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Head and neck anatomy Flashcards

1
Q

Anterior cranial fossa

A

Ethmoid
Smell

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2
Q

Middle cranial fossa

A

Sphenoid
Visual

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3
Q

Posterior cranial fossa

A

Temporal/occipital
Hearing/tongue/shoulder

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4
Q

Foramen ovale

A

O - otic ganglion
V - V3 (mandibular branch of trigeminal - Mandy is an oval)
A - accessory meningeal artery
L - lesser petrosal nerve
E - emissary veins

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5
Q

Foramen spinosum

A

Middle meningeal artery
Meningeal branch of trigeminal

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6
Q

Foramen rotundum

A

V2 - maxillary branch of trigeminal
Max is round

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7
Q

Foramen lacerum

A

Internal carotid passes over (not through)

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8
Q

Jugular foramen

A

Inferior petrosal sinus
Glossopharyngeal nerve (IX)
Vagus nerve (X)
Accessory nerve (XI)
Sigmoid sinus

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9
Q

Foramen magnum

A

Anterior and posterior spinal arteries
Vertebral arteries
Medulla oblongata

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10
Q

Superior orbital fissure

A

Oculomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic branch of trigeminal nerve (V3 of V)
Abducens nerve (VI)
Superior ophthalmic vein

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11
Q

Location of branches of trigeminal

A

Standing Room Only
V1 - Superior orbital fissure
V2 - Foramen rotundum
V3 - Foramen vale

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12
Q

Clinical significance of pterion

A

Thin part where 4 bones meet
Location of middle meningeal artery

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13
Q

Which 4 bones meet at pterion?

A

Frontal
Parietal
Temporal (squamous part)
Sphenoid

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14
Q

Rule of pupil

A

Pupil dilates first before movements are affected due to parasympathetic fibres running on periphery of oculomotor nerve

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15
Q

Down and out pupil reacting to light

A

Diabetes

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16
Q

Down and out pupil not reacting to light

A

Parasympathetic issue

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17
Q

Trochlear nerve palsy

A

4th cranial nerve
Walking down stairs or reading book = neck bent to contralateral side of eye palsy
4 = floor

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18
Q

Which muscle does abducens nerve supply?

A

Lateral rectus muscle

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19
Q

Where does greater auricular nerve supply?

A

Skin of lower ear
Parotid
Angle of mandible

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20
Q

Which nerve supplies sensation of skin of face?

A

Trigeminal - except angle of mandible –> greater auricular

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21
Q

Nervous supply of ear

A

Front of ear –> greater auricular
Back of ear –> lesser auricular

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22
Q

Motor supply of trigeminal

A

Muscles of mastication

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23
Q

Muscles closing mouth

A

3 muscles (V3)
Masseter
TeMporalis
Medial pterygoid
M = munch

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24
Q

Muscles opening mouth

A

Lateral pterygoid
L = lowers

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25
Q

Significance of TMJ being synovial joint

A

Covered by fibrocartilage
All other synovial joints are covered by hyaline cartilage

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26
Q

First nerve affected in cavernous sinus thrombosis

A

CN VI (abducens) –> lateral gaze palsy

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27
Q

Cause of cavernous sinus thrombosis

A
  • Compression (tumour, thrombus)
  • Infections (face, ear, nose)
  • Internal carotid rupture
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28
Q

Symptoms of cavernous sinus thrombosis

A
  • Headache
  • Swollen eyes
  • Horner’s syndrome
  • V1 and V2 sensory loss
  • Chin and lower jaw skin sensation normal
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29
Q

Why do you get swollen eyes with cavernous sinus thrombosis?

A

Compression of superior ophthalmic vein, angular vein and inferior ophthalmic vein

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30
Q

Branches of facial nerve

A

To - temporal
Zanzibar - zygomatic
By - buccal
Motor - marginal mandibular
Car - cervical

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31
Q

Sensory supply of facial nerve

A

Taste to anterior 2/3rd of tongue
Chordae tympani
Let’s face it, your food tastes awful

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32
Q

Parasympathetic supply of facial nerve

A

Lacrimation
Seven - salivation - sublingual - submandibularM

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33
Q

Motor supply of facial nerve

A

Facial expression

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34
Q

Structure at risk during parotid gland surgery

A

Facial nerve
Retromandibular vein
External carotid artery

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35
Q

Cause of hyperacusis

A

Stapedius muscle paralysis - facial nerve palsy

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36
Q

Symptoms of facial nerve palsy

A

Eye - dry, absent corneal reflex
Mouth - dry, loss of taste anterior 2/3rd tongue
Ear - hyperacusis

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37
Q

UMN vs LMN lesions - forehead

A

UMN - forehead sparing
LMN - forehead affected

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38
Q

Which branch of facial nerve is most commonly injured during parotid surgery?

A

Marginal mandibular branch

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39
Q

Where does submandibular gland open?

A

Medial to frenulum
subMandibular = medial

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40
Q

Where does sublingual gland open?

A

Lateral to frenulum
subLingual = lateral

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41
Q

Where is likely location of compression of vestibular schwannoma?

