Exam 2: Head and Neck Flashcards

1
Q

The sternocleidomastoid when contracted unilateral will result in……

A

contralateral rotation and ipsilateral side bending

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2
Q

The sternocleidomastoid when contracted bilaterally will result in……

A

flexion of the neck and (paradoxically) extension if the head already extended

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3
Q

______ is frequently encountered when the airflow in the nose in impeded, predisposition to congestion

A

Deviated nasal septum

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4
Q

_______ develop off the nasal cavity. They enlarge within the bones of the skull but remain connected to the nasal cavity

A

Air sinuses

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5
Q

The lining of the nasopharynx, auditory tube and the middle ear are all innervated by the ______.

A

CN IX: Glossopharyngeal

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6
Q

Define Mastoiditis. What can occur if left untreated?

A

a middle ear infection that has spread to the mastoid process.

Meningitis and infection of CNS

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7
Q

What connects the right and left lobe of the thyroid gland?

A

Isthmus

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8
Q

How many total parathyroid glands are there?

A

4 total, posterior side of the thyroid have 2 each.

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9
Q

During any thyroid procedure what must you pay special attention to and why?

A

All 4 parathyroid glands because their product: Parathyroid hormone: cannot be synthetically replaced.

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10
Q

Parathyroid hormone is responsible for?

A

Increasing serum calcium levels

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11
Q

______ is located posterior to the Pons

A

Cerebellum

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12
Q

The wrinkles on the brain forms…..

A

Distinct sulci (grooves) and gyri (bumps) on the surface

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13
Q

What is the difference between a contusion and a concussion?

A

Concussion is a contusion plus loss of consciousness

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14
Q

Cold or heat pain signals travel faster? Why?

A

Cold, nerves that carry cold signals have myelin versus heat ones do not

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15
Q

Anterior circulation of the brain is?

A

Internal carotid artery

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16
Q

The olfactory bulb extends off the _____, which connects it to the ______.

A

Olfactory tract

Cerebral cortex

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17
Q

The olfactory bulb sends olfactory nerves through the______ of the ethmoid bone to reach the ______.

A

Cribiform plate

superior nasal cavity

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18
Q

The retina of the eye is a direct extension of the ______ and as such, is actually part of the ________.

A

Diencephalon

central nervous system

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19
Q

The _____ extends away from the brain and induces formation of the lens from epidermal tissue

A

optic cup

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20
Q

The _____ sends axons through left and right _______.

A

retina

optic nerves

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21
Q

_____ travel through the optic canal. These converge and swap axons at the ______.

A

Right and Left optic nerve

Optic chiasm

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22
Q

Where do the Left and Right optic nerves axons synapse? In what part of the brain?

A

lateral genicuate nuclei

Thalamus

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23
Q

Where is visual information processed?

A

Occipital lobe

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24
Q

What part of the eye is the retina?

A

The back layer of the eye

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25
Q

When light enters the eye, what happens?
Give an example.

A

It becomes a reversed image by the retina

Lower parts of the visual field project on the superior retina and vice versa

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26
Q

Describe how the brain perceives the Right and Left sides of the visual field.

A

The temporal side of the visual field projects to the nasal aspect of the retina and vice versa

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27
Q

What happens to the nasal and temporal input on a patient’s left side.

A

Left temporal stays on the left side of the brain

Left nasal crosses to the RIGHT to join the right side optic radiation.

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28
Q

What happens to the nasal and temporal input on a patient’s right side.

A

Right temporal stays on the right side of the brain

Right nasal crosses to the LEFT to join the left side optic radiation.

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29
Q

How will a lesion of the optic nerve present?

A

Visual deficits in ONE eye

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30
Q

How do impingements/lesions of optic radiation present?

A

Visual deficits affecting one visual field. Will be in BOTH eyes

Homonymous hemianopia

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31
Q

How do lesions in the optic chiasm present?

A

Loss of bilateral temporal visual field

Bitemporal hemianopia

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32
Q

Define bitemporal hemianopia

A

Loss of bilateral temporal visual field

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33
Q

Define homonymous hemianopia

A

Visual deficits affecting one visual field. Will be in BOTH eyes

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34
Q

After the lateral geniculate nuclei, the axons project (Ipsi or contra) laterally on their way to the occipital lobes. They will also separate once again into ____ and ____ optic radiations.

A

Ipsilaterally

Superior and Inferior

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35
Q

_____ see black and white and motion

A

Rods

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36
Q

______ color and fine detail

A

Cones

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37
Q

What are located in the fovea?

A

Cones

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38
Q

What does the lens do as you get closer and closer to it?

A

Rounds up- Round lens = seeing close

Flat lens = seeing far away

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39
Q

What area of the world does your superior retina see?

A

The ground

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40
Q

The superior tract of the optic radiation goes through what lobe?

A

Parietal lobe

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41
Q

The inferior tract of the optic radiation goes through what lobe?

A

temporal lobe

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42
Q

For quadrantanopia, how do you determine where the problem is coming from?

A

The exact opposite (Superior/Inferior and Right/Left)

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43
Q

What does the inferior oblique eye muscle do?

A

elevate the eye

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44
Q

What does the superior oblique eye muscle do?

A

Depress the eye

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45
Q

What nerve innervates the superior oblique?

