Deep Face II Flashcards

1
Q

What is the pterygopalatine fossa?

A

A small pyramid-shaped space that is found inferior to the apex of the orbit.

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2
Q

What is the anterior boarder of the pterygopalatine fossa?

A

maxillary tuberosity

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3
Q

What is the posterior boarder of the pterygopalatine fossa?

A

pterygoid process of sphenoid (lateral plate)

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4
Q

What is the medial boarder of the pterygopalatine fossa?

A

perpendicular plate of palatine bone

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5
Q

What is the lateral boarder of the pterygopalatine fossa?

A

opens into infratemporal fossa via pterygomaxillary fissure

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6
Q

What makes up the roof of the pterygopalatine fossa?

A

(incomplete) greater wing of sphenoid

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7
Q

What makes up the floor of the pterygopalatine fossa?

A

pyramidal process of palatine bone

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8
Q

What does the superior opening of the pterygopalatine fossa open into?

A

Opens into inferior orbital fissure.

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9
Q

What does the inferior opening of the pterygopalatine fossa open into?

A

Closed, except for the palatine foramen.

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10
Q

What foramen is the only inferior opening in the floor of the pterygopalatine fossa?

A

palatine foramen

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11
Q

What are the fissure openings of the pterygopalatine fossa?

A
  • Inferior orbital fissure

- Pterygomaxillary fissure

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12
Q

What are the foramina openings of the pterygopalatine fossa?

A
  • spheno-palatine foramen

- foramen rotundum

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13
Q

What are the canal openings of the pterygopalatine fossa?

A
  • pharyngeal canal
  • vidian canal (pterygoid canal)
  • pterygopalatine canal
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14
Q

Which foramen does the maxillary nerve (CN V2) pass through?

A

Foramen Rotundum

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15
Q

True or False:

The maxillary nerve (CN V2) only supplies somatic sensory innervation.

A

True

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16
Q

What areas receive somatic sensory innervation from the maxillary nerve (CN V2)?

A

Supplies:
> dura mater of anterior part of middle cranial fossa
> conjunctiva of inferior eyelid
> mucosa of posteroinferior nasal cavity, maxillary sinus, palate, and anterior part of superior oral vestibule
> maxillary teeth
> skin of lateral external nose, inferior eyelid, anterior cheek, and upper lip

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17
Q

What are the contents of the pterygopalatine fossa?

A
  • maxillary nerve (CN V2)
  • pterygopalatine ganglion
  • third part of maxillary artery
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18
Q

Which nerves, that originate in the orbit, pass through the inferior orbital fissure into the pterygopalatine fossa?

A
  • infraorbital n.
  • zygomatic n.
  • orbital branches (from CN V2)
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19
Q

Which vessels, that originate in the orbit, pass through the inferior orbital fissure into the pterygopalatine fossa?

A
  • infraorbital a (and accompanying vv.)

- inferior ophthalmic v.

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20
Q

Which nerves, that originate in the middle cranial fossa, pass through the foramen rotundum into the pterygopalatine fossa?

A

maxillary n. (CN V2)

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21
Q

Which nerves, that originate in the base of the skull, pass through the pterygoid canal (vidian) into the pterygopalatine fossa?

A

N. of pterygoid canal (greater and deep petrosal nn.)

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22
Q

Which vessels, that originate in the base of the skull, pass through the pterygoid canal (vidian) into the pterygopalatine fossa?

A

Artery of pterygoid canal (with accompanying vv.)

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23
Q

Which nerve, that originates in the palate, pass through the greater palatine canal into the pterygopalatine fossa?

A

greater palatine nerve

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24
Q

Which vessels, that originate in the palate, pass through the greater palatine canal into the pterygopalatine fossa?

A
  • descending palatine artery

- greater palatine artery

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25
Q

Which nerve, that originates in the palate, pass through the lesser palatine canals into the pterygopalatine fossa?

A

lesser palatine nn.

