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Gross Anatomy 2 > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

Relating to the covering of an organ

A

Visceral

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1
Q

Relating to the lining of a body cavity

A

Parietal

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2
Q

Motor innervation to the face muscles are from what?

Sensory?

A

Facial nerve CN VII

Trigeminal nerve CN V “great sensory nerve”

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4
Q

What are the three major branches of the Trigeminal nerve before emerging into the face and where do they distribute to?

A

Ophthalmic Nerve - face and scalp

Maxillary Nerve - cheek and lateral to the orbit

Mandibular Nerve - chin and temporal region

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5
Q

What is the name for facial nerve paralysis?

A

Bell’s Palsy

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6
Q

What are the 5 subdivisions of the Opthalmic Nerve? Describe them

A 
Supraorbital
Supratrochlear
External Nasal Nerve
Infratrochlear Nerve
Lacrimal Nerve
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7
Q

Which nerve is very long out of the foramen above orbit. Scapula innervated

Shorter, above the trochlea of orbit, supplies eye and nose

external nose

below trochlea of orbit supplies medial orbit

lacrimal apparatus

A

Supraorbital Nerve

Supratrochlear Nerve

External Nasal Nerve

Infratrochlear Nerve

Lacrimal Nerve

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8
Q

What are three subdivisions of the Maxillary nerve?

A

Zygomaticotemporal Nerve
Zygomaticofacial Nerve
Infraorbital Nerve

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9
Q

Which nerve supplies the lateral to eye brow and is small?

SUpplies cheek region?

Large, infraorbital foramen, supplies region below eye and is most frequently inured in blows from boxing

A

Zygomaticotemporal Nerve

Zygomaticofacial Nerve

Infraorbital Nerve

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10
Q

What are the three subdivisions of the Mandibular nerve?

A

Auriculotemporal nerve

Buccal Nerve

Mental Nerve

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11
Q

Describe Trigeminal Neuralgia (Tic Doloureaux)

A

Condition of sudden attacks of severe pain occurring in an area of sensory distribution of the trigeminal nerve. hyper sensitive.

most common in maxillary division, second most is mandibular region

cause is unknown

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12
Q

Where does the sensory information of the posterior aspect of the neck and scalp come from?

A

Dorsal primary rami of cervical nerves 2-4

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13
Q

Name of posterior primary rams of C2 that supplies the occipital region?

Posterior primary rams of C3 and supplies upper part of the back and neck

Posterior Primary rams of C4 supplies lower part of back of the neck

A

Greater Occipital Nerve

Third Occipital Nerve

No name

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14
Q

Does C1 nerve have a posterior root carrying sensory fibers?

A

No it is only motor nerve

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15
Q

Where does the sensory innervation of the anterior and lateral aspect of the neck come from?

A

Ventral primary rami of cervical nerves 2-4

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16
Q

Which nerves roots make up the Cervical plexus? Brachial Plexus

A

C1-4

C5-8

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17
Q

What are the four sensory branches of the Cervical Plexus?

A

Lesser Occipital Nerve C2

Great Auricular Nerve C2,C3

Transverse Cervical Nerve C2.C3

Supraclavicular Nerve C3 C4

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18
Q

What does the lesser occipital nerve supply?

Great Auricular Nerve?

Transverse Cervical Nerve

Supraclavicular ?

A

lateral part of occipital region posterior to ear

angle of mandible, area inferior to ear, accompanies jugular vein

anterior surface of the neck (throat)

lateral surface of neck and shoulder,

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19
Q

What are the three subdivisions of the Supraclavicular Nerve?

A

Medial Supraclavicular Nerve
Intermediate Supraclivicular Nerve
Lateral Supraclivicular Nerve

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20
Q

Where do the motor branches of the cervical plexus carry fibers to? where do they arise from? (loop)

A

infrahyoid (strap) muscles)

Ansa Cervicalis

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21
Q

Describe the superior root of the Ansa Cervicalis

A

From C1 or C1&C2. descends from the hypoglossal nerve to join the inferior root

From C2 & C3. descends from cervical nerve branches to join the superior root

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22
Q

Which muscles are supplied by the ansa cervicalis (C1,2,3)?

A

three of the four infra hyoid muscles: sternohyoid, sternothyroid, and omohyoid

thyrohyoid receives innervation from C1 fibers through hypoglossal nerves

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23
Q

What is the Phrenic nerve considered a part of?

Originates from which Levels?

Motor to what? Sensory to What?

Where does it lie and run?

A

considered part of cervical plexus

originates from C3, C4, and C5

motor to the diaphragm and sensory to some of the membranes of the thorax and abdomen

found lying on anterior surface of the anterior scalene muscle. runs vertically down the muscle into the thorax

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24
Q

Platysma OINF

A

superficial fascia over the pectorals major and deltoid muscles

lower border of the mandible and the angle of mouth

cervical branch of facial nerve (CN VII)

Function: depresses the mandible and draws down the corner of mouth

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25
Q

Sternocleidomastoid OINF

A

Sternal head from front of manubrium, clavicular head from medial third of clavicle

lateral surface of mastoid process, lateral half of the superior nuchal line

accessory nerve (CN XI)

chief flexor of the head

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26
Q

Describe Torticollis

what are the three types?

A

Pathological contraction of the sternocleidomastoid where head is tilted toward & face turned away from the affected side

Congenital : fibrous tissue tumor develop before birth

Muscluar : due to birth injury

Spasmodic : adults due to abnormal tonicity, responds well to chiro care

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27
Q

Trapezius OINF

A

EOP, ligamentum nuchae, spinous processes of C7 and all T vertebrae

Lateral third of clavicle, spine of scap, acromion

accessory nerve (CN XI) C3 and C4 from cervical plexus

upper portion elevates, middle retracts, lower depresses scapula

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28
Q

What does the External Jugular Vein drain?

What is it formed by and below where?

Where does it run and empty into?

