exam I Flashcards
What nerve supplies motor innervation to the muscles of facial expression?
Facial nerve (CN VII)
What nerve supplies sensory innervation to the face?
Trigeminal nerve (CN V)
What are the three branches of the Trigeminal nerve?
Ophthalmic (CN V1)
Maxillary (CN V2)
Mandibular (CN V3)
Which branch of the Trigeminal nerve supplies the face and scalp?
Ophthalmic branch (CN V1)
Which branch of the Trigeminal nerve supplies the cheek and area immediately lateral to the orbit?
Maxillary branch (CN V2)
Which branch of the Trigeminal nerve supplies the chin and temporal region?
Mandibular branch (CN V3)
What are the branches of the Ophthalmic nerve?
Supraorbital Supratrochlear External nasal Infratrochlear Lacrimal
What are the branches of the Maxillary nerve?
Zygomaticotemporal
Zygomaticofacial
Infraorbital
What are the branches of the mandibular nerve?
Auriculotemporal
Buccal
Mental
Sudden attacks of severe pain in an area of sensory distribution of the trigeminal nerve
most commonly in maxillary division
hyper sensitivity
second most common in mandibular division
least common in ophthalmic division
Trigeminal Neuralgia (Tic Douloureux)
What nerve supplies the occipital region?
Greater occipital nerve (posterior primary ramus of C2)
What nerve supplies the upper part of the back and neck?
Third occipital nerve (posterior primary ramus of C3)
What nerve supplies the lower part of the back of the neck?
Posterior primary ramus of C4
Cervical plexus is formed by which anterior primary rami?
C1
C2
C3
C4
What are the sensory branches of the cervical plexus?
Lesser occipital (C2) Greater auricular (C2, C3) Transverse cervical (C2, C3) Supraclavicular (C3, C4)
Which nerve supplies the lateral part of the occipital region, posterior to the ear?
Lesser occipital (C2)
Which nerve supplies the angle of the mandible, and the area inferior to the ear and accompanies the external jugular vein?
Great auricular (C2, C3)
Which nerve supplies the anterior surface of the neck (the throat)?
Transverse cervical (C2, C3)
Which nerve supplies the lateral surface of the neck?
Supraclavicular (C3, C4)
What are the three branches of the supraclavicular?
Medial Supraclavicular
Intermediate Supraclavicular
Lateral Supraclavicular
What are the motor branches of the cervical plexus?
Superior root (C1 or C1 and C2) Inferiorroot (C2, C3)
The superior root and inferior root connect to form what?
Ansa Cervicalis
Which nerve descends from the hypoglossal nerve?
Superior root (C1 or C1 and C2)
The ansa cervicalis supplies which infrahyoid muscles?
Sternohyoid
Sternothyroid
Omohyoid
What is the infrahyoid muscle that isn’t innervated by the Ansa cervicalis?
Thyrohyoid
What nerve innervates the thyrohyoid?
C1 fibers through the hypoglossal nerve
What is the motor and sensory nerve branch that is part of the cervical plexus?
Phrenic nerve
What cervical nerves make up the phrenic nerve
C3, C4, C5
The phrenic nerve supplies motor innervation to…
the diaphragm
The phrenic nerve supplies sensory innervation to…
membranes of the thorax and abdomen
Where is the phrenic nerve found?
on the anterior surface of the anterior scalene running down into the thorax
What is the origin of the platysma?
superficial fascia over the pectoralis major and deltoid muscles
what is the insertion of the platysma?
lower border of the mandible
angle of the mouth
what is the nerve supply of the platysma?
cervical branch of the facial nerve (CN VII)
What is the function of the platysma?
depress the mandible
draws down corner of the mouth
what is the origin of the sternocleidomastoid?
sternal head from the front of the manubrium
clavicular head from the medial third of the clavicle
what is the insertion of the sternocleidomastoid?
lateral surface of the mastoid process
lateral half of the superior nuchal line
what is the nerve supply of the sternocleidomastoid?
accessory nerve (CN XI)
what is the function of the sternocleidomastoid?
chief flexor of the head
What is the pathological contraction of the sternocleidomastoid where the head is tilted toward and face turned away from the affected side?
Torticollis
What is another name for torticollis?
Wry neck
What are the three types of torticollis?
Congenital
Muscular
Spasmodic
Which type of torticollis is due to fibrous tissue tumor at or shortly before birth?
Congenital
Which type of torticollis is due to a birth injury?
Muscular
Which type of torticollis is in adults and due to abnormal tonicity and responds well to chiropractic care?
Spasmodic
what is the origin of the trapezius?
external occipital protuberance
ligamentum nuchae
spinous processes of the seventh cervical
all thoracic vertebrae
what is the insertion of the trapezius?
lateral third of the clavicle
spine of the scapula
acromion process
what is the nerve supply of the trapezius?
accessory nerve (CN XI) C3, C4 from the cervical plexus
what is the function of the trapezius?
upper: elevates
middle: retracts
lower: depresses scapula
which vein drains the face and scalp and contains a large amount of cerebral blood?
external jugular vein
The external jugular vein is formed immediately under which structure?
Parotid gland
The external jugular vein is formed by the union of which two veins?
Retromandibular
Posterior auricular
The external jugular vein runs down the external surface of which muscle?
