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Medicine Sem 3 > Case 4 anatomy > Flashcards

Case 4 anatomy Flashcards

1
Q

petrous and what part of temporal bone?

A

squamous

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2
Q

what makes up the auricle?

A

made of elastic cartilage and covered by a layer or perichondrium and skin

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3
Q

external auditory meatus - bone or cartilage?

A
  • The outer third is cartilaginous which, like the auricle, is covered by perichondrium and skin
  • The inner two thirds are formed by bone covered by periosteum and skin
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4
Q

what produces ear wax?

A

ceruminous glands

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5
Q

which part of the tympanic membrane is pulled inwards by the tensor tympani muscle?

A

pars tensa

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6
Q

what are the different parts of the tympanic membrane?

A
  • Umbo = the depression which marks the site of the handle of the malleus
  • Pars flaccida = the thin part of membrane which is located superior to the lateral process of the malleus between the mallear folds
  • Pars tensa = forms the majority of the membrane, it is pulled inwards by the tensor tympani muscle
  • Anterior & posterior mallear folds = fibrous thickenings that extend from the lateral process of the malleus to the tympanic bone
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7
Q

what proivdes sensory innervation to the outer surface of the tympanic membrane? inner surface?

A 
auricotemporal nerve (a branch of V3) with supplementation from the auricular branch of the vagus 
MANDIBULAR

Glossopharyngeal nerve provides sensory innervation to the internal surface of the tympanic membrane

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8
Q

what does the tympanic cavity consist of?

A

two parts; the tympanic cavity proper which lies medial to the tympanic membrane and the epitympanic recess that lies superior to the membrane

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9
Q

what connects the tympanic cavity and the mastoid air cells?

A

mastoid antrum

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10
Q

what forms the roof of the tympanic cavity?

A

tegmen tympani

(plate of thin bone (part of temporal bone)), separates the middle ear from the meninges & temporal lobe

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11
Q

what is the promontory?

A

formed by the basal turn of cochlear

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12
Q

where’s the carotid canal?

A

just anterior to the jugular foramen

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13
Q

what is the opening to the mastoid atrum called?

A

aditus

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14
Q

what’s in the anterior and posterior walls of the tympanic cavity?

A

anterior wall:

  • opening of pharyngotympanic tube
  • hole for tensor tympanic muscle

posterior wall:

  • aditus for mastoid antrum
  • pyramid for tendon of stapedius
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15
Q

where does the tensor tympani originate and insert?

A

originates from the auditory tube and attaches to the handle of malleus, pulling it medially when contracting

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16
Q

what innervates the tensor tympani muscle?

A

tensor tympani nerve, a branch of the mandibular nerve

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17
Q

what are the tensor tympani and chorda tympani branches of?

A

chorda tympani - facial nerve

tensor tympani - mandibular - trigeminal

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18
Q

where does the stapedius muscle originate and insert?

A

arises from the posterior wall of tympanic cavity and attaches on the stapes

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19
Q

what innervates the stapedius muscle?

A

facial nerve

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20
Q

what type of joints between the ossicles?

A

synovial

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21
Q

what is the purpose of the ear muscles?

A

damped down high frequency vibrations

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22
Q

what forms the eustachian tube?

A

posterolaterally the skeleton of the tube is formed by bone but the anterior two-thirds are cartilaginous

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23
Q

which muscles attach to the cartilaginous portion of the auditory tube? what do they do?

A
  • levator veli palatini
  • tensor veli palatini
    they are actively involved in opening it
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24
Q

where are tubal tonsils found and what is there purpose?

A

under the mucosa that surrounds the opening of the auditory tube in the nasopharynx
to prevent infection spreading from the nasopharynx to the middle ear

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25
Q

where is the facial canal? what runs through it?

A

Z-shaped canal running though the temporal bone from the internal acoustic meatus to the stylomastoid foramen

  • Facial nerve enters the facial canal and runs laterally above the inner ear
  • Expands to from the geniculate ganglion
  • Turns sharply to run in a posterior directly along the medial wall of the tympanic cavity
  • Turns downwards and descends along the posterior wall of the tympanic cavity
  • Exits the skull through the stylomastoid foramen
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26
Q

within the temporal bone, what are the three main branches that the facial nerve gives off? describe course of each nerve and what it does.