A

CN IV: Trochlear

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46
Q

What nerve innervates the lateral rectus?

A

CN VI: Abducens

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47
Q

How do you test the superior oblique muscle?

A

Have the patient look medial then inferiorly

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48
Q

How do you test the superior rectus muscle?

A

Ask the patient to look laterally and then superiorly

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48
Q

How do you test the Inferior rectus muscle?

A

Ask the patient to look laterally and then inferiorly

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48
Q

How do you test the inferior oblique muscle?

A

Ask the patient to look medially and then superiorly

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49
Q

What CN lesions presents with double vision when looking down?

A

CN IV: Trochlear

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50
Q

What cranial nerve lesion presents with persistently adducted pupil?

A

CN VI: Abducens

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51
Q

What is the consensual reflex?

A

When both pupils reaction to the stimulus of one

If only one reacts, indicates a problem

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52
Q

If you shine a light in the eye and neither pupil reacts, what is the likely cause?

A

Problems with CN II: Optic

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53
Q

What is the most common aneurysm to cause CN III compression?

A

posterior communicating artery

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54
Q

Loss of parasympathetic innervation of an eye is an early sign of increased intracranial pressure due to what?

A

pressure from the oculomotor nerve pushed against the dura mater

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55
Q

What is unique about the internal carotid artery?

A

does a U turn/have a U turn shape present

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56
Q

When the zonule fibers in the eye relax, what happens?

A

The lens becomes rounder aka can see up close

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57
Q

When the zonule fibers in the eye contract, what happens?

A

The lens becomes flatter/ more like an oval. aka can see farther away

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58
Q

What are the three regions of the trigeminal nerve?

A

Ophthalmic - V1
Maxilla - V2
Mandibular - V3

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59
Q

Where does the ophthalmic nerve exit?

A

Superior orbital fissure

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60
Q

The ophthalmic nerve splits into what branches?

A

Frontal
Lacrimal
Nasocilary

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61
Q

What branches come off of the Frontal nerve?

A

Supraorbital nerve
Supratrochlear nerve

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62
Q

What branches come off the nasocilary nerve?

A

-Posterior and anterior ethmoidal nerves
-Long and short ciliary nerves

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63
Q

Where does the maxillary nerve exit?

A

Foramen rotundum

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64
Q

What two nerves are responsible for sensation to the forehead?

Give the nerve route from the CN

A

Supraorbital and supratrochlear

CN: V Trigeminal -> Ophthalmic -> Frontal-> Supraorbital and supratrochlear

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65
Q

What two nerves are responsible for sensation to the eye?

A

Long and short ciliary nerves

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66
Q

The greater palatine nerve is sensory to….

A

hard palate

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67
Q

The lesser palatine nerve is sensory to….

A

Soft palate

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68
Q

What nerves are sensory to the teeth?

A

Posterior and superior alveolar

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69
Q

Where does the mandibular nerve exit?

A

foramen ovale

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70
Q

What nerve gives sensation to the lower teeth? What is special about it?

A

Inferior alveolar

Stays in the mandibule until it pops out as the mental nerve

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71
Q

The ____ nerve provides sensation to the chin

A

Mental

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72
Q

What nerve provides sensation to the tongue?

A

Lingual

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73
Q

What nerve supplies sensation to the inner cheek?

A

Buccal

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74
Q

What is a common cause of trigeminal neuralgia? What can trigger it?

A

blood vessel pushing against the nerve

light touch or cold air

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75
Q

What branch of the trigeminal nerve is responsible for muscles of mastication?

A

Mandibular nerve- V3

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76
Q

What are the 4 muscles of mastication?

A
  1. Masseter
  2. Temporalis
  3. Lateral pterygoid
  4. Medial pterygoid
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77
Q

If there is a problem with the _____ nerve affecting bite strength, when the mouth is actively open, what side will the jaw deviate towards?

A

Mandibular nerve

deviate TOWARDS the problem side

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78
Q

Tensor veli palatini function?

A

Tenses soft palate

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79
Q

Tensor tympani, function?

A

Keeps the middle ear from shacking violently

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80
Q

What are the four rando muscles that are also supplied by the mandibular nerve?

A

-Tensor veli palatini
-Tensor tympani
- Anterior belly of diagastric
- Mylohyoid

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81
Q

Lateral pterygoid, function?

A

open the jaw

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82
Q

Hypoglossus muscle innervation?

A

CN XII: Hypoglossal

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83
Q

Stylohyoid muscle innervation?

A

CN VII, facial

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84
Q

Posterior Belly of digastric muscle innervation?

A

CN VII: Facial

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85
Q

General rule of thumb, facial SENSATION is what nerve?

MOTOR of the face is?

A

CN V: Trigeminal

CN VII: Facial

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86
Q

Where does the facial nerve enter? Where does it exit?

A

Internal acoustic meatus of the temporal bone

Stylomastoid foramen

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87
Q

Name the functions of CN VII

A

-MOTOR to the face
-Sensory to some of the ear
-Taste to anterior tongue
-Innervation to lacrimal, submandibular and sublingual glands

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88
Q

What are the six branches of the Facial nerve

A
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Mandibular
  5. Cervical
  6. Posterior auricular
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89
Q

Where does the facial nerve (and all of its branches) exit?

