Gross Anatomy Exam 1 Q2 Flashcards

Question

Cutaneous Branches of Cervical Plexus

Answer 1

Four main branches emerge from the deep neck along the porterior border of the SCM -Lesser Occipital Nerve - C2 fibers VPR and it innervates the skin of the posterior scalp and behind the ear and base of the skull -Great Auricular Nerve - C2, C3 fibers VPR and it innervates the skin below and anterior to external ear and part of ear including the skin over the angle of the mandible -Transverse Cervical Nerve - C2, C3 fibers of VPR and it innervates most skin of the anterior neck, the terminal branches penetrate the platysma muscle -Supraclavicular Nerves - C3, C4 fibers of VPR, radiates across the clavicular region and forms 3 branches: lateral, intermediate and medial. Innervate the skin of base of neck, upper thorax and top of shoulder

Answer 2

- join with nerves en route to their distinctions, but are really not part of those nerves - C2, C3, C4 fibbers join cranial nerve XI, providing sensory innervation to SCM (C2, some C3) and Trap (C3, C4) - C1 fibbers join with cranial nerve XII and supplies motor innervation to Geniohyoid and Thyrohyoid muscles

Answer 3

-comprised of the ventral ramie of C1, C2, and C3 -supplies the infra hyoid muscles except thyrohyoid -Has 2 roots: Superior Root of Ansa Cervicalis also called the descending hypoglossal Inferior Root of Ansa Cervicalis also called the Descending Cervical Ramus -together these two roots supple sternohyoid, sternothyroid and omohyoid muscles

Answer 4

- is comprised of the ventral rami of C3, C4, C5 | - motor and sensory to the diaphragm

Answer 5

-supply direct innervation of the deep anterior neck muscles: scalene muscles and prevertebral muscles

Answer 6

- strap like, broad and flat - used in activities such as swallowing and speech - there are 4 pairs: sternohyoid, sternothyroid, omohyoid, and thyrohyoid

Answer 7

-the anterior and posterior bellies have different embryonic origins, therefore their innervations are different

Answer 8

parallels the posterior belly of the digastric | the tendon insertion usually splits and passes on either side of the intermediate tendon go the digastric

Answer 9

within the sub mental triangle | helps form the floor of the oral cavity

Answer 10

superior to the mylohyoid and has a different innervation than the other SUprahyoid muscles

Answer 11

also known as the inter scalene triangle Borders are: First rib, Anterior scalene m, and Middle scalene m -exiting en route to the extremities thru the scalene triangle are: Subclavian artery and the roots of the brachial plexus Clinical significance: At the area of the triangle the elements of the plexus and subclavian artery are subject to impingement by the scalene muscles leading to neuromuscular problems to the upper extremity

Answer 12

surrounding muscles and organs of the neck and it has three layers. Superficial layer - attachments to the clavicle, hyoid, occiput, mandible, sp.'s of the cervical vertebrae and ligamentum nuchae and it invest the SCM and Trapezius muscles Pretracheal Layer - defines the visceral compartment in neck. Surround the thyroid gland, trachea and espphagos, larynx, pharynx, and infrahyoid muscles Prevertebral Layer - surrounds cervical spine and deep muscles of the posterior neck. Also surrounds muscles of anterior neck

Answer 13

- all three layers of the deep fascia make the carotid sheath - the sheath contains: common carotid artery, internal jugular vein and the vagus nerve

Answer 14

- These fascial layers are said to establish interfacial planes (potential space b/w fascial layers). - These planes extend longitudinally thru the neck from the base of the skull to the thorax. If a pathogen gets into these spaces it can spread longitudinally.