A

Cerebellopontine angle

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42
Q

Which nerves are at cerebellopontine angle?

A

Triangle = 3 sides = 3 nerves
CN VIII - vestibulocochlear
CN VII - facial nerve
CN V - trigeminal

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43
Q

Sensory supply of glossopharyngeal nerve

A

Sensation and taste posterior 1/3rd tongue
Afferent gag reflex

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44
Q

Motor supply of glossopharyngeal nerve

A
  • Stylopharyngeus (elevate pharynx)
  • Sensation posterior 1/3rd tongue
  • Taste posterior 1/3rd tongue
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45
Q

Parasympathetic supply of glossopharyngeal nerve

A

Salivation - parotid

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46
Q

Why would tumour in posterior 1/3rd tongue cause ear pain?

A

Glossopharyngeal nerve

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47
Q

Deviation of uvula in vagus nerve palsy

A

Away from lesion

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48
Q

Gag reflex

A

Afferent limb - glossopharyngeal
Efferent limb - vagus

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49
Q

Location of accessory nerve

A

1/3rd way down SCM, 2/3rd way down trapezius

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50
Q

Symptoms of accessory nerve palsy

A

Drooping of shoulder - ipsilateral
Weakness of turning head to contralateral side

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51
Q

Hypoglossal nerve palsy

A

Tongue deviate TOwards lesion

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52
Q

Which muscle is responsible for tongue deviation?

A

Genioglossus

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53
Q

Structure of cranial nerves in anterior brainstem

A

4:4:2
4 in medulla
4 in pons
2 in midbrain

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54
Q

Cranial nerves in medulla

A

4
IX - glossopharyngeal
X - vagus
XI - accessory
XII - hypoglossal

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55
Q

Cranial nerves in pons

A

4
V - trigeminal
VI - abducens
VII - facial
VIII - vestibulocochlear

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56
Q

Cranial nerves in midbrain

A

2
III - oculomotor
IV - trochlear

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57
Q

CN II lesion

A

Optic nerve
Loss of direct pupillary light reflex
Afferent

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58
Q

CN III lesion

A

Oculomotor nerve
Loss of consensual pupillary light reflex
Efferent

59
Q

Corneal reflex - afferent

60
Q

Corneal reflex - efferent

A

Facial nerve VII

61
Q

Jaw-jerk reflex - afferent

62
Q

Jaw-jerk reflex - efferent

63
Q

Carotid sinus reflex - afferent

A

Glossopharyngeal - IX

64
Q

Carotid sinus reflex - efferent

65
Q

Cough reflex - afferent & efferent

66
Q

Gag reflex - afferent

A

Glossopharyngeal - IX

67
Q

Gag reflex - efferent

68
Q

Which muscle elevates tongue?

A

Styloglossus

69
Q

Which muscle pushes tongue out?

A

Genioglossus

70
Q

Motor supply to tongue

A

Hypoglossal nerve (XII) EXCEPT palatoglossus which is vagus (X)

71
Q

Taste supply to anterior 2/3rd tongue

A

Facial nerve (VII) - chorda tympani

72
Q

Taste supply to posterior 1/3rd tongue

A

Glossopharyngeal (IX)

73
Q

General sensation to anterior 2/3rd tongue

A

V3 (trigeminal)

74
Q

General sensation to posterior 1/3rd tongue

A

Glossopharyngeal (IX)

75
Q

Lymphatic drainage of tip of tongue

76
Q

Lymphatic drainage of posterior 1/3rd of tongue

A

Deep cervical

77
Q

Lymphatic drainage of anterior 2/3rd of tongue

A

Submandibular

78
Q

Location of parotid duct

A

Lies on top of masseter
BREAKS through BUCCINATOR
Opens at 2nd molar tooth

79
Q

Location of facial artery in relation to masseter

A

Facial artery palpated on anterior border of masseter

80
Q

Frey sundrome

A

Gustatory sweating following injury to facial nerve in parotid surgery

81
Q

Most common parotid tumour

A

Pleomorphic adenoma

82
Q

Components of pleomorphic adenoma

A

Epithelial and stroll cells

83
Q

Salivary gland tumours

A

Parotid - tend to be benign
Salivary - SEVERE - tend to be malignant

84
Q

Warthin tumour

A

Parotid
Cystic
Benign
Bilateral
Smokers

85
Q

Adenoid cystic carcinoma

A

Malignant
Grows along nerve - high perineural invasion

86
Q

How do you know malignant parotid tumour?

A

Facial nerve invasion

87
Q

Sjorgren’s syndrome

A

Autoimmune
Destruction of lacrimal and salivary glands

88
Q

Unilateral parotid gland enlargement

89
Q

Which muscle separates sublingual and submandibular (submylohyoid) space?

