Head Flashcards
Foramen caecum site and transmits
Frontal, most anterior foramen
Has emissary vein to superior sagittal sinus
Optic canal contents
Optic n
Ophthalmic A
Superior orbital fissure contents
CN3
CN4
Lacrimal, frontal, nasociliary branch CNV1
CN6
Sup opthalmic V
Foramen rotundum transmits
CNV2
Foramen ovale transmits
CNV3
Accessory meningeal A
Lesser petrosal N (occasionally)
Foramen spinosum transmits
Middle meningeal A+V
Meningeal branch of mandibular nerve
Jugular foramen transmits
Inferior petrosal sinus
Glossopharyngeal N
Vagus N
Accessory N
Sigmoid sinus
Posterior meningeal A
Foramen magnum transmits
Medulla oblongata
Meninges
Vertebral A
Meningeal branches of vertebral A
Spinal roots of accessory nerves
Space b/w arachnoid and duramater
Subdural space
Where are the arachnoid ville
Herniate into dura mater
What are the cisterns of the brain
Cerebellomedullary cistern
Pontine cistern
Interpenducular cistern
Chiasmatic cistern
What is the point of a cistern
For pooling CSF
What produces CSF & where
Choroid plexus, lateral, 3rd, 4th ventricle
How much production of CSF/day
500ml
What are the parts of lateral ventricle
Body, anterior, posterior and inferior horns
Flow of CSF
Choroid plexus => ant horn of lateral ventricle => interventricular foramen => 3rd ventricle => cerebral aqueduct => 4th ventricle
How does CSF exit the flow
Via lateral aperature or median
What are the folds of the inner layer of dura that project into the cranial cavity
Tentorium cerebelloi
Falx cerebri
Falx cerebella
Diaphragma sellae
What does the tentorium cerebelli separate
Superior petrosal & transverse sinuses, roofs the posterior cranial fossa
What are the attachments of tentorium cerebelli
Posterior clinoid process
Upper border of petrous temporal bone
Inner surface of each side of the skull to internal occipital protuberance
What does the falx cerebri separate
2 hemispheres
What are the attachments of falx cerebri
Crista galli of ethmoid bone
Upper surface of tentoium
Falx cerebella extends from
Internal occipital protuberance to post margin of foramen magnum
Blood supply to anterior cranial cavity
Anterior meningeal branch of ant ethmoidal A
Post ethmoidal A
Blood supply to middle cranial fossa
Middle meningeal A
Blood supply to post cranial fossa
Anterior and posterior meningeal branches of vertebral A
Where does the middle meningeal A arise
From maxillary A
Where does the middle meningeal A enter to reach the vault
Foramen spinosum
What is the drainage of the marrow blood of the skull
Via diploic veins into superior sagittal sinus OR middle meningeal V (into pterygoid plexus)
Nerve supply of anterior cranial fossa
Anterior, posterior ethmoidal N
Twigs from maxillary N
Nerve supply of middle cranial fossa
ANterior portion from maxilary branch
Pot by meningeal branch of mandibular N
Posterior fossa nerve supply
Meningeal branches of vagus & hypoglossal
What are the dural sinuses (names)
Superior sagittal sinus
Inferior sagittal sinus
Transverse sinus
Straight sinus
Superior petrsoal sinus
Sigmoid sinus
Occipital sinus
Where does superior sagittal sinus run
B/w hemispheres
Where does the inferior sagittal sinus run
B/w hemispheres, below superior
What joins to form the sigmoid sinus
Superior petrosal sinus & transverse sinus
What does the sigmoid sinus become
IJV
What drains cavernous sinus
Superior and inferior petrosal sinus =>sigmoid sinus => IJV
Where does the cavernous sinus lie
Body of sphenoid bone in middle cranial fossawhat
What does the cavernous sinus contain
ICA
CN3, CNV, CNV1, CNV2, CNVI, sympathetic plexus
Boundaries of cavernous sinus
Medial = roof continuous with diaphragm sellae
Lateral = inner layer of dura across middle cranial fossa
Anterior = roof attached to anterior & middle clinoid process
Post = roof has a triangular depression b/w attachment to post clinoid process
Floor - narrow strip of periosteum along base of greater wing of sphenoid
Relations medially to the cavernous sinus
Lateral wall of pituitary fossa
Body of sphenoid with air cells
Lateral relations to cavernous sinus
Medial surface of temporal lobe
Superior relations to cavernous sinus
Emerging ICA lies in contact with roof
What does CNIII pick up in cavernous sinus
