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Anatomy > Exam 4: Neck, Head > Flashcards

Exam 4: Neck, Head Flashcards

1
Q

boundaries of neck

A

Sternal notch, clavicle, 1st rib and IV disc C7-T1 to base of skull and lower border of mandible

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2
Q

suprahyoid region of superficial anterior neck

A

Muscles of Suprahyoid Region:
–Anterior belly of Digastric (mylohyoid n from inf alveolar n off mandib div of trigeminal)
Depress & retraction of mandible, elevate hyoid
–Mylohyoid(mylohyoid n from inf alveolar n off mandib div of trigeminal)
Elevate hyoid, floor of mouth & tongue
–Geniohyoid(C1 through hypoglossal)
Elevate & protrude hyoid; elevate larynx; depress mandible

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3
Q

hyoid bone of superficial anterior neck

A 
mylohyoid
geniohyoid
sternohyoid
omohyoid
thyrohyoid
digastric and stylohyoid
hyoglossus
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4
Q

infrahyoid region of superficial anterior neck

A

Muscles:

Ansa Cervicalis (C1,2,3): Nerve loop formed by union of
Descending Hypoglossal n (C1) and Descending Cervical n (C2,3)
–Sternohyoid
–Sternothyroid
–Thyrohyoid
–Omohyoid

–Sternocleidomastoid C2,C3

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5
Q

ansa cervicales inframandibular innervation

A

omohyoid (inf): depress larynx

sternohyoid: depress larynx
sternothyroid: depress larynx
geniohyoid: elevate larynx

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6
Q

submandibular triangle of superficial anterior neck

A 
•Superior: (inf) body of mandible
•Anterior: Anterior Digastric
•Posterior: Posterior Digastric & Stylohyoid
•Medial: mylohyoid, hyoglossus, middle pharngeal constrictor
•Contains:
–Submandibular salivary gland
–Hypoglossal N (mms of tongue)
–Mylohyoid N (mylohyoid mm & ant digastric)
–Lingual n (general sensation to tongue)
–Lingual a (from ext carotid to tongue)
–Lingual v
–Facial a (from ext carotid to face)
–Facial v
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7
Q

submandibular muscles/innervations

A

•Muscles:
–Mylohyoid Mylohyoid n from Mandib div of Trigem.
–Anterior belly of Digastric Mylohyoid n from Mandib div of Trigem.
•Retract mandible
–Posterior belly of Digastric Facial n (post auricular branch)
•Depress, retract mandible; retract elevate stabilize hyoid
–Stylohyoid Facial n (cervical branch)
•Retracts elevate hyoid
–Hyoglossus Hypoglossal n
–Middle Pharngeal Constrictor Vagus n

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8
Q

facial nerve branches

A
  1. temporal
  2. zygomatic
  3. buccal
  4. mandibular
  5. cervical
  6. post auricular
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9
Q

hypoglossus

A

hypoglossal N

depress, retract tongue

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10
Q

carotid triangle

A 
•Superior: Posterior Digastric
•Inferior: sup belly of Omohyoid
•Posterior: sternocleidomastoid
•Contains:
–Common Carotid a
•from brachiocephalic on rt
•arch of aorta on Lt
•External Carotid a (many branches in neck and face)
•Internal Carotid a (to BRAIN)
–Internal Jugular v
–Retromandibular v
–Vagus n
–Ansa cervicalis
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11
Q

carotid triangle innervation

A

•Vagus N
–Preganglionic parasympathetic visceral motorto mm of larynx
through
RECURRENT LARYNGEAL N &
Ext Laryngeal n
–General visceral sensoryfrom larynx by theInternal Laryngeal N.

