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
Q

What is the blood supply to the scalp?

A

External carotid - superficial temporal, post auricular and occipital
Internal carotid - supratrochlear and supraorbital

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26
Q

What are the branches of the external carotid artery?

A

“Some anatomists like freaking out poor medical students”

Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital 
Posterior auricular
Maxillary
Superficial temporal
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27
Q

What is the venous drainage of the scalp?

A

Anastomoses with DIPLOIC VEINS in skull bones to form valveless EMISSARY VEINS

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28
Q

What is the potential complication that can arise from the emissary veins and why?

A

Spread of infection from scalp to brain since valveless

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29
Q

Where doe the post-auricular and superficial temporal veins drain to?

A

External jugular vein –> SVC

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30
Q

What veins drain into the internal jugular vein?

A

Supra-orbital, supra-trochlear, facial

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31
Q

Where does the lymph of the scalp drain?

A

Away into nodes of head and neck

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32
Q

Name 5 muscles of facial expression.

A
Occipitofrontalis
Obicularis oris
Obicularis oculi
Buccinator
Platysmus
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33
Q

What are the two parts of the obicularis oculi?

A

Palpebral and Orbital

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34
Q

What are the branches of the facial nerve?

A

“Two Zebras Bit My Coccyx”

Temporal
Zygomatic
Buccal
Mandibular 
Cervical
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35
Q

Where do the branches of the facial nerve emerge from?

A

Anterior border of the parotid gland

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36
Q

What type of lesion spares the forehead?

A

UMNL

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37
Q

What type of duct is the parotid?

A

Exocrine

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38
Q

What muscle does the parotid lie over?

A

Sternocloidomastoid

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39
Q

What muscle does the apex of the parotid gland lie?

A

Masseter

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40
Q

Where does the parotid duct run?

A

Superficial to masseter then pierces buccinator to open into oral cavity at 2nd maxillary molar

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41
Q

What vessels pierce in to the parotid duct?

A

ECA and retromandibular vein

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42
Q

How is the parotid gland innervated?

A

SNS - external carotid plexus

PNS - CN IX

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43
Q

What provides blood supply to the face?

A

Facial and superficial temporal

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44
Q

What are the 4 compartments of the neck?

A

Vertebral
Visceral
Vascular
Musculofascial collar

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45
Q

What does the vascular compartment of the neck contain?

A

Vagus and blood vessels

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46
Q

What compartment of the neck contains the thyroid and larynx?

A

Visceral

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47
Q

How many cervical vertebrae are there?

A

7

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48
Q

What is found in the anterior triangle of the neck?

A

common carotid, ICA, ECA, Vagus, IJV

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49
Q

What is found in the posterior triangle of the neck?

A

CN XI, phrenic, inferior belly of omohyoid, subclavian artery, scalene muscles, EJV

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50
Q

What are the 4 subdivisions of the anterior triangle of the neck?

A

submental
digastric
carotid
muscular

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51
Q

What forms the borders of the posterior triangle of the neck?

A

Posterior edge of SCM
Anterior edge of trapezius
Superior border of clavicle

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52
Q

What forms the borders of the anterior triangle of the neck?

A

Inferior border of mandible
Anterior border of SCM
Anterior midline of neck

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53
Q

What is the function of the right SCM?

A

Right head tilt and turn face to left

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54
Q

What is the function of the trapezius?

A

Depress scapula
Retract scapula
Elevate scapula

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55
Q

What is found in the carotid sheath?

A

IJV

CN X

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56
Q

At what vertebral level does the CCA split to the ICA and ECA?

A

C4

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57
Q

Is the ECA or ICA most lateral?

A

ICA

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58
Q

What vessels runs superficial to the SCM?

A

ECA

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59
Q

What nerve lies posterior to the carotid sheath?

A

Phrenic nerve

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60
Q

What muscles are attached to the hyoid?

A

Suprahyoid
Infrahoid
Genioglossus
Middle pharyngeal constrictor

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61
Q

Name the suprahyoid muscles.

A

Myelohyoid
Geniohyoid
Stylohyoid
Digastric

“my gravy spoon darling”

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62
Q

Name the infrahyoid muscles.

A

Thyrohyoid
Omohyoid
Sternothyroid
Sternohyoid

“TOSS”

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63
Q

What is the function of the suprahyoid muscles?

A

Elevate hyoid

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64
Q

What is the function of the infrahoid muscles?

