are all purely sensory except […]

A

CN5 divisions are all purely sensory except V3

136
Q

The 3 CN5 sensory nuclei are - […] - […] - […]

A

The 3 CN5 sensory nuclei are - Mesencephalic (proprioception) - Principal Sensory (fine touch) - Spinal Nuclei (pain)

137
Q

What are the foramens that CN V1,V2 & V3 passes through, and which one of these DOES NOT pass through the lateral wall of cavernous sinus? […]

A

What are the foramens that CN V1,V2 & V3 passes through, and which one of these DOES NOT pass through the lateral wall of cavernous sinus? SOF: CN3,4,V1,6 R: CN V2 O: CN V3 S: MMA CS: 6, ICA/CN 3,4,V1,V2,

138
Q

The 3 branches of CN V1 are - […] - […] - […]

A

The 3 branches of CN V1 are - Frontal nerve: run above LPS, gives SOST n - Lacrimal nerve: runs across LR, ss lacrimal gland (parasymp from CN7 greater petrosal nerve, pterygopalatine ganglion) - Nasocillary nerve: carries ciliary nerve to cornea (short for parasymp, long for symp) & supply paranasal sinuses (supplement V2 innervation of nasal cavity)

139
Q

CN V3 sensory motor branches are - […] - […] - […]

A

CN V3 sensory motor branches are - Auricotemporal nerve - Lingual nerve (supplies ant 2/3 of tongue. Recall that taste to ant 2/3 of tongue & parasymp to SMG SLG is from chorda tympani CN7) - Inf alveolar nerve (enters mandibular canal)

140
Q

CN7 supplies 3 major glands, which are […], […] & […]. Demarcated by the oral fissure level, all glands above are innervated by […] while all glands below are innervated by […]

A

CN7 supplies 3 major glands, which are Lacrimal gland (PPG), Lingual gland (SMG) & Submandibular gland (SMG). Demarcated by the oral fissure level, all glands above are innervated by greater petrosal n of CN7 while all glands below are innervated by chorda tympani of CN7

141
Q

Outline the course of CN7. Yes. Emerge from […] –>[…] –> […] –> […] –> […]) –> […] –> […] –> […]

A

Outline the course of CN7. Yes. Emerge from pontomedullary junction as 2 roots (motor & intermediate) –> internal acoustic meatus w CN8 & labyrinthine art –> geniculate ganglion (give great petrosal for lacrimal gland parasympathetic) –> facial canal of middle ear –> give off chorda tympani (to join lingual nerve) –> stylomastoid foramen –> parotid plexus –> 5 branches (The Zebra Bit My Cow

142
Q

Name the 5 motor branches of CN7. Mnemonic: The Zebra Bit My Cow - T[…] - Z[…] - B[…] - M[…] - C[…]

A

Name the 5 motor branches of CN7. Mnemonic: The Zebra Bit My Cow - Temporal - Zygomatic - Buccal - Marginal Mandibular - Cervical

143
Q

CN V3 supplies somatic motor innervation to -[…] & -Mnemonic MATT […] which are derivatives of […] pharyngeal arch

A

CN V3 supplies somatic motor innervation to -muscles of mastication & -Mnemonic MATT (Mylohyoid,Ant belly of digastric,Tensor Palatini,Tensor Tympani) which are derivatives of 1st pharyngeal arch

144
Q

CN7 supplies somatic motor innervation to -[…] & -Mnemonic PSSP […] which are derivatives of […] pharyngeal arch

A

CN7 supplies somatic motor innervation to -muscles of facial expression & -Mnemonic PSSP (Platysma, Stapedius, Stylohyoid, Pos belly of digastric) which are derivatives of 2nd pharyngeal arch

145
Q

CN9 supplies somatic motor innervation to - […] which is a derivative of the […] pharyngeal arch

A

CN9 supplies somatic motor innervation to - Stylopharyngeus which is a derivative of the 3rd pharyngeal arch

146
Q

General sensory & special sensory (taste) of pos 1/3 of tongue is supplied by CN[…].

A

General sensory & special sensory (taste) of pos 1/3 of tongue is supplied by CN9.