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12
Q

larynx innervation

A

vagus N –>recurrent laryngeal N –>intrinsic muscles of larynx

vagus N –>sup laryngeal –>

a. int. laryngeal N : sensory to larynx
b. ext laryngeal N: cricothyroid muscle

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13
Q

laryngeal region

A 
•Larynx
–Thyroid Cartilage
–Cricoid Cartilage
–Arytenoid Cartilage
•Larynx Attachments
–Hyoid bone: sup by thyrohyoid membrane
–Trachea: inf by cricotracheal lig
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14
Q

muscles of larynx

A 
•Extrinsic: move entire laryngeal complex
	Depress larynx:
	–Omohyoid
	–Sternohyoid
	–Sternothyroid
	Elevate larynx:
	–Stylohyoid
	–Ant & post digastrics
	–Mylohyoid
	–geniohyoid
•Intrinsic: change tension in vocal folds
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15
Q

intrinsic muscles of larynx

A 
•Posterior cricoarytenoid
•Lateral cricoarytenoid
•Transverse & oblique arytenoids
•Thyroarytenoid
•Vocalis
•Cricothyroid
•ALLinnervated byRecurrent laryngeal N of Vagus (exceptCricothyroid –ext laryngeal n branch of sup laryngeal n of vagus)
•Sensation of larynx:
–INTERNAL Laryngeal N branch of sup laryngeal n of vagus
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16
Q

deep anterior neck

A 
–Internal Jugular Vein
–Brachiocephalic a
–Carotid a
–Subclavian a
•Vertebral A
•Internal Thoracic
•Costocervical Trunk
•Thyrocervical Trunk
–Vagus n
–Hypoglossal n
–Lingual n
–Cervical portion of sympathetic trunk
–Deep anterior cervical mms
•Longus capitis & Coli mms
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17
Q

muscles of deep anterior neck

A 
•Longus Capitis
•Longus Coli
–superior oblique portion
–Inferior oblique
–Vertical
•Rectus Capitis
–Anterior
–Lateralis
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18
Q

trigeminal nerve

A

general sensation to face:
•Opthalmic Div: skin of forehead & nose
•Frontal n
–Supraorbital: mid & lat forehead
–Supratrochlear: mid & lat forehead
•Nasociliary –Infratrochlear n: root of nose
•Maxillary Div: below eyes & above mouth
•Infraorbital n: side of nose, lower eyelid, below eye, upper lip
•Zygomatic
–Zygomaticofacial n: zygomatic arch
–Zygomaticotemporal n: skin just lateral to eye
•Mandibular Div: lower jaw and anter to ear
•Buccal n: cheek and lateral jaw
•Auriculotemoral n: anterior to ear and lateral scalp

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19
Q

muscles of facial expression innervation

A

ALL mms innervated by FACIAL N (VII)

EXCEPT: Levator Palpebrae Superioris oculomotor n (III)

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20
Q

muscles of facial expression forehead

A

Frontalis: elevates eyebrows

facial N

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21
Q

muscles of facial expression: eye

A

–Orbicularis oculi: full closure; facial N
–Levator palpebrae sup: opens; oculomotor N (CN III)
–Corrugator: medial eyebrow up and lateral; facial N

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22
Q

muscles of facial expression: nose

A

–Nasalis: compress/dilate nostril; facial N

–Procerus: medial brow down, wrinkles skin of nose; facial N

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23
Q

muscles of facial expression: cheek

A

Buccinator: cheek inward, blow & suck;”block a trumpet”; facial N

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24
Q

muscles of facial expression: mouth

A 
Facial N
–Orbic oris: protrude lips, close
–Zygomaticus maj/min: elev angle of mouth
–Lev Labii Sup: elev up lip
–Lev Anguli oris: raises angle
–Risorius: retract corners lat
–Depressor Anguli oris
–Depressor Labii Inferioris
–Mentalis: deprss med lower lip
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25
Q

muscles of facial expression: neck

A

facial N

Platysma: depress lower lip, assist with mouth opening

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26
Q

frontalis

A

Elevates the brows and creates transverse forehead lines when contracted.

