ENT Anatomy Flashcards
sphenoid sinus drains into
sphenoethmoid recess
posterior ethmoidal air cells drain into
superior meatus
frontal sinus, anterior ethmoidal air cells and maxillary sinus drain into
semilunar hiatus
middle ethmoidal air cells drain into
ethmoidal bulla
nasolacrimal duct drains into
inferior meatus
skeleton surrounding brain
neurocranium
facial skeleton
viscerocranium
bone situated at the roof of the nasal cavity between the two orbital cavities
ethmoid bone
bone that makes up the forehead
frontal bone
bone at the lateral wall of the nasal cavity
inferior conchae
bone located at the medial wall of the orbit
lacrimal bone
bone that makes up the jaw
mandible
bone that makes up the area surrounding the nose and between the nose and mouth
maxilla
bone that makes up the nose
nasal bone
bone that makes up the scalp
parietal bone
connects neurocranium and viscerocranium, contains a lateral pterygoid plate and a medial pterygoid plate
sphenoid bone
bone that makes up the skull around the ear
temporal bone
bone in between the nostrils
vomer
bone that makes up the cheekbones
zygomatic bone
connection between sphenoid, parietal, frontal and temporal bones
pterion
foramen that transmits the spinal cord
foramen magnum
foramen that transmits the mandibular nerve
foramen ovale
foramen that transmits the maxillary nerve
foramen rotundum
foramen that transmits the frontal, lacrimal, nasociliary, abducent, trochlear and oculomotor (superior and inferior branches) nerves
superior orbital fissure
foramen that transmits CNIX-XI
jugular foramen
foramen that transmits the hypoglossal nerve and blood vessels
hypoglossal canal
foramen that gathers sound waves
external acoustic meatus
foramen that transmits the vestibulocochlear nerve, facial nerve and labyrinthine artery
internal acoustic meatus
foramen that transmits the olfactory nerve
cribriform plate of ethmoid bone
foramen that transmits the facial nerve and stylomastoid artery
stylomastoid foramen
foramen that transmits the greater palatine nerve and blood vessels
greater palatine foramen
foramen that transmits the lesser palatine nerve and arteries
lesser palatine foramen
area just inside the nostril that leads to the nasal cavity
nasal vestibules
the inside of most of the visible nose
respiratory regions
the part of the nasal cavity close to the roof
olfactory regions
the rounded part of the nostrils that is visible
ala
top of the nose between the eyebrows
root
the long anterior part of the nose
dorsum
cartilage on the lateral aspects of the nose
lateral cartilage
cartilage on the medial aspect of the nose
septal cartilage
small space in the nasal cavity posterior and superior to the superior concha
sphenoethmoidal recess
small space between the superior and middle conchae
superior meatus
small space between the middle and inferior conchae
middle meatus
small space under the inferior concha
inferior meatus
what cells are sinuses lined with?
respiratory epithelium
name the four sinuses
frontal, ethmoid air cells, sphenoid, maxillary
borders of the nasopharynx
posterior nasal cavity to soft palate
borders of the oropharynx
soft palate to superior border of epiglottis
borders of laryngopharynx
superior border of epiglottis to inferior border of cricoid cartilage
gap in the posterior nasal cavity
choanae
elevation in mucous membrane caused by underlying Eustachian tube
torus tubarius
a deep hole behind the Eustachian tube
pharyngeal recess
a raised ridge of mucous membrane extending along the wall of the pharynx
salpingopharyngeal fold
an opening that connects the middle ear with the nasal-sinus cavity
Eustachian tube
bundles of lymphatic tissue located in the lateral oropharynx
palatine tonsils
anterior arch of the oral cavity
palatoglossal arch
posterior arch of the oral cavity
palatopharyngeal arch
bundles of lymphatic tissue at the sides of the tongue at the base
lingual tonsil
the entrance to the larynx
laryngeal aditus
side branches from the vocal tract
piriform fossa
name the 9 pharyngeal cartilages
thyroid cartilage, cricoid cartilage, epiglottis, arytenoid cartilage (x2), corniculate cartilage (x2), cuneiform cartilage (x2)
what is the internal larynx lined with?
