H&N Flashcards
location of right common carotid
behind right SC joint
common carotids bifurcate at
c4
carotid massage purpose
can alleviate supraventricular tachycardia
where and what is carotid body. innervation
CN IX innervation. O2. outside at carotid bifurcation
where ICC enter skull
carotid canal
branches of external carotid
SALFOPMS
superior thyroid, ascending pharyngeal, lingual, facial, occipital, post auricular, maxillary, superior tempora
parotid vasculatur
artery - maxillary and superior temporal
vein - retromandibular vein
what foramen does vertebral arteries go through
c1-6
whats in carotid triangle and its borders
borders - digasrtic, SCM, omohyoid
inside - larynx, pharynx, thyroid, cervical plexus, vagus and hypoglossal
layers of scalp
skin, loose ct, aponeurosis, loose CT with vessels, periosteum
blood supply of scalp
occipital, superior temporal, posterior auricular from ECA, supratrochlear and supraorbital from ICA. all anastamose
dura and skull blood supply
MMA
cavernous sinus location and contents
above pterygoid plexus
contains ICA and abducens. In lateral wall CN3, 4, 5a, 5b
position of IJV and EJV in neck
IJV goes under SCM. EJV goes on top
where does thoracic duct and right lymphatic duct enter veins
thoracic duct - left IJV and left subclavian junction
innervations of extraocular muscles
LR6SO4R3
innervation of LPS and constrictor pupillae of eye
LPS - somatic
constrictor - PS ciliary ganglion from edinger westphal nucleus
CN3 palsy
down and out, dilated pupils, ptosis
CN4 palsy
diplopia on looking down and in
CN 6 damage how?
increaes ICP
motor innervation of CN V c
temporalis, masseter, medial pterygoids, digastric - mastication muscles
innervation of CNVb
upper lip, mucosa of nasal cavity, paranasal sinuses, palate
innervation of CNVc sensory
temples, cheek, chin, inner cheek, anterior 2/3rds of tongue
CN 7 innervation
taste anterior 2/3 (chorda tympani), facial expression, stapedius
PS of lacrimal, submandibular and sublingual glands
course of facial nerve
travels through IAM to facial canal to stylomastoid foramen
what is sensorineural hearing loss
damage to inner ear or nerve
what is conductive hearing loss
problem with conducting sound waves to cochlea
what is calorix reflex and used for
cold or warm water into EAM causes nystagmus if not brain dead
innervation of CN IX
stylopharyngeus, parotid (PS), carotid body, carotid sinus, pharynx, middle ear, posterior 1/3 tongue taste
CN IX test
gag reflex
CN X sensation
external ear, EAM, eardrum, palatopharyngeus, salpingopharyngeus, pharyngeal constrictors, laryngeal muscles, palatoglossus, PS of heart and abdomen
CN X motor
intrinsic larynx and pharynx (cricothyroid, salpingopharyngeus, levator veli palatini, palatoglossus, palatopharyngeus), bronchi and GI smooth muscle
acessory innervation
SCM and trapezius
hypoglossal innervation
genioglossus, hypoglossus, styloglossus, intrinsic muscles of tongue
what side does tongue and uvula deviate to
tongue towards uvula away
What are the 3 extra classes of special cranial nerves? What do they do?
