Head & Neck 2

Question 1

Which cervical vertebrae are atypical?

Answer 1

C1 C2 C7

Question 2

What makes the atypical vertebrae atypical?

Answer 2

C1 - No body
C2 - Dens
C7 - large spinous process

Question 3

Describe the main feature used to discern the cervical vertebrae from the others

Answer 3

Foramina in the transverse processes

Question 4

What is of clinical relevance to the cervical spine regarding the articular surfaces of the vertebrae?

Answer 4

They are more horizontal than in other vertebrae making it easier for them to be dislocated possibly causing paralysis or death

Question 5

What is the most common sites for cervical spine injuries?

Answer 5

Obviously C1, C2 and C7 because they are atypical but also C6
The most sever injuries occur C1-4

Question 6

What can neck hyperflexion injuries lead to?

Hint: Usually lower cervical spine

Answer 6

Crush fractures
Rupture of the supraspinous ligament
Rupture of the lower disc (leading to nerve compression)

Question 7

What can neck hyperextension injuries lead to?

Hint: Usually upper cervical spine

Answer 7

Vertebral fracture
Disc prolapse
Cervical spinous process fracture
Dens fracture

Question 8

What is a hangman’s fracture?

Answer 8

Hyperextension injury (likely at a judicial hanging) disrupting the posterior arch of C2

Question 9

What is a Jefferson’s fracture?

Answer 9

Caused by axial load injuries through the head - it’s a burst fracture of C1 (usually anterior AND posterior arch)

Question 10

What is degenerative spine disease?

Answer 10

Osteoarthritic narrowing of the facet joints of the vertebral arches +/- age related swelling of discs causing compression of a spinal nerve with associated pain and weakness

Question 11

What bones comprise the skull?

Answer 11

Cranium

Mandible

Question 12

What is the cranial cavity?

Answer 12

The space within the cranium which holds the brain

Question 13

Building on last session’s cards, what is the neurocranium comprised of?

Answer 13

Calvaria

Cranial floor

Question 14

What is the diploe?

Answer 14

The spongy layer between the two compact layers of bone that make up the calvaria

Question 15

What is so great about the tri-laminar arrangement of bone in the calvaria?

Answer 15

Increased protection without significant added weight

Question 16

What is the pterion?

Answer 16

Thinnest part of the calvaria

Question 17

What is the clinical relevance of the pterion?

Answer 17

It overlies the middle meningeal artery, fracture here could cause an extradural haematoma

Question 18

What is an extradural haematoma?

Answer 18

When blood accumulates between the periosteal layers of the dura mater and bone putting pressure on the brain

Question 19

How many bones make up the skull?

Answer 19

22

Question 20

How many bones are there in the neuro- and viscerocranium?

Answer 20

Neuro - 8

Viscero - 14

Question 21

Name the bones of the viscerocranium

Hint: 14

Answer 21

2x nasal, 2x lacrimal, 2x zygomatic, 2x maxilla, mandible, 2x inferior nasal concha, vomer, 2x palatine

Question 22

Name the bones of the neurocranium

Hint: 8

Answer 22

Frontal, occipital, 2x parietal, sphenoid, ethmoid, 2x temporal

Question 23

Which types of joints are found in the skull?

Hint: 2

Answer 23

Sutures

Synovial (TMJ)

Question 24

How many sutures are ther in the skull?

Answer 24

4; coronal, squamous, saggital, lambdoid

Question 25

Name the convergance points of the sutures and their associated sutures Hint: 3

Answer 25

Bregma - between saggital and coronal Pterion - between coronal and squamous Lambda - between lambdoid and saggital

Question 26

Fontanelles: What and Why?

Answer 26

Membranous areas of unfused skull which aid in birthing and brain growth, they will close after 2 years and can be enlarged, sunken or bulging

Question 27

Which imaging modality is used for suspected skull fracture?

Answer 27

CT - not X ray, you want to look for brain damage as well

Question 28

What are the signs of basilar skull fractures? | Hint: 4

Answer 28

Leakage of CSF from nose (Rhinorroea) Haemotympanum (blood in middle ear) Mastoid (preauricular) brusing Bilateral bleeding/brusing around the eyes

Question 29

List the features of degenerative spinal disease | Hint: 5

Answer 29

``` Osteophytes Facet joint hypertrophy Disc herniation Disc space narrowing Sclerosis of end plates ```

Question 30

What are the pharyngeal arches?

Answer 30

A sequence of 5 mesenchymal proliferations on the lateral walls of the embryonic pharynx numbered 1-6 as 5 does not form in humans

Question 31

What is the structure of the pharyngeal arches?

Answer 31

Mesenchyme core (with some neural crest cells) surrounded by an ectodermal surface layer on one half and an endodermal layer on the internal surface.

Question 32

What is the significance of the pharyngeal clefts (grooves)?

Answer 32

All but the 1st disappear, the 1st becoming the external auditory meatus

Question 33

What is associated with each arch? | Hint: 3 structures

Answer 33

Nerve, artery and cartilage bar

Question 34

What are the pharyngeal pouches and what are their significance?

Answer 34

The internal equivalent of the clefts - glandular structures arise from them inc. parathyroids, thymus and tonsils

Question 35

What is Meckel's Cartilage?

Answer 35

The cartilage bar of the 1st arch, it will become the mandible, malleus and incus bones

Question 36

Name the 3 vesicle stages that arise as the anterior end of the neural begins to form the brain

Answer 36

Prosencephalon - forebrain Mesencephalon - midbrain Rhombocephalon - hindbrain

Question 37

From what is the facial skeleton (viscerocranium) formed?

Answer 37

Frontonasal prominence and 1st pharyngeal arch

Question 38

Which arch do the muscles of mastication arise from?

Answer 38

Pharyngeal arch 1

Question 39

Which arch do the muscles of facial expression arise from?

Answer 39

Pharyngeal arch 2

Question 40

Which muscles arise from the 6th pharyngeal arch?

Answer 40

Intrinsic muscles of the larynx

Question 41

Which cranial nerves are associated with the pharyngeal arches?

Answer 41

V, VII, IX, X

Question 42

From which arch does the Trigeminal nerve (CN V) arise?

Answer 42

1st - sensory nerve of face and muscles of mastication

Question 43

From which arch does the facial nerve (CN VII) arise?

Answer 43

2 - muscles of facial expression and sensory to anterior 2/3/ tongue

Question 44

From which arch does the Glossopharyngeal nerve (CN IX) arise?

Answer 44

3 - SS to posterior 1/3 of tongue

Question 45

From which arch does the Vagus nerve (CN X) arise?

Answer 45

4 AND 6 - 4th = superior whil 6th = recurrent

Question 46

What name is given to the arteries of the arches? | Hint: only 3 remain

Answer 46

1st & 2nd disappear 3rd = internal carotid 4th = arch of aorta (L) & brachiocephalic (R) 6th = "pulmonary arch"