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ENT > ENT Embryology + Anatomy > Flashcards

ENT Embryology + Anatomy Flashcards

1
Q

When do the pharyngeal arches develop?

A

Weeks 4 & 5 gestation

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2
Q

On what day does Arch 1 begin to develop?

A

Day 22

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3
Q

On which day do arches 2 & 3 begin to develop?

A

Day 24

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4
Q

On which day do arches 4 and 6 begins to develop?

A

Day 29

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5
Q

What separates the arches externally?

A

Pharyngeal clefts

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6
Q

What separates the arches internally?

A

Pharyngeal pouches

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7
Q

What lines the pharyngeal clefts?

A

Ectoderm

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8
Q

What lines the pharyngeal pouches?

A

Endoderm

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9
Q

What does the mesenchyme of the arches form?

A

Musculature of the face

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10
Q

What does the neural crest of the arches form?

A

Skeletal components of the face

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11
Q

What does the artery in the arches form?

A

Aortic arches

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12
Q

Which CNs cover arch 1?

A

CNV2, V3

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13
Q

Which CNs cover arch 2?

A

CNVII

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14
Q

Which CNs cover arch 3?

A

CNIX

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15
Q

Which CNs cover arch 4?

A

Superior laryngeal branch of CNX

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16
Q

Which CNs cover arch 6?

A

Recurrent laryngeal branch of CN X

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17
Q

What does Meckel’s cartilage give rise to?

A

Inchus, malleus and mandible

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18
Q

Where does Meckel’s cartilage develop from?

A

Ventral portion/mandibular process of the first arch

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19
Q

What does the dorsal portion of the first arch give rise to?

A

Zygoma; maxilla and part of the temporal bone.

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20
Q

Which muscles does arch 1 give rise to?

A

Muscles of mastication; anterior belly of digastric muscle, mylohyoid, tensor tympani and tensor palatine.

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21
Q

Which muscles does arch 2 give rise to?

A

Muscles of facial expression, stapedius, stylohyoid, posterior belly of digastric and auricular.

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22
Q

What muscle does arch 3 give rise to?

A

Stylopharyngeus

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23
Q

What do arches 4 and 6 give rise to?

A

Laryngeal cartilages

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24
Q

What does the 1st pharyngeal cleft form?

A

External auditory meatus

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25
Q

What do the 2nd - 4th pharyngeal clefts form?

A

Cervical sinus

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26
Q

What does the 1st pharyngeal pouch form?

A

Middle ear, Eustachian tube and tympanic membrane

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27
Q

What does the 2nd pharyngeal pouch form?

A

Palatine tonsil

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28
Q

What does the 3rd pharyngeal pouch give rise to?

A

Inferior parathyroid gland and thymus

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29
Q

What does the 4th pharyngeal pouch give rise to?

A

Superior parathyroid gland and the C cells of the thyroid gland

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30
Q

What does the inner ear develop from?

A

Otic placodes

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31
Q

What do the semi-circular canals develop from?

A

Utricular part of the otic vesicle

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32
Q

What is the modiolus?

A

A spongy bone structure which acts as the axis of the cochlea

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33
Q

What is the bony nasal septum made of?

A

Ethmoid bone superiorly, vomer inferiorly

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34
Q

What is the function of ostia?

A

Drain mucous into the nasal cavity

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35
Q

Where are the ostia?

A

On the lateral walls of the nasal septum

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36
Q

Describe the mucosa of the nasal cavity.

A

Immediately past the nostril -kertatinised stratified squamous epithelium
Main body - respiratory epithelium
Superior and deep top corner - olfactory

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37
Q

Which nerve passes through the cribiform plate?

A

CN I, olfactory

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38
Q

What is the olfactory bulb?

A

A ganglion containing the cell bodies of the second neurones of CN I

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39
Q

Where are the olfactory bulbs?

A

On either side of the crista galli

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40
Q

Which nerves supply the nasal cavity?

A

CNVI superioposterior

CNV2 posteroinferior

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41
Q

From which arteries do the maxillary and facial arteries come from.

A

Ext and int carotids

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42
Q

What does the ophthalmic artery branch into?

A

Anterior and posterior ethmoidal arteries

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43
Q

Which arteries does the maxillary artery give off?

A

sphenopalatine and great palatine

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44
Q

What artery does the facial artery give off?

A

The lateral nasal branch of the facial artery

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45
Q

What is Kiesselbach’s / Little’s area?