A

greater petrosal, nerve to stapedius, chorda tympani

  • Greater petrosal = arises at the geniculate ganglion, contains preganglionic parasympathetic fibres which pass to pterygopalatine ganglion
  • Nerve to stapedius = arises from the facial nerve as it descends behind the pyramid, contains motor fibres
  • Chorda tympani = arises just above the stylomastoid foramen, contains preganglionic parasympathetic fibres that pass to the submandibular ganglion and sensory fibres for taste from the anterior two-thirds of tongue
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27
Q

describe the orientation of the semicircular canals in terms of the long axis of the petrous temporal bone

A
  • Superior/anterior = vertical and placed at right angles to the long axis of the petrous bone
  • Posterior = vertical and placed parallel with the long axis of the petrous bone
  • Lateral = horizontal and lies in the medial wall of the aditus of the mastoid antrum
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28
Q

where is the vestibule located in relation to the semicircular canals and cochlear?

A

anterior to the semi-circular canals and posterior to the cochlear

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29
Q

what does the oval window lead from and to?

A

middle ear to vestibule

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30
Q

what is the central pillar of the cochlea called? and what passes through it?

A

modiolus, through which branches of the cochlear nerve pass

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31
Q

what is the spiral lamina?

A

a ledge of bone spirals around the modiolus, this ledge is termed the spiral lamina (bony ledge which projects from the modiolus into the interior of the canal) – it projects into the bony canal

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32
Q

what does the basilar membrane extend from and to?

A

from the spiral lamina to the bony wall of the canal

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33
Q

what is superior scala tympani or scala vestibuli?

A

scala vestibuli (think about it like endolymph comes from the vesibule and then goes round to the scala tympani)

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34
Q

the semicircular ducts open into the utricle through how many openings?

A

5

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35
Q

what connects the utricle and saccule?

A

utriculo-saccular duct

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36
Q

what connects the saccule to the cochlea?

A

ductus reuniens

37
Q

what does the utriculo-saccular duct give rise to? what does this do?

A
  • The utriculo-saccular duct gives rise to the endolymphatic duct which passes through the vestibule and bone to enter the posterior cranial fossa
  • It is expanded at its end to form the endolymphatic sac which lies beneath the dura mater on the posterior surface of the temporal bone
  • The endolymphatic sac stores excess endolymph
38
Q

where are the sensory receptors of the utricle and saccule found?

A

in areas of specialised epithelium called maculae

39
Q

where is the macula in the utricle and saccule located?

A

floor of utricle and medial wall of saccule

40
Q

where are the sensory receptors of the semicircular ducts found?

A

ampulla on a transverse crest called the crista

41
Q

the cochlear duct is enclosed between which two membranes?

A

basilar and tectorial membranes

42
Q

what is the spiral organ?

A

organ of Corti

43
Q

what do the different sensory receptors respond to?

A
  • Crista of semi-circular ducts respond to kinetic balance
  • Maculae of utricle and saccule respond to static balance
  • Spiral organ of cochlear duct responds to sound
44
Q

what is the nasopharynx lined by?

A

respiratory epithelium

45
Q

what is located in the nasopharynx?

A

pharyngeal and tubal tonsils and ostium of auditory tube

46
Q

what is the nasopharynx located posterior to?

A

the nasal choanae

47
Q

where does the oropharynx extend from and to?

A

from soft palate to tip of epiglottis

48
Q

what is located in the oropharynx?

A
  • Contains the palatopharyngeal folds (horizontal fold of pharyngeal mucosa that passes from the soft palate and joins with its opposite fold over the entrance to the oesophagus)
  • Contains the palatoglossal folds (thick fold of tissue passing from the soft palate to the lateral border of the tongue)
  • Site of palatine (ones you see when open mouth) and lingual (at back of base of tongue) tonsils
49
Q

where does the laryngopharynx extend from and to? where does it terminate?

