Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Esa 4 > Head And Neck > Flashcards

Head And Neck Flashcards

0
Q

Where does the RCC arise from

A

Brachii cephalic trunk, behind the right sternoclavicular joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Which blood vessels make up the upper systemic vascular loop?

A

Internal, external and anterior jugular veins and common carotid and vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where do the common carotids terminate?

A

Between angle of mandible and mastoid upper boarder of thyroid cartilage. C4 is bifurcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Uses of carotid massage

A

Alleviate supra ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the carotid body

A

Location of peripheral chemoreceptors which detect arterial O2. Different from baroreceptors. Between internal and external. CNIX (glossy pharyngeal nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where does ICC enter skull?

A

Carotid canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Branches of external carotid.

A 
SALFOPMS
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nerves and arteries in parotid?

A

External to maxillary and superficial temporal. Also facial nerve and retro mandible vein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the vertebral arteries

A

From the subclavian. Through the transverse foramen of 1-6. Supply brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the carotid triangle.

A 
Superior digastric
Laterally SCM
Medially- superior belly of omohyoid.
Also has vagus and hypoglossal nerves,
Larynx,
Pharynx
Thyroid gland
Cervical plexus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Layers of scalp

A 
Skin
Loose connective tissue
Aponeurosis
Loose connective tissue (with vessels)
Periosteum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Blood supply of scalp

A

Occipital, superficial temporal and posterior auricular. Also supratrochlear and supra orbital from ophthalmic from internal carotid. All anastomose.
Lacerations made worse by contraction of occiptofrontalis.
Same veins but deep parts can drain to the pterygoid venous plexus.
Also valveless emissary veins to the diploic vein to the dural venous sinuses.- infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Blood supply to skull and dura

A

Middle meningeal artery (ant and post) a branch of the maxillary. Near to the pterion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the angular vein

A

Supra orbital and supratrochlear veins drain into it. Located medial to eye socket?. Drains into facial vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe craniotomies

A

Access to cranial cavity

Bone and skin flap reflected inferiorly to preserve blood supply.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Explain dural venous sinuses

A

Endothelium lined spaces between the periosteum and meningeal layers of Dura forming dural septal which receive blood from the large veins draining the brain. Eventually drain into jugular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Origin of lateral nasal and angular arteries?

A

Facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the cavernous sinus

A

A plexus of extremely thin-walled veins on the upper side of the sphenoid bone. (Above pterygoid plexus which it drains into)
Also contains internal carotid artery.
CN3,4,6,5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Positions of jugular veins in neck

A

Internal under SCM, external is on top/across

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Terminal group of lymphatics?

A

Deep cervical- all afferent lymph vessels of the head and neck.
Then to jugular lymph trunk then to brachiocephalic between SC and IJV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are the cranial nerves numbered and what is the exception?

A

Rostro-cranial. CNXII before CNXI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name CNI

A

Olfactory Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Function CNI

A

Sense of smell (olfaction) - entirely senosry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anatimy CNI

A

Through cribiform plate of the ethmoid bone where they form the olfactory bulb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Loss of sense of smell is known as?

A

Anosmia (can occur in URTI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Does CNI go through thalamus? clinical significance?

A

No, can ‘reboot’ brain with strong stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name CNII

A

Optic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Function CNII

A

Sensory, sub serves vision. Colour, visual acuity, visual fields, reflexes, fundoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ANatomy CNII

A

Brain tract not nerve. Crossing over e.c.t.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Uses of CNII assessment

A

Visual field defects, early signs of meningitis, tumours, elevated CSF pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Name CNII

A

Oculomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Function CNIII

A

somatic motor and autonomic.
Somatic motor - all extraocular muscles apart from lateral rectus and superior oblique. Levator palpaebrae superioris muscle.
Parasympathetic toconstrictor pupillae of eue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CNIII palsy?

A

eye is down and out due to extraocular muscles. dilated pupil any no pupillary light reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Name CN IV

A

Trochlear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Anatomy CN IV

A

Dorsal aspect of midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Function IV

A

Motor - superior oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Damage CN IV

A

Diplopia occurs on looking down and in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cranial nerve VI name

A

Abducent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Function CNVI

A

Motor - Lateral Rectus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How might damage occur to CNVI

A

Intercranial pressure increases, it has a long intracranial course. If damaged then patient cannot look outwards (squint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Name CN V

A

Trigeminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Anatomy CN V

A

LArgest CN, 3 divisions - opthalmic (i) Maxillary (ii) Mandibular (iii)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Function CN V

A

Sensory - whole face, cornea and conjunctiva- divisions at nose/ angle of ete and mouth angle.
Motor - Only iii (mandibular), mastication - temporalis, masseter, medial pterygoids, anterior belly of diagastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What does corneal reflex test

A

CNVi and CNVII - sensory or motor damage, if one eye produces a blink in opposite eye then facial nerve is defective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sensory innervation by CNVii

A

Skin lower eyeld - upper lip, mucosa of nasal cavity, paranasal sinuses, palate and roots of upper teeth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Sensory CNViii

A

Skin temples, cheeks chin
mucosa inner cheek, anterior 2/3 tongue
roots of lower teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Name CN VII

A

Facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Function CN VII

A

Motor - facial nerve, facial expression and stapedius
Sensory - Nervus intermedius, concha of the auricle and behind ear, taste in anteror 2/3 via chorda tympani (temperature)
Autonomic - nervus intermedius (greater petrosal nerve) - glands lacrimal, submandibular, sublingual, mucous membranes of nasopharynx, paranasal sinuses, hard and soft palate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Damage to CN VII

A

Ear surgery, tumours in petrous part of temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Name CN VIII

A

Vestibulocochlear nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Function CNVIII

A

Sensory - balance and hearing - vestibular vs cochlear nerves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

2 recognised forms of deafness?

