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year 2 > ENT anatomy > Flashcards

ENT anatomy Flashcards

1
Q

what are the small hairs in the nasal cavity called

A

vibrissae

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2
Q

what kind of cartilage is nasal cartilage

A

hyaline

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3
Q

what bone forms part of the roof, lateral walls and septum of the nasal cavity

A

ethmoid bone

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4
Q

what bone separates the nasal cavities from the anterior cranial fossa

A

cribriform plate of the ethmoid bone

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5
Q

what fractures can disrupt the cribriform plate of the ethmoid bone

A

le fort II and III

basilar skull fractures

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6
Q

what cells line the nasal vestibule

A

stratified squamous epithelium (keratinised to non-keratinised)

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7
Q

what 2 types of lining are found in the nasal cavity

A 
respiratory epithelium (majority)
olfactory epithelium
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8
Q

what cells make up respiratory epithelium

A

ciliated pseudo-stratified columnar epithelium with goblet cells

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9
Q

what is the special sensory nerve of olfaction

A

CN I (olfactory nerve)

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10
Q 
olfactory pathway;
receptor cells in the \_\_\_\_ \_\_\_\_
pass up through the \_\_\_\_ \_\_\_\_
synapse with the \_\_\_\_ \_\_\_\_
neurones pass along the \_\_\_\_ \_\_\_\_
to the \_\_\_\_ lobe and \_\_\_\_\_ \_\_\_\_\_
A 
receptor cells in the olfactory epithelium
pass up through the cribriform plate
synapse with olfactory bulb (ganglion)
neurones pass along the olfactory tract 
to temporal lobe and olfactory areas
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11
Q

what are the 3 somatic sensory nerves to the nasal cavities

A

anterior ethmoidal nerve
nasopalatine nerve
greater palatine nerves

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12
Q

what is the anterior ethmoidal nerve a branch of

A

the nasocilliary nerve which is a branch of CN V1

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13
Q

what are the nasopalatine nerve and greater palatine nerves a branch of
what do they pass through?

A

branch of CN V2

sphenopalatine foramen

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14
Q

the sphenopalatine and greater palatine arteries are branches of

A

maxillary artery from ECA

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15
Q

the superior labial artery and lateral nasal and septal branches are branches of

A

facial artery from ECA

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16
Q

anterior and posterior ethmoidal arteries are branches of

A

ophthalmic artery from ICA

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17
Q 
what do you call the anastomosis between the septal branch of
- superior labial
- anterior and posterior ethmoidal
- greater palatine
- sphenopalatine
arteries and where is it found?
A

Kiesselbach’s area (little’s)

anteroinferiorly on nasal septum

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18
Q

which of the nasal concha has its own bone and isn’t part of the ethmoidal bone?

A

inferior

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19
Q

what is the sensory supply of the inferior concha

A

CN V2

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20
Q

what can an untreated septal haematoma lead to

A

AVN of septal cartilage (relies on nutrient diffusion)

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21
Q

what is another name for the maxillary sinuses

A

antra

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22
Q

what is the lining of the sinuses

A

respiratory

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23
Q

where does the sphenoid sinus drain

A

sphenoethmoidal recess

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24
Q

where do the posterior ethmoidal air cells drain

A

superior meatus

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25
Q

where do the anterior ethmoidal air cells drain

A

semilunar hiatus in the middle meatus

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26
Q

where do the middle ethmoidal air cells drain

A

ethmoidal bulla in the middle meatus

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27
Q

where does the maxillary sinus drain

A

semilunar hiatus in the middle meatus

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28
Q

where does the frontal sinus drain

A

semilunar hiatus in the middle meatus

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29
Q

where does the nasolacrimal duct drain

A

inferior meatus

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30
Q

what causes facial pain that is worse on bending forward

A

sinusitis

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31
Q

why might sinusitis be referred to the teeth presenting as tooth ache

A

sensation provided by CN V1 and CN V2

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32
Q

what sinus would be effected if the pain from sinusitis was felt between the eyes

A

ethmoidal air cells

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33
Q

give 2 things that interfere with cilia movement and cause less mucous to be drained out leading to infection

A

cold weather

smoking

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34
Q

what sinus is predisposed to infection and why

A

maxillary

ostium is located superiorly so cilia have to work against gravity

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35
Q

what is the pterion

A 
H shaped suture of 
frontal
parietal
temporal
sphenoid bones
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36
Q

what 2 nerves go through the internal acoustic meatus

A 
CN VII (facial nerve)
CN VIII (Vestibulocochlear nerve)
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37
Q

what is the nerve of balance and hearing

A

CN VIII (Vestibulocochlear nerve)