147
Q

Carotid sinus & carotid body is supplied by CN[…]

A

Carotid sinus & carotid body is supplied by CN9

148
Q

Pharyngeal Plexus (CN10) supplies all muscles of the soft palate (except […]), all muscles of the pharynx (except […]) & all muscles of the larynx. Recall that all muscles of the larynx is supplied by […] except […]

A

Pharyngeal Plexus (CN10) supplies all muscles of the soft palate (except tensor palitini V3), all muscles of the pharynx (except stylopharyngeus CN9) & all muscles of the larynx. Recall that all muscles of the larynx is supplied by RLN except cricothyroid (Ext LN)

149
Q

Outline the bony walls of the orbit [Roof] […] [Lat Wall] […], […] [Med Wall] […], […], […] [Floor] […] Thinnest wall of the orbit is the […]

A

Outline the bony walls of the orbit [Roof] Frontal bone (ant cranial fossa on top) [Lat Wall] Zygomatic bone, greater wing of sphenoid [Med Wall] Maxilla, lacrimal bone, ethmoid bone [Floor] Maxilla Thinnest wall of the orbit is the medial wall

150
Q

Name the 4 openings into the orbit and its contents. […]: […] […]: […] […]: […] […]: […]

A

Name the 4 openings into the orbit and its contents. Optic Canal: CN2, ctrl retinal art, ophthalmic art (from ICA) Sup Orbital Fissure: CN3,4,V1,6, sup ophthalmic vein Inf Orbital Fissure: CN V2, inf ophthalmic vein, sympathetic nerves Nasolacrimal canal: Nasolacrimal duct Yknow, if you think about it, the contents that passes through these openings all make sense. if you really want to, can inclu

151
Q

Lacrimal fluid are saline secretion to lubricate […]. Excess = […] Key components of lacrimal fluid are - […] - […]

A

Lacrimal fluid are saline secretion to lubricate conjunctiva & cornea. Excess = tears Key components of lacrimal fluid are - lysozyme (antibacterial) - nutrients & dissolved oxygen (to avascular cornea) So its function is lubricate, moisten, give nutrients and antibacterial/antiviral

152
Q

The Lacrimal Gland lies in fossa for lacrimal gland in […] part of orbit, near lat margin of LPS tendon Outline the course and drainage of lacrimal fluid Lacrimal gland –> Lacrimal […] –> flow over […] and […] –> Lacrimal […] –> Lacrimal […] –> Lacrimal […] –> […] duct –> […] –> […] (usually swallowed) Recall that lacrimal gland is supplied by CN7 parasympathetic innerv

A

The Lacrimal Gland lies in fossa for lacrimal gland in sup/lat part of orbit, near lat margin of LPS tendon Outline the course and drainage of lacrimal fluid Lacrimal gland –> Lacrimal excretory duct –> flow over conjuctiva and cornea –> Lacrimal lake –> Lacrimal canaliculi –> Lacrimal sac –> Nasolacrimal duct –> inferior nasal meatus –> nasopharynx, oropharynx (usually swallowed) Recall t

153
Q

Outline the Secretomotor Innervation pathway to Lacrimal Gland (IMPT) Sensory: […] Sympathetic: […] Parasympathetic: […] Secretomotor pathway: […] + […] –> […] –> course along […] –> course along […] –> Lacrimal gland

A

Outline the Secretomotor Innervation pathway to Lacrimal Gland (IMPT) Sensory: CN V1 Sympathetic: Superior cervical ganglion Parasympathetic: CN7 greater petrosal n from lacrimal nucleus Secretomotor pathway: CN7 greater petrosal n from lacrimal nucleus (parasympathetic) + deep petrosal n from sup cervical ganglion (sympathetic) –> PPG –> course along zygomatic branch of CN V2 –> course along l

154
Q

Causes of Exophthalmos (protrusion of eyeball): […], […] Causes of Enophthalmos (retraction of eyeball): […]

A

Causes of Exophthalmos (protrusion of eyeball): Grave’s Disease (hyperthyroidism), Orbital tumours Causes of Enophthalmos (retraction of eyeball): starvation reducing retrobulbar fat

155
Q

Opthalmic artery is a branch of […]

A

Opthalmic artery is a branch of ICA

156
Q

Trick question: Does the orbit have lymph nodes? […]

A

Trick question: Does the orbit have lymph nodes? No. Eye is part of CNS, and CNS DOES NOT have lymph nodes

157
Q

Levator Palpabrae Superioris (LPS) have both skeletal and smooth muscle (sup tarsal m) component. Skeletal m component is innervated by […] Smooth m component is innervated by […]

A

Levator Palpabrae Superioris (LPS) have both skeletal and smooth muscle (sup tarsal m) component. Skeletal m component is innervated by CN3 Smooth m component is innervated by Cervical sympathetic trunk

158
Q

The 2 causes of Ptosis (drooping of upper eyelid) are: - […] - […]

A

The 2 causes of Ptosis (drooping of upper eyelid) are: - CN3 lesion (skeletal LPS) - Horner Syndrome (smooth LPS - sup tarsal m)

159
Q

Horner syndrome is an interruption of the […]. Pt presents with mnemonic: PMA - […] - […] - […] The commonest cause for Horner’s syndrome is a tumor eroding the cervicothoracic ganglion, which is typically an […].

