Head and Neck Flashcards

1
Q

What are the three parts of the skull?

A

Neuro-cranium
Viscera-cranium
Mandible

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2
Q

What are the 8 bones of the cranium?

A

Parietal, temporal, frontal, occipital, sphenoid, mandible, maxilla, zygomatic

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3
Q

Where does the sagittal suture lie?

A

Between 2 parietal bones

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4
Q

Where does the lambdoid suture lie?

A

Between parietal and occipital bones

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5
Q

Where does the coronal suture lie?

A

Between the frontal and parietal bones

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6
Q

What bone is the mastoid process part of?

A

Temporal bone

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7
Q

What bone is the occipital protuberance a part of?

A

Occipital bone

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8
Q

What bones form the zygomatic arch?

A

Zygomatic and temporal

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9
Q

What is found in the foramen magnum?

A
Medulla 
Meninges
CNXI
Dural veins
Anterior and posterior spinal arteries
Right and left vertebral arteries
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10
Q

What is located at the cribriform plate?

A

CNI

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11
Q

What passes through the foramen rotundum?

A

CN V2

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12
Q

What passes through the foramen ovale?

A

CN V3

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13
Q

What passes through the superior orbital fissure?

A

CNIII, IV, VI, V1, ophthalmic veins

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14
Q

What is found in the optic canal?

A

CNII

Opthalmic arteries

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15
Q

What is located in the foramen spinosum?

A

Middle meningeal artery, vein and meningeal branch of V3

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16
Q

What passes through the foramen lacerum?

A

Cartilage

Small veins

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17
Q

What passes through the jugular foramen?

A

CN IX, X, XI, IJV

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18
Q

Where does the CN VII and VIII pass through?

A

Internal acoustic meatus

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19
Q

What is found in the carotid canal?

A

ICA

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20
Q

Where are the ear ossicles found?

A

Petrous part of temporal bone

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21
Q

Know the bones in the eye orbit.

A

….

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22
Q

What are the layers of the scalp?

A
Skin
Connective tissue
Aponeurosis
Loose CT
Periosteum
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23
Q

In what layer of the scalp are blood vessels located?

A

Connective tissue (dense) - layer under skin

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24
Q

What is the cutaneous innervation to the scalp?