respiratory mucosa
area of larynx above vocal cords
laryngeal vestibule
structure that lies between the vocal and vestibular fold
laryngeal ventricle
laryngeal vestibule and ventricle collective term
supraglottis
space between the vocal cords and cricoid cartilage
infra-glottic cavity
Adam’s apple
laryngeal prominence
connects thyroid cartilage to hyoid bone
thyrohyoid membrane
superior protuberance from thyroid cartilage
superior horn of thyroid cartilage
inferior protuberance from thyroid cartilage
inferior horn of thyroid cartilage
flat portion of cricoid cartilage
cricoid lamina
links vestibular ligament and epiglottis
quadrangular membrane
free lower edge of quadrangular membrane
vestibular ligament
medial edge of laryngeal triangular membrane
vocal ligament
links cricoid cartilage and vocal ligament
conus elasticus
processes of arytenoid cartilage
vocal and muscular
articulation between cricoid and arytenoid cartilages
cricoarytenoid joint
articulation between cricoid and thyroid cartilages
cricothyroid joint
most anterior aspect of the chin
mental protuberance
bony projection at the base of the temporal bone
mastoid process
elevation on posterior surface of occipital bone
external occipital protuberance
space between inside of lips and gums/teeth
oral vestibule
deep layer of fascia surrounding the vertebral column
prevertebral fascia
fascia arranged like a collar around the neck
investing fascia
fascia surrounding the trachea
pretracheal fascia
fascia surrounding internal carotid artery and CNIX-XII)
carotid sheath
anterior boundary of oral cavity
lips and oral fissure
opening between the lips
oral fissure
posterior boundary of oral cavity
isthmus of fauces
lateral boundary of oral cavity
cheeks
superior boundary of oral cavity
hard and soft palates
inferior boundary of oral cavity
floor of mouth
bit that hangs down at the back of the throat
uvula
gums
gingivae
opening for submandibular glands
sublingual caruncle
line in the middle underneath the tongue
lingual frenulum
crest of mucous membrane around the bottom of the tongue
sublingual fold
line between left and right palatine bones
medial palatine suture
connects nasal and oral cavities
incisive foramen
salivary glands in the palatal mucosa secrete…
mucous
mucosal elevations on anterior third of palate
palatal rugae
false vocal cord
vestibular fold
true vocal cord
vocal fold
septal cartilage aka
quadrilateral cartilage
foramen that transmits anterior ethmoidal artery, vein and nerve
anterior ethmoidal foramen
foramen that transmits posterior ethmoidal artery, vein and nerve
posterior ethmoidal foramen
foramen that transmits sphenopalatine artery, posterior superior lateral nasal nerve, and nasopalatine nerves
sphenopalatine foramen
two branches of ophthalmic artery
anterior and posterior ethmoidal arteries
first branch from internal carotid artery after it enters the cranial cavity
ophthalmic artery
two branches of maxillary artery
sphenopalatine artery and descending palatine artery
branch of descending palatine artery
greater palatine artery
terminal branch of external carotid artery
maxillary artery
two branches of facial artery
septal branch of superior labial artery and lateral nasal artery
three origins of vessels supplying nasal cavity
facial, maxillary and ophthalmic arteries
five contributors to Keisselbach’s plexus
anterior ethmoidal artery, posterior ethmoidal artery, septal branch of superior labial artery, sphenopalatine artery, and greater palatine artery
respiratory epithelium
pseudostratified ciliated columnar epithelium with goblet cells
olfactory epithelium
pseudostratified ciliated columnar epithelium with goblet cells and receptor cells
what kind of neurons are receptor cells?
bipolar
function of nasal conchae
keep turbulent air in nasal cavity for a bit longer giving the receptor cells in the olfactory epithelium a chance to pick up odorants
olfactory pathway
olfactory nerves (receptor cells) in olfactory epithelium, pass up through cribriform plate, synapse in olfactory bulb, pass along olfactory tract to temporal lobe and other olfactory areas of brain
CNV1
ophthalmic division of trigeminal nerve
CNV2
maxillary division of trigeminal nerve
two foraminae that nasopalatine nerves pass through
sphenopalatine foramen and incisive foramen
what direction do greater palatine artery and sphenopalatine artery travel through incisive foramen?
ascending
what direction do nasopalatine nerves travel through incisive foramen?
descending
ophthalmic division sends axons through…
superior orbital fissure
maxillary division sends axons through…
foramen rotundum
trigeminal ganglion location
temporal bone
inferior portion of temporal bone
petrous portion
superior portion of temporal bone
squamous portion
slender projection inferiorly from temporal bone
styloid process
fissure in the temporal bone that runs from temporomandibular joint to tympanic cavity
petrotympanic fissure
depression in zygomatic process of temporal bone that the mandible articulates with
glenoid fossa
foramen medial to stylomastoid foramen which transmits the carotid artery
external carotid canal
the part of temporal bone which articulates with the zygomatic bone
zygomatic process
outer ear
cartilaginous pinna/auricle
ear canal
external acoustic meatus
medial end of external acoustic meatus
tympanic membrane
what forms the pinna?
