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Anatomy BMSc > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

what are the borders of the anterior triangle

A

superior: inferior border of mandible
lateral: anterior border of SCM
medial: imaginary line down the midline of the neck

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2
Q

which layers of fascia form the roof and floor of the anterior triangle

A

roof: investing fascia
floor: visceral fascia

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3
Q

what are the general contents of the anterior triangle

A

muscles
nerves
blood vessels
lymph nodes

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4
Q

which groups of muscles are in the anterior triangle

A

supra hyoid

infra hyoid

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5
Q

what are the supra hyoid muscles

A

stylohyoid
digastric
mylohyoid
geniohyoid

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6
Q

what are the infra hyoid muscles

A

omohyoid
sternohyoid
thyrohyoid
sternothyroid

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7
Q

which nerves are found in the anterior triangle of the neck

A 
cranial nerves
CN VII
CN IX
CN X
CN XI
CN XII
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8
Q

which blood vessels are found in the anterior triangle

A

common carotid artery, which bifurcates into the internal and external carotids
internal jugular vein

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9
Q

what are the subdivisions of the anterior triangle

A

carotid triangle
submental triangle
submandibular triangle
muscular triangle

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10
Q

borders of the carotid triangle

A

superior: posterior belly of digastric
lateral: medial border of SCM
inferior: superior belly of omohyoid

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11
Q

what are the contents of the carotid triangles

A

common carotid artery and its bifurcation
internal jugular vein
hypoglossal, accessory and vagus nerves

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12
Q

where is the submittal triangle

A

underneath the chin

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13
Q

contents of the submental triangle

A

submental lymph nodes

beginning of anterior jugular vein

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14
Q

boundaries of the submental triangle

A

inferior: hyoid
medial: midline of neck
lateral: anterior belly of digastric

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15
Q

what forms the floor of the submental triangle

A

mylohyoid muscle, from the mandible to the hyoid bone

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16
Q

contents of the submandibular triangle

A 
submandibular salivary gland 
lymph nodes 
facial artery and vein 
carotid sheath
hypoglossal nerve
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17
Q

borders of the submandibular triangle

A

superior: body of mandible
anterior: anterior belly of digastric
posterior: posterior belly of digastric

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18
Q

borders of the muscular triangle

A

superior: hyoid
medial: imaginary midline of neck
superolateral: superior belly of omohyoid
inferolateral: inferior part of SCM

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19
Q

attachments of platysma

A

from fascia above pectoralis major and clavicle to lateral neck and onto mandible

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20
Q

innervation of platysma

A

facial nerve CN VII

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21
Q

describe the course of the jugular veins in relation to SCM

A

external jugular vein runs anterior/superficial to SCM
internal jugular vein runs posterior/deep to SCM
anterior jugular runs in the midline

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22
Q

which nerve roots make up the cervical plexus

A

anterior rami C1-C4

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23
Q

within which fascial layer do the branches of the cervical plexus lie

A

prevertebral fascia

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24
Q

which modalities are carried in the cervical plexus

A

somatic motor and sensory

sympathetic

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25
Q

what are the main sensory branches of the cervical plexus

A

lesser occipital
great auricular
transverse cervical
supraclavicular

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26
Q

what are the main motor branches of the cervical plexus

A

nerves to geniohyoid and thyrohyoid
ansa cervicalis
phrenic nerve

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27
Q

which muscles are innervated by branches from C1

A

geniohyoid

thyrohyoid

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28
Q

with which nerve do fibres from C1 travel to reach geniohyoid and thyrohyoid

A

hypoglossal nerve

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29
Q

what roots make up the ansa cervicalis

A

C1-C3

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30
Q

which muscles are supplied by ansa cervicalis

A

omohyoid
sternohyoid
sternothyroid
(infra hyoid muscles apart from thyrohyoid)

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31
Q

nerve roots of greater auricular nerve

A

C2-C3

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32
Q

what does the greater auricular nerve supply

A

sensation to skin of external ear and skin over parotid gland

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33
Q

nerve roots of transverse cervical nerve

A

C2-C3

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34
Q

what does the transverse cervical nerve supply

A

sensation to skin of anterior and anterolateral neck and upper sternum

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35
Q

nerve toots of lesser occipital nerve

A

C2

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36
Q

what does the lesser occipital nerve supply

A

posterosuperior scalp

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37
Q

nerve roots of supraclavicular nerves

A

C3-C4

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38
Q

what do the supraclavicular nerves supply

A

skin overlying the supraclavicular fossa and upper thoracic region and sternoclavicular joint

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39
Q

which muscles does the cervical plexus supply with proprioception

A

SCM C2-C3

trapezius C3-C4

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40
Q

nerve roots of phrenic

A

C3,4,5

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41
Q

what does the phrenic nerve supply

A

diaphragm

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42
Q

course of phrenic nerve in neck

A

travels on the anterior surface of the anterior scalene and through the thoracic inlet

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43
Q

what are the actions of the supra hyoid muscles

A

elevate hyoid bone

necessary for swallowing

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44
Q

attachments of stylohyoid

A

styloid process of temporal bone
TO
lateral aspect of hyoid bone

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45
Q

action of stylohyoid

A

initiates swallowing action by pulling hyoid posterosuperiorly

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46
Q

innervation of stylohyoid

A

facial nerve CN VII

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47
Q

attachments of digastric

A

anterior belly from digastric fossa or mandible
posterior belly from mastoid process of temporal bone
intermediate tendon attaches both bellies to hyoid via fibrous sling

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48
Q

actions of digastric

A

depress mandible and elevates hyoid

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49
Q

innervation of digastric

A

anterior belly: CN V3

posterior belly: CN VII

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50
Q

attachments of mylohyoid

A

mandible
TO
hyoid

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51
Q

actions of mylohyoid

A

elevate hyoid bone and floor of mouth

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52
Q

innervation of mylohyoid

A

CN V3

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53
Q

attachments of geniohyoid

A

inferior mental spine of mandible
TO
hyoid bone

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54
Q

actions of geniohyoid

A

depresses the mandible and elevates hyoid bone

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55
Q

innervation of geniohyoid

A

C1 nerve roots via hypoglossal nerve

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56
Q

actions of infra hyoid muscles

A

depress hyoid and thyroid cartilage

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57
Q

attachments of omohyoid

A

inferior belly: scapula
superior belly: hyoid
intermediate tendon attach to clavicle by deep cervical fascia

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58
Q

actions of omohyoid

A

depresses the hyoid

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59
Q

innervation of omohyoid

A

ansa cervicalis (C1-C3)

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60
Q

attachments of sternohyoid

A

sternum
TO
hyoid bone

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61
Q

actions of sternohyoid

A

depress the hyoid

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62
Q

innervation of sternohyoid

A

ansa cervicalis, C1-C3

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63
Q

attachments of sternothyroid

A

sternum (manubrium)
TO
thyroid cartilage

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64
Q

actions of sternothyroid

A

depresses the thyroid cartilage

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65
Q

innervation of sternothyroid

A

ansa cervicalis, C1-C3

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66
Q

attachments of thyrohyoid

A

thyroid cartilage
TO
hyoid

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67
Q

actions of thyrohyoid

A

depresses the hyoid and elevates larynx when hyoid is fixed

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68
Q

innervation of thyrohyoid

A

C1 via hypoglossal nerve

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69
Q

which roots contribute to the superior and inferior roots of ansa cervicalis

A

superior root = C1

inferior root = C2,3

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70
Q

where does the left common carotid arise from

A

arch of aorta

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71
Q

where does the right common carotid arise from

A

brachiocephalic

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72
Q

what are the branches of the common carotid arteries in the neck

A

NO BRANCHES U FOOL

terminates by dividing into internal and external carotids

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73
Q

general supply of they internal and external carotids

A

internal: brain and intracranial structures
external: head, face, neck

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74
Q

what does the common carotid travel within in the neck

A

carotid sheath

along with internal jugular and vagus nerve

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75
Q

which branches of the external carotid are found in the anterior triangle

A

facial artery
lingual artery
superior thyroid artery

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76
Q

which other artery (not a carotid) gives branches to supply the neck

A

subclavian artery via thyrocervical trunk

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77
Q

branches of the thyrocervical trunk

A

inferior thyroid artery
transverse cervical artery
supra scapular artery

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78
Q

which cranial nerve descends in the carotid sheath

A

vagus nerve

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79
Q

which branches of the vagus nerve are given off in the neck

A

recurrent laryngeal branches
- left wraps around the arch of aorta
- right wraps around subclavian artery
internal and external laryngeal branches

