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Anatomy > Head And Neck Part 2 > Flashcards

Head And Neck Part 2 Flashcards

1
Q

What are sutures bones?

A

Normal island-like bones within the lambdoid suture
-mistaken in X-rays for skull fractures

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2
Q

What is the Pterion?

A

Junction of
1. Frontal
2. Parietal
3. Temporal
4. Sphenoid bones

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3
Q

What is deep to the Pterion?

A

Middle meningeal artery

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4
Q

How does an epidural hematoma happen?

A

Lateral head trauma causes
-A ruptured middle meningeal artery

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5
Q

How does a Epidural Hematoma present on CT imaging?

A

Convex or lens shape due to the
-Dura mater separating from cranium forming a cavity containing blood

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6
Q

What do the two layers of the dura mater spilt into?

A

Spilt to form dual venous sinuses containing venous blood

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7
Q

What is deep to the dura mater?

A

Arachnoid mater
-subarachnoid space (with cerebrospinal fluid)
Pia mater (adheres directly to the brain)

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8
Q

What goes into the sulcus of the cerebral cortex and what crosses the sulcus of the cerebral cortex?

A

Into: Pia mater
Crosses: Arachnoid mater

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9
Q

What does the subarachnoid space contain?

A

Cerebrospinal fluid (CSF)
Cerebral arteries
Cerebral veins

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10
Q

What is the bridging vein between?

A

Dura mater and arachnoid mater

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11
Q

What is the middle meningeal artery between?

A
  1. Cranial bone
  2. Dura mater
    *not in subarachnoid space
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12
Q

What do the cerebral veins drain to?

A

Dural venous sinuses
-via bridging veins

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13
Q

What do the bridging veins piece through?

A
  1. Arachnoid mater
  2. Meningeal (inner) layer of the dura mater
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14
Q

How does a subdural hematoma happen?

A

Bridging vein rupture between Dura and Arachnoid mater
-by head trauma or rapid deceleration causing intra-cranial shearing forces

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15
Q

How does a Subdural hematoma present on a CT?

A

Not strictly lens-shaped
-mixture of concave and convex

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16
Q

How does a Subarachnoid hematoma happen?

A

rupture of cerebral arteries
-Caused by ruptured aneurysm
*worse headache of their life

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17
Q

How does a Subarachnoid hematoma present on CT?

A

Blood will fill the subarachnoid space
-Highlighting the brain and brain stem contours
- Star shaped or asterisk

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18
Q

What is the purpose of an Emissary vein?

A

Provide communications between dural venous sinuses and the scalp
-Route for potential spread of infection from scalp into cranial cavity

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19
Q

Where does cerebrospinal fluid drain from?

A

Subarachnoid space into the dural venous sinuses BY THE
-Arachnoid granulations

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20
Q

What are the arachnoid granulations within?

A
  1. Superior Sagittal sinus
  2. Lateral lacuna
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21
Q

How does a Communicating Hydrocephalus happen?

A

Scarring of the Arachnoid Granulation due to a patient surviving
-A subarachnoid hemorrhage
-Will block resorption of CSF into dural venous

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22
Q

What happens to the brain when a Communicating Hydrocephalus occurs?

A

The CSF will accumulate in cavities within the ventricles of the brain

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23
Q

How does a Communicating Hydrocephalus present on CT imaging?

A

There will be an enlargement of the ventricles
-CSF filled spaces within the brain and brain stem

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24
Q

What are the infolding of the dura mater?

A
  1. Tentorium Cerebelli
  2. Falx Cerebri
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25
Q

What is the tentorium cerebelli between?

A

Cerebrum and cerebellum

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26
Q

What is the falx cerebri between?

A

Between cerebral hemispheres

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27
Q

Where does the straight sinus run between?

A
  1. Falx Cerebri
  2. Tentorium Cerebelli
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28
Q

What does the straight sinus connect?

A

Inferior sagittal sinus with confluence of sinuses

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29
Q

Where does the confluence of sinuses receive venous blood from?

A
  1. Superior sagittal sinus
  2. Straight Sinus
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30
Q

Where does the transverse sinus run along?