elastic cartilage
where does the elastic cartilage of the pinna get nutrients?
skin
what forms the lateral third of internal acoustic meatus?
cartilage
what is the term to describe the structure of the internal acoustic meatus?
osseocartilaginous canal
what lines osseocartilaginous canal?
skin continuous with pinna
what glands produce earwax?
ceruminous glands
outer fold of ear
helix
Y-shaped second fold of ear
anti-helix
anterior protrusion of ear
tragus
inferior border of ear
anti-tragus
inferior protrusion of ear
ear lobe
cavity of ear underneath anti-helix
concha
nerve supply to posterior aspect of ear
C2, C3 - lesser occipital nerve
nerve supply to anterior aspect of ear
C2, C3 - greater auricular nerve
nerve supply to inferior aspects of external acoustic meatus and tympanic membrane
CNX
nerve supply to superior aspects of external acoustic meatus and tympanic membrane
CNV3
nerve supply to part of external acoustic meatus
CNVII
used to examine external acoustic meatus
otoscope
external acoustic meatus in a child
short and straight
how to examine external acoustic meatus in a child
gently pull ear posterioinferiorly
external acoustic meatus in an adult
curved
how to examine external acoustic meatus in an adult
gently pull ear posteriosuperiorly
thin part of tympanic membrane superiorly
pars flaccida
most inwardly depressed part of tympanic membrane
umbo
thick part of tympanic membrane posteroinferiorly
pars tensa
first bones to ossify during development that are fully developed at birth
auditory ossicles
functions of auditory ossicles
convey vibrations of tympanic membrane caused by soundwaves and conduct them to apparatus of inner ear
lateral auditory ossicle
malleus (hammer)
middle auditory ossicle
incus (anvil)
medial auditory ossicle
stapes (stirrup)
what connects the auditory ossicles?
small synovial joints
what suspends auditory ossicles in the tympanic cavity?
mucosal folds and small ligaments
muscle of tympanic cavity that inserts onto malleus
tensor tympani
nerve supply of tensor tympani
CNV3 (mandibular)
muscle of tympanic cavity that inserts onto stapes
stapedius
nerve supply of stapedius
CNVII (facial)
part of tympanic cavity posterior to tympanic membrane
tympanic cavity proper
part of tympanic cavity superior to tympanic membrane
epitympanic recess
nerve that carries sensory information from mucosa lining middle ear
CNIX (glossopharyngeal)
opening in epitympanic recess
mastoid aditus
where does the mastoid aditus lead?
air cells of mastoid process
roof of tympanic canal
tegmen tympani
function of tegmen tympani
separates tympanic canal from middle cranial fossa
floor of tympanic cavity closely related to…
internal jugular vein
feature on medial wall that receives footplate of stapes
oval window
feature on medial wall that dissipates forces from cochlear
round window
feature on medial wall that is formed by the first turn of cochlea
promontory
feature on medial wall that contains facial nerve (CNVII)
facial canal
nerve that passes between incus and malleus towards infratemporal fossa
chorda tympani
what forms the posterior third of Eustachian tube?
bone
what forms the anterior two thirds of Eustachian tube?
cartilage
function of Eustachian tube?
equalise air pressure between middle ear and nasopharynx
what is the normal state of the Eustachian tube?
collapsed
when does the Eustachian tube become patent?
during muscular contraction
what does the glossopharyngeal nerve provide sensory innervation to?
mucosa of middle ear cavity, Eustachian tube, nasopharynx, oropharynx and palatine tonsils
function of inner ear
reception of sound and maintenance of balance
series of bony cavities within temporal bone
bony labyrinth
group of ducts and chambers filled with endolymphatic fluid located within bony labyrinth
membranous labyrinth
rigid, bony outer wall of inner ear in temporal bone
otic capsule
part of inner ear that aids hearing
cochlear
parts of inner ear that aid balance
semicircular canals, utricle, saccule
bony core of cochlear
modiolus
shell-shaped spiral encircling modiolus
cochlear
oval-shaped chamber containing utricle and saccule
vestibule
what window does the cochlear feature?
round window
what window does the vestibule feature?
oval window
semicircular canals
posterior, lateral, anterior, situated at right angles to each other
vestibular organs
utricle and saccule
detects motion in the horizontal plane
utricle
detects motion in the vertical/sagittal plane
saccule
where does the endolymphatic fluid come from?