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80
Q

what are the main parts of the thyroid gland

A

2 lobes
isthmus
capsule

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81
Q

borders of the thyroid gland

A

from lamina of thyroid cartilage to 6th trachea ring

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82
Q

where is the isthmus located

A

over tracheal ring 2/3

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83
Q

arterial supply of thyroid

A

superior thyroid artery: branch of external carotid

inferior thyroid artery: thyrocervical trunk of subclavian artery

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84
Q

venous drainage of thyroid

A

superior thyroid vein: internal jugular
middle thyroid vein: internal jugular
inferior jugular: left bracnhiocephalic

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85
Q

where is the submandibular salivary gland located

A

inferior to mylohyoid

with part in floor of mouth superior to mylohyoid

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86
Q

where fo the ducts of the submandibular salivary gland open

A

between first and second lower incisor

either side of frenulum

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87
Q

borders of posterior triangle

A

anterior: posterior border of SCM
posterior: anterior border of trapezius
inferior: middle 1/3 of clavicle

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88
Q

what makes up the roof and floor of posterior triangle

A

roof: investing fascia
floor: prevertebral fascia

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89
Q

contents of posterior triangles

A 
external jugular vein
roots of brachial plexus 
accessory nerve 
cervical and supraclavicular lymph nodes 
supraclavicular nerves
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90
Q

which nerves can be found the posterior triangle

A

lesser occipital C2
greater auricular C2,3
supraclavicular (lateral, intermediate and medial) C3,4
transverse cervical C2,3

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91
Q

which nerve supplies the upper, posterior scalp

A

greater occipital

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92
Q

which nerve supplies the lateral scalp, posterior to ear

A

lesser occipital

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93
Q

which nerve supplies the outer ear, and skin over parotids

A

great auricular

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94
Q

which nerve supplies the anterior neck

A

transverse cutaneous nerve

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95
Q

which nerves supply the lower lateral neck and upper shoulders

A

supraclavicular nerves

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96
Q

which veins join to form the external jugular

A

posterior auricular and retromandibular veins

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97
Q

which veins form the retromandibular vein

A

maxillary and superficial temporal veins

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98
Q

where does the external jugular vein form

A

posterior to the angle of mandible

inferior to the outer ear

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99
Q

where does the external jugular vein travel within the neck

A

descends in superficial fascia

runs anterior to SCM, crosses it in a posteroinferior direction

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100
Q

which vein does the external jugular drain into

A

subclavian vein (passes under clavicle)

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101
Q

attachments of sternocleidomastoid

A

sternum and clavicle

mastoid process of temporal bone

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102
Q

innervation of SCM

A

motor via CN XI

pain/proprioception via C2/3

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103
Q

attachments of trapezius

A 
superior nuchal line
nuchal ligament 
spinous process T1-T12
TO
lateral clavicle, acromion and spine of scapula
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104
Q

innervation of trapezius

A

CN XI

proprioception via C3,4

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105
Q

attachments of levator scapulae

A

transverse processes of C1-C4
TO
medial border of scapula at scapular spine

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106
Q

innervation of levator scapulae

A

C3,4,5 via dorsal scapular nerve

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107
Q

attachments of anterior scalene

A

transverse processes C3-6
TO
rib 1 at scalene tubercle

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108
Q

attachments of middle scalene

A

transverse processes of C2-7
TO
rib 1, behind subclavian artery

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109
Q

attachments of posterior scalene

A

transverse processes of C4-6
TO
rib 2

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110
Q

innervation of anterior scalene

A

anterior rami C4-7

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111
Q

innervation of middle scalene

A

anterior rami C3-7

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112
Q

innervation of posterior scalene

A

anterior rami C5-7

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113
Q

nerve root of sub occipital nerve

A

posterior ramus of C1

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114
Q

course of suboccipital nerve

A

runs between cranium and C1 vertebra to reach sub occipital triangle

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115
Q

what does the sub occipital nerve innervate

A

muscles of the sub occipital triangle

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116
Q

nerve roots of the greater occipital nerve

A

posterior ramus of C2

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117
Q

course of the greater occipital nerve

A

emerges inferior to obliquus capitis inferior and ascends to posterior scalp

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118
Q

what does the greater occipital nerve innervate

A

skin over posterior neck and occipital bone

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119
Q

nerve roots of lesser occipital nerve

A

anterior rami C2-3

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120
Q

course of the lesser occipital nerve

A

passes directly to skin

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121
Q

what does the lesser occipital nerve innervate

A

skin of superior posterolateral neck and scalp posterior to external ear

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122
Q

what do the posterior rami of C3-C7 innervate

A

intrinsic muscles of the back and overlying skin

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123
Q

attachments of splenius capitis

A

ligamentum niche and C7-T3 spinous processes
TO
superior nuchal line and mastoid process

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124
Q

attachments of splenius cervicis

A

T3-T6 spinous processes
TO
C1-C2 transverse processes

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125
Q

innervation of splenius muscles

A

posterior rami C1-C6

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126
Q

actions of splenius muscles

A

bilateral: extension of head and neck
unilateral: ipsilateral rotation and flexion of neck

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127
Q

attachments of semispinalis capitis

A

C4-T7 transverse processes
TO
occipital bone between nuchal lines

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128
Q

actions of semispinalis capitis

A

extension of cervical spine
ipsilateral lateral flexion
contralateral rotation

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129
Q

attachments of longissimus capitis

A

T1-T3 plus C4-C7 transverse processes
TO
mastoid process

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130
Q

actions of longissimus capitis

A

extension of head

ipsilateral flexion and rotation

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131
Q

what are the sub occipital muscles

A

rectus capitis posterior major
rectus capitis posterior minor
obliquus capitis inferior
obliquus capitis superior

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132
Q

attachments of rectus capitis posterior major

A

C2 spinous process
TO
inferior nuchal line

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133
Q

attachments of rectus capitis posterior minor

A

C1 posterior tubercle (no no spinous process on C1)
TO
inferior nuchal line

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134
Q

actions of rectus capitis posterior muscles

A

extension of head

ipsilateral rotation

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135
Q

innervation of rectus capitis posterior muscles

A

suboccipital nerve C1 posterior rami

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136
Q

attachments of obliquus capitis superior

A

C1 transverse process
TO
occipital bone above inferior nuchal line

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137
Q

actions of obliquus capitis superior

A

extension of head
ipsilateral lateral flexion
contralateral rotation

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138
Q

attachments of obliqqus capitis inferior

A

C2 spinous process
TO
C1 transverse process

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139
Q

action of obliquus capitis inferior

A

extension of head

ipsilateral rotation

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140
Q

innervation of obliquus capitis muscles

A

suboccipital nerve posterior rami C1

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141
Q

the occipital artery is a branch of

A

external carotid

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142
Q

the vertebral artery is a branch of

A

subclavian artery

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143
Q

what is the course of the vertebral artery

A

ascends neck in foramen transversarium of cervical vertebrae (C6-C1)
crosses the superior surface of C1 to enter foramen magnum
unite to form basilar artery

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144
Q

which structure runs along with the sub occipital nerve

A

deep cervical vein

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145
Q

which veins drain into the deep cervical vein

A

occipital veins

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146
Q

where does the deep cervical vein end

A

near transverse process of C7 in vertebral vein

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147
Q

what are the vertebral veins

A

vertebral veins are small veins of the internal vertebral plexus, which form a vessel passing through the foramen transversarium

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148
Q

where do the vertebral veins drain

A

runs until C6 when it leaves foramen to joint brachiocephalic vein

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149
Q

which ligaments are associated with the atlantoaxial and atlantooccipital joints

A

cruciate ligament
alar ligament
anterior/posterior Atlanto-axial membrane
anterior/posterior Atlanto-occipital membrane

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150
Q

which ligaments are associated with the entire cervical vertebra

A

anterior and posterior longitudinal ligament

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151
Q

what are the main muscles flexing the neck at the atlantooccipital joint

A

longus capitis
recuts capitis anterior
anterior fibres of SCM
supra hyoid and infra hyoid muscles

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152
Q

main muscles extending the neck at the atlantooccipital joint

A 
rectus capitis posterior (major and minor)
obliquus capitis superior 
splenius capitis 
longissimus capitis 
trapezius
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153
Q

muscles laterally flexing the neck at the atlantooccipital joint

A 
SCM
obliquus capitis superior 
reactus capitis lateralis 
longissimus capitis 
splenius capitis
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154
Q

muscles creating ipsilateral rotation at atlantoaxial joint

A

obliquus capitis inferior
rectus capitis posterior (major and minor)
longissimus capitis
splenic capitis

