H& N Flashcards
2nd arch bobe, cartilage, lig?
HRS Face n muscles
1st arch cartilage/bone/mus?
MMMMIT (mandibular) v2, V3
not V1 frontal nasal prominence
3rd Arch bone, cartilage, lig?
Stylopharngeus, rest Hyoid, 9
4th & 6th arches bone/cart/lig?
-Laryngeal bones,
outside mus- 4- ex. laryngeal mus, pharyg mus and veli palatine (except)
6- inside deep mus- only in. esp
-CN10
1st phary pouch, membrane, groove in order?
- pouch:tympanic cavity/tube/ recess
- groove- ex acousticmeatus/cervical sinus
- membrane ((tympanic membrane.))
2nd pharyngeal pouch?
palatine tonsil/tonsillar sinus
3rd pharyngeal pouch?
- dorsal: inferior parathyroid
- ventral: thymus gland
4th pharyngeal pouch?
-dorsal(superior parathyroid)
ventral(ultimopharyngeal/C cells thyroid)
5th pouch rudimentary
Parotid duct enters oral where?
upper second molar
infection in face veinage bad if?
near facial vein –> orbital by sup opthalmic vein–> cavernous sinus. danger triangle
lymp drainage? lateral face $ scalp upper lip corner lip chin/lower lip
parotid, submandibular, submental
lymph area only in h and n?
pericervical collar- parotid buccal. s,s,p,o,e
deep cervical lymph node by IJV
superior and inf ganglion CN 9 branch?
CN9– parotid, post tongue 1/3, middle pharyg constrictor, carotid
parotid inn?
SA- greater auricular invest sheath(C2,C3), auriculartemp
para-post otic gang, symp ECA plexus, VA
serous, largerst, 1st,
Parotid plexus are? clinical?
facial n under parotid. TZBMC, parotidectomy danger, fxn: Mimetic, post digastric, stylohyoid muscles
retroman makes?
common facial vein?
IJv on face at jug formane?
pterygoid plexus drains?
- max+ sup temp
common facial vein- ant+ facial
IJV- post+ post auricular, inferior petrosus, sigmoid sinus
deep facial vein
artery of scalp? SCALP stands for, infection where what part?clicicals
occipital, post auricular, superficial temp, opthalmic (suprorbiral/supratrochlear profuse bleeding(limit blood const), cut paralle to fibers for healing
2 terminal branches of ECA!
sup temp, maxillary
artery supplies temporal
parotid gland, skin?
transverse facial, facial a
Cutanation inn of face.
supraorbforamen(ISSL), infraorb(iZZ), Mental(MAB) –>SA except auricolotemp (para,symp-post VA,SA)
sides of back of neck– greater auricular- lesser occipital (ventral ramiC2-C3), transverse cervical??
back-of scalp– greater occipital (dorsi rami c2-C3)
trigemelia?
anomalous a (middle meningle) by V2/V3 (SA)ganglion- pulsation PAIN BAD, TRIGMELIA
The inferior alveolar ?
(BM) and (SA) until the mylohyoid nerve branches off SA. supply all
the mandibular teeth. mental innervates the chin (SA).
•
The buccal nerve inn? auricular temp?
SA- skin and oral mucosa of the cheeks and adjacent gingiva
SA-somatic sensory (SA) fibers to the anteriorear and temporal regions.
Tmj? type jt? articular surface?articular jt? movements?
hinge synovial, three different planes.
articular-mandibular fossa, mandibular condyle and the
articular tubercle of the temporal fibrocartilage rather than hyaline cartilage as in a typical synovial joint.
articular disc-
sup(big open) (slide/glide) (ant dislocation) (pterygoid
inf joint cavities- slight gravity
3 mand lig? 1 part of capsule
lateral lig(temporomandibular)- strengthen TMJ & postglenoid tubercle
sphenomandibular lligament
stylomandibular lig little support jt capsul
jaw spasam?
Tetanus (or “Lockjaw”) is caused by the bacterium Clostridium toxin massteric/ temporalis
4 parts thyroid? lobe not spcimmon?
~50% of the population have apyramidal lobe present.
careful for trachiotectomy?
nick inf thyroid or throid ima artery ( c10%)from (brachiocephalc artery) ppulses bc really closese to heart
thyroid veins?
