Gray's Review Head and Neck Flashcards
1
Q
Where is the anterior fontanelle located?
A
junction of the sagittal and coronal suture
2
Q
when does the anterior fontanelle close?
A
18 mo.
3
Q
where is the posterior fontanelle located?
A
junction of the sagittal suture and lambdoid suture
4
Q
when does the posterior fontanelle close?
A
2-3 mo.
5
Q
where is the mastoid fontanelle located?
A
junction of squamous suture and lambdoid suture
6
Q
when does the mastoid fontanelle close?
A
end of 1st year.
7
Q
where is the sphenoid fontanelle?
A
function of the squamous suture and the coronal suture
8
Q
when does the sphenoid fontanelle close?
A
2-3 mo.
9
Q
although there is a lambdoid suture, what is there not?
A
lambdoid fontanelle.
10
Q
what does the first pharyngeal arch give rise to?
A
muscles of mastication + maleus + incus
11
Q
what does the second pharyngeal arch give rise to
A
muscles of fascial expression
stapes
parts of hyoid bone
12
Q
what does the third pharyngeal arch give rise to?
A
stylopharyngeus
parts of hyoid
13
Q
what would an injury to the occulomotor n. cause the eye to do?
A
point down and out - due to unopposed contrations of the trochlear and abducens n.
cause compete ptosis/drooping of eyelid
Dialated pupil because PNS innervation of occulomotor n. is out
14
Q
what supplies sensory innervation to the chin and lower lip?
A
mental n. –> inferior alveolar n. –> mandibular division –> trigeminal n.
15
Q
what does the auticulotemporal n. supply?
A
TMJ
temporal region
parotid gland
ear
16
Q
what does the buccal n. supply sensory innervation to?
A
internal surface of cheek
17
Q
what supplies sensory innervation to the upper lip?
A
infraorbital n.
18
Q
where is the location of the sensory neuron cell bodies of the trigeminal n.?
A
semilunar ganglion aka Trigeminal ganglion aka Gasserian ganglion
19
Q
what is Tic douloureux?
A
pain occurs over the area of distribution of trigeminal nerve branches
20
Q
what does the geniculate ganglion do?
A
found on facial n. and receives sensory fibers for taste and transmits preganglionic parasympathetic fibers
21
Q
what ganglion is for the glossopharyngeal n. mediating pain?
A
inferior glossopharyngeal ganglion
22
Q
where is the otic ganglion located?
A
mandibular division of the trigeminal n.
23
Q
what does the otic ganglion contain?
A
postganglionic parasympathetic cell vodies for parotid secretion
24
Q
what does the pterygopalatine ganglion contain?
A
postganglionic parasympathetic cell bodies for lacrimation and mucosal secretion
25
what travels through the superior orbital fissure?
```
occulomotor n.
trochlear n.
trigeminal -- ophthalamic division = lacrimal, frontal, nasociliary
abducens n.
ophthalamic v. (sup and inf divisions)
symp fibers from cavernous plexus
```
26
which n. is responsible for senosry and motor components of the corneal reflex?
ophthalamic division of the trigeminal n. and the occulomotor n.
27
what travels through the inferior orbital fissure?
maxillary n
infraorbital vessels
branches of sphenopalatine (pterygopalatine) ganglion
28
what does the optic canal contain?
optic n.
ophthalamic a.
sympathetic fibers
29
what passes through the foramen rotundum?
maxillary n.
30
what passes through the foramen ovale?
lesser petrosal n.
mandibular division of trigeminal n.
accessory middle meningeal a
emissary veins
31
what cranial n. is responsible for hyperacusis (sensitivity to loud sounds)?
facial - innervates the stapedius muscle
32
what muscles does teh hypoglossal n. innervate?
tongue muscles
33
what does the recurrent laryngeal n. supply?
motor innervation to larync
| sensation below the the true vocal folds
34
what nerve is often injured in a thyroidectomy?
recurrent laryngeal n.
35
what are the contents of the carotid sheath?
internal jugular v
common carotid a.
vagus n. `
36
what cranial nerves are in the cavernous sinus
```
3 occulomotor
4 trochlear
6 abducens
V1 ophthalamic
V2 maxillary
```
37
what passes through the parotid gland?
retromandibular v.
external carotid a.
CN VII
38
what are the contents of the infratemoral fossa?