A

Stylomastoid foramen

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90
Q

Bell’s palsy is damage to what cranial nerve?

A

CN VII: Facial

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91
Q

What is indicated if you have a patient that screams Bell’s palsy but they can generate wrinkles on BOTH side

A

indicates CENTRALLY LOCATED lesion within the cortex or brainstem

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92
Q

What tiny muscle in the middle ear does the facial nerve innervate? What does de-innervation cause?

A

Stapedius

Hyperacusis: sounds are abnormally and painfully loud

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93
Q

What two parasympathetic nerves come off the facial nerve? and what nerves do they give rise to?

A

Greater petrosal -> lacrimal nerve
Chorda tympani -> Submandibular and sublingual glands

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94
Q

How is taste sensation conveyed?

A

travels backwards on the chorda tympani nerve

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95
Q

Where does CN VIII enter?

A

Enter: Internal acoustic meatus

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96
Q

Where is an acoustic neuroma/schwannoma usually found? What nerves are affected?

A

Near the internal acoustic meatus

Facial and vestibulocochlear

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97
Q

Fluid on the inside of the ear canals is called ?

A

Endolymph

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98
Q

Fluid on the outside of the canals is called?

A

Perilymph

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99
Q

Where does CN VIII exit?

A

It does not, stays within the temporal bone

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100
Q

What nerves innervate the external ear?

A

V3, VII and upper cervical spinal nerves

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101
Q

What nerves innervate the ear canal?

A

CN VII and X

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102
Q

What are the 3 ossicles of the middle ear?

A

Malleus, incus and stapes

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103
Q

What are the crystalline deposits called in the inner ear?

A

otoliths

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104
Q

What are the three semi-circular loops in the ear called?

A

Utricle- Horizontal
Saccule- Vertical
Ampulla- Rotational

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105
Q

The jugular foramen is the exit point for what three nerves?

A

CN IX: Glossopharyngeal
CN X: Vagus
CN XI: Spinal

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106
Q

Name some functions of CN IX. (In order)

A
  1. Sensory to pharynx and middle ear
  2. Motor to stylopharyngeus
  3. General sensory and taste sensory to posterior tongue
  4. Innervates the parotid salivary gland
  5. Innervates baroreceptors and chemoreceptors in the carotid vessels
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107
Q

What does a lesion of CN IX present with?

A

Dry mouth due to decreased salivation

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108
Q

Where does the CN X exit?

A

Jugular foramen

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109
Q

Name the functions of CN X

A
  • Motor to palate, pharynx, larynx and esophagus
  • Sensory to the larynx, esophagus, external ear canal, dura mater of the posterior cranial fossa
  • Innervates the aortic baroreceptors
  • Motor and sensory to all the thoracic organs, foregut and midgut
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110
Q

What would a lesion of CN X present with?

A

Increased heart rate, decreased gut peristalsis and sounds, decreased secretions from digestive glands

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111
Q

What nerves form the pharyngeal plexus? Which one is motor vs sensory?

A

CN IX (Sensory) and CN X (motor)

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112
Q

How do you test CN IX and X?

A

Check their gag reflex

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113
Q

If the patient felt the touch at the back of their throat checking their gag reflex, what nerve is intact?

A

CN IX: Glossopharyngeal

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114
Q

If the patient’s throat twitched as a result of checking their gag reflex, what nerve is intact?

A

CN X: Vagus

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115
Q

Stylopharyngeus muscle is innervated by ?

A

CN IX: Glossopharyngeal

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116
Q

All laryngeal muscles are innervated except _____ by what nerve? What is the exception innervated by?

A

Inferior laryngeal nerve from Recurrent branches of CN X: Vagus

cricothyroid muscle- external branch of superior laryngeal nerve

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117
Q

Uvula deviation leans the strong or weak side?

A

the STRONG side

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118
Q

When swallowing, what happens?

A

The suprahyoid muscles elevate the hyoid bone, closing off the laryngeal opening

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119
Q

Do not forget to look at this slide

A
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120
Q

What nerve innervates the larynx? Motor and sensory?

A

Both by CN X: Vagus

Motor: Inferior laryngeal nerve from recurrent laryngeal nerve

Sensory: Internal branch of superior laryngeal nerve

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121
Q

What branch is sensory to the larynx?

A

Sensory: Internal branch of superior laryngeal nerve

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122
Q

What branch is motor to the larynx?

A

Inferior laryngeal nerve from recurrent laryngeal nerve

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123
Q

What muscle is responsible for deepening or heightening the pitch of our voice?

A

Cricothyroid muscle

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124
Q

What nerve is motor and sensory to the esophagus?

A

Recurrent laryngeal nerve

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125
Q

What nerve innervates the cricothyroid muscle?

A

External branch of the superior laryngeal nerve

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126
Q

What is the only muscle that pulls the airway apart?

A

Posterior cricoaretynoid muscle

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127
Q

What part of the body makes the noise that we hear?

A

Vibrations of the true vocal folds

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128
Q

The ______ muscle tilts the thyroid cartilage anteriorly on the cricoid. What does this cause?

A

Cricothyroid muscle

Raising the voice’s pitch

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129
Q

What would de-innervation of the cricothyroid cause?