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26
Q

Which vessels, that originate in the palate, pass through the lesser palatine canals into the pterygopalatine fossa?

A

lesser palatine aa. (terminal branches of descending palatine a.)

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27
Q

Which nerve, that originates in the nasal cavity, passes through the sphenopalatine foramen into the pterygopalatine fossa?

A

medial and lateral posterior superior and posterior inferior nasal branches (from nasopalatine n., CN V2)

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28
Q

Which vessel, that originates in the nasal cavity, passes through the sphenopalatine foramen into the pterygopalatine fossa?

A

sphenopalatine artery (with accompanying vv.)

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29
Q

Which branch off of the maxillary nerve (CN V2) has a communicating branch that conveys parasympathetic fibers to the lacrimal nerve (CN V1)?

A

zygomaticotemporal nerve

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30
Q

What nerve provides parasympathetic fibers to the pterygopalatine ganglion?

A

Facial nerve (CN VII) via the greater petrosal nerve.

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31
Q

Which two nerves join to form the nerve of the pterygoid canal?

A
  • Greater petrosal nerve

- Deep petrosal nerve

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32
Q

Parasympathetic fibers from the greater petrosal nerve supply the pterygopalatine ganglion. What areas are then supplied with parasympathetic innervation from the pterygopalatine ganglion?

A
  • Lacrimal gland
  • Nasal cavity via sphenopalatine nerves
  • nasal cavity and palate via greater and lesser palatine nerves.
  • pharynx via pharyngeal branch
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33
Q

Where does the deep petrosal nerve arise from?

A

Internal Carotid Plexus

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34
Q

What is the only named sympathetic nerve?

A

deep petrosal nerve

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35
Q

The deep petrosal nerve arises from the internal carotid plexus. What does it convey?

A

Conveys postsynaptic sympathetic fibers which join branches of the maxillary nerve via the pterygopalatine ganglion (but do not synapse there).

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36
Q

True or False:

Presynaptic parasympathetic fibers are from the superior cervical ganglion.

A

True

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37
Q

List the nervous structures found in the pterygopalatine fossa.

A
  • Infraorbital n.
  • Zygomatic n.
  • Orbital branches (V2)
  • Maxillary n. (V2)
  • Nerve of pterygoid canal (greater and deep petrosal n.)
  • Greater palatine n.
  • Lesser palatine n.
  • Medial and lateral superior and posterior inferior nasal branches from nasopalatine n. (V2)
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38
Q

From which main artery do all of the arteries of the pterygopalatine fossa arise from?

A

Maxillary Artery

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39
Q

List the branches of the maxillary artery that are found in the pterygopalatine fossa?

A
  • inferior alveolar a.
  • anterior tympanic a.
  • deep auricular a.
  • middle meningeal a.
  • masseteric a.
  • deep temporal a.
  • pterygoid branches
  • buccal a.
  • descending palatine a.
  • posterior-superior alveolar a.
  • infraorbital a.
  • artery of pterygoid canal
  • sphenopalatine a.
40
Q

What makes up the bony part of the external nose?

A
  • nasal bones
  • frontal process of maxilla
  • nasal part of frontal bone and nasal spine
  • bony part of nasal septum
41
Q

What makes up the cartilagenous part of external nose?

A
  • 2 lateral cartilages
  • 2 alar cartilages
  • septal cartilage (nasal septum)
42
Q

What bone makes up the superior and middle nasal concha?

A

ethmoid bone

43
Q

Except for the vestibule of the nose (considered an external portion), all of the nasal is lined with what?

A

Nasal Mucosa

44
Q

True or False:

Nasal mucosa is firmly connected to the periostium of the bony parts of the nasal cavity and the perichondrium of the cartilagenous nasal components.

A

True

45
Q

What do the areas of the nasal cavity that is lined with nasal mucosa constitute?

A
  • Respiratory area (inferior 2/3)

- Olfactory area (superior 1/3)

46
Q

What does the specialized nasal mucosa of the olfactory area (superior 1/3) contain?

