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Year 2 - Nervous > H&N anatomy wk 3 (special senses) > Flashcards

H&N anatomy wk 3 (special senses) Flashcards

1
Q

7 bones that form the orbit

A 
Ethmoid (lamina papyracea of)
Frontal
Sphenoid (lesser & greater wings, and body)
Maxilla (orbital surface of)
Zygomatic (orbital process of)
Lacrimal
Palatine (orbital process of)
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2
Q

Name the 3 foramina at the apex of the orbit

A

Optic foramen
Superior orbital fissure
Inferior orbital fissure

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3
Q

What 2 things pass through optic foramen

A

Optic nerve

Ophthalmic artery

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4
Q

What 5 things pass through the superior orbital fissure

A 
CN III
CN IV
CN VI (abducens)
CN V1 (ophthalmic division)
Ophthalmic veins
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5
Q

What 1 thing passes through the inferior orbital fissure

A

CN V2 (maxillary division)

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6
Q

Name the 3 paranasal air sinuses that lie adjacent to the orbit

A

Frontal
Maxillary
Ethmoidal

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7
Q

Name the 7 contents of the orbit

A 
Eyeball
Extrinsic ocular muscles
Intrinsic ocular muscles
Ligaments supporting the eye
CN II
Ophthalmic artery (branch of ICA) and its branches
Lacrimal apparatus
Orbital fat - cushions globe
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8
Q

What is the ophthalmic artery a branch of

A

ICA

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9
Q

Clinical significance of paranasal air sinuses lying close to the orbit

A

Can spread infection into the orbit such as orbital cellulitis

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10
Q

Name the 3 layers of the eyeball

A

Outer fibrous layer
Middle vascular layer (urea)
Inner sensory layer

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11
Q

What 2 things makes up the outer fibrous layer of the eyeball + is this layer complete 360

A

Sclera (posterior 5/6)
Cornea (anterior 1/6)

Complete layer

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12
Q

What 3 things makes up the middle vascular layer of the eyeball + is this layer complete 360

A

Choroid
Ciliary body
Iris

Incompletely anteriorly due to aperture in the iris = pupil

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13
Q

What makes up the inner sensory layer of the eyeball + is this layer complete 360

A

Retina

Present posteriorly and stops just in front of equator of the eye at the ORA SERRATA

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14
Q

The crystalline lens divides the eyeball into what 2 things

A

Anterior and posterior segment

Anterior segment anterior to the lens

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15
Q

Anterior segment contains what

A

AH (watery fluid)

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16
Q

Posterior segment contains what

A

VH (gel-like substance)

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17
Q

Function of vitreous humor

A

Cushions the retina

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18
Q

Anterior segment further subdivided into what 2 things

A

Anterior and posterior chamber

  • anterior chamber in front of iris
  • posterior chamber behind iris but in front of lens
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19
Q

2 functions of ciliary body

A

Suspends the lens via zones

Secretes AH

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20
Q

What is the ora serrata - google this

A

Anterior end of retina?

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21
Q

What chamber is AH secreted into first

A

Posterior chamber

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22
Q

Name the 3 intrinsic muscles of the eye

A

Ciliaris
Constrictor/sphincter pupillae
Dilator pupillae

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23
Q

Location of the ciliaris muscle

A

In the ciliary body

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24
Q

Location of the constrictor/sphincter pupillae

A

Pupillary border of iris (the circular edge of the iris)

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25
Q

Location of the dilator pupillae

A

Radially arranged in the iris (like the spokes of a wheel radiating from the pupil)

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26
Q

Function of the ciliaris

A

Accommodation (changes the shape of the lens to allow us to focus on near objects from far objects)

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27
Q

Function of constrictor pupillae

A

Decrease pupil diameter

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28
Q

Function of dilator pupillae

A

Increase pupil diameter

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29
Q

Innervation of ciliaris

A

Parasympathetic fibres of CN III

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30
Q

Innervation of constrictor pupillae

A

Parasympathetic fibres of CN III

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31
Q

Innervation of dilator pupillae

A

Sympathetic fibres from sympathetic plexuses running along blood vessels

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32
Q

General function of intrinsic muscles v extrinsic ocular (extra-ocular) muscles

A

Intrinsic - change size of pupil and shape of lens

Extrinsic - eye movements, i.e. moving the eyeball

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33
Q

Name the 6 UNIOCULAR eye movements

A 
Elevation
Depression
Abduction
Adduction
Intorsion
Extorsion
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34
Q

