ENT Anatomy Flashcards
1
Q
Why can’t adrenaline be used near the nasal cartillages?
A
They rely on nutrient diffusion & adrenaline vasoconstricts
2
Q
What are the flares of the nostril called?
A
Ala
3
Q
What makes up the roof of the ethmoid bone?
A
Cribriform plate
Crista galli
4
Q
What makes up the lateral wall of the ethmoid bone?
A
Superior & middle conchae
5
Q
What makes up the nasal septum?
A
Perpendicular plate of ethmoid + vomer
6
Q
Where does a Le Fort I fracture disrupt?
A
straight across maxilla (moustache)
7
Q
What shape is a Le Fort II fracture disrupt?
A
Triangle
8
Q
Why are Le Fort II & III so dangerous?
A
an disrupt cribriform plate of the ethmoid bone resulting in a danger of infection
9
Q
Why do septal haematomas need to be drained?
A
To prevent AVN of the septal hyaline cartillage
10
Q
What makes up the mucosa at the entrance of the nasal cavity?
A
Keratinised stratified squamous epitheliam
11
Q
What makes up the majority of the mucosa of the nasal cavities?
A
Respiratory epithelium
12
Q
What makes up the most superior section of the nasal mucosa?
A
Olfactory mucosa
13
Q
What is the function of keratinised, stratified squamous epithelium in the nasal mucosa?
A
Protection
14
Q
What is the function of the respiratory mucosa in the nose?
A
Mucous secreting goblet cells give moisture to resp system
15
Q
What is the function of the olfactory mucosa in the nose?
A
Sense of smell
16
Q
Which cranial nerve is olfactory?
A
CN I
17
Q
What is the functional of the olfactory nerve?
A
Special sensory
18
Q
What do receptor cells pass throught to reach the olfactory mucosa?
A
Cribriform plate
19
Q
Why does the olfactory nerve synapse?
A
The olfactory bulb
20
Q
Which nerves supply somatic sensory to nasal cavity?
A
CN V1
CN V2
21
Q
Which branches from the external carotid artery that supply the nose?
A
Facial
Maxillary
22
Q
Which branch of the internal carotid artery also supplies the nose?
A
Ophthalmic
23
Q
What is Kiesselbac’s area?
A
Arterial anastomesis on the nasal septum - common site of epistaxis
24
Q
How to remember the blood supply to the nose?
A
L - Labila/septal
E - Ethmoidal
G - Greater palatine
S- Sphenal palatine
25
What are meatuses?
'Spaces' under each concha
26
What are the 4 eatuses?
Sphenoethmoidal (recess)
Superior meatus
Middle meatu
Inferior meatus
27
Which conchae is not part of the ethmoidal bone?
Inferior conchae
28
What forms the hard palate?
Right & left maxillae
| Palatine bones
29
What are ostia?
"holes" in the receses & meatuses of the lateral walla which allow drainage of mucous from the paranasal sinuses
30
How many sinuses are in the frontal bone?
2 (separated by bony septum)
31
How many sinuses are there?
2 frontal sinuses
2 maxillary sinuses
2 ethmoidal air cells
1/2 sphenoid sinuses
32
hat mucosa lines the sinuses?
Mucous secreting respiratory mucosa
33
Functions of paranasal sinuses?
Resonate voice
Lighten the head
Buoyancy
34
Where does the frontal sinus drain?
Middle meatus
35
Where do the ethmoidal air cells drain?
Auperior & middle meatuses
36
Where does the sphenoidal sinus drain?
Sphenoethmoidal recess
37
Where does the maxillary sinus drain?
Middle meatus
38
What drains into the inferior meatus?
Tears (lacrimal fluid)
39
The pain felt in sinusitis is from which nerves?
V1 & V2
40
Where can the pain be reffered in sinusitis?
Teeth
41
How can a viral URTI cause sinusitis?
Swelling of mucosa blocs ostia
42
Why is the maxillary sinus most predisposed to inflammation?
It's ostia are located superiorly in the medial wall of the sinus so it has to drain against gravity
43
What is non nasal cause of maxillary sinusitis?
Dental abscess
44
What is the pterion?
The thinnest part of the skull
45
Which nerves pass through the tempral bone?
```
CN VII (facial enrve)
CN VIII (vestibulocochlear nerve)
```
46
Where does the facial nerve leave the skull?
Internal auditory meatus > facial canal > Stylomastoid foramen
47
Where does the vestibulocochlear nerve leave the skull?
Internal auditory meatus
48
What are the bones of the anterior cranial fossa?