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155
Q

muscles creating contralateral rotation at atlantoaxial joint

A

SCM

semispinalis capitis

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156
Q

main muscles flexing the cervical IV joints

A

bilateral action of longus coli, scalene and SCM

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157
Q

main muscles extending the cervical IV joints

A 
deep neck muscles
semispinalis cervicis and iliocostalis cervicis
splenius cervicis and levator scapulae 
splenius capitis 
multifidus 
longissimus capitis 
semispinalis capitis 
trapezius
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158
Q

main muscles of lateral flexion of the cervical IV joints

A 
unilateral action of 
iliocostalis cervicis
longissimus capitis and cervicis 
splenius capitis and cervicis 
intertransversari and scalene
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159
Q

main muscles rotating the cervical IV joints

A 
unilateral action of 
rotatores 
semispinalis capitis and cervicis 
mutifidus 
splenius cervicis
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160
Q

what its he stylomandibular ligament made of

what is its purpose

A

extension of dense fibrous capsule surrounding parotid gland
separates parotid and submandibular glands

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161
Q

where is the parotid duct located

A

1 fingers breadth below the zygomatic arch

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162
Q

describe the course of the parotid duct

A

crosses masseter

takes a sharp, medial turn to pierce buccal fat pad and buccinator to enter oral cavity at upper second molar

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163
Q

which nerve divides into its terminal branches within the parotid gland

A

facial nerve

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164
Q

what are the main branches of the facial nerve arising within the parotid gland

A 
posterior auricular (behind the ear)
temporal (anterior to ea, superior)
zygomatic (along zygoma)
buccal (across cheeks)
marginal mandibular (along border of mandible)
cervical (down neck)
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165
Q

transverse facial artery is a branch of…

A

superficial temporal artery (terminal branch of external carotid)

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166
Q

what is the course of the transverse facial artery

A

arises from superficial temporal artery

crosses cheek, close to parotid duct

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167
Q

terminal branches of external carotid artery

A

superficial temporal and maxillary arteries

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168
Q

which veins join to form retromandibular vein

A

superficial temporal and maxillary veins

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169
Q

which nerve divides the parotid gland into deep and superficial parts

A

facial nerve

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170
Q

which neurovascular structures pass through the parotid gland

A

auriculotemporal nerve (CN V3)
external carotid artery
retromendibular vein
facial nerve

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171
Q

which muscles are innervated by the facial nerve before it passes through the parotid gland

A

stylohyoid

posterior belly of digastric

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172
Q

describe how parasympathetic fibres reach the parotid gland

A

parasympathetic fibres of CN IX travel in tympanic branch, through tympanic plexus (without synapsing)
via the lesser petrosal nerve, they pass through the foramen ovale to the otic ganglion, where they synapse
they are then carried to the parotid by the auriculotemporal branch of the CN V3

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173
Q

which structure do the two roots of the auriculotemporal nerve wrap around on their way to the parotid gland

A

middle meningeal artery

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174
Q

what are the muscles of mastication

A

temporalis
masseter
medial pterygoid
lateral pterygoid

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175
Q

innervation of muscles of mastication

A

CN V3

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176
Q

what are the movement of the mandible

A 
elevation 
depression 
protrusion
recursion 
lateral sliding
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177
Q

how is depression of the mandible achieved

A

gravity or against force using the supra hyoid muscles

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178
Q

temporalis is covered in

A

temporalis fascia

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179
Q

attachments of temporals

A

temporal fossa and fascia
TO
coronoid process and anterior border of ramus of mandible

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180
Q

actions of temporalis

A

anterior and superior fibres elevate mandible

posterior fibres retract mandible

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181
Q

innervation of temporalis

A

deep temporal nerve (x2) from anterior division of CN V3

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182
Q

attachments of masseter

A

zygomatic arch
TO
lateral aspect of ramus of mandible

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183
Q

action of masseter

A

elevated mandible

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184
Q

innervation of masseter

A

masseteric nerve from anterior division of CN V3

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185
Q

attachments of lateral pterygoid

A

upper head: infratemporal surface of greater wing of sphenoid
lower head: lateral surface of lateral pterygoid plate
TO
neck of mandible and articular disc

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186
Q

actions of lateral pterygoid

A

bilateral: protrusion (pulls neck of mandible forwards with articular disc)
unilateral: helps in lateral chewing movements with medial pterygoid

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187
Q

innervation of lateral pterygoid

A

nerve to lateral pterygoid from anterior division of CNV3

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188
Q

attachments of medial pterygoid

A

superficial head: tubercle of maxilla
deep head: medial surface of lateral pterygoid plate
TO
medial surface of angle of mandible

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189
Q

action of medial pterygoid

A

assists in elevation

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190
Q

innervation of medial pterygoid

A

nerve to medial pterygoid from main trunk of CN V3

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191
Q

what occurs during elevation of the mandible

A

head of mandible and disc move backward and head rotates on lower surface of disc

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192
Q

which muscles elevate the mandible

A

temporalis
masseter
medial pterygoid

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193
Q

what occurs during depression of the mandible

A

head of mandible rotates on undersurface of articular disc and middle is pulled forward

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194
Q

which muscles cause depression of mandible

A 
lateral pterygoid
digastric 
geniohyoid
mylohyoid 
GRAVITY
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195
Q

what occurs during protrusion of the mandible

A

articular disc and head of mandible move forward

movement occurs in the upper part of the cavity

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196
Q

which muscles cause protrusion of the mandible

A

lateral pterygoid

medial assists

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197
Q

what occurs during retrusion of the mandible

A

articular disc and head of mandible are pulled backwards into mandibular fossa

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198
Q

which muscles retract the mandible

A

posterior fibres of temporalis

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199
Q

what occurs during lateral chewing

A

protrusion and retraction combined

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200
Q

which muscles cause lateral chewing

A

pterygoids

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201
Q

briefly describe the branches of CN V3

A

main nerve trunk: meningeal branch, nerve to medial pterygoid, tensor tympani and tensor vela palatini
anterior division: masseteric, nerve to lateral pterygoid, deep temporal (x2), buccal
posterior division: auriculotemporal, lingual, inferior alveolar (with mylohyoid branch)

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202
Q

which branch of CN V3 passes through the otic ganglion

A

part of nerve to medial pterygoid
no synapse
passes on to tensor veli palatini and tensor tympani

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203
Q

which branches of CN V3 act as carriers of parasympathetic fibres

A

auriculotemporal

lingual

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204
Q

the auriculotemporal nerve carries parasympathetic fibres

where do they originate and where are they travelling

A

fibres originate from CN IX

auriculotemporal nerve carries them from the otic ganglion to the parotid gland

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205
Q

the lingual nerve carries parasympathetic fibres

where do they originate and where are they travelling

A

they originate from the chordates tympani (CN VII)

carried to the submandibular and sublingual glands

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206
Q

what are the posterior branches of the external carotid artery

A

occipital

posterior auricular

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207
Q

course of occipital artery

A

posterior branch of ECA
origin close to facial artery
passes under posterior belly of digastric to enter posterior triangke

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208
Q

what does the occipital artery supply

A

back of scalp

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209
Q

describe course of posterior auricular artery

A

posterior branch of ECA
originates superior to occipital artery
passes posterior to ear

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210
Q

what does the posterior auricular artery supply

A

scalp

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211
Q

which artery arises from deep surface of ECA

A

ascending pharyngeal

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212
Q

describe course of ascending pharyngeal artery

A

deep/medial branch of ECA
ascends between internal carotid and pharynx
gives branches to pharynx

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213
Q

what are the anterior branches of the ECA

A

superior thyroid
lingual
facial

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214
Q

describe the course of the superior thyroid artery

A

anterior branch of ECA
arises near origin of ECA
gives branches to SCM and superior laryngeal artery

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215
Q

describe the course of the lingual artery

A

anterior branch of ECA
arises between superior thyroid and facial arteries, at level of hyoid bone
passes deep to hyoglossus
crossed by the hypoglossal nerve

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216
Q

what does the lingual artery supply

A

oral cavity

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217
Q

describe the course of the facial artery

A

anterior branch of ECA
arises above level of hyoid
passes deep to posterior belly of digastric

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218
Q

which branches does the facial artery give off

A

superior and inferior labial branches

angular artery to face

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219
Q

what is the angular artery of the face

A

branch of facial

reaches up to medial corner of eye

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220
Q

what are the terminal branches of the ECA

A

superficial temporal

maxillary

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221
Q

describe the course of the superficial temporal artery

A

smaller terminal branch of ECA
ascends anterior to auricle
gives off transverse facial artery below zygoma
divides into anterior and posterior branches

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222
Q

supply of the superficial temporal artery

A

skin over frontal and temporal regions

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223
Q

describe the course of the maxillary artery

A

larger terminal division of ECA
arises behind neck of mandible
passes through infra temporal fossa
passes between 2 heads of lateral pterygoid to go into pterygomaxillary fissure/fossa

224
Q

supply of maxillary artery

A

branches to muscles of mastication, tympanic membrane, upper and lower teeth, palate, nasal cavity, nasopharynx and meninges

