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BDS 1 > H&N > Flashcards

H&N Flashcards

1
Q

What are the 4 human tissues?

A

Epithelia
Muscle
Nervous
Connective

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2
Q

What are the 4 classifications of bone?

A

Long - femur
Short - fingers, tarsal
Flat - frontal
Irregular - vertebra

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3
Q

What are the 3 types of joints?

A

Fibrous - no joint cavity; connected by CT
Cartilaginous - entirely cartilage between; usually lots of movement e.g. fingers
Synovial - synovial fluid lubricates joint, continuous with periosteum; lots of movement e.g. H&N, hips

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4
Q

What does the medial plane separate the body into?

A 
Vertical through midline of body
Separates into equal L&R portions 
Lateral - away from midline
Medial - towards midline
Intermediate - between medial and lateral
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5
Q

How is the body separated into anterior and posterior?

A

Coronal plane
Anterior - towards front
Posterior - towards back

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6
Q

What does the transverse plane separate the body into?

A

Superior - above

Inferior - below

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7
Q

Define proximal and distal

A

Proximal - close to P.O.O.

Distal - far from P.O.O.

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8
Q

Define superficial and deep

A

Superficial - near/on surface

Deep - more internal

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9
Q

What are the 2 surfaces of the hand called?

A

Palmer - palm

Dorsal - back

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10
Q

What are the 2 surfaces of the feet called?

A

Plantar - sole

Dorsal - top

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11
Q

What is meant by ipsilateral?

A

On the same side of median plane

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12
Q

What is meant by contralateral?

A

On opposite sides of median plane

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13
Q

Define flexion and extension

A

Flexion - towards P.O.O.

Extension - away from P.O.O.

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14
Q

Define abduction and adduction

A

Abduction - away from body

Adduction - towards body

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15
Q

What are medial and lateral rotations?

A

Medial - towards midline

Lateral - away from midline

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16
Q

What is circumduction?

A

Movement in circular manner

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17
Q

Define protraction and retraction

A

Protraction - move forward

Retraction - move back

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18
Q

Define inversion and eversion

A

Inversion - big toe towards midline

Eversion - sole away from midline

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19
Q

Define pronation and supination

A

Pronation - roll of foot inwards, arch flattening

Supination - outward roll of foot

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20
Q

What is opposition of thumb?

A

Turning and rotating of thumb to touch each fingertip

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21
Q

What are surface markings?

A

External, visual anatomical features

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22
Q

What is the atlas?

A

FIRST of the cervical vertebrae

Does not have a vertebral body

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23
Q

What is the axis?

A

SECOND cervical vertebrae

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24
Q

What are the clavicle?

A

Collar bones

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25
Q

What are the scapula?

A

Shoulder blades

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26
Q

Describe a hinge joint

A

Synovial joint where 2 or more bones can only move along one axis to flex or extend

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27
Q

Describe a ball and socket joint

A

Synovial joint in which ball shaped surface of bone fits into cup like depression in another bone
Allows movement around indefinite number of axes

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28
Q

What is the name of the opening to the ear canal?

A

External auditory meatus

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29
Q

What are the 4 main sutures?

A

Coronal - frontal and parietal
Sagittal - parietals
Lambdoid - parietals and occipital
Squamous - parietal and temporal

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30
Q

What is Pterion and why is it important?

A

Join of frontal, parietal, temporal and sphenoid bones

Weakest part of skull, traumatic blow may rupture meddle meningeal artery causing epidural haematoma

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31
Q

What are fontanelles and why are they important?

A

Unossified remnants of fibrous membranes between fetal bones

Allow for rapid stretching and deformation of developing skull

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32
Q

What are foremen and notches?

A

Holes in bone where blood vessels and nerves enter, incomplete holes called notches
Supraorbital (frontal), infraorbital (maxilla), mental (mandible)

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33
Q

What bones make the hard palate?

A

Maxilla - palatine process

Palatine - horizontal plate

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34
Q

What 7 bones make the orbital cavity?

Many Friendly Zebras Enjoy Lazy Summer Picnics

A
  1. Frontal
  2. Maxilla
  3. Zygomatic
  4. Lacrimal
  5. Ethmoid
  6. Sphenoid
  7. Palatine
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35
Q

What 7 bones make the nasal cavity?

A
  1. Nasal
  2. Frontal
  3. Ethmoid
  4. Sphenoid
  5. Maxilla
  6. Lacrimal
  7. Vomer
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36
Q

What 14 bones make the facial bones?

Virgil Can Not Make My Pet Zebra Laugh

A
  1. Zygomatics
  2. Maxillas
  3. Nasals
  4. Lacrimals
  5. Vomer
  6. Palatines
  7. Inferior conchae
  8. Mandible
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37
Q

What are the 8 bones of the neurocranium?

PEST OF 6

A
  1. Frontal
  2. Parietal (paired)
  3. Temporal (paired)
  4. Occipital
  5. Sphenoid
  6. Ethmoid
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38
Q

What 7 bones form the base of the skull?

A
  1. Maxilla
  2. Palatine
  3. Zygomatic
  4. Temporal
  5. Vomer
  6. Temporal
  7. Sphenoid
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39
Q

What is the foramen magnum?

A

Large forum that connects brain to spinal cord

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40
Q

What are nuchal lines?

A

Protuberances in occipital bone due to muscle attachment

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41
Q

What bones make up the anterior cranial fossa?

A
  1. Frontal
  2. Ethmoid
  3. Sphenoid
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42
Q

What is CSF rhinorrhoea?

A

Drainage of CSF though the nose

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43
Q

What 2 bones make up the middle crania fossa?

A

Sphenoid - greater wing

Temporal

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44
Q

What are optic chiasma?

A

Optical nerves cross over, cause a depression

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45
Q

What is CSF otorrhea?

A

CSF leaks out ear caused by blow to internal acoustic meatus

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46
Q

What 2 bones make the posterior crania fossa?

A

Parietal bone

Occipital

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47
Q

What are the 4 paranasal sinuses?

A
  1. Frontal
  2. Ethmoidal air cells
  3. Sphenoid
  4. Maxillary
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48
Q

What 6 bones make the nasal cavity?

A
  1. Sphenoid
  2. Palatine
  3. Maxillary
  4. Nasal
  5. Inferior nasal concha
  6. Ethmoid
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49
Q

What are the differences between fetal skull and adult skull?

A 
More bones
Mandible, frontal infused
At birth, connected by fontanelles
Little space between oral cavity and orbital
Mandible is flat
No processes or prominences
Larger cranial structure, smaller facial
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50
Q

What are the 4 fontanelles?

A

Anterio
Posterior
Mastoid
Sphenoid

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51
Q

What are the 4 functions of the vertebral column?

A

Protect spinal cords
Permit movement
Site of muscle attachment
Transmits weight of trunk to lower limbs

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52
Q

What are the 26 vertebrae?

A

Cervical - 7
Thoracic - 12
Lumbar - 5
Sacrum and coccyx - 5 (fused so count as 1)

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53
Q

What are the 2 naturally occurring curves in the vertebral column?

A

Lordotic - lumbar region

Kyphotic - upper thoracic, lower cervical

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54
Q

Describe lumbar lordosis and the symptoms

A

Exaggeration of lumbar curve
Associated w/ weakened abdominal muscles

Lower back pain due to weight being focused in single region
Prevalent in gymnasts, swimmers

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55
Q

Describe thoracic kyphosis

A

Exaggeration of thoracic curve
Occurs more frequently than lordosis
Vertebra becomes wedge shaped

Causes hunch back, pain due to muscles being in constant contraction, weight is not transmitted evenly

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56
Q

What is scoliosis and its symptoms?

A

Lateral deviation of spinal column
C or S shaped
Involved thoracic and/or lumbar

Repeated unilateral loading
Associated w disease, leg length abnormalities, muscular imbalances

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57
Q

What are the functions of vertebral disks?

A

Shock absorbers
Bear and distribute motion in vertebral segment
Withstand compression from torsional and bending loads

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58
Q

What happens to the intervertebral disks with age?

