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Neuroanatomy and Clinical Neurology > ENT > Flashcards

ENT Flashcards

1
Q

What are the eyelids?

A

Covered externally by skin and internally by palpebral conjunctiva

Strengthened by the superior and inferior tarsal plates

Orbicularis oculi is in the connective tissue superficial to these plates

In the tarsal plates are the tarsal glands which secrete lipids to lubricate the edges of the eyelids

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1
Q

What is the lacrimal apparatus?

A

Lacrimal Gland
Almond shaped and approximately 2cm long
Lies in the lacrimal fossa, in superolateral orbit

Pathway of Tears
Lacrimal gland > across the eye from lateral to medial > medial angle of eye > enter lacrimal lake > drain through lacrimal puncta and canaliculi > lacrimal sac >nasolacrimal duct >nasal cavity to inferior nasal meatus

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2
Q

What are the areas of the eyeball?

A

Cornea
Anterior Chamber
Aqueous Humor
Iris
Scleral Venous Sinus
Posterior Chamber
Ciliary Body
Pupil
Lens
Vitreous Body
Vitreous Humor
Optic Retina
Choroid
Sclera
Uvea
Macula Lutea
Optic Disc
Optic Nerve
Central Art. and V. of Retina

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3
Q

What is the Vitreous body?

A

Thevitreous body(vitreousmeaning “glass” in Latin) is the clear gel that fills the space between the lens and the retina of the eyeball of humans and other vertebrates. It is often referred to as thevitreous humoror simply “thevitreous

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4
Q

What is the ciliary body?

A

The ciliary body is a part of the eye that includes the ciliary muscle, which controls the shape of the lens, and the ciliary epithelium, which produces the aqueous humor.
The vitreous humor is produced in the non-pigmented portion of the ciliary body.

Connects the choroid with the iris
Folds on internal surface (ciliary processes) secrete aqueous humor which fills the anterior and posterior chambers

The ciliary body isa circular structure that is an extension of the iris, the colored part of the eye. The ciliary body produces the fluid in the eye called aqueous humor. It also contains the ciliary muscle, which changes the shape of the lens when your eyes focus on a near object.

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5
Q

What are the rods?

A

very sensitive to light conditions and important for vision in dim lighting, predominantly in the periphery, lesser towards the Macula.

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6
Q

What are the cones?

A

responsible for colour vision and confirm high visual acuity, more abundant towards the Macula – only cones in the Fovea - at the fovea the neurones and capillaries are displaces so that cones are directly exposed to light thereby allowing for maximal visual acuity

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7
Q

What is Scleral Venous Sinus?

A

Drains aqueous humor
Blockage > pressure build-up in the anterior and posterior chambers > Glaucoma
Blindness may result from compression of the neural layer of the retina

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8
Q

What is the lens?

A

Transparent biconvex structure enclosed in a capsule

Posterior to iris
Anterior to vitreous body

Isolated unattached lens assumes a nearly spherical shape, thus its refraction enables close vision

Anchored by suspensory ligaments to ciliary body → Ciliary muscle in ciliary body changes shape of the lens

When contracted ciliary muscle has a sphincter action reducing tension on the lens and it thickens bringing near objects into focus
(parasympathetic CN III) – this is known as accommodation

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9
Q

What is refraction?

A

Refractive error, also known asrefraction error, is a problem withfocusinglightaccurately on theretinadue to the shape of theeyeand orcornea.

The most common types of refractive error arenear-sightedness,far-sightedness,astigmatism, andpresbyopia. Near-sightedness results in faraway objects beingblurry, far-sightedness and presbyopia result in close objects being blurry, and astigmatism causes objects to appear stretched out or blurry. Other symptoms may includedouble vision,headaches, andeye strain

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10
Q

What nerves are responsible for pupil dilation and contraction?

