CVR: Anatomy of the Head and Neck Flashcards
(145 cards)
1
Q
What is the platysma?
A
A very thin subcutaneous and superficial muscle just under the skin in the neck.
2
Q
What bone helps keep the pharynx open and provides an attachment point for several muscles including the tongue?
A
Hyoid bone.
3
Q
Describe the basic structure of the layrnx.
A
A ‘skeleton’ of small cartilages connected by membranes and small joints.
4
Q
What separates the anterior and posterior triangles of the neck?
A
The sternocleidomastoid muscle (SCM).
5
Q
What two movements of the head 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.
6
Q
What nerve innervates the sternocleidomastoid and trapezium muscles?
A
Cranial nerve XI; the accessory nerve.
7
Q
How do the paired suprahyoid muscles in the anterior triangle of the neck move the hyoid and larynx for speech and swallowing?
A
Raise hyoid bone and larynx during speech and swallowing.
8
Q
How do the paired infrahyoid muscles in the anterior triangle of the neck move the hyoid and larynx for speech and swallowing?
A
Pull the hyoid and larynx down during speech and swallowing.
9
Q
What muscle group forms the floor of the mouth and connects the hyoid to the skull?
A
The suprahyoid muscles.
10
Q
The infrahyoid (strap) muscles connect the hyoid to what two other bones?
A
The sternum and the scapula.
11
Q
Branches of which nerves would you find in the anterior triangle of the neck?
A
Facial (VII), glossopharyngeal (IX), vagus (X), accessory (XI), and hypoglossal (XII).
(7, 9-12)
12
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.
13
Q
What forms the posterior border of the posterior triangle of the neck?
A
The anterior border of trapezius
14
Q
In which triangle of the neck would you find the external jugular vein?
A
The posterior triangle.
15
Q
Which nerves would you find in the posterior triangle of the neck?
A
“BAP”
roots of the Brachial plexus.
Accessory nerve (CN XI)
Phrenic nerve.
16
Q
What muscles is the thyroid gland deep to?
A
Infrahyoid muscles.
17
Q
What joins the two lobes of the thyroid together?
A
The isthmus.
18
Q
What two 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)
19
Q
What three veins drain the thyroid?
A
Superior, middle, and inferior thyroid veins.
20
Q
How many parathyroid glands are there?
A
Four (superior and inferior, bilaterally)
21
Q
What additional artery supplies the thyroid gland in <5-10% of the population?
A
Thyroid ima artery.
22
Q
What does the internal carotid artery supply?
A
The brain
23
Q
What does the common carotid artery bifurcates into?
A
Internal and external carotid arteries.
24
Q
What is the name for the small swelling at the bifurcation of the common carotid artery?
A
The carotid sinus.
25
The carotid sinus detects changes in blood pressure and relays this information to the brainstem via the glossopharyngeal nerve.
What does the carotid sinus contain that senses this information?
Baroreceptors.
26
Which jugular vein drains blood from the brain and part of the face?
The internal jugular vein.
27
Which jugular vein drains blood from the scalp and face?
The external jugular vein.
28
What nerve is sandwiched between the common carotid and the internal jugular vein?
The vagus nerve (CN X).
29
Which nerve descends the neck immediately posterior to the sternocleidomastoid?
The accessory nerve (CN XI).
30
Which nerve provides motor innervation to the tongue?
The hypoglossal nerve (CN XII).
31
What would you find inside the carotid sheath?
the Carotid Sheath Is a Joke
Common and internal carotid arteries, the internal jugular vein, the vagus nerve, sympathetic plexus.
32
What 4 structures make up the laryngeal "skeleton"?
Hyoid bone
Thyroid cartilage
Cricoid cartilage
Arytenoid cartilages x2
33
What sensory and motor functions does the superior laryngeal nerve have?
Sensory: internal larynx above the cords
Motor: cricothyroid muscle only
34
What sensory and motor functions does the recurrent laryngeal nerve have?
Sensory: internal larynx below the cords
Motor: intrinsic muscles other than cricothyroid (which is innervated by the superior laryngeal nerve)
35
Is the thyroid gland anterior or posterior to the thyroid cartilage?
Anterior
36
What nerve mediates the gag reflex?
Glossopharyngeal nerve (CN IX)
37
Do the internal and external jugular veins merge together?