Sternocleidomastoid
The external jugular vein drains into what?
The subclavian vein
What are the tributaries of the external jugular vein?
Retromandibular Posterior auricular Posterior external jugular Anterior jugular Transverse cervical Suprascapular
What causes a prominent external jugular vein?
Congestive heart failure or obstruction of superior vena cava
Where are the superficial cervical lymph nodes?
Along the external jugular vein superficial to the sternocleidomastoid
What are the major triangles of the neck?
Anterior triangle
Posterior triangle
Where is the anterior triangle found?
In front of the sternocleidomastoid
Where is the posterior triangle found?
Behind the sternocleidomastoid
What are the boundaries of the posterior triangle?
Anterior: posterior sternocleidomastoid
Posterior: anterior trapezius
Inferior: superior middle third of the clavicle
What is found inside the anterior triangle?
important visceral structures of the neck
What are the boundaries of the anterior triangle?
Superior: inferior mandible
Anterior: anterior midline
Posterior: Anterior sternocleidomastoid
What is found inferiorly, at the apex of the anterior triangle?
the jugular notch
What forms the roof of the anterior triangle?
investing layer of the deep cervical fascia
superficial cervical fascia
platysma
What are the subdivisions of the floor of the anterior triangle?
Submental
Submandibular
Carotid
Muscular
Which is the only unpaired subdivision of the anterior triangle?
Submental
What are the boundaries of the submental triangle?
left and right anterior bellies of the digastric
body of the hyoid bone
What is the floor of the submental triangle?
mylohyoid muscle
What does the submental triangle contain?
minor veins and submental lymph nodes
What are the boundaries of the submandibular triangle?
Inferior border of the mandible
anterior and posterior bellies of the digastric
what is the floor of the submandibular triangle?
mylohyoid
hyoglossus
What does the submandibular triangle contain?
Submandibular gland internal carotid artery facial artery internal jugular vein **glossopharyngeal nerve (CN IX) **vagus nerve (CN X)
What are the boundaries of the carotid triangle?
Posterior belly of digastric
superior belly of omohyoid
anterior border of sternocleidomastoid
What is the floor of the carotid triangle?
portions of the:
thyrohyoid
hyoglossus
inferior and middle constrictor
What are the contents of the carotid triangle?
common and internal carotid arteries external carotid artery and its branches: -superior thyroid -lingual -facial tributaries of the internal jugular vein
Where does the common carotid usually bifurcate?
carotid triangle
What are the boundaries of the muscular triangle?
superior belly of omohyoid
anterior midline of neck
anterior border of sternocleidomastoid
what is the floor of the muscular triangle?
posterior layer of pretracheal fascia
what does the muscular triangle contain?
sternohyoid sternothyroid thyroid gland trachea esophagus
What bone is located between the mandible and the larynx?
hyoid bone
Which muscles function to move the hyoid bone and larynx?
infrahyoid muscles
Which infrahyoid muscles are in the superficial layer?
omohyoid
sternohyoid
Which infrahyoid muscles are in the deep layer?
sternothyroid
thyrohyoid
what is the origin of the omohyoid?
upper border of the scapula
what is the insertion of the omohyoid?
body of the hyoid
what is the innervation of the omohyoid?
ansa cervicalis (C1, C2, C3)
what is the function of the omohyoid?
depress hyoid bone and larynx
what is the origin of sternohyoid?
posterior surface of the manubrium
medial end of the clavicle
what is the insertion of the sternohyoid?
body of hyoid
what is the innervation of the sternhyoid?
Ansa cervicalis (C1, C2, C3)
what is the function of the sternohyoid?
Depress hyoid and larynx
what is the origin of the sternothyroid?
posterior surface of the manubrium
inferior to sternohyoid
what is the insertion of the sternothyroid?
oblique line on the lamina of the thyroid cartilage
what is the innervation of the sternothyroid?
ansa cervicalis (C1, C2, C3)
what is the origin of the thyrohyoid?
oblique line on the lamina of the thyroid cartilage
what is the insertion of the thyrohyoid?
body of hyoid
what is the innervation of the thyrohyoid?
C1 through hypoglossal nerve
what is the function of the thyrohyoid?
depress hyoid
Why do the infrahyoid muscles depress the hyoid and larynx?
swallowing
breathing
speech
open jaw against resistance(if hyoid is fixed by digastric)
What surrounds and supports both the superficial and deep structures of the neck and has two major layers?
Cervical fascia
What are the two major layers of the cervical fascia?
superficial cervical fascia
deep cervical fascia
Which layer of the cervical fascia is a thin layer which encloses the platysma and contains cutaneous nerves, superficial veins and lymph nodes?
Superficial cervical fascia
Which layer of the cervical fascia is subdivided into four different layers?