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38
Q

what is the motor nerve supply of the face

A

CN VII (facial nerve)

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39
Q

what 2 blood vessels go through the internal acoustic meatus

A

labyrinthine artery and vein

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40
Q

what is the taste supply to the anterior 2/3 of the tongue

A

CN VII (facial nerve)

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41
Q

what makes up the external ear

A

auricle to tympanic membrane via external acoustic meatus

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42
Q

what part of the ear converts special sensory information into fluid waves –> then APs –> then to brain

A

inner ear

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43
Q

what part of ear collects and conveys sound waves to tympanic membrane

A

external ear

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44
Q

what part of the ear contains the eustachian tube

A

middle ear

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45
Q

what part of ear amplifies and conducts sound waves to the inner ear

A

middle ear

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46
Q

what makes up the middle ear

A

tympanic membrane to oval window

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47
Q

what makes up the inner ear

A

oval window to internal acoustic meatus

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48
Q

what kind of cartilage makes up the external ear

A

elastic

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49
Q

what are the glands called that produce ear wax

A

ceruminous glands

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50
Q

how does the external ear cartilage get nutrients

A

avascular so gets nutrients from skin

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51
Q

what proportion of the ear canal is cartilage and what is bone

A

1/3 cartilage

2/3 bone

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52
Q

what lines the ear canal

A

skin

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53
Q

are there ceruminous glands in the ear canal?

A

yes

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54
Q

what is the nerve supply of most of the tympanic membrane (external surface)

A

CN V3 (auriculotemporal nerve branch)

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55
Q

what is the nerve supply of superior parts of the external acoustic meatus

A

CN V3 (auriculotemporal nerve branch)

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56
Q

what is the main sensory supply of the auricle and ear lobe

A

C2 and C3 cranial nerves

greater auricular nerve and lesser occipital nerve - branches of cervical plexus

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57
Q

what nerve supplies small amount of sensory innervation around external acoustic meatus entrance

A

CN VII (facial nerve)

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58
Q

what nerve supplies inferior parts of external acoustic meatus and some tympanic membrane (external surface)

A

CN X (vagus nerve)

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59
Q

where does drainage of the auricle end up

A

deep cervical lymph nodes in carotid sheath

then left to thoracic duct, right to right lymphatic duct at venous angles

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60
Q

what 3 groups of lymph nodes drain the auricle

A

parotid lymph nodes
mastoid lymph nodes
superficial cervical lymph nodes

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61
Q

how should the auricle be pulled in the otoscopic examination of

  • a child
  • an adult
A

child - posteroinferiorly

adult - posterosuperiorly

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62
Q

what is the name for the most inwardly depressed part of tympanic membrane

A

umbo

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63
Q

of the pars tensa and pars flaccida which is thicker

A

pars tensa - thick part of tympanic membrane

pars flaccida - thin part of tympanic membrane (superiorly)

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64
Q

what nerve would cause referred pain to the ear from

  • geniculate herpes
  • sphenoid damage
  • nasal pathology
A 
CN VII (facial nerve)
- post auricular branch
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65
Q

what nerve would cause referred pain to ear from

  • tonsillitis
  • posterior 1/3 tongue
  • pharyngitis
A 
CN IX (glossopharyngeal nerve)
- tympanic branch
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66
Q

what nerve would cause referred pain to ear from

- piriform fossa/larynx

A 
CN X (vagus nerve) 
- auricular branch
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67
Q

what nerve would cause referred pain to ear from

  • tooth ache
  • TMJ lesions
  • salivary gland disease
A

CN V3

- auriculotemporal nerve

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68
Q

what nerve supplies the internal surface of the tympanic membrane

A

CN IX (glossopharyngeal)

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69
Q

what nerve supplies sensory innervation to the middle ear

A

CN IX (glossopharyngeal)

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70
Q

what are the 3 bones contained in the middle ear

A

malleus
incus
stapes

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71
Q

what are the 2 muscles contained in the middle ear

A

stapedius

tensor tympani

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72
Q

what is the motor supply of the stapedius?

what is the sensory supply of the stapedius?

