Aravich Review Flashcards
Pathway of autonomics to parotid gland
- CN IX tympanic n to the lesser petrosal n., exits through the foramen ovale into the infratemporal fossa, then to the otic ganglion.
- post-ganglionics riding on CNV3 auriculotemporal br. to the parotid gland.
Posterior division nerves of CN V3? Sensory or motor?
All sensory except n. to mylohyoid, which is motor. The rest are: 1. Lingual n. 2. Inferior alveolar n. 3. auriculotemporal n.
Anterior division nerves of CN V3? sensory or motor?
All motor except buccal br, which is sensory.
The rest are:
1. Brr to mm of mastication
2. Deep temporal brr.
Three parts of maxillary artery?
Branches on them?
- Mandibular part
a. middle meningeal a.
b. inferior alveolar a.
c. deep auricular - Pterygoid part
a. Buccal a.
b. Pterygoid mm brr
c. ant/post deep temporal aa.
d. masseteric - Pterygopalatine part
a. nasopalatine a. (sphenopalatine a.)
b. infraorbital a.
c. descending palatine a.
d. pterygoid canal a.
O/I of temporalis m?
Temporal bone to coronoid process of mandible.
O/I of medial pterygoid m?
lateral pterygoid plate to INSIDE of mandible
O/I of lateral pterygoid m?
lateral pterygoid plate to TMJ
All motor innervation of CN V3?
- masseter- masseter br
- medial pterygooid- medial pterygoid br
- lateral pterygoid- lateral pterygoid br
- temporalis- deep temporal br.
- ant. belly of digastric- n. to mylohyoid
- mylohyoid- n to mylohyoid
- Tensor palatini m.
- Tensor tympani m.
Cricoarytenoid m. action and innervation?
Opens rima glottidis via abduction, the ONLY muscle that opens the airway. Innervated by CN X vagus n.- recurrent laryngeal n.
cricothyroid m. innervation?
CN X vagus n- external laryngeal n, a branch of superior laryngeal n.
4 infrahyoid mm and their innervation? Together they do what?
sternohyoid omohyoid sternothyroid thyrohyoid- C1 (via CN XII) Innervation to the rest: Ansa cervicalis (C1-C3) They lengthen pipe and lower pitch.
4 suprahyoid mm and their innervation? Together they do what?
digastic- CN VII and V3 stylohyoid- CN VII mylohyoid- V3 geniohyoid- C1 They shorten pipe and raise pitch.
What is dysarthia?
Problem with mechanical production of speech. Can involve hyoid muscles.
CN X laryngeal br divides into?
- Recurrent laryngeal n (becomes inferior laryngeal)
- motor to all intrinsic laryngeal mm except cricothyroid
- sensory to infraglottic larynx (below vocal cords)
- parasympathetics to lower larynx - superior laryngeal br, which divides into:
a. internal laryngeal n
- sensory from epiglottic larynx: larynx above vocal cords, vestibule, piriform recess, and vallecula (pill box)
- parasympathetics for mucus in upper larynx
b. external laryngeal n
- motor to cricothyroid and inferior pharyngeal constrictor
Which is more superior: external or internal laryngeal n?
Internal laryngeal n is more superior
What nerve is viscosensory at the carotid sinus and body?
CN IX
what two nerves are at risk during a thyroidectomy?
CN X Recurrent laryngeal n, and external laryngeal n.
What two structures make the hyoglossus m. sandwhich?
CN XII on top, lingual a. on bottom.
The superior laryngeal a is a branch of what? Travels with what nerve?
Branch of superior thyroid a. Travels with CN X internal laryngeal n.
CN III all function
- motor to all external eye mm including levator palpeprae superioris except lateral rectus and superior oblique
- autonomics to ciliary mm and pupil constricotr
Nasal aa and where they come from?
2 from internal carotid a.
-Ant/Post ethmoidal aa (branch of ophthalmic a)
2 from maxillary a.
- sphenopalatine a
- Greater palatine a.
1 from facial a
-superior labial a.
All 5 anastomose to kiesselbach’s area
Arteries that anastomose on the scalp and where they come from
From internal carotid: (both from ophthalmic a) 1. supratrochlear a. 2. supraocular a. From external carotid: 1. Occipital a. 2. superficial temporal a.
All muscles of the pharynx are innervated by? Exception?
All are innervated by CN X, except the sylopharyngeus m which is innervated by CN IX
What is Zenker’s Diverticulum?