A

monotone voice

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130
Q

***The _____ muscles ABduct the vocal folds. If de-innervation happens unilaterally, what is the result?

A

Posterior cricoaretynoid muscles

it will cause hoarseness as the loose fold flaps in the breeze

Dr. Ward said to really know this one

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131
Q

____ and _____ muscles loosen the vocal folds when they contract. What are they innervated by?

A

Vocalis and thyroaretynoid

Inferior laryngeal nerve

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132
Q

______ and _______ muscles ADduct the vocal folds. Which allows (more/less) air to travel through the larynx

Innervated by?

A

lateral cricoaretynoid and aretynoid

LESS

Inferior laryngeal nerve

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133
Q

The accessory nerve originates from the ______ spinal cord level.

A

C1-5

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134
Q

Axons from the accessory nerve exit the spinal cord and ascend through the ______ and then through the _______.

A

Foramen magnum

Jugular foramen

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135
Q

What muscles does CN:XI innervate?

A

Sternocleidomastoid and trapezius muscle

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136
Q

Where does CN: XII exit the skull?

A

Hypoglossal canal

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137
Q

What muscles does CN XII innervate?

A

All the muscles of the tongue except the palatoglossus

138
Q

Damage to _____ will cause difficult swallowing

A

cervical plexus

139
Q

What levels consist of the cervical plexus? What does it innervate?

A

C1-3

Muscles near the hyoid bone

140
Q

The cervical plexus forms a loop. What is it called?

A

Ansa cervicalis

141
Q

____ axons also hitchhike on the hypoglossal nerve

A

C1

142
Q

The cervical plexus carries (motor/sensory) axons from the ……

A

sensory

neck, ear, clavicles and posterolateral scalp

143
Q

Damage to the cervical plexus can cause _____ ______.

A

Thyrohyoid tilt

144
Q

What is the function of the Genioglossus?

A

sticks the tongue out

145
Q

What is the function of the hyoglossus?

A

Depresses the tongue

146
Q

What is the function of the styloglossus?

A

Retracts the tongue

147
Q

Intrinsic muscles of the tongue are responsible for? Why?

A

All the weird movements the tongue can do

because they attach to other muscles, giving them more freedom

148
Q

Palatoglossus is innervated by ?

A

CN X: Vagus

149
Q

Stylohyoid and Tendon of diagastric muscles are innervated by ?

A

CN VII: Facial

150
Q

Mylohyoid is innervated by ?

A

CN V: Trigeminal V3

151
Q

The Geniohyoid is innervated by ?

A

C1: Ansa Cervicalis

152
Q

Damage to the genioglossus muscle will result in ?

A

The tongue will point TOWARDS the affected side due to the genioglossus muscle crowding out the weaker side

153
Q

The epiglottis is responsible for ?

Innervated by ?

A

General sensation and taste

CN X: Vagus

154
Q

Function of the posterior 1/3rd of the tongue ?

Innervation?

A

General sensation and taste

Glossopharyngeal CN: IX

155
Q

Function of the anterior 2/3rds of the tongue?

Innervation?

A

General sensation-> Lingual nerve (branch of mandibular nerve V3)

Taste -> Chorda tympani (Branch of facial nerve)

156
Q

What nerve is responsible for taste?

A

Chorda tympani

157
Q

The part in blue is called ?

What things does it contain?

A

Anterior Cranial Fossa

Frontal, Ethmoid and Sphenoid Bones
Frontal lobe
Olfactory Bulb (CN I)

158
Q

The part in green is called ?

What does it contain?

A

Middle Cranial Fossa

Sphenoid and Temporal Bones
Temporal lobe
Optic nerve (CN II)
Pituitary Gland
Hypothalamus
Middle meningeal artery
CN III, IV, V, VI

159
Q

The part in light pink is called ?

A

Posterior Cranial Fossa

Temporal and Occipital Bone
Pons
Medulla
Cerebellum
CN VII-> XII

160
Q

The chorda tympani hops on the _____ nerve in order to ?

A

Lingual nerve of V3 to get to sublingual and salivary, taste buds

161
Q

Name the borders of the posterior triangle

A

Trapezius
SCM
Clavicle

162
Q

What is the orange triangle?

A

Occipital

163
Q

What is the blue triangle?

A

Supraclavicular

164
Q

What is the green triangle?

A

Carotid

165
Q

What is the purple triangle?

A

Submandibular

166
Q

What is the white triangle?

A

Submental

167
Q

What are the borders of the occipital triangle?

A

Trapezius
SCM
Inferior belly of the omohyoid

168
Q

Name the 4 structures that the occipital triangle contains.

A
  1. External jugular vein
  2. Cervical Plexus
  3. Accessory Nerve
  4. Trunks of brachial plexus
169
Q

What are the borders of the Omoclavicular triangle?

A

Inferior Belly of the omohyoid muscle
SCM
Clavicle

170
Q

What 2 things does the omoclavicular triangle hold?

A
  1. Subclavian artery and vein
  2. Supraclavicular lymph node
171
Q

What are the borders of the Anterior triangle?

A

Midline of the neck
SCM
Inferior border of mandible

172
Q

What are the borders of the submandibular triangle?