A 
CN VII (facial nerve
CN IX (glossopharyngeal nerve)
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73
Q

what is the motor supply of the tensor tympani

A

CN V3

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74
Q

what 2 nerve branches does the middle ear contain

A 
facial nerve (CN VII)
glossopharyngeal nerve (CN IX)
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75
Q

what kind of joints are the joints between the auditory ossicles

A

synovial joints

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76
Q

what forms the umbo

A

handle of malleus adherent to internal aspect of tympanic membrane

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77
Q

where does the base (footplate) of the stapes fit

A

into oval window

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78
Q

what part of the temporal bone is the tympanic cavity located

A

petrous part

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79
Q

what is the connection from the epitympanic recess to the mastoid process called

A

aditus

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80
Q

what is the promontory

A

bony swelling on medial wall of tympanic cavity formed by cochlea of internal ear

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81
Q

what is the name of the tube that connects the anterior wall of the middle ear cavity to nasopharynx

A

eustachian tube

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82
Q

what is the sensory supply of the eustachian tube

A

CN IX (glossopharyngeal)

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83
Q

what is the sensory supply of the laryngopharynx

A

CN X (vagus nerve)

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84
Q

what nerve should be checked in any facial swelling

A

facial nerve

85
Q

where is the connection of the facial nerve to the CNS

A

pontomedullary junction (only CN VII and CN VIII)

86
Q

what cranial nerve has the longest base of skull foramen part of course

A

facial nerve

87
Q

why might food be less pleasurable if the facial nerve was affected

A

supplies taste buds of anterior 2/3 of tongue via chorda tympani branch

88
Q

why might you get dry eyes leading to infection in a facial nerve palsy

A

facial nerve supplies orbicularis oculi - muscle of facial expression responsible for blinking

89
Q

what gland does the facial nerve pass into

A

parotid gland

90
Q

true or false

the facial canal courses through petrous temporal bone of both internal and middle ear

A

true

91
Q

what is the smallest skeletal muscle in the body

A

stapedius

92
Q

what is the parasympathetic supply of the submandibular and sublingual salivary glands (secretomotor)

A

chorda tympani - branch of CN VII - joins with lingual nerve of CN V3

93
Q

the motor function of what nerve would be tested by asking a patient to frown, close eyes tightly, smile and maintain puffed out cheeks

A

CN VII (facial nerve)

94
Q

loss of what in the face in illness is an indication of malnutrition

A

buccal fat pad

95
Q

what is the name of the border of the lips

A

vermillion border

96
Q

what is the name of a facial nerve palsy

A

bells palsy

97
Q

what fluid is contained in the bony labyrinth of the otic capsule

A

perilymph (like ECF)

98
Q

what does the membranous labyrinth float in

A

perilymph

99
Q

what fluid is contained in the membranous labyrinth of the otic capsule

A

endolymph (like ICF)

100
Q

how many turns is the cochlea

A

2.5

101
Q

what is the cupula

A

apex of spiral of cochlea

102
Q

what nerve conducts APs to brainstem from cochlear duct

A

cochlear nerve (branch of CN VIII)

103
Q

what nerve conducts APs to brainstem from semicircular ducts

A

vestibular nerve (branch of CN VIII)

104
Q

what detects angular movement change

A

semicircular ducts

105
Q

what detects liner movement change

  • horizontal
  • vertical
A

horizontal - utricle

vertical - saccule

106
Q

how are hair cells in the vestibular apparatus stimulated

A

movement of endolymph

107
Q

what detects auditory stimuli

A

receptor cells in organ of corti in cochlear apparatus

located on basilar membrane of cochlear duct

108
Q

what are the 2 parts of the cochlear canal

A

scala vestiboli and scala tympani

109
Q

sound transmission
sound waves make _ _ vibrate
vibrations are transmitted through _
base of _ vibrates in _ window
vibration of stapes creates pressure waves in _
_ cells in cochlea are moved –> APs are stimulated and conveyed to brain by _ nerve
pressure waves descend and become vibrations again
pressure waves are dampened at the _ window

A

sound transmission
sound waves make tympanic membrane vibrate
vibrations are transmitted through ossicles
base of stapes vibrates in oval window
vibration of stapes creates pressure waves in perilymph
hair cells in cochlea are moved –> APs are stimulated and conveyed to brain by cochlear nerve
pressure waves descend and become vibrations again
pressure waves are dampened at the round window

110
Q

where do vestibular nerve axons come from

A

semicircular ducts, saccule and utricle

111
Q

what are the muscles of the floor of the mouth

A

geniohyoid and mylohyoid

112
Q

what is the nerve supply of the geniohyoid

A

C1 via hypoglossal nerve

113
Q

what is the nerve supply of the mylohyoid

A

CN V3

114
Q

what muscle does the parotid duct pierce

A

buccinator

115
Q

where does the parotid duct secrete

A

by the upper 2nd molar

116
Q

which duct enters floor of mouth and secretes via lingual caruncle

A

submandibular

117
Q

which glands lay in floor of mouth and secrete via several ducts superiorly

A

sublingual

118
Q

what is the parasympathetic nerve supply to the submandibular gland (secretomotor)