90
Q

Ludwig angina

A

Cellulitis of sublingual and submandibular space

91
Q

Leukoplakia

A

Likely candida

92
Q

Erythroplakia

A

Higher risk of malignancy

93
Q

C. diphtheria in mouth - toxins

A

A & B (B = bad)
Pseudomembrane
Kills underlying mucosa

94
Q

Sublingual gland blockage

A

Blue cyst in floor of mouth –> ranula

95
Q

Surface landmark for cricothyroidotomy

A

Below thyroid cartilage
Stab incision

96
Q

Landmark for tracheostomy

A

Between 2nd and 3rd or 3rd and 4th tracheal rings

97
Q

Where does thyroid ima artery arise from?

A

Aortic arch

98
Q

3Ss of thyroidectomy

A

Superior thyroid artery (ligate) so close to thyroid gland
Superior, So close, Superior voice

99
Q

Recurrent laryngeal nerve supply

A

All muscles except cricothyroid

100
Q

External laryngeal nerve supply

A

Cricothyroid

101
Q

Injury to recurrent laryngeal

A

Hoarseness

102
Q

Injury to superior laryngeal nerve

103
Q

Which strap muscle should you divide with large thyroid?

A

Sternothyroid

104
Q

Strap muscles

A

TOSS
Thyrohyoid - SUPPLIED BY C1, REST SUPPLIED BY ANSA CERVICALIS
Omohyoid
Sternothyroid
Sternohyoid

105
Q

Sensory supply to larynx above vocal cords

A

Superior laryngeal

106
Q

Sensory supply to larynx below vocal cords

A

Recurrent laryngeal

107
Q

Path of R recurrent laryngeal nerve

A

Arches under subclavian

108
Q

Path of R recurrent laryngeal nerve

A

Arches under aorta - more commonly injured

109
Q

Blood supply to upper half of larynx

A

Superior thyroid artery

110
Q

Blood supply to lower half of larynx

A

Inferior thyroid artery

111
Q

Adduction of vocal cords

A

Lateral cricoarytenoid

112
Q

Abduction of vocal cords

A

Posterior cricoarytenoid

113
Q

Test for CSF rhinorrhoea

A

Beta 2 transferrin

114
Q

Which bone fractured with otorrhoea?

A

Tegmen tympani

115
Q

Pain on looking up and down

A

Entrapped inferior rectus muscle

116
Q

Floor of eye socket

A

Roof of maxillary sinus - infection due to high sinus ostium

117
Q

Anterior nosebleed

A

Kiesselbach’s plexus - more common, less severe

118
Q

Posterior nosebleed

A

Sphenopalatine artery - less common, more severe

119
Q

Lymph drainage of upper eyelid

A

Preauricular

120
Q

Lymph drainage of lower eyelid

A

Submandibular

121
Q

Lymph drainage of forehead

A

Preauricular

122
Q

Lymph drainage of lower lip

123
Q

Lymph drainage of ear lobe

A

Superficial cervical

124
Q

Layers of scalp

A

S - skin
C - connective tissue
A - aponeurosis
L - loose areolar tissue = danger = emissary veins which are valveless
P - pericranium

125
Q

Areas of valveless veins in body

A

Batsons plexus - prostate
Emissary veins - loose areolar tissue scalp

126
Q

Where is CSF produced?

A

All ventricles by choroid plexus

127
Q

Where is CSF absorbed?

A

Absorbed in superior saggital sinus by arachnoid villi

128
Q

Communicating hydrocephalus

A

All ventricles dilated
Reduced absorption in arachnoid villi
Increased ICP
Meningitis

129
Q

Non-communicating hydrocephalus

A

Congenital blockage - between 3rd to 4th ventricle

130
Q

Chiari malformation 1

A

Tonsil herniation
Syringomyelia

131
Q

Chiari malformation 2

A

Cerebellum & medulla herniation
Myelomeningocele

132
Q

Ventriculoperitoneal shunt

A

Catheter places in lateral ventricle

133
Q

Danger space - neck fascia

A

Posterior mediastinum
Potential communication between pericardial and vertebral column

134
Q

Contents of posterior triangle of neck

135
Q

Contents of submandibular triangle

A

Submandibular gland
Submandibular nodes
Facial vessels
Hypoglossal nerve

136
Q

Contents of muscular triangle of neck

A

Strap muscles
External jugular vein

137
Q

Contents of carotid triangle of neck

A

Common carotid artery
Vagus
Internal jugular vein
Ansa cervicalis

138
Q

Branches of internal carotid artery

A

Ophthalmic
Posterior communicating
Anterior cerebral
Middle cerebral (Ant & middle cerebral join to form circle of Willis)

139
Q

Branches of external carotid artery

A

Some Anatomists Like Freaking Out Poor Medical Students
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

140
Q

Which nerve is most commonly injured in carotid endarterectomy?

A

Hypoglossal nerve

141
Q

IC 10 CC in the IV - carotid sheath

A

Internal carotid artery
Vagus nerve
Common carotid artery
Internal jugular vein

142
Q

Structures external to carotid sheath

A

External carotid artery
Sympathetic chain

143
Q

Surface marking for external jugular vein

A

For central line
Mid way between lower lobe of ear to sternoclavicular joint

MRCS (25 decks)

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