Name the extrinsic muscles of the eye

A 
Superior rectus
Inferior rectus
Lateral rectus
Medial rectus
Superior oblique
Inferior oblique
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35
Q

Additional muscle of the eye sometimes considered as an extrinsic muscle but not technically because it doesn’t move the eyeball+ its function

A

Levator palpebrae superioris (LPS)

Elevates upper eyelid

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36
Q

Innervation of extrinsic muscles of the eye

A

SO - CN IV
LR - CN VI
Everything else CN III

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37
Q

Where do the recti muscles insert onto

A

Anterior sclera

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38
Q

Where do the oblique muscles of the eye insert onto

A

Posterior sclera

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39
Q

What is intorsion + extorsion

+ when does it occur

A

Intorsion - when the eye rotates towards (medially)
Extorsion - when the eye rotates away (laterally) from the nose

Only occurs when you tilt your head

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40
Q

Primary/secondary/tertiary actions of the superior rectus

A

Primary - elevation
Secondary - adduction
Tertiary - intorsion

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41
Q

Primary/secondary/tertiary actions of the inferior rectus

A

Primary - depression
Secondary - adduction
Tertiary - extorsion

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42
Q

Name the 6 BINOCULAR eye movements (moving as a pair)

A

Dextroelevation - up and right
Dextrodepression - down and right
Dextroversion - both to the right (so abduction of right eye and adduction of left)

Levoelevation - up and left
Levodepression - down and left
Levoversion

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43
Q

Primary action of medial rectus (no secondary or tertiary actions)

A

Adduction

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44
Q

Primary action of lateral rectus (no secondary or tertiary actions)

A

Abduction

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45
Q

Primary/secondary/tertiary actions of the superior oblique

A

Primary - intorsion
Secondary - depression
Tertiary - abduction

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46
Q

Primary/secondary/tertiary actions of the inferior oblique

A

Primary - extorsion
Secondary - elevation
Tertiary - abduction

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47
Q

Common action of superior and inferior obliques

A

Abduction

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48
Q

Common action of superior and inferior recti

A

Adduction

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49
Q

Origin of the recti muscles of the eye

A

Common tendinous ring at the apex of the orbit

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50
Q

Origin of the superior oblique muscle

A

From roof of orbit posteriorly

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51
Q

Origin of inferior oblique muscle

A

From medial floor of orbit anteriorly

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52
Q

Which is the only extrinsic eye muscle that doesn’t arise posteriorly

A

Inferior oblique

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53
Q

What ligaments prevent over-adduction/abduction of the eye

A

Medial and lateral check ligaments - attached to lacrimal and zygomatic bones respectively

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54
Q

Function of suspensory ligament of eye

A

Connects the ciliary body to the lens

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55
Q

Arterial supply of the orbit and eye

A

Ophthalmic artery (branch of ICA) and its branches

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56
Q

Are there lymphatic vessels in the orbit

A

No

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57
Q

Function of lacrimal gland

A

Secretes lacrimal fluid (tears)

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58
Q

Innervation of lacrimal gland

A

Parasympathetic fibres of CN VII

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59
Q

Position of lacrimal gland

A

Lateral roof of orbit

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60
Q

External ear consists of (2)

A

Pinna and EAC

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61
Q

Middle ear consists of (4)

A

Tympanic membrane
Tympanic cavity containing:
Ossicle - malleus, incus & stapes
Epitympanic recess

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62
Q

Inner ear consists of what 2 chambers + what are these chambers made up of

A

Bony labyrinth - bone lined chambers:
- consists of the cochlea, vestibule and 3 semi-circular canals

Membranous labyrinth (lies within bony labyrinth):
-consists of the cochlear duct, semi-circular ducts, utricle and saccule
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63
Q

What joints are found between the components of the ossicle

A

Synovial

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64
Q

Which part of the ossicle is in contact with tympanic membrane

A

Malleus - head of the malleus

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65
Q

Which part of the ossicle is in contact with the oval window of the inner ear

A

Stapes - footplate of the staples

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66
Q

2 muscles associated with the ossicles (muscles of the middle ear)

A

Tensor tympani

Stapedius (smallest muscle in the body, not visible)

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67
Q

Name the parts of the pinna (auricle) (5)

A 
Helix
Antihelix
Lobule
Tragus
Antitragus
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68
Q

Function of tensor tympani

A

Tenses the tympanic membrane by pulling the malleus medially, to reduce vibration of the ossicles and therefore dampen sound

