Head And Neck Flashcards
The skull consists of the ____________ and the ____________ skeleton
Cranium and facial
What is the cranium
- Bony container for the brain
- Foundation for the facial skeleton
Purpose of the cranium
- Enclose brain
- Provide attachment sites for some head and neck muscles
What are the seven accessory bones
6 bones of the ears (ossicles)
- 2 malleus
-2 incus
-2 stapes
1 hyoid bone
Function of facial bones
(Hint: 5)
- Form a framework of the face
- Form cavities for the sense organs of sight, taste, and smell
- Provide openings for the passage of air and food
- Hold the teeth
- Anchor muscles of the face
Facial bones form the __________aspect of the skull
Anterior
Cranium is divided into 2 parts
- Cranial vault (chamber/cavity of cranium)
- Base
What divides the skull internally into distinct fossae?
Prominent bony ridges
How many cranial fossae do we have ? And what are they ?
3
- anterior cranial fossa
- middle cranial fossa
- posterior cranial fossa
Cranial fossae is on the ____________ aspect of the skull
Interior
How many bones make up the skull ?
29
How many bones make up the face
14
How many bones make up the cranium
8
How many bones make up the associated/accessory bones?
7
What bones make up the face
What bones make up the cranium
What bones make up the associated bones of the skull?
Importance of the hyoid bone
- Supports the larynx
- attachment site for muscles of larynx, pharynx, and tongue
The only bone in the body that does not articulate with any other bone
Hyoid bone
What are sutures
Lines of fusion between cranial bones
Lines of fusion between cranial bones are called ?
Sutures
True or false
Sutures are fully formed in an infant/fetus
False
True or false
In an infant/fetus, the ossification is not complete and the sutures are not fully formed
True
Since infants and fetuses do not have fully developed sutures, what do they have in the spaces between the cranial bones ?
A tough, fibrous membrane (mesenchymal tissue) called FONTANELS
What are fontanels
Mesenchyme-filled spaces between cranial bones that are present at birth
Fontanels are referred to as
“ Soft spots “
Purpose of fontanelles and sutures ?
(Why are they needed for the infant?)
Allows infant’s brain growth and development and expansion of the skull
How many fontanels are there
6 fontanels
(2 paired and 2 unpaired )
What are the 6 fontanels
Which fontanel is the largest fontanel
Unpaired anterior fontanel
Which fontanel is located at the midline between the two parietal bones and the frontal bone ?
Unpaired anterior fontanel
When does the unpaired anterior fontanel close?
Between 9 - 18 months
Which fontanel is located at the midline between the two parietal bones and the occipital bone
Unpaired posterior fontanel
When does the unpaired posterior fontanel close?
Between 1 - 2 months
Which fontanel closes before the other ; unpaired anterior or unpaired posterior ?
Unpaired posterior fontanel closes before the unpaired anterior fontanel
True or false
The unpaired posterior fontanel may already be closed at birth
True
Which fontanels are located laterally between the frontal, parietal, temporal, and sphenoid bones and are SMALL and irregularly shaped
Paired anterolateral fontanels
Which fontanel is located laterally between the parietal, occipital, and temporal bone, and is irregular shaped
Paired posterolateral fontanels
An immovable joint in an adult skull that holds most skull bones together
Suture
What sutures are present on the adult skull
Coronal suture
Sagittal suture
Lambdoid suture
Squamous suture
Which suture unites the frontal bone and both parietal bones
coronal suture
Which suture unites the two parietal bones on the superior midline of the skull
Sagittal suture
Which suture unites the two parietal bones to the occipital bone
Lambdoid suture
Which suture unites the parietal and temporal bones on the lateral aspect of the skull 
Squamous suture
Which suture is a vertical fibrous joint that divides the two halves of the frontal bone and is present in a newborn
Metopic suture
Which suture is ONLY present in infants/newborns and NOT adults
Metopic suture
The intersection of the two sutures: the coronal suture and the sagittal suture
Bregma
Bregma is the intersection between what two sutures?
Coronal suture and sagittal suture
Intersection between the two parietal bones and the occipital bone
Lambda
Lambda is the intersection between what bones ?
