B6-091 Head Anatomy Flashcards
1
Q
5 layers of scalp
A
Skin
Connective tissue (dense)
Aponeurotic layer
Loose connective tissue
Pericranium
2
Q
why does a scalp wound bleed profusely?
A
the dense connective tissue holds the arteries open
3
Q
what layers are considered the scalp when someone has been scalped?
A
skin
dense connective tissue
aponeurotic layer
4
Q
allows scalp movement and also provides a potential space for infection
A
loose connective tissue layer
5
Q
aponeurosis of the scalp comes from which muscle?
A
occipital frontalis
**causes gaping wound
6
Q
what causes a scalp injury to be a gaping wound?
A
cut is through aponeurosis and the
occipital frontalis pulls down on it
7
Q
the anterior cranial fossa houses the […] lobe
A
frontal
8
Q
the middle cranial fossa houses the […] lobe
A
temporal
9
Q
the posterior cranial fossa houses the […] lobe
A
cerebellum and bainstem
10
Q
what nerve passes through the cribriform formina?
A
CN1 olfactory
11
Q
what nerve passes through the optic canal?
A
CN2 optic
12
Q
what nerve passes through the superior orbital fissure? [4]
A
CN 3 occulomotor
CN 4 trochlear
CN 5-1 ophthalmic of trigeminal
CN 6 abducens
13
Q
what nerve passes through the foramen rotundum?
A
CN 5-2 maxillary of trigeminal
14
Q
what nerve passes through the foramen ovale?
A
CN 5-3 mandibular of trigeminal
15
Q
what nerve passes through the internal acoustic meatus? [2]
A
CN 7 facial
CN 8 vestibulocochlear
16
Q
what nerve passes through the jugular foramen? [3]
A
CN 9 glossopharyngeal
CN 10 vagus
CN 11 spinal accessory
17
Q
what nerve passes through the hypoglossal canal?
A
CN12 hypoglossal
18
Q
middle meningeal artery passes through foramen […]
A
spinosum
19
Q
brainstem passes through foramen […]
A
magnum
20
Q
optic nerve and […] pass through optic canals
A
ophthalamic arteries (supply orbit)
21
Q
[…] and accessory meningeal artery pass through foramen ovale
A
mandibular nerve
22
Q
interior pertrosal, sigmoid sinuses, and ascending pharygeal/occipital arteries pass through […] foramen
A
jugular
23
Q
provide a route for infection to go between the scalp and dural venous sinuses
A
emissary veins
24
Q
anosmia indicates damage to
A
CN 1 (olfactory)
25
cerebrospinal fluid rhinorrhea indicates damage to
CN1 olfactory
26
loss of pupillary constriction indicates damage to
CN 2 optic
27
visual field defects indicates damage to
CN 2 optic
28
dilated pupil
lost pupillary reflex on side of lesion
indicates damage to
CN3 occulomotor
29
ptosis
eye turns "down and out"
indicates damage to
CN3 occulomotor
30
inability to look down when eye is adducted indicates damage to
CN 4 trochlear
31
loss of pain and touch over cheek indicates damage to
CN5 trigeminal
32
deviation of mandible to side of lesion when mouth is opened indicates damage to
CN5 trigeminal
33
temporalis and masseter muscles do not contract indicating damage to
CN 5 trigeminal
34
eye fails to move laterally
diplopia on lateral gaze
indicates damage to
CN 6 abducens
35
paralysis of facial muscles (eye remains open, angle of mouth drops, forehead doesnt wrinkle)
indicated damage to
CN 7 facial
36
progressive unilateral hearing loss
tinnitus
indicates damage to
CN 8 vestibulocochlear
37
loss of taste on posterior third of tongue
loss of sensation on affected side of palate
indicates damage to
CN 9 glossopharyneal
38
sagging of soft palate, deviation of uvula to one side, hoarseness
indicates damage to
CN 10 vagus
39
paralysis of SCM and trapezius causing drooping of the shoulder indicates damage to
CN 11 spinal accessory
40
protruded tongue deviates toward affected side indicates damage to
CN 12 hypoglossal
41
"dipping in" of the anterior fontanel indicates
dehydration of infant
42
anterior fontanelle typically fuses by [...]