A

Arterial anastomoses on the nasal septum which is a common site for nosebleeds.

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46
Q

How many conchae are in the nose and what are they called?

A

3

Superior, middle, inferior

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47
Q

What is the purpose of the conchae?

A

Increase surface area and increase turbulence to warm/humidify air

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48
Q

What are meatuses?

A

Spaces under each concha

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49
Q

Where is the sphenoethmoidal recess?

A

The superior part of the nasal cavity

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50
Q

How should an NG tube be placed and what needs to be considered?

A

Avoid Kiesselbach’s area to avoid epistaxis
Passed through nasopharynx without going into the Eustachian tube
Run through oeseophagus (not trachea)
10cm past GOJ
Radiograph to confirm placement

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51
Q

What are the paranasal sinuses?

A

Air filled spaces within bones

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52
Q

What are the paranasal sinuses lined with?

A

Mucous secreting respiratory mucosa

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53
Q

Where do the frontal sinuses drain to?

A

Middle meatus

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54
Q

Where do ethmoidal air cells drain to?

A

Superior and middle meatuses

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55
Q

Where do sphenoidal sinuses drain to?

A

Sphenoethmoidal recess

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56
Q

What is sinusitis?

A

Inflammation of the paranasal sinuses

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57
Q

What is the most common location of sinusitis?

A

Maxillary sinuses (Antra)

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58
Q

Why is the most common location of sinusitis the antra?

A

The ostia of this sinus is superiorly on the medial wall so mucous has to be drained against gravity

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59
Q

What procedure can result in maxillary sinusitis, why?

A

Tooth extraction as it may result in an oro-antral fistula allowing infection spread

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60
Q

What is the pterion?

A

The thinnest part of the skull. It is H shaped suture where frontal, parietal and temporal bones meet

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61
Q

What makes up the anterior fossa of the cranial cavity ?

A

Spenoid, ethmoid and frontal bones

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62
Q

What nerve comes out of the anterior fossa of the cranial cavity?

A

CN I, olfactory

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63
Q

Where is the cribiform plate of the ethmoid bone housed in the cranial cavity?

A

Anterior fossa

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64
Q

Which bones make up the middle cranial fossa?

A

Temporal and sphenoid

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65
Q

Which nerves come out of the middle cranial fossa?

A

CN II - VI

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66
Q

Which openings are present in the middle cranial fossa?

A

Optic canal, superior orbital fissure, foramen rotundum, foramen ovale, opening of carotid canal

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67
Q

Which bones make up the posterior cranial fossa?

A

Parietal and occipital

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68
Q

Which nerves come out of the posterior fossa?

A

CN VII-XII

69
Q

Which openings are present in the posterior cranial fossa?

A

Internal acoustic meatus, jugular foramen and hypoglossal canal

70
Q

What is the external ear?

A

The part of the ear from the auricle to the tympanic membrane via the external acoustic meatus

71
Q

What is the middle ear?

A

From the tympanic membrane to the oval window, including the Eustachian tube

72
Q

What is the function of the external ear?

A

To collect sound waves and amplify them to the tympanic membrane

73
Q

What is the function of the middle ear?

A

To amplify sound and conduct it to the internal ear

74
Q

What is the internal ear?

A

From the oval window to the internal acoustic meatus

75
Q

What is the purpose of the internal ear?

A

Convert special sensory information into fluid waves, then APs

76
Q

Name the three parts of the auricle.

A

Helix, tragus and ear lobe.

77
Q

What is the sensory nerve nerve supply of the posterior helix?

A

C2, 3

78
Q

What is the sensory nerve supply of the medial part of the anterior helix?

A

CN V3, mandibular division of the trigeminal nerve

79
Q

What is the sensory nerve supply of the tragus?

A

CN X, vagus with some CN VII, facial

80
Q

What is the sensory supply of the tympanic membrane?

A

Mostly CNV3, mandibular division of the trigeminal nerve?

81
Q

Which lymph nodes does the auricle drain to?

A

Patorid, mastoid and superficial then all to deep cervical then thoracic duct then venous angle

82
Q

What is the external ear made up of?

A

The temporal bone and hyaline cartilage

83
Q

Describe the blood supply of the cartilage of the auricle?

A

Avascular

84
Q

Which glands produce ear wax?

A

Ceruminous glands

85
Q

What is the sensory supply of the nasopharynx, oropharynx and tonsils?

A

CNIX, glossopharyngeal

86
Q

Which type of joint articulates the ossicles?