A

It drains the face and scalp and obtains a large amount of cerebral blood

formed immediately below the parotid gland by union of the Retromandibular Vein and Posterior Auricular Vein

Runs downward and backward along lateral surface of Sternocleidomastoid and empties into subclavian vein

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29
Q

What are the 6 tributaries of the external jugular vein?

A 
Retromandibular Vein
Anterior Jugular Vein
Transverse Cervical Vein
Suprascapular vein
Posterior Auricular Vein
Posterior External Jugular Vein
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30
Q

Describe the significance of a Prominent External Jugular Vein

A

In congestive heart failure or obstruction of superior vena cava the vein becomes very prominent.

Normally with normal venous pressure the external jugular is invisible or nearly so.

Opera singers or bagpipe players have prominent ones due to increased intrathoracic pressure during singing or playing

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31
Q

What structure divides the Anterior and Posterior triangles of the neck?

A

Sternocleidomastoid

Anterior lies in front of it and posterior lies behind it

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32
Q

What are the boundaries of the posterior triangle of the neck

A

Anterior boundary: posterior border of SCM

Posterior boundary: anterior border of trapezius

Inferior Boundary : superior border of middle third clavicle

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33
Q

What are the boundaries of the anterior triangle of the neck?

Where is apex located?

what are roof?

A

Superior boundary: inferior border mandible

Anterior boundary : anterior midline

Posterior boundary: anterior border of SCM

Apex is at the jugular notch

Roof is deep cervical fascia and superficial cervical fascia and platysma

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34
Q

What are the 4 subdivisions of the Anterior triangle of the neck?

A

Submental Triangle

Submandibular (Digastric) Triangle

Carotid Triangle

Muscular Triangle

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35
Q

Which subdivision of the anterior triangle is the only one that is unpaired?

What are its boundaries?

FLoor?

Contents?

A

Submental

left and right anterior bellies of digastric (submandibular triangle), and the body of the hyoid bone

the mylohyoid muscle

minor veins and lymph nodes

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36
Q

What are the boundaries of the Submandibular (digastric) triangle?

Floor?

Contents?

A

inferior border of the mandible, anterior belly of digastric, and the posterior belly of digastric

mylohyoid and hyoglossus muscles

submandibular gland, internal carotid artery, facial artery, internal jugular vein, glossopharyngeal nerve and vagus nerve

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37
Q

What are the boundaries of the Carotid Triangle?

Floor?

Contents?

A

posterior belly of digastric, superior belly of omohyoid, and anterior border of SCM

portions of thyrohyoid, hyoglossus, and inferior and middle constrictor muscles

parts of common and internal carotid arteries, external carotid artery and three of its branches: superior thyroid artery, lingual artery, and facial artery. Also corresponding tributaries of the internal jugular

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38
Q

Muscular Triangle boundaries?

Floor?

Contents?

A

Superior belly of omohyoid, anterior midline of neck, and anterior border of SCM

Posterior layer of pretracheal fascia

sternohyoid and sternothyroid muscles, thyroid gland, trachea, and esophagus

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39
Q

Where is the hyoid located?

Which bones does it articulate with?

What parts make it up?

A

Located between mandible and larynx, serves as point of attachment for many muscles.

Does not articulate with ANY other bones!

Made up of Body, Greater horn, and Lesser Horn

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40
Q

What are the four Infrhyoid muscles that attach to hyoid and primarily function to move it along with the larynx?

Which are superficial? Which a re deep?

A

Omohyoid - superficial

Sternohyoid - superficial

Sternothyroid - deep

Thyrohyoid - deep

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41
Q

Omohyoid OINF

A

Inferior belly of omohyoid originates from upper border of scapula. It ends in an intermediate tendon located deep to the SCM. Superior belly of omohyoid originates from this tendon

Body of the hyoid bone

Ansa cervicalis C1 C2 C3

Depresses the hyoid bone and larynx

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42
Q

Sternohyoid OIAF

A

Posterior surface of the manubrium, and medial end of clavicle

Body of the hyoid bone

Ansa cervicalis C1 C2 C3

Depresses the hyoid bone and larynx

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43
Q

Sternothyroid OIAF

A

Posterior surface of the manubrium, inferior to the origin of sternohyoid

Oblique line on the lamina of the thyroid cartilage

Ansa cervicalis C1-3

Depresses the larynx

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44
Q

Thyrohyoid OIAF

A

Oblique line on the lamina of the thyroid cartilage

Body of hyoid bone

C1 through hypoglossal nerve

Depresses the hyoid bone

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45
Q

Why do all of these muscles used to depress the hyoid bone and larynx? (3things used for)

Ih hyoid is fixed, what depresses the mandible?

A

Swallowing

Speech

Breathing

If hyoid is fixed, digastric depresses mandible

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46
Q

What are the two major layers of cervical fascia

The further subdivisions?

A 
Superficial Cervical Fascia 
Deep Cervical Fascia (divided further)
     Investing layer of the Deep Cervical Fascia 
     Pretracheal Fascia
     Prevertebral Fascia 
     Carotid Sheath
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47
Q

Is the superficial cervical fascia thick or thin?

What muscle does it enclose?

What three things does it contain?

A

Thin layer connective tissue

encloses platysma,

contains cutaneous nerves, superficial veins, and lymph does

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48
Q

Where does the Deep Cervical Facia lie?

What muscles does it enclose?

What do the four subdivisions of it each enclose?

A

Deep to the superficial cervical fascia

Investing layer - splits to enclose the SCM and trap

Pretracheal Fascia - layer encloses the thyroid gland, trachea, and esophagus

Prevertebral fascia - encloses vertebral column and the deep muscles of back

Carotid sheath - layer of cylindrical fascia whichever extends from the base of skull to the root of neck

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49
Q

What 5 thing does the carotid sheath contain?

A

Common carotid artery

Internal carotid artery

Internal jugular vein

Vagus nerve

Deep cervical lymph nodes

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50
Q

What is the function of fascia layers? The clinical significance?

A

To provide a slippery surface to reduce friction during gross movment of the head and neck, and swallowing.