endolymphatic sac and duct, and cochlear duct
dilation on each semicircular duct
ampulla
which two semicircular ducts have a common stalk?
anterior and posterior
where is inner ear located?
petrous portion of temporal bone
specialised mechanoreceptors that convert mechanical stimuli to neural stimuli
hair cells
two labyrinths of sensory areas of inner ear
cochlear labyrinth and vestibular labyrinth
where are hair cells located?
maculae of utricle and saccule, ampullae of semicircular ducts, and organ of corti
which nerve carries neural stimuli from hair cells to CNS?
vestibular nerve (division of vestibulocochlear nerve (CNVIII))
where are the cell bodies from vestibular nerve located?
vestibular ganglion
3 fluid-filled channels of cochlear
scala vestibuli, scala tympani, scala media (cochlear duct)
site at cochlear where scala vestibuli and scala media are continuous
helicotrema
organ of inner ear that converts fluid vibrations into neural action potentials
organ of corti
medical term for hearing
audition
nerve that carries neural stimuli from organ of corti
cochlear nerve (division of vestibulocochlear nerve (CNVIII))
where are the cell bodies from cochlear nerve contained?
spiral ganglion
where is the organ of corti located?
cochlear duct
modalities of the facial nerve
somatic sensation, special sensation (taste), somatic motor and visceral motor
modalities of greater petrosal nerve
presynaptic parasympathetic secretomotor fibres
modalities of chorda tympani
taste, parasympathetic secretomotor fibres
modality of nerve to stapedius
somatic motor
specialised structure within utricle containing hair cells
utricular macula
specialised structure within saccule containing hair cells
saccular macula
nerve that travels through pterygoid canal
vidian nerve
where is the pterygopalatine ganglion located
pterygopalatine fossa
interconnection between CNV1 and CNV2
zygomatic nerve
do sympathetic fibres synapse in the pterygopalatine ganglion?
no
do parasympathetic fibres synapse in the pterygopalatine ganglion?
yes
what does the vidian nerve run through?
pterygoid canal
symptoms of disruption of vidian nerve
dry eye on ipsilateral side, dry mucosa
symptoms of disruption of facial nerve in internal acoustic meatus
dry eyes, dry mucosa, lack of taste on anterior 2/3 of tongue, dry mouth
what direction does the tympanic membrane push if atmospheric air pressure is greater than tympanic cavity air pressure?
in
what direction does the tympanic membrane push if tympanic cavity air pressure is greater than atmospheric air pressure?
out
what is the bony labyrinth filled with?
perilymph
what is the membranous labyrinth filled with?
endolymph
what detects angular movement?
semicircular ducts
what plane does the anterior semicircular canal detect movement in?
sagittal
what plane does the posterior semicircular canal detect movement in?
coronal
what plane does the lateral semicircular canal detect movement in?
axial
damage to cochlear nerve will lead to…
loss of hearing
damage to vestibular nerve will lead to…
loss of balance
damage to greater petrosal nerve will lead to…
dry eyes and mucosa
damage to chorda tympani nerve will lead to
dry mouth and loss of taste on anterior 2/3 of tongue
portion of facial nerve that leaves brainstem at pontomedullary junction and enters internal acoustic meatus
cranial portion
portion of facial nerve that travels through temporal bone in close relationship to the middle ear and leaves temporal bone through stylomastoid foramen
temporal portion
portion of facial nerve that courses towards and through the parotid gland
extratemporal portion
which papillae have taste buds?
foliate, fungiform and vallate
which papillae detect pain, touch, temperature?
filiform
what is the vertical part of the tongue?
posterior 1/3
what is the horizontal part of the tongue?
anterior 2/3
what nerve supplies the posterior 1/3 of tongue?
CNIX
what nerve supplies the anterior 2/3 of tongue?
