Head & neck Flashcards
Name the three divisions of the bony skull
Neuro-cranium, viscera-cranium (the facial skull)
and mandible
What type of joint is found between most of the bones in the skull?
Fibrous sutures
What part of the skull bone houses red marrow?
Spongy bone (diploe)
What does the sagittal suture separate?
Left and right parietal bones
What does the coronal suture separate?
Frontal and parietal bones
What does the lambdoid suture separate?
Occipital and parietal bones
What bone is the occipital protuberance a part of?
Occipital
What bone is the mastoid process a part of?
Temporal
What bones create the zygomatic arch?
Zygomatic and temporal
What bone is the styloid process a part of?
Temporal
What are the three fossae the cranial cavity is divided into?
Anterior cranial, middle cranial and posterior cranial
What is the largest foramen of the skull floor?
Foramen magnum
Name two structures that pass through the foramen magnum
Spinal cord and R & L vertebral arteries
Where does the scalp extend to anteriorly?
Frontal bone
Where does the scalp extend to posteriorly?
Superior nuchal line
Where does the scalp extend to laterally?
Zygomatic arches
What bone is the superior nuchal line a part of?
Occipital
Name the 5 layers of the scalp (outside to inside)
Skin Connective tissue Aponeurosis of occipitofrontalis muscle Loose areolar tissue Periosteum
What does the epicranial aponeurosis connect?
The frontal and occipital bellies of the occipitofrontalis muscle
What is the anterior part of the scalp innervated by?
Trigeminal (V) nerve- all three branches
What is the posterior part of the scalp innervated by?
C2 and C3
What structure forms from the ventral rami of C5 to T1
Brachial plexus
What is the clinical significance of the 2nd layer of the scalp vasoconstricting the arteries?
If lacerated, the scalp would bleed profusely as the arteries would no longer be vasoconstricted
What are the internal and external carotid arteries branches of?
Common carotid artery
What lies more laterally; the internal carotid artery or external carotid artery?
ICA
What artery is the superficial temporal artery a branch of?
ECA
What artery is the posterior auricular artery a branch of?
ECA
What artery is the occipital artery a branch of?
ECA
What artery is the supratrochlear artery a branch of?
ICA
What artery is the supra-orbital artery a branch of?
ICA
What is the course of the facial vein?
Joins the retromandibular vein and then drains into the internal jugular vein
What is the course of the superficial temporal vein?
Drains into the retromandibular vein and hen into external jugular vein
Do the EJV and IJV run deep or superficial to the sternocleidomastoid?
EJV runs superficial and the IJV runs deep
What is he clinical significance of the emissary veins present in skull bones?
They are valveless, so infection can spread into the cranial cavity quite easily
Where do the muscles of facial expression lie?
Within the superficial fascia of the face and neck
What muscles are present in the orbit of the eye and eyelid?
Orbicularis oculi - palpebral and orbital parts
What muscle is present around the mouth?
Orbicularis oris
What is the muscle within the cheek?
Buccinator
What cranial nerve innervates the muscles of facial expression?
Facial nerve (VII)
Through which foramen does the facial nerve emerge onto the side of the face?
Stylomastoid foramen
What two bone points are on either side of the stylomastoid foramen?
mastoid process and styloid process (of temporal bone)
What would the result be in palsy of the facial nerve?
Bell’s palsy (facial palsy)
What are the three pairs of salivary glands?
Parotid, submandibular and sublingual
What type of gland is the parotid gland? What does this mean?
Exocrine - secretes into ducts leading to target tissue
What nerve branches can be seen on anterior border of parotid gland?
Facial nerve (VII) branches
What muscle does the parotid gland pierce to open onto oral cavity?
Buccinator
Where does the parotid duct open into oral cavity?
Opposite the 2nd maxillary molar tooth
What artery passes into the parotid gland?
ECA
What vein passes into the parotid gland?
retromandibular
What cranial nerve carries parasympathetic fires destined for the parotid gland?