225
Q

what are the main lymph nodes of the head/neck

A 
occipital
parotid 
submandibular 
submental 
superficial cervical 
deep cervical
226
Q

what is the infra temporal fossa

A

space beneath the base of the skull between the skull and the ramus of the mandible

227
Q

what are the boundaries of the infra temporal fossa

A

anterior: posterior surface of maxilla
posterior: styloid process
superior: infratemporal surface of the greater wing of sphenoid bone
meidal: lateral pterygoid plate
lateral: ramus of the mandible

228
Q

what are the contents of the infra temporal fossa

A 
pterygoids 
mandibular division of CN V
maxillary artery and branches 
pterygoid venous plexus 
chordates tympani 
otic ganglion
229
Q

branches of anterior division of CN V3

A

x2 deep temporal
masseteric
nerve to lateral pterygoid
buccal

230
Q

branches of posterior division of CN V3

A

lingual
inferior alveolar
mylohyoid
auriculotemporal

231
Q

pre-division branches of CN V3

A

meningeal branch
nerve to medial pterygoid
communicating branch (tensors tympani and deli palatini)

232
Q

describe the course of they inferior alveolar nerve

A

arises from anterior division of CN V3
descends infra temporal fossa and passes through mandibular fossa
gives of nerve to mylohyoid as a branch

233
Q

what does the inferior alveolar nerve innervate

A

sensory: lower teeth and gums
motor: mylohyoid and anterior belly of digastric via nerve to mylohyoid

234
Q

describe the course of the lingual nerve

A

posterior division of CNV3

descends infra temporal fossa

235
Q

what is innervated by the lingual nerve

A

general sensory: anterior 2/3 tongue and oral cavity

carries special sensory to anterior 2/3 of tongue from cord tympani

236
Q

innervation of buccal nerve

A

sensory to inside of cheek

237
Q

what are the three parts of the maxillary artery

A

mandibular
pterygoid
pterygopalatine

238
Q

what branches arise from the mandibular part of the maxillary artery

A

deep auricular and anterior tympanic arteries
middle meningeal
inferior alveolar (gives off mylohyoid artery)

239
Q

where does the middle meningeal artery travel

A

through the foramen spinosum to reach the meninges

240
Q

branches of the pterygoid part of maxillary artery

A

deep temporal X2

buccal branches

241
Q

branches of pterygopalatine part of maxillary artery

A

posterior superior alveolar
infraorbital
anterior superior alveolar branches
palatine, pharyngeal and sphenoplatine branches

242
Q

where its he pterygoid venous plexus

A

surrounds lateral pterygoid

243
Q

which areas drain into the pterygoid venous plexus

A

veins from orbit, nasal and oral cavities

244
Q

which vein drains the pterygoid venous plexus

A

maxillary vein

245
Q

which other venous structures does the pterygoid venous plexus communicate with and why is this clinically relevant

A

cavernous sinus
facial vein
route for infection

246
Q

which nerve carries parasympathetic fibres from chordates tympani to the tongue

A

lingual nerve of CN V3

247
Q

what type of joint is the TMJ

A

synovial joint between head of mandible and mandibular fossa and articular tubercle on squamous part of temporal bone

248
Q

what are the articular surfaces of the TMJ covered in

A

fibrocartilage

249
Q

which nerves supply the TMJ

A

auriculotemporal and masseteric

250
Q

which ligaments support the TMJ

A

lateral: tempormandibular ligament
medial: sphenomandibular and stylomandibular ligaments

251
Q

what is the purpose of the articular disc of TMJ

A

increases congruity of articular surfaces and is involved in movements
head of mandible and disc: elevation and depression
disc and mandibular fossa/articular process: protrusion and retraction

252
Q

describe movements of the disc/mandible duding opening of the mouth

A

depression and protrusion of both sides to slide disc and condyle forwards towards tubercle

253
Q

describe movement of disc/mandible to close mouth

A

elevation and fracture pull condyle and disc backwards

254
Q

the mastoid and styloid processes are features of which bone

A

temporal bone

255
Q

what are the two parts of the temporal bone

A

petrous (strong, houses middle/inner ear)

squamous (thin)

256
Q

where do the muscles of facial expression insert

A

into the skin

257
Q

what is covered by the deep cervical fascia (in the face)

A

masseter is covered

invests parotid gland

258
Q

where is frontalis

A

forehead

259
Q

what is frontalis also known as and why

A

anterior belly of fronto-occipitalis

attached to occipitalis via aponeurosis which forms layer of scalp

260
Q

which nerve innervates the muscles of facial expression

A

CN VII

261
Q

action of frontalis

A

raises eyebrows

262
Q

where is corrigator supercili

A

deep to frontalis

runs obliquely from lateral bridge of nose skin of medial eyebrow

263
Q

action of corrigator supercilious

A

brings eyebrows together (eg frowning)

264
Q

function of platysma

A

tenses skin of neck

265
Q

where is procerus

A

over superior part of bridge of nose, between eyebrows

vertically orientated fibres

266
Q

action of procerus

A

wrinkles top of nose, and eyebrows

267
Q

where is nasalis

A

over bridge and nose and extends down alas of nose
transverse part = across bridge of nose
alar part = around alae

268
Q

actions of nasalis

A

transverse part = wrinkles nose

alar part = flares nostrils

269
Q

where is buccinator

A

deep to muscles of mastication

forms lateral wall of oral cavity

270
Q

action of buccinator

A

aids chewing by pushing food towards teeth

271
Q

which structure pierces buccinator

A

parotid duct

272
Q

where is orbiculares oculi

A

around eye

273
Q

function of orbicularis oculi

A

circular fibres contract around eye to tightly shit eyelid

274
Q

where are zygomaticus major and minor

A

originate from maxilla and insert near corner of mouth

275
Q

action of zygomaticus muscles

A

does little smirky Elvis face

276
Q

where is orbicularis oris

A

around mouth

277
Q

action of orbicularis oris

A

purses lips

278
Q

where is levator labii superioris

A

lateral to nose, medial to zygomaticus muscles

279
Q

action of levator labii superioris

A

raises upper lip

280
Q

where is levator anguli superioris

A

deep to levator labii superioris, inserts to corner of mouth

281
Q

action of levator anguli superioris

A

lifts corner of mouth

282
Q

where is risorius

A

transverse fibres from ramus of mandible to corner of mouth

283
Q

action of risorius

A

pulls corners of mouth out

284
Q

where is levator labii superioris alaeque naise

A

runs from top of nose, down its sides to below nostrils

285
Q

what does levator labii superioris alaequae nase do

A

flares nostrils and lifts top lip a bit

286
Q

where is depressor anguli oris

A

attaches along lower border of mandible to corner of mouth

287
Q

action of depressor anguli oris

A

pulls down corner of mouth

288
Q

where is depressor labii inferiors

A

from anterior mandible to bottom lip

289
Q

action of depressor labii inferiors

A

pulls down lower lip

290
Q

where is mentalis

A

deep to depressor labii inferioris

291
Q

action of mentalis

A

elevates and protrudes lower lip (pouting)

292
Q

which muscles are innervated by the posterior auricular branches of facial n.

A

occipitalis
stylohyoid
posterior belly of digastric

293
Q

which muscles are innervated by the temporal branches of facial n

A

frontalis

orbicularis oculi

294
Q

which muscles are innervated by the zygomatic branch of facial nerve

A

orbicularis oculi

295
Q

which muscles are innervated by the buccal branch of facial n.

A 
zygomaticus major and minor 
levator labii superioris
levator anguli oris
buccinator 
orbicularis oris 
nasalis
296
Q

which muscles are innervated by the marginal mandibular branch of facial nerve

A

depressor anguli oris
depressor labii oris
mentalis

297
Q

which muscles are innervated by the cervical branch of facial nerve

A

platysma

298
Q

describe the course of the facial artery

A

goes through anterior triangle of neck, around angle of mandible, courses superomedially across face towards inner eye

299
Q

branches of the facial nerve

A

submental
superior and inferior labial
lateral nasal
angular

300
Q

what are the layers of the scalp

A 
skin
connective tissue 
aponeurosis (between frontalis and occipitalis)
loose areolar connective tissue 
periosteum (pericranium)
301
Q

describe the blood supply of the scalp

A

supratrochlear (medial forehead)
supratrochlear (lateral forehead)
superficial temporal (temporal region, anterolateral scalp)
posterior auricular (posterolateral scalp, behind ear)
occipital (posterior scalp)

302
Q

what are emissary veins

A

serve communication between superficial veins of the scalp (in connective tissue layer) and dural venous sinuses

303
Q

what is the clinical significance of the emissary veins

A

possible route for infection to spread to intracranial structures

304
Q

describe nerve supply to the scalp

A

supratrochlear and supraorbital: forehead and medial scalp (from anterior to posterior)
zygomaticotemporal: anterior temporal region
auriculotemporal: temporal region in front of ears
lesser occipital: behind ears
greater occipital: posterior scalp/occipital region

