Head and Neck Anatomy (5-6) Flashcards

1
Q

State the structures in the mouth.

A
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2
Q

Name the 2 folds and 2 muscles in the oral cavity

A
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3
Q

State the location where fish bones are prone to piercing.

Does the posterior 1/3 of tongue make up this location?

A
  1. Vallecula = an anatomical depression located at the base of the tongue, just anterior to the epiglottis
  2. Pyriform recess at lateral wall of laryngopharynx

No, the posterior 1/3 does not contribute to this location.

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4
Q

State the structures of the tongue

A

Important:
- circumvillate papillae (TASTE BUDS) = anterior to terminal sulcus
- fungiform papillae = lateral aspect of anterior 2/3 of tongue
- filliform papillae = medial aspect of anterior 2/3 of tongue
- terminal slulcus

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5
Q

Recap: State the cranial nerves that supply tongue and its muscles

A

TONGUE

(1) SOMATOSENSORY
- anterior 2/3 of tongue = CN V (lingual N -V3)
- posterior 1/3 of tongue = CN IX

(2) SPECIAL SENSORY (TASTE)
- anterior 2/3 of tongue = CN VII (chorda tympani)
- posterior 1/3 of tongue = CN IX

(3) SOMATOMOTOR
- somatomotor = palatoglossus (along with mucles of pharynx except stylopharyngeus, muscles of larynx, muscles of palate except tensor tympani) (pharyngeal branch - CN X)
- somatomotor = all muscles of tongue (CN XII)

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6
Q

State the 4 extrinsic muscles of the tongue. State their actions, origin and insertion and motor supply.

A

(1) PALATOGLOSSUS
- elevation
- soft palate –> tongue

(2) GENIOGLOSSUS
- protrusion
- genioid tubercle (mandible) –> tongue

(3) HYOGLOSSUS
- depression
- hyoid bone –> tongue

(4) STYLOGLOSSUS
- retraction
- styloid process –> tongue

ALL tongue muscles are supplied by CN XII except palatoglossus which is supplied by CN X.

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7
Q

State the presentation of hemiparesis of genioglossus muscle

A

Deviation of tongue towards the paralysed side

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8
Q

State the blood supply/drainage and innervation to the muscles of tongue and mucosa of tongue.

A

MUSCLES OF TONGUE
Blood supply = lingual A + ascending pharyngeal A (branches of ECA)

Blood drainage = lingual V (branch of IJV)

Innervation = All muscles of tongue except palatoglossus innervated by CN XII (hypoglossal N), palatoglossus innervated by CN X (vagus N)

TONGUE
Blood supply = lingual A + ascending pharyngeal A (branches of ECA)
Innervation = anterior 2/3 (CN V -V3 lingual N), anterior 2/3 (CN VII - chorda tympani), posterior 1/3 of tongue (CN IX)
Mucosa = NKSSE (non-keratinised stratified squamous epithelium)

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9
Q

State the location of the soft and hard palates.

State the structures underlying the palates.

A

SOFT PALATE:
- location = posterior 1/3 (oropharynx)
- bones and muscles underlying

HARD PALATE:
- location = anterior 2/3 (oral cavity proper)
- bones underlying only

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10
Q

State the structure that separates the oral cavity proper and oropharynx. State the boundaries of this structure

A

OROPHARYNGEAL ISTHMUS
- laterally - palatoglossal folds
- inferiorly - posterior 1/3 of tongue
- superficially - soft palate

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11
Q

With regard to HARD PALATE and SOFT PALATE, state the
(1) Fossa
(2) Arteries, Veins, Nerves supplying

A

HARD PALATE
(1) INCISIVE FOSSA - nasopalatine N + sphenopalatine A (branch of maxillary A - branch of ECA)
(2) GREATER PALATINE FORAMEN - greater palatine N + greater palatine A

SOFT PALATE
(1) LESSER PALATINE FORAMEN - lesser palatine N + lesser palatine A
(2) Facial A (branch of ECA) –> ascending palatine A
(3) Ascending pharyngeal A (branch of ECA) –> palatine A

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12
Q

State the 5 muscles of the soft palate. State their functions.

A
  1. tensor veli palatini - tenses soft palate
  2. levator veli palatini - elevate soft palate
  3. palatopharyngeus - elevates pharynx if soft palate fixed, depresses soft palate if pharynx is fixed
  4. palatoglossus - elevates tongue if soft palate fixed, depresses soft palate if tongue is fixed
  5. musculus uvulae

ALL muscles of the palate are supplied by CN X (vagus N) except tensor veli palatini which is supplied by CN V since it is derived from 1st pharyngeal arch

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13
Q

Recall the location of submandibular and sublingual glands with respect to the mylohyoid.