A

The lateral edge of Tentorium Cerebelli

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31
Q

What does the sigmoid sinus drain blood from?

A

Drains venous sinus system TO
-Internal Jugular vein at Jugular Foramen

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32
Q

What does the Sphenoid Crest separate?

A

Anterior and Middle Cranial Fossae

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33
Q

What does the Petrous Ridge of Temporal Bone separate?

A

Middle and Posterior Cranial Fossae

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34
Q

What does the Falx Cerebri attach to?

A

Crista Galli

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35
Q

What does the Tentorium Cerebelli attach to?

A
  1. Anterior Clinoid Process
  2. Posterior Clinoid process
  3. Petrous ridge of temporal bone
  4. Groove for Transverse Sinus
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36
Q

Where is the olfactory foramina (CN I-Olfactory) located?

A

In the Cribriform plate of the ethmoid bone

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37
Q

Where is the optic canal (CN II-Optic and ophthalmic artery) located?

A

In the lesser wing of the sphenoid bone

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38
Q

Where is the foramen spinosum (middle meningeal artery) located?

A

In the Greater Wing of Sphenoid Bone

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39
Q

What does the Superior Orbital Fissure contain?

A

CN III- Oculomotor nerve
CN IV- Trochlear
CN V1- Trigeminal (ophthalmic)
CN VI- Abducens

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40
Q

Where is the superior orbital fissure located?

A

Between Lesser and Greater Wings of Sphenoid Bone

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41
Q

What does the Foramen Rotundum contain?

A

CN V2 (maxillary)

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42
Q

Where is the Foramen Rotundum located?

A

In the Greater Wing of Sphenoid Bone

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43
Q

What does the Foramen Ovale contain?

A

CN V3 (mandibular)

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44
Q

Where is the Foramen Ovale located?

A

In the Greater Wing of Sphenoid Bone

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45
Q

What does the Foramen Magnum contain?

A

The spinal cord

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46
Q

Where is the Foramen Magnum located?

A

The occipital bone

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47
Q

Where do the sinuses drain to?

A

The internal jugular vein VIA
-The Groove for Sigmoid Sinus
*Can be followed to Jugular Foramen

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48
Q

What does the Jugular Foramen contain?

A

CN IX- glossopharyngeal nerve
CN X- Vagus Nerve
CN XI- Accessory nerve

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49
Q

Where is the Jugular foramen located?

A

Between Petrous Temporal bone and Occipital Bone

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50
Q

What does the Internal Acoustic Meatus contain?

A

CN VII- Facial Nerve
CN VIII- Vestibulocochlear nerve

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51
Q

Where is the internal Acoustic Meatus located?

A

Petrous Temporal Bone

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52
Q

What does the Hypoglossal Canal contain?

A

CN XII- Hypoglossal

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53
Q

Where is the Hypoglossal canal located?

A

The occipital bone

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54
Q

What is the Sella Turcica composed of?

A
  1. Anterior Clinoid Process
  2. Hypophyseal Fossa
  3. Posterior Clinoid Process
  4. Dorsum Sellae
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55
Q

Where is the pituitary gland located?

A

The Hypophyseal Fossa

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56
Q

What is the Plica Semilunaris?

A

The remnant of 3rd eyelid or nictitating membrane

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57
Q

What is the Limbus?

A

The border between Cornea and Sclera

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58
Q

What does the optic nerve contain?

A

Axons of retinal ganglion cells
-Holds visual information

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59
Q

What is the Fovea?

A

The area of greatest visual acuity
-Center of visual field

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60
Q

Where is the Aqueous humor located?

A

Anterior to the lens on either side of the iris

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61
Q

What causes Glaucoma?

A

Impaired drainage of Aqueous humor
-There will be damaged to retina and optic nerve due to intraocular pressure

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62
Q

What muscle mediates blinking?

A

Palpebral part of Orbicularis Oculi muscle
-Motor innervation=CN VII (facial nerve)

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63
Q

What is the sensory innervation of the Cornea?

A

Ophthalmic Division of the Trigeminal Nerve
CN V1

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64
Q

What does the blink reflex test?

A

CN V1 (Ophalmic division of trigeminal nerve)
CN VII (Facial)

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65
Q

What bones of the orbit osteology are thin and fragile?