A

Horner syndrome is an interruption of the cervical sympathetic trunk. Pt presents with mnemonic: PMA - Ptosis: Drooping eyelids due to paralysis of sup tarsal m - Miosis: Pupillary constriction (paralysis of dilator pupillae) - Anhydrosis: Absence of sweating on ipsilateral side of the face & neck due to absence of innervation of sweat glands (sympathetic as well). In layman’s terms, only 1 side o

160
Q

Recti muscles of the eye originates from […] surrounding optic canal and attach to sup inf lat med aspects of ant eyeball

A

Recti muscles of the eye originates from common tendinous ring surrounding optic canal and attach to sup inf lat med aspects of ant eyeball

161
Q

Eye movements buffet (IMPT) Draw it out! Easy movements: MR […], LR […] Complex movements: SR […] IR […] SO […] IO […] Trick: SIN RAD. Superior always int rotation, Recti alw adduct (except LR6)

A

Eye movements buffet (IMPT) Draw it out! Easy movements: MR adducts, LR abducts (reason why CN6 is called abducens) Complex movements: SR elevates + add + int rotation IR depresses + add + ext rotation SO depresses + abd + int rotation IO elevates + abd + ext rotation Trick: SIN RAD. Superior always int rotation, Recti alw adduct (except LR6)

162
Q

Name the 3 layers of the eyeball and its components. 10m question? HAHAHAHA […]: […] posteriorly: Tough opaque layer, continuous w dura of CN2 […] anteriorly: Transparent, more convex, appearing to protrude from ant […]: […] posteriorly: Vascular bed giving red eye in photos […] anteriorly: Connects choroid with iris, provide attachment of lens (Accommodation: smooth muscle of ciliary

A

Name the 3 layers of the eyeball and its components. 10m question? HAHAHAHA Outer Layer (Fibrous): Sclera posteriorly: Tough opaque layer, continuous w dura of CN2 Cornea anteriorly: Transparent, more convex, appearing to protrude from ant Intermediate Layer (Vascular): Choroid posteriorly: Vascular bed giving red eye in photos Ciliary body anteriorly: Connects choroid with iris, provide attachmen

163
Q

Eye conditions […] is the increase in […] due to increase in amount of aqueous humor fluid, caused by disturbance of normal cycle of aqueous humor fluid production & absorption. Leads to compression of retina and hence […]. […] is the increase in […] that causes edema of the retina. Viewed during ophthalmolscopy as swelling of […]. […] is the increased […] of the lens due to aging

A

Eye conditions Glaucoma is the increase in intraocular pressure due to increase in amount of aqueous humor fluid, caused by disturbance of normal cycle of aqueous humor fluid production & absorption. Leads to compression of retina and hence blindness. Papilledema is the increase in CSF pressure that causes edema of the retina. Viewed during ophthalmolscopy as swelling of optic disc. Caratact is th

164
Q

Print this into your head? Idk. Main point here is CN2 originates from […] fibres.

A

Print this into your head? Idk. Main point here is CN2 originates from ganglion cell fibres.

165
Q

Rods & Cones of the photoreceptor layer in the eye is responsible for transducing light energy into […] Rod is for […] -Most sensitive to dim light -do not convey color -absent from […] Cone is for […] -work in bright light -responsible for acute detail -most numerous in the […]

A

Rods & Cones of the photoreceptor layer in the eye is responsible for transducing light energy into membrane potential Rod is for night vision -Most sensitive to dim light -do not convey color -absent from fovea centralis Cone is for Color, shapes & sizes -work in bright light -responsible for acute detail -most numerous in the fovea centralis

166
Q

Name main differences between Rods & Cones -[…] -[…] -[…]

A

Name main differences between Rods & Cones -presence in fovea -confer color/achromatic vision -light sensitivity

167
Q

Dark current: Activation of photoreceptor is actually […] Resting = […] Stimulated = […]

A

Dark current: Activation of photoreceptor is actually hyperpolarization Resting = depolarized Stimulated = hyperpolarized