```
part of parotid gland
lateral and medial pterygoid mm.
inferior part of temoralis
maxilary a. + branches
pterygoid venous pleuxus
mandibular n. V3
otic ganglion
corda tympani
TMJ
```
39
how does obstructive hydrocephalus occur?
aka - non-communicating hydrocephalus -=obstruction of the cerebral aqueduct - CSF is obstructed within the ventricular system --> increase in pressure = enlarged lateral and third ventricle
40
what is non-obstructive hydrocephalus due to?
communicating hydrocephalus = excessive CSF production
or ineffective CSF reabsorption
leads to enlargement of all ventricular chambers
41
what is anencephaly?
aka meroanencephaly - partial absence of the brain due to defective closure of the anterior neuropore
42
what is holoproencephaly?
failure pof the cleavage of the forebrain and would result in a single fused ventricle
43
what structures pass through the jugular foramen?
glossopharyneal n. (CN IX)
vagus n. (CN X)
accessory n. (CN XI)
Internal jugular v.
44
which nerve is responsible for the gag reflex?
glossopharyngeal n.
45
what veins are found in the "danger zone" of the scalp?
Loose CT is "danger area" - emissary veins --> diploic veins
46
injury to what nerve would cause the uvula to deviate to the right?
left vagus n.
47
what nerve innervates part of the external auditory meatus and when stimulated can trigger a cough reflex?
vagus n.
48
what would a tumor of the hypoglossal canal compress? What would that affect?
the hypoglossal n.
| affect the genioglossus m.
49
what nerve provides parasympathetics to the lacrimal gland of the orbit?
greater petrosal n.
50
what n. provides taste to the anterior 2/3 of the tongue?
chorda tympani
51
What nerve carries sympathetic innervation to blood vessels and mucous glands of the head and neck?
deep petrosal n.
52
which artery is not part of the circle of willis?
middle cerebral a.
53
what makes up the circle of willis?
```
bifurcation of basiar
posterior cerebral
posterior communicating
internat carotid
anterior cerebral
anterior communicating
```
54
what nerve lies closest to the internal carotid a. in the cavernous sinus?
abducens n. (CN VI) - would be affected with aneurysm
55
what nerve carries the afferent/sensory limb of the corneal reflex
nasociliary n. --> ophthalamic division of trigeminal n.
56
what is the efferent limb of the corneal reflex
facial n.
57
if a patient feels a thin ridge running forward across masseter what is it
parotid duct
58
which muscle is involved when there is partial drooping of the eyelid (ptosis)?
superior tarsal (of Muller) - it assists in elevating the eyelid and holding it up
59
which muscle is involved when there is partial drooping of the eyelid (ptosis)?
superior tarsal (of Muller) - it assists in elevating the eyelid and holding it up
60
what muscle is involved in complete drooping of the eyelid (ptosis)?
levator palpebrae superioris
61
what muscle is involved in complete drooping of the eyelid (ptosis)?
levator palpebrae superioris
62
what nerve would be affected by a hemorrhage of the AICA?
abducens n. (CN VI)
63
what nerve would be affected by a hemorrhage of the AICA?
abducens n. (CN VI)
64
what would a tumor of the jugular foramen affect?
glossopharyngeal
vagus
accessory
65
what would a tumor of the jugular foramen affect?
glossopharyngeal
vagus
accessory
66
what muscle prevents the accumulation of saliva and food in the oral vestibule?
buccinator m. - most important muscle of the cheek
67
what muscle prevents the accumulation of saliva and food in the oral vestibule?
buccinator m. - most important muscle of the cheek
68
compression of what nerve can give you tunnel vision or bitemporal herianopia?
optic chiasm
69
what nerve set is located closely above the pituitary gland?
the optic chiasm
70
what could compression of the optic n. cause?
complete blindness
71
what would compression of the optic tract cause?
homonymous hemianopia
72
what nerve is compressed when the eye assumes down and out, ptosis, and mydriasis
oculomotor nerve - 4 extraocular muscles
73
what is mydriasis?
paralysis of constrictor pupillae
74
what nerve lesion would cause weakness in downward and medial gaze and make it difficult to walk down stairs?
trochlear nerve
75
what arterial supply can compress the trochlear n. is there was an aneurysm?
superior cerebellar a.
76
what would a fracture of the lamina papyracea of teh ethmoid bone cause?
entrap of medial rectus
77
hyperacusis can occur following paralysis of what muscle?
stapedis m.
78
A lesion of the vestibulocochlear n. can cause what?
tinnitus and or deafness
79
in Frey syndrome, what nerve and fibers are damaged?
parasympathetic axons of auriculotemporal n.