May serve as channel for infection by allowing it to spread from the head and neck to the mediastinum directly. (Pretracheal facia)

Cancer involving deep cervical lymph nodes can compress the internal jugular vein

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51
Q

What is the superior thoracic aperture (thoracic inlet) and what are its boundaries?

A

The kidney shaped Opening through which structures of the neck pass into the thorax

1 first thoracic vertebra
2 first ribs and their cartilages
3 manubrium of sternum

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52
Q

Which arteries (4) go through the superior thoracic aperture?

Vein?

Nerves? (4)

Viscera (5)

A

Brchiocephalic, left common carotid, left subclavian, internal thoracic arteries

Brchiocephalic vein

Phrenic, vagus, recurrent laryngeal, nerves and sympathetic trunk

Trachea, esophagus, cervical plexus, apex of lung, thymus

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53
Q

What are two potential for lung collapse with neck injury?

A

Cervical pleura and lung apex pass through superior thoracic aperture right below the SCM origin

Also broken first rib or penetration wound may puncture lung and collapse. (Atelectasis)

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54
Q

The Thymus is part of what system? Produces what?

Made up of how many lobes?

Where is it located?

Blood supply?

Innervation?

A

Part of immune system, produces T - lymphocytes

2 irregular lobes,

behind manubrium and body of sternum Inferior to thyroid gland

Blood supply from Internal thoracic artery

Innervation from stellate ganglion of sympathetic trunk and vagus

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55
Q

What type of gland is the Thyroid Gland? What does it produce?

Where does it lie?

What shape is

A

Endocrine gland that produces thyroxine and calcitonin

Lies at the level of cervical vertebra 5 through thoracic vertebra 1

H or U shaped and consists of three parts

 Left lobe, right lobe, and Isthmus connector
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56
Q

Is the thyroid highly vascular?

A

Yes

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57
Q

What are a couple of anatomical variations of the thyroid?

A

Bout half have aPyramidal lobe extending upward from isthmus as a finger of glandular tissue

Also the levator glandulae thyroideae muscle connects isthmus with hyoid bone

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58
Q

What are the two arteries supplying the thyroid gland?

What is a variation common?

A

Superior thyroid artery (from external carotid)

Inferior thyroid artery (from thyrocervical trunk)

Thyroid Ima Artery: any inconstant branch to thyroid gland, from the brachiocephalic trunk

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59
Q

What are the Three veins for the Thyroid GLand and what is the innervation of thyroid gland?

A

Superior Thyroid Vein (to the internal jugular vein)

Middle Thyroid Vein (to the internal jugular vein)

Inferior Thyroid Vein (to the brachiocephalic vein)

From superior, middle, and inferior cervical sympathetic ganglia

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60
Q

Describe a Goiter. What are two types?

A

Abnormal enlargement of the thyroid gland swelling anterior neck

Endemic Goiter : due to dietary deficiency iodine (produces thyroxin) Gland enlarges to increase output, Hormone INactive. Symptoms close to hypothyroidism

Etophtahlmic Goiter: due to autoimmune disease. thyroid stimulating immunoglobuins bind to receptor site leading to overactivity. Hormone active, symptoms close to Hyperthyoridism known as Gravese disease.

CHECK BRI NOTES!!!!

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61
Q

What type of glands are Parathyroid glands? What are they involved in?

Location? Number?

Blood Supply?

Innervation?

A

Endocrine glands involved in calcium homeostasis and are essential to life.

Small ovoid bodies on the posterior surface of thyroid gland. Usually 4 but can be 2-6.

Inferior Thyroid Artery and Superior Thyroid Artery

From inferior or middle cervical sympathetic ganglia

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62
Q

What are the three factors contributing to the Difficulty of Thyroid surgery?

A

Presence of parathyroid gland

Presence of the Reccurent Laryngeal Nerve

Vascularity

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63
Q

Where does the Trachea begin? What does it split into in thorax?

What are its walls supported by?

Which musle spans the posterior gap?

Blood Supply of trachea?

Innervation?

A

Begins at the larynx at C6 level. Within the thorax splits into the left and right main bronchii

Cartilaginous rings opening posterior (these rings permit expansion of esophagus during swallowing)

Trachealis Muscle

Inferior Thyroid Artery

Recurrent Laryngeal Nerve

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64
Q

What does the Esophagus connect? Where does it begin and lie?

A

Muscular tube connecting pharynx and stomach. Begins in neck at C6 and lies posterior to trachea

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65
Q

What are the main arteries of the head and neck?

Where do they ascend within and to?

What are the two divisions?

A

Left and right Common Carotid Arteries

Ascend within carotid sheath to the carotid triangle

Split into Internal and External Carotid Artery

66
Q

How many branches in the neck does the Internal Carotid artery have? Where does it enter the skull and what does it supply?

External Carotid Artery number of branches in neck?

A

None. Enters skull through carotid canal (in temporal bone) to supply blood to brain.

8 branches. enters through carotid canal and is main source of blood to structures in neck, face, and scalp (structures external to skull) Has 8 branches.

67
Q

What are the 8 branches of the External carotid artery?

A 
Superior Thyroid Artery
Ascending Pharyngeal Artery
Lingual Artery
Facial Artery
Occipital Artery
Posterior Auricular Artery
Superficial Temporal Artery
Maxillary Artery
68
Q

Describe the Carotid Sinus.

Function?

Innervation?

A

Slight dilation of internal carotid artery where it joins the common carotid.

Baroreceptor (blood pressure sensor)

Carotid sinus nerve, branch of the glossopharyngeal (CN IX)

69
Q

Describe the Carotid Body

Function?

Innervation?

A

Small reddish-brown mass within or deep to the bifurcation of common carotid artery.

Chemoreceptor detects change in chemical makeup of blood in sinus.

Carotid sinus branch of the glossopharyngeal nerve (CN IX)

70
Q

Describe the Internal Jugular Vein.

The superior jugular bulb?

The Inferior Jugular Bulb

A

Usually largest vein of the neck. Begins at jugular foramen as the direct continuation of the sigmoid sinus. Drains into brachiocephalic vain.

Dilation of the internal jugular vein at its origin below the jugular foramen.

