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Yr 2 - Control > Head and Neck Practical 2 > Flashcards

Head and Neck Practical 2 Flashcards

1
Q

How many terminal branches does the facial nerve have?

A

5 that innervate the muscles of facial expression

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2
Q

How does the facial nerve enters/leave the skull?

A

Enters - internal acoustic canal in temporal bone

Exits - stylomastoid foramen

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3
Q

Motor branches of facial nerve

A

Ten Zebras Bit My Clavicle

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4
Q

How many bellies does the occipitofrontalis have?

A

2 - one in frontal region and one in occipital region

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5
Q

Action of 2 bellies of occipitofrontalis?

A
  • Frontal part: pulls scalp forward, wrinkles forehead and elevates eyebrows
  • Occipital part: retracts scalp
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6
Q

What circular muscle is being pointed to? Function?

A

Orbicularis oculi - closes eyelids (sphincter)

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7
Q

What muscle is this? Function?

A

Orbicularis oris - sphincter of mouth (closing lips - ‘kissing muscle’)

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8
Q

What is the action of orbicularis oris opposed by?

A

A number of muscles that dilate the mouth –> dilators of mouth

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9
Q

Function of buccinator? Location?

A
  • Lateral to corner of mouth and anterior to masseter
  • Contracts and keeps cheeks taut when whistling, talking etc and presses cheek against teeth when eating
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10
Q

What duct is buccinator pierced by?

A

The parotid duct

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11
Q

What gland is being pointed to?

A

Paired parotid gland (anterior to ear)

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12
Q

Where does parotid gland enter into mouth?

A

At level of upper 2nd molar tooth

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13
Q

What muscle is being pointed to? Function?

A

Platysma (flat and thin) - tenses skin of neck

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14
Q

What nerve is this?

A

Temporal branches of facial nerve

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15
Q

What nerve is this? What does it innervate?

A
  • Zygomatic branch of facial nerve
  • Innervates the orbicularis oculi
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16
Q

What nerve is this?

A

Buccal branch(es) of facial nerve

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17
Q

What nerve is this?

A

Marginal mandibular branch of facial nerve

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18
Q

What nerve is this? What does it innervate?

A
  • Cervical branch of facial nerve
  • Innervates platysma
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19
Q

Within the parotid gland, the facial nerve terminates by splitting into five branches. Does it innervate the parotid gland?

A

No - only provides motor innervation to the muscles of facial expression.

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20
Q

Clinical case 1:

Judy is a 29-year-old secretary who has had diabetes since childhood, went to the ER as it looked like she was having a stroke.

She presents with her left face drooping and inability to close her left eye which also felt dry.

Physical examination reveals facial weakness:

  • Left eye would not close completely and appeared to droop slightly
  • Only the right side of her mouth was elevated when she was asked to smile
  • Only the right eyebrow was elevated when she was asked to wiggle her eyebrows

1) What is your preliminary diagnosis?

A
  1. Injury to left facial nerve (unilateral) –> muscles of facial nerve not working
    1. Obicularis oculi not working
    2. Dilators of mouth not working
    3. Occipitofrontalis not working
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21
Q

What level does common carotid artery bifurcate?

A

Between C3 and C4

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22
Q

Describe course of internal carotid artery

A

Travels more posterioly - gives off no branches in neck/face but goes straight to supply brain

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23
Q

Describe course of external carotid

A

More anterior to internal, gives off branches to supply face

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24
Q

What is the 1st branch of the external carotid?

A

Superior thyroid artery - goes to supply thyroid gland

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25
Q

What is the 2nd branch of the external carotid? What does it supply?

A

Lingual branch - goes to supply floor of mouth

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26
Q

What is the 3rd branch of the external carotid?

A

Facial artery (very tortuous)

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27
Q

What are the 2 terminal branches of the external carotid?

A
  • Superficial temporal artery
  • Maxillary artery
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28
Q

What artery is this? What does it supply?

A

Superficial temporal artery - generally supply superficial areas of the face.

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29
Q

What artery is this? What does it supply?

A

Maxillary artery - supplies the deep structures of the face

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30
Q

What pulse is being felt here? How can it be found?

A

Carotid pulse - identify laryngeal prominence and make your way laterally

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31
Q

What pulse is being felt here?

A

Facial pulse (near angle of mandible)

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32
Q

What pulse is being felt here?

A

Temporal pulse (superfical temporal artery)

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33
Q

What nerve is this? Course?

A

Hypoglossal nerve CN VII - Descends down neck then makes a 90 degree turn around the external and internal carotid arteries to make its way towards area of tongue (motor)

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35
Q

Which foramen transmits the middle meningeal artery and middle meningeal vein into the skull?

A

The foramen spinosum

36
Q

Where is the foramen spinosum located?

A

located in the posteromedial part of greater wing of sphenoid bone (posterolateral to foramen ovale)

37
Q

Grooves of middle meningeal artery and its branches

38
Q

Diagram of tentorium cerebelli (protrusion of dura mater)

39
Q

How is the dura mater related to the skull?

A

Firmly attached - can only become a space in:

  • Pathological situations e.g. bleeding
  • Post mortem (chemicals)

Is a potential space

40
Q

What is bleeding between the skull and dura mater called?

A

Epidural/extradural haemorrhage

41
Q

What would an epidural bleed in the anterior cranial fossa compress?

A

The frontal lobe

42
Q

What do the lateral pterygoid plates of the sphenoid bone form important attachment sites for?

