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Phase 1 > CVR: Anatomy > Flashcards

CVR: Anatomy Flashcards

1
Q

What are the three parts of the sternum?

A

Manubrium, sternal body, xiphoid process/xiphisternum.

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2
Q

Where does the manubrium articulate with the clavicle?

A

At the sternoclavicular joint, laterally to manubrium.

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3
Q

What is another term for the sternal angle, other than the angle of Louis?

A

Manubriosternal joint.

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4
Q

What does the manubrium articulate with?

A

Clavicles, first ribs, and the sternal body.

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5
Q

Where is the suprasternal (jugular) notch?

A

Superior border of the sternum.

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6
Q

With which ribs does the body of the sternum articulate, and what are these joints called?

A

Ribs 2-7 (the “true” ribs).
Sternocostal joints.
2nd rib articulates at the manubriosternal joint (sternal angle).

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7
Q

What is the costal margin?

A

The lowest part of the ribs anteriorly.

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8
Q

What is the term for where the ribs articulate with their costal cartilage?

A

Costochondral joints.

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9
Q

How are ribs 8-10 related?

A

Their costal cartilage unite and join the 7th costal cartilage

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10
Q

Why are ribs 11 & 12 different to the other ribs?

A

They are shorter, don’t have costal cartilage and don’t articulate with the sternum, they are “floating” ribs.

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11
Q

What is the name of the joint between ribs and thoracic vertebra and how does the rib articulate with the vertebra?

A

Costovertebral joints.
Tubercle of rib articulates with transverse process, head of rib articulates with vertebral body above and below.

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12
Q

What is the costal groove and what is its function?

A

Groove in the internal aspect of rib, protects the neurovascular bundle.

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13
Q

What forms the boundary of the superior thoracic aperture?

A

Manubrium, first ribs, and first thoracic vertebra.

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14
Q

What is a dermatome?

A

An area of skin innervated by a single spinal nerve.

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15
Q

Are the dermatomes of the thoracic wall in vertical strips or horizontal strips, and which spinal nerves innervate them?

A

Horizontal strips.
T1-T12
(same as the ribs! just all the thoracic vertebra).

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16
Q

In which dermatome is the umbillicus?

A

T10

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17
Q

In which dermatome are the nipples?

A

T4

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18
Q

Where is the axillary tail and what tissue is it part of?

A

The part of the breast tissue extending towards the anterior axilla.

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19
Q

In breast tissue, what is a lobule composed, and what does it lead to?

A

Glandular or secretory tissue.
Leading to ducts which converge on the nipple.

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20
Q

Which arteries supply the breast?

A

Axillary artery, and anterior intercostal arteries, which are branches of the subclavian artery.

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21
Q

What veins return blood from the breast?

A

Axillary and internal thoracic veins.

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22
Q

What nerves supply somatic nerves and sympathetic fibres to the breast?

A

Intercostal nerves.

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23
Q

Why are the axillary lymph nodes often involved in the spread of breast cancer?

A

Because they drain most of the lymph from the breast.

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24
Q

What are the five groups of lymph nodes in the axilla?

A
  1. Central
  2. Pectoral
  3. Humeral
  4. Subscapular
  5. Apical
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25
Q

Where do the axillary lymph nodes drain lymph from (5 places)?

A
  1. Breast
  2. Upper limb
  3. Chest wall
  4. Scapular region
  5. Abdominal wall
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26
Q

What is the most superficial (lies closest to surface) of the anterior thoracic wall? What bones does this muscle attach to?

A

Pectoralis major
Attaches to:
Proximal humerus, sternum, clavicle, ribs 1-6.

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27
Q

Where is the pectoralis minor muscle and what does it attach to?

A

Deep to pectoralis major (underneath it).
Attaches to:
Scapula and ribs 3-5.

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28
Q

Which superficial muscle sweeps around the lateral aspect of the thoracic cage and attaches to the scapula and ribs 1-8?

A

The serratus anterior muscle.

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29
Q

Which upper limb muscles act as accessory muscles in respiratory distress?

A

Pectoralis major, pectoralis minor, and serratus anterior muscles.
Sternocleidomastoid (neck muscle) is also used.

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30
Q

What structures would you find in the intercostal space?

A

Intercostal muscles (3 layers; external, internal, innermost).
Neurovascular bundle (artery, vein, nerve).