A

Sensori-neural (nerve) and conductive (blockage) Rinnes and Webers tests to differentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is caloric response

A

hot or cold water causing a nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Name CN IX

A

Glossopharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Function CN IX

A 
Mixed sensory and motor
motor - branchiomotor - stylopharyngeus
visceromotor (parasympth) - parotid 
Sensory - Viscerosensory - carotid body and carotid sinus, pharynx and middle ear
Special sensory - posterior 1/3 tongue.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Test for CN IX

A

gag reflex/pharyngeal reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

name CN X

A

Vagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Function CN X

A

Snsory - external ear, auditory canal eadrum, pharynx, larynx, visceral in thorax and abdomen
Motor - intrinsic of larynx and pharynx, muscles of palate, smooth muscle of bronchi and GI tract, secretomotor to thoracic and abdominal viscera.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Name CNXI

A

Accessory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Anatoy of CN XI

A

Medulla of brain for cranial division and spinal division from spinal cord and ascends intracranially through foramen magnum to join cranial division.
Exits via jugular foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Function CN XI

A

Motor nerve supplying Sternomastoid and trapezius. To test look for muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Name CNXII

A

Hypoglossal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Function CNXII

A

Motor - muscles of tongue, damage causes dysarthria, inspect fro tongue wasting and fasiculations. Deviates to side of weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the 4 general classes of spinal nerves?

A

General somatic afferents/ efferents and General visceral afferents and general autonomic efferents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Sources of parasympathetic outflow in the head and neck

A

CNIII, VII, IX, X (neck only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How is parasympathetic in the head different to the rest of the body

A

4 discrete ganglia which do not lie in walls of target organs (unlike body)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Where do autonomic nerves in the oculomotor nerve terminate?

A

Ciliary ganglion (around eye) - Opthalmic division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Where do autonomic nerves in the facial nerve terminate?

A

Pteygopalatine ganglion (Vii) or submandibular (Viii) ganglion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Where do glossopharyngeal autonomic nerves terminate?

A

Otic ganlion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Where do vagus autonomic neurones terminate

A

No discrete ganglia (not in head and neck)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Describe the parasympathetic output of the oculomotor nerve anatomy

A

Pre ganglionic enters the orbit inferiorly with the infererior division of the optic nerve to the ciliary ganglion just lateral to optic nerve.
Post ganglionic fibres with short ciliary nerves to enter the eye to supply the sphincter pupillae and ciliary muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is Horner’s syndrome?

A

Damage to sympathetic trunk. Causes miosis (constriction of pupil), ptosis (weak droopy eyelid) enopthalmus (posterior displacement) and possible anhidrosis (decreased sweating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Sympathetic fibres of the ciliary ganglion

A

Innervate the 5 eye muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Describe the Pterygopalatine ganlion

A

Supplied by the greater petrosal branch of the facial nerve.
Supplies the Lacrimal gland, mucous gland of the nose and mucous glands of the palate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Describe the submandibular ganglion

A

Supplied by the Chorda Tympani branch of the facial nerve. It supplies the submandibular, sublingual and mucous glands of the palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Describe the Otic ganglion

A

Pre ganglion neurones are found within the inferior salivatory nucleus from CN IX which terminate via the lesser petrosal nerve. Supplies the parotid and oropharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Name each parasympathetic nerve and its corresponding nucleus

A

III Edinger-westphal
VII Superior salivatory
IX Inferior salivatory
X Dorsal vagal motor nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Name the sympathetic gangla

A 
2/3 cervical (8levels)
11 thoracic (12levels)
4 lumbar (5 neural levels)
4 sacral (5 sacral neural levels)
Somatic nerves via segmental nerves
Visceral along ganglionated trunks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

3 sympathetic ganglion to head and neck?

A

Superior, middle and inferior cervical ganglions (T1-2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

How to sympathetics reach head and what they pass to?

A

Superior cervical ganglion along with the internal carotid nerve ascend along ICA into the cranium to form the internal carotid plexus.
Pass to the pterygopalatine ganglion, abducent nerve, glossopharyngeal, occulomotor, trochlear and opthalmic nerves adn vessels derivered from ICA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Where is the superior cervical ganglion located?

A

Anterior to C1,2,3,4 vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Location of middle cervical ganglion

A

small or absent, anterior to C6 and inferior thyroid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Location inferior cervical ganglion

A

fused with first thoracic occ. anterior to C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

How do sympathetic post ganglionic fibres reach H&N targets?

A

Hitchhiking on arterial system via walls of CC, EC and IC outside of carotid sheath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Superior cervical innervation

A

Along ICA and ECA
Somatic - trigeminal dermatomes to sweat glands
Visceral - dilator pupillae, smoot muscle of levator palpebrae superioris, nasal glands, salivatory glands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Middle cervical innervation

A

Hitch hikes along inferior thyroid artery to lower larynx, trachea, hypo pharynx, uper oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Inferior cervical innervation

A

Vertebral arteries

innervates subclavian and vertebral arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What drives development of the face?

A

Expansion of the cranial neural tube
Appearance of a complex tissue system associated with the cranial gut tube and the outflow of the developing heart
Development of the sense organs and the need to separate the respiratory tract and GI tract.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are neural cells

A

A forth germ line

A specialised population of cells that originate within the neuroectoderm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Where do neural cells come from and migrate to?

A

Lateral boarder of neuroectoderm
Become displaced and enter mesoderm
Migrate and contribute to a variety of H&N structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the philtrum

A

Between nose and mouth from FNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are palpebral fissures

A

Difference between eye lids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Describe the face at end of week 4

A

Superiorly the FNP (frontonasal prominence) which contains the primordia of the eyes. Laterally the Maxillary prominence (1st arch), inferiorly the mandibular prominence (1st arch) and centrally the stomatodeum or buccopharyngeal membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Describe the development of the nose

A

Nasal placodes appear on frontonasal prominence and sink to become the nasal pits. Medial and lateral nasal prominences form on either side of the pits.
Maxillary prominences grow. This pushes nasal prominences together at the midline. Maxillary prominences and medial nasal prominences fuse. Medial nasal prominences fuse in midline.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Fusion of medial nasal prominences creates the intermaxillary segment. What does this consist of?

