final anat revision Flashcards
1
Q
what percent of tissue fluid is transported by the lymphatics and what percent is transported by veins?
A
20% vs 80”
2
Q
Where does lymph empty into the venous system?
A
subclavian vein
3
Q
Are lymph capillaries permeable, blindly ending tubes in connective tissue
A
yes they are
4
Q
Is lymph found in dental pulp?
A
yes
5
Q
Is lymph found in cartilage?
A
yes
6
Q
Does the thoracic duct have lymph nodes?
A
no
7
Q
What is the size of lymph nodes?
A
1-25mm long
8
Q
What lymph trunks do not have valves
A
jugular lymph trunks
This is so lymph can flow from the thoracic duct to the left jugular trunk
9
Q
List the superficial nodes of the head
A
ORB P occipital retroauricular parotid buccal
10
Q
list the superficial nodes of the neck
A
SAS
submental
submandibular
anterior cervical
11
Q
Name a deep node of the head
A
lingual node
12
Q
Name the deep cervical nodes of the neck
A
Superior
jugulodigastric
retropharyngeal
Inferior
Jugulo-omohyoid
Virchow’s node/supraclavicular
13
Q
Where does all the lymph from the head and neck drain into
A
jugular lymph trunks
14
Q
Where does the lymph of the floor of mouth, mandibular teeth and gingivae drain?
A
submandibular and submental lymph nodes
15
Q
where does the lymph of the tongue drain
A
submental, submandibular, upper and lower deep nodes
16
Q
where does the lymph of the hard and soft palate, maxillary teeth and gingivae drain?
A
retropharyngeal nodes
17
Q
Clinical nodes of virchow’s node
A
its also known as the left supraclavicular/anterior scalene group. It is closest to the jugular trunk and it means that there is retrograde flow from the thoracic duct-spread from the extensive territories of the thoracic duct drains there
18
Q
Are anatomical nerves mixed
A
yes
19
Q
difference between somatic motor and autonomic nerves
A
somatic motor neurons are found in the brain and spinal cord, but importantly there is NO SECOND NERVE CELL BODY.
Autonomic neuron has a preganglionic axon which synapses to post ganglionic axons
20
Q
List the origin of the sympathetic nerve
A
thoracic and upper lumbar spinal cord
21
Q
List the 4 parasympathetic ganglions of the head
A
Ciliary ganglion-in orbit
pterygopalatine ganglion in pterygopalatine fossa
submandibular ganglion
otic ganglion
22
Q
Forehead muscles of facial expression
A
frontal belly occiptofrontalis
corregator supercilii
23
Q
eye muscles of facial expression
A
orbicularis occuli
24
Q
nose muscles of facial expression
A
procerus
nasalis
levator labii superioris alaque nasi
25
corregator supercilii function
frowning
26
orbicularis oculi function
closes eye, directs tear flow, lower eyelid
27
What is the modiolus
fibromuscular structure extending from skin to mucosa
28
Function of zygomaticus major
elevate corner of mouth
29
function of levator anguli oris
elevates corner of mouth
30
function of buccinator
draw in position cheeks to direct food over molars
31
buccinator attachments
arises outer surfaces of maxilla, mandible and ptergomandibular raphe to attach to modiolis
32
platysma function
depresses lower lip and corners of mouth
33
platysma attachments
body of mandible, modiolis and modiolar muscles to skin over pectoralis, depresses lower lip and corners of mouth. Tenses skin of anterior neck
34
depressor anguli oris function
moves corners of the mouth down
35
orbicularis oris
sphincter of mouth
36
alaeque nasi function
raises upper lip, dilates nostril
37
levator labii superioris
raises upper lip
38
zygomaticus minor function
raises upper lip
39
depressor labii inferioris
moves lower lip down
40
mentalis function
raises base of lower lip-protrusion and eversion
41
fat pad function
they are important for forming important contours of the face
42
buccal fat pad
lies between the midface muscles of expression and buccinator. The parotid duct and sensory buccal nerve pass through it.
43
Five layers of the scalp
```
Skin
Connective tissue-superficial fascia
Aponeurosis-epicranial aponeurosis
Loose fascia
Periosteum
```
44
what innervates face and scalp
be wary of sensory and motor innervations are different
Sensory innervation is from trigeminal nerve
motor is from facial nerve
45
What is the parotid capsule derived from
deep cervical fascia
46
list the structures which the parotid capsule is attached to
zygomatic arch, mandible, styloid process and tympanic plate
zuper mst
47
What part of the capsule forms the styloid process
The part of the capsule which is attached to the styloid process and angle of mandible forms the stylomandibular ligament
48
What is the parasympathetic supply to parotid
glossopharyngeal hitchiking on auriculotemporal nerve
49
Where is sensory innervation of parotid from
auriculotemporal nerves, and greater auricular branch of the cervical plexus
50
What is the origin of the sympathetic supply of the parotid
external carotid plexus
51
Name structures located in the parotid gland from deepest to most superficial
Deepest:external carotid enters-> maxillary artery and superficial temporal artery-?transverse facial artery. The posterior auricular artery may also arise within parotid
The intermediate: superficial temporal and maxillary veins/arteries and finally the retromandibular vein
Superficial: facial nerve and cutaneous motor branches
52
What nerve fibers anastamose at geniculate ganglion
taste fibres from chorda tympani
taste fibres from soft palate via greater petrosal nerve
cutaneous sensory fibres from skin of ear
parasympathetic fibres do not synapse
53
What part of the facial nerve leaves 5mm above stylomastoid foramen
sensory chorda tympani.