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31
Q

Which artery do the posterior intercostal arteries branch from, and which vein do they drain to?

A

Descending aorta in the posterior thorax.
Azygos system of veins.

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32
Q

Which artery do the anterior intercostal arteries branch from, and which vein do they drain to?

A

Internal thoracic artery (which branches from the subclavian artery).
Internal thoracic vein.

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33
Q

Are intercostal nerves somatic or autonomic? If autonomic, are they sympathetic or parasympathetic?

A

Both, intercostal nerves are somatic (motor & sensory fibres), and they also carry sympathetic autonomic fibres.

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34
Q

Are both the parietal and visceral pleura visible to the naked eye?

A

No, only the parietal pleura (the outermost pleura) is visible to the naked eye.

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35
Q

What produces pleural fluid?

A

The pleural cells.

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36
Q

Where is the cervical pleura?

A

Covering the apex of the lung.

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37
Q

What are the two potential spaces the lungs expand into during deep inspiration?

A

Costodiaphragmatic recess and the costomediastinal recess (“gutters” where different areas of the parietal pleura meet).

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38
Q

Is the visceral pleural innervated by somatic or autonomic sensory nerves?

A

Autonomic only.

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39
Q

Is the apex of the lungs the most superior aspect or most posterior?

A

Superior aspect of the lungs is the apex.

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40
Q

What is the lingula in the lungs?

A

Anterior extension of the superior lobe in the left lung which extends over the heart.

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41
Q

How many lobes does the right lung have and how are they divided (by which fissures)?

A

Right lung has 3 lobes.
Superior and middle lobe separated by oblique fissure.
Middle and inferior lobe separated by horizontal fissure.

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42
Q

Which ribs mark the inferior border of the lungs (anteriorly, laterally, and posteriorly)? How is this different to the parietal pleura?

A

Anteriorly = 6th rib midclavicular
Laterally = 8th rib midaxillary
Posteriorly = 10th rib lateral to vertebral column.
Parietal pleura extends 2 ribs lower in each place.

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43
Q

At which ribs does the oblique fissure start and end?

A

Starts at 4th rib posteriorly.
Ends at 6th costal cartilage anteriorly.

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44
Q

Where is the horizontal fissure of the right lung?

A

Horizontal fissure starts at 4th costal cartilage anteriorly, ends where it intersects the oblique fissure.

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45
Q

What is the hilum of the lung?

A

Region on mediastinal surface where pulmonary artery, veins, and main bronchus enter and exit the lung.

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46
Q

In the hilum of which lung is the pulmonary artery superior to the main bronchus? Where is it positioned in the other lung?

A

Left lung.
In the hilum of the right lung, the pulmonary artery is anterior to the main bronchus.

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47
Q

Which are the most anterior and inferior structures in the hilum of the lung?

A

The pulmonary veins.

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48
Q

A foreign body entering the trachea is more likely to end up in the right or left main bronchus and why?

A

Right main bronchus.
Because the right main bronchus is shorter, wider, descends more vertically than left main bronchus.

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49
Q

Describe the bronchial tree.

A

Branching system of tubes.

Each main bronchus divides into lobar (secondary) bronchi, supply each lobe.

Lobar bronchi further divide into segmental bronchi, supply each bronchopulmonary segment.

Segmental bronchi then divide further into bronchioles which keep dividing until the very smallest which conduct air to/from the alveoli.

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50
Q

How many bronchopulmonary segments are there in each lung?

A

Right lung = 10
Left lung = 8-9

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51
Q

What is the difference between the structure of the bronchioles versus the trachea & bronchi?

A

Trachae & bronchi contain smooth muscle and cartilage.
Bronchioles only contain smooth muscle.

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52
Q

What arteries supply lung tissue and what main artery do they originate from?

A

Bronchial arteries originating from the descending aorta.

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53
Q

Parasympathetic or sympathetic fibres stimulate relaxation of bronchial smooth muscle (bronchodilation)?

A

Sympathetic.

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54
Q

What bones/cartilage does the diaphragm attach to?

A

Xiphoid process, costal margin, and lumbar vertebra.

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55
Q

Is the diaphragm made of smooth or skeletal muscle?

A

Skeletal.

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56
Q

Does the diaphragm contract and flatten during inspiration or expiration, and why?