Dilation of the internal jugular vein near its termination into the brachiocephalic vein.

71
Q

What are the 6 tributaries of the Internal Jugular Vein?

A 
Inferior Petrosal Sinus
Pharyngeal Veins
Facial Vein
Lingual Vein
Superior Thyroid Vein
Middle Thyroid Vein
72
Q

Where does the Glossopharyngeal nerve emerge from and pass through?

List each branch and its function.

A

CN IX emerges from medulla oblongata and passes through jugular foramen.

  1. Tympanic nerve: sensory to tympanic cavity and secretomotor to parotid gland
  2. Branch to the Carotid Sinus: sensory to carotid sinus & body
  3. Pharyngeal Branch: Unites with vagus branches and sympathetic trunk to form pharyngeal plexus. Sensory to pharynx
  4. Branch to Stylopharyngeus: motor to styopharyngeus muscle
  5. Tonsillar Branch: sensory to mucous membrane over tonsil and soft palate
  6. Lingual Branch: taste and general sensation to posterior 3rd of tongue
73
Q

Describe the Vagus Nerve and its two ganglia.

A

Longest cranial nerve, distributions in head, neck, thorax, and abdomen. Vagus means “wanderer.” Emerges from MO and exits skull through jugular foramen.

  1. Superior (jugular) Ganglion: inside the jugular foramen
  2. Inferior (Nodose) Ganglion
74
Q

What are the 5 Branches of the vagus in the head and neck?

A
  1. Meningeal Branch - arises from superior gang. Supplies dura mater with sensory innervation
  2. Auricular Branch - Arises from superior ganglion. Sensory to auricle, floor of external auditory meatus, and tympanic membrane.
  3. Pharyngeal Branch - Arise from inferior gang. Chief motor nerve to pharynx and soft palate muscles. Joins with glossopharyngeal nerve branches and sympathetic trunk to make pharyngeal plexus.
  4. Superior Laryngeal Neve - arise from inferior gang. divides into:
    a. Internal Laryngeal Nerve - sensory mucous membrane of larynx to the true vocal cords
    b. External Laryngeal Nerve - motor to cricothyroid and inferior constrictor muscles
  5. Recurrent Laryngeal Nerve - arise from vagus within thorax then ascend to neck. Ascends through groove between trachea and esophagus closely applied to posterior surface of thyroid gland. sensory to mucous membrane of larynx below the true vocal folds and to the trachea. Motor to all muscles of larynx except cricothyroid.
75
Q

What are the functions of the Pharyngeal Plexus?

A

Motor to all muscles of pharynx except for stylopharyngeus (innervated by glossopharyngeal), and to all muscles of soft palate except tensor veli palatini (innervated by trigeminal nerve).

76
Q

What are two clinical consequences of damage to the recurrent laryngeal nerve?

Four causes of damage to it?

A

Unilateral damage: respiratory distress, hoarsness, partial aphonia
Bilateral: complete aphonia, may result in suffication

  1. Trauma during thyroid surgery
  2. Goiter or thyroid tumor
  3. Lung tumor
  4. Aortic Aneurysm (left side only)
77
Q

What two parts form the Accessory Nerve?

Describe where they originate from and what they supply.

A

CN XI, formed by the union of two parts:

Cranial part - originate from MO, joins vagus just above inferior vagal ganglion, supplies vagus w motor fibers, which travel in the pharyngeal branch of vagus and recurrent laryngeal nerve

Spinal part - originate sides of spinal cord, ascends through foramen magnum to join cranial part where they both exit jugular foramen. Motor to SCM and Trap

78
Q

What is the function of the Hypoglossus nerve?

Originate and exit from?

Where does it loop to?

A

CN XII is the motor nerve to the tongue.

Originates from the MO exits through hypoglossal canal

Loops downward and forward deep to posterior belly and intermediate tendon of digastric

79
Q

What are the 4 major types of branches of the Hypoglossal Nerve?

A

Meningeal Branches - supply the dura mater

Superior root of Ansa Cervicalis - mainly C1 Fibers

Nerves to Thyrohyoid and Geniohyoid - C1 fibers motor to those muscles

Lingual branches - motor for extrinsic and intrinsic tongue muscles

80
Q

Where does the Cervical part of the sympathetic trunk begin and continue with?

Where do preganglionic sympathetic fibers supplying head and neck originate?

Travel up to and synapes with?

Where dopostganglionic fibers distribute to then?

A

Begins at base of skull and is continuous with thoracic part of trunk

Originate from T1 - T3 travel up to several cervical ganglia

Synapse then distribute to blood vessels, smooth muscle, and glands of head and neck

81
Q

Wha are the 4 major cervical sympathetic ganglia?

A

Superior Cervical Ganglion

Middle Cervical Ganglion

Vertebral Ganglion

Cervicothoracic (Stellate) Ganglion

82
Q

Describe the Superior Cervical Ganglion and its branches.

A

Lies at level of C1 - C3. Branches :

Internal Carotid nerve - large nerve accompanies internal carotid artery into skull

Superior Cervical Cardiac Nerve - to cardiac plexus

Branches to the Pharyngeal Plexus

83
Q

Describe the Middle Cervical Ganglion and its branch

Describe the Vertebral Ganglion and its Branches

A

Lies at level of C6, Middle Cervical Cardiac Nerve and Branch to Thyroid Gland

Variable and often fused with middle or inferior cervical ganglion
Lies at C7 and gives off branch to plexus along vertebral artery

84
Q

Describe the Cervicothoracic (stellate) Ganglion and its Branch

A

Formed by fusion of inferior cervical ganglion to the first thoracic ganglion

Lies at C7 through T1 posterior to vertebral artery and anterior to transverse process of C7 and neck of first rib.

Branch is Inferior Cervical Cardiac Nerve (to cardiac Plexus)

85
Q

What is the Ansa Subclavia?

A

neve bundle which loop santerior to the subclavian artery, connecting the vertebral ganglion to the Cervicothoracic ganglion.

86
Q

WHat is the largest and sturdiest facial bone? Describe its 6 main parts.