A

CN VII

119
Q

what is the parasympathetic nerve supply to the parotid gland

A

CN IX (hitches a ride on auriculotemporal branch of CN V3)

120
Q

what supplies taste and general sensory to posterior 1/3 tongue

A

CN IX

121
Q

what supplies general sensory to anterior 2/3 tongue

A

CN V3

122
Q

what are the 3 papillae with taste buds

A

follate vallate fungiform

123
Q

what is the papillae without taste buds

A

filiform

124
Q

what is the problem in someone who is ‘tongue tied’

A

frenulum is too short

125
Q

what are the 4 extrinsic muscles of the tongue

A

hyoglossus
palatoglossus
styloglossus
genioglossus

126
Q

what is the nerve supply of the palatoglossus

A

CN X

127
Q

what is the nerve supply of the hyoglossus, styloglossus and genioglossus

A

CN XII (hypoglossal nerve)

128
Q

where does the hypoglossal nerve attach to the CNS

A

many rootlets at medulla oblongata

129
Q

what nerve is clinically tested by asking a person to stick their tongue straight out and what would happen in a palsy of this nerve?

A

nerve tested - hypoglossal CN XII
normal - tongue remains in midline
if unilateral damage, the tongue will point towards the side of injured nerve

130
Q

what foramen does the hypoglossal nerve travel through

A

hypoglossal canal

131
Q

arteries pass medial/lateral to the hyoglossus

nerves pass medial/lateral to the hyoglossus

A

arteries pass medial

nerves pass lateral

132
Q

the lingual artery is a branch of the

A

ECA

133
Q

what are the regional lymph nodes of the tongue

A

submental nodes

134
Q

what cells make up the hard palate

A

keratinised squamous epithelium

135
Q

what passes through the greater and lesser palatine foramina

A

branches of CN V2 and maxillary artery

136
Q

what cells make up the soft palate

A

non-keratinised stratified squamous epithelium

137
Q

what is the muscle that tenses the soft palate (tenses the palatine aponeurosis)

A

tensor veli palatini

138
Q

what is the muscle that lifts the soft palate (lifts palatine aponeurosis)

A

levator veli palatini

139
Q

what is the muscle that lifts pharynx and thyroid cartilage

A

palatopharyngeus (posterior arch)

140
Q

what is the muscle that brings tongue and soft palate together

A

palatoglossus (anterior arch)

141
Q

what is the muscle that shortens the uvula

A

musculus uvulae

142
Q

what nerve innervates the muscles of the soft palate except the tensor veli palatini

A

CN X

143
Q

what nerve innervates the tensor veil palatini

A

CN V3

144
Q

how do you clinically test the CN X innervation of the soft palate
what is seen in a nerve palsy

A

get patient to say ahh
normally uvula should lift straight up
if unilateral damage the uvula will be pulled away from the non-functioning side

145
Q

what are the outer circular muscles of the pharynx

are they skeletal?

A

3 constrictor muscles

skeletal (voluntary)

146
Q

what does sequential contraction of these muscles do

A

pushes food bolus inferiorly towards the oesophagus

147
Q

what nerve innervates the outer circular muscles of the pharynx

A

CN X

via pharyngeal plexus

148
Q

where do the outer circular muscles of the pharynx insert posteriorly

A

midline raphe

149
Q

what are the 3 paired inner longitudinal muscles of the pharynx

A

stylopharyngeus
palatopharyngeus
salpingopharyngeus

150
Q

what nerve innervates all of the pharyngeal muscles except for stylopharyngeus

A

CN X

151
Q

what nerve innversates the stylopharyngeus

A

CN IX

152
Q

what is the function of the inner longitudinal muscles of the pharynx

A

elevate pharynx and larynx

153
Q

what is the opening that connects the pharynx to the larynx

A

laryngeal aditus

154
Q

what lymph nodes drain the palatine tonsil

A

jugulo-digastric node

155
Q

where are the deep cervical nodes found

A

in the carotid sheath

156
Q

features of an infected node

A 
swollen
painful
soft
smooth
not fixed to adjacent structures
improves with antibiotics
157
Q

features of a cancerous node

A 
swollen
not painful
hard
irregular
fixed to adjacent structures
doesn't improve with antibiotics
158
Q

what is the motor innervation of the larynx

A

CN X

159
Q

what fascia is the larynx found in

A

visceral layer of pre tracheal fascia

160
Q

the strap muscles, thyroid, trachea, larynx, oesophagus and pharynx and recurrent laryngeal nerves are all found in what fascia