A

Ethmoid Bone
Maxilla

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66
Q

What does the Periorbita contain?

A

Fascia investing contents of the orbit

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67
Q

What surrounds CN II (optic nerve)

A

Subarachnoid space

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68
Q

If the optic disc is blurred what could that indicate?

A

Elevated Intracranial Pressure
-Papilloedema

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69
Q

Where is the lacrimal gland located?

A

Posterior to the Orbital Septum

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70
Q

What does the Supraorbital Nerve branch from?

A

Frontal Nerve
-branch of CN V1 (trigeminal nerve)

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71
Q

What is the nerve supply of the Levator Palpebrae Superioris muscle?

A

Oculomotor Nerve (CN III)

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72
Q

What muscles elevate the eyelid?

A
  1. Levator Palpebrae Superioris Muscle
  2. Superior Tarsus Muscle (sympathetic innervation)
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73
Q

What helps close the eyelid?

A

Palpebral Part of Orbicularis Oculi Muscle
-CN VII (facial nerve)

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74
Q

What are the palpebral glands?

A
  1. Tarsal glands (Meibomian glands)
  2. Ciliary glands
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75
Q

What is the purpose of the Tarsal glands (Meibomian glands)

A
  1. Secrete oils that prevents lacrimal fluid from overflowing eyelids
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76
Q

How does a Chalazion happen?

A

When there is an obstructed Tarsal gland
-There will be an inflammatory nodule facing inward toward the eye

77
Q

What is the purpose of the ciliary gland?

A
  1. Secrete oil that prevents lacrimal fluid from overflowing eyelids
78
Q

How does a Hordeolum (sty) happen?

A

From an obstructed Ciliary gland resulting in inflammatory nodule facing outward

79
Q

What are the actions of the Superior Rectus muscle?

A
  1. Elevation
  2. Adduction
    *CN III (oculomotor)
80
Q

What are the actions of the inferior rectus muscle?

A
  1. Depression
  2. Adduction
    *CN III (oculomotor)
81
Q

What is the action of the Lateral Rectus muscle?

A

Abduction
*CN VI Abducens

82
Q

What is the action of the medial rectus muscle?

A

Adduction
*CN III (Oculomotor nerve)

83
Q

What are the actions of the Superior Oblique muscle?

A
  1. Depression
  2. Abduction
  3. Intorsion
    *CN IV (Trochlear nerve)
84
Q

What are the actions of the inferior oblique muscle?

A
  1. Elevation
  2. Abduction
  3. Extortion
    *Oculomotor nerve CN III
85
Q

Clinical eye testing of Abduction

A

Tests Lateral Rectus
*CN VI (Abducens)

86
Q

Clinical eye testing of elevation while abducted

A

Test superior rectus
*CN III (oculomotor nerve)

87
Q

Clinical eye testing of depression while abducted

A

Test Inferior Rectus
*CN III Oculomotor

88
Q

Clinical eye testing of adduction

A

Medial Rectus
*CN III (Oculomotor)

89
Q

Clinical eye testing of Elevation while adducted

A

Inferior Oblique
*CN III (oculomotor)

90
Q

Clinical eye testing of depression while adducted

A

Superior oblique
*CN IV (Trochlear nerve)

91
Q

What is the blood supply of the orbit?

A
  1. Internal carotid artery BRANCHES INTO
  2. Ophthalmic Artery BRANCHES INTO
  3. Supraorbital Artery
92
Q

Where does the Supraorbital artery pass into/

A

The scalp

93
Q

Where does the Ophthalmic artery pass to?

A

Crosses over optic nerve from lateral to medial

94
Q

What does the short ciliary nerves contain?

A

Postganglionic parasympathetic axons

95
Q

What does the ciliary ganglion contain?

A

Cell bodies of postganglionic parasympathetic neurons

96
Q

What does the oculomotor nerve contain?

A

Has preganglionic parasympathic axons

97
Q

What does contraction of the ciliary muscle do? (Parasympathetic)

A

Removes tension on lens and causes it to ball up for near vision

98
Q

What does contraction of the sphincter papillae muscle cause? (Parasympathetic)

A

Causes pupil to constrict
-Reduces light entering the eye

99
Q

What does the long ciliary nerve contain?