2 parietal bones and occipital bones
(Basically the intersection between the sagittal suture and Lambdoid suture)
What bones does the Pterion join
Frontal
Parietal
Temporal
Sphenoid
How many bones does the pterion join
4
What bones does the asterion join
Parietal
Temporal
Occipital
How many bones does the asterion join
3
What is nasion
Bony depression between eyebrows/eyes where the frontal and two nasal bones meet
(Also known as bridge of nose)
What is glabella
Smooth part of the forehead between the eyebrows
True or false
Glabella is located under the nasion
False
Glabella is ABOVE the nasion
What two bones form the zygomatic arch
Temporal bone (zygomatic process)
Zygomatic bone (temporal bone)
What joint is present beneath the zygomatic arch
Temporomandibular joint
What is the outer ear opening called
External acoustic meatus
The external acoustic meatus continues inside the skull to become ________________
Internal acoustic meatus
How many bones form the orbital cavity
7
What two bones form the hard palate
Maxilla (2/3)
Palatine (1/3)
What bone separates the nasal cavity into left and right
Vomer
What do the frontal bones form
- the forehead
- roofs of the orbits
What foramen is on the frontal bone above the orbit ?
Supraoribital foramen
What passes through the supraorbital foramen
Sensory nerve to the forehead
The frontal bones contributes internally to which aspect of the cranial fossae
Anterior cranial fossa
Do the frontal bones contain sinuses ?
Yes. Frontal sinuses
Soon after birth, the left and right sides of the frontal bone are united by the metopic suture.
When does this suture disappear ?
Between the ages 6 and 8
(Double check if years or months)
Parietal bones form __________ and ___________ parts of skull
Superior
Lateral
The occipital contains 4 parts arranged around the foramen magnum
Basilar part
Condylar part (2)
Squamous part
Where is the Basilar part of the occipital bone
- sits anterior to foramen magnum
- adjacent to petrous part of temporal bone
(The two temporal bones converge on it from each side)
Where is the Condylar parts of the occipital bone and what do they consist of
- lateral to the foramen magnum
- consists of 2 occipital condyles
- condylar canals
- hypoglossal canal
Where is the squamous part of occipital bone
Behind the foramen magnum
The squamous part of the occipital bone consists of :
-External occipital protuberance
-3 nuchal lines
-Grooves for the dural venous sinuses
- external occipital crest
The palpable prominence on the squamous part of the occipital bone is called
External occipital protuberance
Importance of the occipital condyles
Joins with atlas C1 to form the atlanto-occipital joint
The occipital bones forms :
POSTERIOR portion of the cranium and cranial base
Posterior cranial fossa
What skull bones does the occipital bone articulate with
Temporal bones
Parietal bones
Largest foramen on occipital bone
Foramen magnum
The temporal bone has 4 parts
Squamous
Tympanic
Petrous
Mastoid
The temporal bones lie _________ to the parietal bones
Inferior
Which bones form the inferolateral portion of the skull
Temporal bones
Tympanic part of temporal bone consists of
External acoustic meatus
The mastoid region of the temporal bone bone consists of
Mastoid process
Styloid process
Stylomastoid foramen
Where can we feel the mastoid process
Behind and below the ear
What part of the temporal bone under the zygomatic process articulates with the condyle of the mandible to form temperomandibular joint
Mandibular fossa
What passes through the stylomastoid foramen
Facial nerve
The facial nerve passes through which foramen
Stylomastoid foramen
Medial to the styloid process there are 2 major openings :
Carotid canal
Jugular foramen
The sharp projection in the mastoid region of the temporal bone
Styloid process
Why is the sphenoid bone referred to as “keystone” bone
Because it joins with almost every other bone of the skull
Which skull bone is referred to as the keystone bone
Sphenoid bone
Which skull bone spans the width of the cranial floor and extends laterally to form the sides of the skull
Sphenoid bone
The shape of the sphenoid bone resembles what
Butterfly or bat
How many processes does the sphenoid consist of
3
How many openings does the sphenoid consist of
5
Palatine is located _________ to the maxilla
Posterior
What are the 3 processes of the sphenoid bone
Lesser wing
Greater wing
Pterygoid process
What are the 5 openings of the sphenoid bone
Optic foramen
Foramen rotundum
Foramen ovale
Foramen spinosum
Superior orbital fissure
Which openings of the sphenoid bone are located on the greater wing ?