A

Integrity dec., lose ability to retain water, dry out thus ability to distribute load across disk changes

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59
Q

Describe a herniated intervertebral disk

A

NP provides out from between vertebrae

Nerves impinged by budging lead to numbness and/or pain

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60
Q

What are the 6 ligaments of the vertebral column?

A

Flavour: connects adjacent vertebral arches
Supraspinous and interspinous: connect spinous processes
Ant. Longitudinal: connect to the body, hold in place
Post. Longitudinal: connect to body, prevent excessive movement
Short: connect vertebra to those above, below

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61
Q

Describe the C1 vertebra

A 
Atlas 
Has articulating processes
No body or spinous process
Ant and post. arches, 2 lateral masses
Sup. surfaces of lateral masses articulate with occipital condyles
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62
Q

Describe the axis

A

2nd cervical vertebra
Has dens that projects sup. into ant. arch of atlas
Allows pivot for rotation of atlas

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63
Q

What are the 2 movements involved in the vertebral column?

A

Atlanta-Occipital - nodding (yes)

Atlantoaxial - rotation (no)

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64
Q

What is whiplash and how does it happen?

A

Rapid flexion/extension injury in cervical region
Strains post. ligaments
Can dislocate post. apophyseal joints
C7 likely site for fracture

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65
Q

Describe the structure of intervertebral disks

A

Nucleus pulposus- gel-like mass in centre, allows disk to expand
Annulus fibrosus - layers of fibrocartilaginous material

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66
Q

What is the TMJ?

A

Bilateral synovial joint formed from articulation of mandible and temporal bones

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67
Q

What are the 4 suprahyoid muscles?

A

Geniohyoid
Mylohyoid
Digastric
Stylohyoid

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68
Q

What is the function of the suprahyoid muscles?

A

Elevate or retract hyoid during swallowing

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69
Q

Describe the mandibular condyle

A

Has articulating surface/head covered with hyaline cartilage, narrows down to neck
Lateral and medial poles
Pterygoid fovea - depression left by muscles of mastication

Important growth site - grows forward and down
Articulates in mandibular fossa of temporal bone

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70
Q

What are the main features of the mandible?

A 
Head/condyle process
Coronoid process
Mandibular notch
Ramus
Angle
Body
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71
Q

Describe where the mandibular fossa are and the articular surface

A

R and L temporal bones

Articular surface covered by dense fibrous articular tissue

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72
Q

What are the lateral, medial, ant. and post. boundaries of the mandibular fossa?

A

Lateral: zygomatic process of temporal bone
Medial: spine of sphenoid bone
Ant: articular eminence
Post: squamotympanic and petrotympanic fissures

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73
Q

What is the function of the joint capsule of the TMJ?

A

Encloses joint like a sleeve, preventing it from slipping out of fossa

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74
Q

Describe the location and composition of the joint capsule

A

Runs post. from temporal bone to mandible condyle infer.

Made of fibrous tissue

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75
Q

What are the superior attachments of the joint capsule?

A

Area surrounding mandibular fossa and articular eminence

Extends ant. to ant. slope of articular eminence, post. to squamotympanic fissur

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76
Q

What is the attachment site of the joint capsule to the periphery condyle neck and below the medial and lateral poles of condylar neck?

A

Posterior attachment

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77
Q

Describe the temporomandibular ligament

A

Lateral thickening of the capsule strengthening the capsule laterally
Runs from zygomatic process of temporal bone to lateral surface of mandibular neck

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78
Q

What is the articulating dick?

A

Dense fibrous tissue lying inside joint capsule dividing joint cavity into sup. and infer. compartments allowing for separate movement in each compartment

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79
Q

Describe the location and anatomy of the articulating disk

A

Prominent post. thickening, less prominent ant. thickening

Lies between condyle and mandibular fossa

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80
Q

What are the 2 accessory ligaments of the temporomandibular joint?

A

Stylomandibular: styloid process to angle of mandible
Sphenomandibular: spine of sphenoid to lingula

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81
Q

What are the 5 movements of the TMJ?

A 
Depression
Elevation
Retraction
Protrusion
Lateral chewing
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82
Q

What nerve supplies the TMJ?

A

Sensory division of auriculotemporal nerve

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83
Q

What 2 arteries supply the TMJ?

A

Superficial temporal artery

Small contribution from maxillary artery - supplies the ant. aspect of TMJ

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84
Q

How is TMJ dysfunction usually detected?

A

Pain and clicking/popping sound

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85
Q

What is arthritis?

A

Joint inflammation resulting in breakdown of articular cartilage

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86
Q

How can arthritis be caused?

A

Age - primary degenerative

Abnormal function - 2ndary degenerative

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87
Q

What can cause 2ndary arthritis?

A

Bruxism - grinding teeth, stress on TMJ

Malocclusion - X-bite; mandibular teeth enclose maxillary teeth

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88
Q

Describe internal disk derangement

A

Articulating disk doesn’t move in sync with condyle

Fibres pull disk through joint causing popping sound

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89
Q

Describe dislocation of the TMJ

A

Head of condyle comes out of mandibular fossa

Can be caused by excessive pressure on mandible such as extraction, big yawn or by trauma

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90
Q

When and where do the branchial arches form?

A

Week 4
Development of frontal prominence forms stomodeum (primitive oral cavity) below which first branchial arch (mandibular arch) forms

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91
Q

Structurally, what do the arches do?

A

Separate stomodeum from developing heart

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92
Q

Describe the structure of the branchial arches

A

Ectoderm - lines outside
Endoderm - lines inside
Mesenchymal tissue - core

Each has own nerve, blood, muscle and cartilage
Nerve and blood supply structures formed

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93
Q

Describe branchial grooves and pouches

A

Groove: ectodermal cleft between adjacent arches
Pouch: endodermal outpocketing from rostral foregut

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94
Q

What is the branchial membrane?

A

Site of contact between groove and pouch

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95
Q

Describe the mandibular arch

A

Forms the face
Has mandible and maxillary processes
Surrounds stomodeum

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96
Q

What is the stomodeum?

A

Depression between brain and pericardium in embryo which is primitive oral and nasal cavity
Formed by ectoderm, contacts endoderm at oropharyngeal membrane

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97
Q

What is the palatoglossal arch?

A

Physical remnant of branchial arches

Site of the oropharyngeal membrane separating oral cavity and pharynx

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98
Q

What are the cartilages of the mandibular arch?

A

Malleus
Incus
Ant. ligament of malleus
Sphenomandibular ligament

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99
Q

The stapes, styloid process, stylohyoid ligament and lesser horn and upper 1/2 body of hyoid bone are the cartilages of which arch?

A

2nd - hyoid arch

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100
Q

The 3rd arch has what cartilages,

A

Greater horn and lower 1/2 body of hyoid bone

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101
Q

The 4 and 6 arches have what cartilage?

A

Cartilages of pharynx

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102
Q

What are the derivatives of the pouch of each arch?

A
  1. Tubotympanic recess - auditory tube, tympanic cavity
  2. Lining (crypts of palatine tonsils)
  3. Inf. parathyroid glands and thymus
  4. Sup. parathyroid glands and C-cells (calcitonin)
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103
Q

The groove of which arch is the only one to form structures in adults and what does it form?

A

Mandibular
Groove - external auditory meatus
Membrane - tympanic membrane
Pouch - auditory tube

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104
Q

What does the face develop from? Name them

A

5 primordia
Frontonasal prominence - forehead, bridge of nose
2 maxillary prominences - cheeks, upper jaw
2 mandibular prominences - chin, lower jaw

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105
Q

What are nasal placodes?

A

Ectodermal thickenings on frontonasal prominence

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106
Q

How and when do the maxillary prominences grow?

A

Week 5
Ventrally (down)
Medically (toward midline)

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107
Q

How and when do nasal pits form?

A

Week 6

Ectoderm in centre of each nasal placode invaginates

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108
Q

What does the formation of nasal pits do?

A

Divides frontonasal prominence into lateral and medial nasal processes on each side of embryonic face

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109
Q

Describe the growth of the face in week 6

A

Medial nasal processes grow medially, fuse in middle forming intermaxillary process
Maxillary prominences grow, fuse with intermaxillary process forming philtrum and primary palate

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110
Q

What can happen if the medial nasal prominences don’t fuse?