Deep fascia
what are the four layers of deep fascia?
investing layer of the deep cervical fascia
pretracheal fascia
prevertebral fascia
carotid sheath
Which layer of the deep fascia of the cervical fascia splits to enclose the sternocleidomastoid anteriorly and the trapezius posteriorly?
investing layer of the deep cervical fascia
Which layer of the deep fascia of the cervical fascia envloses the thyroid gland, trachea and esophagus?
pretracheal fascia
Which layer of the deep fascia of the cervical fascia encloses the vertebral column and the deep muscles of the back and is just posterior to the sympathetic trunk?
prevertebral fascia
Which layer of the deep fascia of the cervical fascia extends from the base of the skull to the root of the neck?
carotid sheath
What is contained within the carotid sheath?
common carotid artery internal carotid artery (direct continuation of common carotid) internal jugular vein vagus nerve deep cervical lymph nodes
what are the functions of fascial layers?
provide slippery surface to reduce friction during:
- gross movements of the head and neck
- swallowing
what is the clinical significance of fascial layers?
may be a tunnel for infection
-pretracheal fascia may allow infection to spread from head/neck to mediastinum directly
cancer involving deep cervical lymph nodes
-can compress internal jugular vein
What is the opening through which structures of the neck pass into the thorax?
superior thoracic aperture
what is another name for the superior thoracic aperture?
thoracic inlet
what are the boundaries of the superior thoracic aperture?
first thoracic vertebra
first ribs and their cartilages
manubrium of sternum
what is the shape of the superior thoracic aperture?
kidney shaped
what are the major arteries that pass thought the superior thoracic aperture?
brachiocephalic trunk
left common carotid artery
left subclavian artery
internal thoracic artery
what is the major vein that passes through the superior thoracic aperture?
brachiocephalic vein
what are the major nerves that pass through the superior thoracic aperture?
phrenic nerve
vagus nerve
recurrent laryngeal nerve
sympathetic trunk
what are the major viscera that pass though the superior aperture?
trachea esophagus cervical pleura apex of lung thymus
why is there a potential for lung collapse with neck injury?
cervical pleura and apex of lung pass through the superior thoracic aperture immediately posterior to the origin of the sternocleidomastoid. if the first rib breaks or there is a penetrating wound of the neck, may cause a lung collapse (atelectasis).
what produces t-lymphocytes?
thymus
what is the location of the thymus?
behind the manubrium and body of the sternum
inferior to the thyroid gland
what muscles lie anteriorly to the thymus?
sternohyoid
sternothyroid
what is the blood supply to the thymus?
internal thoracic artery
what is the nerve supply of the thymus?
stellate ganglion of sympathetic trunk
vagus
what is an endocrine organ which produces thyroxine and calcitonin?
thyroid gland
what is the location of the thyroid gland?
cervical vertebra 5 through thoracic vertebra 1
what are the three parts of the thyroid gland?
left lobe
right lobe
isthmus
what percentage of people have a pyramidal lobe of their thyroid gland?
50%
what is the name of a muscle that some people have that connects the isthmus with the hyoid?
levator glandulae thyroideae muscle
what is the blood supply to the thyroid gland?
superior thyroid artery
inferior thyroid artery
what is a third artery that only 10% of the population has to the thyroid gland?
thyroid ima artery
what does the thyroid ima artery branch from?
brachiocephalic trunk
what are the veins from the thyroid gland?
superior thyroid vein
middle thyroid vein
inferior thyroid vein
where does the superior thyroid and middle thyroid vein dump into?
internal jugular
where does the inferior thyroid vein dump into?
brachiocephalic vein
what is the nerve supply to the thyroid gland?
from the superior, middle and inferior cervical sympathetic ganglia
what is a goiter?
abnormal enlargement of thyroid which produces swelling of the anterior neck
what are the two types of goiters?
endemic
exophthalamic
what is an endemic goiter?
due to dietary deficiency of iodine
gland enlarges to increase output
hormone is highly inactive
symptoms of hypothyroidism
what is an exophthalamic goiter?
due to autoimmune disease thyroid stimulating immunoglobulins bind to receptor site causing overactive gland hormone is active symptoms of hyperthyroidism -graves disease
what nerve branches off of the vagus nerve and travels up into the neck?
recurrent laryngeal nerve
what is and what does the parathyroid gland do?
endocrine gland
calcium homeostasis
where is the parathyroid located?
posterior to the thyroid gland
what is the blood supply to the parathyroid gland?
inferior thyroid artery
superior thyroid artery
what is the innervation of the parathyroid gland?
inferior or middle cervical sympathetic ganglia
what factors contribute to the difficulty of thyroid surgery?
parathyroid glands
vascularity
recurrent laryngeal nerve
where does the trachea start?
cervical vertebra 6
why are the posterior aspect of the cartilage rings of the trachea open?
to allow expansion of esophagus during swallowing
what is the posterior aspect of the cartilage rings spanned by?
trachealis muscle
what is the blood supply of the trachea?
inferior thyroid artery
what is the nerve supply of the trachea?
recurrent laryngeal nerve
where does the esophagus start?
cervical vertebra 6, posterior to the trachea
what are the main arteries of the head and neck?
common carotid arteries
what does the common carotid artery split into?
internal carotid artery
external carotid artery
which branch of the common carotid artery doesn’t have any branches within the neck and enters skull through the carotid canal?
internal carotid artery
which branch of the common carotid artery is the main source of blood to structures of the neck, face, and scalp?
external carotid
what are the branches of the external carotid artery?
superior thyroid ascending pharyngeal lingual facial occipital posterior auricular superficial temporal maxillary
what are the terminal branches of the external carotid artery?
superficial temporal
maxillary
what is the slight dilation of the internal carotid artery where it joins the common carotid?