A

Inspiration.
Increases intrathoracic volume, decreases pressure, air rushes in, lungs expand.

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57
Q

Does expiration always involve contraction of internal intercostal muscles?

A

No, at rest/normal quiet breathing, expiration is passive. Relaxation of diaphragm and recoil of lung tissue is enough.
In vigorous breathing, active expiration uses internal intercostal muscles.

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58
Q

Is a spontaneous pneumothorax due a tear in the visceral or parietal pleura?

A

Visceral - next to lung.

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59
Q

What is mesothelioma?

A

Malignancy of the pleura.

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60
Q

What 6 structures are in the posterior mediastinum?

A

Descending (thoracic) aorta.
Azygos veins
Oesophagus
Thoracic duct
Sympathetic trunk & splanchnic nerves
Posterior intercostal vessels & nerves

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61
Q

What do the following arterial vessels have in common?Posterior intercostal arteries, bronchial arteries, oesophageal, pericardial, and phrenic branches.

A

They all originate from the descending thoracic aorta.

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62
Q

At what vertebral level does the thoracic aorta pass through the diaphragm, and what is it called below this level?

A

T12 vertebrae
Below T12 it is called the abdominal aorta.

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63
Q

Where do the azygos veins drain from, and what vessel do they drain into?

A

The azygos veins drains blood from the posterior thoracic wall (posterior intercostal veins, oesophageal, and bronchial veins) and returns the blood into the superior vena cava.

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64
Q

Where is the azygos vein?

A

In the posterior mediastinum, on the right side of the vertebral column.

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65
Q

Where is the oesophagus?

A

In the posterior mediastinum, slightly to the right of, and posterior to, the aorta.

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66
Q

At what vertebral level does the oesophagus pass through the diaphragm and what is this called?

A

T10.
Called the oesophageal hiatus.

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67
Q

Where is the thoracic duct?

A

In the posterior mediastinum, between the oesophagus and the aorta.

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68
Q

What does lymph from the lower limbs, pelvis, and abdomen flow into before entering the thoracic duct, and where is this structure?

A

Cisterna chyli in the abdomen.

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69
Q

What structure in the lymph system returns most of the body’s lymph to the venous system?

A

The thoracic duct.

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70
Q

Where does the thoracic duct terminate and return lymph to the venous system?

A

At the junction between the left internal jugular vein and the left subclavian vein.

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71
Q

How does lymph drain from the right side of the head and neck, and the right upper limb into the venous system?

A

Lymph drains into lymphatic ducts which enter the venous system at the junction of the right internal jugular and right subclavian veins.

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72
Q

Where are the sympathetic trunks?

A

Posterior mediastinum on the posterior thoracic wall, either side of the vertebral columns and posterior to the parietal pleura. Running from the skull base to the coccyx.

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73
Q

Where do sympathetic fibres leave the spinal cord to join the sympathetic trunks?

A

T1-L3 vertebral segments.

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74
Q

What are splanchnic nerves?

A

Sympathetic fibres exit at several different vertebral levels, enter sympathetic trunk, they then combine and travel together to ganglia closer to their target effector.

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75
Q

What are the three abdominopelvic splanchnic nerves and what vertebra do they originate from?

A

Greater splanchnic nerve, T5-T9
Lesser splanchnic nerve, T10-T11
Least splanchnic nerve, T12

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76
Q

What conveys sympathetic fibres to the thoracic viscera and other organs of the thorax?

A

The cardiopulmonary splanchnic nerves.

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77
Q

What conveys parasympathetic fibres to the thoracic viscera?

A

The vagus nerves.

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78
Q

What happens at autonomic plexuses?

A

The sympathetic and parasympathetic fibres merge.

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79
Q

What does the cardiac plexus innervate?

A

The sinoatrial node to increase (sympathetic) or decrease (parasympathetic) HR and contractility.

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80
Q

What innervates the bronchi?

A

The pulmonary plexus.

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81
Q

What does the oesophageal plexus do?

A

Innervate the oesophagus to inhibit (sympathetic) or stimulate (parasympathetic) peristalsis.

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82
Q

What is the function of visceral afferent fibres in the splanchnic nerves?

A

Carry impulses back to the spinal cord and brain, for example, pain due to ischaemia in the heart.