305
Q

lobes of the brain

A 
frontal
temporal
parietal
occipital 
(cerebellum)
306
Q

where is the longitudinal fissure

A

along the sagittal midline of the brain

splits it into 2 hemispheres

307
Q

where is the lateral fissure

A

between the frontal/parietal and temporal lobes

308
Q

where is the central sulcus

A

runs from longitudinal fissure to lateral fissure, dividing the frontal and parietal lobes

309
Q

define:
sulcus
gyrus
fissure

A 
gyrus = outward 'bump' of brain 
sulcus = inward 'groove' of brain
fissure = deeper sulcus
310
Q

which structure connects the two hemispheres

A

corpus callous (white matter tract)

311
Q

where are the primary motor and sensory cortices

A

primary motor: anterior to central sulcus aka pre-central gyrus
somatosensory: posterior to central sulcus aka post-central gyrus

312
Q

where is the auditory cortex

A

superior gyrus of temporal lobe, inferior to lateral fissure

313
Q

where is Broca’s area

A

frontal lobe, above middle part of lateral fissure

314
Q

what is the function of Broca’s area

A

motor part of speech

expressive, production of speech

315
Q

where is werneke’s area

A

posterior aspect of lateral fissure

316
Q

what is the function of werneke’s area

A

recognition of speech

understanding

317
Q

where is the visual cortex

A

occipital lobe

318
Q

what is connected by association tracts

A

between gyro of the same hemisphere

319
Q

what is connected by commissural tracts/fibres

A

corresponding regions of different hemispheres

320
Q

what is connected by projection fibres

A

cerebrum to thalamus/brainstem etc

321
Q

what is the main action of the basal ganglia

A

regulate initiation and termination of body movements

also maybe involved in memory, planning and emotional response

322
Q

what are the main parts of the basal ganglia

A

caudate nucleus
putamen
globus pallidum
substantia nigra

323
Q

which structures make up the lenitform nucleus

A

globus pallidus and putamen

324
Q

where are the basal ganglia located

A

deep in the bran

except substantia nigra which is in the brainstem

325
Q

which structures does the substantia nigra communicate with

A

caudate nucleus and putamen

326
Q

which structure do sub-thalamic nuclei communicate with

A

globus pallidus

327
Q

what is the internal capsule

A

white matter pathway

328
Q

which basal ganglia are separated by the internal capsule

A

putamen and globus pallidus (lentiform nucleus) separated from the caudate nucleus

329
Q

what are the three areas of the diencephalon

A

thalamus
hypothalamus
pineal gland

330
Q

function of the thalamus

A

sensory relay station
signals pass from spinal cord/midbrain through thalamus then to cerebral hemispheres
also motor pathways

331
Q

function of the hypothalamus

A

regulation of autonomic nerve system and homeostasis (body temp, thirst etc)
production of hormones (connection to pituitary)

332
Q

where is the pineal gland

A

posterior aspect of thalamus

333
Q

function of pineal gland

A

produces melatonin to regulate body clock

contain habenular nucleus (olfaction and emotional response)

334
Q

pineal gland aka

A

epithalamus

335
Q

which cranial nerve originate from midbrain

A

CN III and CN IV

336
Q

external features of midbrain

A

superior and inferior colliculi

337
Q

what is the function of the superior colliculi

A

visual scanning, tracking

338
Q

function of inferior colliculi

A

auditory startle reflex

339
Q

which part of the basal ganglia is found in the midbrain

A

substantia nigra

340
Q

function o substantia nigra

A

control of subconscious muscle action

341
Q

where are the red nuclei located

what is their function

A

midbrain

coordinate muscle movement

342
Q

function of pons

A

coordination and maximising voluntary motor output

pneumotaxic tract to control breathing

343
Q

which cranial nerve originate from pas

A

CN V, VI, VII and vestibular part of CN VIII

344
Q

functions of medulla

A 
contains pyramids (motor tracts)
CV centra (rate/force heartbeat and diameter of vessels)
breathing centres 
sensory nuclei (touch, pressure, vibration)
olives = proprioception
345
Q

which CNs originate from medulla

A

CN IX, X, XI, XII and cochlear part of CN VIII

not spinal part of CN XI

346
Q

where are the olives of the medulla

A

lateral to pyramids

347
Q

what are the parts of the cerebellum

A

vermis (midline)

2 lobes

348
Q

function of cerebellum

A

controls subconscious aspects of skeletal muscle movements and coordinates complex sequences
regulates posture and balance

349
Q

how does the cerebellum communication with the rest of the brain

A

via peduncles

350
Q

which cerebellar peduncles communicate with which bit of brain

A

superior: midbrain
middle: pons
inferior: medulla

351
Q

what are the folds of the cerebellum called

A

folia

352
Q

where is the pituitary gland located

A

connected to hypothalamus via pituitary stalk

sits in pituitary fossa beneath dural covering (sella turcica)

353
Q

function of pituitary gland

A

produces hormones to regulate endocrine system

354
Q

which arteries contribute to circle of willis

A 
internal carotids 
basilar artery (vertebral arteries)
355
Q

what are the main branches of the circle of willis

A 
anterior cerebral (from internal carotids)
middle cerebral (from internal carotids)
posterior cerebral (from basilar)
356
Q

how are the main bracnhes of the circle of willis connected

A

anterior communicating branch between anterior cerebral arteries
posterior communicating branches (x2) between posterior cerebral and internal carotids

357
Q

where do the anterior cerebral arteries supply

A

frontal and parietal lobes

runs in longitudinal fissure

358
Q

where do the middle cerebral arteries supply

A

temporal lobes

runs in lateral fissure

359
Q

where do the posterior cerebral arteries supply

A

occipital lobe and base of brain

360
Q

what other branches of the basilar artery are there

A

cerebellar, pontine and medullary branches

361
Q

layers of the meninges

A 
pia mater (covers neural tissue, run over/between sulci/gyri)
arachnoid mater (middle layer, SAS is deep to it)
dura mater (outer layer, fought connective sheath covering inside of skull)
362
Q

what is the falx cerebri

A

fold of dura that lies between the cerebral hemispheres

363
Q

what is carried in the falx cerebri

A

inferior sagittal venous dural sinus

364
Q

where is the falx cerebelli

A

sits on top of the cerebellum

separates cerebellum from cerebrum

365
Q

blood supply to the meninges

A

anterior meningeal: from ethmoid branch of ICA (anterior fossa)
middle meningeal: from maxillary artery (major vessel)
posterior meningeal: branch fo occipital artery (posterior fossa)

366
Q

how does the middle meningeal artery enter the cranium

A

foramen spinosum

367
Q

damage to the MMA leads to

A

extradural haematoma and compression of brain

368
Q

what is the main nerve supply to the dura

A

trigeminal nerve

369
Q

describe innervation of dura of anterior fossa

A

anterior meningeal of ethmoidal (CN V1): anterior, medial
meningeal branch of maxillary (CN V2): middle part of anterior fossa/bit of middle fossa
meningeal branch of mandibular (CN V3): most of middle fossa + lateral edge of anterior fossa

370
Q

describe innervation of dura of middle fossa

A

mostly meningeal branches of mandibular nerve CNV3

371
Q

describe innervation of dura of falx cerebelli

A

tentorial nerve (recurrent meningeal branch of ophthalmic nerve, CN V1)

372
Q

describe innervation of dura of posterior fossa

A

fibres of C2,3

some distributed by CN XII/X

373
Q

what is the function of the dural venous sinuses

A

act as veins of the meninges and brain

374
Q

how are the dural venous sinuses related to spread of infection

A

connection between the cavernous venous sinus, pterygoid venous plexus, ophthalmic veins and facial veins allow spread of bacteria from superficial veins to venous sinuses

375
Q

where do the dural venous sinuses drain to

A

internal jugular vein

376
Q

how are the dural venous sinuses formed

A

between periosteum of skull and dura (eg sigmoid sinus)

between two layers of dura (inferior sagittal sinus)

377
Q

describe flow of CSF though the ventricles

A 
lateral ventricles 
through inter ventricular foramina of monro 
third ventricle 
cerebral aqueduct 
4th ventricles 
lateral and median apertures 
SAS/central canal of spinal cord
378
Q

where is CSF made

A

ependymal cells of choroid plexus

379
Q

how is CSF drained

A

arachnoid granulations to the dural venous sinuses

380
Q

what is the purpose of CSF

A

mechanical and physical protection of the brain and spinal cord

381
Q

how does the frontal bone contribute to the borders of the bony orbit

A

roof, parts of medial and lateral

382
Q

what other features of the orbit are on the frontal bone and what are their function