Frontal
Ethmoid
Sphenoid
49
What are the bones of the middle cranial fossa?
Sphenoid
| Temporal
50
What are the bones of the posterior cranial fossa
Temporal & occipital
51
Where does the optic nerve exit the skull?
Optic canal
52
Where does the occulomotor nerve exit the skull?
Superior orbital fissure
53
Where does the trochlear nerve exit the skull?
Superior orbital fissure
54
Where does CN V1 exit the skull?
Superior orbital fissure
55
Where des CN V2 exit the skull?
Foramen rotundum
56
Where does CN V3 exit the skull?
Foramen ovale
57
When does the abducens nerve exit the skull?
Superior orbital fissure
58
Where does the vagus nerve (CN X) exit the skull?
Jugular foramen
59
Where does the acessory nerve (CN XI) exit the skull?
Jugular foramen
60
Where does the hypoglossal nerve (CN XII) exit the skull?
Hypoglossal canal
61
Where does the external ear go from and to?
Auricle to tympanic membrane
62
What is the function of the external ear?
Collects and conveys sound waves to tympanic membrane
63
Where does the middle ear extend from and to?
Tympanic membrane to val window (also eustachian tube)
64
What is the function of the middle ear?
Amplifies & conducts sound waves to th internal ear
65
Where does the internal ear extend from and do?
Oval window to internal acoustic meatus
66
What is the function of the internal ear?
Converts special sensory information into fluid waves then APs, conduct APs to brain
67
Why should you not use adrenaline around the ear?
Avascular elastic cartillage relies on nutrient from skin
68
What glands produce ear wax?
Ceruminous glands
69
Which nerve supplies the inferior arts of AM & tympanic membrane?
Vagus nerve (CN X)
70
Which nerves supply the helix and lobe of the ear?
C2, 3 spinal nerve
71
Which nerve supplies the tragus?
Facial nerve (CN VII)
72
Which nerve supplies suprior parts of the EAM & most of the tympanic membrane?
CN V3 (mandibular nerve)
73
Where does most of the auricle and lobe drain?
Superficial cervical lymph nodes
74
Where does the auricle all eventually drain?
Deep cervical lymph nodes
Thoracic duct or right lymphatic duct
Venous angle
75
How to straighten EAM in children?
Pull auricle posteroinferiorly
76
How to straighten EAM in adults?
Pull auricle posterosuperiorly
77
What is the most inwardly dpressed part of the tympanic membrane called?
Umbo
78
What is the pars tensa?
Thick part of the tympanic membrane
79
What is the pars fleccida?
Thin part of the tympanic membrane
80
What should be seen on otoscopic examination?
Umbo
Cone of light
Pars tensa & flaccida
81
Which nerve supplies the external surface of the tympanic membrane?
CN V3
82
Which nerve supplies the internal surface of the tympanic membrane?
CN IX
83
Where does glossopharyngeal nerve (CN IX) provide sensory innervation to?
Middle ear cavity
Eustachian tube
Nasopharynx
Oropharynx
84
What does the eustachian tube connect?
Middle ear cavity to nasopharynx
85
What is the difference in sensory supply between naso/oro & laryngopharynx?
```
Naso/oropharynx = CN IX
Laryngopharynx = CN X
```
86
What are the 3 auditory ossicles?
Malleus ("mallet")
Incus ("anvil")
Stapes ("stirrup")
87
How does the 3 auditory ossicles articulate?
Via synovial joints
88
What creates the umbo?
Handle of malleus adherent to tympanic membrane
89
Where is the epitympanic recess?
Superior ot the tympanic membrane
90
What is the chorda tympani a branch of?
Facial nerve (CN VII)
91
What does the chorda tympani supply?
Taste buds to anterior 2/3rds of tongue
| Parasympathetic supply to the mandibular & sublingual salivary glands
92
What is the function of the right stapedius?
Reduces stapes movement to protect the internal ear from excessive noise
93
What are the muscles of facial expression?
Frontalis
Orbicularis oculi
Elevators of lips
Orbicularis oris
94
What movements can be used to clinically assess muscles of facial expression?
Frown
Close eyes tightly
Smile
Puff out cheeks
95
What is contained within the otic capsule?
Bony labrinth - fluid (perilymph) filled spaces inside otic capsule
96
What is suspended within the perilymph of the bony labyrinth?
Membranous labyrinth
Communicating sacs and ducts
contains endolymph fluid
97
What is the cochlear duct/
A long balloon-like structure within the cochlea filled with endolymph
98
Which nerve conducts APs from the cochlea to the brain?
