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M1 Gross Anatomy > Head and Neck Review > Flashcards

Head and Neck Review Flashcards

1
Q

What embrological tissue gives rise to the facial bones?

A

Neural crest cells

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2
Q

What foramen does CN V traverse to supply subcutaneous innervation to the skin superficial to the frontal bone?

A

Supraorbital foramen (supraorbital branch of CN V-1)

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3
Q

What foramen does CN V traverse to supply subcutaneous innervation to the skin superficial to the maxilla?

A

The infraorbital foramen

from CN V-2

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4
Q

What foramen does CN V traverse to supply subcutaneous innervation to the skin superficial to the maxilla?

A
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5
Q

Cutaneous branches of CN V-1

A

Supraorbital n.
Supratorchlear n. (more medial)
Infratrochlear n.
External nasal n. (from an. ethmoidal branch of CN V-1)
Lacrimal (CN VII hitchikes)

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6
Q

Cutaneous branches of CN V-2

A

Infraorbital n. (medial aspect of cheek)
Zygomatico temporal n.
Zygomatico facial n.

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7
Q

Cutaneous branches of CN V-3

A

Mental n. (continuation of inf. alveolar)
Buccal n.
Auriculotemporal n. (skin on the side of the head and TMJ) - CN IX hitchhikes after synapsing on otic ganglion

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8
Q

Cutaneous branches supplying the posterior head and neck

A
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9
Q

Supraobital and supratrochlear nerves branch from ______ ?

A

The frontal n. (branch of CN V-1)

All of CN V-1 is sensory

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10
Q

Internal and external nasal and infratrochlear nn. branch from ______ ?

A

The Nasocilliary n. (branch of CN V-1)

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11
Q

What supplys the affarent fibers for the corneal reflex?

A

CN V-1 (the ciliary branch of the nasociliary n.)

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12
Q

Type of fibers of CN V-2

A

Only sensory

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13
Q

Trigeminal ganglion

A

Purely sensory cell bodies (no synapses)

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14
Q

What supplies sensory fibers to the upper teeth and gums?

A

The superior alveolar nn (from CN V-2)

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15
Q

What supplies sensory innervation of the hard and soft palates?

A

Hard palate - greater palantine branch of CN V-2

Soft palate - lesser palantine branch of CN V-2

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16
Q

Hitchhikers of CN V

A

CN III ciliary ganglion

CN VII pterygopalantine ganglion - greater petrosal n (hithchike CN V-2) to supply mucosa and lacrimal gland

CN VII - chorda tympani travels with the lingual n. (CN V-3) and synapses at the submandibular ganglion

CN IX otic ganglion - lesser petrosal branch synapses at otic ganglion and exits via the auriculotemporal nerve (carrying parasympathetic fibers from CN IX) to innervate parotid

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17
Q

Accomodation

A

Postsynaptic parasympathetic postganglionic cell bodies - ciliary

Lens balls up (ciliary m. contracts), iris constricts, and eyes move medially - converge (focus on close object)

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18
Q

Sensory ganglion of CN VII

A

Geniculate ganglion

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19
Q

What level does the carotid bifurcation occur?

A

At CV4

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20
Q

List the levels of the hyoid bone, carotid bifurcation, laryngeal prominence, and cricoid cartilage

A
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21
Q

Important ligaments of superior cervical vertebrae

A
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22
Q

Tissue that connects frontalis m. and occipitalis m.

A

The galea aponeurotica

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23
Q

Muscles of facial expression

A
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24
Q

What innervates the platysma m.

A

CN VII

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25
Q

Muscles supplied by ansa cervicalis n.

A

Sternohyoid
Omohyoid
Sternothyroid

Fibers from C1-3

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26
Q

What innervates the thyrohyoid m.?

A

C1 only (not part of ansa cervicalis) - hitchhikes with CN XII (hypoglossal n.)

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27
Q

What innervates the geniohyoid?

A

C1 only (not part of ansa cervicalis) - hitchhikes with CN XII (hypoglossal n.)

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28
Q

What innervates the stylohyoid

A

CN VII

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29
Q

What joins the facial vein to drain into the IJ?

A

The facial vein joins the retromandibular to drain into the internal jugular

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30
Q

Innervation of submandibular gland

A

CN VII chorda tympani (parasympathetic from submandibular gland)

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31
Q

What nerves hitchhike with the hypoglossal nerve?