A

Postganglionic sympathetic axons

100
Q

What does the nasociliary nerve (branch of CN V1) contain?

A

Postganglionic sympathetic axons

101
Q

What does contraction of the Dilator Pupillae muscle do? (Sympathetic)

A

Causes pupil to dilate
-increasing light entering the eye

102
Q

What muscle aren’t weakened in Oculomotor Nerve Palsy

A
  1. Lateral Rectus
  2. Superior Oblique Muscles
103
Q

What is the clinical presentation of Oculomotor nerve palsy

A
  1. Eye oriented down and out
  2. Pupil dilated
  3. Ptosis
104
Q

What muscle is weakened in Abducens Nerve Palsy?

A
  1. Lateral Rectus muscle
    *eye oriented inward
105
Q

What does Trochlear nerve palsy present with?

A

Hypertropia and extortion

106
Q

How will a patient with Trochlear nerve palsy try to correct the diplopia and hypertropia?

A
  1. Patient will tilt their chin down and lateral flex neck away from affected to eye to correct for intorsion deficit
107
Q

What does the Cavernous Sinus contain?

A
  1. Internal carotid artery
  2. CN III
  3. CN IV
  4. CN V1
  5. CN V2
  6. CN VI
108
Q

What is the danger zone?

A

Border of the
1. Upper lip
2. Lateral aspect of the nose
3. Medial corner of the eye

109
Q

If you pop a pimple in the danger zone what can happen?

A

Can drain to the ophthalmic vein which will lead into the cavernous sinus and infection can enter the sinus
-can cause thrombophlebitis, cerebral edema, death

110
Q

What are the muscles of mastication located?

A
  1. Parotid/masseteric
  2. Temporal fossa
  3. Infratemporal fossa
111
Q

What is the origin and insertion of the Temporalis muscle?

A

O: Temporal Fossa
I: Coronoid Process

112
Q

What is the origin and insertion of the Masseter muscle?

A

O: Zygomatic bone and Zygomatic arch
I: Ramus of the mandible

113
Q

Where does the Temproalis muscle pass deep to?

A

Deep to the zygomatic arch

114
Q

What muscles help assist mastication by maintain food between the teeth?

A
  1. Orbicularis Oris
  2. Buccinator
115
Q

Where is the parotid duct located?

A

Near upper 2nd molar

116
Q

What is the origin and insertion of the lateral pterygoid muscle?

A

O: Sphenoid bone
I: Condylar process
Fiber orientation: Anteroposterior

117
Q

What is the origin and insertion of the medial pterygoid muscle?

A

O: Pterygoid Fossa of Sphenoid Bone
I: Ramus of Mandible
Fiber orientation: Anterosuperior

118
Q

What are the muscles of mastication?

A
  1. Temporalis Muscle
  2. Masseter
  3. Lateral Pterygoid Muscle
  4. Medial Pterygoid Muscle
119
Q

What are the actions of the Temporalis muscle?

A

Fibers pull up and posteriorly on Coronoid Process
1. Retrusion
2. Elevation

120
Q

What are the actions of the Masseter Muscle?

A

Fibers directed anterosuperiorly
1. Elevation (major)
2. Protrusion (minor)

121
Q

What are the actions of the Medial Pterygoid muscle?

A

Fibers directed anterosuperiorl
1. Elevation (Major)
2. Protrusion (Minor)

122
Q

What are the actions of the Lateral Pterygoid muscle?

A

Pulls the mandible anteriorly
1. Protrusion (and opener)

123
Q

What movement occurs between the head of the mandible and the articulation disc? (From open to 15 degrees)

A

Mandible depresses to 15 degrees

124
Q

What movement occurs between the articular disc and temporal bone? >15 degrees

A

Protrusion

125
Q

How does Temprormandibular joint dislocations happen?

A

Excessive depression of the Mandible
1. The head of the mandible and articular disc slide anterior to the articular tubercle
2. Jaw is stuck open
3. Pull mandible down and back to get un-stuck

126
Q

During Linear translation what are the movements?