54
facial nerves emerges from the skull at the stylomastoid foramen and curves medially to give off:
1) posterior auricular nerve to occipital belly of occipitofrontalis
small branches to the posterior belly of digastric and stylohyoid
55
temporal branch supplies:
occipitofrontalis, orbicularis oculi
| corregator supercilii
56
zygomatic branch supplies
orbicularis oculi
57
buccal branches supply
zygomaticus major, minor, procerus, nasalis, levator labii superioris alaque nasi, levator labii superioris, levator anguli oris, buccinator, orbicularis oris
58
marginal mandibular branches
risorius and all the muscles that depress lip
59
list the branches of the opthalmic division of the trigeminal nerve
```
supratrochlear
supraorbital
lacrimal
infratrochlear
external nasal
```
60
list the branches of the maxillary division
1) zygomatico-orbital
2) zygomaticofacial
3) zygomaticotemporal
4) infraorbital
61
branches of the mandibular division
deep sensory buccal
auriculotemporal
mental
62
origin of motor root in trigeminal nerve
pons
63
origin of facial nerve
different nuclei of the pons
64
what kind of neurons are the sensory processes of the trigeminal nerve
unipolar neurons
65
Where do the proprioceptive axons of the muscles of mastication have their cell bodies found?
They are found in the sensory nuclei of the trigeminal in the pons
66
meningeal branch of mandibular nerve
pass through foramen spinosum and supply meninges of middle cranial fossa and mastoid air cells
67
medial pterygoid nerve
arises from posterior surface of mandibular trunk and inserts into the medial pterygoid muscle
The medial pterygoid nerve has 2 tiny branches near its origin- the tensor palati and tensor tympani nerves
68
mandibular trunk divisions
meningeal branch and medial pterygoid nerve
69
mandibular nerve anterior division
muscles supplying muscles of mastication such as
1) masseteric nerve
2) deep temporal nerves
3) lateral pterygoid nerve
70
sensory buccal nerve
known to supply motor innervation to buccinator and also supply sensory fibres to cheek, buccal mucosa, buccal gingiva
71
mandibular branch posterior division
1) lingual nerve
auriculotemporal nerve
inferior alveolar nerve
mental nerve
72
What are the articular surfaces of tmj
of mandible-head of condyle
of temporal bone-mandibular/glenoid fossa, anterior articular tubercle
articular disc attached to joint capsule
73
what are the stabilising structures of the TMJ
JOINT capsule
post glenoid tubercle
stylomandibular ligament
sphenomandibular ligament
74
What kind of structures are the articular surfaces of the TMJ
The disc is fibrocartilage
The capsule is collagen
both superior and inferior internal surfaces of the capsule are lined with a synovial membrane. This is a specialised fibrocellular covering which produces synovial fluid and precise viscosity and chemical composition
the condyle
75
What makes the TMJ an atypical synovial joint
Atypical synovial joints are movable joints with membrane in protected locations. They are atypical because of the type covering the ends of the articulating bones. The ends of the bones in most synovial joints are covered with hyaline/articular cartilage.
76
what kind of joint is the TMJ
The TMJ is a ginglymoarthrosis- a sliding hinge joint
77
What is the function of the articular disc in the TMJ
help control movement and limit trauma
78
Innervation of the TMJ
MAD
masseteric
auriculotemporal
deep temporal
these are sensory
proprioception and pain fibres included
79
What is the blood supply to the TMJ
SAD
Superficial temporal
Ascending pharyngeal branch of the external carotid and the deep auricular
80
muscles of mastication vascular supply
arteries are superficial temporal artery and maxillary artery
Venous drainage is into the pterygoid venous plexus
81
Masseter attachments
medial surface of maxillary surface of zygomer and anterior zygomatic arch to angle and ramus of mandible
deep part also connects to coronoid process
82
temporalis muscle attachments
superior temporal line and zygomatic arch to medial coronoid process and upper ramus
83
temporalis vascular supply
superficial temporal artery and deep temporal branches maxillary artery
84
Muscles involved in depressing the TMJ
Lateral pterygoid, supra and infrahyoid
85
Muscles involved in elevating the TMJ
Temporalis, masseter and medial pterygoid
86
Lateral pterygoid muscle origins
smaller head arises from infratemporal surface of sphenoid
Lowerhead rises from lateral pterygoid plate, both insert ont neck of condyle of mandible and capsule of TMJ
87
Medial pterygoid origins
deep head arises medial side of lateral pterygoid plate, superficial head arises from pyramidal process of palatine bone both heads go to medial surface of ramus
88
summary of lateral and medial pterygoid relationships
-masseteric nerve-above upper head of lateral pterygoid-maxillary artery –VARIABLE -superficial (55 –70%)or deep (30 –45%)to lower head of lateral pterygoid, then between two heads into pterygopalatine fossa.-buccal nerve passes between 2 heads.-inferior alveolar nerve & artery & lingual nerve pass between lower border.MEDIAL PTERYGOID-lingual nerve & inferior alveolar artery & nerve are lateral.