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27
Q

bell’s palsy

A

–Unilateral paralysis of mms of facial expression
–Inflammation of facial n often assoc with infection in parotid region
–Recovery SLOW

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28
Q

facial paralysis

A

–Trauma
–Surgery
–Severe infection
–Symptoms: loss of taste ant tongue, decreased salivation from sublingual & submandibular glands
–SENSATION TO FACE INTACT. Sensory from trigeminal n

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29
Q

boundaries of parotid region

A

–Ant: ramus of mandible, masseter, med pterygoid mms
–Post: mastoid process of temp bone, ant border SCM
–Sup: external auditory meatus & TMJ jt
–Infer: post belly of digastric & stylohyoid mm

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30
Q

contents of parotid region

A

–Parotid gland
–facial n, auriculotemoral n (mandib div of V),greater auricular n (C2,3)
–external carotid a & 3 branches, retromandibular v

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31
Q

parotid region: facial N

A 
–Passes through Parotid gland
–Posterior auricular nto post belly digastric
–5 terminal branches
	•Temporal: mm above & around eye
	•Zygomatic: below eye & upper cheek
	•Buccal: buccinator & mm in lower cheek, upper            mouth
	•Mandibular: mm around and below mouth
	•Cervical: platysma, stylohyoid
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32
Q

boundaries of temporal region

A

–Infer: parotid region
–Anter: frontal process of zygomatic bone
–Post: root of zygomatic process of temp bone

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33
Q

contents of temporal region

A 
–Temporalis mm
–Nerves:
	•Temporal branches of facial n,
	•Auriculotemporal n, (Mandib of V)
	•Deep temporal ns (Mandib of V)
	•Zygomaticotemporal n, (Max of V)
–Superficial and deep temporal blood vessels
–TMJ
–External auditory meatus
34
Q

TMJ

A

•Mandibular fossa of temp bone & mandibular condyle
•Intraarticular disc
–Attaches Anterior to lateral pterygoid
–Attaches Posterior to sup & inf lamina of post lig
•Superior ligament: collagen & elastic fibers
–Allows disc to move forward during mouth opening
•Lat to TMJ: temporal branch of facial n
•Post to TMJ: parotid, ext aud meatus, trunk of facial n, auriculotemporal n, sup temp vessels
•Med to TMJ: chorda tympani n off facial n & middle menigeal A

35
Q

opthalmic division of trigeminal

A

sensory to face

36
Q

maxillary division of trigeminal

A

sensory to face, upper teeth, palate

37
Q

mandibular division of trigeminal (goes through foramen ovale)

A

–MOTOR& SENSORY branches
–Anterior div
•Masseteric nto masseter, Deep temp n to temporalis, nerve to lat Pterygoid, Buccal n to skin of cheek
–Posterior div
•Auriculotemp n to skin ant to ear and parotid gland, Lingual n for sensation to ant tongue, inf alveolar n for sensation to mandib teeth, ends as Mental n to skin of chin

38
Q

muscles of mastication

A

•Close the mouth: Mandib div of Trigeminal
•Temporalis
–Elevate & retrusionof mandible, lat dev to SAME side

Lateral deviation to OPPOSITE side:
•Masseter
	–Elevate, protrude
•Medial Pterygoid
	–Elevate, protrude
•Lateral Pterygoid
	–Depression,protrusion
	–Guide retraction of articular disc during jaw closing
39
Q

anterior division of mandibular division of trigeminal N

A

Masseteric n to masseter
Deep temp n to temporalis
nerve to lat Pterygoid
Buccal n to skin of cheek

40
Q

jaw movements: mouth opening

A

(1)Mandib condyles rotate anteriorly
-mouth open 11-25 mm)
(2) Condyles and disc translate anteriorly over tubercle
-mouth opens to 40-50 mm
•Disc move anteriorly, controlled by elastic sup lamina and limited by non-elastic inf lamina
–Functional: PIP index & middle betw incisors
–Normal: PIP index, middle & ring betw incisors

41
Q

jaw movements: mouth closing

A

(1) Mandib condyles, artic disc move post over articular tubercle into mandib fossa
- Disc movement by recoil of sup lamina
- controlled by eccentric contraction of sup head of lat pterygoid
(2) Disc in mandib fossa and does not move as mandib condyle rotates posteriorly to fully close mouth