A

Mandible.

Body - large horizontal part

Alveolar Process - upper border of body, has tooth sockets (alveoli)

Ramus - vertically ascending part

Angle - at posterior terminus of the body

Condylar Process - articulates with temporal bone to for TMJ

Coronoid Process - area of attachment for mastication muscles

87
Q

What are the 6 internal (lingual) surface features of the mandible. Describe them

A

Superior Mental (genial) Spine - origin of Genioglossus muscle

Inferior Mental (genial) Spine - origin of Geniohyoid muscle

Digastric Fossa - origin of anterior belly of Digastric

Mylohyoid Line - origin of Mylohyoid muscle

Sublingual Fossal - location of sublingual gland

Submandibular Fossa - location of submandibular gland

88
Q

What are the Suprahyoid Muscles and Extrinsic Muscles of the Tongue?

A

Diagastric

Mylohyoid

Geniohyoid

Genioglossus

Hyoglossus

Styloglossus

Stylohyoid

89
Q

Digastric OINF

A

Posterior belly from mastoid process, anterior belly from digastric fossa

Both bellies “insert” into hyoid bone by connecting intermediate tendon. This tendon is strapped to hyoid by fibrous loop

Posterior belly by cervical branch of facial nerve (CN VII), anterior belly by nerve to mylohyoid (CN V)

Elevates hyoid and depresses mandible when hyoid fixed

90
Q

Mylohyoid OINF

A

Mylohyoid line

Body of hyoid bone, median raphe (2muscles bound and fused)

Nerve to mylohyoid (CN V)

Elevates hyoid and floor of mouth

91
Q

Geniohyoid Muscle OINF

A

Inferior mental spine

Body of hyoid

C1 fibers through hypoglossal

Elevates hyoid bone and tongue

92
Q

Gnioglossus Muscle OINF (largest tongue muscle)

A

Superior Mental Spine

Tip and entire undersurface of tongue

Hypoglossal nerve

Draws tongue forward, protrudes tip of tongue

93
Q

Hyoglossus OINF

What is unique about potential origin?

A

Body and greater horn of hyoid (upper surface).

Sides of tongue

Hypoglossal Nerve

Draws tongue downward

**Small portion of muscle may originate from lesser horn of hyoid. This muscle slip is called Chondroglossus.

94
Q

Describe the Hypoglossal Nerve.

Originate and exit from?

Where does it loop to?

A

CN XII is the motor nerve to the tongue.

Originates from the MO exits through hypoglossal canal

Loops downward and forward deep to posterior belly and intermediate tendon of digastric

95
Q

What are the 4 major types of branches of the Hypoglossal Nerve?

A

Meningeal Branches - supply the dura mater

Superior root of Ansa Cervicalis - mainly C1 Fibers

Nerves to Thyrohyoid and Geniohyoid - C1 fibers motor to those muscles

Lingual branches - motor for extrinsic and intrinsic tongue muscles

96
Q

Describe the Cervical part of the Sympathetic Trunk.

Where do preganglionic sympathetic fibers supplying head and neck originate?

Travel up to and synapes with?

Where dopostganglionic fibers distribute to then?

A

Begins at base of skull and is continuous with thoracic part of trunk

Originate from T1 - T3 travel up to several cervical ganglia

Synapse then distribute to blood vessels, smooth muscle, and glands of head and neck

97
Q

Styloglossus OINF

A

Styloid process

Sides of tongue

Hypoglossal nerve

Draws tongue upward and backward

98
Q 
Stylohyoid Muscle (pierced by intermediate tendon of digastric
OINF
A

Styloid process
Body of the hyoid
Facial Nerve
Elevates hyoid bone and tongue

99
Q

Describe the Submandibular Gland.

Describe its two parts

Innervation?

A

One of three large paired salivary glands. Wraps around the posterior border of the mylohyoid.

Superficial part: large, lies within the submandibular triangle and in the submandibular fossa

Deep Part: Small and lies superior to the mylohyoid muscle

Parasympathetic fibers from the facial nerve (CN VII) via the submandibular ganglion

100
Q

Describe the submandibular duct?

A

5 cm long. Opens into the oral cavity on the sublingual caruncle, located lateral to the frenulum of the tongue.

101
Q

Describe the Sublingual gland

Where does it lie?

Empty? Located?

Innervation?

A

Smallest salivary gland.

Lies superior to the mylohyoid muscle, in the sublingual fossa

Empties into the floor of the mouth by 12 short ducts, located along the sublingual fold.

Parasympathetic fibers from the facial nerve (CN VII) via the submandibular ganglion

102
Q

List the Nerves associated with the mandible

Blood Vessels

Lymphnodes

A

Lingual, Glossopharyngeal, and Hypoglossal

Lingual artery and vein, facial artery and vein

Submandibular and submental lymphnodes.

103
Q

What are the 4 functions of the Nasal Cavity?

Describe the cavity

A

To provide an airway
Olfaction
Warming and moistening of inspired air
Cleansing of inspired air

Extends from nostirls anteriorly to the choanae posteriorly. Divided into left and right chamber by the nasal septum.

104
Q

Describe Choanae

A

Posterior apertures of the nasal cavity which open into the nasopharynx.

105
Q

What are the four features of the External nose?

A

Tip - free end of the nose

Root - connects the nose to the forehead

Nares - Nostrils

Alae - bound the nares laterally

106
Q

Describe the Roof, Floor, Medial and Lateral Walls of Nasal Cavity

A

Roof: nasal bone, frontal bone, cribriform plate of ethmoid bone, body of sphenoid bone

Floor: palatine process of maxilla and horizontal plate of palatine bone, body of the sphenoid bone.

Medial Wall: septal cartilage, perpendicular plate of ethmoid, vomer

Lateral Wall: nasal bone, frontal process of maxilla, lacrimal bone, ethmoid bone, inferior nasal choncha, perpendicular plate of palatine, medial pterygoid plate of sphenoid.

107
Q

List 10 important structures of the lateral wall of the nasal cavity.