A

Submandibular gland - hooks around mylohyoid

Sublingual gland - anterior to mylohyoid (mylohyoid forms the floor of the oral cavity)

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14
Q

State the 2 branches of V3 division of trigeminal N that splits in ____.
State the supply of the 2 branches.

State any further branches of the nerves.

A

V3 (mandibular) division of trigeminal N splits into 2 branches at infratemporal fossa
(1) INFERIOR ALVEOLAR N - supplies mandibular teeth and gingiva & nerve to mylohyoid (supplies mylohyoid + anterior belly of digastric muscle)
(2) LINGUAL N - supplies somatosensory innervation of anterior 2/3 of tongue

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15
Q

____ ____ of CN____ hitchhikes onto ____ nerve of CN ____
- Parasympathetic component of ____ ____ synapses onto ____ ganglion to supply the ____ and ____ glands

A

CHORDA TYMPANI of CN7 hitchhikes onto LINGUAL nerve of CN5
- Parasympathetic component of CHORDA TYMPANI synapses onto SUBMANDIBULAR ganglion to supply the SUBMANDIBULAR and SUBLINGUAL glands

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16
Q

Match each histological slide to
(1) Submandibular, (2) Sublingual, (3) Parotid gland

A
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17
Q

With reference to the TMJ (temporomandibular joint), state the
(1) Articulation
(2) Posterior relations
(3) Type of joint

A

With reference to the TMJ (temporomandibular joint), state the
(1) Articulation = Head of the mandible + mandibular fossa of the temporal bone + articular tubercle of temporal bone
(2) Posterior relations = external acoustic meatus, stylomastoid foramen, mastoid process, styloid process
(3) Type of joint = modified hinge-type synovial joint (covered by fibrocartilage instead of hualine cartilage as in a typical synovial joint)

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18
Q

Name the 2 structures that run through the mandibular foramen

A
  1. inferior alveolar N (branch of V3)
  2. inferior alveolar A
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19
Q

State the 2 structures that attach to genioid tubercles

A
  1. genioglossus
  2. geniohyoid
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20
Q

State the direct and indirect ligaments of the TMJ (temporomandibular joint).

A

Direct = lateral ligament and capsule
Indirect = stylomandibular (thickening of fibrous capsule of parotid gland) and sphenomandibular ligaments (runs from spine of sphenoid to lingula of mandible)

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21
Q

State the muscles involved in protrusion and retraction of mandible.

A

PROTRUSION
- lateral pterygoid

RETRACTION
- posterior fibres of temporalis
- deep part of masseter
- geniohyoid
- digastric muscles

22
Q

State the muscles involved in elevation and depression of the mandible.

A

ELEVATION
- anterior fibres of temporalis
- masseter
- medial pterygoid

DEPRESSION
- gravity
- digastric muscles
- geniohyoid
- mylohyoid
- lateral pterygoid (jaya says main??)

23
Q

State the muscles involved in protrusion, retraction, elevation and depression of mandible.

A

PROTRUSION
- lateral pterygoid
- medial pterygoid

RETRACTION
- posterior fibres of temporalis
- deep part of masseter
- geniohyoid
- digastric

ELEVATION
- anterior fibres of temporalis
- masseter
- medial pterygoid

DEPRESSION
- gravity
- geniohyoid
- mylohyoid
- digastric muscles
- lateral pterygoid (?? jaya says main muscle)

24
Q

MUSCLES OF MASTICATION:
- ____ gland lies on ____, ____ gland pierces ____ in front of ____
- ____ pterygoid is attached to the ____ surface of ____ pterygoid ____
- ____ pterygoid is attached to the ____ surface of ____ pterygoid ____
- ____ fibres converge and attach to the ____ process of mandible

A

MUSCLES OF MASTICATION:
- PAROTID gland lies on MASSETER, PAROTID gland pierces BUCCINATOR in front of MASSETER
- LATERAL pterygoid is attached to the LATERAL surface of LATERAL pterygoid PLATE
- MEDIAL pterygoid is attached to the MEDIAL surface of LATERAL pterygoid PLATE
- TEMPORALIS fibres converge and attach to the CORONOID process of mandible

25
Q

State the 4 branches of maxilary A that supply the oral cavity.