A

Synovial

87
Q

Name the three ossicles.

A

Incus, stapes and malleus

88
Q

What is the umbo?

A

The central, most inverted part of the ear drum

89
Q

How is the umbo created?

A

By the handle of the malleus adhering to the internal tympanic membrane.

90
Q

Which bone fits into the oval window?

A

The stapes

91
Q

What is the area past the tympanic membrane called?

A

Tympanic cavity proper

92
Q

What is superior to the tympanic cavity proper?

A

Epitympanic recess

93
Q

What does the Eustachian tube connect?

A

Middle ear to the nasopharynx

94
Q

What is a down-side of the Eustachian tube?

A

Easy to spread infection

95
Q

What is the aditus?

A

A doorway into the mastoid antrum from the epitympanic recess

96
Q

Where does the facial nerve come off the brainstem?

A

Between the pons and the medulla

97
Q

Describe the route of the facial nerve from brainstem to middle ear.

A

Comes off of brainstem; passes into the internal acoustic meatus in the posterior cranial fossa; through facial canal in petrous temporal bone; stylomastoid foramen; middle ear

98
Q

What is the petrous part of the temporal bone?

A

pyramid-shaped and is wedged in at the base of the skull between the sphenoid and occipital bones

99
Q

What nerve supplies the stapedius?

A

CN VII

100
Q

What nerve supplies the taste buds of the anterior 2/3rds of the tongue?

A

Chorda tympani, branch of CNVII, facial

101
Q

Which nerve give parasympathetic innervation to the submandibular and sublingual glands?

A

Chorda tympani, branch of CN VII, facial

102
Q

Which muscle of facial expression moves the forehead?

A

Frontalis

103
Q

Which muscle of facial expression moves the eye?

A

Orbicularis occuli

104
Q

Which muscle of facial expression moves the mouth?

A

Orbicularis oris

105
Q

In what scenario is the buccal fat pad lost?

A

Malnutrition

106
Q

What does the otic capsule contain?

A

Bony labyrinth which is filled with perilymph

107
Q

What makes up the bony labyrinth?

A

Semi-circular canals and the cochlea

108
Q

What is the cupula?

A

Apex of the cochlea

109
Q

What does the perilymph contain?

A

Membranous labyrinth

110
Q

What is the membranous labyrinth?

A

Communicating sacs and ducts containing endolymph

111
Q

Describe the transmission of sound in the ear.

A

Sound makes tympanic membrane vibrate
Vibrations transmitted along ossicles
Base of stapes in oval window vibrates to create a pressure wave in the perilymph
Hair cells in the cochlea move which releases a neurotransmitter
AP transmitted to the brain by cochlear nerve

112
Q

What happens to the pressure waves formed on sound transmission?

A

They descend and revert to vibrations which are dampened at the round window

113
Q

Where is the round window?

A

Below the oval window

114
Q

Where do CNVII and CNVII connect?

A

Junction between the pons and medulla oblongata

115
Q

What does the mandibular prominence give rise to?

A

Lower lip

116
Q

What does the frontonasal prominence give rise to?

A

Bridge and nasal septum

117
Q

What do the medial nasal prominences give rise to?

A

Crest and tip of nose

118
Q

On which prominence do the medial and lateral nasal swellings come from, and when?

A

Fronotnasal, week 5

119
Q

Which segment gives rise to the philtrum?

A

Intermaxillary segment

120
Q

What is the anterior border of the oral cavity?

A

Teeth

121
Q

What is the posterior border of the oral cavity?

A

Oropharynx

122
Q

What is the superior border of the oral cavity?

A

Hard and soft palates

123
Q

Which muscles are in the floor of the mouth?

A

Mylohyoid, geniohyoid, anterior belly of digastric

124
Q

What connects the tongue to the mucosa of the floor?

A

Frenulum

125
Q

What are the spaces on either side of the frenulum?

A

Sublingual folds

126
Q

Where are the minor salivary glands?

A

Oral mucosa, lips, cheeks, palate

127
Q

How does the parotid duct get to the buccal mucosa?

A

Crosses the masseter, through the buccinators, opens on the parotid papilla on the buccal mucosa

128
Q

Which nerve supplies parasympathetic secretomotor innervation to the parotid gland?

A

CN IX, glossopharyngeal

129
Q

Which nerve supplies parasympathetic secretomotor innervation to the submandibular and sublingual glands?

A

CNVII, facial

130
Q

Describe the innervation of the tongue.