A

Superior and Middle Nasal Concha (of ethmoid bone)
Inferior Nasal Concha (of a separate bone)

Sphenoethmoidal Recess - space above and behind superior nasal concha, receive opening to sphenoid sinus

Superior, Middle, Inferior Meatus. - next slide

Ethmoidal Bulla - rounded projection into middle meatus, middle ethmoidal cells open onto this structure.

Hiatus Semilunaris - curves slit lying below ethmoidal bulla within the middle meatus. Frontonasal duct, anterior ethmoidal cells and maxillary sinus open into this slit.

Nasolacrimal Duct - Connects lacrimal sac of orbit to the nasal cavity

108
Q

Describe the Three main Meatus’s in the nose

A

Superior - space below the superior nasal concha. Receives opening of the posterior ethmoidal cells

Middle - space below middle nasal concha. Receives openings of frontal sinus (frontonasal duct or infundibulum), maxillary sinus, middle ethmoidal cells and anterior ethmoidal cells

Inferior - Space below inferior nasal concha. Recieves opening of the nasolacrimal duct.

109
Q

Describe a Deviated Septum.

What can happen with one?

Causes?

A

When the nasal septum does not lie in the median plane.

Increased snoring, if serious can touch lateral wall causing breathing difficulty.

Congenital malformation, Birth Injury, Postnatal Trauma.

110
Q

Describe three major regions of the nasal cavity.

A

Nasal Vestibule: area just inside each nostril. Contains hair, sebaceous glands, and sweat glands.

Respiratory Region: Lower two thirds of the nasal cavity. (middle concha)

Olefactory region: Superior nasal concha and upper one third of nasal septum. Contains fibers of the olfactory nerve (CN 1) which pass down through cribriform plate.

111
Q

Describe the Innervation for the Nasal Cavity

Blood Supply

Lymph Nodes

A

Special sensory innervation from olfactory nerve (CN 1)
General sensory from branches of maxillary and opthalmic divisions of the trigeminal nerve (CN V)
Autonomic innervation from the pterygopalatine ganglion.

Lots of blood supply. Sphenopalatine branch of the maxillary artery and anterior ethmoidal branch of the opthalmic artery.

They drain from the nasal cavity into the deep cervical nodes.

112
Q

Describe Epistaxis and what are its two forms?

A

Nose Bleed

Mild form - involves small branches in or near the vestibule caused by minor trauma, low humidity.

Severe form - involves spurting of arterial blood. Result from rupture of the Sphenopalatine artery at one of its major anastomosis caused by trauma.

113
Q

Where do the lymphin the nasal cavity drain to?

A

Lymph from the nasal cavity drains into the deep cervical nodes

114
Q

Describe the paranasal sinuses.

What two factors influence the formation of sinuses?

List them and describe where they go to.

A

Cavities found within the bones of the face. Develop as outgrowths of the nasal cavity therfore all open to it.

Wolff’s law and Weight of skull

Frontal - opens to hiatus semilunaris via frontonasal duct

Maxillary - opens to hiatus semilunaris. Only sinus present at birth

Sphenoidal - Opens into the sphenoethmoidal recess

Ethmoidal - Consists of several groups of ethmoidal cells lie in the bone between orbit and cavity

	Posterior ethmoidal cells open to superior meatus
	Middle ethmoidal cells open to ethmoidal bulla in middle
   Anterior ethmoidal cells open to hiatus semilunaris
115
Q

Where are the 6 places that infection of the nasal cavity can spread to?

A

Paranasal Sinuses - sinusitis

Lacrimal apparatus & conjuctiva via nasolacrimal duct - Conjunctivitis (pinkeye)

Nasopharynx via chonae - Acute pharyngitis

Middle ear via pharygotymanic tube - otitis media

Anterior cranial fossa via cribriform plate - meningitis, brain ameba

Mastoid process via aditos & antrum - mastoiditis

***CSF dripping out nose indicates brain damage

116
Q

Describe the boundaries of the Oral Cavity and its two divisions.

A

Roof: the palate

Floor: the tongue and oral mucosa

Anterior and Lateral: lips and cheeks

Posterior: oropharyngeal isthmus, demarcated by pataloglossal arch

Divided into Oral vestibule and Oral Cavity Proper

117
Q

Describe the Oral Vestibule, its openings to it.

Do same with Oral Cavity Proper

A

Vestibule: Portion between lips and gums or cheek and gums. Portion external to the tooth rows.
Labial glands: small salivary glands
Parotid Duct: opens lateral to maxillary second molar

Proper: Lies internal to the tooth rows.

118
Q

What is the name for the median groove seen externally in the oral cavity from the nose to the vermillion border of the upper lip?

What are the names for the median folds internally connecting the upperlip with the gum and lower lip with gum

A

Philtrum

Frenulum of upper or lower lip

119
Q

WHich muscle and glands do the lips contain?

THe cheeks?

A

Obicularis Oris and labial glands

Buccinator muscle and buccal glands

120
Q

Describe the Palate and its two parts?

A

Forms the roof of the mouth and floor of nasal cavity.

Arched both tranverely and anteroposteriorly

Hard Palate: forms the anterior two thirds of palate
Soft Palate: forms the posterior one third

121
Q

Describe the Hard palate, its two important features, along with three foramen within it.

A

Forms the bony partition between nasal and oral cavities.

Palatine Process of Maxilla (anteriorly)
Horizontal Plate of the Palatine Bone (posteriorly)

Incisive Foramen
Greater Palatine Foramen
Lesser Palatine Foramen

122
Q

What is Mucoperiosteum?

Palatine Raphe?

Incisive Papilla?

Transverse Palatine Folds?

A

Covering of the hard palate

See drawing pg 35

Palatine Raphe endes into this

Extend laterally within mucoperiosteum and aid in gripping food

123
Q

Describe the Soft Palate

Describe its two lateral arches and their components

Describe the Tonsillar Fossa

A

Mobile fibromuscular fold suspended from the posterior border of the hard palate. It is elevated during swallowing to close the opening between nasopharynx above and oropharynx below.

