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Clinical A and P > head 1 and 2 > Flashcards

head 1 and 2 Flashcards

1
Q

Layer of scalp with good lymph drainage

A

Skin

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2
Q

Layer of scalp with good supply of cutaneous nerve

A

Connective tissue

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3
Q

Layer of scalp with many potential spaces that can fill with fluid from injury/infection

A

Loose connective tissue

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4
Q

Importance of anterior fontanelle

A

Diamond shaped, closes by 18 months

Palpating this area can determine HR, ICP, and degree of hydration

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5
Q

Triangular shaped fontanelle

A

Posterior fontanelle

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6
Q

Accounts for half the cases of craniosynostosis and does not produce abnormal neuro development

A

Scaphocephaly (sagittal suture, “boat”)

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7
Q

Premature closure of the coronral or lambdoidal suture

A

Plagiocephaly “slanted”

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8
Q

More common in females, results in a tower shaped skull

A

Oxycephaly (coronal suture, “pointed”)

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9
Q

Tx of craniosynostosis

A

Helmit if suture is not fused

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10
Q

Bones of orbit of eye

A 
Zygomatic
Palatine
Sphenoid
Ethmoid
Maxilla
Lacrimal
Frontal
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11
Q

What bone are the superior, middle, and inferior conchae from?

A

Superior and middle –> ethmoid

Inferior –> palatine

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12
Q

Bone that makes up part of the lateral walls of the nasal cavities and part of the floor of the orbit

A

Maxillae

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13
Q

Two maxillae meet in the middle to form this

A

Intermaxillary suture

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14
Q

Where you would give a nerve block during facial laceration repair

A

Infraorbital foramen

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15
Q

Carries upper teeth

A

alveolar arch

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16
Q

Parts of zygomatic arch

A

maxilla and zygomatic process of the temporal bone

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17
Q

Fracture that crosses bony septum and pterygoid plates of sphenoid. “floating plate”

A

LeFort I

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18
Q

Fracture that separates central part of the face from the skull. “Floating maxilla”

A

LeFort II

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19
Q

Fracture that goes horizontally through superior orbital fissures, separates maxilla and zygomatic bones from rest of skull. “floating face”

A

LeFort III

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20
Q

Fracture that is most likely to result in facial numbness from injury of infraorbital nerve

A

LeFort II “Floating maxilla”

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21
Q

Thinnest part of the lateral wall of the skull that overlies anterior division of the middle meningeal artery

A

Pterion

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22
Q

What condition are we concerned about the middle meningeal artery with?

A

Epidural hematoma

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23
Q

Bones that form the occiput

A

Occipital, parietal, temporal

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24
Q

Inion

A

External occipital protuberance

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25
Q

What structures pass through the foramen magnum?

A 
Spinal cord
Meninges
Vertebral areries
A + P spinal arteries
Spinal branches of accessory nerve (CN 11)
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26
Q

Most superior part of the skull near the midpoint of the sagittal suture

A

Vertex

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27
Q

Landmark formed by the intersection of the sagittal and coronal sutures

A

Bregma

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28
Q

junction of sagittal and lamboidal sutures

A

Lambda

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29
Q

Bones that form the hard palate

A

Maxilla
Palatine
Above posterior edge are choanae, separated by vomer and bound by sphenoid (medial pterygoid plates)

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30
Q

Structures that pass through jugular foramen

A

Internal jugular vein

Cranial nerves 9, 10, and 11

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31
Q

Structures that pass through the internal acoustic meatus

A

Cranial nerves 7 and 8 (facial and vestibulocochlear)

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32
Q

Structures that pass through stylomastoid foramen

A

Cranial nerve 7 (facial) and stylomastoid artery

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33
Q

structures in anterior cranial fossa

A

frontal lobes
crista galli (cock’s comb)
Olfactory nerve

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34
Q

Structures of middle cranial fossa

A

Temporal lobes
Optic canal (optic nerve and opthalmic artery)
Sella turcica

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35
Q

Horn of the saddle

A

Tuberculum sella

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36
Q

Where pituitary gland sits

A

Hypophyseal fossa

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37
Q

Back of the saddle, makes posterior clinoid process

A

Dorsum sellae

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38
Q

Tentorium cerebelli attaches here

A

sella turcica

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39
Q

Connects pituitary to hypothalamus

A

Infundibulum

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40
Q

Anterior lobe of pituitary

A

Adenohypophysis

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41
Q

Posterior lobe of the pituitary

A

neruohypophysis

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42
Q

Route for pituitary surgery

A

Transsphenoidal (endonasal route)

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43
Q

Where is the optic chiasm in relation to the pituitary?