Symp fibres from ICA for levator palpebrae superioris
What passes through foramen lacerum
Greater petrosal nerve
Where does the trigeminal ganglion lie
In a cavity called meckel’s cave in the dura mater near petrous part of temporal bone
What are the veins of the cavernous sinus
Superior orbital V
Inferior orbital V
Sphenoparietal sinus
Superior petrosal sinus
Inferior petrosal sinus
Intercavernous sinuses
What is a carotid-cavernous fistula
Rupture of ICA within cavernous sinus , an A-V fistula is created
What is cavernous sinus syndrome
Lesions affecting the cavenrous sinus
Ophthalmoplegia
Ophthalmic sensory loss
Maxillary senosry loss
Fixed, dilated pupil
Horners
Where would an infection/thrombophlebitis arise if it affected the cavernous sinus
Upper lip, nose, medial cheek
Areas associated with facial V
What bones makes the anterior cranial fossa
Frontal bone
Cribiform plate of ethmoid
Lesser wing & anterior part of sphenoid
What are the anterior and posterior boundaries of middle cranial fossa
Lesser wing of sphenoid
Petrous temporal bone
Superior petrosal sinus
What sits in the median part of the middle cranial fossa
Pituitary gland
Optic nerves & chiasma
Intercavernous sinus
What lies in lateral parts of the middle cranial fossa
Cavernous sinus
III, VI, trigeminal ganglion
ICA
Middle & accessory meningeal vessels
Greater & lesser petrosal n
Temporal lobe
Blood supply of pituitary gland
Single inferior & several superior hypophyseal arteries arise from ICA
Pars anterior releases
GH, PRL, ACTH, FSH, LH, TSH
Pars posterior releases
Oxytocin, ADH
Ophthalmic A arises from
ICA, immedaiately above roof of cavernous sinus
Where is the optic N in relation to ophthalmic A
Optic nerve is above & medial
Where does trochlear nerve emerge
Dorsal surface of brainstem
What does post comm a do
Join ICA & PCA in circle of willis
What are the boundaries of the trigeminal cave/meckel’s cave
Cerebellar tentorium superolatearlly
Lateral wall of cavernous sinus superomedially
Clivus medially
Post petrous face inferolaterally
Blood supply of trigeminal ganglion
Accessory meningeal A
Small branches from ICA
Where does CNV3 pass through
Foramen ovale
Where does CNV2 pass through
Foramen rotundum
Where does CNV1 pass through
SOF
What is the course of greater petrosal N
Emerges from hiatus in petrous bone, runs beneath trigeminal ganglion to foramen lacerum
Joined by deep petrosal nerve to form VIDIAN Nerve
Enters the pterygopalatine ganglion
What is the course of lesser petrosal N
From CN9
Leaves hiatus, runs to emerge from foramen ovale & join otic ganglion
What does the post cranial fossa lodge
Cerebellar hemispheres
Pons
Medulla oblongata
In it nerves CNV-XII pierce the dura mater
Where does trigeminal nerve arise
Anterolateral surface of pons (2 roots)
Where does the vestibulocochlear nerves and facial nerves arise
With nervous intermedius (which goes on to give greater petrosal n) leave lateral end of junction b/w pons &medulla to enter IAM with labyrinthe artery
What is the nervus intermedius origin and goal
Part of facial
Contributes to greater petosal N
Labyrinthe origin
Branch of basilar OR AICA
Where is IAM set
Post surface of petrous bone of temporal bone
What nerves arise from medulla oblongata
CN9, 10, 11 as a series of rootlets b./w olive & Inf cerebellar peduncle then exit through jugular foramen
What are the compartments and contents of jugular foramen
Anterior - CN9, IPS
Middle - CN10, 11
Post - sigmoid sinus
Where does hypoglossal nerve arise and exit
Series of rootlets b/w pyramid & olive
Enter hypoglossal canal
Arterial supply to posterior fossa
Vertebral A
Basilar A
What does the vertebral A give off
Small post spinal A
Ant spinal A
PICA to form basilar A
Where does basilar A run
Up infront of pons
Branches of basilar A
AICA
Pontine branches
Labyrinthe A
Ends by dividing into PCA
Olfactory nerve course
20 filaments, through foramina in cribiform plate, pierce dura & arachnoid mater of anterior cranial fossa
Enter olfactory bulb
What are rods & cones supply
Rods - photosensitive
Cones - coloursensitive
What is the course of CNII
Via optic canal, then chiasma then decussate to LGN -> optic radiation -> visual cortex