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69
Q

Function of Stapedius

A

Reduces vibration of the ossicles and therefore dampen sound by stabilising the stapes bone so it doesn’t move around excessively

70
Q

Function of tympanic membrane

A

When sound waves enter ear, they hit the tympanic membrane which vibrates it, it transmits these vibrations to the ossicle attached to it

71
Q

Sensory innervation of the pinna and EAC

A

CN VII

72
Q

2 areas that the tympanic cavity of the middle ear communicates with

A 
Nasopharynx
Mastoid antrum (cavity in mastoid process)
73
Q

Which bone (be specific) does the middle and inner ear lie in

A

Petrous part of temporal

74
Q

What fluid lies in the bony labyrinth

A

Perilymph

75
Q

What fluid lies in the membranous labyrinth

A

Endolymph

76
Q

Function of the cochlea + semi-circular canals (inner ear)

A

Hearing + balance respectively

77
Q

Describe the intracranial course of the facial nerve

A

Emerges from pontomedullary junction then exits posterior cranial fossa from the internal auditory meatus –> passes into the facial canal in the petrous temporal bone –> extends inferiorly and laterally to exit at the stylomastoid foramen

78
Q

What foramen does CN VII exit in the cranial fossa + what other CN exits at this fossa

A

Internal acoustic meatus

CN VII

79
Q

Where is the facial canal located into the tympanic cavity

A

Medial wall

80
Q

What branch does CN VII give off in the middle ear + what fibres does this branch contain

A

Chorda tympani

Parasympathetic efferent fibres to the submandibular and sublingual salivary glands
Special sensory fibres to the anterior 2/3 of tongue for TASTE

81
Q

Damage to facial nerve in middle ear can cause hyperacusis because

A

Hyperacusis - increased sensitivity to everyday sounds that are not usually a problem
Chorda tympani branch innervates stapedius so loss of stapedius function –> less dampening of sound –> normal sounds perceived louder

82
Q

Innervation of tensor tympani

A

CN V3

83
Q

Innervation of Stapedius

A

Chorda tympani

84
Q

Innervation of inner ear

A

CN VIII
Cochlear branch of CN VIII innervates cochlea
Vestibular branch of CN VIII innervates semi-circular canals

85
Q

Small lymphatic capillaries in the head & neck first drain into …… then from these, lymph drains into ……, then from these ultimately into the …

A

Regional lymph nodes

  • -> Deep cervical lymph nodes
  • -> IJV
86
Q

Deep cervical lymph nodes are a linked chain of nodes found where (2)

A

Around the IJV and within the fascia of the carotid sheath

87
Q

Where are the jugular lymph trunks + what joins to make these trunks

A

At the inferior end of the deep cervical chain nodes

Efferent lymphatic vessels joining together

88
Q

Where do efferent lymphatics from the right jugular lymph trunk drain into

A

Right lymphatic duct –> Right brachiocephalic

89
Q

Where do efferent lymphatics from the left jugular lymph trunk drain into

A

Thoracic duct –> L brachiocephalic

90
Q

Name the regional groups of lymph nodes in the FACE + SCALP (6)

A 
Parotid
Buccal
Submental
Submandibular
Mastoid - overlie mastoid process
Occipital - overlie occipital process
91
Q

Areas that the parotid lymph nodes drain (3)

  • just think of what’s around parotid gland
A

Around parotid gland
Lateral parts of eyelid
Middle ear

92
Q

Area that the buccal lymph nodes (over the buccinator) drain (1)

A

Cheek region

93
Q

Areas that the submental lymph nodes (under mandible) drain (2)

  • just think of what’s around submental lymph nodes
A

Anterior tip of tongue

Central part of floor of mouth + chin

94
Q

Areas that the submandibular lymph nodes drain (9)

  • just think of what’s around submandibular lymph nodes
A 
Front of scalp
Nose, lips
Air sinuses - ethmoidal, frontal, maxillary
Teeth, gums
Anterior tongue
Floor of mouth
Lymph from submittal nodes
95
Q

Areas that mastoid lymph nodes drain (2)

A

Middle region of scalp

EAC

96
Q

Area that the occipital lymph nodes drain (1)

A

Back of scalp

97
Q

Name the groups of lymph nodes in the NECK (5)

A 
Anterior cervical
Superficial cervical
Retropharyngeal
Laryngeal
Tracheal
98
Q