A
Anterior = V1, 2 and 3
Posterior = C2 and 3
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25
What is the blood supply to the scalp?
External carotid - superficial temporal, post auricular and occipital Internal carotid - supratrochlear and supraorbital
26
What are the branches of the external carotid artery?
"Some anatomists like freaking out poor medical students" ``` Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Maxillary Superficial temporal ```
27
What is the venous drainage of the scalp?
Anastomoses with DIPLOIC VEINS in skull bones to form valveless EMISSARY VEINS
28
What is the potential complication that can arise from the emissary veins and why?
Spread of infection from scalp to brain since valveless
29
Where doe the post-auricular and superficial temporal veins drain to?
External jugular vein --> SVC
30
What veins drain into the internal jugular vein?
Supra-orbital, supra-trochlear, facial
31
Where does the lymph of the scalp drain?
Away into nodes of head and neck
32
Name 5 muscles of facial expression.
``` Occipitofrontalis Obicularis oris Obicularis oculi Buccinator Platysmus ```
33
What are the two parts of the obicularis oculi?
Palpebral and Orbital
34
What are the branches of the facial nerve?
"Two Zebras Bit My Coccyx" ``` Temporal Zygomatic Buccal Mandibular Cervical ```
35
Where do the branches of the facial nerve emerge from?
Anterior border of the parotid gland
36
What type of lesion spares the forehead?
UMNL
37
What type of duct is the parotid?
Exocrine
38
What muscle does the parotid lie over?
Sternocloidomastoid
39
What muscle does the apex of the parotid gland lie?
Masseter
40
Where does the parotid duct run?
Superficial to masseter then pierces buccinator to open into oral cavity at 2nd maxillary molar
41
What vessels pierce in to the parotid duct?
ECA and retromandibular vein
42
How is the parotid gland innervated?
SNS - external carotid plexus | PNS - CN IX
43
What provides blood supply to the face?
Facial and superficial temporal
44
What are the 4 compartments of the neck?
Vertebral Visceral Vascular Musculofascial collar
45
What does the vascular compartment of the neck contain?
Vagus and blood vessels
46
What compartment of the neck contains the thyroid and larynx?
Visceral
47
How many cervical vertebrae are there?
7
48
What is found in the anterior triangle of the neck?
common carotid, ICA, ECA, Vagus, IJV
49
What is found in the posterior triangle of the neck?
CN XI, phrenic, inferior belly of omohyoid, subclavian artery, scalene muscles, EJV
50
What are the 4 subdivisions of the anterior triangle of the neck?
submental digastric carotid muscular
51
What forms the borders of the posterior triangle of the neck?
Posterior edge of SCM Anterior edge of trapezius Superior border of clavicle
52
What forms the borders of the anterior triangle of the neck?
Inferior border of mandible Anterior border of SCM Anterior midline of neck
53
What is the function of the right SCM?
Right head tilt and turn face to left
54
What is the function of the trapezius?
Depress scapula Retract scapula Elevate scapula
55
What is found in the carotid sheath?
IJV | CN X
56
At what vertebral level does the CCA split to the ICA and ECA?
C4
57
Is the ECA or ICA most lateral?
ICA
58
What vessels runs superficial to the SCM?
ECA
59
What nerve lies posterior to the carotid sheath?
Phrenic nerve
60
What muscles are attached to the hyoid?
Suprahyoid Infrahoid Genioglossus Middle pharyngeal constrictor
61
Name the suprahyoid muscles.
Myelohyoid Geniohyoid Stylohyoid Digastric "my gravy spoon darling"
62
Name the infrahyoid muscles.
Thyrohyoid Omohyoid Sternothyroid Sternohyoid "TOSS"
63
What is the function of the suprahyoid muscles?
Elevate hyoid
64
What is the function of the infrahoid muscles?
Depress hyoid except sternothyroid which depresses thyroid cartilage
65
What muscles are supplied by C1-3 (ansa cervicalis)?
Omohyoid | Sternohyoid
66
What are the three compartments of the nose?
Nasopharynx, oropharynx, laryngopharynx
67
What forms the lateral wall of the nasal cavity?
Ethmoid, cribriform plate of ethmoid, Septal cartilage, inferior turbinate
68
What forms the nasal septum?
Perpendicular plate of ethmoid, septal cartilage, Vomer, Maxilla
69
What type of epithelium is found in the nose?
Ciliated pseudostratified columnar epithelium
70
What innervates the nasal mucosa?
CNI
71
Where are the meatuses located in relation to the turbinates?
Meatus lies below turbinate
72
What is the space above the superior turbinate?
Ethmoid sinus
73
What turbinates are part of the perpendicular plate of the ethmoid?
Superior and middle
74
What provides blood supply to the nose?
Ophthalmic artery
75
Name 4 functions of the paranasal air sinuses.
Reservoir for warm humid air Immune barrier Crumple zone Lighten skull
76
What does the sphenoid sinus open into?
Spheno-ethmoidal recess
77
What does the posterior ethmoid air cells open into?
Superior meatus
78
What drains into the middle meatus?
Frontal sinus Anterior ethmoidal air cells Maxillary sinus Middle ethmoid air cells