A

Philtrum, 4 incisors and the primary palate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is the secondary palate derived from

A

Maxillary prominences which give rise to palatal shelves. These grow vertically downwards into oral cavity on each side of developing tongue. Mandible grows and tounge drops. Palatal shelves fuse in midline. Nasal septum grows down and fuses with palatal shelves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Fates if the medial and lateral prominences

A

Medial - philtrum, primary palate and mid upper jaw.

Lateral - Sides of nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What do the eyes develop from and where.

A

Out pocketings of forebrain, make contact with overlying ectoderm (otic placodes lens).
The lens placode then invaginates into optic vesicle (from brain) and pinches off. Develop laterally on head. As facial prominences grow the eyes move to the front of the face (binocular vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Describe the development of the ears briefly

A

External auditory meatus from the 1st ph cleft and the auricles from 1st and 2nd arches surrounding it.
Begin in the neck. As mandible grows the ears ascend to the side of the head to lie in line with the eyes.
All common chromosomal abnormalities have associated external ear abnormalities
Inner ear from otic placodes which invaginate auditory vesicles to form the membranous labrynth of the cochlea and semi-lunar canal system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Describe the articular surfaces of the temporomandibular joint

A

Under surface of temporal bone. Sinuous.
Superior: Mandibular fossa(posterior and concave), articular tubercle (anterior and convex) - Eminentia Articularis.
Inferior: Condyle of the mandible, superior edge and ellipsoid circumference.
2 vs 1 articular surfaces.
Lined with fibrocartilage not hyaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What stabalises TMJ?

A

Fibrous capsule. permits movement. A fibrous disk or meniscus prevents bone-bone contact. Creates 2 cavities.
1 lateral ligament - temporomandibular -
2 medial ligaments
Accessory ligaments
Liable to subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

2 movements of the TMJ?

A

Gliding/ translational movement and modified hinge joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Describe the articular disk of the TMJ

A

Shape fits shape of articular surfaces.
Thicker at the periphery where it attaches to the articular capsule.
It can recoil or stretch a little with movement
Thinner centrally.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Describe the temporomandibular ligament

A

Lateral
Strongest
Deep fibres blend with capsule.
From lower boarder of zygomatic process to posterior board of neck and ramus of mandible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Describe accessory ligaments of the TMJ

A

Sphenomandibular ligamnet
Remains constant in length and tension for all positions of mandible
Medial
Prevents inferior dislocation.
Stylomandibular joint:
Near apex of styloid process to the posterior border of the ramus of the mandible near its angle.Separates parotid from submandibular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Muscles in glinding of TMJ

A

Lateral pterygoid muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Muscles in hinge movement of TMJ

A

Digastric (not a prime mover) needs work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Muscles in retracting the mandible

A

Posterior fibres of temporalis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Closing muscles of TMJ

A

Temporalis (not posterior), Massater muscles, medial pterygoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What prevents posterior displacement of TMJ?

A

Post glenoid tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Describe some common disorders of the TMJ

A

Bruxism - grinding when asleep
Knacking - loud sounds when jaw displaces
TMJ pain dysfunction disorders
Mal-occlusion disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What is the Infratemporal fossa?

A

Irregularly shaped cavity.

Medial and deep to zygomatic arch behind the maxilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Describe the boarders of the infratemporal fossa

A

Anterior - infratemporal surface of maxilla and descending ridge of zygomatic
Posterior - articular tubercle of the temporal bone and spina angularis of the sphenoid
Superior - Infratemporal surface of the greater wing of sphenoid.
Inferior - Alveolar border of the maxilla/ none
Medial - Lateral pterygoid plate.
Lateral- zygomatic process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Contents of the infratemporal fossa

A

Muscles: Temporalis, Medial pterygoid muscles, lateral pterygoid muscles
Nerves: Mandibular Viii and its branches:, Buccal, Linguinal, Inferior alveolar, Chorda tympani, auriculotemporal
Arteries: Deep- Maxillary (MMA off of this) - many branches. Superficial - Superficial Temporal artery.
Veins: Maxillary, MMV, Pterygoid venous plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Openings of the infratemporal fossa

A 
Froamen ovale (Viii)
Formaen spinosum (MMA)
Alveolar canal
Inferior orbital fissue
Pterygomaxillary fissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Clin Sig of infratemporal fossa

A

Mandibular nerve block site
Inferior alveolar nerve block site during dental treatment around the mandibular foramen on the medial side of the mandible.
Tumors can grow without detection for a long time - symotomatic then advanced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Describe the axis of the orbit

A

Optical axis - facing forward
Orbital axis (optic nerve) - 45 deg
orbit walls - 90 deg - verticle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Where are the central artery and vein of the retina found?

A

Centre of the optic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Describe the bones of the orbit

A

Superior - Frontal
Medial - Ethmoid, lacrimal and maxilla
Lateral - Zygomatic and sphenoid
Inferior - Maxilla and zygomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Main fissures and fossae of orbit

A

Optic canal, superior and inferior orbital fissures, fossa for lacrimal gland and the fossa for lacrimal sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Contents of the superior orbital fissure

A

Lat to medial - lacrimal, trochlear, frontal, superior branch occulomotor, Nasocillary, inferior occulomotorabducent nerves, superior opthalmic vein, sympathetic.
Large French Teeneagers Sit Numb In Anticipation Of Sweets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

COntents of the inferior orbital fissure

A

Infraorbital nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What is papilloedema

A

Optic disk swelling from raised ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Describe fractures of the orbit

A

Medial and inferior walls are thin, ethmoidal and sphenoidal sinus may be involved on the medial wall and the maxillary on the inferior wall.
Blow out fracture displaces walls and contents (muslce entrapment and diplopia and inferior)
Enophthalmos (posterior displace) and infraorbital bleeding

125
Q

Function of inferior obliquE

A

moves eye up and out (abduction and extorsion or ecternal rotation or lateral rotation)

126
Q

Superior oblique function

A 
Primary (if looking forward) - intorsion (internal rotation)
Secondary action - depression in adducted postion (reading a book)
Tertiary action (abduction)
To test ask pt to look inwards and downward.
127
Q

Arterial supply of orbit

A

Opthalmic artery ICA via optic canal - central artery of retina.
Orbital floor- infraorbital artery branch of ECA
Short and long ciliary arteries supply external aspect of eye.