A

Sphincter Muscle of Pupil, Sphincter Pupillae (Parasympathetic CN III)

Dilator Muscle of Pupil, Dilator Papillae (Sympathetic – Cervical Sympathetic Trunk – Ciliary nerves)

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11
Q

What is the retina?

A

Retina receives visual light rays, and has 2 layers
Neural layer is light receptive

Pigmented Layer to absorb light (assists choroid) and reduce scattering

Optic Disc
Where the optic nerve enters the eyeball
Insensitive to light and is a “blind spot”

Macula Lutea
Lateral to the optic disc
Not usually seen on funduscopy

Fovea Centralis
Central depression at the centre of the macula lutea
Is the area of most acute vision

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12
Q

What are the veins of the eyes?

A

Superior & Inferior Ophthalmic
Facial
Cavernous Sinus
Pterygoid Venous Plexus

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13
Q

What are the arteries of the eyes?

A

Internal carotid
Ophthalmic
Supratrochlear
Supraorbital

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14
Q

What is the palate?

A

Forms the arched roof of the mouth and the floor of the nasal cavities
It separates the oral cavity from the nasal cavities and the nasopharynx

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15
Q

What is the hard palate?

A

Is the anterior 2/3’s of the palate

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16
Q

What is the soft palate?

A

Is the movable posterior third of the palate, which is suspended from the posterior border of the hard palate

Extends posteroinferiorly as a curved free margin from which hangs a conical process, the uvula

17
Q

What is the Fauces?

A

Passage from the mouth to the pharynx, including the lumen and its boundaries

18
Q

What is the nerve innervation of the final 3rd of the tongue?

A

Glossopharyngeal Nerve (CN IX)
General sensation (touch & temperature) & special sensation (taste)

Internal Laryngeal Nerve, branch of Vagus Nerve (CN X)
Mostly general but some special sensation over a small area of the tongue just anterior to the epiglottis

19
Q

What are the Palatine Tonsils?

A

Masses of lymphoid tissue on each side of the oropharynx
In the tonsillar fossa, bounded by the palatoglossal and palatopharyngeal arches and the tongue

20
Q

What consists of the tongue?

A

Root (posterior third)
Body (anterior third)
Apex
Terminal Sulcus

Anterior part of tongue contains papillae (vallate, foliate, filiform, fungiform)

Posterior part of tongue contains lingual lymphatic follicles

21
Q

What are the 4 basic taste sensations and their locations?

A

Four basic taste sensations
Sweetness (apex)
Saltiness (lateral margins)
Sourness & Bitterness (posterior part)

22
Q

What is the innervation of the anterior 2/3rd of the tongue?

A

Lingual nerve, branch of mandibular nerve (CNV3)
General sensation (touch & temperature)

Chorda tympani nerve, branch of facial nerve (CN VII)
Special sensation (taste)

23
Q

What is the motor supply of the tongue?

A

Hypoglossal Nerve (CNXII)
All muscles of the tongue except for the palatoglossus (CN X) are supplied by CN XII

24
Q

What is the nose?

A

Part of the respiratory tract superior to the hard palate

Divided into left and right halves by the nasal septum

25
Q

What are the functions of the nose?

A

Olfaction
Respiration
Filtration of dust
Humidification of inspired air
Reception of secretions from the paranasal sinuses and nasolacrimal ducts

26
Q

What is the lateral wall of the nasal cavity?

A

The lateral nasal wall is characterised by 3 nasal conchae

The space beneath each concha is the meatus

Nasolacrimal duct opens into the inferior nasal meatus

Fontal and maxillary sinuses open into the middle nasal meatus

Anterior and middle ethmoidal sinuses open beneath the middle nasal concha

Posterior ethmoidal sinus opens into the superior meatus

27
Q

What is the Pharyngotympanic Tube?