89
Buccinator
attached to outer surfaces of posterior mandible & maxilla & to the pterygomandibular raphe* -posterior part of muscle is deep /medial to medial pterygoid, anterior part curves towards to modiolus where fibres cross over & insert into orbicularis oris.-dual innervation -buccal branch of facial nerve (motor) and probably long/sensory buccal branch of mandibular nerve.-buccal fat pad separates posterior buccinator & pterygomandibular raphe from ramus of mandible & masseter.
90
What are spaces between the eye, nerves, muscles and blood vessels filled with
Orbital fascia-coarsely loculated fat
91
origin of levator palpebrae superioris
arises lesser wing of sphenoid, above rectus superior and optic canal
92
Where do superior inferior and medial recti arise
tendinous ring around optic nerve
93
Where does lateral rectus arise
from lateral part of tendinous ring and from lateral margin of orbital fissure.
94
Where does the superior oblique arise from
body of sphenoid superomedial to optic canal and between superior and middle recti. Forms a tendon anteriorly that passes through a fibrocartilagenous sling
95
Inferior oblique
arises orbital surface of maxilla lateral to nasolacrimal groove. Passes between inferior rectus and orbital floor and then between orbit and lateral rectus. Inserts into sclera behind equator and between rectus inferior and lateral rectus
96
inferior oblique movement
eye up and out
97
superior oblique movement
down and out
98
tarsal plates
eyelid ligament things
99
what is the orbital septum?
A fascial sheet attached to periosteum of orbital rim and levator tendon
100
What does the conjunctiva contain
goblet cell
101
Meibom's glands/ sebaceous tarsal glands
empty into the free margin of the eyelid. The oily secretion spreads out over the tear film and contributes to its stability
102
conjunctiva vs sclera
conjunctiva is a mucous membrane covering the outer part of the sclera
103
iris function
vary aperture to control amount of light into retina
104
how many cell layers is the lens
2 cell layers
105
what is the shape of the lens
anterior cuboidal
106
ciliary body function
production of aqueous humor
accomodation for far and near vision
107
What is the main refractive apparatus of the eye
cornea-not lens
108
accomodation notes
less tension on zonule fibres, less pull and this causes long vision
Tension, and rounder lens accomodates for near vision
109
What is the junction between sensory retina and non-sensory retina
ora serrata
110
Where does aqueous humour drain?
80% drains from eye via the trabecular meshwork into scleral venus sinus. the remainning 20% drains into the uveoscleral angle
111
Ophthalmic nerve innervation
lacrimal gland and skin
frontal side of face via supratrochlear and supraorbital
nasociliary division into the anterior and posterior ethmoidal foramina
112
autonomic innervation of iris and ciliary body
The ophthalmic nerve is not just sensory, as both the nasociliary and lacrimal branches carry parasympathetic fibres deriived from other nerves to iris-from occulomotor nerve via ciliary ganglion and to the lacrimal gland. The ophthalmic nerve itself is purely sensory
113
Parasympathetic innervation in the eye reasons?
contract sphincters of pupil and ciliary body
contraction of ciliary muscle decreases tension on zonule fibres connecting ciliary body and lens results in a decrease in the diameter of the ciliary body. This results in lens becoming more round which gives accomodation for near vision
114
sympathetic innervation in eye reasons
dilate pupil
| vasomotor to blood vessels
115
Blood supply of eye
ophthalmic artery and venous drainage via retinal veins.