A

Depress hyoid except sternothyroid which depresses thyroid cartilage

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65
Q

What muscles are supplied by C1-3 (ansa cervicalis)?

A

Omohyoid

Sternohyoid

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66
Q

What are the three compartments of the nose?

A

Nasopharynx, oropharynx, laryngopharynx

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67
Q

What forms the lateral wall of the nasal cavity?

A

Ethmoid, cribriform plate of ethmoid, Septal cartilage, inferior turbinate

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68
Q

What forms the nasal septum?

A

Perpendicular plate of ethmoid, septal cartilage, Vomer, Maxilla

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69
Q

What type of epithelium is found in the nose?

A

Ciliated pseudostratified columnar epithelium

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70
Q

What innervates the nasal mucosa?

A

CNI

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71
Q

Where are the meatuses located in relation to the turbinates?

A

Meatus lies below turbinate

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72
Q

What is the space above the superior turbinate?

A

Ethmoid sinus

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73
Q

What turbinates are part of the perpendicular plate of the ethmoid?

A

Superior and middle

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74
Q

What provides blood supply to the nose?

A

Ophthalmic artery

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75
Q

Name 4 functions of the paranasal air sinuses.

A

Reservoir for warm humid air
Immune barrier
Crumple zone
Lighten skull

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76
Q

What does the sphenoid sinus open into?

A

Spheno-ethmoidal recess

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77
Q

What does the posterior ethmoid air cells open into?

A

Superior meatus

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78
Q

What drains into the middle meatus?

A

Frontal sinus
Anterior ethmoidal air cells
Maxillary sinus
Middle ethmoid air cells

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79
Q

What drains into the inferior meatus?

A

Nasolacrimal duct

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80
Q

What innervates the ethmoidal sinus?

A

V1

81
Q

What innervates the sphenoid sinus?

A

V1 and 2

82
Q

What innervates the frontal sinus?

A

V1

83
Q

What innervates the maxillary sinus?

A

V2

84
Q

Where are the adenoids located?

A

Nasopharynx

85
Q

Describe the anatomy of the mandible?

A
Coronoid process anterior 
Condylar process posterior 
Angle 
Ramus
Mental protuberance
Mandibular foramen 
Mental foramen
86
Q

What anatomical changes are seen in an edentulous mandible?

A

Thinning of mandible

Retraction of blood and nerve supply

87
Q

What type of joint is the TMJ?

A

Hinge and sliding

88
Q

What forms the TMJ?

A

Mandibular fossa of temporal bone and head of mandible

89
Q

What movements can occur at the TMJ?

A
Elevation 
Depression 
Protrusion
Retraction 
Side-to-side
90
Q

Name the 4 muscles of mastication.

A

Temporalis
Masseter
Medial pterygoid
Lateral pterygoid

91
Q

What is the function of the masseter?

A

Elevate mandible

92
Q

Describe the function of the anterior and posterior fibres of the temporalis muscle.

A
Anterior = elevate
Posterior = retract
93
Q

What muscles of mastication are almost parallel?

A

Middle pterygoid and masseter

94
Q

What is the function of the lateral pterygoid?

A

Protraction

95
Q

What nerve supplies sensory and motor innervation to the muscles of mastication?

A

V3

96
Q

Where does the lateral and medial pterygoids attach?

A

Lateral plates

97
Q

What happens when the medial pterygoids contract?

A

Elevate mandible

98
Q

What muscles depress the mandible?

A

NONE (job of gravity and suprahyoid muscles)

99
Q

What muscles cause protrusion of the mandible?

A

Masseter and pterygoids

100
Q

What muscles cause retraction of mandible

A

Temporalis and digastric

101
Q

What muscles cause side-to-side movement of mandible?

A

Pterygoids

102
Q

What muscles elevate the mandible?

A

Masseter, temporalis, medial pterygoid

103
Q

What innervates the muscles of the soft palate?

A

Vagus

104
Q

What are the muscles of the soft palate?

A
Tensor veli palatini
Levator veli palatini
Muscularis uvulae
Palatoglossus
Palatopharyngeus
105
Q

Where do the palatine tonsils lie?

A

Between palatoglossus (anterior) and palatopharyngeus (Posterior)

106
Q

What is the foramen caecum?

A

Point where thyroid diverticulum descends in embryo

107
Q

Know the anatomy of the larynx.

A

108
Q

Know where the false and true vocal cords are located

A

109
Q

What is characteristic of the cricoid cartilage?

A

Complete ring

110
Q

What is located in the laryngeal inlet?