A

Connects the tympanic cavity to the nasopharynx, where it opens posterior to the inferior meatus of the nasal cavity

The posterolateral 1/3rd of the tube is bony and the remainder is cartilaginous

Its function is to equalise pressure in the middle ear with the atmospheric pressure, thereby allowing free movement of the tympanic membrane

Since the walls of the cartilaginous part are normally in opposition, the tube must be actively opened by the levator veli palatini and the tensor veli palatini

28
Q

What is the tympanic membrane (external ear)?

A

Approximately 1cm in diameter

Thin oval semitransparent membrane at the medial end of the external auditory meatus

Partition between the external auditory meatus and the tympanic cavity (air chamber in the temporal bone containing the auditory ossicles) of the middle ear

External surface supplied by the auriculotemporal nerve, a branch of CNV3

Internal surface supplied by the glossopharyngeal nerve (CN IX)

29
Q

What is the middle ear?

A

Tympanic Cavity

Ossicles

Epitympanic Recess (space superior to the tympanic membrane)

Connected anteriorly with the nasopharynx by the pharyngotympanic tube

Posterosuperiorly, the tympanic cavity connects with the mastoid cells through the mastoid antrum

30
Q

What does the Tensor tympani (CN V3) do?

A

pulls the handle of the malleus medially, tensing the tympanic membrane and reducing the amplitude of its oscillations

31
Q

What does Stapedius (CN VII) do?

A

pulls the stapes posteriorly and tilts its base in the oval window, reducing the oscillatory range and preventing excessive movement of the stapes

32
Q

What are the contents of the internal ear?

A

Internal ear contains the vestibulocochlear organ concerned with the reception of sound and maintenance of balance
Membranous labyrinth contains endolymph

Membranous labyrinth is suspended within the boney labyrinth by perilymph

Both fluids carry sound waves to the end organs for hearing and balancing

33
Q

What is the location of the inner ear?

A

Internal ear is buried in the petrous part of the temporal bone

34
Q

What is the pathway of sound?

A

Sound Waves
Captured by pinna
Channelled through external auditory meatus
To tympanic membrane
To malleus, incus, and stapes
Stapes fits into oval window of membranous labyrinth of inner ear
Sound waves transmitted to perilymph of scala vestibuli
Through Reissner’s membrane
- Cochlear duct - tectorial membrane
To hair cells of Organ of Corti
To CN VIII

35
Q

What is the vestibule?

A

Small oval chamber (± 5mm long)
Contains utricle & saccule

Respond to translational head movements (linear accelerations)

36
Q

What are Semi-circular Canals?

A

These canals (anterior, posterior and lateral) communicate with the vestibule of the bony labyrinth

Are set at 90º to each other

Records movements from rotation of the head in plane of duct (horizontal, posterior & anterior rotation)

37
Q

What are the movements of the eye?

A

ABduction
ADDuction
Medial rotation
Lateral rotation
Elevation
Depression

38
Q

What is the Pupillary response?

A

CN II Afferent > CN III Efferent)

In dim light observe the pupillary response to light using the pen torch.

Direct pupillary reflexis pupil’s response to light entering the ipsilateral eye.

Consensual pupillary reflexis the pupil response to light entering the contralateral pupil

39
Q

What is the accommodation reflex?

A

Focussing on a near object following more distant gaze fixation
The reflex, controlled by the parasympathetic nervous system (CN III), involves three responses: pupil constriction, lens accommodation, and convergence.

Transparent biconvex structure enclosed in a capsule

Posterior to iris
Anterior to vitreous body

Isolated unattached lens assumes a nearly spherical shape, thus its refraction enables close vision

Anchored by suspensory ligaments to ciliary body → Ciliary muscle in ciliary body changes shape of the lens

When contracted ciliary muscle has a sphincter action reducing tension on the lens and it thickens bringing near objects into focus
(parasympathetic CN III) – this is known as accommodation

40
Q

What is convergence?

A

CN III > Medial Rectus to adduct eye to focus near object

Neuroanatomy and Clinical Neurology (16 decks)

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