carotid sinus
what does the carotid sinus do?
it is a blood pressure sensor (baroreceptor)
what is the nerve supply of the carotid sinus?
carotid sinus nerve of the glossopharyngeal nerve (CN IX)
what is a small reddish-brown mass within or deep to the bifurcation of the common carotid artery?
carotid body
what does the carotid body do?
it is a chemoreceptor which detects changes in the chemical makeup of the blood
what is the nerve supply of the carotid body?
carotid sinus branch of the glossopharyngeal (CN IX)
what is the largest vein of the neck?
internal jugular vein
where does the internal jugular vein begin?
jugular foramen
what is the internal jugular vein a direct continuation of?
sigmoid sinus
where does the internal jugular vein drain into?
brachiocephalic vein
what is the dilation of the internal jugular vein at its origin below the jugular foramen?
superior jugular bulb
what are the tributaries of the internal jugular vein?
inferior petrosal sinus pharygneal facial lingual superior thyroid middle thyroid
what is the dilation of the internal jugular vein near it is termination into the brachiocephalic vein?
inferior jugular bulb
what are the branches of the glossopharyngeal nerve (CN IX)?
tympanic branch to the carotid sinus pharyngeal branch to the stylopharyngeus tonsillar lingual
which branch of the glossopharyngeal nerve is the sensory to the tympanic cavity and secretomotor to the parotid gland?
tympanic nerve
which branch of the glossopharyngeal nerve is sensory to both the carotid sinus and carotid body?
branch to the carotid sinus
which branch of the glossopharyngeal nerve unites with branches from the vagus and sympathetic trunk to form the pharyngeal plexus and is sensory to the pharynx?
pharyngeal branch
which branch of the glossopharyngeal nerve is motor supply to the stylopharyngeus muscle?
branch to the stylopharyngeus
which branch of the glossopharyngeal nerve is sensory to the mucous membrane over the tonsil and to the soft palate?
tonsillar branch
which branch of the glossopharyngeal nerve supplies taste and general sensation to the posterior third of the tongue?
lingual branch
what are the two ganglia of the vagus nerve in the neck?
superior (jugular) ganglion
inferior (nodose) ganglion
what are the branches of the vagus nerve?
meningeal auricular pharyngeal superior laryngeal recurrent laryngeal
Which branch comes from the superior ganglion of the vagus nerve and supplies the dura mater with sensory innervation?
meningeal
Which branch comes from the superior ganglion of the vagus nerve and is sensory to the auricle, the flood of the external auditory meatus and the typmanic membrane?
auricular
Which branch comes from the inferior ganglion of the vagus nerve and is the chief motor nerve of the pharynx and the soft palate?
pharyngeal
Which branch arises from the inferior ganglion of the vagus nerve and divides into two nerves?
Superior laryngeal
what are the two branches of the superior laryngeal nerve?
internal laryngeal
external laryngeal
Which branch of the superior laryngeal nerve is sensory innervation to the mucous membrane of the larynx?
internal laryngeal nerve
which branch of the superior laryngeal nerve is motor innervation to the cricothyroid and inferior constrictor muscles?
external laryngeal nerve
Which branch of the vagus nerve arises directly from the vagus nerve ascends back into the neck and is sensory innervation to mucous membrane of the larynx and is motor innervation to all muscles of the larynx except the cricothyroid?
recurrent laryngeal nerve
Unilateral damage to the recurrent laryngeal nerve can cause…
respiratory distress
hoarsness (partial aphonia)
Bilateral damage to the recurrent laryngeal nerve can cause…
complete aphonia
may result in suffication
Causes of damage to the recurrent laryngeal nerve are…
trauma during thyroid surgery
goiter/thyroid tumor
lung tumor (apex of lung)
aortic aneurysm (left side only)
The accessory nerve (CN XI) is formed by a cranial part which originates from the __________ and a spinal part which originates from the sides of the ___________.
medulla oblongata, spinal cord
The spinal part of the accessory nerve (CN XI) ascends through the ________ to join the cranial part then both exit thru the _________.
foramen magnum, jugular foramen
The cranial part of the accessory nerve (CN XI) joins what nerve just above the inferior vagal ganglion?
vagus nerve
The cranial part of the accessory nerve supplies the vagus nerve with motor fibers which travel thru which branches of the vagus nerve?
pharyngeal branch of the vagus
recurrent laryngeal nerve
The spinal part of the accessory nerve (CN XI) is motor innervation to what?
Sternocleidomastoid
Trapezius
Which nerve is the motor nerve to the tongue?
hypoglossal nerve
The hypoglossal nerve originates from the _________ and exits the skull thru the _________.
medulla oblongata, hypoglossal canal
What are the branches of the hypoglossal nerve?
meningeal
superior root of the ansa cervicalis
nerves to thyrohyoid and geniohyoid
lingual
which branch of the hypoglossal nerve supply the dura mater?
meningeal
which branch of the hypoglossal nerve supplies motor innervation to the infrahyoid muscles and consist of mainly C1 fibers?
superior root of the ansa cervicalis
which branch of the hypoglossal nerve consists of C1 fibers and is motor innervation to the thyrohyoid and geniohyoid?
nerves to the thyrohyoid and geniohyoid
which branch of the hypoglossal nerve is motor innervation to the extrinsic and intrinsic muscles of the tongue?
lingual
Where does the cervical part of the sympathetic trunk begin?