Division of CNIII
Superior - sup rectus & levator palpebrae superioris
Inf- mid rectus, inf rectus, inf oblique
CNIV arises from & travels
From dorsal midbrain, around cerebral pedunble b/w PCA and sup cerebellar A
Then passes in lateral wall of cavernous sinus
Then SOF to within tendinous ring to sup oblique
Ophthalmic nerve branches that pass through SOF
Lacrimal
Frontal
Nasociliary
Lacrimal nerve origin
CNV1
Lacrimal nerve supplies
Secremotor branch
Skin of upper lateral eyelid, both palpebral & ocular surfces of conjunctiva
Frontal nerve origin
CNV1
Frontal N division & supplies
Supraorbital N - front sinus
Supratrochlear N - upper lid & conjunctiva, central strip of forehead
Nasociliary N origin
CNV1
Nasociliary N broadly supplies
Sensory to whole eyeball, paranasal sinuses along medial wall of orbit, mucus membranes of nasal cavity & skin of external nose
Branches of nasociliary N
Anterior ethmoidal
Infratrochlear
Post ethmoidal
Communicating branch
Long ciliary nerves
What does the long ciliary nerve carry
SNS fibres to dilator papillae muscle & sensory to eye including cornea
Course of CNV2
Through lateral wall cavernous sinus
Foramen rotundum
Upper part of pterygopalatine foramen
Deviates into inf orbital fissure, infraorbital groove to become INFRAORBITAL
Branches of CNV2
Nasal (nasopalatine, post sup nasal)
Greater, lesser palatine
Orbital
Pharyngeal N
Zygomatic n (zygomaticofacial, zygomaticotemporal)
Post sup alveolar nerve
Infraorbital
Nasopalatine nerve origin
CNV2
Nasopalatine n supplies
Gum behind 2 incisor teeth
Posterior superior nasal nerves origin
CNV2
Post sup nasal nerve supplies
Lateral wall of nose & septum
Greater palatine nerve origin
CNV2
Greater palatine nerve supply
Lateral wall of nose & medial wall of maxillary sinus
Lesser palatine nerve origin
CNV2
Lesser palatine nerve supplies
Palatine tonsil
Zygomatic nerve branches
Zygomaticotemporal
Zygomaticofacial
When does the zygomatic branch form
In iOF
Origin of zygomatic branch
CNV2
Infraorbital nerve supplies
Lower lid conjunctiva, skin of lower lid, mid face, cheek, nose, upper lip & labial gum
Branches of the mandibular nerve
Small anterior branch *mainly motor
Large posterior branch * mainly senosry
Branches from main trunk of mandibular N prior to divison
Meningeal branch (to middle cranial fossa)
Nerve to medial pterygoid
Branches of ant div of CNV3 & supplies
Two deep temporal branches (lateral pterygoid, temporalis)
Masseteric n
N to lateral pterygoid
Buccal n (only sensory nerve)
Abducens nerve course
Emerges from lower border of pons
Enters pontine cistern
Passes b/w AICA and pons
Passes into cavernous sinus, inferolateral to ICA
Enters SOF through tendinous ring to lateral rectus
CN7 intracranial branches
Greater petrsoal nerve
Nerve to stapedius
Chorda tympani
Course of CN7
Emerges from lower border of pons above olive
B/w pons and inferior cerebellar peduncle near CN8
Enter into IAM
Run into petrous bone, then into facial canal and emerges from stylomastoid foramen
Passes through parotid gland
Which foramen does greater petrsoal nerve pass through
Foramen spinosum
Greater petrosal n supplies
With deep petrosal nerve (to form vidian n)
Relays secrotomotors fibres
Taste from soft palate & SNS
Secretomotor to nose, paranasal sinus, hard, soft palate & nasopharynx
Chorda tympani
From CN&, secretomotor fibres to submandibular ganglion
Extracranial branches of CN7
Post auricular n
Nerves to post belly of digastric & stylohyoid
5 branches of parotid (temporal, zygomatic, buccal, marginal mandibular, cervical)
Receptors of CN8
Cochlear n - spiral organ hair cells in internal ear
Vestibular n - hair cells in maculae of utricle & saccule & ampullae of semicircular ducts
CN9 course
Emerges on surface of medulla b/w olive and inf cerebellar peduncle in a series of rootlets
Enters ant compartment of jugular foramen
Tympanic nerve given off in ganglion
Pases b/w IJV and iCA , then b/w ICA & ECA
Passes b/w superior & inferior constrictors
Branches of CN9
Tympanic branch
N to stylophgaryngeus *only muscular
Carotid branch
Pharyngeal branch
Tonsilar branch
Lingual branch
Vagus nerve course
Leaves medulla in rootlets in b.w olive & inf cerebellar peduncle