Special visceral efferents – muscles derived from pharyngeal arches (CNV, VII, IX, X)
Special somatic afferents – equilibration, hearing, and sight
Special visceral afferents – taste
give PS ganglia and nuclei and what they innervate
COPS - 3977
Ciliary ganglion - edinger westphal nucleus - sphincter pupillae, ciliary muscle
Otic ganglion - inf salivatory nucleus - parotid
pterygopalatine - sup salivatory nucleus - lacrimal, nasal, nasopharynx, palate
submandibular - sup salivatory - submandibular and sublingual
what is horners
damage to symp trunk. Miosis, ptosis (superior tarsal innervation), enophthalmos, anhydrosis
what are symp ganglioa of head and neck
sup mid and inf cervical ganglions
where is philtrum and palpebral fissure
philtrum between nose and mouth
palpebral fissure between eyelids
what is TMJ made of
mandibular fossa and articular tubercle and condyle of mandible
ligaments of TMJ
stylomandibular, lateral ligament, sphenomandibular ligament
muscles in mandible elevation and depression
elevation - temporalis, masseter, medial pterygoid
depression - digastric, mylohyoid, geniohyoid, lateral pterygoid
muscles in mandible protraction and retraction
protraction - masseters, lateral and medial pterygoid
retraction - temporalis, digastric
what prevents posterior displacement of mandible
posterior glenoid tubercle
what is clinical significance of infratemporal fossa
used for mandibular nerve block (dental)
bones of orbit
frontal, zygomatic, mandibular, lacrimal, ethmoid, sphenoid
fissures into orbit
SOF, IOF, optic foramen
what goes into SOF
large french tarts sit nakedly in anticipation of sweets
lacrimal, frontal, trochlear, superior oculomotor, nasociliary, inferior oculomotor, abducens, superior opthalmic vein, sympathetic
what goes into IOF
infraorbital artery vein nerve
what is orbital and blowout fracture. results??
orbital - fracture of bones on outer rim
blowout - partial herniation through inf or medial walls
both lead to increased ICP and exophthalmos
actions of eye muscles
sup rectus - elevates, adducts, intorts
inf rectus - depresses, adducts, extorts
sup oblique - depresses, intorts, abducts
inf oblique - elevates, extorts, abducts
arteries of eye and venous
artery - central artery, infraorbital, short and long ciliary
vein - superiro and inferior opthalmic, central vein
what is infraorbital a branch of
maxillary
why can infection of facial vein bad
connected to cavernous sinus, no valves in facial vein. Infection of face can lead to brain
what is tarsal, ciliary and lacrimal gland
ciliary and tarsal - seceretes meibum (oil) prevents evaportation of eyes tear film
lacrimal - aqueous layer of tear film
what muscles open and close eyelid
open - LPS and superior tarsal
clsoe - orbicularis oculi
what is bells palsy and symptoms
facial nerve palsy. self limited. paralysis of forehead and therefore no wrinkles
how differentiate between stroke and bells palsy
stroke is forehead sparing
auricle anatomy
see book
concha, helix, antihelix, EAM, lobule, tragus, antitragus
how cauliflower ear
haematoma between cartilage and perichondrium leads to necrosis
TM anatomy
umbo, handle of lmalleus, pars flacida and pars tensa
mid ear muscles and innervations
stapedius (facial), tensor tympani (mandibular nerve)
what is acute otitis media and otitis media with effusion. how differenite
AOM - inflammation of mid ear due to inabiliy to equalise, bulging TM
OME - negative pressure leads to effusion and sucking in of TM
both present wth conductive hearing loss but AOM has pain
how treat otitis media
grommets - small tubes placed in TM to allow equalisation
complications of AOM
mastoiditis leading to intracranial infecition. Damage to facial nerve.
Cholesteatoma - accumulation of dead squamous cells resulting in erosion of mid ear and bone via lytic enzymes
saccule and utricle function
saccule - head movements in vertical plane
utricle - head movements in horizontal plane
where endolymph and perilymph
perilymph in bony labyrinth
endolymph in membranous labyrinth
explain structure of cochlea
If cochlea is a hotdog. Scala vestibule is superior bun. Scala tympani is inferior bun. Hotdog is tectorial membrane surounded by scala media.
Oval to round window
what makes up septum of bone
vomer inferior, ethmoid superior, and septal cartilage
what is superior, middle, inferior concha made of
superior and middle - ethmoid
inferior concha own bone
name the nasal drainage
SENSE semilunar hiatus (frontal, maxilary, ant ethmoid), ethmoidal bulla, nasolacrimal duct, sphenoid sinus, eustachian tube
arteris of nasal cavity
post and mid - sphenopalatine
inferior - greater palatine
sup and anterior - ethmoidal
nasal veins
facial vein, pterygoid plexus, cavernous sinus
commonest site of anterior epistaxis
keisselbachs plexus
innervation of nasal cavity
CN1,
septum and lateral wall - ophthalmic and maxillary
post and inferior - nasopalatine nerve
anterior and superior - anterior ethmoidal
what tests should you run in chronic epistaxis and how treat
test - bleeding abnormalitis
treat - lean forward and pinch cartilage. Can cauterise blood vessels, use nasal tampons
sensation of meninges
Vb
motor nerves from facial nerve
To Zanzibar By Motor Car Please
temporal, zygomatic, buccal, mandibular, cervical, posterior auricular
what is torticolis
asymmetrical head/neck position poss due to shortened SCM
what is pagets disease of bone
misshapen bones. localised.