Answer 15

- the right common carotid artery originates from the brachiocephalic artery / trunk - the left common carotid originates directly from the aortic arch - both common carotids ascend to the level of the superior border of the thyroid cartilage where they bifurcate into the external and internal carotid

Answer 16

- the dilation area of bifurcation of the common carotid artery - is at the vertebral level of C3,C4 - receptor morphology is speciallized epithelial cells and a rich plexus of nerve endings turning it into a sensory receptor - mechanoreceptor - baroreceptor that monitors changes in the increase of blood pressure that increase the rate of nerve impulses which can result in vasodilation and decreased heart rate - innervation from the sinus branch of CN IX and some from CN X

Answer 17

- increase in blood pressure stimulated the carotid sinus that stimulates branches of the IX nerve to the CNS and the CNS coordinates cardiovascular changes causing vasodilation, decrease blood pressure and decreased heart rate - the carotid sinus responds to any changes in mechanical pressure, i.e. externally pressing on the sinus, this can result in activation of the carotid sinus reflex and cardiovascular changes

Answer 18

- located near the carotid bifurcation, is small in size only 2-5 mm in diameter - the morphology of the receptor is that it has specialized epithelial cells, nerve endings and is a rich bed of capillaries - it is a chemoreceptor that monitors changes in the concentration of oxygen and carbon dioxide (actually levels of protons and HCO3 - is innervated by the sinus branch of CN IX and some by CN X

Answer 19

- from the carotid bifurcation, it travels deep and superiorly to the base of the skull - enters the skull via carotid canal and is distributed to the brain and orbit including the eyeball - usually has no defined branches in the neck

Answer 20

``` Superior THyroid Artery Ascending Pharyngeal Artery Lingual Artery Facial Artery Occipital Artery Posterior Auricular Artery Maxillary Artery Superficial Temporal Artery Also has the superior laryngeal artery and transverse facial artery ```

Answer 21

- usually gives off a superior laryngeal artery | - supplies blood to thyroid, larynx, infra hyoid muscles and parts of SCM

Answer 22

- difficult to dissect - small | - supplies pharyngeal wall

Answer 23

Branch of external carotid near the posterior belly of digastric muscle, travels deep to it to the hygoglossal nerve

Answer 24

- 20% facial and lingual share a common trunk - travels thru the submandibular triangle and crosses mid mandible - it traverses across the superficial face, paralleling the facial vein and it terminates at the medial angle of the eye - supplies the submandibular gland and the anterior face- inf and sup lips via the inferior and superior labial arteries - also give rise to the angular artery that anastomoses with the infraorbital artery

Answer 25

travels posterior to the external ear, parallel to the greater occipital nerve and supplies the posterior scalp

Answer 26

-travels behind the ear and supplies parts of the external ear and some of the skin behind the ear

Answer 27

- largest branch - arteries arise deep to the neck of the mandible - sends branches to the: lower teeth and mandible, maxilla and upper jaw teeth, muscles of mastication, dura mater around the brain

Answer 28

- palpable above the TMJ in front of the ear | - supplies much of the superficial structures of the parieto-temporal region of the head and parotid gland

Answer 29

- there is a left and a right subclavian artery - the right one branches from the braciocephalic artery and the left one branches from the aortic arch - there are four major branches off the subclavian artery: Internal Thoracic Artery, Vertebral Artery, Costocervical Trunk and the Thyrocervical Trunk that gives off 4 more branches being the Ascending Cervical, Inferior Thyroid, Transverse Cervical and Suprascapular

Answer 30

descends into the thorax along the internal surface of the thoracic wall

Answer 31

Ascends and enters a transverse foramen at C6, it then sends branches to deep neck structures, spinal nerves and the spinal chord and becomes on of the major arteries to the brain

Answer 32

Inferior Thyroid - helps supply thyroid, esophagus, larynx, and trachea Ascending Cervical - supplies strucutures in deep cervical region Transverse cervical - branches to transverse cervical and dorsal scapular Suprascapular

Answer 33

- originates posterior to the anterior scalene muscle - gives off two branches, the deep cervical branch that supplies the deep posterior neck structures and the superior intercostal branch that supplies superior part of thorax

Answer 34

- begins in the jugular foramen forms from the sigmoid dural sinus - travels inferiorly thru the neck and receives tributaries from facial, lingual, thyroid and pharyngeal veins - joins with subclavian vein to form the braciocephalic, this is the major drain from the brain

Answer 35

- begins in the sub occipital triangle region - parallel to the vertebral arteries - drain deep neck structures - drain into the braciocephalic veins

Answer 36

- endocrine gland (ductless), is quite big - found at the C5, 6 ,7 levels straddling the upper part of the trachea - has two lobes that are connected by the isthmus: left lobe, right lobe and sometimes there is a third lobe on top of the isthmus called the pyramidal lobe - synthesizes and secretes thyroxin (cellular metabolism) and calcitronin (increases blood calcium levels) - suppied by the sup and inf thyroid arteries - thyroid veins is what it primarily drains into, the superior, middle and inferior

Answer 37

- endocrine glands (ductless), small and ovoid - four glands (two pairs) superior parathyroid and inferior parathyroid - embedded in posterior aspect of the thyroid gland - synthesizes and secretes parathyroid hormone that increases the blood calcium levels

Answer 38