A

superior

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44
Q

Lateral to pituitary gland are what strucutres?

A

Cavernous sinus, which contains

CN 3, CN 4, CN 5, CN 6 and internal carotid artery

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45
Q

Structures in cavernous sinus

A

CN 3-6, internal carotid artery

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46
Q

Structures that pass through the superior orbital fissure

A

CN 2, 3, 4, 6 (just not trigeminal) and opthalmic VEIN

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47
Q

Where does the maxillary division (V2) of the trigeminal nerve pass through? What does it supply?

A

Foramen rotundum

Skin, teeth, cheek mucosa

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48
Q

Where does the mandibular division of the trigeminal nerve pass through?

A

Foramen ovale

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49
Q

What passes through the foramen spinosum?

A

Middle meningeal artery

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50
Q

What passes OVER the foramen lacerum?

A

Internal carotid artery

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51
Q

“battle signs”, “raccoon’s eyes”, clear fluid/blood from external ear canal/nose, and hemotympanum are signs of what?

A

basilar skull fracture (cranial base fx)

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52
Q

Shallowest and deepest cranial fossa

A

Shallow: anterior
Deep: Posterior

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53
Q

Structures in the posterior cranial fossa

A 
hind brain (cerebellu, pons, medulla)
Jugular foramen (CN 9.10.11)
Internal acoustic meatus (CN7,8)
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54
Q

Where does the sigmoid sinus leave the skull to become the internal jugular vein?

A

Posterior cranial fossa

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55
Q

what lies between the periosteal and meningeal layer of the dura mater?

A

Dural venous sinuses

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56
Q

What do dural venous sinuses do?

A

Collect venous drainage and CSF and drain to internal jugular vein

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57
Q

Which meninge has direct communication with the 4th ventricle via Foramen of Magendie and the paired foramen of Luschka?

A

Subarachnoid space

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58
Q

Which layer gives rise to the falx cerebri?

A

Pia mater

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59
Q

Where is CSF produced?

A

Choroid plexus, in lateral, 3rd, and 4th ventricl.es

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60
Q

Leptomeninges

A

Arachnoid and pia mater. Both composed of loose CT

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61
Q

separates the cerebellum from the cerebral hemisphere.

A

Tentorium cerebelli

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62
Q

Allows communication between cerebellum and cerebral hemisphere

A

Tentorial incisure

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63
Q

Separates cerebellar hemispheres

A

Falx cerebelli

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64
Q

Dura mater blood supply

A

Middle meningeal artery

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65
Q

Blood supply of pituitary

A

Branches of internal carotid artery

Sup. and Iinf. hypophyseal artery

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66
Q

Which hormone stimulates spermatogenesis and follicle growth?

A

FSH

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67
Q

Which hormone stimulates ovulation?

A

LH

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68
Q

Which sinuses become the sigmoid sinuses?

A

Transverse sinuses

69
Q

Which sinuses become the internal jugular veins?

A

sigmoid sinuses

70
Q

Right transverse sinus is also made of what?

A

Superior sagittal sinus

71
Q

Straight sinus is made of what?

A

Union of inferior sagittal sinus and great cerebral vein (junction of falx cerebri and tentorium cerebelli)

72
Q

Left transverse sinus is a continuation of what?

A

straight sinus

73
Q

What goes into the cavernous sinus?

A

Inferior ophthlamic vein and central vein of the retina

74
Q

Where does the cavernous sinus drain?

A

Transverse sinus

75
Q

What travels through the sella turcica connecting the two cavernous sinuses?

A

Internal carotid artery
CN 3-6
Hypophysis cerebri
Veins of the face

76
Q

How can a sinus infection spread to the CNS if left untreated?

A

Through facial vein (NO VALVES) and inferior ophthalmic vein which drain into the cavernous sinus

77
Q

“vowels” of bleeding in the head

A

Epidural
Arterial, oval, interval (lucid)
Middle meningeal artery

78
Q

“consonants” of bleeding in the head

A

Subdural
Venous, crescent, shearing force
Emissary veins usually affected

79
Q

Amorphous appearance in brain bleed

A

Subarachnoid hemorrhage

80
Q

Fracture of jaw

A

Usually involves 2 fractures on opposing sides

Usually in region of opposite canine tooth

81
Q

Nerve supply of muscles involved in mastication

A

Mandibular division of trigeminal nerve

82
Q

Muscles that elevate the mandible

A

Medial pterygoid, anterior temporalis, masseter

83
Q

Muscle that acts to protrude the jaw

A

lateral pterygoid

84
Q

Retraction of jaw

A

Posterior temporalis

85
Q

Depression of jaw

A

gravity, platysma

86
Q

What nerve supplies periorbital structures?