A

supraorbital ridges: protects orbit from direct trauma

supraorbital notch: passage of supraorbital nerve and artery

383
Q

how does the anterior orientation of the orbit affect the field of view

A

allows eyes to face more forward and allows overlap of field of view
can compare each visual field to create depth perception

384
Q

how does the zygoma contribute to the borders of the bony orbit

A

lateral wall

385
Q

how does the maxilla contribute to the borders of the bony orbit

A

forms the floor of the orbit

386
Q

which foramen passes through the maxilla (associated with the orbit)
and what structures pass through

A

infraorbital foramen

infraorbital branch of CN V2 passes through it

387
Q

how does the lacrimal bone contribute to the bony orbit

A

associated with the lacrimal apparatus and nasolacrimal duct that carries excess lacrimal fluid into the nasal cavity

388
Q

how does the ethmoid bone contribute to the bony orbit

A

forms part of medial wall and contributes to nasal cavities

389
Q

how does the sphenoid bone contribute to the bony orbit

A

forms optic canal and superior orbital fissure

contributes to inferior orbital fissure

390
Q

what structures support the eye

A 
tarsal plates 
orbital septum 
palpebral ligament
check ligaments 
suspensory ligaments
391
Q

what are the tarsal plates and what is their function

A

dense connective tissue plates that support the eyelid

contain glands that release oily and watery secretions to lubricate surface of eye

392
Q

where is the orbital septum found and what is it made of

A

deep to skin and orbicularis oculi

strong connective tissue

393
Q

where are the palpebral ligaments and what is their function

A

medial and lateral palpebral ligaments at corners of eye

support corners of eye

394
Q

where are the check ligaments found and what is their function

A

close to insertion of medial and lateral rectus muscles

restrict movements of extra ocular muscles

395
Q

where is the suspensory ligament found int he orbit and what is its function

A

creates a hammocky band under the eyeball

supports position of eyeball

396
Q

what are the three layers of the orbit

A

outer fibrous layer
middle vascular layer
inner photoreceptive layer

397
Q

what structures make up the outer layer of the eye

A

cornea (anteriorly, over iris and pupil)

sclera (white part of eye)

398
Q

what structures make up the middle vascular layer of the eye

A

iris
ciliary body
choroid (blood vessels)

399
Q

what makes up the inner layer of the eye

A 
retina 
contains photoreceptors (rods and cones)
400
Q

what are some features of the retina

A

optic disc = point optic nerve leaves retina (no rods or cones = blind spot)
macula = area rich in rods and cones (fovea in centre)

401
Q

where is the anterior chamber of the eye and what is it filled with

A

space between lens and cornea

aqueous humour

402
Q

where is aqueous humour of the anterior chamber produced, and how is it removed

A

ciliary body

recycled into veins at the junctions of the cornea and sclera

403
Q

where is the posterior chamber of the eye and what is it filled with

A 
posterior to the lens 
vitreous humour (gel-like)
404
Q

what is the function of the vitreous humour

A

supports retina by pressing it up against the choroid

choroid contains blood vessels so helps prevent damage to them

405
Q

what are the intraocular muscles of the eye

A

dilator pupillae
sphincter pupillae
ciliary muscles

406
Q

describe dilator pupillae (attachments, action, innervation)

A

small radial fibres attaching from edge of pupil to outer margin of iris
contraction to pull iris out and increase diameter of pupil
sympathetic

407
Q

describe sphincter pupillae (attachments, action, innervation)

A

circular fibres around edge of pupil
contraction narrows the pupil
parasympathetic fibres from CN III

408
Q

how is the ciliary muscle attached to the lens

A

circular fibres around lens, attached by radial fibres

409
Q

describe the effect of relaxation of the ciliary muscle

A

when muscle is relaxed, the distance between the muscle and lens is greatest, so the fibres between them are taut
this pulls the edges of the lens out, making it flat and wide

410
Q

describe the effect of contraction of the ciliary muscle

A

when muscle contracts, the distance between the lens and the muscle decreases so the fibres are relaxed
due to internal pressure, lens becomes more spherical

411
Q

how does the shape of the lens affect vision

A

shape of lens changes how light is refracted and focused on the retina
flat lens is better for distance vision
round lens better for close up

412
Q

innervation of the ciliary muscle

A

parasympathetic via CN III

413
Q

what are the extra ocular muscles

A

levator palpebrae superioris
superior, inferior, medial and lateral rectus
superior and inferior oblique

414
Q

what is the equator of the eye and how does it affect the action of the extra ocular muscles

A

its a circle around the diameter of the eye in the coronal plane
muscles attaching anterior to the equator pull the eye in its expected direction
muscles posterior to it pull it in the opposite direction (eg inferior oblique elevates the eye)

415
Q

describe levator palpebrae superioris (attachments, action, innervation)

A

roof of orbit to upper eyelid
raises upper eyelid
CN III

416
Q

describe superior rectus (attachments, action, innervation)

A

annular ring to superior sclera, anterior to equator
elevates, adducts, intorts eye
CN III

417
Q

describe medial rectus (attachments, action, innervation)

A

annular ring to medial sclera, anterior to equator
adducts eye
CN III

418
Q

describe lateral rectus (attachments, action, innervation)

A

annular ring to lateral sclera, anterior to equator
abducts eye
CN VI

419
Q

describe inferior rectus (attachments, action, innervation)

A

annular ring to inferior sclera, anterior to equator
depresses, extorts and adducts eye
CN III

420
Q

describe inferior oblique (attachments, action, innervation)

A

floor of orbit to inferior sclera, posterior to equator
elevates, extorts and abducts eye
CN III

421
Q

describe superior oblique (attachments, action, innervation)

A

lesser wing of sphenoid to superior sclera, posterior to equator (via trochlea)
depresses, intorts and abducts eye
CN IV

422
Q

what is the annular ring

A

common insertion for rectus muscles

423
Q

what mnemonic helps remember the actions of extra ocular muscles

A 
RADSIN
Rectus Adducts (apart from lateral rectus)
Superior Intorts (inferior extorts)
424
Q

describe the course of the optic nerve

A

enters cranial cavity in the optic canal (sphenoid bone)
nasal fibres cross over above pituitary fossa to form chiasm
optic tracts extend posteriorly to lateral geniculate nucleus (thalamus)
optic radiations travel to primary visual cortex (occipital lobe)

425
Q

what is the purpose of association areas in the visual cortex

A

give images context

426
Q

which nerves pass through the superior orbital fissure

A

CN III, CN IV, CN V1 and CN VI

427
Q

describe the course of cranial nerves through the cavernous sinus

A

CN III, CN IV and CN V1 pass close to lateral wall

CN VI passes through middle with internal carotid artery

428
Q

which nerves pass through the annular ring and which dont

A

frontal, lacrimal (CN V1) and CN IV DO NOT

CN III, rest of CN V1 and CN VI DO PASS

429
Q

how does CN V1 leave skull

A

superior orbital fissure

430
Q

which branches of CN V1 is most easily visualised and what are its branches

A

frontal branch

divides into supraorbital and supratrochlear which leave via supraorbital notch

431
Q

what are the branches of CN V1

A

frontal: lies superior to extraocular muscles
nasociliary: passes through ethmoid bone to supply nasal cavities
lacrimal: travels to lacrimal gland

432
Q

what are the divisions of the CN III

A

superior: LPS and SR
inferior: MR, IR, IO and parasympathetic fibres

433
Q

how do parasympathetic fibres of CN III reach the ciliary muscles

A

travel in inferior division to ciliary ganglion

then via short ciliary nerves

434
Q

what is the main blood supply of the orbit and where is its origin

A

ophthalmic artery
ICA
enters in optic canal

435
Q

branches of the ophthalmic artery

A

forehead and scalp: supraorbital, supratrochelar and zygomaticotemproal
nose: dorsal nasal and. ethmoidal

436
Q

describe venous drainage of the orbit

A

superior ophthalmic vein drains to cavernous sinus
inferior ophthalmic vein drains to pterygoid venus plexus
communicated via the inferior orbital fissure with the facial vein = spread of infection

437
Q

what is the puropse of the lacrimal gland

A

secretes thin watery fluid to lubricate surface of eye and remove debris

438
Q

where is the lacrimal gland

A

lateral edge of orbit

439
Q

how is lacrimal fluid drained from eye

A

tears wash across surface of eye and gathered though lacrimal punctum into the lacrimal canaliculi
drains via lacrimal sac to inferior meatus of nose via nasolacrimal duct

440
Q

innervation of the lacrimal gland

A

parasympathetic secretomotor fibres from CN VII via CN V1 and CN V2
facial nerve branches to form greater petrosal nerve carrying parasympathetic fibres
joins deep petrosal nerve (sympathetic fibres from internal carotid plexus) to form nerve of pterygoid canal
passes to pterygopalatine ganglion to join CN V2 (zygomatic branch) which joins the lacrimal nerve (CN V1) to reach lacrimal gland