A

C1 to the thyrohyoid/geniohyoid mm. and the superior root (ansa cervicalis)

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32
Q

Where does the descending cervicalis of ansa cervicalis originate?

A

The C1-2 loop of the cervical plexus

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33
Q

What muscles attach to the styloid process?

A

Stylohyoid (CN VII)
Stylopharyngeus (CN IX)
Styloglossus (CN XII)

Stylopharyngeus is the only muscle supplied by CN IX

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34
Q

Where does the phrenic n. originate?

A

Off the C3-4 loop of the cervical plexus and C5 from the brachial plexus

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35
Q

Branches of the right subclavian artery

A
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36
Q

What parasympathetic n. innervates the carotid sinus?

A

CN IX is the afferent (sensory portion)

-Also afferent to carotid body (detects pCO2)

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37
Q

Main branches of the external carotid artery

A

External carotid a
6 branches in neck/face

1 medial:
Ascending pharyngeal a

2 posterior:
Post auricular a
Occipital a

3 anterior:
Facial a
Lingual a
Sup thyroid a
Internal laryngeal a

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38
Q

Structures that drain into the nasopharynx

Three areas draining into to one area each

A
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39
Q

Structures that drain into the nasopharynx

Three areas draining into one area

A
40
Q

Arterial supply to nasopharynx mucosa

A
41
Q

Nerves of the nasopharynx

A
42
Q

Sympathetics that innervate carotid

A

Carotid nerve becomes the deep petrosal and joins with the great petrosal (CN VII) to form the vidian nerve before the sympathetic fibers pass through the pterogopalantine ganglion

43
Q

Parasympathetics of the nasopharynx

A

Via the greater petrosal nerve (CN VII) that synapse at the pterygopalantine ganglion and hitchhike on CN V-2 to innervate the mucosal glands

44
Q

Parasympathetic innervation of the lacrimal gland

A
45
Q

Autonomic innervation of nasopharynx

A
46
Q

Ciliary ganglion

A
47
Q

Parasympathetic ganglia

A

Otic ganglion
Pterogopalantine ganglion
Submandibular ganglion
Ciliary ganglion

48
Q

Where does the lesser petrosal n. synapse before reaching its target tissue?

A

The lesser petrosal n. (CN IX) synapses at the otic ganglion where the auriculotemporal branch (carrying hitchhiking postsynaptic parasympathetic fibers) leaves innervating the parotid gland

49
Q

Sensory ganglia

A

Trigeminal ganglion
Geniculate ganglion

50
Q

Only muscle of mastication that retracts mandible?

Opposite of protrusion

A

Posterior fibers of temporalis

51
Q

How does the mandible fully open?

A
52
Q

Submandibular muscles that are innervated by CN VII

A
53
Q

Only muscle supplied by CN IX

A

stylopharyngeus

54
Q
A

Styloglossus (CN X)

55
Q

How to determine the lingual (CN V3) vs hypoglossal nn at the mandible

A

Lingual wraps around the submandibular duct

56
Q

What lies deep to the hyoglossus muscle?

A

The lingual artery

57
Q

What muscles in the face/neck are innervated by C1

A

The geniohyoid and the thyrohyoid mm. are innervated by C1 from cervical plexus hitchiking with the hypoglossus n.

58
Q

The chorda tympani hitchhikes onto what nerve to innervate the sublingual and submental glands?

A

Onto the lingual n.

59
Q

The tongue

A

Posterior 1/3 gets taste and general sense from CN IX

Root of tongue gets general sense and taste from CN X

60
Q

Embryonic tissue derivation of the tongue

A

Anterior 2/3 - ectoderm (from stomodeum) - no gag reflex

Posterior 1/3 - (endoderm down to rectum - afferent limb of gag reflex (CN IX)

Efferent portion of gag reflex - to constrictors (controlled by CN X)

61
Q

Arteries of the palantine tonsil

A
62
Q

What borders the palantine tonsil

A
63
Q

Where does the retropharyngeal space run longitudinally

A

From the base of the skull to the superior mediastinum

64
Q

What is the only scalene muscle that attaches at the second rib (as opposed to the first)

A

The posterior scalene m.

65
Q

What does the tensor veli palatini arch around to tense the soft palate?

A

The hammulus of the pterygoid plate

Closes off the soft palate

66
Q

Pterygomandibular raphe

A

What attaches the superior pharyngeal constrictor m. to the buccinator m.