18 months
43
bulging of anterior fontanel indicates
increased ICP
44
posterior fontanel usually fuses by
end of 1st year
45
fontanelles located deep to temporalis [2]
sphenoidal
mastoid
46
3 layers of meninges
dura mater
arachnoid mater
pia mater
47
protrudes through meningeal layer of dura into venous sinuses and spinal cord
arachoid mater
48
what meninge is adherent to the brain and highly vascularized?
pia mater
49
2 layers of dura mater
periosteal layer
meningeal layer
50
the space between the arachnoid mater and pia mater contains
CSF
51
dural sheath that separates the right and left hemispheres of brain
falx cerebri
52
dural sheath that separates the occipital lobe from cerebellum
tentorium cerebelli
53
dural sheath that separates the two hemispheres of the cerebellum
falx cerebellum
54
dural sheath that covers the pituitary gland
diaphragma sellae
55
eventually the dural sinuses lead to the
internal jugular vein
56
sinus that extends from superior orbital fissure, runs along either side of the stella tursica to petras bone
cavernous dural sinus
57
cavernous sinus has direct communication with the
ophthalmic vein (has direct communication with facial vein)
58
how can zits cause infection of the cavernous sinus?
valveless veins with direct communication between facial and ophthalmic veins
59
the region where the frontal, parietal, temporal, and sphenoid bones join
pterion
60
a blow to the side of the head can cause a fracture of the pterion, damaging what artery?
middle meningeal artery
61
what nerves supply innervation to the anterior fossa? [2]
CN V1-opthalmic
CN V2-maxillary
62
what nerve supplies innervation to the middle fossa?
CN V3, mandibular
63
tentorium cerebelli is innervated by
CN1 olfactory
**tumor pressing here can cause headaches behind eyes
64
what nerve supplies innervation to posterior fossa?
C2 and C3 but carried by Hypoglossal and Vagus
65
the [...] produces CSF
choroid plexus
66
describe the flow of CSF
lateral ventricle -> foramen of monroe -> third ventricle -> cerebral aqueduct -> 4th ventricle -> subarachnoid space
67
CSF is returned to blood stream via
subarachnoid granulations and villi
68
CSF drains primarily into the [...] sinus
superior sagittal
69
true space that contains CSF, arteries of Circle of Willis, and veins
subarachnoid space
70
potential space between cranium and periosteal dura
epidural
71
potential space between dura and arachnoid
subdural
72
fracture of middle meningeal artery at pterion would result in [...] hematoma
epidural
73
lens shaped deficit on CT imaging
epidural hematoma
74
crescent shaped deficit on CT imaging
subdural hematoma
75
blood leaking into ventricles on CT imaging
subarachnoid hematoma
76
falls or lumbar punctures can tear the [...] causing a subdural hematoma
cerebral veins
77
a subarachnoid hematoma results from tearing what vessels?
vessels in circle of willis
78
what structures run through the parotid gland? [3]
CN 7 (facial)
retromandibular vein
external carotid artery
79
a tumor of the parotid gland can cause
facial paralysis (compression of CN 7)
80
muscle going around eye
orbicularis oculi
81
muscle going around mouth
orbicularis oris
82
what muscle keeps the cheeks taut when chewing so food doesn't fall out?
buccinator
83
muscle that helps you smile
zygomaticus major
84
muscle that helps you frown
compressor anguli oris
85
muscles of mastication [2]
masseter
temporalis
86
branches of external carotid artery in face [3]
facial
superficial temporal
transverse facial
87
branches of internal carotid artery [2]
supraorbital
supratrochlear
88
facial artery terminates as
angular artery (at the eye)
89
what branches of facial a. supply the lips?
superior and inferior labial (anastomose with each other)
90
artery that lies anterior to the ear, enabling you to take a pulse there
superficial temporal
91
superficial temporal a. anastomoses with
supraorbital
92
facial a. anastomoses with
supratrochlear a.