42
Q

jaw movements: protrusion, retrusion

A

•Protrusion: Masseter, medial & lateral pterygoid
–Bilateral anterior translation of mandibular condyles and disk
–Normal: 6-9 mm
•Retrusion: Temporalis & digastrics
–Posterior translation of condyles and disc
–Normal: 3 mm

43
Q

lateral jaw movement

A

–Closed mouth
•Ant translation of one condyle and horizontal rotation of other condyle
–Open mouth
•Retrusion of condyle on side to which jaw is moving and ant translation (protrusion) of opposite side condyle
–Example: LEFTlateral jaw movement
•Temporalis & digastrics (retruders)move left condyle posteriorly
•Masseter, medial & lateral pterygoid (protruders)move right condyle anteriorly

44
Q

TMJ dysfunction

A 
–Trauma
–Poor posture
	•Forward head compresses jt
–Malalignment of teeth
–DJD
–Stress
	•Increased tension in jaw mms
	•Clenching & grinding of teeth
	•Cervical mm pain and stiffness
–Most common in women
45
Q

signs of TMJ dysfunction

A 
–Tenderness and spasms of jaw mms
–Decreased ROM
–Referred pain to ear, face and neck
–Locking of jaw
–Clicking or popping at the TMJ with opening & closing
	•? ant dislocation of disc
46
Q

infratemporal fossa boundaries

A
  • anteriorly, post surface of maxilla & inf orbital fissure
  • posteriorly, condylar process of mandible and styloid process
  • superiorly, by the greater wing of the sphenoid
  • inferiorly, by inferior attachment of med pterygoid mm
  • medially, by the lateral pterygoid plate
  • laterally, by the ramus of mandible
  • it has no floor
47
Q

contents of infratemporal fossa

A 
–Lateral & medial pterygoid
–Temporalis mm inf attachment
–Mandibular Division of Trigeminal n
–Chorda Tympani of VII
–Maxillary A. branches
48
Q

anterior division of mandibular division of trigeminal N (enters through foramen ovale)

A
  • Masseteric nerve to masseter
  • Deep temporal nerves to temporalis mm
  • Nerve to lateral pterygoid
  • Buccal n to skin of cheek region
49
Q

post division of mandibular division of trigeminal N (foramen ovale)

A

•Auriculotemporal n to skin anterior to ear & parotid gland
•Lingual n sensation to anterior tongue
•Inferior alveolar n: sensory to mandibular teeth
–Mylohyoid n to mylohyoid mm and ant belly of digastric
–Ends as Mental nerve to skin of chin

50
Q

maxillary A (infratemporal fossa)

A

•Three parts by lateral pterygoidmm

  1. Inferior to lateral pterygoid
    1. Deep auricular a to ear
    2. Middle meningeal a to meninges of cortex
    3. Inferior alveolar a to mandibular teeth and chin
  2. Crosses belly of lat pterygoid
    1. Masseteric a to masseter
    2. Two deep temporal a to temporalis
    3. Pterygoid a to med & lat pterygoid
    4. Buccal a to buccinator
  3. Anterior to lateral pterygoid
    1. Post sup, middle sup, ant sup alveolar a to teeth
    2. Descending palatine a (greater & lesser) to palate
    3. Sphenopalatinea to anterior hard palate
    4. Infraorbital a to area of face below eye
51
Q

contents of palate

A

•Hard palate –anterior
–Palatine plate of maxillary bone & palatine bone
–Innervation:
»Anterior: Nasopalatine n (maxillary div of trigeminal)
»Posterior: Greater Palatine n (maxillary div of trigeminal)
–Blood supply: sphenopalatine a and greater palatine a (from Maxillary a)
•Soft palate –posterior
–Glandular tissue and five pairs of muscles
–Innervation: Lesser Palatine n
–Blood supply: Lesser Palatine a

52
Q

nasopalatine N
greater palatine N
lesser palatine N

A

runs with sphenopalatine A, greater palatine A, lesser palatine A

53
Q

tongue innervation, blood supply

A

–Superior surface
•Anterior 2/3
–Lingual n (mandib div of V) for general sensation
–Chorda tympani (VII) for taste
•Posterior 1/3
–Glossopharyngeal n (IX) for general sensation & taste except root of tongue by Vagus N. (X)