Unite to enter middle compartment of jugular foramen
Runs in carotid sheath, deep to ICA/CCA & IJV
Branches in neck of vagus
Small meningeal, auricular & carotid body
Pharyngeal brach
Superior laryngeal branch *int/ext n
Cervical cardiac branch (deep, superfiical)
R & L recurrent laryngeal nerves
Journey of vagus in mediastinum
L lies b/w CCA and subclavian arteries, crosses L side of aortic arch
R comes into contact with trachea
Both pass BEHIND lung root, contributing to ant/post pulmonary plexus
Then break into oesophageal plexuses
Pass through oesophageal opening
Ant vagal - hepatic
Post vagal - coeliac
Accessory nerve course
Spinal root - ant horn of upper 5-6 cervical segments
Cranial - b/w olive & inf cerebellar peduncle
unite to form ACCESSORY NERVE
middle compartment of jugular foramen
lie infront of TP of atlas
supply SCM & trapezius
hypoglossal course
surface of medulla b/w pyramig & olive
enter hypoglossal canal and emerge as 1 nerve
pass b/w IJV & ICA
cross the carotids and loop at lingual A
nerve passes sup to hyoglossuss *lingual a passes deep
hypoglossal nerve supplies
all muscles of tongue EXCEPT palatoglossus
branches of sup root of ansa cervicalis supply
omohyoid
sternohyoid
sternothyroid
sutures of the skull
coronal
bregma
sagittal
lambda
what is it called when frontal bones fail to fuse
metopic suture
lambda is the
site where sagittal suture meets lambdoid suture
occipital protuberance
both int & ext, lie approx 6cm below lambda
sup nuchal line and such insert here
temporalis arises from
inf temporal line
what forms zygomatic arch
zygomatic process of temporal bone & temporal process of zygomatic bone
what crosses the zygomatic arch
auriculotemporal n
superificial temporal N
temporal & zygomatic branches of facial N
what gives rise to buccinator
tuberosity of maxilla
where do rectus capitis post minor & major insert
foramen magnum
where do semispinalis capitis & superior oblique insert
superior & inferior nuchal lines
what type of joint is the atlanto-occipital
ball & socket
pharyngeal tubercle site & what attaches here
anterior to foramen magnum, site of attachment of pharyngobasilar fascia
what muscles attach on styloid process & where
stylopharyngeus, high up medially
stylohyoid, high up post
styloglossus low down in front
Stylohyoid lig, from tip
What is transmitted in stylomastoid foramen
Facial n
Stylomastoid branch of post auricular vessels
What is transmitted in foramen ovale
V3
Accessory meningeal A
Lesser petrosal N
Emissary V
Foramen spinosum transmits
Middle meningeal vessels
Medial pterygoid plate attachments
Pterygomandibular raphe
Auditory tube
Pharyngobasilar fascia
Attachments of lateral pterygoid plate
Lower head of lat pterygoid m
Deep head of medial pterygoid m
Incisive fossa transmits
Greater palatine artery
Nasopalatine N
Greater palatine foramen transmits
Greater palatine n and vessels
Lesser palatine foramen transmits
Lesser palatine n + vessels
Mandible features
Body
Ramus
Neck
Head
Condylar process
Coronoid process
What part of mandible do the buccinators attach
Ext oblique line
Which muscle inserts on the ramus
Masseter
What attaches to coronoid process
Temporalis
Inner surface of mandible is characterised by
Mylohyoid line
Mental spines
Digastric fossae
Sublingual fossa (above mylohyoid line)
Submandibular fossa
Medial surface of ramus is characterised by
Lingula
Mandibular foramen
Sphenomandibular lig
Medial pterygoid m
Hyoid bone features
Body
Greater horn
Lesser horn
What level does hyoid bone lie at
C3
Where does thyrohyoid muscle attach
Upper border of body
Greater horns
Where does sternohyoid & omohyoid attach
Lower border of hyoid
Where does thyrohyoid attach
Lower border of greater horn
What is anterior to all muscles that attach to hyoid bone
Investing layer of deep cervical fascia
What does the lesser horn of hyoid give attachment to (lig)
Stylohyoid lig
Where does the middle constrictor arise
Stylohyoid lig & whole of greater horn & lateral part of hyoid body
Where does hypoglossus arise
Lateral to the medial constrictor,
Whole length of greater horn & the lateral part of body
What is the fibrous sling that digastrics attach to
Split tendon of stylohyoid