128
Q

Venous supply of the orbit

A

Superior and inferior opthalmic veins exit via SOF to cavernous sinus.
Superior from inner angle and inferior from plexus on floor and medial wall.
Central vein of retina to cavernous sins directly or to opthalmic veins.
Occlusion then slow painful loss of vision. Infection to brain

129
Q

Branches of the opthalmic artery

A

Central retinal artery
Lacrimal artery - also to conjunctiva and eyelids
Posterior ciliary arteries - posterior external eye
Muscular branches to extraocular muscles
Few others e.g. ethmoidal and frontal sinses, forehead, scalp, supra orbital

130
Q

Infraorbital artery is a branch of the…?

A

Maxillary

131
Q

what is the danger triangle?

A

Communication between facial vein to CS - thrombosis, meningitis, brain absess in CS.

132
Q

Function of eyelids

A

Protect from light and injury
Prevent corneal drying through controlled spread of lacrimal fluid.
Opening called palpebral fissure.

133
Q

Describe the types of conjunctiva

A

Palpebral - back of eye lids
Bulbar - anterior sclera of eye
Fornix - between palpebral and bulbar

134
Q

Describe the anatomy of the upper eyelid

A 
Skin
Areolar Tissue
Fibres of orbicularis oculi
Levator palpebrae superioris
Superior tarsus - dense CT
Tarsal (Meibomian) glands secrete oil and dry eye.
Cilliary glands (end) sebacous
Stye
Palpebral conjunctiva
135
Q

Triggers of blinking

A

Corneal drying
Corneal irritation or contact
Expectation of contact
Corneal (blink) reflex

136
Q

Muscles opening the eyelids

A

Levator palpabrae superioris

Superior tarsal muscles (AKA Muller’s muscle)

137
Q

Muscles closing eyelids

A

Orbicularis oculi (round) VII

138
Q

What is Bells palsy

A

Orbicularis oculi paralysis - CN VII - dry eyes, loss of blink, infection likely

139
Q

Paralysis of Levator Palpebrae superioris

A

Oculomotor - CN III - ptosis

140
Q

innervation of superior tarsal muscle and clin sig

A

Symp - Horners - partial ptosis

141
Q

Describe lacrimation

A

Eyes close lat to med so collect in lacrimal lake (medial canthus). Travekky through nasolacrimal duct to inferior meatus of nasal cavity.
Produced by CN VII para.
Sensory via lacrimal branch of opthalamic division of CN V

142
Q

Features of the auricle

A 
Helix,
Antihelix,
Crus of helix
Concha
Tragus
Antitragus
Lobule
External auditory meatus
Triangular fossa
143
Q

Name so common pinna deformities

A

Antihelix deformity (not all the way round)
Pinna malformation (basically gone)
Pre-auricular Pit (small hole)
Pre-auricular skin tag

144
Q

What is a pinna Haematoma

A

Haematoma between cartilage and perichondrium — pressure necrosis.
Result from trauma.
Results in cauliflower ear

145
Q

What is cauliflower ear

A

Result of pinna haematoma

Outer ear becomes swollen and deformed

146
Q

Describe the external auditory canal

A

Sigmoid shape
Lat 1/3 is cartilage with hair and medial 2/3 is bone lined
Contain ceruminous glands - ear wax

147
Q

What is Otitis Externa

A

Like cellulitis - inflam/ infection of deep layers of skin

148
Q

Describe the tympanic membrane

A 
Pars flacida and pars tensa
In middle - handle of malleus - inferior is umbo - superior is lateral process
Light reflex
Annulus around the outside
Collagen inbetween epithelium
1cm across
149
Q

Describe the contents of the middle ear

A

Malleus - head and handle (on typanic)
Incus (anvil) - body- short process and long process
Stapes - head and footplate, anterior and posterior crus#
Oval window (stapes), round window and eustachian tube

150
Q

Muscles of the middle ear

A 
Tensor tympani (medial pterygoid Viii)
Stapedius (facial VII)
151
Q

Cause of tympanic retraction

A

Eustachian tube dysfunction - cannot equalise.

Angle of light dissapears

152
Q

Cause of pus in middle ear

A

Acute otitis media

153
Q

What is Glue Ear

A

Otitis media with effusion- secondary to prolonger neg pressure results in thick effusions accumulating behind ear drum.
Conductive hearing loss

154
Q

What are gommets

A

Ventilation tubes to equalise the middle ear pressure - placed in tympanic membrane.

155
Q

Complications of acute otitis media?(AOM)

A

Mastoiditis due to suppuration (discharge of pus from a wound). Can lead to intracranial infection and death

Cholesteatoma

Facial nerve dysfunction - chorda tympani may be affected

156
Q

What is a cholesteatoma?

A

neg ear pressure - retraction pockets, dead skin cells accumulate, necrotic mass of dead skin, erosion of middle ear structures and bone via lytic enzymes

157
Q

Components of the inner ear

A

Vestibule
Cochlea - scala vestinulu (top) Scala tympani (bot) (buns), cochlear duct/ organ of corti/ basilar membrane (hot dog), cochlear nerve

158
Q

Describe vestibular disease

A

4 main symptoms with true rotational vertigo. Causes:
Secs-mins - Benign Paraoxysmal postional vertigo - otolith displacement
Mins-hours - Meniere’s disease - endolymphatic hydrops
24+ - labryinthine failure
Random with other symptoms - vertiginous migraine

159
Q

Other causes of vertigo

A 
Vascular
Epilepsy
Receiveing treatment
Tumous, trauma, thyroid
Infections
Glial (MS)
Ocular
160
Q

Describe the vestibular compartment

A

Utricle
Saccule
3 semicircular canals (sup, pos, lat/ hori)

161
Q

What does balance involve

A

Vestibular end organ
Vision
Sensation

162
Q

Functions of the nose

A

Olfaction
Respiration
Filter and humidify
Drain & eliminate paranasal sinus and nasolacrimal duct secretions

163
Q

Features of the external nose

A

Dorsum, naris and ala
Skin covers and extends into vestibule
limen (nasi) around vestibule

164
Q

Skeleton of external nose?