Superior & middle thy vein (IJV)
inf ty vein drain brachicep ( biiggest an most variable)
recurrent laryngeal nerves? fxn comp?
left recurrent wraps around aorta
right recurrent wraps right subclavian artery.
(BM, SA) (VE-para/pre) mucosa and mucus glands below the
vocal folds.
Sympathetic trunk injury?
ptosis, miosis, anhydrosis, hyperema
injury (central, pregang, or post ganglionic) 2nd to disease or 1
Stellate gangion n block?
- block cervical and superior thoracic n block
- ganglion block may relieve vascular spasms in brain and upper limb
- esp to see if resection good for excess vasoconstriction of the ipsilateral upper limb.
- right behind subclavian is stellate ganglion
2nd part swallowing vs thrid? long muscle fxn, inn? constrictor fxn, inn?1st const of esphogus? popcorn stuck? chicken bone stuck?- clinical?
- long/suprahy vs constrictors
-salpingo(10), palatopharyngeus(10), stylopharyngeus( CN9)
elevate layrnx(thus epig drop cover) , pharynx-speak/swallow
-suprahyoid- ant dig+ myhloid(v3), post dig(cn7)
elevate layrnyx, hyoid, - 1st cons at circopharyngeus
-vallecula side not over epiglottis food
-space btwn layrnyx and pharynx. chicken bone damage recurrent/sup layrngeal n bc skeletal muscle thin
RCL, &RCA?
LC?
difference from true back muscles?
RCA- vent rami C1-C2-ant/lateral flex head on neck(atlato-occipt jt)
RCL- ven ramiC1-C2 ( on transverse foramen)- flex head/stabilize
L capitus - vent rami C1-C3, flex head on neck(atlato-occipt jt)
Longus coli- @ C1-T3 –ramiinn C2-C6 - ant/lateral flexing neck part C2-C6
ant. vetebral mus(LC,RCA,Ant.Scalaene)
lateral vetebral(RCL, mid& post scalaene, (((splenius, levator scapulae) dorsi rami))
Scalanes?
lateral flexors/1st rib forced insp
middle- c3-c8
ant-C4-c6
post-c7-c8
Root neck?
C C6 tubercle?
Pyramidal space?
arteries, nerve block stellate, compression c
neural crest, ectoderm placode, paraxial mesoderm, lateral plate mesoderm,? weeks form arches?
pia/arachnois/sensory neuron/ CT/dentin senory neuron 7,5,9,10, w neural crest cells voluntary muscles somites, laryngeal mus, cartilage ct 4-5 week
CC/ECA/ R subclavian/left part aorta make ? derived(ICA/ECA)? 7th intersegmental make?
- cc-/ECA3rd, -R subclavian/left aorta- r/L 4th arch,
- aortic sac, r horn aortic sac
- distal R and left subclavian
- 4 pouches, 5th arch dissappears
tongue ant/pos origin? muscle? Lingual papillae/inn? cervical cyst forms? sclera, cornea origin?
-lateral lingual swelling fuse (1st arch) & post (3-4arch) hyophargyneal eminence (terminal sulcus),mucosa/submucosa only SS/VA vs occipital somites/CN12 muscle, papillae (4 types)-filliform only senation no taste. foliate, vallate(arch 3) & fungiform(arch 2/chorda tympani)
-thyroglyossus duct closes in back to foramen cecum
sclera- dura, choriod - arachnoid .
frontonasal prominence facial prom in n? chonea, hard/soft palate, nostrils,nasolacrimal, conchas, ? cleft palate cause by? eye detachment sig? main sources food for eye? myelination optic n, maxilllary sinus? cornea layer(ect, endo, neural crest/ cip mig endo),
forehead, nasal part, front stomedum and the nose. V1 not part phary arch
nasal placode->nasal pit(nostrils) –>lateral(nasalacrimal groove) /medial nasal prominence-> intermaxillary prominence -> oral sac– oroalnasal memebrane disintegrates (primordial choanae) –>lateral/medial palatine prominence( fuse 1 palate) – lateral zippering in back ( 2nd palate, soft palate) –> choane now in nasopharynx separation nose from mouth
- sup and middle ethmoid but inf by self lateral palatine promence not zippering ( mouth or palate only)
- retinal fissure stalk–>hyaloid blood–> distal portion digenerate–> central a/v optic nerve
- 1st eye only fed of aqueous humer, until later, inner layer neural and outer pigmented layer retinal epithelium
Mandibulofacial dystostosis. Treacher-Collins Syndrome and Pierre Robin Syndrome , DiGeorge Syndrome
neural crest cell mig bad thus arch bad 1/2, 1 syndrome(malnormal eepm )or 3/4(1)craniofacial defe. micrognathia (small jaw), low set ears, auricular abnormalities, and cleft palate; (2)agenesis 3rd & 4th pharyngeal pouches (thymus &
parathyroid glands) (3) cardiovascular defects. partial monosomy of chromosome 22, or children of alcoholic women.