A

Epiglottis
Corniculate cartilages
Arytenoid cartilage
Aryepiglottic fold

111
Q

What is the innervation of the intrinsic muscles of the larynx?

A

Recurrent laryngeal nerve (except for the cricothyroid muscle!)

112
Q

What supplies the recurrent laryngeal muscle?

A

Superior laryngeal nerve

113
Q

What happens if the recurrent laryngeal is transected?

A

Hoarseness or aphasia

114
Q

What is the sensory supply to the mucous membrane of the larynx?

A

Internal laryngeal nerve

115
Q

What is located on the roof of the nasopharynx?

A

Nasopharyngeal tonsil

116
Q

What is the function of the epiglottis?

A

Prevents food entering the larynx

117
Q

What is the function of the soft palate?

A

Prevents food bolus from entering the nasopharynx

118
Q

What are the three layers of the pharynx?

A

Outer muscular layer
Middle fibrous layer
Inner mucous membrane

119
Q

Describe the muscular layer of the pharynx.

A

Outer circular layer (superior, middle and inferior constrictors)
Inner longitudinal layer (stylopharyngess, salpingopharyngeus, palatopharyngeus)

120
Q

What provides innervation to the pharynx?

A

Pharyngeal plexus (IX sensory and X motor)

121
Q

What is Waldeyer’s ring?

A

Pharyngeal lymphoid ring which protects entrance to oropharynx

122
Q

Name three lymphoid collections in the pharynx.

A

Inguinal tonsil
Nasopharyngeal tonsil
Lymphoid tissue in soft palate

123
Q

What make up the orbit?

A
Eyeball
Extrinsic ocular muscles
Ligaments 
Optic nerve 
Branches of ICA
Lacrimal apparatus
Adipose tissue
124
Q

What forms the outer layer of the eye?

A

Sclera and cornea

125
Q

What forms the middle layer of the eye?

A

Choroid and ciliary body and oris

126
Q

What forms the inner layer of the eye?

A

Retina

127
Q

What does the anterior segment of the eye contain?

A

Aqueous humour

128
Q

What produces aqueous humour?

A

Ciliary body in posterior chamber

129
Q

What is located in the posterior chamber of the eye?

A

Vitreous humour

130
Q

Name three intrinsic eye muscles.

A

Ciliaris
Constrictor pupillae
Dilator pupillae

131
Q

What is the role of the ciliates muscle?

A

Accommodation

132
Q

What innervates the ciliates muscle?

A

CN III

133
Q

What innervates the constrictor pupillae to cause pupil constriction?

A

CN III (PNS)

134
Q

What are the 5 eye movements?

A

Intort, extort, elevate, depress, adduct, abduct

135
Q

What are the 6 extrinsic eye muscles?

A

Medial rectus, lateral rectus, superior rectus and inferior rectus
Superior oblique
Inferior oblique

136
Q

What eye muscle doesn’t arise from the posterior aspect of the orbit?

A

Inferior oblique

137
Q

What is the function of the medial rectus?

A

Adduction

138
Q

What is the function of the lateral rectus?

A

Abduction

139
Q

What is the function of the superior rectus?

A

Elevate, adduct, intort

140
Q

What is the function of the superior rectus?

A

Suppress, adduct, extort

141
Q

What is the function of the superior oblique?

A

Depress, abduct and intort

142
Q

What is the function of the inferior oblique?

A

Elevate, abduct and extort

143
Q

What eye muscle adduct?

A

Recti (excluding lateral) (RADSIN)

144
Q

What muscles intort?

A

Superior rectus and Superior oblique (RADSIN)

145
Q

What is the function of medial and lateral check ligaments?

A

Prevent over-abduction and over-adduction

146
Q

What innervates the stapedius?

A

VII

147
Q

What is the function of the stapedius?

A

Decrease ossicle range

148
Q

What is the function of tensor tympani?

A

Dampens vibrations

149
Q

What innervates tensor tympani?

A

V3

150
Q

What are the ossicles of the middle ear?

A

Malleus, incus, stapes

151
Q

What ossicle is connected to the tympanic membrane?

A

Malleus

152
Q

What ossicle if connected to the oval window?

A

Stapes

153
Q

What type of joints are present in the ear ossicles?

A

Synovial

154
Q

What does perilymph and endolymph line in the ear?

A
Perilymph = bony labyrinth
Endolymph = membranous labyrinth
155
Q

What nodes drain the head and neck?