No. There is no common jugular vein.
Internal drains into brachiocephalic.
External drains into subclavian.
38
How many cervical vertebrae are there?
7
39
What is the function of the sternocleidomastoid?
Nodding and shaking the head
40
Which triangle of the neck is the brachial plexus located in?
Posterior triangle of the neck.
41
What is the name of the muscles that form the walls of the pharynx?
Constrictors
42
Which nerve supplies the cricothyroid muscle?
External branch of superior laryngeal nerve
43
Which nerve carries visceral sensory information from the carotid sinus and body?
Glossopharyngeal (CN IX)
44
Which vein is formed by the Internal Jugular Vein and Subclavian Vein combining?
Brachiocephalic vein.
45
What are the two inner and outer layers of muscle in the walls of the pharynx?
Outer/external circular muscles.
Inner longitudinal muscles.
46
What are the three constrictor muscles of the pharynx?
Superior, middle, and inferior constrictors.
47
During swallowing, what pushes food from the oral cavity into the oropharynx?
The tongue
48
What stops food entering the nasopharynx during swallowing?
The soft palate.
49
What is the epiglottis and what is its key role?
One of the cartilages of the larynx. During swallowing, the epiglottis closes off the laryngeal inlet and prevents food/liquid entering the larynx.
50
Sensory and motor fibres from which nerves innervate the pharynx?
Sensory = glossopharyngeal nerve
Motor = vagus nerve
51
What tissue forms the tonsils?
Lymphoid tissue.
52
What are the four different tonsils?
Pharyngeal
Tubal
Palatine
Lingual
53
Which are visible in the oropharynx and are the structures laypeople refer to as "the tonsils"?
Palatine; these are the tonsils next to the pharyngeal wall in the oropharynx that laypeople call "the tonsils".
54
Which tonsils are found on the posterior aspect of the tongue?
Lingual tonsils.
55
What lymphoid tissue surrounds the Eustachian tube?
The tubal tonsils.
56
Where are the pharyngeal tonsils (commonly called the adenoids)?
The roof of the nasopharynx.
57
How many cartilages compose the larynx and what connects them together?
9; three unpaired, three paired.
Very small joints and membranes connect them together.
58
What are the three unpaired cartilages of the larynx?
Epiglottis, thyroid, cricoid.
59
What are the three paired cartilages of the larynx?
Arytenoids, cuneiforms, corniculate.
60
Which are smaller, the paired cartilages or the unpaired cartilages of the larynx?
The paired cartilages are smaller.
61
What is the Adam's apple?
The laryngeal prominence on the thyroid cartilage of the larynx.
62
What do the superior horns of the thyroid cartilage attach to?
The hyoid bone.
63
What part of the thyroid cartilage articulates with the cricoid cartilage?
The inferior horns.
64
Which part of the cricoid cartilage is thicker, the anterior or posterior?
Posterior is thicker.
65
Is the cricoid cartilage a complete ring?
Yes.
66
What membrane connects the inferior border of the thyroid cartilage to the superior border of the cricoid cartilage?
the cricothyroid membrane.
67
What cartilage of the larynx is vital for phonation and where are they?
The arytenoids.
Superior surface of cricoid cartilage posteriorly, attach to the vocal cords.
68
What are names of the two pairs of folds that project into the cavity of the larynx? What are they composed of?
Vestibular folds (false vocal cords).
Vocal folds (part of the true vocal cords).
Both are folds of mucous membrane.
69
Which are more superior, the vestibular folds or the vocal folds?
The vestibular folds.
70
How are the vocal ligaments protected?
By the vocal folds.
71
What do the vocal ligaments and the vocal folds form?
The true vocal cords.
72
What are the vocal ligaments attached to anteriorly and posteriorly?
Anteriorly; internal aspect of the laryngeal prominence of the thyroid cartilage.
Posteriorly; the arytenoid cartilages.
73
What is the space between the true vocal cords and why is adduction/abduction of this space important for speech?
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.
74
What are the two groups of muscles that act on the larynx and how do their actions differ?
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.
75
What two branches of the vagus nerves innervate the intrinsic muscles of the larynx?
What specific muscles do they innervate?
The superior laryngeal nerve; innervates the cricothyroid.