A

Lead to formation of bifid nose

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111
Q

How is the primary palate formed?

A

From internal swelling of intermaxillary process

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112
Q

How does the 2ndary palate form?

A

From 2 lateral palatine shelves

Develop as internal projection of maxillary prominences
Shelves grow down on either side of tongue from maxillary prominences while nasal septum grows down from base of skull
When tongue descends into throat palatine shelves rotate upward

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113
Q

Where do the palatine shelves fuse and with what?

A

At midline with nasal septum

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114
Q

How does a cleft lip occur?

A

Failure of maxillary prominences to fuse with intermaxillary process

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115
Q

How can a cleft lip be restored?

A

Using nasal retainer

Maintains shape of nasal passage after surgery, helps mound and approximate parts of cleft before surgery

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116
Q

What is a X-bite?

A

Abnormal occlusion in which mandibular teeth enclose the maxillary

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117
Q

How does a cleft palate occur?

A

Failure of palatine shelves to fuse OR

tongue too large or oral cavity too small for palatine shelves to rotate up and fuse

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118
Q

What is Meckel’s cartilage?

A

Cartilage of 1st branchial arch associated with formation of mandible

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119
Q

Describe the growth of the mandible in week 6

A

Meckel’s cartilage develops rod surrounded by fibrocellular capsule
2 cartilages don’t meet, separated by symphysis
On lateral aspect of symphysis condensation of mesenchymal forms

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120
Q

What happens to the mandible in week 7?

A

Intramembranous ossification beings in mesenchyme, spreads ant. and post. to form bone
Ant. to midline of developing jaw, don’t fuse forms mandibular symphysis

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121
Q

What are the 3 secondary growth cartilages that influence growth of mandible until birth?

A

Condylar
Coronoid
Symphyseal

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122
Q

Describe the function of the condylar cartilage

A

Week 12
Developing ramus by endochondral ossification
Thick layer persists at birth on condylar head providing mechanism for post-natal growth of ramus

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123
Q

Describe the coronoid cartilage

A

Active at 4 months, disappears before birth

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124
Q

Describe the symphyseal growth cartilage

A

Appear in CT at ends of Meckel’s cartilage

Disappears 12 months after birth

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125
Q

Name the 2 parts of the tongue and describe the tongues development

A

During week 4
Localised proliferation of mesenchyme results in formation of several swellings on floor of oral cavity

Oral part (ant 2/3): fusion of lateral lingual swellings and tuberculum inpar 
Pharyngeal part (post 1/3): from copula and hypobranchial eminence
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126
Q

Where do the muscles and mucosa of the tongue develop?

A

Muscle: occipital somites
Mucosa: endoderm of pharyngeal floor

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127
Q

Where does the mucosa of the 2 parts of the tongue develop?

A

Oral (ant 2/3): distal tongue buds of 1st branchial arch

Pharyngeal (post 1/3): overgrowth of 2nd arch by hypobranchial eminence of 3+4 arches

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128
Q

What is the terminal sulcus?

A

Boundary between 1st and 3rd arch mucosa

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129
Q

Which common carotid artery arises directly from the aortic arch?

A

The L carotid artery

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130
Q

Where does the R common carotid artery arise?

A

From the brachiocephalic trunk that divides into R carotid and subclavian

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131
Q

What are the 2 branches of the carotid arteries?

A

External - H&N

Internal - cranial

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132
Q

What is the carotid sheath?

A

Fibrous CT enclosing: carotid artery, IJV, vagus nerve and lymph nodes

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133
Q

What are the 7 branches of the external CA?

Some Like Fucking Others Prefer S&M

A
  1. Sup. thyroid
  2. Lingual
  3. Facial
  4. Occipital
  5. Post. auricular
  6. Superficial temporal
  7. Maxillary
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134
Q

Describe the superficial temporal artery

A

Arises ant. to ext. auditory meatus (EAM), deep to parotid
Many branches to scalp
Transverse facial artery above parotid duct

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135
Q

What branch of the external CAs arises behind angle of mandible and supplies deep facial structures?

A

Maxillary

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136
Q

What are the 3 branches of the maxillary A?

A

Infraorbital
Posterior superior alveolar
Inferior alveolar

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137
Q

Describe the infraorbital A

A

Branches to ant. and middle sup. alveolar

Ant. supplies upper incisors, canines, maxillary sinus

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138
Q

Describe the post. sup. alveolar A

A

Distributes to maxillary molar and premolars teeth and gingiva, lining of maxillary sinus and gums

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139
Q

Describe the infer. alveolar A

A

Descends close to medial surface of ramus to mandibular foreman
Has incisor, mental, lingual and mylohyoid branches

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140
Q

What branch of external CA arises from the ant. side of the CA?

A

Facial

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141
Q

Describe the facial A

A

Very tortuous and winding
Courses medially to mandible then ant.
Site of facial pulse

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142
Q

What are the 3 branches of the facial A?

A

Sup. and inf. labial A: upper and lower lips

Angular A: nose, angle of eye

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143
Q

Where does the lingual artery arise?

A

Ant. of external CA at level of hyoid bone

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144
Q

What are the 4 branches of the lingual A and what do they supply?

A
  1. Dorsal lingual
  2. Deep lingual
  3. Sublingual
  4. Suprahyoid

Sully tissues sup. to hyoid bone: suprahyoid muscles, floor of mouth, tongue

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145
Q

Describe the entry of the internal CA to the cranium

A

Through carotid canal passing through cavernous sinus

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146
Q

What is the cavernous sinus?

A

Thin walled vein where blood pools and is drained

Has CNs 3,4,51,52,6 running through

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147
Q

What are the 3 cranial cavity As?

A

Internal CA
Vertebral
Middle meningeal

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148
Q

Describe the internal CA

A

Enters through carotid canal
2 branches:
Supraorbital - to scalp, above orbit
Supratrochlear - medial of supraorbital, above trochlear

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149
Q

Describe the vertebral A

A

Branches from subclavian, enters through foramen magnum

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150
Q

Describe the middle meningeal

A

From maxillary A of external CA, enters through spinosum

Courses outside dura, supplies calvarium

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151
Q

What can damage to the middle meningeal A lead to?

A

Tearing of A resulting in epidural haematoma - pooling of blood between dura and bone inc. pressure

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152
Q

What is the circle of Willis?

A

Cerebral arterial circle supplied by internal CA, post. by basilar and vertebral A
Branches to ant. middle and post cerebral
Provides uninterrupted, continuous blood supply to brain even if one A is blocked

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153
Q

What are the boundaries of the scalp?

A

Ant.: sup. orbital margin
Post.: sup. nuchal line
Laterally: zygomatic arch

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154
Q

What are the 5 layers of the scalp?

A 
S - skin
C - CT
A - aponeurosis
L - loose areolar tissue
P - pericranium
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155
Q

Describe the skin layer of the scalp

A

Outer most layer
Contains hair, sebaceous and sweat glands
Blockage of glands leads to dryness and dandruff

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156
Q

Describe the CT layer of scalp

A

Dense network of fibro-fatty tissue
Connects skin with aponeurosis
Large blood vessels and nerves

Injury to scalp results in vessels being unable to contract so profuse bleeding which can cause haematoma causing pain

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157
Q

Describe the aponeurosis layer of scalp

A

Epicranius muscle and aponeurosis - raises eyebrows and causes horizontal wrinkles of forehead
Continual contraction results in headaches
Tightly attached to CT

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158
Q

Describe the pericranium

A

Periosteum of skull

Continuous with endosteum at sutures

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159
Q

What are the 3 meninges of the cranium?

A

Cerebral dural mater
Cerebral pia mater
Cerebral arachnoid mater

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160
Q

Describe the dura mater

A

Thick, dense inelastic membrane

2 layers: inner/meningeal and outer/endosteal

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161
Q

What are the 4 folds of the dura mater?

A

Cerebri falx
Cerebri tentorium
Cerebelli falx
Diaphragma sellae

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162
Q

Describe the cerebri falx

A

Separates cerebral hemispheres

Attaches ant. to crista galli of ethmoid; post. blends into cerebri tentorium

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163
Q

Describe the cerebri tentorium

A

Roof of post. cranial fossa

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164
Q

Describe the cerebelli falx

A

Between cerebellar hemispheres

Along post. wall of post. cranial fossa

165
Q

Describe the diaphragma sella

A

Fold Oliver sella turcica

166
Q

What are the 3 falx cerebri sinuses?