Location of the anterior cervical lymph nodes

A

Along the anterior jugular VEINS

99
Q

Location of the superficial cervical lymph nodes

A

Along the external jugular vein

100
Q

Location of the retropharyngeal lymph nodes

A

Between the pharynx and the vertebral bodies

101
Q

Location of the laryngeal lymph nodes

A

Around the cricothyroid ligament in the larynx

102
Q

What do the anterior cervical lymph nodes drain

A

Superficial structures of the anterior neck

103
Q

What do the superficial cervical lymph nodes drain (3)

A

Parotid lymph nodes
Angle of mandible
Structures that lie at the junction between neck, face and scalp

104
Q

What do the retropharyngeal lymph nodes drain (3)

A

Nasopharynx
Eustachian tube
Upper cervical vertebral column

105
Q

What do the laryngeal lymph nodes drain (2)

A

Larynx and adjacent structures

106
Q

What do the tracheal lymph nodes drain (2)

A

Trachea

Thyroid gland

107
Q

Name the lymph node that lies at the junction of the internal jugular and common facial veins + what level lymph node is this

A

Jugulodigastric (tonsillar) node

Level II

108
Q

What lymph node enlarges in tonsillitis (commonest lymph node to enlarge in neck)

A

Jugulodigastric (tonsillar) node - level II

109
Q

Block dissection of the neck for tumours requires removal of lymph nodes in what regions

A

Lymph nodes of the anterior and posterior triangles and their associated lymph channels

110
Q

Name the 3 cranial fossa

A

Anterior, middle, posterior

111
Q

What bone forms posterior boundary of anterior cranial fossa

A

Sphenoid (greater wing)

112
Q

Which bones form the floor of the middle cranial fossa

A

Sphenoid and temporal (Squamous AND petrous parts)

113
Q

Which bone forms the posterior border of the middle cranial fossa

A

Temporal

114
Q

Which 4 bones come together to form the pterion

A

Frontal
Parietal
Temporal
Sphenoid (Greater wing)

115
Q

Which bones forms the anterior and posterior border of the posterior cranial fossa

A

Anterior - petrous temporal bone + dorsum sellae of sphenoid

Posterior - occipital

116
Q

Foramen in the anterior cranial fossa (1)

A

Foramina of cribriform plate

117
Q

Foramina in the middle cranial fossa (7)

A 
Optic foramen
Superior orbital fissure
Foramen rotundum
Foramen ovale
Foramen spinosum
Foramen lacerum
Carotid canal
118
Q

Foramina in the posterior cranial fossa (4)

A

Internal acoustic foramen
Jugular foramen
Hypoglossal foramen
Foramen magnum

119
Q

Structure passing through foramina of cribriform plate

A

Olfactory nerve

120
Q

Structures passing through optic foramen (2)

A

Optic nerve

Ophthalmic artery

121
Q

Structures passing through superior orbital fissure (5)

A

Ophthalmic veins
CN III, IV, VI
CN V1

122
Q

Structure passing though foramen rotundum (1)

A

CN V2

123
Q

Structures passing through foramen ovale (2)

A

CN V3

Accessory meningeal artery

124
Q

Structures passing through foramen spinosum (3)

A

Middle meningeal artery + vein

Meningeal branch of CN V3

125
Q

Structures passing through foramen lacerum (3)

A

ICA (lies on top of it, doesn’t actually traverse it)

Sympathetic and venous plexuses accompanying the ICA

126
Q

Structures passing through carotid canal (2)

A

ICA

Sympathetic plexus

127
Q

Structures passing through internal acoustic foramen (2)

A

CN VII

CN VIII

128
Q

Structures passing through jugular foramen (6)

A 
CN IX
CN X
CN XI
IJV
Inferior petrosal + sigmoid sinuses?
129
Q

Structure passing through hypoglossal foramen (1)

A

CN XII

130
Q

Structures passing through foramen magnum (3)

A

Medulla + meninges
2 Vertebral arteries
Spinal part of accessory nerve

131
Q

What are the intra-cranial venous blood sinuses found between

A

Inner (dura proper) and outer layer (periosteum of inside face of skull bone) of dura mater

132
Q

What 2 things lie in the grooves in the floor of the skull

A

Arteries or

Intra-cranial venous blood sinuses

133
Q

What artery lies in the groove lateral to the foramen spinosum

A

Middle meningeal artery

134
Q

What artery supplying the brain is commonly damaged in injuries such as a blow to the head + why