441
Q

which muscles of facial expression overlie the nose

A

nasalis
levator labii superioris alaeque nasi
procerus (superior bridge)

442
Q

what are the named bits of nasal cartialge

A

septal cartilage separates nasal cavities

alar cartialge makes up nostrils

443
Q

blood supply of the external nose

A

anterior and posterior ethmoidal (ophthalmic)
sphenopalatine and greater palatine (maxillary)
septal branches of labial artery (facial)
lateral nasal (facial)

444
Q

nerve supply of external nose (skin of nose)

A

bridge: CN V (infratrochlear and anterior ethmoidal)
alae: CN V2 (nasal branches of infraorbital)

445
Q

what structures make up the nasal septum

A

cartilage anteriorly
perpendicular plate of ethmoid superiorly
vomer inferiorly
sphenoid posteriorly
palatine and maxilla contributes to nferior part

446
Q

which bones make up the lateral wall of nasal cavity

A

maxilla, sphenoid, ethmoid, frontal

447
Q

which bones make up the conchae

A

ethmoid: superior and middle

inferior concha is separate bone

448
Q

describe passage of air through the nasal cavity

A

in nostrils to vestibule of nose

air passes between conchae/meati towards choanae to nasopharynx

449
Q

what is the choanae

A

posterior part of nasal canal, at entrance of nasopharynx

450
Q

the opening of which structure is found in the nasopharynx and what is its purpose
(related to ear)

A

auditory tube

leads to middle ear and allows passage of air to equalise pressure on either side of the tympanic membrane

451
Q

what is the purpose of the conchae

A

create air turbulence, which swirls air around the nasal cavity and helps to warm it

452
Q

what is the nasal cavity lined with

A

respiratory epithelium

olfactory epilthelium in roof

453
Q

what are features of respiratory epithelium

A

has cili and produces mucous to trap airborne particles and filter air

454
Q

what are the spaces underneath the conchae called

A

meatus

455
Q

what is the sphenoethmoidal recess

A

space above the superior concha

456
Q

where are the paranasal sinuses found

A

frontal
maxillary
ethmoid
sphenoids

457
Q

what is the function of the paranasal sinuses

A

makes head lighter so is easier to balance on top of VC

can absorb force from direct trauma to help protect cranial cavity

458
Q

describe the paranasal sinuses

A

frontal: may be 2 separate cavities or 1 large one
sphenoid: in body of sphenoid bone
maxillary: either side of nasal cavities
ethmoid: made up of many small air cells instead of 1 large space

459
Q

what can be visualised if the conchae are removed

A

openings of the paranasal sinuses and nasolacrimal duct

460
Q

where does the nasolacrimal duct open into

A

inferior meatus

461
Q

where do the sinuses open into

A 
frontal: middle meatus
anterior and middle ethmoidal: middle meatus 
maxillary: middle meatus 
posterior ethmoidal: superior meatus 
sphenoidal: sphenoethmoidal recess
462
Q

innervation of the paranasal sinuses

A

frontal: supraorbital CN V1
all ethmoidal: nasociliary CN V1
maxillary: superior alveolar CN V2
sphenoidal: posterior ethmoidal CN V1

463
Q

how does sinusitis occur

A

sinuses create mucous which can become backed up if the openings to the nasal cavity are blocked by inflammation

464
Q

blood supply of the lateral wall of nasal cavity

A

anterior and posterior ethmoidal branches (ophthalmic)
sphenopalatine (maxillary)
lateral nasal (facial)
greater palatine (maxillary

465
Q

blood supply to medial wall of nasal cavity

A

anterior and posteiror ethmoidal (ophthalmic)
sphenopalatine and greater palatine (maxillary)
septal branch of superio labial artery (facial)

466
Q

what is Kiesselbach’s area

A

area of anastomosis in the medial wall of nasal cavity (septum)

467
Q

nerve supply of nasal cavities

A

anterosuperior: CN V1
posteroinferior: CN V2
olfactory mucosa: CN V1

468
Q

describe venous drainage of the nasal cavities

A

facial, sphenopalatine and ophthalmic viens

communicates with pterygoid plexus and cavernous sinus

469
Q

what is a frenulum

A

fold of tissue attaching upper lip and under tongue

470
Q

what are the names of the arch of the oral cavity

A 
palatoglossal arch (anterior)
palatopharyngeal arch (posterior)
471
Q

what is found in the space between the arches of the oral cavity

A

palatine tonsil

472
Q

what is the fauces

A

opening of the oral cavity aka mouth

473
Q

lateral wall of the oral cavity

A

buccinator

474
Q

what makes up the floor of the oral cavity

A

mylohyoid
digastric below
geniohyoid above

475
Q

describe mylohyoid (attachments, innervation and action)

A

hyoid line of mandible to hyoid bone
mylohyoid branch CN V3
elevates the hyoid and oral floor OR depresses the mandible

476
Q

describe anterior belly of digastric (attachments, innervation and action)

A

digastric fossa of mandible to hyoid via fibrous sling
mylohyoid branch CN V3
elevate hyoid or depress mandible

477
Q

describe stylohyoid (attachments, innervation and action)

A

styloid process to hyoid bone
facial nerve CN VII
elevates hyoid

478
Q

describe posterior belly of digastric (attachments, innervation and action)

A

mastoid process to hyoid bone via fibrous sling

facial nerve CN VII

479
Q

describe geniohyoid (attachments, innervation and action)

A

inferior genial tubercle of mandible to hyoid bone
C1 carried by hypoglossal nerve
elevates hyoid bone

480
Q

where does the parotid duct open

A

at upper second molar

481
Q

innervation of parotid duct

A

CN IX parasympathetic fibres

482
Q

where is the submandibular gland

A

outer part posterior to mandible, inner part crosses hylohyoid to lie in floor of the mouth

483
Q

where does the submandibular duct open in the oral cavity

A

opens between 1st and 2nd incisors either side of the frenulum

484
Q

where is the sublingual gland

A

entirely in the floor of the mouth

under the tongue

485
Q

where does the sublingual gland open

A

many small ducts that open directly into the floor of the mouth

486
Q

what are the vallate papillae

A 
largest papillae (detect taste) 
form a line 2/3 of the way along tongue
487
Q

describe the surface of the posterior tongue

why is it like this

A

bumpy appearance

presence of lingual tonsil

488
Q

innervation of the anterior 2/3 of tongue

A

general sensation from lingual nerve CN V3

taste from chorda tympani CN VII via lingual nerve CN V3

489
Q

where does chorda tympani meet the lingual nerve

A

infra temporal fossa

490
Q

innervation of posterior 1/3 of tongue

A

general sensory and taste from CN IX

491
Q

what is the function of the intrinsic muscles of the tongue

how are they oriented

A

change the shape of the tongue

fibres in different orientations, but all within the tongue

492
Q

what are the extrinsic muscles of the tongue

what are their general function

A

palatoglossus, styloglossus, genioglossus, hyoglossus
change position of tongue in mouth
originate in oral cavity and insert into mouth

493
Q

describe palatoglossus (attachments, innervation and action)

A

palatine aponeurosis to tongue
CN X
elevates tongue, moves soft palate

494
Q

describe styloglossus (attachments, innervation and action)

A

styloid process to tongue
CN XII
elevates and retracts tongue

495
Q

describe genioglossus (attachments, innervation and action)

A

superior genial tubercle of mandible to tongue
CN XII
depresses tongue, protrude

496
Q

describe hyoplgossus

attachments, innervation and action

A

hyoid bone to tongue
CN XII
depress tongue

497
Q

blood supply of the tongue

what is its course

A

via lingual artery (branch of external carotid artery)

arises from ECA, is crossed by hypoglossal nerve, passes under hyoglossus and enters floor of mouth

498
Q

venous drainage of the tongue

A

lingual vein to internal jugular

dorsal, deep and sublingual branches

499
Q

what is the course of the hypoglossal nerve

A

passes from hypoglossal canal at the base of the skull and passes over hyoglossus but under mylohyoid to enter the floor of mouth

500
Q

describe lymph drainage of the tongue

A

tip: submental nodes
lateral edges: submandibular nodes
central/posterior: deep cervical

501
Q

which bones make up the hard palate

A

mostly maxilla

palatine bones contribute posteriorly

502
Q

features of the hard palate

A

glands embedded in mucosa (produce mucus)
rugae at anterior part of hard palate
palatine raphe in midline

503
Q

innervation of the mucus glands of hard palate

A

CN VII

504
Q

innervation of hard palate

A

greater palatine nerve
branch of CN V2
descends in palatine canal and enter greater palatine foramen