Palatoglossal Arch
	Palatoglossal Fold (superficial)
	Palatoglossus Muscle (deep to fold)
Palatopharyngeal Arch
	Palatopharyngeal Fold (superficial)
	Palatopharyngeus Muscle (deep to the fold)

Lies between palatoglossal and palatopharyngeal arches on each side and contains the Palatine Tonsil

124
Q

Musculus Uvulae OINF

A

Posterior Nasal Spine

Mucous membrane of uvula

Vagus nerve (X) via the pharyngeal plexus

Elevates the uvula

125
Q

Levator Veli Palatini OINF

A

Inferior surface of temporal bone

Aponeurosis of soft palate

Vagus nerve (X) via pharyngeal plexus

Elevates soft palate

126
Q

Tensor Veli Palatini OINF

A

Scaphoid fossa of the medial pterygoid plate, pharyngotympanic tube

Tendon winds around the pterygoid hamulus and inserts into the aponeurosis of the soft palate

Mandibular division of Trigeminal (V)

Tenses soft palate, opens pharyngotympanic tube

127
Q

What is the innervation and blood supply of the hard palate and soft palate?

A

Hard Palate:
Greater Palatine Artery (from maxillary)
Greater Palatine and nasopalatine nerves

Soft Palate:
Lesser Palatine and Facial arteries
Lesser Palatine Nerve

128
Q

What would you suspect if the uvula deviates to the right?

A

Possible damage to the left vagus nerve because paralysis of the Musculus Uvolus??? on the left side.

Check Bri notes

129
Q

Describe the tongue

Its 4 functions?

Its 5 parts?

A

Muscular organ which attached to hyoid, mandible, styloid, palate, and pharynx by muscles.

Taste, Mastication, Swallowing, Speech

Apex: rests against incisor teeth
Margin: rests against teeth and upper gums on each side
Dorsum: upper surface of tongue
Inferior surface: lower surface of the tongue (not attached?)
Root: the attached base of the tongue

130
Q

Where does the tongue lie?

What is the sulcus Terminalis?

Foramen Cecum?

Median groove

A

Partly in the oral cavity (anterior two thirds) and partly in the oropharynx

V shaped groove which divides tongue into two parts (above)

Shallow groove visible on surface

Located at the apex of V of sulcus terminalis. (Remnant of embryonic thyroglossal duct.

131
Q

What are the four types of Lingual Papillae?

A

Filiform Papillae: conical projections sharp tips (sensory)

Fungiform Papillae: mushroom shaped. (Sweet T buds)

Vallate Papillae: Largest, arranged in V shaped row (Bitter T buds)

Foliate Papillae: Grooves and ridges along margin, poorly developed. (Sour T buds)

132
Q

Which way does the Oropharyngeal part of the Dorsum of tongue face?

Describe the Lingual Tonsil

Which two folds connect the tongue to the epiglottis?

Name for the space on either side of the median glosoepiglottic fold?

A

Posteriorly

A mass of lymphoid tissue found on oropharyngeal surface of tongue

Median Glossoepiglottic Fold and Lateral Glossoepiglotic Fold

Vallecula

133
Q

What is the inferior surface of the tongue connected to the floor of the mouth by?

Describe Ankyloglossia

A

Frenulum of the tongue

134
Q

Describe the Root of the Tongue

A

Part of tongue that is anchored to floor of oral cavity

Nerves vessels and extrinsic muscles enter or leave the tongue through the root.

135
Q

What do the intrinsic muscles of the tongue do? What are they innervated by? WHat do they form?

A

Originate within the tongue. Form the shape of the tongue and alter it. Innervated by hypoglossal

136
Q

What are the 4 Extrinsic muscles of the Tongue?

What are they all (except one) innervated by?

A

Genioglossus

Hyoglossus

Styloglossus

Palatoglossus

Hypoglossal nerve

137
Q

Palatoglossus OINF

A

Soft Palate

Sides of tongue

Vagus nerve (X) via pharyngeal plexus

Elevates Back of tongue

138
Q

Clinical importances of Genioglossus

A

Pulls tongue forward

Prevents it from falling backward and blocking airway

Very important during general anesthesia and in seizure disorders

139
Q

What is the innervation that provides general sensation to the anterior 2/3rds of the tongue?

Provides taste sensation to this location?

Both general sensation and taste to posterior 1/3?

A

Lingual nerve (branch of mandibular division of trigeminal)

Through the Chorda Tympani (branch of the facial nerve)

Glossopharyngeal nerve (this includes Vallate Papillae

140
Q

Where do the Lingual Artery and Vein drain from and to the tongue?

Where do the Submental, submandibular and deep cervical nodes drain lymph to?

A

Artery from the External carotid

Vein to the Internal Jugular

All end up in the deep cervical nodes

141
Q

What is the function of the teeth? Describe the following:

Enamel

Dentin

Pulp

Cementum

A

To break down food to increase its surface area for better digestion

Hardest substance in human body, covers the crown

Internal to the enamel

Fills central cavity. Has vessels, nerves and lymphatics which enter pulp through a foramen at apex of the root.

Bone-like substance which covers root.

142
Q

What are the three parts of a tooth? Describe them

Also describe Gingivae (gums)

A

Crown: projects above gingivae and is covered by enamel

Neck: junction between crown and root

Root: embedded in the alveolar process of maxilla and mandible. Covered with cementum

Specialized oral mucosa which surrounds the teeth and covers adjacent alveolar bone

143
Q

What are the four types of teeth. Describe them

A

Incisors: single rooted chisel shape used for cutting

Canines: single rooted pointed used for puncturing & tearing

Premolars: single or double root broad chewing surface for grinding

Molars: multiple root very broad surface for grinding

144
Q

List and describe the 6 surfaces of the teeth.

A

Labial surface: (incisors and canines) only, side facing lip.

Buccal surface: (premolars and molars only), side facing cheek

Lingual surface: side facing tongue

Mesial surface: side facing anteriorly or toward midline

Distal surface: side facing posteriorly or away from midline

Occlusal surface: the chewing surface

145
Q

WHat are the two sets of teeth? Differences?