93
exits the skull via the internal acoustic meatus
runs in facial canal
exits via stylomastoid foramen
facial nerve CN7
94
provides motor innervation to muscles of facial expression
CN 7 facial
95
provides parasympathetic innervation to lacrimal, nasal, and palatine glands
and submandibular/sublingual salivary glands
CN 7 facial
96
provides taste to anterior 2/3 of tongue
CN 7 facial via chorda tympani
97
provides sensation to external acoustic meatus
CN 7 facial
98
provides motor innervation to muscles of mastication
CN V3- mandibular
99
passes through the cavernous sinus and enters the orbit via the superior orbital fissure
V1-ophthalmic
100
passes through the cavernous sinus and exits the skull via foramen rotundum
V2 maxillary
101
exits the skull via the foramen ovale
V3 mandibular
102
provides sensation from cornea, skin of forehead, scalp, upper eyelid, and part of nasal cavity
V1 ophthalmic
103
provides sensation from the skin of face, lower eyelid, cheek, upper lid, maxillary teeth, mucosa of nose, maxillary sinus
V2 maxillary
104
sensation from skin of mandible, lower lip, side of head, mandibular teeth, TMJ joint, anterior 2/3 of tongue
V3 mandibular
105
4 paranasal sinuses
frontal
ethmoid
sphenoid
maxillary
106
all of the sinuses are innervated by
CN 5
107
inflammation of the mucous membranes of paranasal sinuses
sinusitis
108
maxillary and frontal sinuses develop first followed by
ethmoid, sphenoid
109
why is it unlikely for a young child to have sinusitis?
sinuses develop later in life
110
provides blood supply to frontal sinus
anterior ethmoid a.
111
aperture of the frontal sinus
frontonasal duct into middle meatus
112
nerve that supplies the frontal sinus
supraorbital via V1
113
structures superior to the sphenoid
hypophyseal fossa (pituitary)
optic chiasm
114
provides blood supply to sphenoid sinus
pharyngeal arteries from maxillary
115
nerves that supply the sphenoid sinus [2]
posterior ethmoid via V1
orbital branches via V2
116
first sinus to develop
maxillary
117
aperture of maxillary sinus
middle meatus
118
nerves that supply maxillary sinus
infraorbital and alveolar branches of V2
119
provides blood supply to maxillary sinus
infraorbital and superior alveolar a. from maxillary
120
apertures of ethmoid sinus [3]
middle meatus
ethmoid bulla
superior meatus
121
chronic bacterial infections in the ethmoid air cells can erode into the
orbit
122
provides blood supply to ethmoid
anterior and posterior ethmoid
123
nerve that supplies ethmoid
anterior and posterior ethmoids via V1 and nasal branches from V2
124
if bacterial rhinosinusitis goes into the cranial fossa, it can cause
intracranial abscess
meningitis
125
if a bacterial infection breeches the sphenoid laterally it can cause
septic carvernous sinus thrombosis
(cranial nerve palsies with or without fever)
126
posterior ethmoid air cells open into the [...] meatus
superior
127
the middle ethmoid air cells open into the [...]
ethmoid bulla of middle meatus
128
the frontal sinus, anterior ethmoid sinus, and maxillary sinus open into the
semilunar hiatus
129
the nasolacrimal duct opens into the [...] meatus
inferior
130
why do we get so much maxillary sinus pain during sinusitis?
opening to maxillary sinus is superior --> hard for mucus to drain
131
nasal mucosa become swollen/inflamed during URTIs or allergic reactions
rhinitis
132
what is this image showing?
septal deviation
133
brings a lot of blood from the maxillary artery causing posterior nosebleeds
sphenopalatine a.
134
anastomosis in anterior nasal cavity prone to anterior nosebleeds
Kesselbachs
135
veins originating from the maxillary drain to
pterygoid plexus
136
veins originating from ophthalmic drain to
cavernous sinus
137
veins originating from facial drain into
facial v.
138
what is the significance of the triangle of danger?
consists of superior ophthalmic vein, facial vein, pterygoid plexus, and cavernous sinus
an infection in this area will go straight to the cavernous sinus
139
major nerve that innervates the nasal septum
nasal palatine
140
what layer of the scalp contains sweat/sebaceous glands and hair follicles?
skin
141
what layer of the scalp is richly vascularized and contains the cutaneous nerves?
dense connective tissue
142
broad, strong tendinous sheath that covers the calvaria and serves as the attachment site for the occipitofrontalis muscle
aponeurosis
143
sponge-like layer of scalp including potential spaces that can distend with fluid as a result of injury or infections
loose connective tissue
144
forms the external periosteum of the neurocranium
pericranium
145
[...] and [...] pass through the foramen ovale
mandibular division of trigeminal
accessory meningeal artery
146
what cranial nerves pass through the superior orbital fissure?