–Blood supply: Lingual a offexternal carotid

54
Q

muscles of tongue

A

Genioglossus –protrudes (hypoglossal n)
Hyoglossus –depress (hypoglossal n)
Palatoglossus –elevates post tongue (vagus)
Styloglossus –retracts (hypoglossal n)

55
Q

boundaries of pharynx

A 
•Nasal cavity to esophagus
	–Nasal Pharynx
	–Oral Pharynx
	–Laryngeal Pharynx
		•Behind larynx and continuous with esophagus
56
Q

muscles of pharynx

A

•Muscles posterior and lateral
–Superior constrictor (level of oral cavity)
–Middle constrictor (level of hyoid)
–Inferior constrictor (level of thyroid cartilage)

  • Action: constrict pharynx for swallowing
  • Innervation: Vagus N
57
Q

bony orbit (eye)

A 
–Frontal, zygomatic, maxillary, ethmoid, sphenoid, lacrimal and palatine bones
–Optic foramen
	•Optic nerve and retinal vessels
–Superior orbital fissure
	•Frontal, lacrimal, nasolacrimal nerves off V1
	•Oculomotor, trochlear nerves, abducens
–Inferior orbital fissure
	•Infraorbital n &a
58
Q

regions of eyeball

A

•Anterior region
–Cornea, Iris, Pupil, Lens, Ciliary body
•Posterior region
–Retina, choroid, optic disc
•Sclera
–Outside choroid extends anteriorly to cornea
–Attachment of mms of eye

59
Q

cornea

A

Light first passes through a lubricating tear film that coats the cornea.
The clear cornea covers the front of the eye and helps to focus incoming light.

60
Q

aqueous humor

A

After light passes through the cornea it travels through a clear, watery fluid called the aqueous humor. The aqueous humor circulates throughout the front part of the eye, maintaining a constant pressure inside the eye.

61
Q

iris

A

The iris is the colored part of the eye. As light conditions change, the iris may dilate to make the pupil bigger or constrict to make the pupil smaller. This allows more or less light into the eye.

62
Q

lens

A

After light travels through the pupil, it must pass through the lens. The lens can change its shape to focus on nearby and distant objects.

63
Q

vitreous humor

A

After being focused by the lens, light passes through the center of the eye to the retina. The eye is filled with a clear, jelly-like substance called the vitreous.

64
Q

retinal vessels

A

The retinal blood vessels nourish the inner layers of the retina.

65
Q

macula

A

The center of the retina is called the macula. It contains a high concentration of photoreceptor cells which convert light into nerve signals. At the very center of the macula is the fovea, the site of our sharpest vision.

66
Q

choroid

A

Behind the retina, a layer of blood vessels called the choroid supplies oxygen and nutrients to the outer layers of the retina.

67
Q

sclera

A

The white part of the eye is called the sclera. The sclera is composed of tough, fibrous tissue that protects the inner workings of the eye.

68
Q

optic nerve

A

The optic nerve is a bundle of nerve fibers which carries visual information from the eye to the brain.

69
Q

6 muscles of the eye

A
  • Medial rectus:oculomotor (III), adduct pupil
  • Lateral rectus:abducens (VI), abduct
  • Superior rectus:oculomotor (III), elevate
  • Inferior rectus:oculomotor (III), depress
  • Inferior oblique:oculomotor (III), elevate, lat rotate
  • Superior oblique:trochlear (IV), depress, lat rotate
70
Q

components of external ear

A

Auricle, external auditory meatus

71
Q

components of middle ear

A

–Tympanic membrane
–Auditory ossicles: malleus, incus, stapes
–Eustachian (auditory) tube
–tensor tympani mm (mandibular div of trigeminal n)
–stapedius mm (facial n)
–facial n, chorda tympani

72
Q

components of inner ear

A

*innervated by vestibulocochlear N (CN VIII)

–Cochlea: sesory organ for hearing
–Vestibule: equilibrium
–Semicircular canals: equilibrium