gray communicion fxn?
spinal n get to head neck how?
white commion location?
cardiopulmonary?
- location- base skull - ganglion impur,
@bifurcation of ventral/dorsal ramifor symp-post
- always sympost distally accompany muscle, but arteries periartierlias - T1-L2
- sympost-VA
cut artery fxn ?
ganglion missing/small, that are fused, highest sympost/symppre level?
ganglion branches?
sympost VA middle cervical gang( level C1-C2), inn(C1-4) thoriocervical(stellate) C6, C5-6 superior cervical ganglion, C7, C7-C8 cardiopulmonary (sympost, VA)
pharyngeal layer clinical space dangerous? para-pre becomes post what layer? tonsil/lympoid circle called?
Danger - btn prever/alar –post mediastinum/ spreads up T12
retros- btw buccapharyngeal/ alar– and tied down sup mediastianum
MRI/clinically-retropharygnealdanger space bc no alar seen
muscle-pharygnbasilar fascia- submucosa-para-ganglion-mucosa
Waldeyerʼs Ring(4 tonsils) incomplete circle on sup pharynx
otis media?
nasopharyx infection spread ear inflammation maybe permenent hear lose- risk adenoids
gaps btwn constrictors? 1st, 2nd, 3rd, 4th?
- nothing bc pharyngealbasilarfascia covers it?
- stlopharyngeus, stylohyoid ligament, cn9, (3)
- tyro-hyoid membrane hole–
internal laryngeal , superior laryngeal a/v (3) - under cricopharyngeus mus
recurrent n, inf laryngeal a/v (3)
blood supply pharynx- ECA/ICA mainly • Ascending pharyngeal • Facial • Lingual • Pharyngeal artery branches (branch of inferiorthyroid artery)
pharynx SA, VE inn? skeketal motor inv? blood supply?
1.) symp& para post, VA, SA —>pharyngeal branch
upper 1/2 phary pharynx
rest pharyngeal plexus w buccopharyngeal fascia
2.) sympost fibers from near by vessels, vasoconst
sensation mucosa
V2(SA) 1/2 sup naso, CN 9 (SA) 1/2 inf naso/ oro, CN10 (VA) larygnealphayrnx
——–/——-SA from CN 9 not apart of pharygneal plexus
Mucosa gland
Pharyngeal branch of PPG- para-post sup 1/2 phary
( para-post( CN 7 via PPG)
Pharyngeal plexus-CN10- para-pre synapse @ submucosa para post-rest of pharynx
( parap-post , ………symp-post artery, VA, CN10 BM/SA for pharygneal mus)
BM/SA- dont go through pharyngeal plexus blood- FLAP • Ascending pharyngeal • Pharyngeal artery branches (branch of inferiorthyroid artery)
Deglutition (the act of swallowing) occurs in three stages?
- break food w palate, tongue brings it back space
- swallow by suprahyoid, and pharyngeal long elevate phanyx, hyoid or/ larynx— causes epiglotissis to passively fold, widen pharnyx, to recieve food bolus
- pharynx conx food down to espohagu
parathyroids are highly variable ? thyroglossus duct? frenulum not deep almost not attached?? causes of diff cleft palates?coloboma?
2-6, anywhere near or within the thyroid gland or thymus.
-superior constant but inferior near bifurcation CC or down w/ thymus in superior mediastinum
- • infection,perforation forming thyroglossal duct sinus ( back tongue or ant neck)
- ankyloglossia (tongue-tie).
- Cleft palate-common in females
• Clefts of the anterior palate -primary palate (F).
• Clefts of the posterior palate -result from lateral palatine processes to fuse, the nasal septum.