Foramen rotundum
Foramen ovale
Foramen spinosum
Which bone lies between sphenoid and nasal bones
Ethmoid bone
Which bone forms most of the medial bony region between the nasal cavity and orbits
Ethmoid bone
What are the different parts of the ethmoid bone
Crista gali
Cribiform plate
Ehtmoid sinuses (air cells)
Superior nasal concha
Middle nasal concha
Perpendicular plate
Importance of perpendicular plate
Splits nasal cavity into left and right (along with vomer)
True or false
Inferior nasal concha is a part of the ethmoid bone
False
(Only superior and middle nasal concha)
NOTE: inferior nasal concha is a facial bone
What are the 7 bones of the orbit
Frontal bone
Zygomatic bone
Maxilla
Palatine bone
Ethmoid bone
Lacrimal bone
Sphenoid bone
What are the unpaired bones of the face
Mandible
Vomer
What are the paired bones of the face
Maxilla
Zygomatics
Nasals
Lacrimals
Palatines
Inferior nasal conchae
What forms the anterior part of the hard palate
Maxilla (palatine process)
What forms the posterior part of the hard palate
Palatine bone (horizontal plate)
What bone forms the upper jaw
Maxillary bone (maxilla)
_________ forms the anterior 3/4 of hard palate
Maxillary bone (palatine process)
____________ forms the posterior 1/4 of hard palate
Palatine bone
Which bone consists of the largest paranasal sinuses
Maxillary bone
What is the largest paranasal sinuses
Maxillary sinuses
The maxillary bone forms a part of which orbital opening ?
Inferior orbital fissure
Which bones form the bridge of the nose
Nasal bones
Which bones are thin and curved and project medially from the lateral walls of the nasal cavity
Inferior nasal conchae
What bone forms the lateral wall of the orbit
Zygomatic bones
What bone is located in the medial orbital walls
Lacrimal bones
What forms the superior part of the nasal septum
Perpendicular plate of ethmoid bone
What forms the inferior part of the nasal septum
Vomer
What is the largest and strongest facial bone
Mandible
What facial bone forms the lower jaw
Mandible
What part of the mandible articulates with the mandibular fossa of the temporal bone to form the temperomandibular joint?
Mandibular condyle
What are the two main parts of the mandible
Horizontal body
Two upright rami
(Review the other parts of the mandible in this picture)
What bone is located inferior to the mandible and acts as a movable base for the tongue
Hyoid bone
Parts of the hyoid bone
Body
Lesser horn
Greater horn
True or false
The makeup of the scalp is important clinically because trauma to the scalp is frequent
True
The scalp is made up of how many layers
5
What are the 5 layers of the scalp?
A blow to the lateral side of the head may fracture what?
What is the consequence of this fracture ? 
The bones of the pterion
This could damage a major branch of an artery right beneath it which supplies the skull and covering layers of brain (meninges) 
What two arteries supply the brain
Vertebral artery
Internal carotid artery
What foramen is present on the anterior aspect of the frontal bone
Supraorbital foramen
What openings are on the anterior aspect of the sphenoid
Optic canal
Superior orbital fissure
Inferior orbital fissure
What passes through the optic canal
Optic nerve
What passes through the inferior orbital fissure
Maxillary branch of trigeminal nerve
What opening is seen on the anterior aspect of the maxilla
Infraorbital foramen
What opening is on the anterior aspect of the mandible
Mental foramen
What openings are seen on the inferior aspect of the sphenoid 
Foreman lacerum
Foramen ovale
What passes through foramen lacerum 
Internal carotid artery after leaving carotid canal
What passes through foramen ovale
Mandibular branch of the trigeminal nerve
What openings are found on the inferior aspect of the temporal bone
External acoustic meatus
Carotid canal
Stylomastoid foramen
What structure passes through carotid canal
Internal carotid artery
What structure passes through Stylomastoid foramen
Facial nerve
What openings are seen on the inferior aspect of the occipital bone
Foramen magnum
Jugular foramen
What structure passes through foramen magnum
Vertebral arteries
What opening is seen on the superior aspect of the ethmoid
Olfactory foramina
What structure passes through olfactory foramina
Olfactory nerve
What openings are seen on the superior aspect of the sphenoid bone
Optic canal
Foramen rotundum
Foramen lacerum
Foramen ovale
Foramen spinosum 
What openings are seen on the superior aspect of the temporal bone
Carotid canal
Internal acoustic meatus 
What openings are seen from the superior part of the occipital bone
Foreman magnum
Hypoglossal canal
Jugular foramen
What structure passes through the hypoglossal canal
Hypoglossal nerve
What structure passes through the jugular foramen
Internal jugular vein
Muscles of facial expression
Frontalis
Orbicularis oculi