A

Anterior belly of the digastric muscle
Posterior belly of the digastric muscle
Inferior border of the mandible

173
Q

The submandibular triangle contains what 4 important things.

A

Submandibular gland
submandibular lymph nodes
Hypoglossal nerve
Facial artery and vein

174
Q

What are the borders of the submental triangle?

A

Anterior belly of digastric muscle
Hyoid bone
Midline of neck (OR) opposite anterior belly of digastric muscle

175
Q

What important structure is found in the submental triangle

A

Submental lymph nodes

176
Q

What are the borders of the carotid triangle?

A

Superior belly of omohyoid
SCM
Posterior belly of digastric

177
Q

Name the 8 important structures found within the carotid triangle.

A

Carotid sheath
- All carotid arteries
- Internal jugular vein
- Vagus nerve
Hypoglossal nerve
Accessory nerve
Thyroid gland
Larynx
Deep cervical lymph nodes

178
Q

What are the borders of the carotid triangle?

A

Superior belly of omohyoid muscle
SCM
Sternohyoid muscle

179
Q

What 2 important structures are within the muscular triangle.

A

Thyroid gland
Parathyroid gland

180
Q

The flat, paired bones of the skull form from _______ via ______.

A

somatic mesoderm

intramembranous ossification

181
Q

In children the coronal suture and sagittal suture meet at ?

A

Anterior fontanelle (soft spot)

182
Q

What does it mean if the anterior fontanelle is sucked in?

A

The child is dehydrated

183
Q

Before the pterion is formed it is the ____ in children.

A

Anterolateral or sphenoidal fontanelle

184
Q

Before the asterion is formed it is the ______ in children

A

Posterolateral or mastoid fontanelle

185
Q

The only true synovial joint of the skull is the _______, allowing the _____ process of the mandible to articulate with the temporal bone. A _______ disc allows smooth movement

A

temporomandibular joint

condylar

fibrocartilage

186
Q

There are ____ pharyngeal arches in human development. Name them.

A

5

1
2
3
4
6
there is NO 5

187
Q

Arch 1 is innervated by ? What muscles are derived from it? Bone?

A

V3

Muscles of mastication

Mandibule

188
Q

Arch 2 is innervated by ? Muscles?

A

CN VII: Facial

Muscles of facial expression

189
Q

Arch 3 innervates? Muscles?

A

CN IX: Glossopharyngeal

Stylopharngyeal and muscles of pharynx/palate

190
Q

Arch 4 innervates ? Muscles?

A

CN X: Vagus

muscles of pharynx/palate

191
Q

Arch 6 innervates ? muscles?

A

Recurrent branch of CN X

Muscles of phonation (speaking/voice)

192
Q

First groove gives rise to ?

A

External auditory meatus

193
Q

First pouch gives rise to?

A

Auditory tube

194
Q

Second pouch gives rise to?

A

Palatine tonsil

195
Q

third pouch gives rise to ?

A

Parathyroid gland and thymus

196
Q

fourth pouch gives rise to ?

A

parathyroid gland and ultimobranchial body

197
Q

ultimobranchial body produces ____ ?

A

Calcitonin releasing cells of the thyroid

198
Q

The 2nd, 3rd and 4th grooves develop into ?

A

Cervical sinus

199
Q

The ____ develops off the tongue by descending down the neck

A

thyroid

200
Q

The ear/auricular hillocks develops off of what two arches?

A

First and Second

201
Q

The external ear, _____, develops from ________ that fuse, migrate and eventually form the mature auricle.

A

Auricle

Six auricular hillocks

202
Q

Failure of the cervical sinus to obliterate can result in _______

A

branchial fistulae or cysts.

203
Q

______ are openings from the skin (external) or oral region (internal) that extend to a cervical cyst.

A

Branchial fistulae (sometimes called branchial sinuses)

204
Q

_____ are isolated, fluid-filled sacs that do not open to either the skin or pharynx.

A

Branchial cysts

205
Q

Branchial fistula present with ?

A

Persistent bad breathe

206
Q

Describe how a thyroglossal duct cyst forms

A

Part of the thyroid tissue lodges along the path, separate from the thyroid gland

207
Q

What is a pyramidal lobe?

A

an additional lobe on the thyroid gland that extends superiorly along the path of the thyroglossal duct

208
Q

What is the early opening of the GI tract called?

A

Stomodeum

209
Q

Describe an oblique facial cleft

A

Failure of medial and lateral nasal prominences to fuse with the maxillary prominences

210
Q

The _____ is connected to the incisive bone, or primary palate, which contributes the _______ to the maxilla and fuses with the rest of the hard palate. Palatine shelves “swivel” to form the rest of the hard palate

A

philtrum

four incisor teeth

211
Q

If you have a baby with a cleft palate, what difficulties might they have?

A

latching on the nipple to nurse

212
Q

Cleft lips are failures of the ______ to fuse with the ______.

A

maxillary prominence

medial nasal prominences

213
Q

Describe holoprosencephaly. What gene is responsible?

A

Failure of the cerebral hemispheres and lateral ventricles to separate

Sonic hedgehog

214
Q

What two prominences fuse to form the upper lip?

A

maxillary and medial nasal prominences

215
Q

The yellow section is what?

A

Primary palate also called the incisive bone

216
Q

The orange section is called ?

What does it contain?