3, occulomotor
4, trochlear
V1, ophthalmic
6, abducens
147
opthalmic veins pass through the [...] fissure
superior orbital
148
what nerves pass through the internal acoustic meatus? [2]
facial nerve CN7
vestibulocochlear CN 8
149
the spinal accessory will enter the skull through [...] and exit through [...]
enter via foramen magnum
exit via jugular foramen
150
what nerves exit via the jugular foramen? [3]
CN 9 glossopharyngeal
CN 10 vagus
CN 11 spinal accessory
151
the mandibular division of trigeminal and the accessory meningeal artery travel through
foramen ovale
152
pterion is formed by the fusion of [4]
frontal
parietal
temporal
sphenoid
153
fusion of the anterior fontanelle will form [...] between the front and parietal bones
bregma
154
fusion of the posterior fontanelle will form [...] between the occipital and parietal bones
lambda
155
what artery lies in the cavernous sinus?
internal carotid
156
the posterior aspect of tentorium cerebelli is innervated by
ophthalmic division of trigeminal
157
[...] innervates a portion of the dura in the anterior cranial fossa and part of the anterior wall of the middle cranial fossa
CN V2-maxillary
158
[...] innervates dura on the lateral wall of the anterior cranial fossa and middle cranial fossa
mandibular
159
[...] will innervate the dura of the posterior cranial fossa
C1 and C2 carried by hypoglossal or vagus
160
space that contains CSF and the circle of Willis
subarachnoid
161
rupture of the middle meningeal artery will cause bleeding in the [...] space
epidural
162
rupture of the arteries of the Circle of Willis will bleed into the [...] space
subarachnoid
163
rupture of the cerebral veins will cause bleeding in the [...] space
subdural
164
structures that can be damaged when removing parotid gland tumors [3]
**facial nerve**
retromandibular vein
external carotid artery
165
supplies the anterior 2/3 of the tongue with general sensation
lingual (from trigeminal)
166
supplies anterior 2/3 of tongue with taste
chorda tympani (from facial CN 7)
167
frontal sinus drains into the [...] meatus via the frontonasal duct
middle meatus
168
the sphenoid sinus drains into the
sphenoethmoid recess
169
the maxillary sinus will drain into the [...] meatus
middle
170
the anterior ethmoid air cells will drain into the [...] meatus
middle
171
the middle ethmoid air cells will drain into the [...] meatus
middle
172
the posterior ethmoid air cells will drain into the [...] meatus
superior
173
the roof of the sphenoid is located inferior to the
hypophyseal fossa and pituitary gland
174
erosion of the lateral wall of the sphenoid sinus will lead to the
cavernous sinus
175
the [...] sinus is located inferior to the orbit and superior to the molar teeth
maxillary
176
the maxillary sinus is located inferior to [...] and superior to [...]
orbit
molar teeth
177
nasolacrimal duct drains into the [...] meatus
inferior
178
the lateral nasal branches supply the
lateral walls of the nasal cavity
179
infection from the nasal cavity can spread to [...] sinus
cavernous
180
the nose can drain via the [...] into the cavernous sinus
pterygoid plexus
181
the superior and inferior ophthalmic veins drain into the
cavernous sinus
182
why does the scalp bleed so profusely?
the dense connective tissue holds the lumen of the arteries open
183
why is a circular dressing used for head wounds?
blood vessels run inferior to superior
compresses both inferior and superior
184
how can a head wound cause black eyes?
the fascial sheet is continuous from forehead to zygomatic arch, so bleeding in the loose connective tissue will allow it to pool in the periorbital area
185
when would a head wound require stitches?
if it goes through to aponeurosis it will gape, requiring closure
186
why is infection a primary concern of a head wound?