A

Deep cervical and jugular lymph trunk

156
Q

What drains into the jugular lymph trunk form the right and left side?

A

Internal jugular and subclavian = right

Thoracid duct and left subclavian = left

157
Q

What lymph nodes does the face, scalp and neck drain into?

A

Can be variable

158
Q

What artery is often damaged in an extradural haemorrhage?

A

Middle meningeal artery

159
Q

What are the grooves on the inside of the skull?

A

Internal occipital protuberance
Transverse sinus
Sigmoid sinus

160
Q

Where is the pituitary found?

A

Sella turcica of sphenoid bone

161
Q

When do fontanelles close?

A

Around 18 months

162
Q

What type of epithelium is found on the tongue?

A

Stratifies squamous keratinised

163
Q

What papillae are found on the tongue?

A

Filiform (no taste buds)
Fungiform (taste buds) NOT keratinised
Vallate

164
Q

What provides taste sensation to the posterior tongue?

A

CN IX

165
Q

What provides taste sensation to the anterior tongue?

A

CN VII

166
Q

What provides somatic sensation to the anterior 2/3 of the tongue?

A

V3 (lingual branch)

167
Q

What fixes the tongue to the floor?

A

Frenulum

168
Q

What is the function of the intrinsic muscles of the tongue?

A

XII

169
Q

Name the 4 extrinsic muscles of the tongue.

A

Genioglossus
Hypglossus
Styloglossus
Palatoglossus

170
Q

What muscle of the tongue is not innervated by CN XII?

A

Palatoglossus - X (pharyngeal plexus)

171
Q

If the nerve innervating the right genioglossus was damages, what would happen?

A

Tongue would deviate to the right

172
Q

What lies posterior to the isthmus of the thyroid gland?

A

2nd and 3rd tracheal rings

173
Q

Recognise SCM, IJV, CCA and trachea on USS.

A

174
Q

What side is preferred for central venous line insertion and why?

A

Right - straight route into SVC, left IJV smaller, left IJV dome higher increasing risk of PTX

175
Q

What surface landmarks are used for point of entry of a central line?

A

Sternal notch

Between two heads of sternocleidomastoid

176
Q

What is the valeculla?

A

Space between the epiglottis and inguinal tonsil

177
Q

What muscles are used during the oral phase of swallowing?

A

Intrinsic and extrinsic

Suprahyoid

178
Q

What muscles are used during the pharyngeal phase of swallowing?

A

Constrictor muscles

179
Q

Recognise the odontoid peg on radiological images.

A

180
Q

What is the most common imaging modality for spinal studies?

A

MRI

181
Q

What is located immediately below the pituitary fossa?

A

Sphenoid sinus

182
Q

Know the lymph drainage of the head.

A

183
Q

What is diploe?

A

The spongy bone separating the inner and outer layers of cortical bone.

184
Q

From which foramen does the facial nerve emerge onto the side of the face/

A

Stylomastoid foramen

185
Q

What are the vertebral root values for the cervical plexus?

A

C1-4

186
Q

What is the ansa cervicalis?

A

Loop of nerves formed by C1-3 nerve roots

187
Q

Name three functions of the nose.

A

Traps dirt (immune barrier)
Nasal airway
Drainage and aeration of middle ear and sinuses

188
Q

What problem could arise from a deviated septum?

A

Blocks drainage of sinuses –> sinusitis

189
Q

What sinus has a floor indented by tooth sockets?

A

Maxillary

190
Q

What bone forms the roof of the nasopharynx?

A

Sphenoid

191
Q

What is the total number of teeth in an adult?

A

32

192
Q

Name 9 groups of lymph nodes in the head and neck.

A
Parotid
Buccal
Submandibular
Submental 
Deep cervical 
Superficial cervical
Occipital 
Post-auricular
193
Q

Which four bones join to form the pterion?

A

Frontal
Parietal
Temporal
Sphenoid

194
Q

What foramen lies immediately anterior to the groove for the cavernous sinus?

A

Superior orbital fissure

195
Q

What change occurs in the tympanic membrane form birth to adulthood?

A

More superficial initially and then depresses in

196
Q

When do the soloed and mastoid process form?

A

Non-existent at birth then mastoid forms first and then styloid process.

197
Q

When do the posterior fontanelles fuse?

A

Approx. 2 months

198
Q

What bodies in the thalamus do fibres from hearing and vision travel to?

A

Hearing –> medial
Vision –> lateral

(“Music to medial and light to lateral”)