Buck BOOK test 1 Flashcards
identify all twelve cranial nerves by name?
CN I = Olfactory CN II = Optic CN III = Oculomotor CN IV = Trochlear CN V = trigeminal CN VI = abducens CN VII = facial CN VIII =Acoustic CN IX =Accessory CN X = Vagus CN XI = Accessory CN XII = Hypoglossal
GSA fibers provide exteroceptive impulses (pain, touch, temperature) to what structures?
structures from ectodermal origin such as: skin, lining of external ear, tympanic membrane, conjunctiva of eye, lining of external nares, nasal cavity, paranasal sinuses, lining of the mouth, anterior two thirds of tongue, and dura matter
-proprioceptive impulses from sensory endings in body wall, tendons, joints
GVA fibers carry sensory impulses from where?
visceral structures of endodermal origin=posterior third of tongue, larnyx, ducts of parotid gland, carotid sinus,pharynx, pharyngealtympanic tube, middle ear, bronchial tree, esophogus, gut, pancreaticohepatic ducts, lining of genitourinal ducts
AND BLOOD VESSELS (even though they come from mesoderm)
what receives SSA?
special somatic afferent= ear and eye (vision hearing equilibrium)
what receives SVA
specialized fibers for olfactory and gustatory (taste) receptors
SVE fibers innervate what?
skeletal muscles derived from visceral arch mesoderm (branchiomeric/pharygeal) includes muscles of mastication, fascial expression, pharynx, palate, and larynx
Olfactory nerve number, fiber types, what it innervates
CN I sense of smell, SVA, causes reflex salivation and increase in gastric motility
Optic nerve number, fiber types what it innervates
CN II SSA afferent fibers of retina primary receptor for sight
Oculomotor nerve number, fiber types what it innervates?
CN III GSE, GVE-P
GSE innervates extraoccular muscles of eye and assist in rotational movement of eye
Trochlear nerve number, fiber types, innervates?
CNIV GSE innervates superior oblique eye muscle
Trigeminal nerve number and fiber types, innervates?
CN V GSA SVE
GSA- V1=opthalmic V2=Maxillary, V3= mandibular innervates= portion of scalp, mot of face, all conjunctiva, epithelium of the nasal cavity, paranasal sinuses, oral cavity, skin of outer ear, external auditory meatus, external surface of tympanic membrane, cranial dura matter
provides PROPRIOCEPTIVE FIBERS TO ALL SKELETAL MUSCLES OF HEAD
SVE- only in v3 motor innervation to muscles derived from first pharyngeal arch muscles of mastication mylohyoid, anterior belly of digastric, tensor veli palatini, and tensor typani
what autonomic nerves are carried with the trigeminal nerve?
GVE-P fibers of CN III, CN VII, CN, IX
GVE-S deep petrosal n and internal carotid plexus provide post ganglionic sympathetic fibers to V1 and V2 which innervate dilator of pupillae, lacrimal gland, and all mucous glands of head
Abducens nerve number and fiber types and innervates
CN VI GSE innervates lateral rectus (turns eye lateral abducts eye)
facial nerve number, fiber types, and innervates
CN VII SVE GSA SVA GVA GVE–P
SVE- muscles of facial expression- stylohyoid, posterior belly of digastric muscle, and stapedius
GSA- sensory portion of external ear and external auditory meatus
SVA- taste to anterior 2/3 of tongue via CHORDA TYMPANI
GVA- sensory to pharyngeal vault
GVE-P lacrimal gland, nasal, palatal, oral, and pharyngeal mucous glands via GREATER PETROSAL NERVE and the PTERYGOPALATINE GANGLION, to the submandibular and sublingual salivary glands via CHORDI TYMPANI and the SUBMANDIBULAR GANGLION
If the chorda typani is damaged what fibers of what nerve will be wrecked?
GVE-P to the submandibular and sublingual salivary glands as well as SVA to the anterior 2/3 of tongue responsible for taste
vestibulocochlear nerve number and fiber types and innervates what
CN VIII SSA SSE
SSA- afferent fibers from organ of corti related to sense of hearing and fibers from semicircular canals, urticle and saccule of the internal ear relative to sense of equilibrium
SSE DGAF not on test
Glossopharyngeal nerve fiber types and innervates and number?
CN IX SVE GSA SVA GVA GVE-P
SVE-pharyngeal arch 3 -stylopharyngeus motor
GSA- sensory to portion of skin on external ear
SVA- taste from posterior third of tongue
GVA-sensory to epithelium of endodermal origin, majority of pharynx lining, eustacian tube, middle ear, internal surface of the tympanic membrane, mastoid air cells tonsils, posterior third of tongue parotid gland and carotid sinus
GVE-P secretory fibers to parotid salivary glands via LESSER PERTODSAL NERVE and OTIC GANGLION
what type of cell bodies does the superior ganglia of the main trunk of CN IX possess?