A

Nasal bone superiorly
Lateral to nasal bone = frontal process of maxilla
Lateral process of septal cartilages (main part)
Major ala cartilage inferiorly
Septal cartilage in between
Minor alar cartilages laterally
Posterior to nasal bone is the lacrimal bone and nasolacrimal groove

165
Q

Complications of a nasal fracture

A

Septal haematoma

166
Q

Features of the nasal cavity

A

Nostrils, choanae (posterior holes into nasopharynx), mucosal lining, continuous with areas draining into the cavity.

167
Q

Bones contributing to the skeleton of the nose

A

Frontal, nasal, ethmoid (plus its perpendicular plate), sphenoid, vomer (inferior of nasal septum), palatine process of maxilla, horizontal process of palatine bone, inferior concha

168
Q

Lateral and medial walls nasal cavity

A

Lateral wall = conchae - creat 5 passages, one unpaired and 3 paired (sphenoethmoidal recess, superior, middle and inferior nasal meatus)
Septum = bony and cartilaginous part - Ethmoid sup, vomer inferior (palatine and maxillary), SC anteriorly

169
Q

Drainage into nasal cavity?

A

Nasolacrimal duct into inferior
Frontal sinus and ethmoidal sinus into middle
Sphenoid - spheno-ethmoidal recess
Maxillary - middle

170
Q

Describe ethmoid bone in detail

A

Laterally ethmoidal labyrinths joined by the cribriform plate (perpendicular plate and crista galli).
Infundibulum, groove penetrating ethmoidal labyrinth and drains frontal sinus.
Middle concha attached inferior to labyrinths (still part of bone)

171
Q

Openings into the nasal cavity

A

Cribriform plate -olfaction, spenopalatine foramen, incisive foramen, foramen cecum (nasal veins to superior sagittal sinus (some individuals))

172
Q

Blood supply to the nose

A 
Facial artery (ECA branch of superior labial artery). - anterior.
Maxillary artery (ECA sphenpalatine (sphenopalatine foramen) and greater palatine artery (inferior))
Ophtalamic artery (ICA) anterior and posterior ethmoidal (superior)
173
Q

Venous drainage

A 
Cavernous sinus superiorly
Facial vein (anterior inferior)
Pterygoid plexus (posterior)
174
Q

Most common site for anterior epistaxis?

A

Kiesselbach’s plexus (little’s area)

175
Q

Nasal septum clinical anatomy

A

Nasal septum deviation - congenital or aquired, narrowing or obstruction
Nasal septum necrosis - injury to nasal septum, saddle nose deformity

176
Q

Innervation of the nasal cavity

A

CNI special sensory
Gen sensory to septum and lateral walls - ophthalmic (V1) and maxillary (V2).
PI - maxillary nerve - nasopalatine nerve and branches greater palatine nerve to lateral wall
AS- ophthalmic nerve- branches of nasociliary nerve

177
Q

primary function of nasal sinuses

A

Contributes to conditioning of inspired air

178
Q

Describe the maxillary sinus

A

roof = floor of orbit
Floor = alveolar part of maxilla- cf roots of first 2 molars, superior alveolar nerve)
Posterior = pterygopalatine and infratemporal fossae)
Enlarges from 8 years, opens into middle meatus

179
Q

Describe the frontal sinus

A

Not present at birth, variable in size, related to anterior cranial fossa and the orbit, drains to middle through the frontonasal duct (ethmoid bone?

180
Q

Describe the sphenoid sinus

A

Related to pituitary fossa and middle cranial fossa, cavernous sinus and ICA, posterior cranial fossa and pons, roof of nasopharynx

181
Q

Ethmoidal sinus

A

Air cells between orbit and nasal cavity.
Anterior cells - middle meatus via infundibulum
Middle - bulla, directly into middle meatus
Posterior - superior meatus

182
Q

spread of infection from nasal cavity to anterior cranial fossa

A

Foramen caecum and olfactory foramina

183
Q

rhinitis describe

A

Inflammation of nasal mucosa - swelling and increased volume of secretion
Causes include - infective (viral), allergic and nasal polyps

184
Q

Describe nasal polyps

A

Prevalence 2-4%, linked to chronic rhino sinusitis, grow close to the ostiomeatal complex of nasopharynx causing nasal obstruction resulting in snoring/ sleep apnoea

185
Q

Types of sinusitis

A

Inflammation of the mucosal lining of the sinuses
Acute: 7-30 days
Sub acute 4-12 weeks
Chronic >90 days
infection - viral with secondary bacterial infection - S pneumoniae and H influenzae

186
Q

Infection from nasal cavity to middle ear

A

eustachian tube

187
Q

why do blood tests for epistaxis

A

Hb, bleeding abnormalities

188
Q

Treatment for epistaxis

A

Lead forward - pinch cartilage
Second - cautery (silver nitrate or elctro) to ‘solder’ blood vessels
Nasal tampons (go in horizontally)
Posterior packing +/- urinary catheter
Last resort - surgerical intervention with ligation of SPA, maxillary and ECA
Radiological embolisation

189
Q

Posterior bleed of nose, what artery?

A

Sphenopalatine

190
Q

Describe innervation by the oculomotor nerve proper

A

Somatic efferent
Supplies all extra-ocular muscles except lateral rectus and superior oblique.
Supplies lavator palpebrae superioris

191
Q

Damage to just the oculomotor nerve proper?