A

Maxillary A is a branch of ECA.
1. sphenopalatine A
2. greater palatine A
3. lesser palatine A
4. inferior alveolar A

26
Q

State the 3 structures that pass through the parotid gland

A
  1. facial N (CN VII) - temporal, zygomatic, buccal, marginal mandibular, cervical
  2. retromandibular V
  3. ECA (branches into 8 branches only in parotid gland)
27
Q

State the sensory and secretomotor innervation of the parotid gland

A

Sensory = auriculotemporal N (mandibular nerve (V3))

Secretomotor = salivatory ganglion –> otic ganglion –> parotid gland

28
Q

State the contents of the pterygopalatine fossa
(1) Veins
(2) Nerves
(3) Arteries

A

PTERYGOPALATINE FOSSA
(1) Veins - pterygoid plexus of veins –> drains into cavernous sinus via emissary veins (risk of infection)

(2) Nerves - Pterygopalatine ganglion of lacrimal nucleus (CN7) + V2 of Trigeminal nerve exits from the foramen rotundum in the cranial cavity → Pterygopalatine fossa

(3) Arteries - sphenopalatine artery + Maxillary artery starts at the infra temporal fossa → then enters the pterygopalatine fossa

29
Q

State the epithelium of nasopharynx, oropharynx and laryngopharynx.

A

nasopharynx = respiratory epithelium (pseudostratified ciliated columnar epithelium)

oropharynx = stratified squamous epithelium

laryngopharynx = stratified squamous epithelium

30
Q

State the 3 openings of the pharynx.
State their sensory innervation

A

nasopharynx (CN V2) = posterior nasal aperture

oropharynx (CN IX) = oropharyngeal isthmus

laryngopharynx (CN X) = laryngeal inlet

31
Q

State the stuctures that make up the WALDEYER’S RING

A

WALDEYER’S RING
1. palatine tonsils
2. pharyngeal tonsils
3. lingual tonsils

32
Q

NASOPHARYNX
- runs from ____ nasal ____ to ____ ____
- ____ veli palatini runs from ____ ____ to ____ ____

A

NASOPHARYNX
- runs from POSTERIOR nasal APERTURE to SOFT PALATE
- LEVATOR veli palatini runs from SOFT PALATE to EUSTACHIAN TUBE

33
Q

OROPHARYNX
- Runs from ____ ____ to upper end of ____
- Recap: State the structure that separates the oral cavity proper and the oropharynx

A

OROPHARYNX
- Runs from SOFT PALATE to upper end of EPIGLOTTIS
- Structure = oropharyngeal isthmus (laterally bounded by palatoglossal fold, superiorly bounded by soft palate, inferiorly bounded by posterior 1/3 of tongue)

34
Q

State the 4 components of closure of oropharyngeal isthmus

A
  1. medial and downward movement of palatoglossal arches
  2. medial and downward movement of palatopharyngeal arches
  3. upward movement of tongue
  4. downward and forward movement of soft palate
35
Q

State the 2 groups of muscles of the pharynx

A

LONGITUDINAL (SSP)
- salpingopharyngeus (from eustachian tube)
- stylopharyngeus (from styloid process)
- palatopharyngeus (from soft palate)

CONSTRICTOR/SPHINCTER
- superior, middle and inferior

36
Q

With regard to longitudinal muscles, state their
(1) function
(2) motor supply
(3) blood supply

A

LONGITUDINAL MUSCLES (salpingopharyngeus, stylopharyngeus, palatopharyngeus)
(1) function = shorten and widens pharynx
(2) motor supply = ALL supplied by CN X except stylopharyngeus (CN IX)
(3) blood supply = pharyngeal branches from ECA and branches from lingual and facial artery

37
Q

With reference to the larynx, state the
(1) Borders
(2) Lining epithelium
(3) Spaces + Folds

A

LARYNX

(1) Borders - from upper border of epiglottis to lower border of cricoid cartilage

(2) Lining epithelium - respiratory epithelium (pseudostratified ciliated columnar epithelium)

(3) Spaces + Folds - vestibular & vocal folds, rima vestibule (space between vestibular folds), rima glottidis (space between vocal folds)

38
Q

Are the vocal folds and vestibular folds covered by epithelium? What kind of epithelium if they are covered?

A

vocal folds - SSNKE (stratified squamous non-keratinised epithelium)

vestibular folds - PCCE (pseudostratified ciliated columnar epithelium)

39
Q

Name the unpaired and paired cartilages of the larynx

A

UNPAIRED - epiglottis, thyroid, cricoid

PAIRED - arytenoid, corniculate, cuneiform

40
Q

Name and locate the laryngeal cartilages.

A
41
Q

Name the intrinsic muscles of the larynx.
Hint: Draw table with thyroid, cricoid, epiglottis and arytenoid.