168
Q

Representation of Visual Field Peripheral vision field falls on […] Central vision field falls on […] 2/3 of visual field is […], 1/6 on each side is […]

A

Representation of Visual Field Peripheral vision field falls on central (nasal hemi-retina) Central vision field falls on peripheral (temporal hemi-retina) 2/3 of visual field is binocular, 1/6 on each side is monocular

169
Q

Meyer’s loop are fibres from […] sweep forward into […] lobe before turning back It may be affected by a […] lobe stroke (MCA)

A

Meyer’s loop are fibres from sup visual field (inf retinal quadrants) sweep forward into temporal lobe before turning back It may be affected by a temporal lobe stroke (MCA)

170
Q

Visual Pathway Lesion (IMPT) (draw out and deduce) Optic n: […] Optic chiasma: -ant optic chiasma (pituitary tumor) = […] -lat optic chiasma = […] Optic tract: […] Meyer’s loop: […] Optic Radiation: […] Lesions close to visual cortex: […]

A

Visual Pathway Lesion (IMPT) (draw out and deduce) Optic n: ipsilateral monocular blindness Optic chiasma: -ant optic chiasma (pituitary tumor) = bitemporal hemianopia (narrow vision) -lat optic chiasma = binasal hemianopia (can’t see middle) Optic tract: contralateral homonymous hemianopia Meyer’s loop: contralateral superior quadrant anopia Optic Radiation: contralateral inferior quadrant anopia

171
Q

Outline the boundaries of the nasal cavity [Roof] […] [Floor] […] [Med] […] [Lat] […] [Ant] […] [Pos] […]

A

Outline the boundaries of the nasal cavity [Roof] Nasal, frontal, ethmoidal (cribriform plate), sphenoidal bones [Floor] hard palate, soft palate [Med] Nasal septum [Lat] Nasal concha: sup, mid, inf [Ant] Naris [Pos] Nasopharynx

172
Q

Name the 4 paranasal sinuses, their functions and epithelial lining. […]: Btw inner & outer tables of frontal bone […]: ant/middle/pos invaginations into the ethmoidal bone […]: In body of sphenoid, may extend into wings […]: in body of maxilla Function: […] Epithelial lining:[…] Clinical: Which paranasal sinus is most prone to infection? Why? […] Clinical: Which paranasal sinus is s

A

Name the 4 paranasal sinuses, their functions and epithelial lining. Frontal Sinus: Btw inner & outer tables of frontal bone Ethmoidal Sinus (cells): ant/middle/pos invaginations into the ethmoidal bone Sphenoidal Sinus: In body of sphenoid, may extend into wings Maxillary sinus: in body of maxilla Function: Reduce weight of skull Epithelial lining:Paranasal sinuses are extensions of respiratory p

173
Q

The 3 types of epithelial lining in the nasal cavity are - […] - […] - […]

A

The 3 types of epithelial lining in the nasal cavity are - Olfactory: Olfactory epithelium - Respiratory (including paranasal sinuses): PSCColumnarE + Goblet cells - Vestibular: Skin epithelium and hair follicles

174
Q

Name the 3 nasal concha + 1 recess of the nasal cavity and corresponding openings. -[…]: […], opening of […] posteriorly -[…]: opening of […], opening of […], opening of […] onto […] -[…]: opening of […] spheno-ethmoidal recess: opening of […]

A

Name the 3 nasal concha + 1 recess of the nasal cavity and corresponding openings. - Inf nasal concha –> inf nasal meatus: nasolacrimal duct, opening of pharyngotympanic tube posteriorly - Middle nasal concha –> middle nasal meatus: opening of frontal sinus, opening of maxillary sinus, opening of mid ethmoidal cells onto ethmoidal bulla - Sup nasal concha –> sup nasal meatus: opening of pos eth

175
Q

Nasal cavity infection spread: Rhinitis (swollen & infected mucosa) may spread via openings to -[…] -[…] -[…] -[…] -[…] 脑洞大开: Infection of ethmoidal cells may break thru fragile […] wall of orbit –> spread to orbit and affect CN2

A

Nasal cavity infection spread: Rhinitis (swollen & infected mucosa) may spread via openings to - paranasal sinuses –> sinusitis + local pain (esp. maxillary sinus) - Nasopharynx - Ant cranial fossa: thru cribriform plate - Middle ear: thru pharyngotympanic tube - Lacrimal apparatus & conjunctiva: thru nasolacrimal duct 脑洞大开: Infection of ethmoidal cells may break thru fragile medial wall of orbit

176
Q

Blood supply of the nasal cavity is mainly by […], supplemented by […]. Nasal cavity arterial anastomosis is called the […]

A

Blood supply of the nasal cavity is mainly by maxillary art, supplemented by ophthalmic art. Nasal cavity arterial anastomosis is called the Kiesselbach Area

177
Q

Somatic sensory innervation of the nose is mainly by […] (posterio-inferior), supplemented by […] (anterio-superior) (similar to blood supply) Special sensory of the nose is by CN1. (no need question right???)