retinal veins converge on optic disc and enter optic nerve as central vein of retina. Drain into superior ophthalmic vein then into the cavernous sinus
Inferior ophthalmic vein drains orbit into the cavernous sinus
116
Larynx main functions
respiration
vocalisation
protection of respiratory passages during swallowing such as closure of epiglottis preventing food from passing into the larynx during swallowing
117
vocal process of arytenoid attachments
attaches to vocal ligament, vocalis muscle
118
Synovial joints of the larynx
cricothyroid
| cricoarytenoid
119
What surrounds the laryngeal inlet
the upper border of epiglottis and aryepiglottic folds
120
What are the vocal folds made of
elastic vocal ligament, vocalis muscle, and its changes in width and shape of space between folds control sounds and flow of air
121
Vestibular folds
soft folds of mucous membrane. Play only a minor role in normal phonation but have a protective function and are used in conjunction with the vocal folds to produce specialised sounds
122
what are the 2 extrinsic membranes
Thyrohyoid membrane
| cricotracheal membrane
123
What are the 2 intrinsic membranes
quadrangular membrane and cricothyroid membrane
124
What is special about quadrangular membrane
free inferior margin forms vestibular ligament
125
What is special about cricothyroid membrane
free superior margin forms vocal ligament
126
lateral cricoarytenoid function
rotate vocal processes of arytenoids medially
127
transverse arytenoid and oblique arytenoid function
pull the arytenoids together
128
What tenses and tighten vocal folds
cricothyroids
129
What relaxes vocal folds
thyroarytenoids and vocalis
130
What closes and widens inlet
aryepiglottic and oblique arytenoids close inlet, thyroepiglottics widen inlet
131
vagus and aorta left side
on the left side of the thorax the vagus crosses anterior surface of the arch of the aorta and gives off recurrent laryngeal nerve which loops under the arch of the aorta
132
recurrent laryngeal nerve and right side
vagus crosses the anterior surface of the subclavian artery and gives off recurrent laryngeal nerve which loops under the subclavian artery
133
recurrent laryngeal nerve and trachea
On both sides the recurrent laryngeal nerves run in the groove between oesophagus & trachea & then pass deep/posterior to thyroid gland (see below)In the thorax both vagi then divide up into plexuses (cardiac, pulmonary & oesophageal plexuses & then form anterior & posterior vagi & finally enter abdomen on oesophagus)
134
internal branch of superior laryngeal nerve function
pierces through thyrohyoid membrane and supplies mucosa down to level of and including vocal folds.
135
external branch of superior laryngeal nerve supplies
supplies cricothyroid muscle and inferior constrictor muscle
136
recurrent laryngeal nerve function
ascends in groove between trachea & oesophagus, behind thyroid , passes deep to lower border of inferior constrictor to enter larynx -supplies all laryngeal muscles except cricothyroid & also supplies mucus membrane below vocal fold
137
Thyroid
endocrine gland, two lateral lobes joined medially by an isthmus. May also have an extra pyramidal lobe.-lobes extend from thyroid cartilage of larynx to 4thor 5thtracheal cartilage-deep to infrahyoid musclesThyroid produces thyroid hormones (metabolic stimulation) & calcitonin (reduces blood calcium). Parathyroids (usually 4) are separate organs closely associated with the posterior surface of the thyroid (parathyroid hormone –elevates blood calcium, essential for life). Thyroid & parathyroids are in close proximity to the recurrent laryngeal nerves & care has to be taken to locate their exact position when thyroid surgery is being planned.
138
function of the external ear
collects mechanical sounds and vibrations
139
function of the eardrum and tympanic membrane
transmission, amplification
140
funcyion of inner ear
sensation and balance
141
What is found in the cartilagenous part of the external accoustic meatus
ceruminous glands (waxy sweat glands)
142
Ossicles
joints
bones
```
all joints are synovial joints covered with mucosa.
MIS
Malleus
Incus
Stapes
```
143
Stapedius
facial nerve--is a muscular part that lies in canal in post wall, supplied by the facial nerve
144
Function of tensor tympani
muscles usually work together in a reflex response to high intensity sounds. They contract and reduce the vibrations of the ossicles and in turn reduces sound intensity before it reaches the inner ear. The tensor tympani also pulls the tympanic membrane inward, which reduces intensity transmission. Tensor tympani also reduces intensity of sounds produced by chewing.
145
What kind of epithelium is the auditory tube?
respiratory epithelium
146
What is the function of the auditory tube
allows air into the middle ear and mucus out-it keeps the air pressure from both sides of the tympanic membrane the same.
147
attachment of superior pharyngeal constrictir
pharyngeal raphe, and skull and tongue and pterygomandibular raphe
148
attachment of pharyngeal constrictor
hyoid bone
149
attachment of inferior pharyngeal constrictor
thyroid and cricoid of larynx
150
salpingopharyngeus
salpinx means horn
| it attaches to the auditory tube, blends with palatopharyngeus and attaches to thyroid and pharyngeal wall
151
stylopharyngeus muscle
it binds to the styloid process of temporal bone. Thyroid and pharyngeal wall
152
Palatopharyngeus muscle
attaches with soft palate, binds with thyroid and pharyngeal wall, blends with salpingopharyngeus muscle