67
Q

Salpingopharyngeus

A
68
Q

What node swells with infections of the palatine tonsils?

A

The jugulodigastric node

69
Q

What node swells due to metastatic disease of the anterior 2/3 of the tongue?

A

The submental nodes

70
Q

What connects the right and left lobes of the thyroid?

A

The isthmus

The thyroid is derived emryonically from the foramen cecum - the pyramidal lobe is a remnant of the thyroglossal duct

71
Q

What innervates the cricothyroid m..

A

The external laryngeal n. (only structure it innervates) the internal laryngeal nerve is only sensory fibers

Ext. laryngeal n travels with the sup thyroid a.

The ext/int laryngeal nn. are branches of the superior laryngeal n.

72
Q

Veins of the anterior larynx

A
73
Q

What is the opening into the larynx

A
74
Q

Space between the two vocal chords

A

The rima glottidis

75
Q

Unpaired cartilagenous elements of the larynx

A
76
Q

Three paired cartilagenous elements of the larynx

A

Remember arytenoid - adjust position and tension of vocal cord for phonation

Attached to cricoid cartilage

77
Q

Site of emergent airway

A

At the cricothyroid membrane

78
Q

Only cartilagenous element of larynx with a complete ring

A

The cricoid cartilage

79
Q

How the airway is closed off naturally

A

The suprahyoid muscles pull up (contract) the larynx, and the hyoglossus muscle pulls the tongue back to close the epiglottis

80
Q

Superior internal fibers of the thyroaretenoid m.

A

vocalis m. - can contract discretely along its longitudinal axis

81
Q

What is the only muscle of the vocal chord that abducts?

A

The posterior cricoarytenoid m.

82
Q

Horner’s syndrome ptosis

A

Mild ptosis (superior tarsal muscle is smoot m. that is innervated by sympathetic fibers)

83
Q

Parasympathetic portion of CN III

A

The lower division synapses at the ciliary ganglion and go to muscles of the ciliary body (ball up lens) and iris (constricts pupil) via short ciliary nn.

84
Q

Sensory for the corneal reflex

A

Nasociliary branch of CN V-1 (opthalmic n.)

Remember:

Motor is from CNVII (greater petrosal n.) innervating the orbicularis oculi m. to close the eye

85
Q

Where does the chorda tympani n. exit the middle ear

A

The petrotympanic fissure into the mandibular fossa

Remember - parasympathetic to para and submandibular glands

Chorda tympani is internal to malleus and external to the incus

86
Q

Where does the tympanic n. enter the middle ear?

A

The tympanic branch of the glosspharyngeal n. enters the inferior wall of the middle ear through the tympanic canaliculus (opening between the carotid canal and the jugular foramen)

Exits the middle ear into the medial cranial fossa and then back out of the skull foramen ovale/spinosum/other unamed foramen

86
Q

What is posterior to the antrum?

A

Ethmoidal air cells

87
Q

Most of the venous system is in what meningeal layer?

A

The subarachnoid space

88
Q

Where do the ophthalmic veins drain?

A

Into cavernous sinus,

Remember opthalmic v. anastomoses with facial v. and the pterygoid plexus

89
Q

What structures can be affected by infection/tumor of the cavernous sinus?

A

Int carotid a (sympathetics on carotid)

CN III, IV, CN V-1 and V-2

Sympathetics and CN VI are most likely to be affected by something affecting the cavernous sinus

90
Q

What structures can be affected by infection/tumor of the cavernous sinus?

A

Int carotid a (sympathetics on carotid)

CN III, IV, CN V-1 and V-2

Sympathetics and CN VI are most likely to be affected by something affecting the cavernous sinus

91
Q

What surrounding structures are most likely impacted by a tumor of the pituatary gland?

A

Optic chiasm

92
Q

Structures running longitudinall (posterior to anterior) through the cavernous sinus.

A
93
Q
A
94
Q

All muscles of the glossus receive motor supply from _____ except for _____

A

All muscles of the glossus (tongue) receive motor innervation from CN XII except for the palatoglossus m. which receives innervation from CN X (because it is a muscle of the palate)

95
Q

All muscles of the palate receive motor innervation from _____ except for _____

A

All muscles of the palate receive motor innervation from CN X except for tensor veli palatini which is supplied by CN V-3

M1 Gross Anatomy (16 decks)

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