``` -skin of the face S - skin C - connective tissue (subcutaneous tissue, hypodermis) A - Aponeurosis (Galea Aponeurotica) L - Loose CT P - Pericranium ```

Answer 39

Frontalis muscle attaches anterior to the skin and soft tissue of the eye brow, posteriorly to the galea aponeurotic a Occipitalis muscle attaches anterior to the galea aponeurotic a and posterior to the occiput Actions it performs is the elevate the eyebrows, elevate the skin of the forehead and move the scalp over the dome of the head

Answer 40

- concentric arrangement around the orbit - has three portions, orbital - around the orbital rim, palpebral - with in the eyelids, and lacrimal - actions are close the eyelids, blink muscle

Answer 41

-concentric arrangement around the mouth | action is to purse the lips and close lips tightly

Answer 42

-originates from the fascia of the cheek and inserts into the corner of the mouth actions is to retract the angle of the mouth

Answer 43

Major - inserts into the angle of the mouth and it elevates the angle of the mouth Minor - inserts into the upper lip and elevates the upper lip in the middle

Answer 44

action is to depress the angle of the mouth

Answer 45

more medial than depressor anguli oris and the action is to depress the lower lip

Answer 46

muscle of the cheek and its action is to compress the cheek against the teeth and gums

Answer 47

action is to depress the lower lip along the midline

Answer 48

- provide motor and sensory innervation and is fairly complex - for now only consider somatomotor roots/neurons of the facial nerve: these emerge from the parotid gland and makes six named branches - Temporal branch of the facial nerve - Zygomatic branch of the facial nerve - Buccal branch of the facial nerve - Mandibular (Marginal) branch of the facial nerve - Descending cervical branch of the facial nerve - Posterior Auricular branch of the facial nerve

Answer 49

- biggest of the large group at 25 grams - develops from the wall of the oral cavity - connecting the oral cavity to the parotid gland is the parotid duct = Stensons duct, this duct travels across the cheek ant and penetrates the buccinator muscle and enter the oral cavity opposite the 2nd upper molar at a landmark called the parotid Papilla - it secretes serous fluid that contributes to saliva - it is innervated by sympathetic vasomotor fibbers and parasympathetic secretomotor fibbers, preganglionic from facial nerve and postganglionic from the otis ganglion

Answer 50

- has a left and a right - about the size of a walnut in the submandibular triangle - mainly a serous gland, but some mucous secretions - develop from the walls of the oral cavity and is connect by the submandibular duct= Whartons duct connecting at the sublingual papilla or caruncle - innervated by sympathetic - vasomotor and parasympathetic - secretomotor with pre G from facial n and post from submandibular ganglion

Answer 51

- smallest of the three large glands - located deep to the mandible, superior to the mylohyoid muscle in the floor of the oral cavity - sublingual ducts - series of small ducts thru which the gland secretes it products - innervated by sympathetic vasomotor and parasympathetic secretomotor with pre G from facial nerve and post G from submandibular ganglion

Answer 52

- small glands on the oral side of the upper and lower lips - numerous, small - innervated by sympathetic vasomotor and parasympathetic secretomotor with pre G from facial nerve and post G from submandibular ganglion