Cochlear nerve
99
Which nerve conucts APs from the semicircular duct to the brainstem?
Vestibular nerve
100
How is sound transmitted in the internal ear?
Sound wvaes make tympanic membrane vibrate
Vibrations transmitted through ossicles
Base of stapes vibrates in oval window
Vibration of stapes creates pressure waves in perilymph
Hair cells in the cochlea are moved, neurotransmitter released, APs stimulated and conveyed to brain by cochlear nerve
Pressure waves descend and become vibrations again
Pressure waves are dampened at the round window
101
Symptoms associated with pathology at the IAM?
```
Ipsilateral loss of facial expression
Dry mouth
Ipsilateral loss of taste
Reduced tragus sensation
Ipsilateral loss of hearing
Ipsilateral loss of balance
```
102
Why are the lingual veins important clinically?
Delivery of sublingual drugs
103
Where is the parotid duct?
Crosses masseter and pierces medially through buccinators and opens in the parotid papilla of the buccal mucosa
104
Where is the submandibular duct?
Deep to the mucosa of the floor of the mouht and opens on the subligual papilla
105
Where is the sublingual gland?
Deep to the mucosa of the floor of the mouth
106
What is the geniculate ganglion?
Bend in the facial canal & nerve where sensory ganglion of the facial nerve synapse
107
What is parasympathetic innervation to the parotid gland from?
CN IX
108
What newrve suplies special sensory to the anterior 2/3rds of the tongue?
CN VII
109
Which nerve supplies general sensory to the anterior 2/3rds of the tongue?
CN V3
110
What is the general and sensory supply to the posterior 1/3rd of the tongue?
CN IX
111
What is the foramen caecum?
Origin of the thyroid gland
112
What is the function of the extrinsic muscles of the tongue?
Change position of tongue (not shape)
113
What are the 4 extrinsic muscles of the tongue?
Palatoglossus (from soft palate)
Styloglossus (from styloid process)
Hyoglossus (from hyoid bone)
Genioglossus (from genial tubercles)
114
Which extrinsic muscles are supplied by CN XII?
Styloglossus
Hypoglossu
Genioglossus
115
Which nerve supplies palatoglossus?
CN X (as is technically a palate muscle)
116
What nerve supplies the intrinsic muscles of the tongue?
CN XII (hypoglossal)
117
How is the function of CN XII check clinically?
Stick out tongue (tongue will point towards the side of the injured nerve)
118
Where is the palatine tonsil?
Tonsillar fossa/sinus (space between the arches)
119
Where are ruggae found in the mouth?
Hardpalate
120
What kind of mucosa is on the hard palate?
Keratinised squamous
121
What kind of mucosa is on the soft palate?
Non-keratinised squamous
122
What are the 5 pairs of muscles of the soft palate?
```
Levator veli palatinin
Tensot veli palatini
Palatoglossus
Palatopharyngeus
Musculus uvulae
```
123
Which muscle supplies themaority of the palate muscles?
CN X
124
Which muscle supplies tensor veli palatini?
CN V3
125
Functions of the soft palate?
Stops food entering nose
irects ar into nose or mouth
Helps close off the entrance into the oropharynx during the gag reflex
126
How to clinically test CN X and CN V3?
Ask patient to say "Aahh"
| (Uvula wil be pulled aay from non-functioning side) `
127
Which nerve innervates the pharyngeal constrictor muscles?
CN X
128
Which pharyngeal muscle is supplied by IX?
Stylopharyngeus
129
Where do all the pharyngeal constrictor muscles insert?
Midline Raphe
130
What are the 3 longitudinal pharyngeal muscles?
Stylopharyngeus
Palatopharyngeus
Salpinopharyngeus
131
What are the pharyngeal tonsils also known as?
Adenoids
132
Which is the sentinel node of the tonsils?
Jugulo-digastric
133
What is enclosed within the pre-tracheal fascia of the neck?
The strap muscles
Thyroid muscles
Trachea & larynx
134
What is the function of the strap muscles?
Accessory muscles of breathing
135
What level is the cricoid cartillage?
Around C6
136
What is the first palpable spinous process?
C7
137
At what level does the larynx become the trachea?
C6
138
At wat levels does the pharynx become the oesophagus?
C6
139
Functions of the larynx
Produce sound
Maintain patency of URT
Help revent entry of foreign bodies into LRT
140
What is the epiglottis made of?
Elastic cartillage
141
What do the vocal chords attach to anteriorly?
Arytenoid processes