A

Somatic sensory innervation of the nose is mainly by CN V2 (posterio-inferior), supplemented by CN V1 (anterio-superior) (similar to blood supply) Special sensory of the nose is by CN1. (no need question right???) In a nutshell, nerve supply of the nose is not just from V1 and V2, but also CN1! Dont forget CN1!!!

178
Q

Outline the contents of the pterygopalatine fossa -[…] -[…] -[…]

A

Outline the contents of the pterygopalatine fossa -Maxillary art (ECA) -Maxillary n (V2) - Pterygopalatine ganglion (PPG): link to lacrimal gland autonomic innervation straight!! Recall lacrimal gland innervation

179
Q

Temporal mandibular joint is a […] Joint, formed by - Mandible: […] - Temporal bone: […], […] What is the type of cartilage found in the temporal mandibular joint? What is unusual of this joint compared to other synovial joints? - […] - […] - […]

A

Temporal mandibular joint is a Synovial Modified Hinge Joint, formed by - Mandible: head (condyle) - Temporal bone: mandibular fossa, articular tubercle What is the type of cartilage found in the temporal mandibular joint? What is unusual of this joint compared to other synovial joints? - Fibrocartilagious articular disc creates sup & inf compartments - Sup compartment for gliding movement (protru

180
Q

TMJ movements: […] movement in inf joint cavity: […] […] movement in sup joint cavity: […], […]

A

TMJ movements: Hinge movement in inf joint cavity: Elevation + Depression Gliding movement in sup joint cavity: Protrusion + retraction, side to side mvmt

181
Q

The 4 muscles of mastication are […], […], […], […]. - All protract except […] (retract) - All elevate except […] (depress) IAN & LN (branches of CN V3) emerge between […] & […]

A

The 4 muscles of mastication are Temporalis, Lat Pterygoid, Med Pterygoid, Masseter. - All protract except Temporalis (retract) - All elevate except Lat Pterygoid (depress) IAN & LN (branches of CN V3) emerge between Lat & Med Pterygoid

182
Q

The anterior portion of digastric muscle is supplied by […] The posterior portion of digastric muscle is supplied by […]

A

The anterior portion of digastric muscle is supplied by CNV3 The posterior portion of digastric muscle is supplied by CN7 Rmb MATT (1st PA) & PSSP (2nd PA)

183
Q

In the infratemporal fossa the terminal branch of the ECA that can be found here is the […].

A

In the infratemporal fossa the terminal branch of the ECA that can be found here is the Maxillary artery.

184
Q

Parasympathetic innervation to parotid gland is from CN[…], carried by auriculotemporal n of CN […]

A

Parasympathetic innervation to parotid gland is from CN9, carried by auriculotemporal n of CN V3

185
Q

Briefly outline the embryological basis of tongue development. (6m) - […] - […] - […] - […] - Muscles of the tongue develop from […] which migrate to the developing tongue […]

A

Briefly outline the embryological basis of tongue development. (6m) - Start with lingual swellings (1st arch) and hypobranchial eminences (2nd,3rd,4th arches) on the ventral floor of the primitive pharynx - Opp lateral lingual swellings fuses with each other at median sulcus - Medial lingual swelling kena overgrown by lat lingual swellings (failure results in persistent medial lingual swelling. No

186
Q

Primordial tongue detaches from ventral floor of primordial pharynx via […] Failure to complete the process leads to […], which results in […]

A

Primordial tongue detaches from ventral floor of primordial pharynx via apoptosis Failure to complete the process leads to ankyloglossia (tongue tie), which results in speech difficulties

187
Q

Recall question. Relate the embryological basis of tongue development to its innervation. - Since lateral lingual swelling is from 1st arch and forms ant 2/3 of the tongue, sensory innervation to ant 2/3 of the tongue is supplied by […] - Since 2nd arch is overgrown by 3rd arch, […] supplies the special sensory (taste) and secretomotor innervation to ant 2/3 of the tongue (SMG,SLG via […]) -