infection can spread from loose connective tissue via emissary veins into dural venous sinuses
**can cause thrombosis, meningitis
187
the nerves of the head run what direction?
inferior to superior
**important to facial surgery, will use U shaped flaps to preserve the neurovascular structures
188
what two nerves run in the internal acoustic meatus?
facial nerve- CN7
vestibulocochlear- CN 8
189
weakness or paralysis of ipsilateral muscles of facial expression indicates lesion in
facial CN 7
**issues smiling, puckering lips, closing one eye lid
190
supplies taste to anterior 2/3 of tongue
facial CN 7 via chorda tympani
191
supplies general sensation to anterior 2/3 of tongue
lingual via trigeminal (V3)
192
reduced/lack of tear production indicates a lesion in
facial CN7
193
provides parasympthetic innervation to sublingual and submandibular glands
facial CN 7 via chora tympani
194
tinnitus/ringing/hearing loss in ears indicates lesion in
vestibulocochlear- CN 8
195
vertigo/dizziness/nausea and vomiting can indicate a lesion in
vestibulocochlear- CN 8
196
the parasympathetic innervation of CN 7 (facial) travels via [...] to the lacrimal gland
greater petrosal
197
hyperacoutistic sound may indicate a lesion to
CN7-facial to stapedius
198
CN7 branches through the geniculate ganglion and runs downs the [....] to supply sensory and motor innervation to the face
facial canal
199
a lesion in CN 7 at the facial canal would leave what functions **unaffected**?
tear production
maybe stapedius
200
lens shaped deficit on CT
epidural hematoma
201
what vessel is the source of the bleed in epidural hematoma?
middle meningeal a.
202
what foramen does the middle meningeal a. run through?
foramen spinosum
**middle cranial cavity
203
between the skull and the periosteal layer of the dura
epidural space
204
a blow to the side of the head can damage what structure?
pterion
205
what bones fuse to form pterion?
frontal
parietal
temporal
sphenoid
206
cresent shaped deficit on CT
subdural hematoma
207
what vessel is the source of the bleed in subdural hematoma?
cerebral veins
208
what space do subarachnoid hematomas form in?
subarachnoid
209
subarachnoid space contains
CSF
210
what vessel lies in close approximation to pterion?
middle meningeal a.
211
what can cause teeth pain in maxillary sinus infection?
pain travels maxillary nerve-->infraorbital nerve --> middle superior alveolar and anterior superior alveolar nerves
212
what is superior to the maxillary sinus?
orbital floor
213
what is inferior to the maxillary sinus?
teeth/oral cavity
214
where is the aperture of the maxillary sinus?
semilunar hiatus of the middle meatus
215
when you cry, why does your nose run?
tears run from lacrimal duct to inferior meatus out nose
216
what 5 arteries make up Kesselbach's plexus?
sphenal palantine
greater palantine
anterior ethmoidal
posterior ethmoidal
septal branch from labial
217
what causes spurting of blood from the nose in a anterior nose bleed?
Kesselbachs plexus
218
what artery causes a posterior nose bleed?
sphenopalantine
**usually needs to be ligated
219
what causes obstruction of the nasal airway? [2]
septal deviation
cartilage/nasal bone displacement
220
if a nasal fracture extends into the cranium, what happens?
CSF rhinorrhea
221
what nerve goes through the cribiform plate?
olfactory
222
halo or target sign indicates
CSF mixed with blood
223
symptoms of septic cavernous thrombosis
orbital edema and swelling
CN palsies effecting eye pattern
fever
AMS
224
how does infection spread to the cavernous sinus?
ophthalmic vein --> cavernous sinus
facial vein --> pterygoid plexus of veins --> cavernous sinus
due to **valveless** veins in this area
225
loss of abducens nerve may be an indication of aneurysm in
internal carotid artery
**run in close proximity
226
large opening that connects posterior cranial fossa with the exterior base of the skull
jugular foramen
227
what three nerves lie in the interior jugular foramen?