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83
Q

What is the difference in perception of pain from visceral afferents as opposed to somatic afferents?

A

Visceral afferent fibres convey less detailed information about the pain, so pain might feel dull/aching/burning/tightness, hard to describe.

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84
Q

Why does a painful stimulus affecting the diaphragm cause perception of pain in the neck/shoulder?

A

The phrenic nerve is formed of fibres from C3-C5, so painful stimulus from the phrenic nerve enters the spinal cord at C3-C5 and the brain interprets this as pain coming from the C3-C5 dermatomes; the side of the neck and shoulder.

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85
Q

Why do people suffering an MI often have pain in their left arm?

A

The cardiopulmonary splanchnic nerves come from T1-T5, so the brain interprets this as pain coming from the T1-T5 dermatomes; the thorax and the medial upper limb.

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86
Q

What is the platysma?

A

A very thin subcutaneous and superficial muscle just under the skin in the neck.

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87
Q

What bone helps keep the pharynx open and provides an attachment point for several muscles including the tongue? Where is this bone situated?

A

Hyoid bone.
Anterior in the upper neck, inferior to the mandible.

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88
Q

Describe the basic structure of the layrnx.
What is its function?

A

A ‘skeleton’ of small cartilages connected by membranes and small joints.
Protects the airway, and can be moved by muscles to move the vocal cords.

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89
Q

What separates the anterior and posterior triangles of the neck?

A

The sternocleidomastoid muscle (SCM).

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90
Q

What movements are controlled by the sternocleidomastoid muscle?

A

Unilateral (using just the left or right SCM); turning the head.
Bilateral (using both left and right SCM together); nodding the head.

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91
Q

What nerve innervates the sternocleidomastoid and trapezium muscles?

A

Cranial nerve XI; the accessory nerve.

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92
Q

What are the anterior, posterior, and superior borders of the anterior triangle?

A

Anteriorly; midline of the neck
Posteriorly; the anterior border of sternocleidomastoid muscle
Superiorly; the lower border of the mandible

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93
Q

Which triangle of the neck (anterior or posterior) contains the thyroid, parathyroid, and submandibular salivary glands?

A

The anterior triangle.

94
Q

Name two groups of four paired muscles in the anterior triangle of the neck. How do they move the hyoid and larynx for speech and swallowing?

A

Suprahyoid muscles; raise hyoid bone and larynx during speech and swallowing.
Infrahyoid muscles; pull the hyoid and larynx down during speech and swallowing.

95
Q

What muscle group forms the floor of the mouth and connects the hyoid to the skull?

A

The suprahyoid muscles.

96
Q

The infrahyoid muscles connect the hyoid to what two other bones?

A

The sternum and the scapula.

97
Q

What’s another name for the infrahyoid muscles?

A

The infrahyoid muscles are also known as the strap muscles.

98
Q

Branches of which nerves would you find in the anterior triangle of the neck?

A

Branches of the facial nerve (CN VII), the glossopharyngeal nerve (CN IX), the vagus nerve (CN X), the accessory nerve (CN XI), and the hypoglossal nerve (CN XII).

99
Q

The common carotid artery, branches of the external carotid artery, and the internal jugular vein, are all vessels in the anterior or posterior triangle of the neck?

A

Anterior triangle.

100
Q

What are the anterior, posterior, inferior, and apex borders of the posterior triangle of the neck?

A

Anteriorly; the posterior border of the sternocleidomastoid
Posteriorly; the anterior border of trapezius
Inferiorly; the clavicle
Apex; formed by sternocleidomastoid and trapezius

101
Q

What is the function of muscles in the posterior triangle of the neck?

A

To move the head.

102
Q

In which triangle of the neck would you find the external jugular vein?

A

The posterior triangle.

103
Q

Which nerves would you find in the posterior triangle of the neck?

A

The accessory nerve (CN XI)
The roots of the brachial plexus.
The phrenic nerve.

104
Q

Where is the thyroid gland situated?

A

Each lobe is just lateral to the lower larynx and upper trachea, and is deep to the infrahyoid muscles.

105
Q

What joins the two lobes of the thyroid together?

A

The isthmus.

106
Q

What arteries supply the thyroid gland?

A

Superior thyroid arteries (branches of external carotid)
Inferior thyroid arteries (branches of thyrocervical trunks - which are branches of subclavian)

107
Q

What veins drain the thyroid?