A

Sup. sagittal: follows sagittal suture ant. from falx cerebri post.
Inf. sagittal
Straight: connects inf. to sup. at confluence

167
Q

What are the sinuses of the falx cerebelli?

A

Trans: transverse along endosteal
Sigmoid: drains venous blood into IJV

168
Q

Describe the cavernous sinuses

A

Lies bilaterally on either side of sella turcica
Internal CA and abducent nerve run through
Oculomotor, trochlear, ophthalmic and maxillary of trigeminal lie in lateral wall

169
Q

Where are the sup. and inf. petrosal sinuses?

A

Petrous part of temporal bone

170
Q

Describe the blood flow in dural sinus

A

Sup. sagittal drains directly to confluence
Inf. sagittal drains to confluence through straight
Confluence drains to transverse

Cavernous drains to sup. and inf. petrosal
Sup. drains into transverse
Inf. drains directly to IJV

Transverse drains to sigmoid
Sigmoid drains to IJV

171
Q

What is the facial vein made up of?

A

Supraorbital and supratrochlear veins: collect blood from forehead and supraorbital regions

172
Q

How does the facial vein communicate with cavernous sinus?

A

Through ophthalmic vein via supraorbital fissure

173
Q

What happens to the facial vein as it descends?

A

Joined by: deep facial, ptyergoid, retromandibular to form common facial vein that drains to IJV

174
Q

Where does the deep facial vein join?

A

Angle of mouth bringing pytergoid drainage

175
Q

What is the pytergoid plexus?

A

Network of veins behind ramus

176
Q

Describe the retromandibular vein

A

Made of maxillary and superficial temporal veins
Passes through parotid gland

Ant: joins facial vein
Post: joins post. auricular vein to form EJV

177
Q

Where is the maxillary vein located?

A

Adjacent to sphenomandibular ligament

178
Q

What is the function of the lymphatic system?

A

Drain excess interstitial fluid
Immune response
Transport dietary lipids and lipid soluble vits

179
Q

What are the 5 regional groups of the lymphatic system?

A
  1. Post of head
  2. Ant of head
  3. Beneath mandible
  4. Along superficial jugular veins
  5. Deep
180
Q

The occipital and mastoid LNs are part of which LN region?

A

Post part of head

181
Q

Describe the post head LNs

A

Occipital: over occipital bone at apex of occipital protuberance
Afferent vessels: collect at back of scalp
Efferent: DCLN

Mastoid: over lateral surface of mastoid process
Afferent: scalp above auricle, post. med. auricle, post. wall of EAM
Efferent: DCLN

182
Q

Describe the ant. head LN

A

Parotid: on/in parotid gland
Afferent: scalp above parotid, lat. surface of auricle, ant. wall of EAM, lat. eyelids, middle ear
Efferent: DCLN

Buccal: over buccinator muscle, close to facial vein
Afferent: ant. scalp and forehead, ant. part of nose
Efferent: submandibular LN

183
Q

What 2 LNs are found beneath the mandible?

A

Submandibular: superficial to submandibular salivary gland
Afferent: buccal, upper lip, lat. lower lip, frontal, max. and ethmoidal air sinuses, upper and lower teeth, gingival (except ant.), floor of mouth
Efferent: unknown

Submental
Afferent: tip of tongue, lower incisors and associated gums, central lower lip
Efferent: submandibular LN

184
Q

Describe the ant. cervical and superficial cervical LNs

A

Along superficial jugular veins

Ant: along course of ant. jugular veins
Afferent: ant. neck
Efferent: DCLN

Superficial
Afferent: angle of mandible, lobule of auricle
Efferent: DCLN

185
Q

What is the DCLN?

A

Deep cervical lymph node

Chain of LNs along lateral aspect of IJV
Runs from base of skull to root of neck in carotid sheath

Afferent: all lymphatic structures
Efferent: jugular lymph trunk -> lymphatic ducts -> sup. vena cava

186
Q

What are the 3 lobes of the cerebrum?

A

Frontal
Parietal
Occipital

187
Q

What are the functions of the cerebrum?

A 
Sensory and motor
Emotion
Intellectual processes
Auditory 
Visual
Speech
188
Q

What are the functions of the cerebellum?

A

Smooth, coordinated movements

Posture and balance

189
Q

What are the 3 segments of the brain stem?

A

Midbrain
Pons
Medulla oblongata

190
Q

What is the function of the medulla?

A

Relays sensory and motor info

Regulates heartbeat, breathing, vessel dilation

191
Q

What is the function of the pons?

A

Control breathing

192
Q

What are the 12 cranial nerves?

A
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Vestibulocochlear
  9. Glossopharyngeal
  10. Vagus
  11. Accessory
  12. Hypoglossal
193
Q

Name which nerves are sensory, motor or both

A
  1. Olfactory - Sensory
  2. Optic - Sensory
  3. Oculomotor - Motor
  4. Trochlear - Motor
  5. Trigeminal - Both
  6. Abducens - Motor
  7. Facial - Both
  8. Vestibulocochleae - Sensory
  9. Glossopharyngeal - Both
  10. Vagus - Both
  11. Accessory - Motor
  12. Hypoglossal - Motor
194
Q

Describe the olfactory nerve

A

Travels up through cribriform plate of ethmoid bone and synapses in olfactory bulb
Shortest course of all nerves
Terminates in sensory receptors responsible for smell

195
Q

What is anosmia, how can it arise and what are clinical tests for it?

A

Partial/whole loss of smell

Basal skull fracture - cribriform plate of ethmoid
Chronic nasal inflammation - medication can damage too
Tumour of olfactory region

Ask to identify common smells

196
Q

Describe the optic nerve

A

Originates in diencephalon, passes through skull at optic foreman in sphenoid bone, terminates in retina

197
Q

What are optic chiasma?

A

Crossing over of optic nerve fibres

Fibres from med. half cross midline, enter optic tract in opp. side
Fibres from lat. half pass post. in optic tract of same side

198
Q

Where do nerves in the optic tract synapse?

A

Synapse in visual area of thalamus

Run post. terminate in visual cortex

199
Q

What do rod and cone cells sense?

A

Rod: dim light, high signal amplification
Cone: colour

200
Q

Describe the oculomotor nerve

A

From ant. of midbrain, runs through cavernous sinus, enters orbit through sup. orbital fissure

201
Q

What muscles does the oculomotor nerve supply?

A

Muscles controlling eye movement:
Ciliary ganglion: control ciliary muscle which controls size of lens
Med. and sup. rectus
Levator palpebrae superioris - eyelid

202
Q

What is the effect of damage to the oculomotor nerve and can this be tested?

A

Effects: drooping eyelid, dilated pupil, double vision
Test: differences in pupil size, pupillary response to light, eye tracking (rectus muscle function)

203
Q

Describe the trochlear

A

From post. midbrain, enters cavernous sinus enters orbit through sup. orbital fissure

204
Q

What muscle does the trochlear supply?

A

Sup. oblique muscle function of eye movement

205
Q

What is the effect of damage to the trochlear?

A

Double vision, tilt head towards side effected

Test: ability to rotate eye inferolaterally (inf. and lat.)

206
Q

Describe the trigeminal nerve

A

Larger CN
From ant. pons
Sensory root gives off branches V1 (ophthalmic sensory), V2 (maxillary sensory), V3 (mandible sensomotor)

207
Q

What is the function of the trigeminal?

A

Sensory: tactile, proprioception, nociceptive afference of face and mouth
Motor: muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid, ant. belly of digastric

208
Q

Describe the V1 nerve

A

Ophthalmic - sensory

Leaves skull through sup. orbital fissure to enter orbital cavity

209
Q

What are the 3 branches of the ophthalmic nerve?

Forever Losing Notes

A
  1. Frontal: supratrochlear, supraorbital
  2. Lacrimal - runs ant., to lacrimal gland
  3. Nasociliary - angle of nose
210
Q

Describe the maxillary branch of the trigeminal nerve

A

Leave through foramen rotundum

211
Q

What are the 4 branches of V2?