79
What drains into the inferior meatus?
Nasolacrimal duct
80
What innervates the ethmoidal sinus?
V1
81
What innervates the sphenoid sinus?
V1 and 2
82
What innervates the frontal sinus?
V1
83
What innervates the maxillary sinus?
V2
84
Where are the adenoids located?
Nasopharynx
85
Describe the anatomy of the mandible?
``` Coronoid process anterior Condylar process posterior Angle Ramus Mental protuberance Mandibular foramen Mental foramen ```
86
What anatomical changes are seen in an edentulous mandible?
Thinning of mandible | Retraction of blood and nerve supply
87
What type of joint is the TMJ?
Hinge and sliding
88
What forms the TMJ?
Mandibular fossa of temporal bone and head of mandible
89
What movements can occur at the TMJ?
``` Elevation Depression Protrusion Retraction Side-to-side ```
90
Name the 4 muscles of mastication.
Temporalis Masseter Medial pterygoid Lateral pterygoid
91
What is the function of the masseter?
Elevate mandible
92
Describe the function of the anterior and posterior fibres of the temporalis muscle.
``` Anterior = elevate Posterior = retract ```
93
What muscles of mastication are almost parallel?
Middle pterygoid and masseter
94
What is the function of the lateral pterygoid?
Protraction
95
What nerve supplies sensory and motor innervation to the muscles of mastication?
V3
96
Where does the lateral and medial pterygoids attach?
Lateral plates
97
What happens when the medial pterygoids contract?
Elevate mandible
98
What muscles depress the mandible?
NONE (job of gravity and suprahyoid muscles)
99
What muscles cause protrusion of the mandible?
Masseter and pterygoids
100
What muscles cause retraction of mandible
Temporalis and digastric
101
What muscles cause side-to-side movement of mandible?
Pterygoids
102
What muscles elevate the mandible?
Masseter, temporalis, medial pterygoid
103
What innervates the muscles of the soft palate?
Vagus
104
What are the muscles of the soft palate?
``` Tensor veli palatini Levator veli palatini Muscularis uvulae Palatoglossus Palatopharyngeus ```
105
Where do the palatine tonsils lie?
Between palatoglossus (anterior) and palatopharyngeus (Posterior)
106
What is the foramen caecum?
Point where thyroid diverticulum descends in embryo
107
Know the anatomy of the larynx.
...
108
Know where the false and true vocal cords are located
...
109
What is characteristic of the cricoid cartilage?
Complete ring
110
What is located in the laryngeal inlet?
Epiglottis Corniculate cartilages Arytenoid cartilage Aryepiglottic fold
111
What is the innervation of the intrinsic muscles of the larynx?
Recurrent laryngeal nerve (except for the cricothyroid muscle!)
112
What supplies the recurrent laryngeal muscle?
Superior laryngeal nerve
113
What happens if the recurrent laryngeal is transected?
Hoarseness or aphasia
114
What is the sensory supply to the mucous membrane of the larynx?
Internal laryngeal nerve
115
What is located on the roof of the nasopharynx?
Nasopharyngeal tonsil
116
What is the function of the epiglottis?
Prevents food entering the larynx
117
What is the function of the soft palate?
Prevents food bolus from entering the nasopharynx
118
What are the three layers of the pharynx?
Outer muscular layer Middle fibrous layer Inner mucous membrane
119
Describe the muscular layer of the pharynx.
Outer circular layer (superior, middle and inferior constrictors) Inner longitudinal layer (stylopharyngess, salpingopharyngeus, palatopharyngeus)
120
What provides innervation to the pharynx?
Pharyngeal plexus (IX sensory and X motor)
121
What is Waldeyer's ring?
Pharyngeal lymphoid ring which protects entrance to oropharynx
122
Name three lymphoid collections in the pharynx.
Inguinal tonsil Nasopharyngeal tonsil Lymphoid tissue in soft palate
123
What make up the orbit?
``` Eyeball Extrinsic ocular muscles Ligaments Optic nerve Branches of ICA Lacrimal apparatus Adipose tissue ```
124
What forms the outer layer of the eye?
Sclera and cornea
125
What forms the middle layer of the eye?
Choroid and ciliary body and oris
126
What forms the inner layer of the eye?
Retina
127
What does the anterior segment of the eye contain?
Aqueous humour
128
What produces aqueous humour?
Ciliary body in posterior chamber
129
What is located in the posterior chamber of the eye?
Vitreous humour
130
Name three intrinsic eye muscles.
Ciliaris Constrictor pupillae Dilator pupillae
131
What is the role of the ciliates muscle?
Accommodation
132
What innervates the ciliates muscle?
CN III
133
What innervates the constrictor pupillae to cause pupil constriction?
CN III (PNS)
134
What are the 5 eye movements?
Intort, extort, elevate, depress, adduct, abduct
135
What are the 6 extrinsic eye muscles?
Medial rectus, lateral rectus, superior rectus and inferior rectus Superior oblique Inferior oblique
136
What eye muscle doesn't arise from the posterior aspect of the orbit?
Inferior oblique
137
What is the function of the medial rectus?
Adduction
138
What is the function of the lateral rectus?
Abduction
139
What is the function of the superior rectus?