Answer 53

- small glands on the tongue - numerous, small - innervated sympathetic by vasomotor and parasympathetic by secretomotor with pre G from the facial nerve and post G from the submandibular ganglion

Answer 54

- small gland in the roof of the oral cavity - innervated sympathetic vasomotor and parasympathetic secretomotor with pre G from facial nerve and post G from Pterygopalatine ganglion = spenopalatine ganglion

Answer 55

- parallels the facial artery just posterior to it - has 3 main tributaries: Sup and Inf Labial and the Angular vein what begins near the medial angle of the eye and has clinical significance because if someone was to get an infection or tumour nearby it could migrate into the vein and go into the cranial cavity thru the ophthalmic and infraorbital veins that it anastomoses with - drains into either the external, internal or anterior jugular veins

Answer 56

- it is a mixed nerve where it has sensory and motor neurones on it - has 3 divisions that happen before it leaves the cranial vault. Ophthalmic nerve V1, Maxillary nerve V2, and Mandibular nerve V3 - motor innervation travel on the mandibular nerve and supply muscles of mastication, anterior belly of digastric, mylohyoid, tensonr veli palatine and tensor tympani - general sensory innervation is done to 2/3 of anterior part of head, the cell bodies of the sensory neurones for the trigeminal nerve occupy the trigeminal ganglion = gasserian ganglion and distributed out to all divisions

Answer 57

``` frontal 1 parietal 2 temporal 2 occipital 1 sphenoid 1 ethmoid 1 -these bones also form the cranial vault ```

Answer 58

``` maxilla 2 zygomatic 2 palatine 2 inferior conchae 2 nasal 2 lacrimal 2 vomer 1 mandible 1 ```

Answer 59

malleus 2 incus 2 stapes 2

Answer 60

-the majority of the bones are fibrous Sutural Joints - bone surfaces are very close together attached by fibrous CT -sutural joints are usually described as relatively rigid immoveable joints -most sutures become ossified with age -some joints of the skull are not sutures: TMJ and Ear ossicles

Answer 61

Serrated suture - Coronal suture that is b.w the frontal and parietal bones, Sagittal suture that is b/w the L and R parietal bones, Lamboidal Suture that is b/w occipital bone and parietal Bevel Sutures - Squamousal suture is b/w the squamous, temporal and parietal bone

Answer 62

Vertex - top most point of the skull when head is upright Bregma - point of junction b/w coronal and sagittal sutures Lamba - point of junction b/w the sagittal and occipital sutures Parietal Emminences - area of greatest convexity on the side of the skull Supercilary Arches - supraorbital crest (eyebrows) Glabella - smooth prominence just above nose (indian dot spot) EOP Temporal Fossae - depressions on the side of the skull Zygomatic Arch - part zygomatic bone and zygomatic process of temporal bone

Answer 63

Borders: orbital plates of the frontal bone that form the orbital roof, cribriform plate of the ethmoid bone (cribriform foramina and crista galli), lesser wings of the body of the sphenoid

Answer 64

Borders: Great wings of the sphenoid body, Body of Sphenoid (sella turcia and hypogphyseal fossa), Temporal Bones (squamous and petrous portions)

Answer 65

Borders: occipital bone, part of the temporal bone (petrous portion), body of the sphenoid Landmarks: Internal Occipital Proteberance, Internal Occopital Crest, Sulci for the transverse and sigmoid sinuses.

Answer 66

- middle cranial fossa - connects middle cranial fossa to the orbit - passing thru it is the Orbital nerve CN II and the Opthalmic Artery

Answer 67

- middle cranial fossa - inferior to the lesser wing of sphenoid connecting to the orbit - passing thru it is CN III Oculomotor, CN IV Trochlear, CN VI Abduscents, and V1 Opthalmic of CN V (sensory)

Answer 68

- middle cranial fossa - connects to the pterygo palatine fossa - passing thru it is V2 Maxiallry nerve of CN V (sensory)

Answer 69

- middle cranial fossa - connects to the infratemporal fossa - passing thru it is V3 Mandibular Nerve of CN V (sensory and motor)