A

Middle meningeal artery

135
Q

What prevents extradural haemorrhages (between periosteum of skull and dura mater) from spreading over a wider area/being restricted to a lens shaped area

A

The attachment of dura at the sutures of the skull

136
Q

What runs in the grooves lateral to the internal occipital protuberance

A

Transverse sinus

137
Q

What does the transverse sinus continue on as

A

S- shaped sigmoid sinus

138
Q

Transverse sinus –> sigmoid sinus –> what foramen

A

Jugular foramen

139
Q

What is the sella turcica

A

Deep depression in the midline of the middle cranial fossa housing the pituitary gland

140
Q

Which bone is the sella turcica part of

A

Sphenoid

141
Q

Sella turcica is anteriorly, inferiorly and posteriorly composed of

A

Anterior - Tuberculum sellae
Inferior - Pituitary (hypophyseal) fossa
Posterior - Dorsum sellae

142
Q

Name the 4 processes on anterior and posterior of the sella turcica

A

2 Anterior and 2 posterior clinoid processes

143
Q

Which fold of dura attaches to the clinoid processes

A

Tentorium cerebelli

144
Q

What lies in the grooves lateral to the sella turcica

A

Cavernous sinus

145
Q

Which foramen lies immediately anterior to the groove for the cavernous sinus

A

Superior orbital fissure

146
Q

Most structures that pass through the superior orbital fissure (i.e. CN III/IV/VI etc) actually pass within what sinus

A

Cavernous sinus

147
Q

What sinus lies in the groove in the midline of the inner surface of the skull cap

A

Superior saggital

148
Q

Bones that make up the base of the skull

A 
Palatine process of maxilla
Palatine bone
Vomer
Parts of temporal bone
Parts of occipital bone
Parts of sphenoid bone - medial and lateral pterygoid plates, pterygoid hamulus
149
Q

What is the pterygoid hamulus

A

Most inferior part of the medial pterygoid plate, forming a hook like process

150
Q

Muscle that attaches to the medial pterygoid plate

A

Superior pharyngeal constrictor

151
Q

Muscles that attach to the lateral pterygoid plate

A

Medial pterygoid muscle attaches to medial surface of lateral pterygoid plate

Lateral pterygoid muscle attaches to the lateral surface of the lateral pterygoid plate

152
Q

2 advantages of neonate having flexible skull

A

Allows for compression of skull during childbirth

Allows brain to grow + expand during infancy

153
Q

Disadvantage of neonate having flexible skull

A

Brain could get damaged through breakage of the fontanelles if you fall

154
Q

Type of ossification that occurs in flat bones of the skull

A

Membranous

155
Q

Type of ossification that occurs in irregular bones of the base of the skull

A

Endochondrial

156
Q

How many teeth do adults v child have

A

32

20

157
Q

Name differences between adult and foetal skulls (3)

A

Babies have fontanelles
32 teeth in adults, 20 in children
Babies don’t have styloid or mastoid process yet

158
Q

What age range does the anterior fontanelle fuse

A

18-24 months

159
Q

What age range does the posterior fontanelle fuse

A

2-3 months

160
Q

Another name for C1

A

Atlas

161
Q

What epithelium lines dorsal surface of tongue

A

Stratified squamous keratinised

162
Q

What type of muscle fibres lie under epithelium of tongue

A

Skeletal

163
Q

Name the 3 paired salivary glands

A

Parotid
Sublingual
Submandibular

164
Q

What is the rounded secretory component of a gland called, not just salivary gland

A

Acinus

165
Q

Serous acini secrete what type of secretion + describe the stain

A

Protein rich secretion so strain strongly with H&E stain

166
Q

Mucous acini secrete what type of secretion + describe the stain

A

Glycoprotein mucous so stain poorly (pale) with H&E stain

167
Q

What cells line the acinus of salivary glands + function of these cells

A

Myoepithelial cells

To help squeeze the contents of the salivary duct out

168
Q

What type of secretion does parotid gland secrete + describe its stain

A

Predominantly serous so strongly stained

169
Q

What type of secretion does submandibular gland secrete + describe its stain

A

Mixed serous and mucous so both dark + pale staining seen

170
Q

What type of secretion does sublingual gland secrete + describe its stain

A

Predominantly mucous so pale staining

171
Q

Name 4 conditions where a clinical sign can be seen at the anterior fontanelle in an infant

A

Hydrocephalus
Raised intracranial pressure
Meningitis
Dehydration

Year 2 - Nervous (39 decks)

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