GSA
what type of cell bodies does the inferior ganglia of the main trunk of CN IX possess?
SVA GVA
Vagus number, fiber types, innervates?
CN X SVE GSA SVA GVA GVE-P
SVE-pharyngeal arches four and six, superior inferior and middle pharyngeal constrictor muscles, salpingopharygeus, levator veli palatini, palatoglossus, palatopharyngeus, larynx, upper portion of esophogus
GSA- cutaneous innervation of external portion of ear
SVA- taste from the area of the epiglottic valleculae
GVA-sensory innervation to epithelium of endodermal origin which lines root of tongue, larynx, lining of respiratory system, heart, entire gut tube to distal transverse colon, capsule of liver spleen kidney, and cardiac muscle
GVE-P mucosal glands of larynx, smooth muscle and glands of gut tube, respiratory system cardiac
what type of cell bodies does the superior ganglia of the main trunk of CN X possess?
GSA
what type of cell bodies does the inferior ganglia of the main trunk of CN IX possess?
SVA/GVA
spinal accessory nerve number, fiber types, innervates what
CN XI GSE
GSE-motor innervation to trap and sternocleidomastoid
hypoglossal nerve number, fiber types and innervates
CN XII GSE
GSE- motor innervation to tongue: styloglossus, genioglossus, hypoglossus, and intrinsic muscles of tongue
NOTE: CN XII also carries GSA of C1 C2 from posterior cranial fossa dura to dorsal root of spinal nerves C1 C2
Some say marry money but my brother says big boobs matters more
s=sensory m-motor b=both mneumonic for which nerves carry what
what cranial nerves contain GSA?
V, VII, IX, X
what cranial nerves contain GSE?
III, IV, VI, XI, XII
what cranial nerves contain GVA?
VII, IX,X
what cranial nerves contain GVE-P?
III, VII, IX,X
what cranial nerves contain SVA?
I, VII, IX, X
what cranial nerves contain SVE?
V VII IX, X
what cranial nerves contain SSA
II, VIII
what cranial nerves contain SSE?
VIII
what facia incorporates the platysma muscle?
superficial fascia
what innervates the platysma?
cervical branch of facial N
what makes up the roof of the anterior and posterior triangles?
investing fascia
what is contained in the suprasternal space?
communicating vein with anterior jugular veins
the superficial layer of infrahyoid fascia invests what muscles?
sternohyoid and omohyoid muscles
what is the sling for the intermediate tendon of omohyoid muscle made up of?
superficial layer of infra hyoid fascia
the deep layer of infrahyoid fascia invests what muscles
strernothyroid and thyrohyoid muscles
the laminae of the infrahyoid facia fuse inferiorly with what? and laterally with what?
with the adventitia of the brachiocephalic veins, fibrous pericardium via the SUPERIOR STERNOPERICARDIAL LIAGAMENT and laterally with the carotid sheath
what fascia is the primary covering of the thyroid gland?
pre-trachyeal fascia
what muscles does buccopharyngeal fascia encase?
pharyngeal constrictors, buccinator
what fascial layer fuses with the adventitia of the esophogus?
buccopharyngeal fascia
what forms the floor of the posterior cervical triangle
prevertebral fascia
what is sibsons fascia?
suprapleural membrane which is a specialization of prevertebral fascia on the underside of the scalene muscles
what is the clinical significance of the danger space and where is it located?
also called retropharyngeal space located between prevertebral and buccopharyngela/alar fascia. can lead to rectopharyngeal abcess which can lead to dysphagia or dysarthria and can dissect into the posterior aspect of the superior and posterior mediasteinum= chronic tonsilitis can lead to mediasteinal abcess inflammation of esophagus all the way to diaphram
what structures can an infection in the anterior visceral compartment (pre-tracheal space) endanger?
space located between infrahyoid fascia and pretracheal fascia, risks aorta, brachiocephalic veins, and pericardium
chronic tonsillitis can lead to what?
mediasteinal abcess that can inflame the esophogus all the way to the diaphram
what is the action of the SCM acting unilaterally? and innervation of SCM
rotates head to the opposite side while elevating chin
CN XI and C2 C3
what is the pathology of torticollis?
sidebend to same side rotate away shortened SCM
a prominent external jugular vein can indicate what?
heart failure, SVC obstruction, enlarged supraclaviular lymph nodes, or increased intrathoracic pressure
laceration of the external jugular vein can lead to what condition?
air embolism noted by hear a bruit upon ausculatiton of the thoracic wall
what is the most important venous drainage of the brain and skull? and if it is compromised how does blood drain?
internal jugular vein is most important if it is blocked at its origin, uses anastomoses between the anterior retromandibular vein which joins the facial vein to become common facial vein which dumps in internal jugular past blockage/ also uses anastomoses of the posterior retromandibular vein which comes together with great auricular v to form external jugular which dumps into the subclavian.
what nerves emerge from beneath the posterior border of the SCM also known as ERBS point?