73
Q

opthalmic division of trigeminal N (V1)

A 
*innervates skin of forehead/nose
branches:
1.nasociliary
  a.infratrochlear (root of nose)
  b.anterior ethmoidal/external nasal (tip of nose)
2.frontal: middle,lat portions of forehead
  a.supratrochlear
  b.supratrochlear
3.lacrimal
74
Q

maxillary division of trigeminal N (V2)

A

*innervates region of face below eyes, above mouth
branches:
1.zygomatic
a.zygomaticofacial: skin over zygomatic arch
b.zygomaticotemporal: skin lateral to eye
2.infraorbital: side of nose, lower eyelid, below eye, upper lip
a.superior alveolar (ant, midd, post)
3.pterygopalatine ganglion
a.greater palatine: posterior end of hard palate
b.nasopalatine: anterior end of hard palate
c.lesser palatine: soft palate

75
Q

mandibular division of trigeminal N (V3)

A

*innervates region of lower jaw, area in front of ear
*contains both sensory, motor innervation
branches:
1.N to medial pterygoid muscle
2.Meningeal: meninges of middle, post cranial fossa
3. Anterior division
a.masseteric N: masseter
b.2-3 deep temporal N: temporalis
c.N to lateral pterygoid muscle
d.buccal N: skin of cheek region
4.posterior division
a.auriculotemporal N: skin anterior to ear, parotid gland
b.lingual N: general sensation to ant 2/3 of tongue
c.inf alveolar (lower teeth) –>mental N (skin of chin)
d.mylohyoid N (mylohyoid muscle, ant. belly of digastric)

76
Q

maxillary A

A

*begins in parotid region, runs horizontally and ant through infratemporal fossa
*divided into 3 parts by lateral pterygoid m.
1st part (inf to lat pterygoid)
a.deep auricular: ear
b.middle meningeal: meninges of cerebral cortex
c.inferior alveolar (mandibular teeth) –>mental (chin)
2nd part (crosses belly of lateral pterygoid m)
a.masseteric: masseter m
b.2 deep temporal: temporalis m
c.pterygoid: med/lat pterygoid m
d.buccal: buccinator m
3rd part (ant to lateral pterygoid)
a.superior alveolar (ant, mid, post): upper teeth
b.descending palatine
-greater palatine A (post hard palate)
-lesser palatine A (soft palate)
c.sphenopalatine: ant hard palate
d.infraorbital: area of face below eye

77
Q

tongue innervation and blood supply

A

*terminal sulcus divides ant 2/3 from post 1/3
ant 2/3:
a.lingual N (off V3): general sensation
b.chorda tympani N (off facial N): taste

post 1/3:
a. glossopharyngeal N (general sensation & taste)

root of tongue: vagus N (sensation, taste)

blood supply: lingual A (off ext carotid A), lingual V

78
Q

muscles of tongue

A

intrinsic: form transverse, longitudinal, vertical muscle bands w/ in body of tongue
* INNERVATED BY HYPOGLOSSAL N

extrinsic: ALL INNERVATED BY HYPOGLOSSAL N EXCEPT FOR PALATOGLOSSUS (VAGUS N)
1. genioglossus: protrudes tongue
2. hyoglossus: depresses tongue
3. palatoglossus: elevates post tongue; vagus N
4. styloglossus: retracts tongue

79
Q

boundaries of parotid region

A

ant: mandibular ramus, masseter, med pterygoid m
post: mastoid process, ant border of SCM
super: external auditory meatus, TMJ
inf: post belly of digastric, stylohyoid m

80
Q

facial N in parotid region

A

*arises from stylomastoid foramen and passes through parotid gland
branches:
1.posterior auricular N: post belly of digastric
2.temporal branch: muscles above & around eye
3.zygomatic: muscles below eye & in upper cheek
4.buccal: buccinator, muscles in lower cheek, upper mouth
5.mandibular: muscles around & below mouth
6.cervical: platysma (depresses the lower lip and angles of the mouth and assists in mouth opening)

Anatomy (10 decks)

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