• Clefts of the anterior & posterior-lateral palatine processes fuse with the primary palate, with each other, and with nasal septum
chromosomal syndrome like trisomy 13.
• Clefts can include uvula, soft and hard;severe cases cleft in the palate extends through alveolar of maxilla, lips both sides
- Infants defect in iris or pupillary keyhole appearance.can extend deeper and involve the ciliary body & retina.
-failure of closure of the retinal fissure during in 6th week.
tear journey? ligaments/fascia of eye fxn? bone boundaries? 7 ocular muscles fxn? layers of eyelid? angle of eye?
gland, duct,fornix,lake,punctum,cancuoa,sac,lacrimalduct, inf meatus
check lig expan of fascial sheath(AD/AB) supspensory (too down)
LPS, every except sup olblique and lateral rectus CN3,opticalaxis(fovea), orbital axis(back optic–23 degres sep axis
Up? down?
AB?AD?
LR rotation? MR? cornea is how much of sclera?
optic n/cn 3 fxn comp/nasocillary? cornea v1
dilator, & const pupilla inn, cillary body, LPS/tarsal mus? order of nerves ID?
Sup rec/infoblique(horiz),
lateral rectus, obliques, (vertical axis)
inferior (anteroposterior axis), 1/6 of cornea is 5/6 of sclera(choriod 5/6 of eye retina) mus att
SS -see, ((inf division-para-post after cillary ganglion, VA, SE/SA-constictit/cill body)) ((sup division-sympost(fromICA) va,SA/SE)), VA/sympost/SE/SA
long, short cillary, superior divsion,
TFL,N(4), O
inflammation of mucous?teeth? greater palatine and lesser palatine? mucosa on hard palate, pharaynx, or nasal inn by parasym?
inn soft palate? muscles soft palate? space leads to naspho or oropha? m
rhinntis, 4 incisors, 2canins, 4- premolars, 6 molars. hard (ant 2/3) vs soft palate (1/3)some overlap, ex palatoglossus, tensor veli, levator veli
skeletal(V3/CN10) not lesser palatine(taste(geniculate ganglion, mucousa, SA blood vessels)
- fauces( palatoglossus/back of tongue)choane
-
CN10 branches ?
CN 10- recurrent, suplary,
BM/SA- in. lary, esp ex. lary, consts, long (ex stylo) palantin(ex. tesnor)
VE - 1/2 inf nasophary and rest phary
VA- laryngopharynx,
CN9 branches?
- tympanic n (VA/VE-para-pre)—> auroc ( SA, symp-post/para-post, VA)
- 1/3 post (SA/SS) tongue
- SA 1/2 sup. nasopharynx not part of pharyngeal plexus or pharyngeal of PLG
- BM/SA sytlopharyngeus
- caroid sinus/body
CN7 branches ?
- greater petrosal(VA-para-pre, VE, SS, ) –>sympost w vividian and PPG after para- post, SA ( atone of branches but only lesser ends up w ss)
- BM/SAmotor face, stapeduis, supryhyoid
- chorda tympani– VA-para pre/VE/SS– > after # 1 parapost, SA, VE, , only here sympost from periarterial
nosebleed area,vasculature,causes? inflamation nose spread 4?
ant 1/3, kiesselbach’s area (anastomsis greater and spenopalatine a in incisive foramen), nose picking-(veins), cause infection, HPTN
rhinnitis(upper resp infect/hay fever allergy)
ant cranial cribiform plate fossa,middle ear–nasopharynx –> retropharyngeus , parasinuses, lacrimal apparatus /conjucrive,
musculus uvulae?palatoglossu?
sup elevates, and shortens uvula
elevate post tongue, and dpresses soft palate
Medial orbital wall clinical? inferior orbital wall? optic septum tag ? 2 types CN palsy? CN of Corneal reflex and pupillary reflex? shlem or aqueous humor block? old age eyes/lense? high CSF pressure? eyelid infection?
medial wall ( MEL) & inf wall (ZM) - Max sinus
dilated, pitosis, no reflex, unopposed CN 3+ 4
-partial palsy gone/blown pupila. INO subd/epidhemotoma, aneurysm
V1 & CN 7
CN1/CN 3
gluacoma? open angle iris and cornea angle not blocked, most common
presbyobia- flat lense, cataract
papillaedema
chalazia(tarsal), sty (cillary body)