A

Recall question. Relate the embryological basis of tongue development to its innervation. - Since lateral lingual swelling is from 1st arch and forms ant 2/3 of the tongue, sensory innervation to ant 2/3 of the tongue is supplied by CN5 (V3) - Since 2nd arch is overgrown by 3rd arch, CN7 supplies the special sensory (taste) and secretomotor innervation to ant 2/3 of the tongue (SMG,SLG via chorda

188
Q

Briefly outline the embryological basis for thyroid development, and abnormalities - […] - […] - […] - […] Abnormalities: Failure of initial diverticulum to migrate inferiorly results in […] Failure of thyroglossal duct to degenerate results in […]

A

Briefly outline the embryological basis for thyroid development, and abnormalities - Thyroid gland originates from midline endodermal diverticulum between 1st & 2nd PA - Grows caudally to reach developing larynx - Proliferates and divides to form 2 solid lobes connected by isthmus - Thyroglossal duct degenerates Abnormalities: Failure of initial diverticulum to migrate inferiorly results in Lingua

189
Q

The 4 papillae found on the ant 2/3 of the tongue are […], […], […], […] The tonsil found on the pos 1/3 of the tongue is the […] The ant 2/3 and pos 1/3 of the tongue is divided by […] Although Circumvallate papillae (with taste buds) is found on ant 2/3 of the tongue, it is innervated by […]

A

The 4 papillae found on the ant 2/3 of the tongue are fungiform papillae (no taste buds), filiform papillae (with taste buds), Follate papillae (with taste buds), Circumvallate papillae (with taste buds) The tonsil found on the pos 1/3 of the tongue is the Lingual tonsil The ant 2/3 and pos 1/3 of the tongue is divided by sulcus terminalis Although Circumvallate papillae (with taste buds) is found

190
Q

Extrinsic tongue muscles change […] Intrinsic tongue muscles change […] All muscles of the tongue are innervated by CN[…] except for […]

A

Extrinsic tongue muscles change position of tongue Intrinsic tongue muscles change shape of tongue All muscles of the tongue are innervated by CN12 except for palatoglossus (pharyngeal plexus/CN10)

191
Q

Lingual nerve carries - General sensory fibres from […] - Special sensory & parasympathetic fibres from […]

A

Lingual nerve carries - General sensory fibres from CNV3 - Special sensory & parasympathetic fibres from Chorda Tympani of CN7

192
Q

The composition of the major salivary glands are Parotid Gland: […] Submandibular Gland:[…] Sublingual Gland:[…] Secretomotor fibres to Parotid Gland: - Pre-g from […] - Post-g from […] Secretomotor fibres to SMG & SLG: - Pre-g from […] - Post-g from […]

A

The composition of the major salivary glands are Parotid Gland: Totally serous (can remember as parotid is totally serious HAHAHHA) Submandibular Gland:Mixed serous & mucus Sublingual Gland:Almost completely mucous Secretomotor fibres to Parotid Gland: - Pre-g from CN9 - Post-g from Otic ganglion (hitchhike auricolotemporal n of V3) Secretomotor fibres to SMG & SLG: - Pre-g from CN7 chorda tympani

193
Q

The nerve that crosses ext carotid art, curve ant to appear below the jaw is CN[…]

A

The nerve that crosses ext carotid art, curve ant to appear below the jaw is CN12

194
Q

CN12 LMN lesion: tongue deviates to […] CN12 UMN lesion: tongue deviates to […]

A

CN12 LMN lesion: tongue deviates to side of lesion because other side protrudes normally CN12 UMN lesion: tongue deviates to side opposite lesion cuz there is bilat UMN influence but contralateral is dominant

195
Q

Outline the embryological basis of Lip & Palate development (6m) - […] - […] - […] - […] - […]

A

Outline the embryological basis of Lip & Palate development (6m) - Start with frontonasal, maxillary and mandibular process located around the primitive oral cavity - Pair of nasal pits appear in frontonasal process, bounded by lateral and medial nasal prominences - Maxillary prominence grow medially to compress medial nasal prominences together, forming intermaxillary segment –> primary palate (

196
Q

In Lip & Palate development, - Failure of maxillary prominence to fuse w medial nasal prominence results in […] - Failure of palatine shelves to fuse results in […]

A

In Lip & Palate development, - Failure of maxillary prominence to fuse w medial nasal prominence results in lat cleft lip, cleft upper jaw, cleft between primary & secondary palate - Failure of palatine shelves to fuse results in secondary cleft palate, cleft uvula

197
Q

The palatine fossa lies between […] and […]