Zygomaticus major
Levator labii superioris alequae
Levator anguli oris
 Orbicularis oris
Risorius
Depressor anguli oris
Depressor labii inferioris
Mentalis
Platysma

True or false
The masseter is one of the muscles for facial expression
False
It’s a muscle for mastication
What are the two portions of orbicularis oculi
Orbital portion
Palpebral portion
Which muscle elevates the upper lip
Levator labii superioris
What muscle elevates the mouth
Levator anguli oris
What muscle depresses the angle of the mouth
Depressor anguli oris
What muscle depresses the lower lip
Depressor labii inferioris
Describe the attachment of facial expression muscles
They have only one attachment to bone or sometimes no attachment to bone at all ; while the other end of the muscle is inserted into the skin or blending with other muscles
Function And location of the orbital part of orbicularis oculi 
Surround the eye has a sphincter
Closes the eye tightly
What is the function and location of palpebral part of orbicularis oculi
In the eyelid
Closes the eye gently as in sleep
What is the most important function of buccinator
Keep the cheeks in contact with the gums so that food does not collect in this region
Which muscle extends down the neck and over the clavicle and upper part of the chest
Platysma
What are the four main muscles of mastication
Temporalis
Masseter
Medial pterygoid
Lateral pterygoid

All four muscles of mastication are innervated by what
Mandibular division of the trigeminal nerve
(Muscular branch V3)
What are the prime movers of jaw closure
Masseter and temporalis
Which mastication muscle is responsible for side to side movement
Pterygoid muscles
Which mastication muscle is responsible for compression of cheeks
Buccinator muscles
Medial pterygoid and lateral pterygoid are located under which muscle
Masseter
Origin and insertion of masseter
Origin: Zygomatic arch
Insertion: ramus and angle of mandible
Origin and insertion of medial pterygoid
Origin: lateral pterygoid plate and maxillary tuberosity
Insertion: ramus and angle of mandible
Origin and insertion of lateral pterygoid
Origin:
-upper head: greater wing of sphenoid
- Lower head: lateral pterygoid plate
Insertion:
-Upper head: articular disc
- lower head: neck of condyle
Origin and insertion of temporalis
Origin: temporal fossa
Insertion: coronoid process and anterior border of ramus
Action of masseter
Closes mouth
Action of medial pterygoid
Closes mouth and helps protrude mandible
Action of lateral pterygoid
Open and protrudes mandible +
moves mandible side to side
Action of temporalis
Closes and retracts mandible
Function of trigeminal nerve
Provides sensory innervation to the face
Motor innervation to chewing muscles
How many divisions do we have of the trigeminal nerve
3
What are the three divisions of the trigeminal nerve
Ophthalmic division (V1)
Maxillary division (V2)
Mandibular division (V3)
What structure does the ophthalmic division of the trigeminal nerve pass through
Superior orbital fissure
What structure does the maxillary division of the trigeminal nerve pass through
Foramen rotundum
What structure does the mandibular division of the trigeminal nerve pass through
Foramen ovale
Which division of the trigeminal nerve provides motor innervation for mastication muscles
Mandibular division
The trigeminal nerve provides sensory innervation to the whole face EXCEPT for the area over the __________
Parotid
What structure as seen on the trigeminal nerve
Trigeminal (semilunar or gasserian) ganglion
The facial nerve passes through what 2 structures
Middle ear
Parotid gland
What foramen does the facial nerve pass through
Stylomastoid foramen
What structure does the facial nerve enter when it divides
Parotid
What are the branches of the facial nerve
Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical
Which branch of the facial nerve will supply the platysma
Cervical branch
What is parotid gland
A salivary gland
(Located above the posterior digastric muscle)
What happens to the parotid gland in mumps
Becomes infected and swollen
If the parotid gland is infected and swollen in mumps, which function is difficult to perform
Opening mouth
What are the five blocks of tissue running longitudinally in the neck
- cervical vertebra: prevertebral fascia
- Pharynx and larynx: pretracheal fascia
3 & 4. Two vascular packets : 2 carotid sheaths
- Outer enclosing sheath: investing layer of deep fascia of the neck
Which fascia surrounds the trachea and esophagus
Pretracheal fascia
Which fascia surrounds vertebrae and a number of muscles
Prevertebral fascia 
What does the carotid sheath consist of
- Common and internal carotid arteries
- Internal jugular vein
- vagus nerve
What is present in the investing layer of deep fascia
Sternomastoid and trapezius
Carotid artery, jugular vein, and vagus nerve are surrounded by which fascia ?