Recurrent laryngeal nerve; innervates all the other intrinsic muscles.
76
Which muscles abduct the true vocal cords to open the rima glottidis?
The posterior cricoarytenoid muscles.
77
Where are the cricothyroid muscles and what function do they perform?
Anterior between the thyroid and cricoid cartilages. Contraction places tension on the vocal cords.
78
Which muscles adduct the vocal folds to close the rima glottidis? What cartilage do they connect?
The inter-arytenoid muscles. Connect the two arytenoid cartilages.
79
The thyrocervical trunks branch from which arteries to supply parts of the neck including the thyroid gland?
The subclavian arteries.
80
What is the vallecula?
The vallecula is the space between the posterior surface of the tongue and the anterior surface of the epiglottis.
81
What separates the right and left nasal cavities?
A thin midline septum formed of cartilage anteriorly and two thin plates of bone posteriorly.
82
What separates the nasal cavity from the brain and oral cavity?
Brain: bone in the roof of nasal cavity.
Oral cavity: the hard palate bones in the floor of the nasal cavity.
83
What bones form the posterior nasal septum?
Perpendicular plate of the ethmoid bone superiorly, the vomer bone inferiorly.
84
What is another word for turbinates?
Conchae (Latin for 'shell').
85
What bone separates the nasal cavity from the brain?
The cribriform plate; a delicate section of bone perforated with tiny holes.
86
Why is the cribriform plate perforated?
The olfactory nerve axons travel through the perforations to the brain.
87
Why is the anterior nasal septum often a site of bleeding?
It is supplied by an anastomotic network of arteries to warm air in the nasal cavity.
88
What provides sensory innervation of the nose?
Branches of the trigeminal nerve (CN V)
89
What is the hard palate composed of?
Parts of the maxillary and palatine bones.
90
What does the tongue push up against during the first phase of swallowing?
The hard palate.
91
What is the uvula attached to?
Posterior border of the soft palate.
92
What is the soft palate composed of and why is this important during swallowing?
Several muscles which contract and elevate the soft palate during swallowing to close off the nasal cavity to food/fluid.
93
What innervates the muscles of the soft palate?
The vagus nerve.
94
What are the sinuses named after?
The bones inside which they are located e.g. frontal sinuses are inside the frontal bone.
95
Where is the buccinator muscle?
In the cheeks.
96
What forms the floor of the oral cavity?
Soft tissues and muscles.
97
How many teeth do adults have? Break this down into number of incisors, canines, premolars, and molars.
32
Incisors = 4
Canines = 2
Premolars = 4
Molars = 6
98
How many different types of teeth do adults have and what are they?
4 types; incisors, canines, premolars, molars.
99
Describe the structure of a tooth from outer to inner.
Enamel. Dentin. Pulp; containing vessels and nerves which exit via the root canal.
100
What is found on the superior surface of the tongue, some of which detect taste?
Papillae.
101
What provides motor innervation for the muscles of the tongue?
Hypoglossal nerve (CN XII)
102
What forms the tongue?
Intrinsic and extrinsic muscles.
103
Where are the intrinsic muscles of the tongue and what do they do?
Located entirely inside the tongue and change the shape of the tongue.
104
Where are the extrinsic muscles of the tongue and what do they do?
Attached to the tongue but originate from outside it (attach to the mandible and hyoid bone). They move the tongue.
105
How many nerves provide sensory innervation for the tongue? What are they?
Three cranial nerves.
Facial nerve (CN VII), Trigeminal nerve (CN V), Glossopharyngeal nerve (CN IX).
106
What innervation does the trigeminal nerve (CN V) supply for the tongue and in what area?
General sensation (touch, pain, temperature). Anterior two thirds of the tongue.
107
What innervation does the facial nerve (CN VII) supply for the tongue and in what area?
Taste. Anterior two thirds of the tongue.
108
What innervation does the glossopharyngeal nerve (CN IX) supply for the tongue and in what area?
Taste and general sensation in the posterior third of the tongue.
109
What arteries supply the oral cavity and what larger artery do they branch from?
Lingual, maxillary, and facial arteries. Branches of the external carotid artery.
110
What innervates the muscles of the soft palate?
The vagus nerve.
111
How many pairs of salivary glands are there and what are they?