A

The palatine fossa lies between palatoglossal and palatopharyngeal folds

198
Q

The 5 muscles of soft palate are: […], […], […], […] & […]. All muscles of the soft palate are supplied by […] except for […]

A

The 5 muscles of soft palate are: TVP, LVP, Palatoglossus, Palatopharyngeus & Uvula. All muscles of the soft palate are supplied by pharyngeal plexus/CN10 except for TVP (CN V3)

199
Q

The 4 extrinsic muscles of the tongue are […]. All tongue muscles are supplied by CN[…] except for […]

A

The 4 extrinsic muscles of the tongue are genioglossus, hyoglossus, styloglossus, palatoglossus. All tongue muscles are supplied by CN12 except for palatoglossus (Pharygeal Plexus/CN10)

200
Q

Palate is innervated by […], supplemented by CN9 to pos soft palate Ant hard palate: - […] via incisive canal (V2) - […] via greater palatine foramen (V2) Pos soft palate, palatine tonsil - […] via lesser palatine foramen (V2) (Palatine tonsil by CN9)

A

Palate is innervated by CN V2, supplemented by CN9 to pos soft palate Ant hard palate: - Nasopalatine n via incisive canal (V2) - Greater palatine n via greater palatine foramen (V2) Pos soft palate, palatine tonsil - Lesser palatine n via lesser palatine foramen (V2) (Palatine tonsil by CN9)

201
Q

Name the 3 divisions of the pharynx and the boundaries […]: […] […]: […] […]: […]

A

Name the 3 divisions of the pharynx and the boundaries Nasopharynx: pos to nose, from base of skull to soft palate Oropharynx: pos to mouth, from soft palate to epiglottis Laryngopharynx: pos to larynx, from epiglottis to cricoid cartilage

202
Q

The eustachian/ pharyngotympanic tube connects […] & […], allowing […]

A

The eustachian/ pharyngotympanic tube connects nasopharynx & tympanic cavity, allowing equalization of pressure in middle ear

203
Q

The laryngeal inlet is formed by […], […], […] - […] recess is located lateral to the laryngeal inlet.

A

The laryngeal inlet is formed by epiglottis, aryepiglottic fold, inter-arytenoid fold - Piriform recess is located lateral to the laryngeal inlet.

204
Q

The muscles of the pharynx are the 3 outer circular constrictors and 3 inner longitudinal […]pharyngeus, […]pharyngeus & […]pharyngeus. All muscles of the pharynx is innervated by […] except for […]

A

The muscles of the pharynx are the 3 outer circular constrictors and 3 inner longitudinal Palatopharyngeus, Salpingopharyngeus & Stylopharyngeus. All muscles of the pharynx is innervated by pharyngeal plexus (CN10) except for stylopharyngeus (CN9)

205
Q

All muscles of soft palate and pharynx are supplied by […] except for […] & […]

A

All muscles of soft palate and pharynx are supplied by pharyngeal plexus (CN10) except for TVP (CN V3) & stylopharyngeus (CN9)

206
Q

The 4 main cartilage of the larynx are -[…] Cartilage: gives laryngeal prominence, C4 level -[…] cartilage: signet ring shape, C6 level, denotes end of laryngopharynx -[…] cartilage: closes laryngeal inlet -[…] cartilage: paired, vocal process for attachment of vocalis m, muscular process for cricoarytenoid m (pos CA is the only abductor of the larynx)

A

The 4 main cartilage of the larynx are - Thyroid Cartilage: gives laryngeal prominence, C4 level - Cricoid cartilage: signet ring shape, C6 level, denotes end of laryngopharynx - Epiglottic cartilage: closes laryngeal inlet - Arytenoid cartilage: paired, vocal process for attachment of vocalis m, muscular process for cricoarytenoid m (pos CA is the only abductor of the larynx)

207
Q

Histology of vocal folds - Vestibular fold (false vocal cord): […] - Vocal fold (true vocal cord): […]

A

Histology of vocal folds - Vestibular fold (false vocal cord): Respiratory (PStCColumnarE + Goblet cells) - Vocal fold (true vocal cord): Wear & tear (StSquamousE) Note that this is as good as saying that the entire interior of the larynx is covered with respiratory epithelium except for the vocal folds.