A

Facial nerve

87
Q

Pulls the eyes closed taught

A

orbital part of orbicularis oculi

88
Q

Closes the eyelids gently

A

Palpebral part of orbicularis oculi

89
Q

Empties tears from lacrimal sac

A

Lacrimal part of orbicularis oculi

90
Q

Pulls eyebrows medially

A

Corrugator supercilli

91
Q

Moves scalp on skull, raises eyebrows, furrows the forehead

A

Occipitofrontalis

92
Q

Wrinkles skin at root of nose (for nasal breathers)

A

Procerus

93
Q

Sphincter muscle of lips

A

Oricularis Oris

94
Q

Dilator of lips

A

Levator labii superioris, levator labii inferioris, zygomaticus major, zygomaticus minor, levator angulii oris, risorius muscle

95
Q

Compresses cheeks and lips against teeth preventing it from folding and being injured during chewing

A

Buccinatior

96
Q

“Dicke turtleneck”

A

platysma

97
Q

Most common location for facial nerve to be affected

A

Stylomastoid foramen

98
Q

Lower lid everts, difficulty chewing, drooping of mouth are characteristic of what?

A

Injury to facial nerve

99
Q

Food gets stuck in corners of mouth, dribbles out. What muscles are affected?

A

buccinator and orbicularis oris

100
Q

Pt presents with sudden attacks of excruciating lightening like jabs of facial pain that last 15 minutes. What is this called and what nerve is affected?

A 
Trigeminal neuralgia "Tic douloureux)
Maxillary nerve (V2) most commonly involved.
101
Q

Branches of facial nerve

A 
Tell Ziggy Bob Marley Called
Temporal
Zygomatic
Buccal
Mandibular
Cervical
102
Q

Branch of facial nerve that supplies occipitofrontalis and superior part of orbicularis oculi, as well as auricularis

A

Temporal branch

103
Q

Branch of facial nerve that supplies inferior part of orbicularis oculi. Injury here causes ectropion, corneal ulcer

A

Zygomatic branch

104
Q

Branch of facial nerve that supplies buccinator and upper part of orbicularis oris and levator labii. Lesion prevents emptying of food from the vestibule of cheek

A

Buccal branch

105
Q

Branch of facial nerve that supplies risorius and muscles of lower lip and chin. Paralysis causes drooping of the mouth

A

Mandibular branch

106
Q

Branch of facial nerve that supplies the platysma

A

Cervical branch

107
Q

Vascular supply to right side of head

A

Brachiocephalic trunk to

Right subclavian artery and right common carotid artery

108
Q

External carotid artery in order from inferior to superior

Some Ladies Find Makeup Stupid

A 
Superior thyroid
Linugal
Facial
Maxillary (middle meningeal)
Superficial temporal (major supply to scalp)
109
Q

Vascular supply of left side of head

A

Left common carotid and left subclavian artery directly off the aorta. The rest follows the same as the right side

110
Q

Trauma to the orbital walls causing fracture and displacement. What’s it called and what should you assess for?

A

“blowout fracture”
EOMs
Exophthalmos
Hyphema

111
Q

What travels through the superior orbital fissure?

A

CN 3,4,5 (V1),6 and superior ophthlamic vein

112
Q

What travels through the inferior orbital fissure?

A

CN 5 (V2, maxillary), and inferior ophthalmic vein

113
Q

What passes through the optic canal?

A

Optic nerve and ophthalmic artery

114
Q

What cranial nerve supplies lateral rectus?

A

6

115
Q

What cranial nerve supplies superior oblique?

A

4

116
Q

What nerve supplies all eye muscles besides lateral rectus and superior oblique?

A

3

117
Q

Paralysis of EOM results in what?

A

diplopia

118
Q

What EOM allows incyclotorsion?

A 
Superior oblique
(cornea looks downward and medial)
119
Q

What EOM allows excyclotorsion?

A

Inferior oblique

cornea looks upward and lateral

120
Q

Provides converging power for the eye, main refractive surface of eye.

A

Cornea

121
Q

Area of sclera that is pierced by the nerve fibers of the optic nerve

A

Lamina cribrosa

122
Q

Where sclera is directly continuous with the cornea

A

limbus

123
Q

Blood supply to outer retina is from this

A

choroid

124
Q

Changes shape of lens, secretes aqueous humor to fill anterior and posterior chambers of the eye

A

Ciliary body (sp. muscles and processes)

125
Q

“blind spot” of the eye

A

optic disk; contains nerve fibers but no photoreceptors

126
Q

Area of most acute vision

A

Fovea centralis (found in the macula)

127
Q

What nerve allows accomodation of the lens?