Elevate, adduct, intort
140
What is the function of the superior rectus?
Suppress, adduct, extort
141
What is the function of the superior oblique?
Depress, abduct and intort
142
What is the function of the inferior oblique?
Elevate, abduct and extort
143
What eye muscle adduct?
Recti (excluding lateral) (RADSIN)
144
What muscles intort?
Superior rectus and Superior oblique (RADSIN)
145
What is the function of medial and lateral check ligaments?
Prevent over-abduction and over-adduction
146
What innervates the stapedius?
VII
147
What is the function of the stapedius?
Decrease ossicle range
148
What is the function of tensor tympani?
Dampens vibrations
149
What innervates tensor tympani?
V3
150
What are the ossicles of the middle ear?
Malleus, incus, stapes
151
What ossicle is connected to the tympanic membrane?
Malleus
152
What ossicle if connected to the oval window?
Stapes
153
What type of joints are present in the ear ossicles?
Synovial
154
What does perilymph and endolymph line in the ear?
``` Perilymph = bony labyrinth Endolymph = membranous labyrinth ```
155
What nodes drain the head and neck?
Deep cervical and jugular lymph trunk
156
What drains into the jugular lymph trunk form the right and left side?
Internal jugular and subclavian = right | Thoracid duct and left subclavian = left
157
What lymph nodes does the face, scalp and neck drain into?
Can be variable
158
What artery is often damaged in an extradural haemorrhage?
Middle meningeal artery
159
What are the grooves on the inside of the skull?
Internal occipital protuberance Transverse sinus Sigmoid sinus
160
Where is the pituitary found?
Sella turcica of sphenoid bone
161
When do fontanelles close?
Around 18 months
162
What type of epithelium is found on the tongue?
Stratifies squamous keratinised
163
What papillae are found on the tongue?
Filiform (no taste buds) Fungiform (taste buds) NOT keratinised Vallate
164
What provides taste sensation to the posterior tongue?
CN IX
165
What provides taste sensation to the anterior tongue?
CN VII
166
What provides somatic sensation to the anterior 2/3 of the tongue?
V3 (lingual branch)
167
What fixes the tongue to the floor?
Frenulum
168
What is the function of the intrinsic muscles of the tongue?
XII
169
Name the 4 extrinsic muscles of the tongue.
Genioglossus Hypglossus Styloglossus Palatoglossus
170
What muscle of the tongue is not innervated by CN XII?
Palatoglossus - X (pharyngeal plexus)
171
If the nerve innervating the right genioglossus was damages, what would happen?
Tongue would deviate to the right
172
What lies posterior to the isthmus of the thyroid gland?
2nd and 3rd tracheal rings
173
Recognise SCM, IJV, CCA and trachea on USS.
...
174
What side is preferred for central venous line insertion and why?
Right - straight route into SVC, left IJV smaller, left IJV dome higher increasing risk of PTX
175
What surface landmarks are used for point of entry of a central line?
Sternal notch | Between two heads of sternocleidomastoid
176
What is the valeculla?
Space between the epiglottis and inguinal tonsil
177
What muscles are used during the oral phase of swallowing?
Intrinsic and extrinsic | Suprahyoid
178
What muscles are used during the pharyngeal phase of swallowing?
Constrictor muscles
179
Recognise the odontoid peg on radiological images.
...
180
What is the most common imaging modality for spinal studies?
MRI
181
What is located immediately below the pituitary fossa?
Sphenoid sinus
182
Know the lymph drainage of the head.
...
183
What is diploe?
The spongy bone separating the inner and outer layers of cortical bone.
184
From which foramen does the facial nerve emerge onto the side of the face/
Stylomastoid foramen
185
What are the vertebral root values for the cervical plexus?
C1-4
186
What is the ansa cervicalis?
Loop of nerves formed by C1-3 nerve roots
187
Name three functions of the nose.
Traps dirt (immune barrier) Nasal airway Drainage and aeration of middle ear and sinuses
188
What problem could arise from a deviated septum?
Blocks drainage of sinuses --> sinusitis
189
What sinus has a floor indented by tooth sockets?
Maxillary
190
What bone forms the roof of the nasopharynx?
Sphenoid
191
What is the total number of teeth in an adult?
32
192
Name 9 groups of lymph nodes in the head and neck.
``` Parotid Buccal Submandibular Submental Deep cervical Superficial cervical Occipital Post-auricular ```
193
Which four bones join to form the pterion?
Frontal Parietal Temporal Sphenoid
194
What foramen lies immediately anterior to the groove for the cavernous sinus?
Superior orbital fissure
195
What change occurs in the tympanic membrane form birth to adulthood?
More superficial initially and then depresses in
196
When do the soloed and mastoid process form?
Non-existent at birth then mastoid forms first and then styloid process.
197
When do the posterior fontanelles fuse?
Approx. 2 months
198
What bodies in the thalamus do fibres from hearing and vision travel to?
Hearing --> medial Vision --> lateral ("Music to medial and light to lateral")