Three. Parotid, submandibular, and sublingual salivary glands.
112
What and where are the largest salivary glands?
Parotid glands. Posterior part of the mandible.
113
Is glandular secretion stimulated by sympathetic or parasympathetic fibres?
Parasympathetic.
114
Where is the parotid duct and what does it do?
Empties saliva from the parotid glands, opens adjacent to the upper (maxillary) second molar tooth.
115
What innervates the parotid gland to secrete saliva?
Parasympathetic fibres of the glossopharyngeal nerve (CN IX).
116
How is the facial nerve associated with the parotid glands?
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.
117
Where are the submandibular glands and where do they secrete saliva?
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.
118
What is the lingual frenulum?
The string-like structure that tethers the tongue to the floor of the mouth.
119
Secretion of saliva from the submandibular and sublingual glands is stimulated by parasympathetic fibres of the which nerve?
The facial nerve (CN VII).
120
Where are the sublingual glands and how do they secrete saliva?
Floor of the mouth. Open via several small ducts into the floor of the mouth.
121
In which glands does mumps cause inflammation and swelling?
Parotid.
122
What is the anatomical name for the nostrils?
The anterior nares.
123
What are the turbinates and why are they useful?
"Shelves" fitted on lateral wall of nasal cavity, increase the surface area available for heating, humidifying, and filtering air.
124
How many turbinates are there? What are they called?
3 in each nasal vestibule.
Superior, middle, and inferior turbinates.
125
What are the spaces underneath each turbinate called?
Meatus e.g. the superior meatus is directly inferior to the superior turbinate.
126
What different sinuses/ducts drain into the superior meatus, the middle meatus, and the inferior meatus?
Superior meatus; posterior ethmoid sinuses.
Middle meatus; frontal, anterior ethmoid, and maxillary sinuses. Inferior meatus; orifice of the nasolacrimal duct.
**Sphenoid sinuses drain into the spheno-ethmoidal recess which is ABOVE the superior turbinate**
127
What is the nasolacrimal duct?
Colloquially known as the tear duct; drains tears from the eye to the inferior nasal meatus.
128
How many paranasal sinuses are there? What are they?
4 pairs (8 in total)
Frontal
Maxillary
Ethmoid
Sphenoid
129
Where are the ethmoidal sinuses?
Intraocular (between the eyes).
130
What is the lamina papyracea?
The thin fragile bone separating ethmoid sinuses from orbital cavity.
131
Where are the sphenoidal sinuses?
Just inferior to the pituitary gland, optic canal, and medial to the cavernous sinus. Posterior to the ethmoid sinuses.
132
What is the pharynx and how is it divided?
Fibromuscular tube lined with epithelium, constrictor muscles move food downwards when swallowing.
Divided into the nasopharynx, oropharynx, and laryngopharynx.
133
What tube in the nasopharynx connects to the middle ear?
The eustachian tube.
134
What is the purpose of the eustachian tube?
Equalise air pressure in the ear when yawning or swallowing.
Drains fluid from the middle ear.
135
What structures are visible in the oropharynx?
The uvula, palatoglossus arch/fold (joins palate to tongue), palatopharyngeal arch/fold, tonsils.
136
Name the 9 cartilage of the larynx.
Single: epiglottis, thyroid, cricoid.
Pairs: Cuneiform, corniculate, arytenoid.
137
What is the function of the arytenoid cartilage?
Stretch or relax vocal cords of higher or lower tone.
138
Where would you perform an emergency cricothyroidotomy?
Anterior neck, in the gap between the thyroid and cricoid cartilage.
139
What is the function of the pinna?
To concentrate sound waves.
140
How many layers does the ear drum have?
Bottom 2/3 = 3 layers
Top 1/3 = 2 layers
141
What are the three middle ear bones?
Malleus, incus, and stapes.
142
What is the function of the tensor tympani muscle in the middle ear?
Attaches to malleus bone, tenses the ear drum, which helps protect inner ear structures from loud noises.
(Also dampens noise of chewing).
143
In which part of the ear would you find the Eustachian tube?
Middle ear
144
What would happen if you removed the incus bone?
60dB hearing loss, because incus bone amplifies sound - works as a lever.
145
What fluid-filled bony tube, shaped like a snail shell, is important for hearing?
Cochlear