A

Superior, middle, and inferior thyroid veins.

108
Q

What are the four parathyroid glands and where are they situated?

A

Right and left superior and inferior parathyroid glands.
Posterior to the thyroid.

109
Q

What additional artery supplies the thyroid gland in <5-10% of the population?

A

Thyroid ima artery.

110
Q

Does the internal or external carotid artery supply the brain? Does this artery supply anything else?

A

The internal carotid artery supplies the brain only.

111
Q

The common carotid arteries bifurcate into…

A

Left and right internal and external carotid arteries.

112
Q

What the name for the small swelling at the bifurcation of the common carotid artery?

A

The carotid sinus.

113
Q

Why is the carotid sinus important for regulating blood pressure?

A

The carotid sinus contains baroreceptors, relaying visceral sensory information about blood pressure to the brainstem via the glossopharyngeal nerve.

114
Q

Where is the internal carotid artery palpable?

A

Immediately lateral to the larynx.

115
Q

Which jugular vein drains blood from the brain and part of the face? Where does the other jugular vein drain blood from?

A

The internal jugular vein.
The external jugular vein drains blood from the scalp and face.

116
Q

What nerve is sandwiched between the common carotid and the internal jugular vein?

A

The vagus nerve (CN X).

117
Q

Does the vagus nerve of the phrenic nerve pass anteriorly to the hila of the lungs?

A

The phrenic nerve.
The vagus nerve (CN X) passes behind the hila.

118
Q

Which nerve descends the neck immediately posterior to the sternocleidomastoid?

A

The accessory nerve (CN XI).

119
Q

Which nerve provides motor innervation to the tongue?

A

The hypoglossal nerve.

120
Q

Explain the difference between how the right and left posterior intercostal veins drain into the azygos vein.

A

The right posterior intercostal veins drain directly into the azygos vein.
The left posterior intercostal veins first drain into the accessory hemiazygos and the hemiazygos veins on the left side of the vertebral column, which then empty into the azygos.

121
Q

Between which two layers of tissue is the intercostal neurovascular bundle located?

A

Internal intercostal and innermost intercostal muscle

122
Q

The internal thoracic artery branches from which larger artery?

A

The internal thoracic artery branches from the subclavian artery.

123
Q

The inferior border of the lung is located at the level of which rib posteriorly?

A

10th rib

124
Q

The inferior border of the lung is located at the level of which rib anteriorly?

A

6th rib

125
Q

In foetal life, which structure shunts blood from the aorta to the pulmonary trunk?

A

The ductus arteriosus shunts blood from the aorta to the pulmonary trunk.

126
Q

The right recurrent laryngeal nerve loops under which structure, before ascending back into the neck?

A

The right RLN loops under the right subclavian artery.

127
Q

The left recurrent laryngeal nerve loops under which structure, before ascending back into the neck?

A

The left RLN descends into the thorax and loops under the arch of the aorta before ascending back up to the larynx.

128
Q

The diagonal artery (or arteries) typically arise from which larger coronary artery?

A

Left anterior descending

129
Q

Where is the crista terminalis located and what is it?

A

The crista terminalis is located in the right atrium. It is a raised ridge that separates the smooth-walled part of the right atrium from the rough-walled part.

130
Q

Over which region of the chest wall would you place a stethoscope to best hear the tricuspid valve?

A

5th intercostal space, left sternal margin

131
Q

In more than 50% of individuals, the sinoatrial node (SAN) is supplied by which blood vessel?

A

Right coronary artery

132
Q

Over which region of the chest wall would you place a stethoscope to best hear the mitral valve?

A

5th intercostal space, left midclavicular line.

133
Q

Over which region of the chest wall would you place a stethoscope to best hear the pulmonary valve?

A

2nd intercostal space at the left sternal margin.

134
Q

Over which region of the chest wall would you place a stethoscope to best hear the aortic valve?

A

2nd intercostal space at the right sternal margin.

135
Q

What would you find inside the carotid sheath?

A

Common and internal carotid arteries, the internal jugular vein, the vagus nerve, sympathetic plexus.

136
Q

What 4 structures make up the laryngeal “skeleton”?

A

Hyoid bone
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilages x2

137
Q

What sensory and motor functions does the superior laryngeal nerve have?