A

INTRINSIC MUSCLES OF THE LARYNX:

Thyroid - cricothyroid, thyroepiglottis, thyroarytenoid, vocalis

Cricoid - cricoarytenoid (lateral and posterior)

Epiglottis - aryepiglottis

Arytenoid - interarytenoid (transverse arytenoid), oblique arytenoid

42
Q

State the intrinsic muscles involved in the adduction and abduction and tension of vocal folds.

A

adduction of vocal folds - all intrinsic muscles

abduction of vocal folds - posterior cricoarytenoid

tension of vocal folds - cricothyroid –> high pitch sounds by pushing thyroid cartilage forward

43
Q

State the boundaries of the laryngeal inlet.

State the structure the laryngeal inlet opens into.

A

LARYNGEAL INLET:
Superiorly - epiglottis
Laterally - aryepiglottic folds
Posteriorly - interarytenoid folds

Laryngeal inlet opens into laryngopharynx

44
Q

With reference to the LARYNX, state the
(1) nervous supply
(2) blood supply

A

LARYNX
(1) nervous supply = CN X (gives rise to superior laryngeal nerve + recurrent laryngeal nerve)
- superior laryngeal nerve branches into external laryngeal (supplies cricothyroid) and internal laryngeal (supplies area above vocal folds)
- recurrent laryngeal nerve supplies all other muscles in larynx and area below vocal folds

(2) blood supply = superior thyroid A (branch of ECA) + inferior thyroid A

45
Q

State the type of cartilage epiglottis is. State if this is typical or atypical .

A

epiglottis = elastic cartilage
all other cartilage is hyaline

46
Q

If patient presents with hoarseness of voice and inability to speak at higher pitches, what structure is likely to be affected and why?

A

CRICOTHYROID is likely affected
- cricothyroid acts to tense vocal folds by pushing thyroid cartilage outwards –> produce higher pitch sounds

47
Q

EXTERNAL EAR:
- ____ 2/3 is ____ ____
- ____ 1/3 is ____ ____
- From ____ to ____

A

EXTERNAL EAR:
- LATERAL 2/3 is ELASTIC CARTILAGE
- MEDIAL 1/3 is BONEY STRUCTURES
- From AURICLE to TYMPANIC MEMBRANE

48
Q

MIDDLE EAR
- Contains ____ ossicles =
- Between ____ and ____ = ____ joint
- Between ____ and ____ = ____ joint
- State the structure that sits on the oval window. State the pathway of vibrations.

A

MIDDLE EAR
- Contains 3 ossicles = malleus –> incus –> stapedes
- Between MALLEUS and INCUS = INCUDO-MALLEOLAR joint
- Between INCUS and STAPEDES = INCUDO-STAPEDIO joint
- STAPEDES sits on the oval window –> vibrates –> stimulate organ of corti found in cochlear duct

49
Q

MUSCLES OF THE MIDDLE EAR
(1) Tensor tympani
- muscle of the ____ pharyngeal arch
- supplied by CN ____
- contration of muscle –> ____ ossicles ____ to stop sound from entering inner ear

(2) Chorda tympani
- muscle of the ____ pharyngeal arch
- supplied by CN ____
- contraction of muscle –> ____ ossicles ____ to stop sound from entering inner ear

A

MUSCLES OF THE MIDDLE EAR
(1) Tensor tympani
- muscle of the 1ST pharyngeal arch
- supplied by CN 5
- contration of muscle –> PULLS ossicles AWAY to stop sound from entering inner ear

(2) Chorda tympani
- muscle of the 2ND pharyngeal arch
- supplied by CN 7
- contraction of muscle –> PULLS ossicles AWAY to stop sound from entering inner ear

50
Q

State the blood supply to the different parts of the ear

A

Inner ear: Labrynthine artery (remember passes through IAM with CN7 and CN8), is a branch of the basilar arteries

Middle and External ear: both maxillary

51
Q

INNER EAR
- Is a _____ _____
- Consists of ____ and ____
- Cochlea =
- Vestibular system (____, ____, ____) =
- Cochlear N + Vestibular N = CN ___

A

INNER EAR
- Is a BONY LABYRINTH
- Consists of COCHLEA and VESTIBULAR SYSTEM
- Cochlea = hearing (impulses passed on through cochlear N to brain)
- Vestibular system (UTRICLE, SACCULE, SEMICIRCULAR CANALS) = balance and posture (impulse passed on to brain via vestibular N)
- Cochlear N + Vestibular N = CN 8