A
  1. Protrusion=anterior glide
  2. Retrusion=posterior glide
127
Q

During circumduction what are the movements?

A
  1. Mediotrusion=glide toward midline
  2. Laterotrusion=glide away from midline
128
Q

Where does the maxillary artery pass?

A

Superficial or deep to the lateral pterygoid muscle

129
Q

Where does the middle meningeal artery pass?

A

Through foramen spinosum to Exeter the cranial cavity

130
Q

Where does the Inferiror Alveolar Artery pass through?

A

Through Mandibular Foramen and into mandibular canal

131
Q

What does the inferior alveolar artery supply?

A

The lower teeth

132
Q

What does the masseteric artery supply?

A

Masseter muscle

133
Q

What does the deep temporal artery supply?

A

Temporalis muscle

134
Q

What does the Sphenopalatine artery supply?

A

Nasal cavity

135
Q

What does the infraorbital artery supply?

A

Anterior upper teeth

136
Q

What does the posterior superior alveolar artery supply?

A

Posterior upper teeth

137
Q

What does the descending palatine artery supply?

A

The palate

138
Q

What are the sensory nerves of the teeth, face, and tongue for touch and pain?

A

General somatic afferents

139
Q

What are the nerves of the general somatic afferents?

A

THEY’RE ALL BRANCHES of CN V3 (trigeminal-mandibular nerve)
1. Auriculotemporal nerve
2. Inferior alveolar nerve
3. Lingual nerve
4. Buccal nerve

140
Q

What do the inferior alveolar and lingual nerves separate?

A

Pterygoid muscles

141
Q

What nerve supplies the lower teeth?

A

Inferior Alveolar Nerve

142
Q

What branches from the inferior alveolar nerve?

A

Mental nerve
-exits by the mental foramen

143
Q

What is in the mandibular canal?

A

Inferior alveolar N. A. V

144
Q

What supplies the anterior 2/3 of the tongue?

A
  1. Trigeminal ganglion
    *touch and pain
  2. Lingual Nerve
    *touch and pain (GSA)n
145
Q

What does the Buccinator muscle get supply by?

A

Buccal branch of CN VII (Facial nerve)

146
Q

What supplies the sensory of the cheek mucosa?

A

Buccal Nerve (branch of CN V3-mandibular nerve)

147
Q

What is deep and superficial to the masseter muscle of the Buccal Branch vs Buccal Nerve?

A

Superficial: Buccal Branch of CN VII
Deep: Buccal nerve (arises from infra temporal fossa)

148
Q

What is the sensory innervation of the TMJ?

A
  1. Auriculotemporal Nerve
  2. Deep Temporal Nerves
  3. Masseteric Nerve
149
Q

What is motor to the muscles of mastication?

A

Branchial efferents (CN V3)

150
Q

During embryonic formation what are the pharyngeal arches supplied by?

A

Arch 1: CN V- trigeminal nerve
Arch 2: CN VII- facial nerve
Arch 3: CN IX- glossopharyngeal nerve
Arch 4: CN X- vagus

151
Q

What is the motor supply of the Temporalis muscle?

A

CN V3

152
Q

What is the blood and nerve supply of the masseter muscle?

A
  1. Masseteric nerve
  2. Masseteric artery
    *Pass through the mandibular notch
153
Q

If there is a CN V3 (trigeminal- mandibular) lesion where does the chin deviate to?

A

TOWARD the side of the CN V3 lesion
*Ipsilateral Lateral pterygoid is weakened

154
Q

What supplies the taste buds and salivary glands?

A

Taste buds: special afferents
Salivary glands: General visceral efferents

155
Q

What is the Chorda Tympani a branch of?

A

CN VII (Facial nerve)

156
Q

What does the Submandibular ganglion have?

A

Postganglionic parasympathetic neurons

157
Q

What function does the trigeminal ganglion supply the tongue?

A
  1. Touch
  2. Pain
158
Q

What function does the geniculate ganglion supply the tongue?

A

Taste

159
Q

What information does the brain stem have for lingual nerve and Chorda tympani function

A

preganglionic parasympathetic neurons

160
Q

What function does the Chorda Tympani supply the tongue?