A

Sensory: internal larynx above the cords
Motor: cricothyroid muscle only

138
Q

What sensory and motor functions does the recurrent laryngeal nerve have?

A

Sensory: internal larynx below the cords
Motor: intrinsic muscles other than cricothyroid (which is innervated by the superior laryngeal nerve)

139
Q

Is the thyroid gland anterior or posterior to the thyroid cartilage?

A

Anterior

140
Q

What nerve mediates the gag reflex?

A

Glossopharyngeal nerve (CN IX)

141
Q

Do the internal and external jugular veins merge together?

A

No. There is no common jugular vein.
Internal drains into brachiocephalic.
External drains into subclavian.

142
Q

How many cervical vertebrae are there?

A

7

143
Q

What is the function of the sternocleidomastoid?

A

Nodding and shaking the head

144
Q

Which triangle of the neck is the brachial plexus located in?

A

Posterior triangle of the neck.

145
Q

What is the name of the muscles that form the walls of the pharynx?

A

Constrictors

146
Q

Which nerve supplies the cricothyroid muscle?

A

External branch of superior laryngeal nerve

147
Q

Which nerve carries visceral sensory information from the carotid sinus and body?

A

Glossopharyngeal (CN IX)

148
Q

Which vein is formed by the Internal Jugular Vein and Subclavian Vein combining?

A

Brachiocephalic vein.

149
Q

What are the two inner and outer layers of muscle in the walls of the pharynx?

A

Outer/external circular muscles.
Inner longitudinal muscles.

150
Q

What are the three constrictor muscles of the pharynx?

A

Superior, middle, and inferior constrictors.

151
Q

During swallowing, what pushes food from the oral cavity into the oropharynx?

A

The tongue

152
Q

What stops food entering the nasopharynx during swallowing?

A

The soft palate.

153
Q

What is the epiglottis and what is its key role?

A

One of the cartilages of the larynx. During swallowing, the epiglottis closes off the laryngeal inlet and prevents food/liquid entering the larynx.

154
Q

Sensory and motor fibres from which nerves innervate the pharynx?

A

Sensory = glossopharyngeal nerve
Motor = vagus nerve

155
Q

What tissue forms the tonsils?

A

Lymphoid tissue.

156
Q

What are the four different tonsils?

A

Pharyngeal
Tubal
Palatine
Lingual

157
Q

Which are visible in the oropharynx and are the structures laypeople refer to as “the tonsils”?

A

Palatine; these are the tonsils next to the pharyngeal wall in the oropharynx that laypeople call “the tonsils”.

158
Q

Which tonsils are found on the posterior aspect of the tongue?

A

Lingual tonsils.

159
Q

What lymphoid tissue surrounds the Eustachian tube?

A

The tubal tonsils.

160
Q

Where are the pharyngeal tonsils (commonly called the adenoids)?

A

The roof of the nasopharynx.

161
Q

How many cartilages compose the larynx and what connects them together?

A

9; three unpaired, three paired.
Very small joints and membranes connect them together.

162
Q

What are the three unpaired cartilages of the larynx?

A

Epiglottis, thyroid, cricoid.

163
Q

What are the three paired cartilages of the larynx?

A

Arytenoids, cuneiforms, corniculate.

164
Q

Which are smaller, the paired cartilages or the unpaired cartilages of the larynx?

A

The paired cartilages are smaller.

165
Q

What is the Adam’s apple?

A

The laryngeal prominence on the thyroid cartilage of the larynx.

166
Q

What do the superior horns of the thyroid cartilage attach to?

A

The hyoid bone.

167
Q

What part of the thyroid cartilage articulates with the cricoid cartilage?

A

The inferior horns.

168
Q

Which part of the cricoid cartilage is thicker, the anterior or posterior?

A

Posterior is thicker.

169
Q

Is the cricoid cartilage a complete ring?

A

Yes.

170
Q

What membrane connects the inferior border of the thyroid cartilage to the superior border of the cricoid cartilage?

A

the cricothyroid membrane.

171
Q

What cartilage of the larynx is vital for phonation and where are they?

A

The arytenoids.
Superior surface of cricoid cartilage posteriorly, attach to the vocal cords.

172
Q

What are names of the two pairs of folds that project into the cavity of the larynx? What are they composed of?