A

The muscles of mastication

43
Q

What is being pointed to? (sphenoid bone from inferior view)

A

Lateral pterygoid plate (on one each side)

44
Q

What is being pointed to? (inferior view of spheniod)

A

Medial pterygoid plate (paired)

45
Q

Space between the medial and lateral pterygoid plates of sphenoid bone

46
Q

The lateral pterygoid plate of the sphenoid bone has an internal and external aspect. What do these form attachment points for?

A

Lateral and medial pterygoid plate –> N.B. both of these muscles attach to the lateral pterygoid plate

47
Q

How can the orientation of the temporal bone be established?

A

Mastoid process posteriorly and zygomatic process anteriorly

48
Q

What part of the temporal bone is being pointed to?

A

Zygomatic process

49
Q

What part of the temporal bone is being pointed to?

A

Mastoid process

50
Q

Where does masseter originate from?

A

Zygomatic process of temporal bone

51
Q

Which muscles attach to the mastoid process of the temporal bone?

A

Sternocleidomastoid and posterior belly of digastric

52
Q

What is being pointed to? What articulates here?

A

Mandibular fossa of temporal bone - for articulation with the mandible at TMJ

53
Q

Picture of mandible

54
Q

What part of the mandible is being pointed to?

A

Ramus - has an internal and external surface

55
Q

What does the external aspect of the mandibular ramus form an attachment point for?

A

Masseter muscle of mastication

56
Q

What does the internal aspect of the mandibular ramus (near angle of mandible) form an attachment point for?

A

Medial pterygoid muscle

57
Q

What part of the mandible is being pointed to?

A

Condyloid process / condyle (paired)

58
Q

What part of the mandible is being pointed to? What muscle attaches here?

A
  • Coronoid process of mandible
  • Temporalis muscle attaches here
59
Q

What is the temporal fossa?

A

fossa (shallow depression) on the side of the skull bounded by the temporal lines and terminating below the level of the zygomatic arch.

60
Q

Which muscle does the temporal fossa provide attachment for?

A

Temporalis muscle of mastication

61
Q

What muscle is being pointed to? Origin and insertion?

A

Temporalis:

  • Origin: the temporal fossa
  • Inserts: It condenses into a tendon, which inserts onto the coronoid process of the mandible.
62
Q

What muscle is being pointed to? Origin and insertion?

A

Masseter:

Origin: the zygomatic arch of the temporal bone.

Inserts: ramus and angle of the mandible.

63
Q

Picture of temporalis - fan shaped muscle

A

N.B. zygomatic arch has been removed

64
Q

What muscle is being pointed to? Origin and insertion?

A

Lateral Pterygoid:

Origin: external/lateral aspect of lateral pterygoid plate of the sphenoid

Inserts: condyloid process of mandible

65
Q

What muscle is being pointed to? Origin and insertion?

A

Medial pterygoid muscle:

Origin: medial aspect of the lateral pterygoid plate of the sphenoid bone.

Inserts: ramus of the mandible near the angle of mandible (internally)

66
Q

What are the 4 muscles of mastication?

A
  • Masseter
  • Temporalis
  • Lateral pterygoid
  • Medial pterygoid
67
Q

What is the highlighted muscle?

A

Masseter (mandible has been faded out)

68
Q

What is the highlighted muscle?

A

The medial pterygoid (the masseter and medial pterygoid sandwich the mandible either side)

69
Q

What is the highlighted muscle?

A

Lateral pterygoid

70
Q

Function of the superior rectus muscle (extraocular)?

A

Pulls eyeball superiorly (look up)

71
Q

Function of the medial rectus muscle (extraocular)?

A

Contracts to adduct the eyeball (look medially)

72
Q

Function of the superior oblique muscle (extraocular)?

A

Depresses, abducts and medially rotates the eyeball.

73
Q

Function of the lateral rectus muscle (extraocular)?

A

Contracts to pull eyeball laterally (abducts)

74
Q

What is this gland?

A

Lacrimal gland

75
Q

Function of the inferior rectus muscle (extraocular)?

A

Helps to look down

76
Q

Which cranial nerve is most likely to have been damanged if someone cannot move the right eye to look laterally?

A

Abducens (as this nerve innervates lateral rectus which abducts the eyeball)

77
Q

Innervation of extraocular muscles?

A

LR6 SO4

  • Lateral rectus - 6 (abducens nerve CN VI)
  • Superior oblique - 4 (trochlear nerve CN IV)

Everything else innervated by CN III oculomotor nerve

78
Q

A 34-year-old man is hit in the head with a heavy object that was thrown out of a window under which he was walking. He was taken to the ER, given a MRI scan, and 36 hours later, regained consciousness. Several days later, the patient reported difficulty in following a moving object presented within his visual field and also felt little or no sensation of the forehead after a mild pinprick administered to that region.

The MRI provided evidence that the head injury most likely caused damage to:

a) Peripheral fibres of the facial nerve
b) Central processes of the trigeminal nerve
c) Nerve fibres in the superior orbital fissure
d) Nerve fibres passing through the jugular foramen

A

Nerve fibres in the superior orbital fissure (oculomotor nerve passes through here)

79
Q

Which cranial nerve is responsible for moving the muscles of the tongue?

A

CN XII Hypoglossal

80
Q

Which cranial nerve is responsible for sensation to the face?

A

CN V trigeminal

81
Q

Which cranial nerve is responsible for motor function of muscles of facial expression?

A

CN VII Facial nerve

82
Q

Which cranial nerve is responsible for supplying the muscles of mastication?

A

Mandibular branch of the trigeminal ( CN V3)

83
Q

Which cranial nerve is responsible for moving the eyeballs medially?

A

CN III oculomotor

84
Q

Which cranial nerve is responsible for closing the eyelids (orbicularis oculi)?

A

CN VII facial nerve

Yr 2 - Control (71 decks)

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