A

Infraorbital - skin of middle face, labial mucosa
Zygomatic
Sup. alveolar: post.(molars, gingivae, sinus), mid.(premolars, cheek, gums), ant.(canine, incisor, lat. wall + floor of nose)
Pyterygopalatine

212
Q

Describe the mandibular branch of trigeminal

A

Leaves through foramen ovale enter infratemporal fossa exits as mental nerve through mandibular foramen

213
Q

What are the 5 branches of V3?

Always Believe Lots (Info Actually) Matters

A
  1. Auriculotemporal: sensory to auricle temporal regions (EAM, IJV, scalp), secretomotor to parotid gland
  2. Buccal
  3. Lingual: floor of mouth, ant. 2/3 of tongue
  4. Inf. alveolar: mandible
  5. Masticatory muscles
214
Q

What is trigeminal neuralgia?

A

Uncommon cranial nerve disorder resulting in abrupt, excruciating pain in face

215
Q

What are some therapies of trigeminal neuralgia?

A

Meditative: antiseizure, muscle relaxant
Conservative: nerve block
Surgery: microvascular decompression, radiofrequency rhizotomy, gamma-knife radio surgery, glycerol rhizotomy

216
Q

Describe the abducens nerve

A

From hind brain b/w pons and medulla, exits through cavernous sinus to sup. orbital fissure to supply lateral rectus muscle

217
Q

What is the effect of damage to the abducens and how can this be tested?

A

Inability to rotate eye laterally, at rest eye moves medially

Test: lateral movement of eye

218
Q

What 3 nerves supply the eye?

LR6 SO4 3

A
  1. Oculomotor: eyelid and pupillary constriction
  2. Trochlear: sup. oblique muscle; inferolateral eye movement
  3. Abducens: lateral rectus muscle; lateral eye movement
219
Q

Describe the facial nerve

A

Runs from bind brain through IAM forming geniculate nucleus, runs further, emerges through stylomastoid foramen but before gives off stapedius nerve, greater petrosal, chorda tympani before running to parotid gland

220
Q

What is the function of the facial nerve?

A

Facial expression - motor

Sense of taste - sensory

221
Q

What is the effect of damage to the facial nerve and how can it be tested?

A

Inability to control facial muscles, distorted sense of taste, dry eyes

Test: motor functions (close eyes, raise brows, smile, whistle); taste

222
Q

What are the 5 branches of the facial nerve outside the facial canal?

Two Zebras Behind My Car

A
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Mandibular - lower lip and chin
  5. Cervical
223
Q

What are the 3 branches of the facial nerve inside the facial canal?
Come Great Steed

A
  1. Chorda tympani: joins lingual of mandibular, ant. 2/3 tongue
  2. Greater petrosal: lacrimal, ant. palate
  3. Stapedius: to stapedius muscle
224
Q

Describe the glossopharyngeal

A

From medulla exits through jugular foramen
Motor innervates stylopharyngeus muscle
Sensory to oropharynx and post. tongue

225
Q

Describe the vestibulocochlear

A

From hind brain exits through IAM gives off
Vestibular: balance; connects to semicircular canals, position relative to space
Cochlear: sound; vibrations from hairs

226
Q

What is the function of the vestibulocochlear and what are the effects and tests for damage?

A

Function: balance and equilibrium
Damage: deafness, dizziness, nausea, loss of balance
Test: hearing, balance, walk in straight line

227
Q

What are the functions of the glossopharyngeal?

A

Swallowing, salivation, gagging (motor); touch, pressure, taste, pain of tongue, pharynx, outer ear

228
Q

What is the effect of damage to the glossopharyngeal and how is this tested?

A

difficulty swallowing

Test: gag reflex, swallowing, coughing

229
Q

Describe the vagus nerve

A

From medulla exits through jugular foramen

230
Q

What do the sensory fibres of the vagus supply?

A

EAM and tympanic membrane

231
Q

What does the motor fibres of vagus supply?

A

Muscles of larynx, respiratory passages, lungs, heart, oesophagus, stomach, SI, most of large intestine and gallbladder

232
Q

What is the function of the vagus nerve?

A

Swallowing; taste; speech; respiratory, CV, GI regulation

Sensations of hunger, fullness, intestinal discomfort

233
Q

What are the effects of damage to the vagus?

A

Hoarseness/loss of voice, impaired swallowing and GI motility

234
Q

Describe the accessory nerve?

A

From medulla and spinal cord emerge through jugular foramen

235
Q

What does the accessory nerve supply?

A

Trapezius (neck upright) and sternocleidomastoid (lat. move. of neck) muscles

236
Q

What are the general functions of the accessory nerve?

A

H&N, shoulder movement

237
Q

What are the effects of damage to accessory nerve and how to test for this?

A

Impaired movement of H&N + shoulders; paralysis of sternocleidomastoid

Test: rotate head, shrug shoulders against resistance

238
Q

What is the function of the hypoglossal?

A

Innervates tongue muscles: movements of speech, swallowing, food manipulation

239
Q

Describe the hypoglossal

A

From medulla, exits through hypoglossal canal

240
Q

What are the effects of damage to the hypoglossal and how is this tested?

A

Difficulty in speech and swallowing, atrophy of tongue, inability to protrude tongue

Test: tongue function

241
Q

Forever Losing Notes

A

V1 - ophthalmic branches
Frontal
Lacrimal
Nasociliary

242
Q

Always Believe Lots Info Actually Matters

A 
V3 mandibular branches
Auriculotemporal
Buccal
Lingual
Inf. alveolar
Masticatory muscles
243
Q

Two Zebras Behind My Car

A 
Branches of facial nerve outside facial canal
Temporal
Zygomatic
Buccal
Mandibular
Cervical
244
Q

Come Great Steed

A

Branches of facial nerve inside facial canal
Chorda tympani
Greater petrosal
Stapedius muscles

245
Q

Standing Room Only

A

Exits of V1-3
Superior orbital fissure
Foramen rotundum
Foramen ovale

246
Q

O TOM CAT

A

Structures in cavernous sinus

Oculomotor

Trochlear
Ophthalmic - V1
Maxillary - V2

Carotid artery
Abducens
Trochlear

247
Q

Live Frankly To See Absolutely No Insult

A

Nerves passing through sup. orbital fissure

Lacrimal - V1
Frontal - V1
Trochlear 
Sup. of oculomotor
Abducens
Nasociliary - V1
Inf. oculomotor
248
Q

LR6 SO4 3

A

Lateral rectus - VI abducens
Sup. oblique - IV trochlear
Other 4 (sup., med. rectus, levator palpebrae superioris, ciliary ganglion) - III oculomotor

249
Q

My Ass Meets The Toilet

A

Muscles innervated by V3

Mylohyoid
Ant. belly of digastric
Muscles of mastication
Tensor tympani
Tensor veli palatini
250
Q

Some Like Fucking, Others Prefer S and M

A 
Sup. thyroid
Lingual
Facial
Occipital
Post. auricular
Maxillary
Superficial temporal
251
Q

I See 10 CCs in the IV

A

Carotid sheath contents

I See = Internal Carotid
10 = X Vagus
CC = Common Carotid
IV = Internal Jugular Vein

252
Q

What muscles make up the occipitofrontalis muscles?

A

Frontalis

Occipitals

253
Q

Describe the frontalis muscle

A

Origin: galea aponeurotica
Insertion: skin near eyebrows, root of nose
Action: raise eyebrows, wrinkle forehead

254
Q

Describe the occipitals muscle

A

Origin: occipital bone
Insertion: galea aponeurotica
Action: scalp backwards

255
Q

Describe the temporalis muscle

A

Origin: temporal fossa between inf. temporal line
Insertion: med. and ant. aspect of coronoid process of mandible
Action: elevate mandible (close jaw)

256
Q

Describe the masseter muscle

A

Origin: ant. 2/3 of zygomatic arch and zygomatic process of maxilla
Insertion: lat. surface of angle and lower ramus
Action: elevate mandible - forced closure

257
Q

Describe the auricularis muscle

A

Origin: galea aponeurotica
Insertion: cartilage of auricle
Action: ear position

258
Q

Describe the buccinator

A

Origin: alveolar portion of maxilla and mandible
Insertion: orbicularis oris
Action: flatten cheek, retract angle of mouth

259
Q

Describe the orbicularis oculi

A

Origin: med. orbital margin and lacrimal sac
Insertion: lid of eye
Action: close eye, aid passage and drainage of tears

260
Q

Describe the orbicularis oris

A

Origin: ant. surface of maxilla and mandible, angle of mouth
Insertion: margin of lips
Action: narrows orifice of mouth, purses lips

261
Q

Describe the zygomaticus major

A

Origin: frontal process of mandible
Insertion: angle of mouth
Action: lifts angle sup. and lat.