208
Q

The 6 inner larynx muscles are mnemonic: 2T(EAv), 2C(TA),2A(TO) […] […] […] […] […] […] - (P) CA is the only abductor - CT tilts thyroid forward - All inner larynx muscles supplied by RLN except for CT (Ext LN)

A

The 6 inner larynx muscles are mnemonic: 2T(EAv), 2C(TA),2A(TO) TE: Thyro-epiglottic TA: Thyro-arytenoid & Vocalis CT: Cricothyroid (Ext LN) CA: Crico-arytenoid (L & P) AT: Transverse arytenoid AO: Oblique arythenoid - (P) CA is the only abductor - CT tilts thyroid forward - All inner larynx muscles supplied by RLN except for CT (Ext LN) Lesion of ELN = hoarseness, bilateral PARTIAL lesion of RLN

209
Q

Blood supply of larynx is the same as the […]. - […] - […]

A

Blood supply of larynx is the same as the thyroid gland. - Sup thyroid art (from ECA) –> sup laryngeal art - Inf thyroid art (from Subclavian art)–> inf laryngeal art

210
Q

Nerve supply for larynx is ALL FROM […] - Motor: all […] except […] - Sensory: […] above vocal fold, […] below vocal fold

A

Nerve supply for larynx is ALL FROM CN10 - Motor: all RLN except CT (Ext LN) - Sensory: Int LN above vocal fold, RLN below vocal fold Rmb RLN loops around arch of aorta (LHS)/subclavian (RHS)

211
Q

Middle ear/Tympanic cavity is located within […] bone 3 Ossicles (MIS) transmit sound from tympanic membrane to inner ear - […] - […] - […] - Handle of […] to tympanic membrane, base of […] fills oval window The two muscles in tympanic cavity that dampen vibration to soften loud sounds thru reflex contraction are - […] - […]

A

Middle ear/Tympanic cavity is located within petrous temporal bone 3 Ossicles (MIS) transmit sound from tympanic membrane to inner ear - Malleus (1st PA) - Incus (1st PA) - Stapes (2nd PA, hence stapedius is also CN7) - Handle of malleus to tympanic membrane, base of stapes fills oval window The two muscles in tympanic cavity that dampen vibration to soften loud sounds thru reflex contraction are

212
Q

Lai. Walls & relations of the middle ear. Print it into your brain nibba!!! (try drawing out) (10m) [Lat] […], […] [Med] […], […], […], […] [Ant] […], […], […] [Pos] […] [Floor] […], […] [Roof] […], […] [Contents] […]

A

Lai. Walls & relations of the middle ear. Print it into your brain nibba!!! (try drawing out) (10m) [Lat] tympanic membrane (not shown in pic), chorda tympani deep to membrane [Med] Promontory (1st turn of cochlea), tympanic plexus, oval + round window, prominence of facial canal (CN7) [Ant] pharyngotympanic tube, tensor tympani, ICA [Pos] aditus communicating w mastoid sinus [Floor] base of skull

213
Q

Inner ear is located in […] Vestibular system: innervated by […] o […] & […] (sense static head rotation) o […] (sense head rotation) Cochlea system: organ of Hearing, innervated by […] o […] o […] o […] o Scala vestibuli & tympani separated by […]

A

Inner ear is located in petrous temporal as well Vestibular system: innervated by CN8 (vestibular n) o Utricle & saccule (sense static head rotation) o Semi-circular canals w 3 diff axis (sense head rotation) Cochlea system: organ of Hearing, innervated by CN8 (cochlear n) o Scala vestibuli (perilymph) o Scala tympani (perilymph) o Scala media/cochlear duct (endolymph) o Scala vestibuli & tympani

214
Q

Transmission of sound pathway Vibration of Tympanic membrane transmitted by auditory ossicles (M.I.S) –> at […], transduction of vibration to pressure waves of the […] –> […] –> […] –> […] dissipates pressure wave

A

Transmission of sound pathway Vibration of Tympanic membrane transmitted by auditory ossicles (M.I.S) –> at oval window, transduction of vibration to pressure waves of the scala vestibuli –> helicotrema –> scala tympani –> round window dissipates pressure wave

215
Q

Cochlear basilar membrane properties changes from thick & taut from base of cochlear to thin & floppy at apex of cochlear. Hence - base of cochlear senses […] frequency - apex of cochlear senses […] frequency Hair cells on […] on basilar membrane transduces vibration to membrane potential

A

Cochlear basilar membrane properties changes from thick & taut from base of cochlear to thin & floppy at apex of cochlear. Hence - base of cochlear senses high frequency - apex of cochlear senses low frequency Hair cells on Organ of Corti on basilar membrane transduces vibration to membrane potential

Head and neck (25 decks)

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