Head & Neck 1 Flashcards
label the parts of the external and internal nose
what are the 3 bony components to the external nose?
nasal bones
maxillary bones
frontal bone
what are the cartilaginous components of the external nose
major ala cartilages (n=2)
minor ala cartilages
lateral nasal cartilages (n=2)
septal cartilage x4
what are the regions of the nasal cavity?
Vestibule of the nasal cavity
* Consists of coarse hair (vibrissae)
Respiratory region of the nasal cavity
* Walls of nasal cavity humidify
inhaled air
Olfactory region of the nasal cavity
* Allows smell (olfaction)
what are the nerves that innervate the olfactory bulb
CN1 (olfcatory nerve) for olfaction (smell/special sense)
CN6 (opthalmic) and CN7 (maxillary) of the trigeminal (CN5) for general sensory innervation
what makes the medial wall of the nasal cavity? (nasal septum)
- Septal cartilage (anteriorly)
- Perpendicular plate of ethmoid (superiorly and posteriorly)
- Vomer (inferior and posterior)
label this saggital section of the medial wall of nasal cavity
what causes occlusion of one of the two nasal chambers (partial/complete) leading to difficulty breathing and treatment?
Deviated Septum
septum is displaced to a side
Septoplasty
what are the 2 main divisions of the lateral wall of the nasal cavity
3 nasal conchae/ turbinates and 3 nasal meati
What are the bony shell shaped structures within the nasal cavity called?
What is their function?
What covers them?
concha
superior and middle are bony projections from ethmoid bone
Superior, middle and inferior concha/ turbinates
Function: Will warm up and humidify the air and trap foreign particles
Covered by a mucus membrane
difference between 3 nasal cochae and label them
Superior nasal concha
*Bony projection from ethmoid bone
Middle nasal concha
*Bony projection from ethmoid bone
Inferior nasal concha
*Independent bone
label
outer dark purple is inferior nasal conchi
middle blue is middle nasal conchi
inner light purple is the superiro nasal conchi
label the nasal meati
posterior nare (choanae) of nasal cavity
What is the vertical and horizontal plane of th ethmoid bone?
What does the horizontal plane form?
What does the vertical plane contain?
Vertical = Cribiform plate of ethmoid bone
Contains foramina which allows olfactory nerves to pass through
Horizontal = Perpendicular plate of ethmoid bone
Forms the nasal septum
Ethmoid bone also makes up the superior and middle conchae
What is the opening and exit of the nasal cavity called?
Opening = nasal recess
Exit = Nasal choanae
Function of turbinates
-Warm up and humidify the air as it passes through the nose
-Create a turbulence effect and trap foreign particles
-Covered by mucus membranes
what is the arterial blood supply of the nasal cavity
there is a few. original branch is common carotid
branches from internal carotid arteries are:
* Anterior ethmoidal artery
* Posterior ethmoidal artery
branches from external carotid arteries:
* Greater palatine artery
* Sphenopalatine artery
* Superior labial artery
* Lateral nasal artery
great palestine sees suffering lately
what is epistaxis (nose bleed)
2 forms:
- anterior: from kiesselbachs plexus (enastamoses between arteries), most common
- posterior: from woodruffs plexus
What are the paranasal sinuses?
What is their function?
air filled cavities
frontal, sphenoid, ethmoid, maxillary
Lighten skull
Vocal resonance
Cleans out air
Shock absorption
Contains pseudostratified columnar epithelial cells
where is the frontal paranasal sinus?
location of ostium (opening)
- Paired
- Located within the frontal bone
- Flattened triangular shape
- Typically, asymmetrical
ostium = middle meatus
location of maxillary sinus
in teh maxilla
what si maxillary sinusitis
inflammation of maxillary sinus
Why are the maxillary sinuses more prone
to infection?
- Its ostium is located at the superior part of the sinus
- Ostium lies at an obtuse angle toward the nasal roofàdifficult to be emptied in the erect position
what does this CT scan show?
CT scan of the head in the coronal plane
showing left maxillary sinusitis
where is the ethmoidal sinus?
and where is its ostiums?
Paired
* Divided into:
*Anterior, middle and posterior groups
Location of ostium for the:
* Anterior ethmoidal air cells: middle meatus
* Middle ethmoidal air cells : middle meatus
* Posterior ethmoidal air cells : superior meatus
where is the sphenoid sinus and its ostium
- Paired
- Large irregularly shaped cavities
Location of ostium: - Sphenoethmoidal recess (superoposterior to the superior nasal concha)
Where does the sphenoidal sinus drain into?
Sphenoethmoidal recess located superior to superior concha
Where do the anterior, posterior and middle ethmoidal air cells drain into?
Posterior drain into the superior meatus
Anterior will drain through canals into the middle meatus in the semilunar hiatus via openings called ostia
Middle drain into the ethmoidal bulla of the middle meatus
Where do the maxillary and frontal sinuses drain into?
Maxillary and frontal drain into the middle meatus via canals into the semilunar hiatus (groove) through openings called ostia
(along with anterior and middle ethmoidal air cells)
do any paranasal sinuses drain into the inferior nasal meatus?
no.
only the nasolacriminal duct drains into this (tears)
Why does a persons nose start running when they cry?
because the nasolacrimal duct opens into the inferior meatus
Summarise the drainage of the sinuses into the nasal cavity
Sphenoid = sphenoethmoidal recess
Ethmoidal air cells
Anterior = Middle meatus
Middle = Middle meatus
Posterior (closer to back) = So superior meatus
Frontal and maxillary = Middle meatus
what sinuses do you see in the CT scans?