Food fills a pouch in the cricopharyngeus region, or anywhere that constrictors don’t overlap.
All muscles of the palate are innervated by? Exception?
All palate muscles are innervated by CN X, except the tensor palatini muscle which is innervated by CN V3
Nasopharynx sensory innervation?
CN V2 and CN IX
Oropharynx and upper laryngopharynx innervation?
Lower laryngopharynx?
CN IX
Lower laryngopharynx by CN X
Oropharynx borders?
From bottom of soft palate till the tip of the epiglottic cartilage, and anteriorly until palatoglossal arch.
Which tonsils, if inflammed, could spread infection to the middle ear? What about closing off the airway?
Palatine tonsils could close off airway, and adenoids (pharyngeal) could spread to middle ear.
hyoid is at level of? Also end of?
C3. Also end of the oropharynx.
C6 is the end of? Start of?
the laryngopharynx, and start of esophagus and trachea.
Innervation to nasal cavity?
- CN I
- CN V1 ant/post ethmoidal
- CN V2 nasopalatine
- posterior superior lateral brr, posterior inferior lateral brr
then sympathetics from deep petrosal riding on CN VII, and parasympathetics from greater petrosal CN VII
Posterior 1/3 tongue innervation?
CN X does some general sensation
CN IX does general sensation and taste
What does sensory to most of the external ear, and on either side?
Cervical plexus, specifically C2 and C3. CN V3- auriculotemporal does the sideburns area.
sneeze, gag, and cough reflex?
.Sensory: sneeze- CN V2 gag- CN IX cough- CN X Motor: All are CN X
Cone of light in the right ear should be at?
Left ear?
What would distortion indicate?
5 o’clock
7 o’clock
Distortion indicates increased inner ear pressure, or otitis media.
Corneal blink reflex: sensory and motor?
sensory: CN V1
Motor: CN VII
If i poke you in the eyeball, you’ll close your eye.
Pupillary reflex: sensory and motor?
sensory: CN II
Motor: CN III
shine light in your eye, your pupil constricts
blink reflex :sensory and motor? startle
Sensory: CN II, or CN VIII
Motor: CN VII
scare you, you blink
Pterion fracture danger?
middle meningeal artery, and possible epidural hematoma
Skull base fracture danger?
Blow to top of head. Possible CSF fistula (CSF leakage from dural arachnoid tear), or a dural sinus thrombosis
fracture to petrous part temporal bone?
Blood/CSF could escape from ear, possible hearing loss, facial nerve damage.
Anterior cranial fossa fracture?
can cause anosmia, raccoon eyes, CSF rhinorrea
Cavernous sinus thrombus?
Late complication in infection in midface or paranasal sinuses. Could be due to infections of ear or maxillary teeth. Headache is most common sign, precedes fever, periorbital edema, etc.
Preseptal infection would do what to eye? comes from which sinus?
Comes from anterior ethmoidal sinus. Swells front of eye and closes it.
Macula lutea (with fovea centralis)
Biggest focus center. Only cones for color.
Damage to trochlear nerve presentation?
Can’t look down and in with injured eye. Head is tilted to opposite side of injury to reduce diplopia.
Damage to abducens nerve usually due to? How does it present?
cavernous sinus thrombosis. Eye is adducted.
Occularmotor nerve damage usually due to? Presents?
Increased cranial pressure. Presents with eye down and out, with ptosis. Often has pupil constriction problems.
Tic doulrouleaux also called?
Trigeminal neuralgia TN (at the ganglion). sometimes intermittent sometimes constant pain, can be just a branch as well.
What is zoster keratitis?
When shingles gets to the cornea.
Pharangeal neoplasms irritate what? What happens?
CN IX and X. Pain when swallowing, referred to ear.
otitis externa?
also called swimmers ear. External ear canal infection.
Otitis media?
Middle ear infection. painful due to pressure buildup, can rupture tympanic membrane.
SENSORY innervation to the whole palate?
CN V2
why is infraglottic choking more dangerous?
Because recurrent laryngeal doesn’t have as strong of sensation.
What bones make up the pterion?
- GW of sphenoid
- Temporal bone
- frontal bone
- parietal bone.
step ladder superior to inferior?
- tendon of digastric
- CN XII hypoglossa
- lingual a
- int. laryngeal n.
- superior thyroid a.
- (possibly CN X recurrent, if there)
great auricular and lesser occipital nerves are dorsal or ventral roots?
Ventral roots
Greater occipital n and 3rd occipital are dorsal or ventral roots?
Dorsal roots