A

Vestibular folds (false vocal cords).
Vocal folds (part of the true vocal cords).
Both are folds of mucous membrane.

173
Q

Which are more superior, the vestibular folds or the vocal folds?

A

The vestibular folds.

174
Q

How are the vocal ligaments protected?

A

By the vocal folds.

175
Q

What do the vocal ligaments and the vocal folds form?

A

The true vocal cords.

176
Q

What are the vocal ligaments attached to anteriorly and posteriorly?

A

Anteriorly; internal aspect of the laryngeal prominence of the thyroid cartilage.
Posteriorly; the arytenoid cartilages.

177
Q

What is the space between the true vocal cords and why is adduction/abduction of this space important for speech?

A

The rima glottidis.
Adduction of the true vocal cords closes the rima glottidis, creating phonation.
Abduction of the true vocal cords opens the rima glottidis slightly for whispering.

178
Q

What are the two groups of muscles that act on the larynx and how do their actions differ?

A

Extrinsic muscles; suprahyoid and infrahyoid move the larynx as one for speech/swallowing.
Intrinsic muscles; move laryngeal cartilages to move the vocal cords for speech.

179
Q

What two branches of the vagus nerves innervate the intrinsic muscles of the larynx?
What specific muscles do they innervate?

A

The superior laryngeal nerve; innervates the cricothyroid.
Recurrent laryngeal nerve; innervates all the other intrinsic muscles.

180
Q

Which muscles abduct the true vocal cords to open the rima glottidis?

A

The posterior cricoarytenoid muscles.

181
Q

Where are the cricothyroid muscles and what function do they perform?

A

Anterior between the thyroid and cricoid cartilages. Contraction places tension on the vocal cords.

182
Q

Which muscles adduct the vocal folds to close the rima glottidis? What cartilage do they connect?

A

The inter-arytenoid muscles. Connect the two arytenoid cartilages.

183
Q

The descending (thoracic) aorta passes through the diaphragm at which vertebral level?

A

The aorta passes through the diaphragm at the level of T12.

184
Q

The inferior vena cava passes through the diaphragm at which vertebral level?

A

The inferior vena cava passes through the diaphragm at the level of T8.

185
Q

The oesophagus passes through the diaphragm at which vertebral level?

A

The oesophagus passes through at the level of T10.

186
Q

Which arteries branch directly from the descending (thoracic) aorta?

A

Posterior intercostal arteries

187
Q

The anterior intercostal arteries branch from which arteries to supply the anterior thoracic wall?

A

The internal thoracic arteries.

188
Q

The internal thoracic arteries branch from which arteries to supply the anterior part of the thoracic wall?

A

The subclavian arteries.

189
Q

The thyrocervical trunks branch from which arteries to supply parts of the neck including the thyroid gland?

A

The subclavian arteries.

190
Q

Sympathetic fibres that travel to the cardiac plexus originate from which segments of the spinal cord?

A

Sympathetic fibres that innervate the heart originate from T1 - T5.

191
Q

What is the vallecula?

A

The vallecula is the space between the posterior surface of the tongue and the anterior surface of the epiglottis.

192
Q

What separates the right and left nasal cavities?

A

A thin midline septum formed of cartilage anteriorly and two thin plates of bone posteriorly.

193
Q

What separates the nasal cavity from the brain and oral cavity?

A

Brain: bone in the roof of nasal cavity.
Oral cavity: the hard palate bones in the floor of the nasal cavity.

194
Q

What bones form the posterior nasal septum?

A

Perpendicular plate of the ethmoid bone superiorly, the vomer bone inferiorly.

195
Q

What is another word for turbinates?

A

Conchae (Latin for ‘shell’).

196
Q

What bone separates the nasal cavity from the brain?

A

The cribriform plate; a delicate section of bone perforated with tiny holes.

197
Q

Why is the cribriform plate perforated?

A

The olfactory nerve axons travel through the perforations to the brain.

198
Q

Why is the anterior nasal septum often a site of bleeding?

A

It is supplied by an anastomotic network of arteries to warm air in the nasal cavity.

199
Q

What provides sensory innervation of the nose?

A

Branches of the trigeminal nerve (CN V)

200
Q

What is the hard palate composed of?

A

Parts of the maxillary and palatine bones.