A

from epiglottis to oesophagus

- terminates at C6

50
Q

what does the laryngopharynx contain?

A

piriform recess

51
Q

what does the wall of the pharynx consist of?

A

3 layers:
• Innermost – mucosal layer = the type of epithelium is dependent on location
• Middle – fibromuscular layer = comprised of the pharyngobasilar fascia, pharyngeal raphe (where each muscle joins its fellow of the opposite side in a fibrous midline) and muscles
• Outermost – the buccopharyngeal fascia = contains nerves and vessels

52
Q

what is the external layer of muscles of the pharynx?

A

circular:
• Superior constrictor – located in oropharynx
• Middle constrictor – located in laryngopharynx
• Inferior constrictor – located in laryngopharynx

(none in the nasopharynx)

53
Q

what is the inner layer of muscles of the pharynx?

A

longitudinal:
• Stylopharyngeus
• Salpingopharyngeus (arises from eustachian tube – opens to equalise pressure in middle ear)
• Palatopharyngeus

54
Q

which is the innervation of the pharyngeal muscles?

A

all vagus except stylopharyngeus innervated by glossopharyngeal nerve

55
Q

where do the longitudinal muscles originate and insert onto?

A

stylopharyngeus - styloid process to pharynx
salpingopharyngeus - eustachian tube to pharynx
palatopharyngeus - hard palate of oral cavity to pharynx

56
Q

what goes through the superior and middle constrictor muscles?

A

stylopharyngeus muscle

57
Q

what forms passavant’s ridge?

A

some of the upper fibres of the superior constrictor muscle combine with fibres of the palatopharyngeal muscle to form this

58
Q

what does the palatopharyngeus muscle do to the oropharyngeal isthmus during swallowing?

A

widens it

59
Q

what does the salpingopharyngeus do?

A

elevates the pharynx and assists in opening the auditory tube

60
Q

what does the inferior constrictor consist of?

A

the thyropharyngeus and the cricopharyngeus which attach anteriorly to the thyroid and cricoid cartilages respectively

61
Q

what is the pharyngeal plexus?

A

network of nerves that is located in the buccopharyngeal fascia on the posterior aspect of the pharynx – it contains the following fibres:
• Motor fibres from vagus
• Sensory fibres from glossopharyngeal
• Parasympathetic fibres from glossopharyngeal
• Sympathetic fibres from superior cervical ganglion

62
Q

what does the layrngeal skeleton consist of?

A
  • Consists of 3 unpaired (thyroid, cricoid, epiglottis) and 3 pairs (arytenoid, corniculate, cuneiform) cartilages
  • Hyoid bone is also considered to be part of the laryngeal framework
63
Q

describe the thyroid cartilage

A
  • Lamina
  • Angle/prominence (adam’s apple)
  • Superior thyroid notch (above the prominence), superior & inferior cornu (horn)
64
Q

describe the cricoid cartilage - whats anterior and posterior

A
  • Lamina (posterior – unlike thyroid)

* Arch

65
Q

describe the arytenoid cartilages

A
  • Apex
  • Base
  • Muscular process (lateral)
  • Vocal process (anterior)
66
Q

how are the thyroid and epiglottis orientated with each other?

A

cup both hands together - one horizontal one vertical

67
Q

what sits on top of the arytenoid cartilage?

A

corniculate cartilage

68
Q

where are the cuneiform cartilages?

A

in the aryepiglottic folds

69
Q

which spinal levels hyoid bone, thyroid and cryoid cartilages lie opposite?

A
  • Hyoid bone lies opposite C2
  • Thyroid cartilage lies opposite C4
  • Cricoid cartilage lies opposite C6
70
Q

what are the three membranes of the larynx?

A
  • thyrohyoid
  • cricothyroid
  • ariepiglottic
71
Q

where does the thyrohyoid membrane extend from and to? what does it form?