505
Q

arterial supply of the hard palate

A

greater palatine artery (branch of maxillary artery)

descends in palatine canal to enter palate via greater palatine foramen

506
Q

what is the soft palate

A

muscular core covered in mucous lining hanging from posterior border of hard palate

507
Q

what is the palatine aponeurosis

what is its function

A

tough connective tissue attaching soft palate to hard palate
strengthens soft palate and site of muscle attachment

508
Q

how many muscles are associated with the sfot palate

what are they

A 
5
palatoglossus 
palatopharyngeus
levator veli palatini
tensor veli palatini 
musculus uvulae
509
Q

describe levator veli palatini (attachments, innervation and action)

A

petrous temporal bone and cartilage of auditory tube to palatine aponeurosis
CN X
raises soft palate

510
Q

musculus uvuluae

attachments, innervation and action

A

palatine bone to palatine aponeurosis
CN X
elevates/retracts uvula

511
Q

palatoglossus (attachments, innervation and action)

A

palatine aponeurosis to tongue
CN X
elevates tongue/closes oropharynx
forms anterior arch of oral cavity

512
Q

palatopharyngeus (attachments, innervation and action)

A

wall of pharynx to palatine aponeurosis
CN X
elevates pharynx and moves pharyngeal wall towards soft palate
forms posterior arch in oral cavity

513
Q

tensor veli palatini (attachments, innervation and action)

A

cartilage of auditory tube, wraps a tendon around pterygoid hamulus to palatine aponeurosis
CN V3
tenses soft palate

514
Q

blood and nerves supply of soft palate

A

lesser palatine branches of greater palatine artery/nerve

uvula sensroy innervation by CN IX

515
Q

how does the facial nerve innervate the mucus glands of the palate

A

sends fibres to pterygopalatine ganglion (via greater petrosal nerve) which joins CN V2 to supply glands

516
Q

how do missing teeth affect the bony structure of the face

A

alveolar bone that supported the tooth is resorbed

517
Q

how many permanent teeth

A

32

518
Q

innervation of teeth

A

top teeth: CN V2 superior alveolar branches

bottom teeth: CN V3 inferior alveolar branches

519
Q

blood supply of teeth

A

anterior and posterior alveolar
inferior alveolar
branches of maxillary artery

520
Q

where is the pharynx located

A

runs from the base of skull to the oesophagus C6

posterior to nasal and oral cavities and larynx

521
Q

what are the layers of the pharynx

A

mucosa
fibrous layer
muscular layer

522
Q

where is the fibrous layer connected

A

base of skull and submucosal layer of oesophagus

523
Q

what are the divisions of the pharynx and where are they located

A

nasopharynx: posterior to nasal cavities, above soft palate
oropharynx: posterior to oral cavity, between soft palate and epiglottis
laryngopharynx: posterior to larynx, meet oesophagus at C6

524
Q

borders of the nasopharynx

A

roof: sphenoid and occipital bone, pharyngeal tonsil
floor: soft palate
anterior: nasal passages
posterior: roof and C1 level
lateral: auditory tube, salpingoparyngeal fold

525
Q

borders of the oropharynx

A

roof: soft palate
floor: posterior 1/3 tongue, lingual tonsil, glossoepiglottic folds
anterior: motuh
posterior: C2/3 level
lateral: palatoglossal and palatopharyngeal arches and palatine tonsil

526
Q

borders of the laryngopharynx

A

anterior: larynx
posterior: C3-6 vertebral bodies
lateral: thyroid cartilage, aryepiglottic flods and thyrohyoid membrane

527
Q

what are the two subdivisions of pharyngeal muscles

A

constrictors (x3) and longitudinal muscles (x3)

528
Q

describe superior constrictor muscle (attachments, action and innervation)

A

lower medial pterygoid plate, hamulus, pterygomandibular ligament, mandible, side of tongue TO pharyngeal tubercle of occipital bone, fibrous raphe and middle constrictor
push food towards middle constrictor and upper fibres pull pharynx anteriorly to close nasopharynx
vagus nerve via pharyngeal plexus

529
Q

describe middle constrictor

attachments, action and innervation

A

lower part of stylohyoid ligament, hyoid bone TO raphe and blend with other constrictors
propel food to lower constrictor
vagus via pharyngeal plexus

530
Q

describe inferior constrictor

attachments, action and innervation

A

lamin of thyroid and cricoid cartilages TO raphe and middle onstrictor/oesophagus
propel food to oesophagus
vagus nerve via phasryngeal plexus

531
Q

what are the two parts of inferior constrictor

A 
thyropharyngeus = fibres that pass to midline 
cricopharynxgeus = circular fibres at inferior part (act a bit like a sphincter)
532
Q

what are the longitudinal muscles of pharynx

A

stylopharyngeus
salpingopharyngeus
palatopharyngeus

533
Q

describe stylopharyngess (attachments, action and innervation)

A

styloid TO thyroid cartilage
elevates larynx and pharynx in swallowing
CN IX

534
Q

describe salpingopharyngeus (attachments, action and innervation)

A

cartialge of auditory tube TO palatopharyngeus
elevates pharynx and forms lateral wall of nasopharynx
vagus via pharyngeal plexus

535
Q

describe palatopharyngeus (attachments, action and innervation)

A

hard palate and palatine aponeurosis TO lamina of thyroid cartilage
elevates pharynx and forms lateral wall of oropharynx
vagus nerve via pharyngeal plexus

536
Q

describe the movements of soft palate/pharynx etc involved in swallowing

A

food moulded by togue/hard palate and pushed to back of mouth
soft palate raised and pharynx elevates to keep food away from nasopharynx
larynx raised and epiglottis passively bends over opening to larynx
aryepiglottic folds move toether to ensure food doesnt go down larynx
peristalsis

537
Q

course of recurrent laryngeal nerve in pharynx

A

travels between oesophagus and trachea and then passes deep to inferior constrictor of pharynx

538
Q

which nerve runs alongside stylopharyngeus

A

CN IX

539
Q

what is the innervation of the lymphoid tissue associated with each region of the pharynx

A

nasopharynx: CN V2
oropharynx: CN IX
laryngopharynx: CN X

540
Q

which nerves are involved in the pharyngeal plexus

A

CN IX and CN X fibres supply he pharynx

cranial part of CN XI joins and supply soft palate via vagus nerve

541
Q

arterial supply of pharynx

A

greater palatine and pharyngeal branches of maxillary artery
ascending pharyngeal branches of facial
ascending pharyngeal branches of external carotid

542
Q

venous drainage of pharynx

A

pharyngeal plexus to internal jugular vein

543
Q

lymphatic drainage of pharynx

A

retropharygneal and paratracheal nodes

deep cervical nodes

544
Q

were are prevertebral structures located and what are they

A

posterior to pharynx, anterior to vertebrae

muscles and sympathetic ganglia

545
Q

what are the prevertebral muscles

A

longus capitis
longus colli
rectus capitis anterior
rectus capitis lateralis

546
Q

describe longus capitis

attachments, action and innervation

A

transverse processes of C3-6 to base of occipital bone
flexion of head
anterior rami C1-3

547
Q

what are the parts of longus colli and what are their attachments

A

inferior oblique: T2-3 bodies TO anterior tubercle of transverse processes C5/6
superior oblique: anterior tubercle C3-5 to anterior tubercle of atlas
vertical: anterior aspect T1-3 to C4-6

548
Q

describe longus colli (attachments, action and innervation)

A

atlas to T3
flexion of neck
contrlateral rotation by inferior obliue part
anterior rami C2-6

549
Q

describe rectus capitis anterior

attachments, action and innervation

A

anterior sruface and root of transverse processes of atlas to occipital bone
flexion of atlanto-occipital joint
anterior rami C1-2

550
Q

describe rectus capitis lateralis (attachments, action and innervation)

A

transverse process of atlas to occipital bone
lateral flexion of head
anterior rami C1-2

551
Q

where are the cervical sympathetic ganglia found

A

embedded in deep fascia between carotid sheath and fascia over longus capitis and longus colli

552
Q

describe superior cervical ganglia

A

large, immediately below skull
C1-4
internal carotid nerve to internal carotid plexus
pharyngeal branches to pharyngeal plexus
superior cardiac branch to cardiac pelxus

553
Q

describe middle cervical glanlgion

A

level of cricoid cartilage
C5/6
thyroid branches along inferior thyroid artery to gland
middle cardiac branch to cardiac pelxus

554
Q

describe inferior cervical ganglion

A

usually fused with 1st thoracic ganglion (stellate ganglion)
behind vertebral artery between C7 TP and head of 1st rib
C7/8
arterial branches to subclavian nand vertebral arteries
inferior cardiac branch to cardiac plexus

555
Q

what is the ansa subclavia

A

nerve cord connecting the middle and inferior cervical sympathetic ganglia
loops around subclavian artery

Anatomy BMSc (9 decks)

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