A

Occipital triangle

SCM
Inferior belly of omohyoid
Trapezius

217
Q

_____ headache, pain is related to the location and innervation of paranasal _____

A

Sinus

218
Q

_____ headache: recurring, intense, UNILATERAL pain around the eye and cheek for about 30 minutes

A

Cluster

219
Q

______ headache: muscle tension and fatigue creating BILATERAL scalp pain, can co-exist with other headaches

A

Tension

220
Q

_______ headache: variable UNILATERAL headache may or may not have sensory changes

A

Migraine

221
Q

The “worst headache of my life” can be caused by what 3 major kinds

A

Epidural hematoma
Subdural hematoma
Subarachnoid hematoma

222
Q

______ hematomas are between dura and arachnoid mater, and are not impeded by suture of the cranial bones. What are they shaped liked?

A

Subdural

Semilunar (half moon)

223
Q

_______ due to ruptured aneurysms can be difficult to spot since the blood is not confined in any one area but can spread throughout the ______ space. How are these best diagnosed?

A

Subarachnoid hemorrhages

MRI- due to being able to see the contrast between CSF and blood

224
Q

Vestibular schwannoma causes ???? Which CN is involved?

A

Sensorineural hearing loss and vertigo

CN VIII (sometimes can involve VII as well)

Note: Sensorineural means hearing loss due to damage to the inner ear or damage to CN XIII

225
Q

Acute neurologic signs for eye pain and visual disturbances points to ???

A

vascular cause

225
Q

Slowly progressive signs of eye pain and visual disturbances point to ???

A

Tumor

226
Q

Infection, thrombi or general dysfunction of what four CNs most likely involves the cavernous sinus

A

CN III, IV, VI and V1

227
Q

Dysfunction of _____ can be caused by aneurysm of the internal carotid artery in the cavernous sinus or increased intracranial pressure

A

CN VI

228
Q

Dysfunction of _____ is often caused by a space-filling lesion that pushes the _____ nerve against the opposite tectorial notch. This will also lead to increased intracranial pressure.

A

CN III

229
Q

Temporalis

Origin/Insertion/Function

A

Temporal fossa

Coronoid process of mandible

Elevate the mandible, particularly the incisors

230
Q

Masseter

Origin/Insertion/Function

A

Zygomatic Arch

Angle and body of mandible

Elevate the mandible- particularly the molars

231
Q

Medial Pterygoid

Origin/Insertion/Function

A

Pterygoid plates of sphenoid

Angle and body of mandible

Elevate and medially deviate mandible

232
Q

Lateral Pterygoid

Origin/Insertion/Function

A

Pterygoid plates of sphenoid

Condylar process and TMJ joint disc

Open and protrude the mandible

233
Q

Superior pharyngeal constrictor

Origin/Insertion/Function

A

Raphe with buccinator muscle

Occipital bone and pharyngeal constrictors

Constrict pharynx to move bolus of food inferiorly

234
Q

Middle Pharyngeal Constrictor

Origin/Insertion/Function

A

Hyoid bone

Other pharyngeal constrictors

Constrict pharynx to move bolus of food inferiorly

235
Q

Inferior Pharyngeal Constrictors

Origin/Insertion/Function

A

Thyroid cartilage

Other pharyngeal constrictors

Constrict pharynx to move bolus of food inferiorly

236
Q

Stylopharyngeus

Origin/Insertion/Function

A

Styloid process of temporal bone

Pharyngeal constrictors

Elevate and shorten pharynx

237
Q

Muscles of soft palate and uvula

Origin/Insertion/Function

A

Hard palate and pterygoid plates of sphenoid bone

Same muscle from the opposite side

Separate the nasopharynx and oropharynx

238
Q

Levator Veli Palatini

Origin/Insertion/Function

A

Cartilage of auditory tube

Soft palate

Separate the nasopharynx and oropharynx

239
Q

Tensor Veli Palatini

Origin/Insertion/Function

A

Cartilage of auditory tube and pterygoid plates

Soft palate

Separate the nasopharynx and oropharynx

240
Q

Palatopharyngeus

Origin/Insertion/Function

A

Soft palate

Pharyngeal constrictors

Depress palate and elevate pharynx

241
Q

Palatoglossus

Origin/Insertion/Function

A

Soft palate

Base of tongue

Depress palate

242
Q

Digastric

Origin/Insertion/Function

A

Mastoid process of temporal bone

Genu of mandible and hyoid bone

Elevate hyoid bone during swallowing

243
Q

Stylohoid

Origin/Insertion/Function

A

Styloid process of temporal bone

Hyoid bone

Elevate hyoid bone during swallowing

244
Q

Mylohyoid

Origin/Insertion/Function

A

Body of right and left mandible

Midline raphe

Elevate hyoid bone during swallowing

245
Q

Sternohyoid

Origin/Insertion/Function

A

Posterior sternum

Hyoid bone

Depress hyoid bone

246
Q

Sternothyroid

Origin/Insertion/Function

A

Posterior sternum

Thyroid cartilage

Depress hyoid bone

247
Q

Thyrohyoid

Origin/Insertion/Function

A

Thyroid cartilage

Hyoid bone

Depress hyoid bone

248
Q

Omohyoid

Origin/Insertion/Function

A

Superior scapula

Hyoid bone

Depress hyoid bone

249
Q

_____ Contains cardiorespiratory center, pain sensation in head, facial movement, swallowing

A

Medulla

250
Q

_______ Relay between cortex and cerebellum, muscles of mastication, fine touch of face

A

Pons

251
Q

_____ Coordination of ongoing motor activity

A

Cerebellum

252
Q

______ Assists with motor planning, jaw proprioception

A

Midbrain

253
Q

_____ Day-to-night and seasonal cycles

A

Epithalamus (pineal gland)