A

CN 8

128
Q

Cranial nerve that dilates pipil

A

CN2 (sympathetic control)

129
Q

Cranial nerve that constricts pupil

A

CN 3 (parasympathetic control)

130
Q

First sign of compression of CN3 (oculomotor) is what?

A

ipsilateral slowness of pupillary response to light

131
Q

Where does the aqueous humor drain into?

A

Canal of Schlem

132
Q

Circulation of aqeuous humor in the eye

A

Posterior chamber –> pupil –> anterior chamber –> canal of Schlemm –> venous system

133
Q

Thickened structure at the lid margins to form the tarsal plates.

A

Ortibal septum

134
Q

The orbital septum is thickened at the lid margins to form the ______.

A

Tarsal plates

135
Q

Why does your nose run when you cry?

A

Tears enter lacrimal sac in upper end of nasolacrimal duct, which enters inferior meatus of the nose

136
Q

Curved tube about 1 inch long that leads from auricle to TM.

A

External Auditory meatus

137
Q

Middle ear is also known as…?

A

tympanic cavity

138
Q

Located at the depth of the depression of the tympanic membrane

A

Umbo (can see cone of light)

139
Q

Footplate of stapes contacts cochlea at _______.

A

oval window

140
Q

What does the stapedius muscle do and what happens if it’s injured? Innervation?

A

dampens down vibrations of stapes
Hyperacusis
Facial nerve CN7

141
Q

Contraction reduces sound pressure and transmission by dampening movement of ossicular chain. Muscle and innervation

A

Tensor tympani muscle

CV mandibular branch (V3)

142
Q

Muscles that open the auditory/Eustachian tube

A

Soft palate muscles:
Levator veli palatine
Tensor veli palatine

143
Q

Reception of sound and maintenance of balance

A

Vestibulocochlear organ

144
Q

Contains endolymph

A

Membranous labyrinth

145
Q

Contains perilymph

A

Bony labyrinth

146
Q

Tx of external ear injury

A

Aspiration to avoid cauliflower ear

147
Q

Pt has untreated middle ear infection. What can it cause and where can it spread?

A

Mastoiditis

Dural venous sinuses

148
Q

Each nasal cavity extends from the nostril int eh front to the ______ behind

A

Choanae

149
Q

Superior meatus lies (above, below) superior concha

A

Below

150
Q

Where does the maxillary sinus, frontal sinus, and anterior and middle ethmoidal sinuses drain?

A

Middle meatus

151
Q

Where does the nasolacrimal duct drain?

A

Inferior meatus

152
Q

What is “Kiesselbach’s area”

A

Anterior third of the nose where someone is most likely to have a nosebleed

153
Q

What does a nosebleed increase your chances for?

A

meningitis

154
Q

Where do sphenoidal sinuses drain?

A

Sphenoethmoidal recess above superior conchae

155
Q

Where do posterior ethmoidal sinuses drain to?

A

Superior meatus

156
Q

Infection of the ethmoidal cells

A

Sinusitis

157
Q

What can result from bacteria from sinusitis breaking through the thin plate between ethmoid and orbit?

A

Blindness or optic neuritis

158
Q

What sinuses are most commonly infected?

A

Maxillary. Ostia here do not drain well.

159
Q

What symptom do people with maxillary sinus infections often complain of?

A

toothache

160
Q

How many teeth do children have? Adults?

A

20 deciduous teeth

32 secondary teeth

161
Q

What type of muscle is the tongue?

A

striated

162
Q

Where are different flavors detected on the tongue?

A

Sweetness: tip
Saltiness: Lateral margins
Bitterness: Posterior part

163
Q

Intrinsic muscles of the tongue (after its shape)

A

Longitudinal
Transverse
Vertical

164
Q

Extrinsic muscles of the tongue (after position)

A

Genioglossus, hyoglossus, styloglossus

165
Q

Pts tongue is noted to fall posteriorly. You are worried about their airway becoming obstructed. What muscle is damaged?

A

genioglossus

166
Q

Pts tongue is paralyzed and one side is atrophied. What muscle is affected?

A

hyoglossus

167
Q

Retracts and draws tongue up to create trough for swallowing

A

Styloglossus (swallow “s)

168
Q

Elevates posterior part and is related to the gag reflex. Muscle and innervation

A

Palatoglossus afferent of CN9 and efferent of CNX (vagus)

puke “p”

169
Q

Tx of being “tongue tied”

A

frenectomy

Clinical A and P (5 decks)

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