CNVII and CNV3
medical term for swallowing
deglutition
this structure is lost in illness, giving a ‘sunken cheek’ appearance
buccal fat pad
outline of the lips
vermilion border
this muscle opens the jaw
lateral pterygoid
these 3 muscles close the jaw
medial pterygoid, masseter, temporalis
this muscle acts as a sphincter around the mouth
orbicularis oris
this muscle assists in aligning a food bolus between dentition
buccinator
part of the mandible that articulates with the temporal bone
mandibular condyle
part of the temporal bone that sits in front of the mandibular condyle
articular tubercle
action of extrinsic tongue muscles
control movement of tongue around oral cavity
action of intrinsic tongue muscles
change shape of tongue
extrinsic tongue muscles
palatoglossus, hyoglossus, styloglossus, genioglossus
innervation of styloglossus, styloglossus and hyoglossus
CNXII
innervation of palatoglossus
CNX
intrinsic tongue muscles
superior longitudinal, inferior longitudinal, horizontal, vertical
muscles of the soft palate
palatoglossus, musculus uvulae, palatopharyngeus, tensor vali palatini, levator vali palatini, superior pharyngeal constrictor
innervation of tensor vali palatini
CNV3
innervation of palatoglossus, musculus uvulae, palatopharyngeus, levator vali palatini, superior pharyngeal constrictor
CNX
aponeurosis between tensor vali palatini muscles
palatine aponeurosis
hook-shaped bony process on medial pterygoid plate of sphenoid bone
pterygoid hamulus
action of palatoglossus
depresses soft palate towards tongue
action of musculus uvulae
shortens uvula
action of palatopharyngeus
elevates pharynx and depresses soft palate
action of tensor vali palatini
tenses palatine aponeurosis
action of levator vali palatini
lift palatine aponeurosis
Waldeyer’s tonsillar ring, from superior to inferior
pharyngeal tonsil, tubal tonsil, palatine tonsil, lingual tonsil
salivary glands
parotid gland, submandibular gland, sublingual gland
sensory component of gag reflex
posterior 1/3 of tongue, palatine tonsils or wall of oropharynx, CNIX
motor component of gag reflex
constrictors of pharynx and soft palate (CNX), longitudinal muscles of pharynx (CNIX-X), and tongue (CNXII)
space in the side of the neck, from hyoid bone to base of skull
parapharyngeal space
inner longitudinal layer of pharyngeal muscles
stylopharyngeus, salpingopharyngeus, palatopharyngeus
outer circular layer of pharyngeal muscles
superior pharyngeal constrictor, middle pharyngeal constrictor, inferior pharyngeal constrictor
insertion of longitudinal muscles
posterior border of thyroid cartilage
insertion of circular muscles
midline raphe
innervation of stylopharyngeus
CNIX
innervation of circular muscles, salpingopharyngeus and palatopharyngeus
CNX
innervation of muscles of voice
CNX
action of cricothyroid muscle
tenses vocal ligament
origin of cricothyroid muscle
anterolateral cricoid cartilage
joint that cricothyroid muscle acts on
cricothyroid joint
insertion of cricothyroid muscle
inferior horn of thyroid cartilage
action of thyroarytenoid muscle
relaxes vocal ligament
joint that thyroarytenoid muscle acts on
cricoarytenoid joint
origin of thyroarytenoid muscle
posterior thyroid
insertion of thyroarytenoid muscle
anterior arytenoid cartilage
action of lateral cricoarytenoid muscle
adducts vocal ligaments
joint that lateral cricoarytenoid muscle acts on
cricoarytenoid joint
origin of lateral cricoarytenoid muscle
muscular process of arytenoid
insertion of lateral cricoarytenoid muscle
anterior cricoid cartilage
3 bands of arytenoid muscle
oblique (x2) and transverse
action of arytenoid muscle
adducts vocal ligaments
joint that arytenoid muscle acts on
cricoarytenoid joint
origin of arytenoid muscle
ipsilateral arytenoid cartilage
insertion of arytenoid muscle
contralateral cricoid cartilage
action of posterior cricoarytenoid muscle
abducts vocal cords
joint that posterior cricoarytenoid muscle acts on
cricoarytenoid joint
origin of posterior cricoarytenoid muscle
posterior cricoid cartilage
insertion of posterior cricoarytenoid muscle
muscular process of arytenoid cartilage
infrahyoid muscles
omohyoid, thyrohyoid, sternohyoid, sternothyroid
suprahyoid muscles
digastric, stylohyoid, geniohyoid, mylohyoid
5 modalities of CNX
somatic sensation, somatic motor, special sensation (taste), visceral sensation, visceral motor (latter 2 thorax/abdomen only)
where does CNX leave CNS?
medulla oblongata
what foramen does CNX pass through?
jugular foramen
3 branches of CNX
superior laryngeal, recurrent laryngeal, pharyngeal
where does CNX become vagal trunks?
posterior to root of lung hilum around oesophagus
oral sounds
soft palate tenses (CNV3) and elevates (CNX) to close off nasopharynx
nasal sounds
soft palate tenses (CNV3) and depresses (CNX) to close off oropharynx