Answer 70

- middle cranial fossa - to the infratemporal fossa - passing thur it is the middle menigeal artery into the cranial cavity

Answer 71

- middle cranial fossa - closed by fibrocartilage, the carotid canal open into this cavity - nothing travels thru this foramen but the internal carotid artery travels across it

Answer 72

- posterior cranial fossa - connects to the petrous temporal bone / inner ear - passing thru is the CN VII Facial, CN VIII Vestibulocochlear, Internal Auditory Atery

Answer 73

- posterior cranial fossa - connects to the skull bone - passing thru is CN IX Glossalpharyngeal, CN X Vagus, CN XI Spinal Accesory, and Internal Jugular Vein from sigmoid dural sinus

Answer 74

- posterior cranial fossa | - passing thru it is the Spinal chord to the brainstem transition, Vertebral Arteries, Spinal root of XI

Answer 75

- also can be called the anterior condylar canal | - passing thru it is CN XII Hypoglossal

Answer 76

- also can be called the posterior Condylar canal | - passing thru are the emmisary veins

Answer 77

Three layers: Dura Mater, Arachnoid, Pia Mater The pia and arachnoid are sometimes refered to jointly as the leptomeninges, the dura can be called the pachymeninges Spaces b/w the meninges are: Subarachnoid space b/w pia and arachnoid filled with cerebrospinal fluid Epidural Space b/w the dura and the cranial vault bones creating a potential space that can be filled by the leaking of meningeal arteries Subdural Space b/w the dura and arachnoid and it is a potential space that can be filled with blood from leaking cerebral veins

Answer 78

-lines cranial vault, two layer (periosteal - outermost formed by periosteum, and meningeal - innermost continuous with spinal dura) Features: Dura folds; Falx cerebri - is the longitudinal cerebral fissure b/w R and L hemishpere of brain, attaches ant to crista galli and post to tentorium cerebelli Tentorium Cerebelli - b/w occipital lobes and the cerebellum, horizontal plane Falx Cerebelli - separates the two cerebellar hemispheres Diaphragma Sella - covers pituitary gland over sella turcia

Answer 79

-within dura, dural walls and lined with endothelium with no muscles or valves -receives venous drainage from brain, cerebral veins Superior Sagittal Sinus, sup border of Falx Cerebri Inferior Sagittal Sinus, inf border of Falx Cerebri Straight Sinus, lies along junct of Falx Cerebri and Tentorium Occipital Sinus, drains superiorly to confluence COnfluence of SInuses, just inf to IOP Transverse Sinuses - confluence to sigmois sinus Sigmoid Sinus, drain to jugular foramen, Internal Jug V Cavernous Sinuses, located on each side of the sphenoid body, drain by petrous sinuses

Answer 80

-within the dura Anterior Meningeal Artery - formed from branches of Internal Carotid A, traverses the dura of the anterior fossa Middle Minengeal Artery - formed by branches of Maxillary A, largest, traverses middle fossa, enters skull thru f. spinosum Posterior Meningeal Artery - formed by branches of occipital and vertebral, traverses the dura of posterior fossa -often imprint grooves on cranial vault bones -blood from these arteries distributed to skull bones -Clinical Sig- Epidural and Subdural hematoma where vessel breakage causes increase CSF pressure

Answer 81

Diploic Veins -veins within the medullar cavity of the cranial bones -drains blood from the cranial bones -drains into the superficial veins of the scalp and/or the dural venous sinuses Emmisary Veins -directly connect veins from outside of skull to sinus inside skull

Answer 82

- innervate the dura especially near dural vessels - dura of ant and mid fossae are innervated by the meningeal branches of the trigeminal, all divisions - dura of the post fossa innervated by branches of upper 3 cervical spinal nerves, and CN X Vagus - functional role is to provide pain innervation to pain sensitive tissues such as 1. dura 2. dural sinuses 3. Meningeal A. 4. Cerebral A. - some autonomics travel to dura with the arteries providing some vasomotor innervation to the cerebral A and meningeal A.