A

Ptosis, down and out movement of eye

BUT pupil is a-okay

192
Q

Origins and course of oculomotor proper and symapthetic portion of CN3

A 
Oculomotor nucleus (midbrain) - cavernous sinus- lateral wall, uncus (art of brains) and tentorial notch, ciliary ganglion. Exits from superior OF.
Edinger-Westphal Nucleus, Same path but terminates in ciliary ganglion - short ciliary nerve
193
Q

Describe dorsal and ventral branches of oculo proper

A

Dorsal - levator palp and superior Rectus

Ventral - med and inf rectus, inf oblique. Only inferior oblique division goes past/ through ciliary ganglion

194
Q

Sensory to meinges

A

Vii

195
Q

diff between facial nerve and CNVII

A

Motor vs motor, special sensory and parasymp

196
Q

Origins of CNVII

A

facial from the facial motor nucleus in pons
Solitarious - taste efferents
Geniculate ganglion - primary senosry neurons to solitarious?

197
Q

Roots of CNVII

A

Facial motor nucleus - motor root
Nervus intermedius - pons (part of nucleus solitarious), taste and sensory
Autonomic - superior salivatory nucleus (also called nervus intermedius)
Geniculate ganglion -gen sensory - nervus intermedius
Know the 4

198
Q

Terminal branches of the motor root of the facial nerve

A 
TO Zanzibar by motor car
Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical branch
Posterior auricular
199
Q

Bilateral damage to facial nerve?

A

Parkinsons, Medication, bilateral damage (rare)

200
Q

What is torticolis?

A

Presenting sign in SCM injury - rotated and tilted towards normal side

201
Q

What is Paget’s disease

A

Middle ages, repair reabsorption of bone, pain, enlargement, dental complications

202
Q

Clin sig of inferior alveolar nerve

A

Enters via mental foramen. Sensory to mucous membranes of lower lip/ mouth

203
Q

Main muscles of facial expression

A

Orbicularis oris/ oculi

204
Q

Describe the jugulo-omohyoid and jugulodigastric lymph nodes

A

Jugulodigastric aka tonsilar, drainage of tonsils and tongue.
Jugulo-omohyoid - tounge, oral cavity, trachea, oesophagus and thyroid gland

205
Q

What is proptosis

A

Bulging of the eyes forward - thyroid dysfunction or a mass in the orbit

206
Q

what is the cervical sinus?

A

Formed when flap from second covers 3-6. Normally obliterated

207
Q

Main derivative of the 3rd/4th arches

A

Hypobranchial eminence, becomes

epiglottis

208
Q

Fate of the pouches

A 
POUCH BECOMES
1 Eustachian tube and middle ear cavity
2 Crypts of palatine tonsil
3 Dorsal part – inferior parathyroid
Ventral part - thymus
4 Dorsal part – superior parathyroid
Ventral part (ultimobranchial body) – C cells of thyroid
209
Q

Name of one eye, no eyes and small eyes

A

Gross anomalies of eye development may occur during these early stages. They
include cyclopia (single midline eye), anophthalmia (absence of eye or eyes) and
microphthalmia (abnormally small eyes).

210
Q

Blood supply to neurocranium

A

Internal carotid and vertebral arteries

211
Q

describe the two chambers of the eyeball

A

Anterior- cornea and iris

Posterior - ciliary body and lens

212
Q

Secretions of the cilliary body

A

Aqueous humour

213
Q

Describe the middle layer of the eye ball

A

Choroid - cilliary body- iris

214
Q

Describe the lens

A

Biconcave, attached to the cilliary body by the suspensory ligament

215
Q

What supports the lens and holds the retina in place?

A

Vitreous humour found posterior to lens

216
Q

What is the fovea

centralis?

A

Depression in macula lutea, lateral to optic disk responsible for visual acuity

217
Q

What is presbyopia?

A

During old age, the lens becomes harder and more flattened and these changes
slowly reduce their focusing capacity

218
Q

What is hyphema

A

Blunt trauma to the eyeball may result in haemorrhage into the anterior chamber
of the eye

219
Q

Where do the extrinsic eye muscle attach?

A

Common tendinous ring, surrounds optic canal

220
Q

Arterial supply to eye

A

Opthalamic artery - Internal carotid

221
Q

Pupillary enlargement, name and causes

A

Mydriasis- glaucoma, sympathetic agents

222
Q

Depressors and elevators of eye

A

Depress - IR & SO

Elevat - SR & IO

223
Q

Medial and lateral rotation of eye

A

Medial - SO and SR

Lateral - IO & IR

224
Q

How is a Meibomian cyst

different from a stye?

A

Meibomian cyst- blocked tarsal gland (posterior eye lid)

Style - infection of sebaceous gland tat readily forms a cyst (End of eyelid)

225
Q

Does the facial vein have valves?

A

No

226
Q

What is thrombophlebitis

A

Inflammation of a vessel with secondary thrombosis

227
Q

What is ecchymosis

A 
The term refers to the
discoloured patch
produced by
extravasation of blood
into the subcutaneous
tissues
228
Q

What is a motor unit

A

A combination of a motor nerve and all the fibres it innervates

229
Q

What causes bilateral proptosis of the eyes

A

Grave’s disease (hyperthyroidism does not)

230
Q

Apart from a tumor, what other pathologies may cause

unilateral proptosis?

A

Retrobulbar haemorrhage

ii) Swelling of soft tissues of the orbit

231
Q

What bony structure is the carotid pulse palpated against?

A

Transverse process of C6 Vertebra (termed the carotid tubercle)

232
Q

Bifurcation of carotid at which level?

A

C4

233
Q

Paget’s disease

A

Misshapen bones

234
Q

Describe the epitympanic recess

A

Superior to tympanic membrane in middle ear

235
Q

Location of mastoid air cells and eustachian tube compared with middle ear

A

MAC post.

Eu ant

236
Q

What is exstosis of the outer year?

A

Surfer’s ear, bone growth, can lead to infection

237
Q

Meaning of supperative

A

Produces pus

238
Q

Refferred pain in ear?

A

It is important
to realise that pain from the teeth, pharynx or cervical spine is commonly referred
to the ear. Inflammation, trauma, or neoplasms anywhere along the course of the
trigeminal, facial, glossopharyngeal and vagus cranial nerves or cervical nerves C2
and C3 may be responsible for referred pain to the ipsilateral (same side) ear.
Pruritis (itching) of the ear may result from primary disorder of the external ear

239
Q

Superior and inferior to Middle ear

A

Superior floor of middle/ posterior cranial cavities (posterior part contains internal acoustic meatus containing the facial and vestibulocochlear nerves)
Inferior - irregular and contains carotid canal

240
Q

What is cerumen?