Vasculature of the sinuses
Maxillary sinuses– branches of the maxillary artery
Frontal sinuses- branches of the ophthalmic artery
Ethmoidal sinuses- branches of the ophthalmic artery
Sphenoidal sinuses- branches of the ophthalmic artery
what are the 2 parts of the oral cavity?
Oral vestibule
* Area between teeth and lips or cheek
Oral cavity proper
* Area located internal to the teeth
what is the tongue?
its parts?
appearance
*Muscular structure
*Divided into two parts:
*Oral (pre-sulcal) part:
*Anterior 2/3rd
*Movable
*Pharyngeal (post-sulcal)
*Posterior 1/3rd
*Non-movable
Appearance:
*Pink
*Covered in papillae (some of which contain tastebuds)
what is the sulcus terminalis
V shaped-groove separating the tongue’s oral part from its pharyngeal part
what is the lingual frenulum
Lingual frenulum: Attaches the tongue to the floor of the oral cavity
what are the 2 muscles of the tongue
- Extrinsic muscles
- Intrinsic muscles
people sometimes have gas
svis
what are the intrinsic muscles of the tongue? and function? innervation?
- Transverse
- Vertical
- Superior longitudinal
- Inferior longitudinal
*Alter the shape of the tongue
*Innervated by hypoglossal nerve (CNXII)
label the intrinsic muscles of the tongue
what are the extrinsic muscles of the tongue? function? innervation?
Palatoglossus - not innervated by CN12, instead by CN10
*Styloglossus
*Hyoglossus
*Genioglossus
*Alter the position of the tongue (i.e., protrusion, retraction or moving the tongue laterally)
*All innervated by the hypoglossal nerve (CNXII) except the palatoglossus (CNX)
label extrinsic muscle parts
what is the nervous supply to the tongue?
sensory:
anterior 2/3rds is linguinal nerve CN3
posterior 1/3rd is CN9
motor:
hypoglossal nerve CN12
vagus nerve CN10 (only palatoglossul extrinsic muscle )
special (taste):
anterior 2/3rds is chorda tympani CN3
postriro 1/3rd is glossopharyngeal CN9
what are salivary glands and the two parts
produce saliva
*Minor Salivary Glands (AKA intrinsic salivary glands)
Scattered within the mucosa of the tongue, palate, lips, and cheeks
*Major Salivary Glands (AKA extrinsic salivary glands)
*Lie external to the oral cavity
*Connect to the oral cavity via ducts
*There are three major salivary glands
what is the largest major salivary gland?
parotid salivary glanda major
- (extrinsic) salivary gland
(near the ear) and on each side of the face
*Parotid duct pierces the buccinator muscle and opens opposite to the upper second molar
*Parotid gland and duct run superficial to the masseter muscle
parasymp innervation is teh glossopharyngeal (CN9)
where does the parotid duct (the parotid salivary gland) pierce?
Parotid duct pierces the buccinator muscle and opens opposite to the upper second molar
what is the clinical relevance and relation of parotid tumours and nerves nearby
*The extracranial portion of the facial nerve (CNVII) pierces the parotid gland
*Once it emerges from it, it gives off its 5 terminal motor branches which innervate the muscles of facial expression
Parotid tumors
*Parotidectomy (resection of parotid tumor) a potential injury to facial nerve
= facial nerve paralysis
name the three major (extrinsic) salivary glands
parotid
submandibular
sublingual
what, where is the submandibular salivary gland? its parasymp innervation?
*Lies inferomedial to the angle of the mandible
*Submandibular duct opens in the floor of the oral cavity, lateral to the lingual frenulum
Parasympathetic innervation to the submandibular gland: Facial Nerve (CNVII)
where is the sublingual salivary gland, its parasymp innervation?
*Lies in the floor of the oral cavity, inferior to the tongue
*It has many ducts that open superior to the gland
Facial Nerve (CNVII)
label the sublingual and submanibular salivary glands
what is TMJ (Temporomandibular Joint) and what type of joint is it
STCM
Articulation between the squamous portion of the temporal bone and the condyle of the mandible
What type of joint is the TMJ?
*Ginglymoarthrodial
*Hinge
*Gliding
label what you can
what are the 4 structural components of the TMJ? and label
*Squamous portion of temporal bone
*Condyle of mandible
*Articular disc (within the TMJ joint)
*Ligaments
what happens if mandibular condyle moves anterior to articular eminence? and treatment?
mouth appears wide open
= mandibular dislocation (AKA sublaxation of the TMJ)
Treatment of Mandibular Dislocation:
*Relocation involves repositioning the condyle of the mandible posterior, to the articular eminence
what are the 2 types of msucles of mastication and their 2 corresponding forms
what are the muscles of mastication innervated by?
by branches of the mandibular division (CNV3) of the trigeminal nerve (CNV)
what muscle is this?
where is it? where does it insert? innervated by..?
function?
Temporalis
*Fan-shaped muscle
* Lies within the temporal fossa of the temporal bone
* Its tendon inserts on the coronoid process of the mandible
Actions:
*Elevates the mandible
*Retraction of mandible
what is this muscle?
function?
originates? inserts?
innervation?
Masseter
* Masseter= “chewer”
* Originates from the zygomatic arch and zygomatic bone
* Its tendon inserts on the ramus and angle of the mandible
- It has 2 heads:
- Superficial head
- Deep head
what muscle is this? function? innervation?
deep muscle - medial pterygoid
Action:
*Protracts mandible
*Elevates mandible
*Produces side- to-side movement
what muscle is this? action? innervation, insertion etc?
deep - Lateral Pterygoid
Action:
* Protracts mandible
* Produces side-to-side movement