A

Peripheral nerve endings from the olfactory nerve (CN1) fro special sense olfaction (smell).

47
Q

What bones make up the roof of the nasal cavity?

A
  • frontal bone
  • ethmoid bone
  • sphenoid bone
48
Q

What makes up the floor of the nasal cavity?

A
  • palatine process of maxilla

- horizontal plate of palatine bone

49
Q

What makes up the medial wall of the nasal cavity?

A

Nasal Septum (perpendicular plate of ethmoid, vomer, septal cartilage, nasal crests of maxillary and palatine bones).

50
Q

What is the nasal septum composed of?

A
  • perpendicular plate of ethmoid
  • vomer
  • septal cartilage
  • nasal crests of maxillary and palatine bones
51
Q

What makes up the lateral wall of the nasal cavity?

A

superior, middle, and inferior nasal conchae

52
Q

What are the 4 passages that the nasal cavity is divided into?

A

(1) spheno-ethmoidal recess (opening of sphenoid sinus)
(2) superior nasal meatus (openings of ethmoidal sinuses)

(3) middle nasal meatus (opening of frontal sinus)
> maxillary sinus also opens into middle nasal meatus in posterior part of semilunar hiatus at the maxillary ostium (below ethmoid bulla)

(4) inferior nasal meatus (oepning of nasolacrimal duct)

53
Q

What artery supplies most of the blood to the lateral and medial walls of the nasal cavity?

A

Branches of the Maxillary Artery.
> sphenopalatine a.
> anterior and posterior ethmoidal aa.
> greater palatine a.

**But also from the facial artery:
> superior labial a.
> lateral nasal branches

54
Q

What vessels handle venous drainage from the nasal cavity?

A

Venous drainage to:

  • sphenopalatine v.
  • facial v.
  • ophthalmic v.
55
Q

Most of the blood is supplied to the lateral and medial walls of the nasal cavity from branches of the maxillary artery. What other artery also supplies blood to this region?

A

Facial Artery:

  • superior labial a.
  • lateral nasal branches
56
Q

In the nasal cavity, what is Kiesselbach area?

A

Where all five arteries come together in a capillary bed that can bleed profusely.

57
Q

Which divisions from the trigeminal nerve supply innervation to the nasal cavity?

A
  • opthalmic division (CN V1)

- maxillary division (CN V2)

58
Q

What nerve supplies innervation to the posterior 2/3 of the nasal cavity?

A

CN V2 via the nasopalatine n. (nasal septum) and greater palatine n. (lateral wall).

59
Q

What nerve supplies innervation to the anteriosuperior nasal mucosa of the septum and lateral walls in the nasal cavity?

A

CN V1 via the anterior ethmoidal nerves.

60
Q

What are paranasal sinuses?

A

Air-filled extensions of the respiratory portion of the nasal cavity.

** found in frontal, ethmoid, sphenoid, and maxillary bones of the face **

61
Q

True or False:

Paranasal sinuses are not lined with nasal mucosa.

A

False - they are lined with nasal mucosa.

62
Q

Where do paranasal sinuses drain into?

A

The nasal cavity via openings in the spheno-ethmoidal recess, and superior, middle, and inferior meatuses.

63
Q

What are the 4 paranasal sinuses (paired structures)?

A
  • maxillary sinus
  • ethmoid sinus
  • sphenoid sinus
  • frontal sinus
64
Q

Which paranasal sinus is the largest?

A

maxillary sinus

65
Q

Where does the maxillary sinus drain into?

A

Drains via the maxillary ostium into middle meatus.

66
Q

What is the arterial supply to the maxillary sinus?

A
  • superior alveolar branches of maxillary a.

- greater palatine a.

67
Q

What supplies innervation to the maxillary sinus?

A

superior alveolar nerve branches

68
Q

Where does the ethmoid sinus drain?

A

Anterior and middle ethmoidal cells drain into middle meatus.

69
Q

What is the arterial supply to the ethmoid sinus?