Carotid sheath
Which muscle creates the anterior and posterior triangles of the neck
Sternocleidomastoid
Anterior border of the anterior triangle
Midline of neck
Posterior border of anterior triangle of neck
Sternocleidomastoid
Superior border of anterior triangle of neck
Mandible
Contents of anterior triangle of neck
- Hypoglossal nerve
- Ansa cervicalis
- Carotid sheath
- Internal and common carotid arteries
- Internally jugular vein
- Vagus nerve
What is ansa cervicalis
Loop of nerves that are part of the cervical plexus
Anterior border of posterior triangle
 sternocleidomastoid
Posterior border of posterior triangle
Trapezius
Inferior border of posterior triangle
Clavicle
Contents of posterior triangle
1. Occipital artery
2. External jugular vein
3. Nerves
Anterior triangle is divided into four subdivisions
- Submental
- Submandibular
- Muscular
- Carotid
The posterior triangle is divided into 2 subdivisions
- Occipital
- Supraclavicular (subclavian)
What muscle further divided the posterior triangle into two more triangles (occipital and supraclavicular)
Omohyoid
Muscles of posterior triangle
(Hint: 6)
What are the suprahyoid muscles
Digastric
Stylohyoid
Myelohyoid
Geniohyoid
What are the infrahyoid muscles
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
What are the infrahyoid muscles
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
Geniohyoid is under which muscle
Myelohyoid
What are the three main branches of the aortic arch
Brachiocephalic artery
Left common carotid artery
Left subclavian artery
What are the two branches of the brachiocephalic artery
Right common carotid artery
Right subclavian artery
The left and right subclavian arteries give rise to what arteries
Vertebral arteries
The left and right common carotid arteries give rise to what arteries
Internal and external carotid arteries
What is the largest artery in the body
Aorta
What are the main divisions of the aorta
Ascending aorta
Arch of aorta
Descending aorta
Thoracic aorta
Abdominal aorta
Which part of the aorta gives off 2 coronary arteries
Ascending aorta
What artery passes through the transverse foramen of the cervical vertebrae
Vertebral arteries
Which artery gives rise to face blood vessels
External carotid artery
What does the external carotid artery supply
What does the internal carotid artery supply
Brain
Eyes
Forehead
Part of nose
True or false
The internal carotid artery has NO branches in the neck
True
The internal carotid artery enters the cranial cavity through which opening
Carotid canal
The right common carotid artery arises from
Brachiocephalic artery
The left common carotid artery arises from
Arch of aorta
What is carotid sinus
Localized dilation at the point of division of the common carotid
Function of carotid sinus
Reflex pressoreceptor
What is carotid body
A small structure that lies posterior to the point of bifurcation of the common carotid artery
Function of carotid body
Chemoreceptor 
After entering the foramen magnum, the two vertebral arteries join to form one artery called
Basilar artery
The posterior cerebral artery is a branch of which artery
Basilar artery
The anterior cerebral artery is a branch of which artery
Internal carotid artery
The middle cerebral artery is a branch of which artery
Internal carotid artery
What does the anterior communicating artery connect
The right and left anterior cerebral arteries
What does the posterior communicating artery connect
Posterior cerebral artery to internal carotid artery
What four arteries anastomosis to create the circle of Willis
Anterior communicating artery
Anterior cerebral artery
Posterior communicating artery
Posterior cerebral artery
What are parts of the venous system of head and neck
Veins of brain
Venous sinuses
Veins of face and neck
Coverings of the brain
Parts of the brain
Cerebrum
Diencephalon
Brain stem
Cerebellum
What are ventricles
Expansions of the brain’s central cavity filled with cerebral spinal fluid CSF
What are ventricles lined with
Ependymal cells
True or false
Ventricles are continuous with each other and the spinal cord
True
Where are lateral ventricles located and what is their shape
Cerebral hemispheres
Horse-shoe shaped
Where is the third ventricle
In diencephalon
What connects lateral ventricles to third ventricle
Interventricular foramen
What connects the 3rd and 4th ventricles
Cerebral aqueduct
Where is the 4th ventricle
Hindbrain
4th ventricle connects to
Central canal of spinal cord
what are the nuclei of the midbrain
Substantia nigra
Red nuclei
What does substantia nigra mean
Black substance
What type of neurons are in substantia nigra
Dopaminergic neurons
Function of substantia nigra
Control subconscious muscle activities
What disease can occur with loss of substantia nigra neurons
Parkinson’s disease
Why does the red nuclei appear red ?
Due to rich blood supply and an iron containing pigment
Function of red nuclei
Together with cerebellum, it coordinate muscular movements
What synapses in red nuclei
Axons from cerebellum and cerebral cortex
What is pyramidal decussation
90% of the axons of the right pyramid cross to the left side and 90% of axons from the left pyramid cross to the right side
Therefore damage to the left side of brain will affect the right side of the body and damage of the right side of brain will affect the left side of the body
Function of the cerebellum
Skilled muscular activities
Regulate posture and balance
Role in cognition and language processing