where jugulo-omohyoid and jugulodigastric found. what do they drain
corner of IJV and omohyoid or digastric
jugulo-omohyoid - tongue, oral cavity, trachea, oesophagus, thyroid
jugulo-digastric - tonsils and tongue
anatomy of eye
see book
vitreous humor, iris, lens, ciliary body
where do extraocular muscles attach to
common tendinous ring
what is name for dilated pupil and causes
mydriasis - physiological, glaucoma
what is a stye and meibomian cyst
cyst - blocked tarsal gland
stye - blocked ciliary gland
where carotid palpated at
c6
what is superior and inferior portion of middle ear called and what sinuses contianed
epitympanic recess - mastoid antrum entrance
tympanic cavity - eustachian tube
what is exocytosis of ear canal
bony growth in EAM
what CNs can refer pain to ear
facial, trigeminal, glossopharyngeal, vagus
innervation of TM?
auricular branch of vagus and glossopharyngeal
where would you block anterior sensory 2/3 of tongue?
inferior alveolar nerve block
causes of sensorineural hearing loss
menieres, gentamicin
development of pituitary gland
downward outgrowth of forebrain known as infundibulum. Grows towards rathkes pouch (from roof of mouth). Rathkes becomes ant pit. Infundibulum becomes post pit and connecting stalk
development of tongue
4 swellings - lateral swelling and tuberculum impar (1), cupola (2,3) and epiglottal swelling (4)
lateral overgrows TI, 3rd cupola overgrows 2nd. Apoptosis aside from lingual frenulum
innervation of tongue, sensory + taste
ant 2/3 sens - mandibular
ant 2/3 taste - chorda tympani (facial)
posterior 1/3 taste and sense - glossopharyngeal
thyroid development
descends from foramen cecum of tongue via thyroglossal duct
what is 1st arch syndrome
failure of colonisation of 1st arch with neural crest cells. hyoplasia of mandible and facial bones
what is charge syndrome
CH7 mutation, no multipotent neural crest cells
Coloboma, Heart defects, Atresia of back of nasal passage, Retardation of growth and development, Genital hypoplasia, Ear defects
nasopharynx epithelia
ciliated pseudostratified. rest of pharynx squamous
what are the tonsils and where
pharyngeal (back of nasal cavity), palatine (palate), tubule tonsils (next to ustachian tube), lingual tonsils (base of tongue)
what is lymph drainage of palatine tonsils
jugulodigastric
what is stridor and stertor
stridor - lower airway obstruction. inspiratory or expiratory
stertor - upper airway obstruction. inspiratory only
what is rolling and sliding hernia
rolling - herniates away from oesophagus
sliding - herniates into oesophagus
infection between investing and visceral pretracheal. and posterior to prevertebral fascia. where go
first one - anterior mediastinum
2nd - erode through prevertebral fascia and into retropharyngeal space to fibrous pericardium
muscles of pharynx and innervations
stylopharyngeus - CNIX
salpingo and palatpharyngeus - CNX
where food can get stuck in mouth
vallecula, palatine tonsils, base of tongue
muscles of larynx function and innervation
all inferior laryngeal except cricothyroid
thyroarytenoid
posterior cricoarytenoid - abduct vocal folds
lateral cricoarytenoid - adduct vocal folds
transverse and oblique arytenoids - adducts arytenoid cartilage
suprahyoid muscles and innervation
stylohyoid (mandibular), digastric (ant = mandibular, post = facial), mylohyoid (mandibular), geniohyoid (C1)
infrahyoid muscles and innervation
sternohyoid, omohyoid, sternothyroid, thyrohoid
all C1-3
tongue musscles and innervation
genioglossus, palatoglossus (X), styloglossus, hypoglossus
all but P = XII