A

extends from the thyroid cartilage to the hyoid bone and is thickened medially and laterally to form the medial and lateral thyrohyoid ligaments respectively

72
Q

where does the cricothyroid membrane extend from and to? what does it form?

A
  • The cricothyroid (cricovocal) membrane attaches inferiorly to the upper border of the cricoid cartilage
  • Anteriorly, in the midline, it is attached to the inferior border of the thyroid cartilage (cricothyroid ligament)
  • Posteriorly, it is attached to the vocal processes of the arytenoid cartilages
  • Vocal fold formed by the free upper border of the cricothyroid membrane
73
Q

where does the aryepiglottic membrane extend from and to? what does it form?

A
  • The aryepiglottic (quadrangular/quadrate) membrane attaches posteriorly to the body and apex of the arytenoids and superiorly to the sides of the epiglottis
  • Aryepiglottic fold is formed by the free upper border of the aryepiglottic membrane
74
Q

what folds are there in the larynx? going lateral to medial

A

aryepiglottic fold, ventricular fold (false), vocal fold (true)

75
Q

what is the ventricle of the larynx?

A

the recess that extends laterally between the vestibular and vocal folds

76
Q

what is the saccule of the larynx?

A

an outpouching of the mucous membrane from the ventricle which contains many mucosal glands

77
Q

what are the muscles of the larynx?

A

extrinsic (suprahyoid and infrahyoid) and intrinsic

78
Q

what do the intrinsic muscles of the larynx do?

A

control the position and tension of the vocal and aryepiglottic folds, thereby modifying the shape of the airway

79
Q

name the intrinsic muscles of the larynx

A
  • cricothyroid
  • transverse arytenoid
  • oblique arytenoid
  • posterior cricoarytenoid
  • lateral cricoarytenoid
  • thyroarytenoid
  • aryepiglotticus
80
Q

how many muscles attach onto the arytenoid?

A

all of them apart from cricothyroid

81
Q

cricothyroid - origin, insertion and action

A
  • origin - anterolateral aspect of cricoid cartilage
  • insertion - lower border of inferior horn of thyroid cartilage
  • action - increases length & tension of vocal cords and therefore raises the pitch
82
Q

transverse arytenoid - origin, insertion and action

A
  • origin - one arytenoid
  • insertion - other arytenoid
  • action - adducts the arytenoids. so closes the rima glottidis
83
Q

oblique arytenoid - origin, insertion and action

A
  • origin - muscular process of one arytenoid
  • insertion - apex of contralateral arytenoid
  • action - adducts the arytenoids, so closes the rima glottidis
84
Q

posterior cricoarytenoid - origin, insertion and action

A
  • origin - posterior surface of cricoid lamina
  • insertion - muscular process of arytnenoid
  • action - rotates arytenoids backwards, so abducts vocal cords & opens glottis
85
Q

lateral cricoarytenoid - origin, insertion and action

A
  • origin - lateral aspect of cricoid cartilage
  • insertion - muscular process of arytenoid cartilage
  • action - adducts vocal cords
86
Q

thyroarytenoid - origin, insertion and action

A
  • origin - posterior surface of thyroid cartilage
  • insertion - vocal process and body of arytenoid
  • action - relaxes the vocal cords
87
Q

aryepiglotticus - origin, insertion and action

A
  • origin - apex of arytenoid
  • insertion - side of epiglottis
  • action - narrows laryngeal inlet
88
Q

what is the arterial supply of the larynx? which veins?

A

via laryngeal branches of the superior and inferior thyroid arteries
laryngeal veins drain into the superior and middle thyroid veins

89
Q

what innervates the larynx?

A

two important branches of the VAGUS nerve:

  • superior laryngeal nerve (internal and external branches)
  • recurrent laryngeal nerve
  • internal branch - sensory innervation to mucosa of larynx above vocal cords
  • external branch - motor innervation to cricothyroid muscle
  • recurrent laryngeal - sensory innervation to mucosa below vocal cords & motor innervation to all intrinsic muscles except cricothyroid

Medicine Sem 3 (23 decks)

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