A

Anterior 2/3rds: CNVII for special sensory, CNV3 for general sensory

Posterior 1/3rd: general and special sensory from CN IX, glossopharyngeal

131
Q

Which structure is the origin of the thyroid gland?

A

Foramen caecum

132
Q

Name the extrinsic tongue muscles

A

Styloglossus, hyoglossus, genioglossus

133
Q

How many pairs of intrinsic tongue muscles are there?

A

4

134
Q

Describe the course of the hypoglossal nerve to the muscles of the tongue

A

Medulla oblongata to hypoglossal canal in the posterior cranial fossa
Through occipital bone, descends in the carotid sheath
Passes anteriorly to the lateral aspect of the tongue

135
Q

How do you test CN XII, hypoglossal nerve function?

A

Get patient to stick tongue out, in midline good, if pathology it deviates toward the affected side

136
Q

Name the 5 pairs of muscles in the soft palate

A

Levator veli palatini, tensor veli palatini, palatoglossus, palatopharyngeus, musculus uvulae

137
Q

What is the function of levator veli palatini?

A

Lift the soft palate

138
Q

What is the function of tensor veli palatini?

A

Tense the soft palate

139
Q

Which nerve supplies the muscles of the soft palate?

A

CNX, vagus - except tensor veli palatini which is CNV3.

140
Q

How to test nerve supply to soft palate?

A

Get patient to say “ahhh”, damage to CNV3 or CNX will result in uvula deviating AWAY from pathological side

141
Q

Which nerve innervates external layer on constrictor muscles in the pharynx?

A

CNX (pharyngeal plexus of)

142
Q

Where do all of the constrictor muscles on the pharynx insert?

A

Midline raphe

143
Q

Name the longitudinal muscles of the pharynx.

A

Stylophayngeus (styloid process) palatopharyngeous (palate), salpingopharyngeus (cartilage of pharyngotympanic tube)

144
Q

Which nerve innervates palatopharyngeus and salpingopharyngeus?

A

CNX

145
Q

Which nerve innervates stylopharyngeus?

A

CN IX

146
Q

Which tonsils are included in Waldeyer’s ring?

A

Adenoid (nose) tonsil; tubual tonsils (Eustachian tube); palate-associated-lymphoid-tissue; lingual tonsil (post 1/3 tongue) and palatine tonsil (tonsillar fossa)

147
Q

At what level is the larynx?

A

C4-C6

148
Q

What is the function of the pharynx?

A

Maintain patency of URT, prevent entry of foreign bodies into LRT and produce sound

149
Q

Which layer of fascia in the pharynx in?

A

Pre-tracheal fascia

150
Q

What other structures are in the pre-tracheal fascia?

A

Thyroid gland, trachea, oesophagus, pharynx and recurrent laryngeal nerves

151
Q

What are the true vocal cords?

A

Vocal processes of the arytenoid cartilage to thyroid cartilage

152
Q

What are the false vocal cords?

A

Arytenoid cartilage to the epiglottis

153
Q

What is the rima glottidis?

A

Space between the true vocal cords

154
Q

What is the function of the intrinsic muscles of the larynx?

A

To move the vocal cords

155
Q

What nerve innervates the intrinsic muscles of the larynx?

A

CN X, vaugs

156
Q

What happens when the vocal cords tense?

A

Pitch increases

157
Q

What happens when the vocal cords adduct?

A

Sound is quieter

158
Q

Which muscles contract to abduct the cords?

A

Posterior crico-arytenoids

159
Q

Which muscles contract to adduct the cords?

A

Arytenoids

160
Q

Which muscles contract in whispering?

A

Lateral cricothyroids

161
Q

Where would a supra-glottis tumour drain?

A

Superior deep cervical nodes

162
Q

How do glottis tumours present?

A

Voice changes and airway obstruction

163
Q

Where would a sub-glottis tumour drain?

A

Paratracheal nodes

164
Q

What happens on controlled expiration?

A

Contraction of anterolateral abdo wall, contraction of inspiratory intercostal muscles
This builds subglottal pressure

165
Q

What is required for phonation?

A

Subglottal pressure to reach a set threshold

166
Q

What are the intrinsic muscles supplied by?

A

inferior laryngeal nerve

167
Q

What is mucosa above the vocal folds innervated by?

A

Internal laryngeal nerve

168
Q

What is mucosa below the vocal folds innervated by?

A

Recurrent laryngeal

ENT (2 decks)

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