A

ethmoidal aa. (from ophthalmic a.)

70
Q

What supplies innervation to the ethmoid sinus?

A

nasociliary nerves (CN V1)

71
Q

What recess does the sphenoid sinus drain via?

A

Drains via spheno-ethmoidal recess.

72
Q

What is the arterial supply of the sphenoid sinus?

A

posterior ethmoidal a.

73
Q

What supplies innervation to the sphenoid sinus?

A

posterior ethmoidal nerve

74
Q

Where is the frontal sinus found?

A

Between outer and inner tables of frontal bone, posterior to superciliary arches.

75
Q

Where does the frontal sinus drain?

A

Drains via frontonasal duct into semilunal hiatus of middle meatus.

76
Q

What provides arterial supply to the frontal sinus?

A
  • supraorbital a.

- anterior ethmoidal aa.

77
Q

What supplies innervation to the frontal sinus?

A

supraorbital nerves (CN V1)

78
Q

True or False:

The ear consists of external, middle, and internal portions. The external and middle ear transfer sound to the internal ear. The external ear captures and funnels acoustic signals through the tympanic membrane to the middle ear, which contains a complex of small bones (ossicles) that then transmit sound vibrations to the inner ear where the organs of hearing and equilibrium are found.

A

True

79
Q

What are the contents of the middle ear?

A
  • auditory ossicles: malleus, incus, stapes
  • stapedius and tensor tympani muscles
  • chorda tympani n. (taste to anterior 2/3 of tongue from facial nerve
  • tympanic plexus of nerves
80
Q

How does the middle ear (found within the petrous part of the temporal bone) connect to the nasopharynx?

A

Connects to nasopharynx via pharyngotympaic tube (Eustacian tube).

81
Q

What makes up the roof of the middle ear?

A

tegmental wall (temporal bone = tegman tympani)

82
Q

What makes up the floor of the middle ear?

A

jugular wall

83
Q

What makes up the lateral boundary of the middle ear?

A

membranous wall (tympanic membrane)

84
Q

What makes up the medial boundary of the middle ear?

A

labrynthine wall (cochlea, oval, and round windows)

85
Q

What is the anterior boundary of the middle ear?

A

carotid wall (internal carotid a.)

86
Q

What is the posterior boundary of the middle ear?

A

mastoid wall (opening to mastoid antrum)

87
Q

What innervates the tensor tympani muscle?

A

trigeminal nerve

88
Q

What innervates the stapedius muscle?

A

facial nerve

89
Q

Middle Ear Auditory Ossicles

A

> A mobile “chain” of tiny bones that articulate with each other and transmit sound vibrations.

> Span between the tympanic membrane (from external ear and the oval window (to inner ear).

> Covered with mucus membrane, but no periosteum.

> (tympanic membrane) malleus - incus - stapes (oval window).

> Stapedius muscle moves the stapes.

> Tensor tympani muscle inserts on malleus.

90
Q

What does the internal ear contain?

A

vestibulocochlear organ (hearing and equilibrium)

91
Q

Where is the internal ear located?

A

Buried deep within petrous part of temporal bone within otic capsule (hardest part of this bone).

92
Q

Where does the internal ear receive (nerve)?

A

Vestibulocochelar n. (CN VIII) via internal acoustic meatus.

93
Q

What is the cochlea?

A

Shell shaped part of bony labyrinth containing cochlear duct, concerned with hearing.

94
Q

What is the vestibule?

A

Small oval chamber containing utricle and saccules; vestibular labyrinth for balance.

95
Q

What is the semicircular canals?

A

Communicate with vestibule; also for balance.

96
Q

What is the internal acoustic meatus?

A

A narrow canal within the petrous part of the temporal bone that transmits the facial n. (CN VII) and vestibulocochlear n. (CN VIII), and blood vessels through to the internal ear.

97
Q

What artery supplies blood to the middle and inner ear?

A

Labyrinth Artery - which arises from the anterior inferior cerebellar artery.