A

Modified sebum secreted by cartilaginous part of external ear (forms wax with discarded cells)

241
Q

Fluid in inner ear labyrinth

A

endolymph

242
Q

Where is perilymph found

A

Between bony and membranous labyrinths

243
Q

The outer aspect of
the auricle is
supplied by:

A

auriculotemporal

nerve(Viii) and cervical plexus

244
Q

Innervation of tympanic membrane

A 
The External Surface
a)Auriculotemporal nerve, a branch of
the mandibular division of the fifth
nerve
b) Small branch of the Vagus (CN X)
Internal Surface
Supplied by the Glossopharyngeal nerve
(CN IX).
(think about arches)
245
Q

Danger of mastoid infection

A

sigmoid venous sinus and cerebellum anteriorly

246
Q

3 branches of facial nerve given off in parotid gland

A

Greater petrosal nerve, chorda tympani and the nerve to stapedius

247
Q

When can the lingual (Viii) nerve become anaethetised and what is the clin sig?

A

inferior alveolar nerve block - sensory ant 2/3 tongue

248
Q

How to treat haematoma in ear?

A

Drain

249
Q

describe tympanosclerosis

A

calcification, conductive

250
Q

How long does tympanic membrane take to heal?

A

6-8 weeks

251
Q

Origins of malleus, incus and stapes?

A

1st and 2nd arches

252
Q

Innervation of stapedius

A

Facial nerve (2nd arch)

253
Q

Result of bells on hearing

A

Louder due to stapedius

254
Q

What is otosclerosis

A

Fusion - immovable, deafness, aut dom

255
Q

Acquired forms of sensorieural hearing loss?

A

Meniere’s disease, oxytocin drugs (Gentimycin), infection e.g. rubella

256
Q

Muscle that extends and flexes the head?

A

Extension - splenius capitis

logissimus capitis - flex

257
Q

Treatment surgial for glue ear

A

Myringotomy (drain)

Mastoidectomy

258
Q

Which bone is the pituitary gland located in?

A

Sphenoid

259
Q

Describe the developmental origin of the pituitary gland

A 
Ant = ectoderm(normal gland)
Post= neuroectoderm
260
Q

Describe the development of the pituitary gland

A

Downward outgrowth of forebrain towards the roof of the pharynx known as the infundibulum.
Grows towards Rathke’s pouch (ectoderm of the stomatodeum) which is an envagination of the roof of the oropharynx. This is pinched off and becomes the anterior pit whilst the infundibulum becomes the posterior pit and the connecting stalk

261
Q

What is the lingual frenulum

A

Attaches tongue to floor

262
Q

Describe the development of the tongue

A

Forms from 2 lateral swellings of the 1st pharangeal arch, and 3 median swellings from arches 1 (tuberculum impar), 2&3 (cupola) and 4 (epiglottal swelling).
Lateral swellings overgrows the tuberculum impar and the 3rd part of the cupola overgrows the second arch.
Apoptosis (apart from lingual frenulum) frees tongue from pharyngeal base.

263
Q

Name the three median lingual swellings

A

Tuberculum impar, cupola, epiglottal swelling

264
Q

Explain the innervation to the tongue

A

Ant 2/3 from 1 and 3 arches so gen sensory innervation from V and IX
Posterior 1/3 from 3 (&4) so general (and special) sensory CN IX and X
taste buds bedelop in papillae so CNVII.
Myogenic precurs migrate from somites so CN XII

265
Q

Why does the chorda tympani pass through the middle ear?

A

From second arch to first as branch of CNVII

266
Q

Describe development of the thyroid

A

From primitive pharynx and neuroectoderm
Originate at foramen cecum.
Bifurcates and descends - remains conected by thyroglossal duct. Forms pyramidal lobe potentionally.
Follicular cells from thyroid diverticulum
Parafollicular cells from ultimobranchial body of the 4th arch

267
Q

What is the foramen cecum

A

Mediun sulcus in tongue

268
Q

What are the sulcus terminalis

A

Divide ant and post tongue - V shape

269
Q

What is first arch syndrome.

A

Spectrum of defects in eyes, earch and mandible and palate due to failure of colonisation of the 1st arch with neural crest cells

270
Q

What is treacher-collins syndrome

A

Hypoplasia of manduble and fascial bones. resulting in low set ears
Aut dom

271
Q

What is CHARGE syndrome

A 
CHD7 - production of multipotent NC
Coloboma (gap in eye)
Heart defect
Choanal atresia (back of nasal passage is blocked)
Growth and development retardation
Genital hypoplasia
Ear defects
272
Q

Describe the boundaries of the nasopharynx

A

Superior - skull base
Inferior - level of the doft alate
Anterior - Posterior choanae (nasal apertures)
Posterior - nasopharyngeal tonsil, C1

273
Q

What are choanae

A

2 parts separated by vomer
Channels that allow breathing when the mouth is closed
Nasocavity to nasopharynx

274
Q

Epithelium of nasopharynx

A

Ciliated psuedostrat (resp) and strat squamous

275
Q

What are adenoids?