A
  1. Taste (anterior 2/3)
  2. Preganglionic parasympathetic
161
Q

What contains postganglionic neurons ?

A

Submandibular ganglion
-Parasympathetic ganglion

162
Q

What is the function of the Lingual nerve?

A
  1. General somatic afferents to anterior 2/3 of tongue
    (Touch and pain)
163
Q

What is the function of the Chorda tympani?

A
  1. Taste for anterior 2/3 of tongue
  2. Preganglionic parasympathetic to sublingual and submandibular glands
164
Q

What is sensory to mucosa of the middle ear?

A

Tympanic plexus

165
Q

What does the lesser petrosal nerve branch from?

A

CN IX- glossopharyngeal nerve
*Preganglionic parasympathetic

166
Q

Where does the tympanic nerve come from?

A

CN IX (glossopharyngeal)

167
Q

What does the Auriculotemporal nerve supply?

A

General somatic afferents to parotid-masseteric region of the face

168
Q

What supplies the Parotid Gland?

A
  1. CN IX (glossopharyngeal)
  2. Lesser Petrosal Nerve
  3. Otic Ganglion
  4. Auriculotemporal nerve
169
Q

Which nerve supplies the mylohyoid and digastric muscles (anterior)?

A

Trigeminal nerve (CN V3)

170
Q

What nerves supply the stylohyoid and digastric (posterior) muscles?

A

Facial Nerve (CN VIII)

171
Q

What does the greater Petrosal nerve have?

A

preganglionic parasympathetic to the lacrimal gland

172
Q

What is the parasympathetic pathway to the Lacrimal and mucosal glands?

A
  1. Facial Nerve
  2. Greater Petrosal Nerve
  3. Pterygopalatine ganglion
  4. Lacrimal glands
173
Q

What does the Pterygopalatine ganglion have?

A

Postganglionic parasympathic neurons
*Will supply the lacrimal and mucosal glands

174
Q

What is the nerve supply of the stapedius muscle?

A

CN VII
-Facial

175
Q

What is the purpose of the stapedius muscle?

A

Protects the innear ear
-Attenuates movement of the bone in response to loud sounds

176
Q

What causes complex Bell’s palsy?

A

Damage to the Facial nerve proximal to internal acoustic meatus

177
Q

What nerves are affected during Complex Bells Palsy?

A
  1. Chorda Tympani
  2. Greater Petrosal Nerve
  3. Nerve to Stapedius muscle
178
Q

If there is a TMJ Disc Dislocation (internal Derangement) what will and will not feel pain?

A

Main part of disc: NO pain
Retrodiscal Lamina: PAIN

179
Q

What is the patient presentation of a TMJ Disc Dislocation?

A
  1. Painful or tender temporomandibular joint
  2. Popping or clicking
  3. Patient prefers to chew on ipsilateral side
180
Q

If there is TMJ dislocation where is the Disc located when the patients mouth is open or closed?

A

Open: Anterior to condylar process
Closed: Posterior to condylar process

181
Q

During mastication which side is protruded or retruded?

A

Chewing side: retruded
Non-chewing side: Protruded

182
Q

What muscle is working during mastication on the chewing side?

A

Temporalis muscle

183
Q

What is the action of the Temporalis muscle?

A

Fibers pull up and posteriorly on Coronoid process
1. Retrusion
2. Elevation
3. Regulates intracapsular pressure

184
Q

What is heard from TMJ Ostoarthritis?

A

Occurs from chronic TMJ dislocation
1. Painful with jaw movement and crepitus is heard

185
Q

During Far vision what are the ciliary muscles and suspensory ligaments doing?

A

Ciliary: Relaxed
Suspensory ligaments: Tense

186
Q

During Near vision what are the suspensory ligaments and ciliary muscles doing?

A

Ciliary muscles: contracted
Suspensory ligaments: Relaxed

187
Q

What are the muscles of mastication?

A
  1. Temporalis
  2. Masseter
  3. Lateral Pterygoid
  4. Medial Pterygoid muscles
188
Q

What CN contains axons that help mediate accommodation?

A

CN III (oculomotor)

Anatomy (19 decks)

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