Base of the skull
The preganglionic sympathetic fibers which supply structures of the head and neck originate where?
T1 to T3
Where do preganglionic sympathetic fibers synapse?
Cervical ganglia
Postganglionic fibers distribute from cervical ganglia and supply…
blood vessels
smooth muscle
glands of the head and neck
What are the different cervical sympathetic ganglia?
superior
middle
vertebral
cervicothoracic (stellate)
which cervical sympathetic ganglion is at cervical vertebrae level 1 - 3 immediately below base of skull and has 3 branches?
superior
What are the branches of the superior cervical ganglion?
internal carotid nerve
superior cervical cardiac nerve
branches to the pharyngeal plexus
which cervical sympathetic ganglion lies at the cervical vertebra 6 level and has 1 branch?
middle
What is the branch off the middle cervical ganglion?
middle cervical cardiac nerve
which cervical sympathetic ganglion is often fused and is at at the level of cervical vertebra 7?
vertebral ganglion
which cervical sympathetic ganglion is a fusion of the inferior cervical ganglion to the first thoracic ganglion and is at the level of cervical vertebra 7 to thoracic vertebra 1?
cervicothoracic (stellate) ganglion
What is the branch off the cervicothoracic (stellate) ganglion?
inferior cervical cardiac nerve
What is a nerve bundle that loops anterior to the subclavian artery connecting the vertebral ganglion to the cervicothoracic ganglion?
ansa subclavia
what is the largest and sturdiest facial bone?
mandible
what part of the mandible articulates with the temporal bone?
condylar process
what part of the mandible is an area of attachment for muscles of mastication?
coronoid process
what is the upper border of the body of the mandible?
alveolar process
what is the origin of the posterior belly of the digastric?
mastoid process
what is the origin of the anterior belly of the digastric?
digastric fossa
what is the insertion of the digastric
hyoid bone by the intermediate tendon
what is the nerve supply of the posterior belly of the digastric?
cervical branch of the facial nerve (CN VII)
what is the nerve supply of the anterior belly of the digastric?
nerve to the mylohyoid of the trigeminal nerve (CN V)
what is the function of the digastric?
elevate hyoid
depress mandible when hyoid is fixed
what is the origin of the mylohyoid?
mylohyoid line of the mandible
what is the insertion of the mylohyoid?
body of the hyoid
median raphe
what is the nerve supply of the mylohyoid?
nerve to the mylohyoid of the trigeminal nerve (CN V)
what is the origin of the geniohyoid?
inferior mental spine
what is the insertion of the geniohyoid?
body of hyoid
what is the nerve supply of the geniohyoid?
C1 fibers through hypoglossal
what is the function of the geniohyoid?
elevate hyoid and tongue
what is the origin of the genioglossus?
superior mental spine
what is the largest tongue muscle?
genioglossus
what is the insertion of the genioglossus?
tip and entire undersurface of tongue
what is the origin of the hyoglossus?
body and greater horn of hyoid
what is the insertion of the hyoglossus?
sides of the tongue
what is the nerve supply of the hyoglossus?
hypoglossal
what is the nerve supply of the genioglossus?
hypoglossal
what is the function of the genioglossus?
draws tongue forward
protrudes tip of tongue
what is the function of the hyoglossus?
draws tongue downward
What is it called if part of the hyoglossus takes origin on the lesser horn of the hyoid?
chondroglossus
what is the origin of the styloglossus?
styloid process
what is the insertion of the styloglossus?
sides of the tongue
what is the nerve supply of the styloglossus?
hypoglossal
what is the function of the styloglossus?
draws tongue upward and backward
What is the origin of the stylohyoid?
styloid process
what is the insertion of the stylohyoid?
body of hyoid
what is the nerve supply of the stylohyoid?
facial nerve
what is the function of the stylohyoid?
elevates hyoid and tongue
the submandibular gland wraps around the posterior border what what muscle?
mylohyoid
Which part of the submandibular gland is large and lies within the submandibular triangle and submandibular fossa?
superficial part
which part of the submandibular gland is small and lies superior to the mylohyoid?
deep part
How does the submandibular gland open into the oral cavity?
sublingual caruncle
where is the sublingual caruncle located?
lateral to the frenulum of the tongue
what is the smallest of the three major salivary glands?
sublingual
where is the sublingual gland located?
superior to mylohyoid in sublingual fossa
where does the sublingual gland empty into?
floor of the mouth along sublingual fold
what is the innervation of the submandibular gland?
parasympathetic fibers from the facial nerve (CN VII) via the submandibular ganglion
what is the innervation of the sublingual gland?
parasympathetic fibers from the facial nerve (CN VII) via the submandibular ganglion
what are the nerves associated with the mandible?
lingual
glossopharyngeal
hypglossal
what are the blood vessels associated with the mandible?
lingual artery and vein
facial artery and vein
what are the lymph nodes associated with the mandible?
submandibular
submental
what are the functions of the nasal cavity?
provide an airway
olfaction
warming/moistening of inspired air
cleansing of inspired air
the nasal cavity extends from the _____ anteriorly to the ______ posteriorly.
nostrils (nares), choanae
The nasal cavity is divided into a left and right chamber by the _______.
nasal septum
What are the posterior apertures of the nasal cavity which open into the nasopharynx?
choanae
What are the external parts of the nose?
tip
root
nares
alae
what are the boundaries of the nasal cavity?
roof
floor
medial wall (nasal septum)
lateral wall
what is the roof of the nasal cavity formed by?
nasal bone
frontal bone
cribriform plate of ethmoid bone
body of sphenoid bone
what is the floor of the nasal cavity formed by?
palatine process of maxilla
horizontal plate of the palatine bone
what is the medial wall (nasal septum) of the nasal cavity formed by?
septal cartilage
perpendicular plate of the ethmoid bone
vomer
What is a deviated septum?
when the nasal septum does not lie in median plane
what are causes of a deviated septum?
congenital malformation
birth injury
postnatal trauma
What is the lateral wall of the nasal cavity formed by?
nasal bone frontal process of the maxilla lacrimal bone ethmoid bone inferior nasal concha perpendicular plate of the palatine bone medial pterygoid plate of the sphenoid bone
What is a small space located above and behind the superior nasal concha which receives the opening of the sphenoid sinus?
sphenoethmoidal recess
which meatus receives the opening of the posterior ethmoidal cells?
superior meatus
which meatus receives the openings of the frontal sinus, maxillary sinus, middle ethmoidal cells and anterior ethmoidal cells?
middle meatus
what is the rounded projection into the middle meatus and middle ethmoidal cells open into it?
ethmoidal bulla
what is the curved slit lying below the ethmoidal bulla within the middle meatus that has the frontonasal duct, anterior ethmoidal cells and maxillary sinus open into it?
hiatus semilunaris
which meatus receives the opening of the nasolacrimal duct?
inferior meatus
what connects the lacrimal sac of the orbit to the nasal cavity?
nasolacrimal duct
What does the nasal vestibule contain?
hair
sebaceous glands
sweat glands
what is considered the respiratory region of the nasal cavity?
lower two thirds of the nasal cavity
what is considered the olfactory region of the nasal cavity?
superior nasal concha and upper one third of nasal septum
what does the olfactory region contain?
fibers of the olfactory nerve (CN 1)
what is the general sensory innervation of the nasal cavity?
branches of the maxillary and ophthalmic divisions of the trigeminal nerve (CN V)
what is the autonomic innervation of the nasal cavity?
prerygopalatine ganglion
what is the blood supply of the nasal cavity?
sphenopalatine branch of maxillary artery
anterior ethmoidal branch of ophthalmic artery
What is epistaxis?
a nose bleed
commonly due to richness of blood supply
or due to hypertension, blood disorders, cocaine abuse
what are the two forms of epistaxis?
mild: in/near vestibule caused by minor trauma/low humidty
severe: spurting arterial blood from rupture of the sphenopalatine artery by major trauma
where do the lymph nodes of the nasal cavity drain into?
deep cervical nodes
What are cavities found within the bones of the face developed as outgrowths of the nasal cavity?
paranasal sinuses
Why do paranasal sinuses form?
wolffs law
reduce weight of skull
what are the paranasal sinuses?
frontal
maxillary
sphenoidal
ethmoidal
which sinus opens into the hiatus semilunaris of the middle meatus via the frontonasal duct?
frontal
which is the largest sinus which opens into the hiatus semilunaris and is the only sinus to possibly be present at birth?
maxillary
which sinus opens into the sphenoethmoidal recess?
sphenoidal
the posterior ethmoidal cells open into what?
superior meatus
the middle ethmoidal cells open into what?
ethmoidal bulla in middle meatus
the anterior ethmoidal cells open into what?
hiatus semilunaris in middle meatus
Sinusitus
nasal cavity infection spread to the paranasal sinuses
acute pharygitis
nasal cavity infection spread to the nasopharynx through the choanae (sore throat)
conjunctivitis
nasal cavity infection spread to lacrimal apparatus and conjuctiva via nasolacrimal duct (pink eye)
otitis media
nasal cavity infection spread to middle ear via pharyngotympanic tube
menignitis
nasal cavity infection spread to anterior cranial fossa via cribriform plate (brain abscess)
mastoiditis
nasal cavity infection spread to mastoid air cells via aditus from middle ear
what is the posterior boundary of the oral cavity?
oropharyngeal isthmus
what are the 2 parts of the oral cavity?
oral vestibule
oral cavity proper
which part of the oral cavity lies between lips/cheek and gums (portion external to the tooth rows)?
oral vestibule
which part of the oral cavity lies internal to the tooth rows?
oral cavity proper
what are the openings into the oral vestibule?
labial glands
parotid duct
what is the median groove seen externally which extends from teh nose to the vermilion border of the upper lip?
philtrum
muscle of the lips
orbicularis oris
muscle of the cheeks
buccinator
glands of the cheeks
buccal glands
what are the foramina of the hard palate?
incisive
greater palatine
lesser palatine
The hard palate is covered by a…
mucoperiosteum
the center of the mucoperiosteum of the hard palate is a…
palatine raphe
at the end of the palatine raphe of the mucoperiosteum of the hard palate is the…
incisive papilla
what extend laterally within the mucoperiosteum of the hard palate and aid in gripping food against the tongue during mastication?
transverse palatine folds
what two arches is the soft palate continuous with?
palatoglossal arch
palatopharyngeal arch
what is the median projection of the soft palate?
uvula
what lies between the palatoglossal and palatopharyngeal arches on each side?
tonsillar fossa
what does the tonsillar fossa contain?
palatine tonsils
what is the origin of the musculus uvulae?
posterior nasal spine
what is the insertion of the musculus uvulae?
mucous membrane of uvula
what is the nerve supply of the musculus uvulae?
vagus nerve (CN X) via pharyngeal plexus
what is the function of the musculus uvulae?
elevates uvula
what is the origin of the levator veli palatini?
inferior surface of temporal bone
what is the insertion of the levator veli palatini?
aponeurosis of soft palate
what is the nerve supply of the levator veli palatini?
vagus nerve (CN X) via pharyngeal plexus
what is the function of the levator veli palatini?
elevates soft palate
what is the origin of the tensor veli palatini?
scaphoid fossa of medial pterygoid plate
pharyngotypmanic tube
what is the insertion of the tensor veli palatini?
the tendon winds around the pterygoid hamulus and inserts into the aponeurosis of the soft palate
what is the nerve supply of the tensor veli palatini?
mandibular division of the trigeminal (CN V)
what is the function of the tensor veli palatini?
tenses soft palate
opens pharyngotympanic tube
what is the nerve supply of the hard palate?
greater palatine and nasopalatine nerves
what is the nerve supply of the soft palate?
lesser palatine nerve
what is the blood supply of the hard palate?
greater palatine artery (from maxillary)
what is the blood supply of the soft palate?
lesser palatine and facial arteries
How do you diagnose nerve damage of the vagus nerve?
whichever side is damaged, the uvula will deviate to the opposite side due to paralysis of the musculus uvulae
what are the functions of the tongue?
taste
mastication
swallowing
speech
what is a v-shaped groove which divides the tongue into two parts?
sulvus terminalis
what are the two parts of the tongue?
oral
oropharyngeal
what is a foramen located at the apex of the sulcus terminalis?
foramen cecum
The foramen cecum is the remnants of what?
embryonic thryoglossal duct
what is the shallow groove visible on the surface of the tongue?
median groove
what is a mass of lymphoid tissue found on the oropharyngeal surface of the tongue?
lingual tonsil
what are the three folds of the epiglottis?
median glossoepiglottic fold (1)
lateral glossoepiglottic fold (2)
what is the space on either side of the median glossoepiglottic fold?
vallecula
what is ankyloglossia?
being tongue tied
nerves, vessels, and extrinsic muscles enter or leave the tongue through what part?
the root
what is the origin of the palatoglossus?
soft palate
what is the insertion of the palatoglossus?
sides of the tongue
what is the nerve supply of the palatoglossus?
vaugs nerve (CN X) via the pharyngeal plexus
what is the function of the palatoglossus?
elevate back of tongue
what are 3/4 extrinsic tongue muscles that are innervated by the hypoglossal nerve?
genioglossus
hyoglossus
styloglossus
the anterior two thirds of the tongue have general sensation thru which nerve?
lingual nerve (a branch of the mandibular division of the trigeminal nerve)
the anterior two thirds of the tongue taste by which nerve?
chorda tympani (a branch of the facial nerve)
the posterior third of the tongue tastes and has general sensation thru which nerve?
glossopharyngeal nerve (IX)
what is the blood supply of tongue?
lingual artery and vein
the lingual artery comes from which artery?
external carotid
the lingual vein drains to where?
internal jugular
the lymph nodes of the tongue are…
submental
submandibular
deep cervical
all lymph nodes of the tongue drain to…
deep cervical nodes
what is the hardest part of the tooth?
enamel
what is internal to the enamel of a tooth?
dentin
what fills the central cavity of the tooth and contains blood vessels, nerves and lymphatic which enter at the apex of the root?
pulp
what is the bone-like substance which covers the root of the tooth?
cementum
what is the visible part of the tooth that is covered by the enamel?
crown
what is the junction of a tooth between the crown and the root?
neck
what is the part of the tooth that is embedded int he alveolar process of the maxilla and mandible covered by cementum?
root
what is the specialized oral mucosa which surrounds the teeth and covers adjacent alveolar bone?
gingivae (gums)
what is the surface of the tooth that faces anteriorly or toward midline?
mesial surface
what is the surface of the tooth that faces posteriorly or away from midline?
distal surface
what is the chewing surface of the tooth?
occlusal surface
what is the “baby” set of teeth?
deciduous teeth
what is the nerve supply of the maxillary teeth?
superior alveolar branches of the maxillary division of the trigeminal nerve
what is the nerve supply of the mandible teeth?
inferior alveolar nerve from the mandibular division of the trigeminal
tooth ache affects…
only 1 tooth
trigeminal neuralgia affects…
the whole row of teeth
what are the boundaries of the pharynx?
base of skull
inferior border of the cricoid cartilage
what are the three parts of the pharynx?
naso-
oro-
laryngopharynx
the nasopharynx communicates with the nasal cavity thru the…
choanae
the nasopharynx communicates with the oropharynx thru the….
pharyngeal isthmus
what are the boundaries of the nasopharynx?
roof of pharynx
soft palate
posterior border of the inferior nasal concha
posterior wall of pharynx
the nasopharynx lies what vertebral level?
cervical vertebra 1
what are embedded into the posterior wall of the nasopharynx?
pharyngeal tonsils (adenoids)
the phayngotympanic tube opens into the lateral wall of the nasopharynx and is limited by what cartilaginous structure?
torus tubarius
what is the small tonsil which lies immediately behind the opening of the pharyngotympanic tube?
tubal tonsil
what is a fold which descend from the torus tubaris to the wall of the pharynx?
salpingopharyngeal fold
what is the muscle just deep to the salpingopharyngeal fold?
salpingopharyngeus msucle
what are the boundaries of the oropharynx?
soft palate
superior border of the epiglottis
palatoglossal fold
posterior wall of the pharynx
what vertebral level is the oropharynx at?
cervial vertebrae 2 and 3
the oropharynx communicates with the oral cavity thru the….
oropharyngeal isthmus
the oropharyngeal isthmus is bound by the….
palatoglossal folds
what is the circular arrangement of tonsils around the oropharynx formed by the lingual, palatine, tubal and pharyngeal tonsils?
tonsillar ring
what is the function of the tonsillar ring?
first line of defense agaisnt infection
what are the boundaries of the laryngopharynx?
superior border of the epiglottis
lower border of the cricoid cartilage where it joins the esophagus
posterior surface of the larynx
posterior wall of the pharynx
what is the opening to the larynx within the laryngopharynx?
laryngeal inlet
the laryngeal inlet is bounded laterally by the _________ and inferiorly by the _________.
aryepiglottic folds, interarytenoid notch
what is the recess in the anterior wall of the laryngopharynx located on either side of the laryngeal inlet which creates a channel for passage of food around inlet?
piriform fossa (recesss)
what is the origin of the inferior constrictor muscle?
cricoid cartilage
thryoid cartilage
what is the insertion of the inferior constrictor muscle?
pharyngeal raphe
what is the nerve supply of the inferior constrictor muscle?
vagus nerve (CN X) via the pharyngeal plexus external laryngeal nerve
what is the function of inferior constrictor muscle?
contracts pharynx during swallowing
what is the origin of the middle constrictor muscle?
greater and lesser horns of hyoid bone
what is the insertion of the middle constrictor muscle?
pharyngeal raphe
what is the nerve supply of the middle constrictor muscle?
vagus nerve (CN X) via the pharyngeal plexus
what is the function of the middle constrictor muscle?
contracts pharynx during swallowing
what is the origin of the superior constrictor muscle?
medial pteyrgoid plate
alveolar part of mandible
side of tongue
what is the insertion of the superior constrictor muscle?
pharyngeal raphe
what is the nerve supply of the superior constrictor muscle?
vagus nerve (CN X) via the pharyngeal plexus
what is the function of the superior constrictor muscle?
contracts the pharynx during swallowing
what is the specialized band of muscle formed by the superior constrictor which helps to seal the pharyngeal isthmus during swallowing?
palatopharyngeal sphincter
what is the muscle that passes between the middle and superior constrictor muscles?
stylpharyngeus muscle
what is the origin of the stylpharyngeus muscle?
styloid process
what is the insertion of the stylpharyngeus muscle?
thyroid cartilage
some fibers blend with those of the constrictors
what is the nerve supply of the stylpharyngeus muscle?
glossopharyngeal nerve (IX)
what is the functioin of the stylpharyngeus muscle?
elevate pharynx
what is the origin of the palatopharyngeus muscle?
soft palate
what is the insertion of the palatopharyngeus muscle?
wall of pharynx
thyroid cartilage
what is the nerve supply of the palatopharyngeus muscle?
vagus nerve (CN X) via pharyngeal plexus
what is the function of the palatopharyngeus muscle?
elevate pharynx
narrow oropharynx
what is the origin of the salpingopharyngeus muscle?
torus tubarius
opening of pharyngotympanic tube
what is the insertion of the salpingopharyngeus muscle?
wall of pharynx
what is the nerve of the salpingopharyngeus muscle?
vagus nerve (CN X) via phayrngeal plexus
what is the function of the salpingopharyngeus muscle?
elevates pharynx
opens pharyngotympanic tube
The pharyngeal plexus is formed by…
pharyngeal branch of the vagus (CN X)
pharyngeal branch of the glossopharyngeal (CN IX)
sympathetic fibers from the superior cervical ganglion
which nerve supplies motor innervation of the pharynx?
pharyngeal branch of the vagus (CN X)
which nerve supplies sensory innervation to the mucosa of the pharynx?
pharyngeal branch of the glossopharyngeal (CN IX)
what are the arteries of the pharynx?
ascending pharyngeal
maxillary
what is the layer of fascia which surrounds the pharynx external to the muscles of the pharynx and is continuous with the pretracheal fascia?
buccopharyngeal fascia
what is the layer of fascia which lies internal to the muscles and external to the mucosa of the pharynx?
pharyngobasical fascia
what is the potential space between the buccopharyngeal fascia and prevertebral fascia and extends downward to permit free movement of the pharynx and esophagus during swallowing?
retropharyngeal space
what is deglutition?
swallowing
what is dysphagia?
difficulty swallowing