A

pretracheal

161
Q

what is the name of the space between the epiglottis and tongue

A

vallecula

162
Q

what is the name of where the vocal cords meet

A

anterior commissure

163
Q

what are the true vocal cords

A

vocal processes of arytenoid cartilage to thyroid cartilage

164
Q

what are the false vocal cords

A

between arytenoid cartilage to epiglottis (vestibular folds)

165
Q

are the true or false vocal cords more superior

A

false

166
Q

what kind of epithelium are the true vocal cords

A

stratified squamous epithelium

167
Q

what nerve innervates the intrinsic skeletal muscles of the larynx

A

CN X

168
Q

tension of the vocal cords does what to sound

A

increases pitch

169
Q

relaxation of the vocal cords does what to sound

A

decreases pitch

170
Q

adduction of the vocal cords does what to sound

A

quieter

171
Q

abduction of the vocal cords does what to sound

A

louder

172
Q

what muscles are the tensors of the vocal cords

A

cricothyroid muscles

173
Q

what muscles are the relaxers of the vocal cords

A

thyroarytenoid muscles

174
Q

what muscles are the adductors of the vocal cords

A 
lateral circo-arytenoid muscles
arytenoid muscles (oblique and transverse bands)
175
Q

what muscles are the abductors of the vocal cords

A

posterior circo-arytenoid muscles

176
Q

what larynx muscles contract in forced respiration

A

posterior circo-arytenoid muscles

177
Q

what larynx muscles contract in phonation

A

arytenoids contract - assist lateral crico-arytenoid muscles

178
Q

what larynx muscles contract in whispering

A

lateral circo-arytenoid muscles

179
Q

where would a supraglottic tumour drain

A

superior deep cervical lymph nodes

180
Q

where would a glottic tumour present

A

on vocal cords

181
Q

how might a glottic tumour present

A

voice changes / airway obstruction

182
Q

where would a subglottic tumour spread

A

paratracheal nodes

183
Q

how might a subglottic tumour present

A

voice changes / airway obstruction

184
Q

what nerve would cause the soft palate to tense and elevate in oral sounds (most vowels and consonants) or descend in nasal sounds (m n or ing)

A

soft palate tense - CN V3

and elevate/descend - CN X

185
Q

what nerve causes the tongue to interrupt sound

A

CN XII

186
Q

what nerve causes the teeth/lips to interrupt sound

A

CN VII

187
Q

CN X supplies the larynx
3 of its branches are the inferior, internal and external laryngeal nerves
what do they supply specifically?

A 
inferior = all intrinsic muscles except cricothyroid and mucosa below folds
internal = mucosa above folds
external = motor to cricothyroid muscle
188
Q

how can you clinically test the CN X to the pharynx

A

ask patient to swallow water and watch larynx move up and down - do they splutter?

189
Q

how can you clinically test the CN X to the larynx

A

listen to patient speak

ask patient to cough - is it normal and powerful? - also requires functioning diapragm etc

190
Q

what foramen does CN X pass through

A

jugular foramen

191
Q

how does CN X descend in the neck

A

in carotid sheath

192
Q

when do pharyngeal arches develop

A

weeks 4/5

193
Q

what are the pharyngeal clefts made up of

A

ectoderm

194
Q

what are the pharyngeal pouches made up of

A

endoderm

195
Q

what prevents anterior dislocation of the TMJ

A

zygomatic process

196
Q

where does the TMJ sit

A

mandibular fossa

197
Q

what kind of fracture can damage the nasolacrimal duct

A

Le fort I

198
Q

how would infection spread from the middle ear to the mastoid process causing mastoiditis

A

aditus

199
Q

what bones make up the anterior cranial fossa

A

frontal
ethmoid
sphenoid

200
Q

what bones make up the middle cranial fossa

A

sphenoid
temporal
parietal

201
Q

what bones make up the posterior cranial fossa

A

temporal
occipital
parietal

202
Q

what vertebra level is the hyoid bone

A

C3

203
Q

what vertebra level is the cricoid cartilage

A

C6

204
Q

what vertebra level is the larynx –> trachea

A

C6

205
Q

what vertebral level is the pharynx –> oesophagus

A

C6

206
Q

what kind of joint is the cricothyroid joint

A

synovial

207
Q

what muscle makes up the upper oesophageal sphincter

A

cricopharyngeus

208
Q

what is the name of the smooth muscle completing the posterior wall of the trachea

A

trachealis

209
Q

what is the secretomotor supply to the lacrimal gland

A

CN VII

year 2 (19 decks)

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