List the teeth for each set and their location based on quadrant.

A

Deciduous (primary or baby) teeth and Permanent (adult) teeth.

Permanent are larger whiter and thicker enamel

Each draw can be separated into left and right quadrant. Number of teeth is usually stated by quadrant

Deciduous: two incisors, one canine, two molars each quadrant for total of 20

Permanent: two incisors, one canine, two premolars and three molars in each quadrant for 32 total

**deciduous molars are replaced by premolars

146
Q

What is the innervation of the Maxillary teeth?

The Mandibular teeth?

A

Maxillary: innervated by superior alevolar branches from maxillary division of trigeminal (V)

Mandibular: inferior alveolar nerve from mandibular division of trigeminal

147
Q

What is the common pathway for food and air? It is part of both the digestive and respiratory systems.

Where does it lie and what are its three parts?

A

Pharynx. A funnel-shaped fibromuscular tube extends from base of skull to inferior border of the cricoid cartilage.

Posterior to nasal cavity, oral cavity and larynx.

Nasopharynx: posterior to nasal cavity

Oropharynx: posterior to oral cavity

Laryngopharynx: posterior to larynx

148
Q

What does the nasopharynx communicate with the nasa cavity through?

What does it communicate with the oropharynx through? Is this item opened or closed during swallowing

What are the boundaries of the Nasopharynx:

A

Choanae.

Pharyngeal isthmus. Closed.

Superior boundary: roof of pharynx

Inferior: soft palate

Anterior: posterior border of inferior nasal concha

Posterior: posterior wall of the pharynx

149
Q

What is the name for the opening to the larynx found within the laryngopharynx?

What is it bounded laterally by? Inferiorly by?

What is a Piriform Fossa? WHat often gets stuck here? Causes what?

A

Laryngeal inlet

Aryepiglottic folds. Interarytenoid notch.

A recess in the anterior wall of laryngopharynx located on either side of laryngeal inlet. Fish bones often become lodged here and Deep piriform fossa are one cause of halitosis.

150
Q

Which two layers do the muscles of the pharynx lie in? Which muscles lie in each layer?

A

External (circular) Layer
Inferior constrictor muscle
Middle constrictor muscle
Superior constrictor muscle

Longitudinal Layer
Stylopharyngeus muscle
Palatopharyngeus muscle
Salpngopharyngeus muscle

151
Q

Superior Constrictor Muscle OINF

Name for specialized band of muscle formed by superior constrictor and helps seal pharyngeal isthmus during swallowing?

A

Medial pterygoid plate, alveolar part of mandible, side of tongue

Pharyngeal raphe

Vagus nerve (X) via pharyngeal plexus

Contracts the pharynx during swallowing

Palatopharyngeal Sphincter

152
Q

Middle Constrictor Muscle OINF

A

Greater and lessor horns of the hyoid bone

pharyngeal raphe

Vagus nerve (X) via the pharyngeal plexus

Contracts the pharynx during swallowing

153
Q

Inferior Constrictor Muscle OINF

A

Cricoid cartilage and thyroid cartilage

Pharyngeal raphe

Vagus nerve (CN X) via pharyngeal plexus and external laryngeal nerve

Contracts the pharynx during swallowing

154
Q

Stylopharyngeus Muscle OINF

A

Styloid process

Thyroid cartilage, some fibers blend with those of the constrictors

Glossopharyngeal nerve (CN IX)

Elevates Pharynx

155
Q

Palatopharyngeus Muscle OINF

A

Soft palate

Wall of pharynx, thyroid cartilage

Vagus nerve (X) via the pharyngeal plexus

Elevates pharynx, narrows oropharynx

156
Q

Salpingopharyngeus Muscle OINF

A

Torus Tubarius and opening of pharyngotympanic tube

Wall of pharynx

Vagus nerve (CN X) via the pharyngeal plexus

Elevates pharynx, opens pharyngotympanic tube & tenor veli palitini

**fibers of palatopharyngeus and salpingopharyngeus blend together within the wall of the pharynx

157
Q

Where is the pharyngeal plexus located and what three things make it up?

A

Lies on the middle constrictor muscle. Formed by the:

Pharyngeal branch of Vagus
Motor to all muscles of pharynx except stylopharyngeus which innervated by glossopharyngeal

Pharyngeal branch of Glossopharyngeal
Sensory to the mucosa of pharynx

Sympathetic fibers from the Superior Cervical Ganglion

158
Q

What are the two arteries of the Pharynx?

A

Ascending Pharyngeal Artery

Maxillary Artery

159
Q

Describe the following:

Buccopharyngeal Fascia

Pharyngobasilar Fascia

Retropharyngeal Space

A

Layer of fascia surrounding pharynx external to its muscles. Continuous with pretracheal fascia below

Layer which lies internal to pharynx muscles and external to mucosa.

Potential space between buccopharyngeal fascia (or pretracheal fascia) and prevertebral fascia. Extends down into thorax and permits free movment of the pharynx and esophagus during swallowing.

160
Q

Clinical signifance of Retropharyngeal space

A

Hemorrhage from cervical trauma or abscess from pharyngeal insection???

LOOK AT BRI NOTES

161
Q

What is Deglutition? Describe its 4 stages.

A

Swallowing.

Tongue moves bolus back into oropharyngeal isthmus

Palatoglossus and palatopharyngeus squeeze bolus back into oropharynx. Levator veli palatini and tensor veli palatini elevate the soft palate to close off pharyngeal isthmus

Stylo, palato, and salpingopharyngeus elevate the walls of the pharynx. Suprahyoid muscles elevate the hyoid bone and the larynx under the buldge of the tongue, which flexes the epiglottis back over laryngeal inlet.

Superior, middle, and inferior constrictors contract to move food through oropharynx and laryngopharynx and into the esophagus. Peristalsis then propels it toward stomach.

***If anything goes wrong with any of the above muscles, person ends up with Dyshagia. (difficulty swallowing)

Gross Anatomy 2 (2 decks)

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