Lesser occipital, greater auricular, transverse cervical, and supraclavicular
when operating on the neck and anethsitizing erb’s point what must the surgeon be wary of?
C3, C4, are part of the phrenic nerve which can partially paralyze the diaphragm on the same side therefore extra car must be taken with respiratory or cardiac disease patients
what are the contents of the posterior triangle?
external jugular vein, spinal accessory nerve, great auricular nerve, supraclavicular n, transverse cervical n, lesser occiptial n, brachial plexus, inferior belly of omohyoid, third portion of subclavian, transverse cervical, suprascapular, dorsal scapular, and occipital arteries, some deep cervical lymph nodes
thoracis outlet syndrome can result from hypertrophy of what muscles?
anterior and middle scalenes
dorasal scapular N cord level
c5
accessory phrenic nerve cord level
branch of c5
nerve to the subclavius cord level?
c5, c6
suprascapular n cord levels
c5, c6
long thoracic nerve cord levels
c5, c6, c7
the subclavian artery is invested by what fascial layer?
prevertebral fascia
what is the innervation of the anterior and posterior digastric bellies?
anterior belly: mylohyoid N (CN V3)
posterior belly: digastric branch of facial N (CN VII)
innervation of stylohyoid?
digastric branch of facial N CN VII
innervation of mylohyoid bone?
Mylohyoid branch of CN V3
innervation of the sternohyoid?
ansa cervicalis of cervical plexus
innervation and action of sternothyroid
action depresses larynx N ansa cervicalis of cervical plexus
innervation and action of thyrohyoid
A: depresses hyoid and tongue when larynx is fixed from below, elevates larynx when hyoid is fixed from above
N: C1 via hypoglassal N
what is the innervation of the omohyoid?
ansa cervicalis of the cervical plexus
where is a pyramidal lobe of the thyroid located and what is its significance?
at the junction of the isthmus with the left lobe marks the loction where the thyroid primordium decended through the thyroglossal duct, can be a path of ectopic thyroid tissue which can cause cysts
where does the superior thyroid artery branch off?
external carotid artery
where does the inferior thyroid artery branch off?
thyrocervical trunk
what is the relationship between the inferior thyroid artery and the carotid sheath?
passes posterior to the carotid sheath and sympathetic trunk
what are the consequences of inadvertent removal of the parathyroid gland?
tetany and death
what could be a possible consequence to surgery approaching through the carotid triangle to remove atherosclerotic plaque? (called a carotid endartectomy)
manipulation of the vagus and recurrent laryngeal n during this approach can lead to changes in voice
what artery is located in the deep parotid space?
external carotid artery
how can a surgeon access the right internal jugular vein?
apex of triangle formed between tow heads of SCM aim inferior at 30 degree
what fibers are in the recurrent laryngeal nerve
SVE, GVA, GVE-P
what CN have parasympathetic ganglia associated with them?
ciliary ganglia of CN III, submandibular and pterygopalatine ganglia of CN VII, and the otic ganglia of IX
what is the innervation and action of the anterior scalene?
action: raise first rib sidebend and rotates cervical column to opposite side
N: ventral rami spinal nerves C5-C7
what is the innervation and action of the middle scalene?
A: raise first rib sidebend and rotates cervical column to opposite side
N: ventral rami of spinal nerves C3-C8
what is the innervation and action of the posterior scalene?
A: elevates 2nd rib, sidebend and rotates vertebral colom both sides flexes
N: ventral rami of c7-c8
in thoracic outlet syndrome where is the brachial plexus and subclavian artery compressed?
in between the anterior and middle scalenes
what is dysphagia lusoria?
right subclavian comes off left side distally to left subclavian artery and passes posterior to the esophagus and trachea
where does the right lymphatic duct drain?
right jugulovenous angle
where does the thoracic duct drain?
left jugulovenous angle
what vein is commonly used to place a central line?
subclavian vein
how do sympathetics get to the head and neck and heart?
neurons located in lateral horn of T1-T4 traverse teh ventral root and white ramus communicons to ascend to cervical ganglia on sympartheitc chain, THEN POST GAGNGLIONIC neurons innervate the head and neck and part of heart
Are their preganglionic sympathetic fibers in the head?
NO they end at cervical ganglia then post ganglionics enter head
In a patient with raynauds phenominon where should a surgeon inject anesthetic?
they inject aroun the cervicothoracic aganglion
what is sibsons fascia (supraplueral membrane)?
a thickening of the prevertebral fascia on the underside of the scalene muscles
what lymphatics does the right thoracic duct receive and where does it drain?
right subclavian, right transverse cervical, right jugular, right bronchomediatinal trunks lmphatics
right jugulovenous angle
the deep cervical artery anastomoses with what artery?
descending branch of occipital artery