262
Q

Describe the zygomaticus minor

A

Origin: lat. infra-orbital margin
Insertion: skin and muscle of upper lip
Action: draw skin between philtrum and lip corner obliquely upwards and lat.

263
Q

What are the 3 major extrinsic tongue muscles?

A

Genioglossus
Hyoglossus
Styloglossus

264
Q

Describe the genioglossus

A

Origin: sup. mental spine on post. surface of symphysis menti
Insertion: central mass of tongue and mucous membrane
Action: protracts tongue

265
Q

Describe the hyglossus

A

Origin: sup. border of greater cornu of hyoid bone
Insertion: lat. sides of tongue
Action: depress tongue

266
Q

Describe the styloglossus

A

Origin: ant. surface and apex of styloid process and upper 1/4 of stylohyoid process
Insertion: superolateral sides of tongue
Action: elevate, retract tongue, aids initiation of swallowing

267
Q

What 4 muscles make up the suprahyoid?

A

Digastric, stylohyoid, mylohyoid, geniohyoid

268
Q

What are the functions of the suprahyoid muscles?

A

Anchor tongue
Elevate hyoid
More larynx sup. during swallowing

269
Q

What 4 muscles make up the infrahyoid muscles?

A

Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid

270
Q

What is the function of the infrahyoid muscles?

A

Depress hyoid

271
Q

Describe the platysma

A

Origin: skin over lower neck and upper lat. chest
Insertion: inf. border of mandible, skin over lower face and angle of mouth
Action: depress and wrinkle skin of lower face and mouth, aids forced depression of mandible

272
Q

Describe the sternocleidomastoid

A

Origin: ant. and sup. manubrium and sup. medial 1/3 of clavicle
Insertion: mastoid process
Action: flex and lat. rotate cervical spine, extend neck when partially extended, protract head (together)

273
Q

Describe the post. neck triangle

A

Boundaries: ant: sternocleidomastoid; post: trapezius; inf. clavicle

Contents
Nerves: accessory, cranial plexus, phrenic, branchial plexus
Artery: subclavian
Vein: external jugular

274
Q

Describe the ant. neck triangle

A

Boundaries: ant: midline; post: sternocleidomastoid; sup: inf. margin of mandible

Contents
Glands: submandibular
Muscles: supra and infra hyoid
Artery: carotid
Vein: internal and external jugular vein
Nerve: accessory
275
Q

Describe the masseter muscle

A

Thick, somewhat quadrilateral muscle
Deep and superficial heads

Action: elevate and protrude mandible (close), deep fibres retrude
Innervation: V3 through masseteric
Blood: masseteric artery from maxillary artery

276
Q

Describe the superficial head of the masseter

A

Larger
Origin: ant. 2/3 lower border of zygomatic arch
Insertion: fibres down and back into angle and lower 1/2 of ramus

277
Q

Describe the deep head of the masseter muscle

A

Small, more muscular
Origin: from post. 1/3 lower border and whole med. surface of zygomatic arch
Insertion: fibres down and forward to upper 1/2 ramus
Relation
Ant: superficial head
Post: parotid gland

278
Q

Describe the origin, insertion and action of the temporalis muscle

A

Broad, radiating, situated at side of head

Origin: temporal fossa and deep surface of temporal fascia
Insertion: fibres des., converge end in tendon. Passed deep to zygomatic arch, inserted into med surface, apex and ant border of coronoid process and ant border of ramus
Action: ant, middle fibres elevate. Post. retrudes

279
Q

Describe the innervation and blood supply of the frontalis

A

Innervation: deep temporal branches of mandibular
Blood: deep temporal branches of maxillary artery

280
Q

What are the two heads of the lat. pterygoid muscle?

A

Sup.

Inf.

281
Q

Describe the origin of the sup. head

A

Greater wing of sphenoid bone

282
Q

Describe the origin of the inf. head of lat. pterygoid muscle

A

Lat. surface of lat. pterygoid plate

283
Q

Describe the action of the lat. pterygoid muscle when functioning alone and together

A

Together: protrude and depress mandible
Alone: side-side movement of mandible

284
Q

Describe the insertion, innervation and blood supply of the lat. pterygoid

A

Insertion: fibres back into neck of mandible and articular disk of TMJ
Innervation: ant. division of mandibular nerve through lat. pterygoid nerve
Blood: maxillary artery through pterygoid branch

285
Q

What are the 2 heads of the medial pterygoid muscle?

A

Superficial

Deep

286
Q

Describe the origin of the superficial head of the med. pterygoid muscle

A

Maxillary tuberosity

287
Q

Describe the origin of the deep head of the med. pterygoid muscle

A

Med. surface of lat. pterygoid plate

288
Q

Describe the action of the med. pterygoid muscle

A

Elevate and protrude mandible

Act with lat. pterygoid of same side in rotating mandible

289
Q

Describe the insertion, innervation and blood supply of the med. pterygoid muscle

A

Insertion: fibres down, back and lat. into med. surface of angle of mandible
Innervation: main trunk of mandibular nerve through nerve to med. pterygoid
Blood: maxillary artery through med. pytergoid artery

290
Q

Describe the action of how the mandible is depressed

A

1A: muscles pull mandible back
1B: muscles pull mandible down
2: mandible rotates at TMJ

291
Q

What 3 muscles are involved in depressing the mandible?

A
  1. Digastric
  2. Mylohyoid
  3. Omohyoid
292
Q

What are the 2 regions of the nose?

A
  1. External

2. Internal nasal cavity

293
Q

Describe the structure of the external nose

A

Nostrils separated by nasal septum

Lat. margin: ala of nose; mobile and rounded

294
Q

What 4 things is the external nose made of?

A

Nasal bones
Maxillae bone
Frontal bone
Plates of hyaline cartilage

295
Q

Describe the internal nasal cavity

A

Separated by midline nasal septum
Ant. apertures are nares - open onto inf. surface of nose
Post. apertures are choanae - open into nasopharynx

296
Q

Describe the medial wall of the internal nasal cavity

A

Nasal septum: vertical in median sagittal plane, separate into R and L nasal cavities

297
Q

What does the nasal septum consist of?

A
  1. Septal cartilage
  2. Vertical plate of ethmoid
  3. Vomer
298
Q

Describe the floor of the internal nasal cavity

A

Palatine process of maxilla and horizontal plate of palatine bone forming hard palate
Naris opens ant. into floor

299
Q

Describe the roof of the internal nasal cavity

A

Cribriform plate of ethmoid
Nasal and frontal bones
Post. by sphenoid bone

300
Q

What are conchae and meatus?

A

Conchae: 3 curved, long bone projections in breathing passage
Meatus: spaces below each conchae

301
Q

What are the 3 nasal conchae?

A
  1. Sup.
  2. Middle
  3. Inf.
302
Q

What are the 4 nasal meatus?

A
  1. Spheno-ethmoidal recess (above sup. conchae)
  2. Sup.
  3. Middle
  4. Inf.
303
Q

Describe the innervation of the nasal cavity

A

Sensory: ophthalmic (V1) and maxillary (V2) of trigeminal
Olfactory: smell; supplies olfactory mucosa in roof of nasal cavity

304
Q

What are the 3 arteries that supply the nasal cavity?

A
  1. Branches of maxillary
  2. Septal branch of facial
  3. Ethmoidal branches of ophthalmic
305
Q

What is the name for bleeding from the nose?

A

Epistaxis

306
Q

What are paranasal air sinuses?