201
Q

What does the tongue push up against during the first phase of swallowing?

A

The hard palate.

202
Q

What is the uvula attached to?

A

Posterior border of the soft palate.

203
Q

What is the soft palate composed of and why is this important during swallowing?

A

Several muscles which contract and elevate the soft palate during swallowing to close off the nasal cavity to food/fluid.

204
Q

What innervates the muscles of the soft palate?

A

The vagus nerve.

205
Q

What are the sinuses named after?

A

The bones inside which they are located e.g. frontal sinuses are inside the frontal bone.

206
Q

Where is the buccinator muscle?

A

In the cheeks.

207
Q

What forms the floor of the oral cavity?

A

Soft tissues and muscles.

208
Q

How many teeth do adults have? Break this down into number of incisors, canines, premolars, and molars.

A

32
Incisors = 4
Canines = 2
Premolars = 4
Molars = 6

209
Q

How many different types of teeth do adults have and what are they?

A

4 types; incisors, canines, premolars, molars.

210
Q

Describe the structure of a tooth from outer to inner.

A

Enamel. Dentin. Pulp; containing vessels and nerves which exit via the root canal.

211
Q

What is found on the superior surface of the tongue, some of which detect taste?

A

Papillae.

212
Q

What provides motor innervation for the muscles of the tongue?

A

Hypoglossal nerve (CN XII)

213
Q

What forms the tongue?

A

Intrinsic and extrinsic muscles.

214
Q

Where are the intrinsic muscles of the tongue and what do they do?

A

Located entirely inside the tongue and change the shape of the tongue.

215
Q

Where are the extrinsic muscles of the tongue and what do they do?

A

Attached to the tongue but originate from outside it (attach to the mandible and hyoid bone). They move the tongue.

216
Q

How many nerves provide sensory innervation for the tongue? What are they?

A

Three cranial nerves.
Facial nerve (CN VII), Trigeminal nerve (CN V), Glossopharyngeal nerve (CN IX).

217
Q

What innervation does the trigeminal nerve (CN V) supply for the tongue and in what area?

A

General sensation (touch, pain, temperature). Anterior two thirds of the tongue.

218
Q

What innervation does the facial nerve (CN VII) supply for the tongue and in what area?

A

Taste. Anterior two thirds of the tongue.

219
Q

What innervation does the glossopharyngeal nerve (CN IX) supply for the tongue and in what area?

A

Taste and general sensation in the posterior third of the tongue.

220
Q

What arteries supply the oral cavity and what larger artery do they branch from?

A

Lingual, maxillary, and facial arteries. Branches of the external carotid artery.

221
Q

What innervates the muscles of the soft palate?

A

The vagus nerve.

222
Q

How many pairs of salivary glands are there and what are they?

A

Three. Parotid, submandibular, and sublingual salivary glands.

223
Q

What and where are the largest salivary glands?

A

Parotid glands. Posterior part of the mandible.

224
Q

Is glandular secretion stimulated by sympathetic or parasympathetic fibres?

A

Parasympathetic.

225
Q

Where is the parotid duct and what does it do?

A

Empties saliva from the parotid glands, opens adjacent to the upper (maxillary) second molar tooth.

226
Q

What innervates the parotid gland to secrete saliva?

A

Parasympathetic fibres of the glossopharyngeal nerve (CN IX).

227
Q

How is the facial nerve associated with the parotid glands?

A

The facial nerve exits the skull, enters the deep surface of the parotid gland and divides into five branches, which emerge to innervate the muscles of facial expression. It does NOT innervate the parotid gland.

228
Q

Where are the submandibular glands and where do they secrete saliva?

A

Inferior to the body of the mandible.
Secrete saliva from the submandibular ducts, which opens into the floor of the mouth, under the tongue, either side of the lingual frenulum.

229
Q

What is the lingual frenulum?

A

The string-like structure that tethers the tongue to the floor of the mouth.

230
Q

Secretion of saliva from the submandibular and sublingual glands is stimulated by parasympathetic fibres of the which nerve?

A

The facial nerve (CN VII).

231
Q

Where are the sublingual glands and how do they secrete saliva?

A

Floor of the mouth. Open via several small ducts into the floor of the mouth.

232
Q

In which glands does mumps cause inflammation and swelling?

A

Parotid.

Phase 1 (16 decks)

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