A

Nasopharyngeal tonsils - part of Waldeyer’s ring
Can obstruct eustachian tube orifice.
Produce IgA, IgG and IgM

276
Q

Describe the boundaries of the oropharynx

A

Superior - level of the softpalate
Inferior - superior edge of epiglottis
Posterior - C2&3
Anterior- oral cavity

277
Q

Contents of the oropharynx

A

Palatine tonsils (within the tonsillar fossae between anterior and posterior tonsilar pilars)
Anterior pillar - boundary between buccal cavity and oropharynx. Fuses with lateral wall of tongue, contains palatoglossal muscle.
Posterior pillar - Blends with wall of pharynx, cotains palatopharyngeus muscle

278
Q

Describe the palatine tonsils

A

Encapsulated
Tonsillar fossa floor - superior constrictor muscel
Lymphoid tissue covered with squamous epithelium
Contains crypts
atophies after puberty

279
Q

Describe components of Weldeyers ring

A 
MALT
Adenoids (only called with when inflamed)/ pharyngeal tonsils
Palatine tonsils
Tubule tonsils (by eustachian tube)
Lingual tonsils (posterior tongue)
280
Q

Blood supply to the palatine tonsils

A

Facial artery - tonsillar branch

Venous - pharyngeal plexus

281
Q

Lymph drainage of the palatine tonsils

A

Jugulodiagastric nodes

282
Q

Describe the boundaries of the laryngopharynx

A

Superior edge of epiglottis
Inferior - level of inferior edge of cricoid cartilage
Anterior - larynx
Posterior- C3-6
Inferiorly opens into oesophagus and larynx
Stat squamous epithelium

283
Q

Describe the pharyngeal musculature

A

Superior, middle and inferior constrictors overlap each other (inferior on top). Open anteirorly. Attached posteriorly by median raphe. Inferior constrictor = cricopharyngeus

284
Q

Describe mechanisms of swallowing

A

Tongue and suprahyoid muscles pull hyoid and larynx up, soft palate elevates - nasophasrynx closed
Superior constrictors contract.
Middle and inferior - food bolus passes into hypopharynx by middle and inferior constrictors.
Tongue, epiglottis, vocal cords protect the larynx.
Cricopharyngeus relaxes

285
Q

Describe the blood supply to the pharynx

A

Superior thyroid artery,
Ascending pharyngeal artery
Ascending and descenging palatine arteries
Branches of lingual, facial and maxillary arteries (ECA)

286
Q

Pharyngeal nerve supply

A 
Motor:
X
IX
XII
VII
Senory:
Nasopharynx = Vii
Oropharynx = IX
Hypopharynx= XII
287
Q

Describe the levels of the vertebrae to the larynx/ pharynx

A 
C1 - hard palate
C2 - Angle of mandible
C3 - hyoid bone
C4/5 - thyroid cartilage
C6 - cricoid cartilage
288
Q

Effects of adenoid enlargement

A 
Nasal obstruction:
Mouth breathing
Hyponasla speech
Feeding difficulties
Snoring/ obstructive sleep apnoea

Eustachian tube obstruction - recurrent otitis media, chronci otitis media with effusion (glue ear)

289
Q

Descrube assessment of the adenoids

A 
Difficult
Post-nasla space x-ray
Post-nasal mirror
Fibre optic endoscope
Theatre
290
Q

Describe obstructive sleep apnoea

A

Tiredness

Impaired breathing during sleep - 5 episodes an hour

291
Q

Describe adenoidectomy

A

Curettage (blind and old fasioned)
No suction diathermy )mirror)
Complications include bleeding, atlanto-occipital joint dislocation and eustachian tube stenosis

292
Q

Describe Nasopharyngeal carcinoma

A

SCC

Chinese

293
Q

Describe tonsillectomy

A 
In:
Recurrent tonsillitis (5/year for 2 years)
Previous peritonsillar abcess (quinsy)
Suspected cancer (unilateral)
Obstructive sleep apnoea
Risks - GA, bleeding, infection
Many techniques
294
Q

Describe pharyngeal pouch

A

Posterior herniation of pharyngeal mucosa (true diverticulum so all mucosa layers)
Killian’s degiscence - weakness between inferior constrictor and cricopharyngeus.
Due to weakness, incoordination of pharyngeal phase and cricopharyngeal spasm

295
Q

How are children different from small adults?

A 
Anatomy:
Head:body
Small face
Large tongue
Adenotonsilar hypertrophy
Short/soft trachea
high SA: Wgt
Physiology:
Different baseline
smaller resp reserve
compliant chest wall
Greater metabolic rate/ O2 consumption
Cannot rely on specific commands (AVPU)
296
Q

Why do children have more airway resistance?

A

Due to radius

Poiseuille’s law

297
Q

How are why are children’s larynxs different?

A

Adult - circular, Children - funnel due to narrow underdeveloped cricoid cartilage

298
Q

Describe visualisation of larynx

A

Fexible nasasl endoscope, microlaryngoscope and bronchoscopy (under GA but allow spontaneous breathing so no muscle relaxants), laryngoscope (rigid?)

299
Q

Describe stidor

A

Lower airway obstruction, sound on insiration

300
Q

Describe acute epiglottitis presentation

A

Children
Bacterial (usually Haemophilis influenzae type B (now vaccine)
Sepsis/ pyrexial
Leaning forward and drooling
Tripod position (assisted breathing)
Rare
Epiglottis obstructs larynx due to inflam

301
Q

Describe management of acute epiglottis

A

Secure airway
Anaesthetist and surgeon
Tracheostomy rarely needed
Swab and steroids

302
Q

Describe laryngotracheobronchitis/ Croup

A

Stridor
Viral throat infection
Harsh cough (bark) subglottic
Infective oedema narrows subglottis

303
Q

Describe management of laryngotracheobronchitis/ croup

A 
Mild - home with oral abx and steam inhalation
Mod-sever admit for obs
IV abx, humidified O2, dex, adren neb
Worsening - intubate
Varyrare-tracheostomy
304
Q

Describe foreign bodies presentation

A

.5-4 year olds male
choking, coughing bout or playing with FB
Often unwitnessed
Sometime svague symptoms.

305
Q

Describe FB radiology

A 
Opaque FB
Segmental/ lobar collapse
Locallised emphysema (ball-valve effect
Insipatory/ expiratory films
Normal
306
Q

FB management

A

Bronchoscopy
May have post-instrumental oedema needing steroids and inhaled bronchodilators
Occassionally ventilation on PICU for 24 hours

307
Q

Descrbe laryngomalacia

A

Epiglottis is soft and covers larynx on inspiration

308
Q

Describe aryepiglottoplasty

A

treatment for laryngomalacia

309
Q

Describe sterdor

A

Like a snore insp. Often due to upper obstruction

Esa 4 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions