Face and Scalp (pg. 18 - in note packet) Flashcards
Muscles of the face originate on ___ and insert on ____.
Bones of head/face; skin
All muscles of face are innervated by:
Facial N (CN VII)
Action of epicranius m.
Wrinkle and elevate skin of forehead, elevate eyebrow, move scalp
Action of orbicularis oculi m.
Blink
Action of orbiculares oris m.
Purse lips, close mouth
Action of risorius m.
Smile (elevate angle of mouth)
Action of zygomaticus major and minor m.
Major: elevates angle of mouth
Minor: elevates the upper lip
Action of levator labii superioris m.
Elevate upper lip
Action of levator anguli oris m.
Smile (elevate angle of mouth)
Action of depressor anguli oris m.
Frown (depress angle of mouth)
Action of depressor labii inferioris m.
Sad face (depress lower lip)
Action of buccinator m. (trumpeter muscle)
Drinking from straw (compress cheek against lips/gums)
Action of mentalis m.
Action of elevate and wrinkle skin of chin, protrude lower lip
Action of platysma m.
Wrinkles skin of neck, aids in depressing mandible and corners of mouth
Name the 5 branches of Facial n. (to zanzibar…)
Temporal branch Zygomatic branch Buccal branch Mandibular branch Cervical branch
Plus, posterior auricular branch, innervates occipitals belly of epicranius m.
Name the 3 main facial VEIN tributaries
Angular vein - begins near medial angle of the eye, anastomoses with opthalmic v. and infraorbital v.
Superior labial vein - from upper lip
Inferior labial vein - from lower lip
Name the three branches of CN V
Trigeminal N.
V1 - opthalmic n.
V2 - maxillary n.
V3 - mandibular n.
Name the 14 bones of the facial skeleton
Maxilla (paired) Zygomatic (paired) Mandible Lacrimal (paired) Nasal (paired) Palatine (paired) Vomer Inferior concha (paired)
Name the 6 bones of middle ear (ear ossicles)
Malleus (paired)
Incus (paired)
Stapes (paired)
The joints of the skull are rigid, immoveable joints called ____
Synarthrosis type
Name 8 bones of cranial cavity/vault
Frontal Parietal (paired) Temporal (paired) Occipital Ethmoid Sphenoid
Name the 3 layers of the meninges of the cranial vault:
Dura mater**
Arachnoid mater*
Pia mater*
- Arachnoid and pia are sometimes referred to jointly as leptomeninges
- *Dura is sometimes called the pachymeninges
Name the space that is filled with cerebrospinal fluid (CSF)
Subarachnoid space
Name the 2 spaces that are potential spaces that appear in clinical conditions:
Epidural and Subdural spaces
Name the feature that forms a partial covering of the hypophyseal fossa and pituitary gland
Diaphragma sellae
Name the 3 veins of the cranium
Cerebral, Diploic, Emissary
What do Meningeal nerves do?
Provide sensory innervation for pain associated with dura and dural vessels
Dura of the anterior and middle cranial fossae are innervated by:
Meningeal branches of Trigeminal n.
Dura of the posterior cranial fossa is innervated by branches of:
Vagus n.
C1, C2, C3 spinal nerves
Spinal cord ends at what vertebral level:
L1 or L2
What is the significant space between the dural sac and borders of vertebral canal?
Epidural space
Name the 2 extensions (ligaments) that anchor the spinal cord along its length:
Denticulate ligaments
Filum terminale
Veins within the subarachnoid space:
Cerebral v
Veins within the medullary cavity of cranial bones:
Diploic v
Veins that directly connect scalp to dural venous sinuses:
Emissary v
Dural sleeves along spinal nerves are attached to borders of the _____ and continuous with ______ of nerves
IVFs; Epinenurium
The dural sac tapers and ends at:
S2 vertebral segment
Name the thing ligamentous extension of the dura that attaches the inferior dural sac to the coccyx
Dural coccygeal ligament
Name the sheet-link ligaments that extend from lateral surface of spinal cord to dural sac
Denticulate ligaments
Name the slender filament (ligament) of pia that extends from inferior aspect of spinal cord through subarachnoid space:
Filum terminale:
- internum extends from conus medullar is to inferior aspect of dural sac at S2 vertebral level
- externum extends from dural sac to coccyx (dural coccygeal ligament)
Name the portion of subarachnoid space inferior to the conus medullaris of the spinal cord:
Lumbar cistern
The lumbar cistern extends from ___ to ___ vertebral level
L2; S2
Name the structure that contains nerve rootlets of cauda equina:
Lumbar cistern
Flow of CSF is caused by:
continued CSF secretion, pulsing of arteries in subarachnoid space, movements of the vertebral column
Most CSF resorption occurs at:
Arachnoid villi
CSF diffuses directly into ___ and mixes with _____
dural venous sinuses; blood
Most of the arachnoid villi are found in the:
superior sagittal sinus
Arachnoid granulations are ___ arachnoid villi.
hypertrophied
What are fovea granulares?
Pit-like depressions on internal surface of skull
Ventral compartment tissue is innervated by:
- branches of gray rami communicates of the sympathetic chain
- branches of ventral primary rami of spinal nerves
- recurrent meningeal nerve (sinuvertebral n)
Recurrent meningeal nerve innervates:
- Posterior longitudinal ligament
- Posterior outer anulus fibrosus of IVDs
- Vertebral bodies (including posterior periosteum)
- Dural sleeves and anterior dural sac
Dorsal compartment tissue is innervated by:
medial and lateral branches of dorsal primary rami (innervate skin and muscles of back)
Medial branch of dorsal primary rami innervates:
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum
- Zygapophyseal joints
Zygapophyseal joints innervated by _____ primary rami of spinal nerve exiting through ___ and spinal nerve ___ spinal level(s) above
Dorsal; IVF; 1
Dorsal rami from which 2 spinal nerve levels contribute to L2-L3 A-joint?
DPRs of L2 and L1
Dorsal rami that contribute innervation to C2-C3 Z-joint are what nerve levels?
DPRs of C3 and C2 spinal nerves
Name the 2 groups of neurons
visceral afferents
- sensory neurons
visceral efferents
- motor (visceromotor) neurons
What do visceral afferents do?
- carry information to the CNS from viscera.
- carry information representing many sensations including: chemoreception, baroreception, stretch/distention and pain
What do visceral efferents do?
- carry information to the viscera, specifically visceral effector cells, including: cardiac & smooth muscle, and gland cells
Visceral efferents form the:
autonomic nervous system (ANS)
The ANS is what kind of system?
visceral efferent/motor system
The ANS (visceral efferent/motor system) is split up into 2 divisions. Name the divisions:
Sympathetic and Parasympathetic
Somatic efferents go to ______ muscle, while visceral/ANS efferents go to _______
skeletal; smooth muscle, cardiac muscle and glands
Somatic efferents is 1 neuron between the __ and __; visceral/ANS efferents is:
CNS and effector cell; 2 neurons between CNS and effector cell (preganglionic and postganglionic neurons)
Somatic efferents includes a neuron cell body always located in the ____ or ____ while the visceral efferents is:
brain or spinal cord; 1 preganglionic neuron cell body in the CNS and a postganglionic cell body in a ganglion outside the CNS
Where are visceral efferents pre- and postganglionic neuron cell bodies located?
pre- neurons are in the CNS, post- are in a ganglion outside the CNS
Where does the sympathetic division exit the spinal column?
exits the CNS via T1-L2 spinal nerves
sometimes called the thoracolumbar division of the ANS
Where does the parasympathetic division exit the spinal column?
exits CNS via CN 3, 6, 9, 10 and S2-4 spinal nerves
sometimes called craniosacral division
What cell bodies are in the lateral horn of the spinal cord gray matter?
preganglionic sympathetic cell bodies
The lateral horn is present in spinal cord segments:
T1-L2
______________ axons are thinly myelinated and exit the spinal cord through ventral rootlets/roots of spinal nerves T1-L2. They enter sympathetic chain via white rami communicantes.
Preganglionic sympathetic
______________ are usually only associated with T1-L2 spinal nerves
White rami communicantes
_____ axons terminate on _______ sympathetic neurons
preganglionic; postganglionic
Postganglionic sympathetic neuron cell bodies are located in 1 of 2 types of sympathetic ganglia. Name the two types:
- paravertebral ganglia - make up sympathetic chain
2. prevertebral ganglia - located near the organ to be innervated
what are paravertebral ganglia?
- series of ganglia connected by interganglionic nerves
- paravertebral (chain) ganglia and interganglionic nerves form the sympathetic chain/trunk
- paired left and right
- extend long the lateral aspect of the vertebral column from base of skull to coccyx
How many chain ganglia in the cervical ganglia?
3 per chain:
- superior cervical ganglion: adjacent to C1-C2 vertebrae
- middle cervical ganglion: adjacent to TP of C5, C6. Smallest cervical ganglion.
- inferior cervical ganglion: adjacent to C7 vertebra, sometimes fused with 1st thoracic ganglion (stellate)
What is the stellate ganglion?
When the inferior cervical ganglion fuses with the first thoracic ganglion
How many thoracic chain ganglia?
12
How many lumbar chain ganglia?
4
How many sacral chain ganglia?
4-5
What ganglion is unpaired?
the ganglion impar, anterior to the coccyx
what does the ganglion impar do?
connects left and right sympathetic trunks/chains
What are inside chain ganglia?
postganglionic sympathetic neuron cell bodies
Postganglionic sympathetic axons of the postganglionic sympathetic neuron cell bodies are unmyelinated and leave the sympathetic trunk in 1 of 3 ways:
- join spinal nerves via gray rami communicantes
- join nerve plexuses in walls of arteries and pass to effector cells
- pass to individual organs via visceral nerves
Gray rami communicantes are associated with what spinal nerves?
all spinal nerves
Preganglionic sympathetic fibers enter the sympathetic chain through ______________ of T1-T5 spinal nerves and then ascend the chain to terminate on ____________ of the cervical chain ganglia
white rami communicantes; postganglionic neurons
What cervical ganglion branches to thyroid gland?
middle cervical ganglion postganglionic neurons
What forms cardiac nerves to thoracic structures?
all cervical ganglion postganglionic neurons
What branches to blood vessels of neck and arm?
Inferior cervical ganglion postganglionic neurons
What cervical chain ganglia enters the external and internal carotid plexuses to pass to head and neck structures?
superior cervical ganglion postganglionic neurons
Where is the celiac ganglion located?
Near or along celiac trunk
What kind of cell bodies does the celiac ganglion have inside of it?
postganglionic sympathetic neurons that innervate foregut and midgut (like mesenteric and aorticorenal ganglia) structures
Where is the superior mesenteric and aorticorenal ganglia?
near the superior mesenteric artery and renal arteries
What kind of cell bodies does the superior mesenteric and aorticorenal ganglia have within it?
postganglionic sympathetic neurons that innervate midgut structures (like celiac ganglia)
Where is the inferior mesenteric ganglion located?
on or near inferior mesenteric artery
What does the inferior mesenteric ganglion have within it?
postganglionic sympathetic neurons innervating handgun structures
Which prevertebral ganglia innervates
- foregut?
- midgut?
- hindgut?
- celiac ganglion innervates foregut
- celiac ganglion and superior mesenteric and aorticorenal ganglia innervate midcut
- inferior mesenteric ganglion innervates hindgut
What are the functions of sympathetic division of the ANS?
“fight or flight”
- innervation of cutaneous structures including sweat glands, arrector pili muscles, vasoconstriction of arteries of the skin
- vasodilate arteries in skeletal muscles
- dilate pupils
increase heart rate, blood pressure
The parasympathetic division of the ANS is a two neuron pathway:
preganglionic and postganglionic
Preganglionic parasympathetic neurons have their cell bodies in the
CNS
Preganglionic parasympathetic neurons cell bodies in the brain exit via:
CN 3, 6, 9, 10
Preganglionic parasympathetic neurons cell bodies in the spinal cord exit via:
Postganglionic parasympathetic neurons cell bodies are located in various parasympathetic ganglia (name the pairs)
S2-S4 spinal nerves; ciliary ganglia otic ganglia pterygopalatine ganglia submandibular ganglia (3977-COPS)
Preganglionic parasympathetic axons are myelinated/unmyelinated?
Postganglionic parasympathetic axons are myelinated/unmyelinated?
myelinated; unmyelinated
Name the 4 pairs of parasympathetic ganglia, their innervation and their effector target
3977-COPS
Ciliary ganglia, CNIII - oculomotor, pupil
Otic ganglia, CNIX /9 glossopharyngeal, parotid gland
Pterygopalatine (spenopalatine) ganglia - CNVII /7 facial, lacrimal gland and palatine glands
Submandibular ganglia, CNVII /7 facial, submandibular gland, sublingual gland, lingual and labial glands
Postganglionic parasympathetic cell bodies are also found in intramural (or terminal) ganglia/plexuses like:
- myenteric plexus (muscular external of GI tract between layers of smooth muscle)
- submucosal plexus (submucosal layer of GI tract)
- cardiac
- pulmonary
- inferior hypogastric
Preganglionic fibers to the intramural/terminal ganglia are from:
CN X or S2-S4 spinal nerves
Functions of the parasympathetic nervous system:
“rest and digest”
- decrease heart rate
- decrease arterial blood pressure
- increase secretions from digestive glands (salivary and gastrointestinal)
- increase peristalsis of the gut
- cause constriction of pupils
What is the sensory division of the visceral nervous system that is NOT a part of the ANS?
visceral afferents
What is the functional types of visceral afferents?
- physiological afferents: chemoreception, baroreception, stretch/distension
- pain afferents: parallels sympathetic nervous system, fibers enter spinal cord through spinal nerves T1-T2
Visceral afferent fibers are [myelinated/ unmyelinated/ both]?
Both
Where are cell bodies of visceral afferents located?
in sensory ganglia of cranial and spinal nerves:
- ganglia of glossopharyngeal nerve and vagus nerve
- dorsal root ganglia of T1-L2 and S2-S4
What is the single neuron pathway that provides sensory information from organs to CNS?
Visceral afferents