A

Cavities found in the ethmoid, frontal, sphenoid and maxilla bones

307
Q

What are the 3 functions of the paranasal air sinuses?

A
  1. Make skull lighter
  2. Resonating chamber for voice
  3. Increase SA of nasal mucous membrane (warm air before entering lung)
308
Q

Describe the frontal air sinus

A

Separated by septum, variable in size

309
Q

What are the 3 ethmoid air sinuses?

A
  1. Ant.
  2. Mid.
  3. Post.
310
Q

Where is the sphenoid air sinus located?

A

Body of sphenoid bone

311
Q

What 2 air sinuses do NOT open into the middle meatus?

A
  1. Sphenoidal sinus

2. Post. ethmoidal sinus

312
Q

Where does the sphenoidal sinus open into?

A

Spheno-ethmoidal recess

313
Q

Where does the post. ethmoidal sinus open into?

A

Sup. meatus

314
Q

Describe the maxillary air sinus

A

Pyramidal cavity in body of maxilla

Largest paranasal air sinus

315
Q

What are the boundaries of the maxillary air sinus?

A

Roof: separates sinus from orbit and lodges infra-orbital nerve and vessels
Floor: formed by alveolar process of maxilla, roots of molars and premolars

316
Q

What is the pharynx?

A

Musculo-membranous wall that connect mouth and nasal cavity sup. to oesophagus inf.

317
Q

What 5 things is the pharynx composed of?

A
  1. Mucosa
  2. Submucosa
  3. Pharyngobasilar fascia
  4. Muscles: circular and longitudinal
  5. Buccopharyngeal fascia
318
Q

What is the buccopharyngeal separated from the prevertebral fascia by?

A

Retropharyngeal space

319
Q

What is the retropharyngeal space?

A

Potential space between buccopharyngeal fascia and pre-vertebral fascia containing loose alveolar tissue

320
Q

What does the retropharyngeal space allow for?

A

Movement of larynx, pharynx, oesophagus, and trachea during swallowing

321
Q

Describe the location of the nasopharynx

A

Post. to nasal cavity
Inf. to sphenoid bone
Sup. to soft palate
Continuous with nasal cavity via post. nasal aperture

322
Q

What is the function of the uvula?

A

During swallowing closes nasopharynx

323
Q

What is the pharyngeal tonsil and what is its function?

A

Collection of lymph nodes

Prevent spread of infection to nasal cavity

324
Q

Where does the pharyngiotympanic tube open into?

A

Lat. wall of nasopharynx

325
Q

What is the function of the pharyngiotympanic tube?

A

Connect middle ear cavity to nasopharynx
Drainage
Equalisation of pressure

326
Q

Where is the oropharynx located?

A

Post. to OC

327
Q

What is the fauces?

A

Arch like entrance of OC to oropharynx

328
Q

Describe the path of the oropharynx

A

Extends inf. from soft palate to epiglottis

329
Q

What is the function of the oropharynx?

A

Passage of food and air

330
Q

Where are the palatine tonsils and lingual tonsils located?

A

Palatine: lat. wall of fauces
Lingual: post. surface of tongue

331
Q

Describe the location and path of the laryngopharynx

A

Post. to epiglottis

Extends to larynx - continuous with oesophagus

332
Q

What is the function of laryngopharynx?

A

Passage of food and air

333
Q

What are the 2 muscle types in the pharynx?

A

Constrictor

Longitudinal

334
Q

What are the 3 constrictor muscles of the pharynx?

A

Sup.
Middle
Inf.

335
Q

Describe the constrictor muscles of the pharynx

A

Extend around pharynx, insert post. into fibrous raphe extending from pharyngeal tubercle on occipital bone to oesophagus

336
Q

What is the phayngobasilar fascia?

A

Fibrous tissue filling gap between sup. border of sup. constrictor and occipital bone

337
Q

What are the 3 longitudinal muscles of the pharynx?

A

Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus

338
Q

What is the function of the 3 longitudinal muscles of the pharynx?

A

Elevate larynx and pharynx during swallowing

339
Q

What is adenoid facies?

A

Typical facial expression of patient with adenoids - enlarged pharyngeal tonsils causing obstruction of nasal breathing

340
Q

Where does the larynx extend from and what are its boundaries?

A

Extends from 6th cervical vertebra
Sup. attached to hyoid bone and opens into laryngopharynx
Inf. continuous with trachea

341
Q

What are the 3 functions of the larynx?

A
  1. Provide patent airway
  2. Route air and food into proper channels
  3. Voice production
342
Q

What are the 6 cartilages of the larynx?

A
  1. Thyroid
  2. Cricoid
  3. Arytenoid (paired)
  4. Cuneiform (paired)
  5. Corniculate (paired)
  6. Epiglottis
343
Q

Which of the 6 cartilages of the larynx is not hyaline?

A

Epiglottis

344
Q

Describe the thyroid cartilage

A

Largest
2 rectangular lamina fuse in midline forming thyroid notch
Forms Adam’s apple
Ossified 20-30yo

345
Q

Describe the cricoid cartilage

A

Strongest
Immediately below thyroid cartilage
Ring shaped - only laryngeal cartilage to completely encircle airway
Joins first tracheal ring inf.

346
Q

Describe the arytenoid cartilage

A

Articulates with cricoid cartilage via cricoarytenoid joint - allows movement to open/close vocal cords
Processes for attachment of vocal cords

347
Q

Describe the cuneiform and corniculate cartilages

A

Accessory

Probably for structural support

348
Q

Describe the epiglottis

A

Elastic fibrocartilage
Leaf shaped
Cover laryngeal inlet preventing aspiration during swallowing

349
Q

What are intrinsic membranes and ligaments? Name 2

A

Membranes/ligaments that connect laryngeal cartilages with each other

Quadrangular membrane
Cricothyroid ligament

350
Q

What are extrinsic membranes/ligaments? Name 3

A

Membranes/ligaments that connect laryngeal cartilages to other structures such as hyoid bone and trachea

Thyrohyoid membrane
Hyo-eppiglottic
Cricotracheal

351
Q

What is cricothyrotomy?

A

Incision made through the skin and cricothyroid membrane in certain life threatening situations that cause obstruction of airway

352
Q

In what situations might cricothyrotomy be required?

A

Obstruction by foreign body, angioedema, massive facial trauma

353
Q

What is tracheotomy?

A

Cut between 1/2 or 2/3 tracheal cartilages to open airway to lungs below obstructed larynx

354
Q

Describe the thyroid gland

A

Largest endocrine gland
Lobes are cone shaped
Highly vascular

355
Q

What are the functions of the thyroid gland?

A

Produce thyroid hormones (T…, calcitonin): vital for growth and metabolism
Iodine storage: essential for T3/4 synthesis

356
Q

Describe the function and T3/4 hormone and what it is stimulated by

A

Inc.: metabolic rate, protein synthesis, energy production

Stimuli: dec. metabolic rate

357
Q

Describe the function of calcitonin and what it is stimulated by

A

Dec.: blood Ca conc., dec. reabsorption of Ca and P from bone

Stimuli: inc. blood Ca levels

358
Q

Describe the location of the thyroid gland

A

Ant. and lat. to larynx and trachea
In ant. region of neck
Base located ~4/5 tracheal cartilage

359
Q

Describe the lobes of the thyroid gland

A

Cone shaped, connected by isthmus
Attached to cricoid cartilage by ligaments
Med. surface adapted to larynx and trachea

360
Q

Describe the isthmus of the thyroid gland

A

Connect 2 lobes
Occasionally absent
Crosses at ~2-4 tracheal rings
Pyramidal lobe - small projection

361
Q

Describe the blood supply of the thyroid gland

A

R and L inf. and sup. thyroid arteries

362
Q

Describe the effect thyroid hormones can have on the cardiovascular system

A
  1. Inc. HR
  2. Inc. cardiac contraction force
  3. Inc. cardiac output
363
Q

Describe the effect thyroid hormones can have on O2 carrying capacity

A

Inc. O2 dissociation from haemoglobin

364
Q

Describe the effect thyroid hormones can have on intermediary metabolism

A

Inc. glucose absorption from GIT

Inc. carb, protein, lipid turnover

365
Q

Describe the effect thyroid hormones can have on the nervous system

A

Enhance wakefulness and alertness
Enhance memory and learning capacity
Required for normal CNS neuronal development and normal emotional tone

366
Q

Describe the parathyroid glands

A

Usually 2-4 on each side
Lie on post. surface of thyroid gland
May be embedded within thyroid
Regulate Ca/PO4 levels

367
Q

What are the 6 general components of saliva?