254
Q

______ Primal drives: appetite, sexual, thermoregulation

A

Hypothalamus

255
Q

_____ Growth, thyroid, water balance, lactation, pregnancy maintenance

A

Pituitary gland

256
Q

Frontal lobe function

A

Personality, motor activity, executive impulse control

257
Q

Pre-central gyrus function

A

Primary motor cortex

258
Q

Parietal lobe function

A

Perception of senses, mathematics, language

259
Q

Post-Central gyrus function

A

Primary somatosensory cortex

260
Q

Temporal lobe function

A

Memory, emotion, hearing, language

261
Q

Occipital lobe function

A

Vision

262
Q

Corpus callosum function

A

Sharing information between right and left lobes

263
Q

Longitudinal cerebral fissure function

A

Separates left and right cortex

264
Q

Central Sulcus function

A

Separates frontal and parietal lobes

265
Q

Lateral Sulcus function

A

Separates frontal & parietal lobes from temporal lobe

266
Q

Parieto-occiptal sulcus function

A

Separates parietal and occipital lobes

267
Q

Calcarine sulcus function

A

Separates upper and lower aspects of occipital lobe

268
Q

The ______ separates the right & left lobes of the cortex

A

falx cerebri

269
Q

The _______ separates the occipital and temporal lobes from the cerebellum.

A

tentorium cerebelli

270
Q

Telencephalon gives rise to ______ and ______

A

Cerebral hemispheres and lateral ventricles

271
Q

Diencephalon gives rise to _____ and ______

A

Thalamus and 3rd ventricle

272
Q

Mesencephalon gives rise to ____ and _____

A

Midbrain and aqueduct

273
Q

Metencephalon gives rise to _____, ______ and ______

A

Pons, cerebellum and 4th ventricle

274
Q

Myelencephalon gives rise to ______ and _____.

A

Medulla and 4th ventricle

275
Q

What is the thinnest tube in the flow of CSF?

A

Cerebral aqueduct

276
Q

What is the structure called where the CSF exit the 4th ventricle?

A

At the lateral and median aperture

277
Q

Tuffs of arachnoid mater that allow CSF to leave are called ?

A

Arachnoid granulations

278
Q

Where does the arachnoid granulations drain into?

A

Superior sagittal sinus

279
Q

What are the 3 fine touch receptors?

A

Meissner corpuscles, Ruffini end organs and Merkel cells

280
Q

_____ sense pressure and vibration

A

Pacinian corpuscles

281
Q

_______ are sensitive to pain and temperature

A

Free nerve endings

282
Q

DCML conveys what 3 things to the brain

A

Fine touch, vibration and proprioception

283
Q

Anterolateral/Spinothalamic tract receives what 3 things

A

Pain, temperature and crude touch

284
Q

Where is the first neuron for DCML?

A

Posterior root ganglion

285
Q

Name and where is the second order neuron for DCML?

A

Lower limb = Gracile fasculis
Upper limb = Cunuate fasculis

in the inferior medulla

286
Q

DCML 3rd order neuron are called ?
Location?

A

Ventral Posterior Lateral Nucleus (VPL)

Thalamus

287
Q

Anterolateral tract are responsible for what 3 things?

A

Pain
Temperature
Crude touch

288
Q

Anterolateral System decussates ….

A

in the anterior white commissure

289
Q

Anterolateral system ascends…..

A

CONTRAlaterally

290
Q

Where does the Anterolateral system synapse?

A

Synapses almost immediately in the posterior horn

291
Q

Spinothalamic leads to the ???

A

conscious perception of pain

292
Q

Spinoreticular is responsible for ???

A

arousal aspects of pain

293
Q

Spinobulbar is responsible for ???

A

wincing and withdrawal

294
Q

Spinomesencephalic is responsible for ???

A

pain modulation

295
Q

Spinohypothalamic is responsible for ???

A

Emotional/autonomic response to pain

296
Q

____ take blood from the cortex to the Superior sagittal sinus

A

bridging veins

297
Q

______ signals the spinal cord to increase tone to the stretched muscle

A

Muscle spindles

298
Q

_____ signals the spinal cord to decrease tone to agonist muscles

A

Golgi Tendon Organs

299
Q

Deeper nervous structures drain to the _____ or ______

A

inferior sagittal sinus or Basilar vein

300
Q

T/F: The Basilar vein is parallel to the basilar artery.

A

False, basilar vein is NOT parallel to the artery

301
Q

Blood flows through the straight sinus to join the superior sagittal sinus at the ________

A

confluence of sinuses

302
Q

Why is the cavernous sinus clinical important?

A

Because it has lots of nerves traveling through there

303
Q

What connects the anterior and posterior venous blood drainage?

