CST Test Part 4

Question 1

Which nerves and other structures pass through the Superior Orbital Fissure

Answer 1

Ophthalmic Vein - venous drainage from orbit to cavernous sinus
Cn III - Oculomotor nerve,
Cn IV - Trochlear nerve,
Cn V - Trigeminal nerve (ophthalmic division)
Cn VI – Abducent

Question 2

Where does the Facial nerve CR VII, exit from the cranium

Answer 2

Styloid mastoid foramen

Question 3

Describe, left side bending pattern of the maxillae with a diagram

Answer 3

Left side is more superior to the right.
Upper Teeth would be asymmetry, nostrils and orbit + eyeball on left side would all be superior to the right. Face would look lopsided and asymmetry

Question 4

How does the Optic nerve relate anatomically to the pituitary gland, why might this be significant

Answer 4

The optic nerve travels posteriorly through the optic canal to the optic chiasma.
The optic chiasma is located anteriorly to the sella turcica in the sphenoid body which houses the pituitary gland.
A pituitary tumour affecting medial fibres within the chiasma can lead to tunnel vision.
Optic nerve compression caused by restrictions in sella turcica.

Question 5

Describe the origin, pathway, and function of Cr XI, the accessory (Spinal Accessory) nerve

Answer 5

Cn XI - accessory nerve - arises outside the cranium at C1-C4 thru dura
Travels up thru foramen magnum
To Jugular foramen to briefly bind with the cranium division
Passes down to target trapezium and sterno-cleido mastoid muscles of neck and shoulder.

Question 6

Which nerve pathways regulate: A) Pupil constriction :

Answer 6

Parasympathetic branch of Oculomotor CN III.
Emerging from the mid-brain,
Passes through the ciliary ganglion along the optic tract with Cr IV, VI and CRV ophthalmic branch,
Through the superior orbital fissure to the ciliary muscle, muscle that contracts the pupil.

Question 7

Which nerve pathways regulate:

B) Pupil dilation

Answer 7

CN III
Sympathetic nerve fibres that emerge in the Superior Cervical Ganglia T1/T2,
Passes through the carotid plexus on the carotid artery of the muscle of the pupil

Question 8

Describe the pathway of the mandibular branch of the Trigeminal Nerve Cr V from its root to its final destination

Answer 8

Trigeminal nerve V3
Motor division - Pons> underside of trigeminal ganglion > foramen ovale > mental foramen to target muscles of mastication
Sensory division - Pons > trigeminal ganglion > foramen ovale anterior > mental foramen to sensations of teeth, jaw and lower face
Meningeal branch passes back up through foramen spinosum to meninges.

Question 9

What are the symptoms of Bells’s Palsy? And which cranial nerve is affected

Answer 9

Eye dropping on one side, dribbling, extra saliva, loss of control of one side of the face.
Cn VII - facial nerve muscles and glands of face

Question 10

Describe the motion of the following bones during the flexion phase:
A) The maxillae

Answer 10

Front portion of maxillae rises superiorly coming up to meet the frontal bone, while at same time, spread laterally at posterior part of inter-maxillary suture (back teeth move apart)

Question 11

Describe the motion of the following bones during the flexion phase:
B) The Zygoma

Answer 11

Externally rotate with temporals and arching down and out (with frontal).

Question 12

What are the symptoms of Meniere’s’ disease and which Cn is affected?

Answer 12

Cn VIII - vestibulo-cochlear nerve and CN VII - Facial nerve (motor division) that control the muscle to the stapes.
Symptom - motion sickness, vertigo, loss of hearing

Question 13

With which bones does the Vomer articulates

Answer 13

2 Palantine
Ethmoid
Sphenoid
Maxillae

Question 14

Describe the CS motion of the Orbit during flexion phase

Answer 14

Orbit flattens on vertical plane and gets larger on horizontal plane as they get squeezed between Frontal and Maxillae.

Question 15

List 2 cranial contacts and one facial contact which might be specifically relevant to assisting drainage of the middle ear and treatment of ear infections. Explain why

Answer 15

2 cranial holds - Ear hold/ Mastoid tip/ temporal hold
1 facial - TMJ/ palatine hold
They release tension around the exit of the eustachian tube to allow for more drainage. The ear hold allows for a tentorium release.
All holds engage and allow closer contact to - Cr VIII vestibular-cochlear nerve and internal auditory foramen eustachian tube, nasal muscosa glands and lacrimal glands for enabling better drainage of middle ear and release of any blockages.

Question 16

How would you treat a patient with sinusitis

Answer 16

Release the emotional centres
Release the cranial base (occiput etc) to allow the jugular vein to have space to drain.
Encourage drainage through the venous sinuses. Release the falxes & membranous system.
Target eustachian tube, venous and air sinuses, (frontal, ethmoid, maxillary, sphenoid sinuses) through face holds
Cn VII - Facial nerve for mucus secretions and lacrimal glands.
Whole CS integration.

Question 17

How might a trauma to the face affect the rest of the system?

Answer 17

Any trauma to the face (ie car accident, birth trauma, dentist etc ) which causes restriction and compression to the bone, fissure and foramen in the cranium and pinching to associated nerves may result in physo emotional holding in the fascia (as tissue tension/memory) and viscera.
Trauma to temporal, mastoid process or occiput may affect jugular foramen that is housed between these bones. Affecting nerves Cn IX glossopharyngeal nerve, X vagus , XI accessory.

Question 18

What reasons might draw you to treat the face

Answer 18

Birth trauma
Recent dentistry work 
Sinus infections
Meniere's disease, 
Torticollis, 
Face is asymmetry, 
Tension at TMJ, 
Grinding teeth

Question 19

What aspect of a person do you associate with the Ethmoid?

Answer 19

Enlightenment, 3rd eye - spiritual aspect, foresight, vision

Question 20

What are the names of the palatine sutures

Answer 20

TIM,
Transverse palatine suture
Intermaxillary suture
Median palatine suture

Question 21

What do vertebral arteries do?

Answer 21

Both vertebral arteries supply major arterial blood to brain along with two carotid arteries

Question 22

What structure would you associate with the Foramen Lacerum?

Answer 22

Carotid Artery

Question 23

What is the Eustachian tube

Answer 23

Tube between the middle ear to nasopharynx

Question 24

Why is the Occiput prone to distortion at birth

Answer 24

In 4 separate portions - surrounding the Foramen Magnum so severe birth trauma or head injuries before can affect how the bones fuse and impinge on the spinal cord and medulla.

Question 25

What nerve passes through the stylo-mastoid foramen?

Answer 25

Motor branch of Facial nerve Cr VII