A
  1. Salivary glands: water, electrolytes, small organic molecules
  2. Blood and blood derivatives: intra-oral bleeding, gingival cervicular fluid (serum and inflammatory cells)
  3. Extrinsic substances: food debris, toothpaste, m/w
  4. Fluids: bronchial and nasal secretions
  5. Lining cells: epithelial keratin
  6. Microbiota
368
Q

What are the 6 general functions of saliva?

A
  1. Protection
  2. Buffering
  3. Digestion
  4. Antimicrobial
  5. Maintenance of tooth integrity
  6. Taste
369
Q

What 5 factors can affect saliva production,

A
  1. Local disease
  2. Systemic disease
  3. Medications
  4. HandN radiation
  5. Chemotherapy
370
Q

What are the 3 major salivary glands?

A
  1. Parotid
  2. Submandibular
  3. Sublingual
371
Q

Describe the shape and location of the parotid gland

A

Pyramidal shape

Sup: external auditory meatus, TMJ
Ant: overflows mandible with overlying masseter
Inf: overflows post. belly of digastric
Med: styloid process and muscles separating parotid from IJV, internal carotid artery

372
Q

Describe the blood supply, venous and lymph drainage of the parotid gland

A

Blood: branches of carotid artery
Venous: retromandibular vein
Lymph: LN within parotid sheath :> DCLN

373
Q

Describe the the parotid capsule

A

2 capsules: CT capsule, dense fascial capsule of investing layer of deep cervical fascia

374
Q

Describe the parotid duct

A

Stensen’s duct
5cm long

Appears in ant. border of gland
Run ant. and down on masseter
Pierces buccinator
Opens opposite 2nd maxillary molar

375
Q

From superficial to deep list the 4 structures within the parotid gland

A
  1. Facial nerve
  2. Retromandibular vein
  3. External carotid artery
  4. Auriculotemporal nerve - from V3
376
Q

Describe the submandibular gland

A

Irregular gland with 2 parts: large superficial part, small deep part

377
Q

Describe the location and boundaries of the superficial part of the mandibular gland

A

Digastric between mylohyoid muscle and body of mandible

Ant: ant. belly of digastric
Post: post. belly of digastric and stylohyoid
Med: mylohyoid
Lat: in contact with submandibular fossa on med. surface of mandible

378
Q

Describe the location and boundaries deep part of the submandibular gland

A

Superficial to hyoglossus

Med: hyoglossus and styloglossus
Lat: mylohyoid and superficial part of gland
Sup: lingual nerve and submandibular ganglion
Inf: hypoglossal nerve

379
Q

Describe the blood supply, venous and lymph drainage of the submandibular gland

A

Blood: facial artery
Venous: facial vein
Lymph: submandibular LN, DCLN

380
Q

Describe Whartons duct

A

Submandibular duct
5cm long

Emerges at ant. end of deep part of gland
Runs forward on hyoglossus and mylohyoid
Crossed by lingual nerve and then opens in floor of mouth at side of frenulum of tongue

381
Q

Describe the sublingual gland

A

Smallest of major glands

Beneath oral mucosa, in contact with sublingual fossa in lingual aspect of mandible

382
Q

Describe the blood supply, venous and lymph drainage of the sublingual gland

A

Blood: sublingual and submental arteries
Venous: sublingual and submental veins
Lymph: submandibular LNs

383
Q

Describe the ducts of rivinus

A

Sublingual duct
8-20 ducts
Most open directly onto floor of mouth
Some join submandibular duct

384
Q

What are 3 salivary disorders?

A
  1. Sialadenitis: inflammation of glands
  2. Submandibular duct obstruction: usually by infection
  3. Xerostomia: caries, dry, fissured tongue
385
Q

What are the 3 portions of the tongue?

A
  1. Root: post. 1/3
  2. Body: ant. 2/3
  3. Apex
386
Q

What are the 5 structures found on the mucous membrane layer of the tongue?

A
  1. Sulcus terminalis
  2. Foramen cecum - thyroglossal duct
  3. Papillae
  4. Lymph nodules
  5. Frenulum
387
Q

What are the 4 types of tongue papillae?

A
  1. Filiform
  2. Fungiform
  3. Foliate
  4. Vallate
388
Q

Describe filiform papillae

A 
Most numerous - ant. 2/3
Tiny, pointed parakeratinised projections
Pink/grey colour
Aid in food handling
Touch sensory nerve endings
389
Q

Describe fungiform papillae

A

Tiny, globular and raised red spots
Scattered among filiform
Ant 2/3 and mainly lat. and tip
Taste buds

390
Q

Describe foliate papillae

A

Lat. margins of tongue
From 3/4 short vertical folds (folia linguae)
Rudimentary in humans
Few taste buds

391
Q

Describe vallate papillae

A

Circular and large (2mm diameter)
About 12/13 in V-shaped arrow (towards oropharynx)
Each surrounded by circular depression (valley)
Numerous taste buds
Von Ebner minor salivary glands

392
Q

What are the 2 types of tongue muscle?

A

Intrinsic

Extrinsic

393
Q

Name the 3 intrinsic tongue muscles

A
  1. Longitudinal
  2. Transverse
  3. Vertical
394
Q

Name the 4 extrinsic tongue muscles

A
  1. Genioglossus
  2. Hyoglossus
  3. Styloglossus
  4. Palatoglossus
395
Q

What are the 4 movements of the tongue and what muscles are responsible for each?

A
  1. Protrusion: genioglossus
  2. Retraction: styloglossus, hyoglossus
  3. Depression: hyoglossus, genioglossus
  4. Retraction and elevation: styloglossus, palatoglossus
396
Q

Describe the motor innervation of the tongue muscles

A

All supplied by hypoglossal EXCEPT palatoglossus supplied by pharyngeal plexus

397
Q

Describe the taste sensory innervation of the tongue muscles

A

Ant. 2/3 by facial nerve via chorda tympani

Post. 1/3 glossopharyngeal

398
Q

What nerves supply general sensation to the tongue?

A

Ant. 2/3 lingual from mandibular nerve (V3)

Post. 1/3 glossopharyngeal

399
Q

Describe the lymph drainage of the tongue

A

Apex: submental LN
Ant 2/3: submandibular and DCLN
Post. 1/3: DCLN

400
Q

Name 3 clinical conditions affecting the tongue

A

Hairy tongue: filiform grow long trapping food, OB causing malodour
Glossitis: inflammation of tongue, tongue smooth and painful
Oral cancer: can initiate from foliate papillae

401
Q

Describe acute tonsillitis

A

Inflammation of the tonsils usually due to infection

Swollen tonsils
Fever
Painful, sore throat
Difficulty swallowing

402
Q

What nerves innervate the maxillary teeth?

A

1-3: ant. sup. alveolar
4-5: mid. sup. alveolar
6-8: post. sup. alveolar

403
Q

What nerve innervates the mandibular teeth?

A

Inf. alveolar

404
Q

What nerves innervate the maxillary soft tissue?

A

Ant., mid., post. sup. alveolar

405
Q

What nerves innervate the mandibular soft tissue?

A

1-5: mental nerve (branch of inf. alveolar)

6-8: buccal

406
Q

What nerves innervate the maxillary palate?

A

1-3: nasopalatine (branch of V2)

4-8: greater palatine (branch V2)

407
Q

What nerve innervates the floor of the mouth?

A

Lingual

408
Q

Compare infiltration and block LA

A

Target nerve ends; target main nerve supply

Localised affect; all sensation downstream lost

409
Q

What are some of the complications that may arise from LA?

A 
Pain, swelling when injected into muscle
Trauma as can't feel burning/chewing
Facial nerve palsy
Bleeding
Acute infection

BDS 1 (11 decks)

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