glossopharyngeal IX
vagus X
spinal accesory XI
228
the posterior compartment of the jugular foramen contains the
internal jugular vein
229
originates at the terminal end of the sigmoid dural sinus
internal jugular
230
connects the middle cranial fossa with the exterior base of the skull
foramen ovale
231
transmits the mandibular division of the trigeminal nerve and small accessory meningeal artery
foramen ovale
232
conveys the middle meningeal artery from the infratemporal fossa into the cranium
foramen spinosum
233
large opening that connect the floor of the middle cranial fossa with the exterior base of the skull
foramen lacerum
234
transmits the greater petrosal nerve to the pterygoid canal
foramen lacerum
235
large, oblique passage running through the base of the skull
carotid canal
236
the carotid canal merges with the [...] to bring the internal carotid to the sella tursica
foramen lacerum
237
identify A-E
A. foramen ovale
B. foramen spinosum
C. foramen lacerum
D. carotid canal
E. jugular foramen
238
supplies general sensation to the skin of the lower lip, chin, cheek, anterior auricle, and lateral scalp
mandibular division of trigeminal V3
239
supplies innervation to the mandibular teeth and gingivae via the inferior alveolar nerve
mandibular division of tigeminal V3
240
supplies sensory to skin of upper eyelid, anterior aspect of the nose, forehead, and anterior scalp
opthalmic division of trigeminal V1
241
supplies sensory to the skin of the lower eyelid, cheek, upper lips, upper dentition/gingivae, maxillary sinus, and lateral nose
maxillary division of trigeminal V2
242
supplies motor to the buccinator muscle and muscles of upper lip
buccal branch of facial n.
**no sensory**
243
supplies motor to the muscles of the lower lip/chin
marginal mandibular of facial n.
**no sensory**
244
most likely layer for shear injury of scalp
loose connective tissue
245
external scalp layer containing sweat/sebaceous glands and hair follicles
skin
246
layer of scalp that is richly vascularized and contains cutaneous nerves
dense connective tissue
247
layer of scalp that is a broad tendinous sheath covering the calvaria
serves as an attachment for muscle bellies of occipitofrontalis
aponeurosis
248
sponge-like layer of the scalp that includes potential spaces that may distend as the result of injury/infection
loose connective tissue
249
opens into the superior nasal meatus
posterior ethmoidal sinus
250
open into the semilunar hiatus in the middle meatus [3]
maxillary
frontal
anterior ethmoid
251
drain into the ethmoid bulla in the middle nasal meatus
middle ethmoidal
252
rupture of the [...] causes epidural hemorrhage
middle meningeal
253
rupture of [...] causes subarachnoid hemorrhage
circle of willis arteries
254
rupture of [...] causes subdural hematoma
cerebral veins
255
cranial dural sinuses normally contain
venous blood
256
parallels the course of the internal carotid within the cavernous sinus
abduces CN6
257
most likely to be damaged as a result of internal carotid aneurysm in the cavernous sinus
CN 6 abducens nerve
258
lies in the hypophyseal fossa of the sella tursica of the sphenoid
pituitary gland
259
lies immediately posterior and superior to the sphenoid sinus
pituitary gland
260
lies in the maxilla lateral to the wall of the nasal cavity
maxillary sinus
261
sinus that lies between the orbit and nasal cavity
ethmoid air cells
262
pain from an anterior nosebleed would be sensed by
**nasopalatine n**
septal branch of ethmoidal
263
innervate the lateral walls of the nasal cavity [2]
anterior ethmoid
lateral nasal nerves
264
vessels that form Kiesselback plexus
anterior and posterior ethmoidal arteries
sphenopalatine artery
greater palatine artery
septal branch of superior labial
265
ipsilateral paralysis of the face (bells palsy) indicates at lesion where?
internal acoustic meatus (facial n.)
266
a lesion in the facial nerve at the level of the facial canal would result in
ipsilateral facial paralysis
decreased saliva from submandibular and sublingual glands
lack of taste on ipsilateral 2/3 of anterior tongue
hyperacusis d/t lack of stapedius
decreased sensation to ear
267
a lesion in facial nerve at the parotid gland would result in
ipsilateral facial paralysis
268
a lesion in facial nerve at the stylomastoid foramen would result in
ipsilateral facial paralysis
reduced sensation to ear
269
nerves that pass through the superior orbital fissure [4]
oculomotor III
trochlear IV
V1 opthalmic
abducent VI