A

Superior and Inferior petrosal sinuses

304
Q

The Inferior and Superior petrosal sinuses connect with the posterior drainage at the ???

A

Transverse and sigmoidal sinuses.

Then head down to the internal jugular vein

305
Q

______ is site that is vulnerable to venous infections or an internal carotid artery aneurysm

A

Right cavernous sinus

306
Q

What is the artery located below the pterion?

A

Middle meningeal artery

307
Q

This is an example of?

Usually artery or vein?

A

Epidural hematoma

The blood hemorrhaging into the epidural space pushes the dura away from the skull but cannot separate the dura from the sutures

Usually ARTERIES

308
Q

This is an example of ?

Usually artery or vein?

A

Subdural hematoma

Between the dura mater and arachnoid, not impeded by the sutures of the cranial bones

usually VEIN

309
Q

What kind of vessel is common in subdural hematomas.

A

Bridging veins

310
Q

______ bleeds are usually slower than their counter parts

A

Venous bleeds are slower than arterial bleeds

311
Q

______ most frequently cause subarachnoid hematomas

A

Ruptured cerebral arteries by burst aneurysms

312
Q

Rupture of vessels inside the brain is a _______.

A

cerebral hemorrhage

313
Q

______ artery supplies the hip, leg and foot region of the post central gyrus.

A

Anterior cerebral artery

314
Q

What is the area in Blue? If it is affected, how does it present? What is the technical term for it?

A

Wernicke’s area

CANNOT comprehend, but can speak

Receptive aphasia

315
Q

What is the area in red? If it is affected, how does it present? What is the technical term for it?

A

Broca’s area

Can comprehend, but CANNOT speak

Expressive Aphasia

316
Q

Name some symptoms of Korsakoff’s syndrome

A
  • results from chronic alcoholism
  • confusion, severe memory loss and apathy
  • due to poor nutrition- develop thiamine deficiency
  • damage to thalamus and parts of the hypothalamus
317
Q

What is circled in purple?

A

Caudate nucleus

318
Q

What is outlined in red?

A

Putamen

319
Q

What is outlined in yellow?

A

Globus pallidus (external segment)

320
Q

What is outlined in green?

A

Crura of fornix

321
Q

The pathways of Basal Ganglia; the direct pathway _____ motion

A

INCREASES

322
Q

The pathways of Basal Ganglia; the indirect pathway _____ motion

A

decreases

323
Q

Parkinsons’s is the loss of _______

A

Substantia nigra

324
Q

The loss of _____ and ______ is Huntington’s Disease

A

Putamen and Caudate Nucleus

325
Q

_____ Inability to make coordinated and accurate movements

A

Ataxia

326
Q

______ Movements are too short or too long and are adjusted after completion.

A

Dysmetria

327
Q

______ Inability to make rapidly alternating movements.

A

Dysdiadochokiesia

328
Q

The venous drainage of the nasal cavity is into the ­_____ and ______.

A

anterior facial and ophthalmic veins

329
Q

Arterial bleeding in the nose can be difficult to control due to the multiple vessels feeding into _______

A

Kiesselbach’s area

330
Q

What is the technical term for a nose bleed?

A

Epistaxis

331
Q

The ______ is the ONLY place you can directly observe the circulatory system to look for pathology, degeneration, etc

A

central artery of the retina

332
Q

Anastomosis in the head and neck rely on what two arteries? Both branch of what larger artery?

A

The facial artery and infraorbital artery

External carotid artery

333
Q

The terminal (forehead) part of ______ artery anastomoses with branches of the ______ artery, which originates from what larger artery?

A

Facial artery and ophthalmic artery

Internal carotid artery

334
Q

What are the five layers of the scalp?

A

S= Skin
C = Connective tissue
A = Aponeurosis (tendon between occipitalis and frontalis muscles
L = Loose (areolar) connective tissue
P = Periosteum

335
Q

Blood near the nose & upper lip drains through the ______ to reach the ______

A

facial veins

jugular veins

336
Q

However, blood near the nose and upper lip can drain through _____ to the _______.

A

ophthalmic veins

cavernous sinus

337
Q

Dysfunction of what cranial nerves in addition to swelling of the orbit are most common signs of cavernous sinus thrombosis.

A

cranial nerves III, IV, V1, V2 & VI

338
Q

The Pericervical lymph collar consists of what 5 groups of lymph nodes?

A

Occipital
Mastoid
Parotid
Submandibular
Submental

339
Q

The superficial fascia of the face and scalp drain into what lymph group?

A

Pericervical lymph collar

340
Q

After the pericervical lymph collar the fluid goes to ______. Then they are passed to _____.

A

Superficial cervical lymph nodes

Deep cervical lymph nodea

341
Q

After the deep cervical lymph nodes, they collect ???? and then ?????

A

Right and left jugular lymphatic trunk

Subclavian veins

342
Q

What are MALT? Give an example. Cellular type?

A

Mucosa-associated lymphatic tissue

Tonsils

Lymphocytes

343
Q

What is the submental lymph node drainage route?

A

Chin-> middle of lower lip -> tip of tongue -> Submental node

344
Q

What is the submandibular lymph node drainage route?

A

Rest of lower lip-> Upper lip -> Sublingual gland -> Submandibular node