80
which blood supplies most of the blood to the palatine tonsils?
lingual a.
81
what 2 arteries does the oculormotor n. (CN III) run between?
posterior cerebellar a. and superior cerebellar a.
82
what is the most common cause of a cleft lip?
failure of fusion of hte maxillary process and he inter maxillary segment
83
what would produce a median cleft lip?
failure of fusion of the medial nasal prominences
84
what causes a cleft lip not embryologically, but before that?
genetic defect - strong, most important factor
| but there cleft lips are multifactoral etiology
85
what is a dermatoid cyst and where does it occur?
cystic teratoma that often occurs near the lateral aspect of the eyebrow
86
what is the rima glottidis?
opening between the vocal folds and the arytenoid cartilages
87
what is the piriform recess?
recess lateral to the laryngeal opeining of the laryngopharynx
88
what is the vestibule?
region between the epiglottis and the rima glottidis
89
what is the ventricle?
area between the true and false vocal chords
90
what is the vallecula?
bilateral recess anterior to the epiglottis in the laryngopharynx
91
what is arachnoid villi
extensions of the arachnoid mater into the superior sagittal sinus
they allow proper drainage of the CSF into the venous blood stream from the subarachnoid space in which CSF circulates - crucial for intracranial pressure maintenance and circulation of CSF
92
what vessels anastomose to form Kiesselbach (Little) plexus in the nasal septum?
anterior ethmoidal a.
sphenopalatine a. - large (max-ECA)
superior labial a.- large (facial -ECA
greater palatine a.
93
what structures would you most likely encounter while performing a midline incision below the isthmus of the thyroid gland?
inferior thyroid v.
| thyroidea ima a.
94
what 2 nerves are at risk of injury during thyroidectomy?
external laryngeal n.
| recurrent laryngeal n.
95
what artery is easily injured in an emergency tracheostomy with a midline incision over hte trachea?
the throidea ima artery
96
what results in a slow bleeding hematoma?
torn cerebral v.
97
what would a rupture of the anterior communicating artery result in?
subarachnoid hematoma - blood present in CSF upon lumbar puncture
98
where is there no lymphatics in the neck?
in the middle of the vocal cord
99
what gives rise to the efferent motor fibers of the vagus n. that would essentially supply the laryngeal and pharyngeal m.?
the nucleus ambiguus
100
what happens if the nucleus ambiguus and vagus n. is interrupted?
loss of swallowing, cough and gag reflex
101
what does the nucleus solitarius receive info from?
general visceral sensation and taste from the facial, glossopharyngeal and vagus n.
102
what does the dorsal motor nucleus contain?
cell bodies of preganglionic parasympathetic fibers of the vagus n. innervating the heart muscle and smooth musculature and glands of respiratory and intestinal tract
103
what does the superior ganglion of the vagus n. contain?
cell bodies of the general somatic afferent sensory fibers
104
what does the inferior ganglion of the vagus n. contain?
visceral afferent sensory - no pain though! - form the heart, lungs, larynx and alimentary tract
105
what nerve does the inferior alveolar n. give rise to just before it passes into the mandible to supply the lower teeth and chin?
mylohyoid n.
106
what does the mylohyoid n. innervate?
anterior belly of digastric and mylohyoid
107
what innervates geniohyoid?
motor fibers from spinal nerve C1 that runs with hypoglossal n.
108
what innervates the stylohyoid m.?
facial n.
109
what innervates the palatoglossus m.?
vagus n.
110
if you want to anesthetize the conjunctival covering of the sclera, what nerve should be knocked out?
nasociliary branch of ophthalmic Vi
111
if you wanted to anesthetize the conjunctival covering of the sclera, where would you place the needle?
through the upper eyelid deeply towards the obital apex to infiltrate the nasociliary n.
112
how would you anethitize the lacrimal n. and twigs of maxillary n. ?
also between the orbital septum and the palpebral musculature laterally
113
what is SLOS?
craniofacial and limb defects
| 5% have holoprosencephaly
114
what is schizencephaly?
rare and characterized by large clefts in the cerebral hemispheres which can sometimes cause the loss of brain tissue
115
what is exencephaly/anencephaly/merocephaly?
failure of the cephalic part of the neural tube to close
116
what do crainial defeciets usually involve?
the squamous part of the occipital bone and in some cases the posterior aspect of the foramen magnum
usually occuring at posterior fontanelle