Glossopharyngeal (IX) nerve
Where does sympathetic innervation to the parotid gland originate from?
External carotid nerve plexus
What are the facial and superficial temporal arteries branches of?
External carotid artery
What bone does facial artery wind around to reach the face?
inferior border mandible
Where does the facial artery end?
Medial angle of the eye as the angular artery
What are the three horizontal compartments of the neck? What do they contain?
vertebral compartment - cervical vertebrae and postural muscles
vascular compartments - major blood vessels and the vagus nerve (carotid sheath)
visceral compartment - thyroid, parathyroid glands, pharynx, larynx, trachea and oesophagus
What encloses the four horizontal compartments of the neck?
musculofascial collar
What type of joint is between the occipital condyles and C1 (atlas)?
synovial condyloid
what kind of joint is present between C1 and C2 (odontoid peg)?
synovial planar
What structures pass through the transverse foramen?
vertebral arteries
What is the vertebral prominens?
C7- prominent spinous process felt at the base of the neck
What are the special features of cervical vertebrae?
3 foramina, a bifid spinous process
what curvature exists in cervical part of the vertebral column?
lordosis
What are the boundaries of the anterior triangle of the neck?
Superiorly - inferior border of mandible
Posteriorly - anterior border of SCM
Anteriorly - median line of neck
What are the boundaries of the anterior triangle of the neck?
Anteriorly- posterior border of SCM
Posteriorly- anterior border of trapezius
Inferiorly- middle 1/3 of clavicle
What are the 3 bony attachments of the sternocleidomastoid muscle?
Mastoid process, clavicle and manubrium of sternum
If SCM contracted, where would head tilt?
same side
If SCM contracted, where would face turn?
opposite side
Which cranial nerve innervates the SCM and trapezius?
accessory nerve (XI)
What is the anterior triangle of the neck further divided into?
Submental, digastric, carotid and muscular triangles
What is the contents of the submental triange?
submental lymph nodes
What is the contents of the digastric triangle?
facial artery and submandibular salivary gland
What is the contents of the carotid triangle?
contents of neurovascular sheath
What is the contents of the muscular triangle?
strap muscles of the neck (sternohyoid, thyrohyoid, sternothyroid & omohyoid)
Which artery is the common carotid artery a branch of on the right side?
brachiocephalic artery
Which artery is the common carotid artery a branch of on the left side?
arch of the aorta
What three structures make up the carotid sheath?
common carotid artery, internal jugular vein and vagus nerve
at what vertebral level does the common carotid artery divide into the ECA and ICA?
C4
What are the 2 terminal branches of the ECA? Where are they given off?
Maxillary artery and superficial temporal artery
Given off in the parotid gland
From which sinus does the internal jugular vein arise?
Jugular venous sinus
What is the course of the internal jugular vein?
Merges with the subclavian vein to form the brachiocephalic vein
In the carotid sheath, where does the nerve lie in relation to the vascular contents?
The vagus nerve lies in between the CCA and IJV
Where does the phrenic nerve lie in relation to the carotid sheath? What does it supply?
Runs lateral to the carotid sheath to innervate the diaphragm (C3, 4, 5 keep the diaphragm alive)
What other bones does the hyoid bone articulate with?
It articulates with no other bones
What sets of muscles are attached to the hyoid bone?
Suprahyoid muscles, infrahyoid muscles, hyglossus/genioglossus (muscles of the tongue),
middle pharyngeal constrictor
What are the four suprahyoid muscles?
Mylohyoid, geniohyoid, digastrc and stylohyoid
What nerves innervate the suprahyoid muscles?
Mylohyoid - inferior alveolar
Geniohyoid- C1 (of ansa cervicalis)
Digastric - inferior alveolar nerve and facial nerve (VII)
stylohyoid- facial nerve
What are the four infrahyoid muscles?
sternohyoid, sternothyroid, thyrohyoid and omohyoid
What nerves supply the infrahyoid muscles?
the sternohyoidand omohyoid are innervated by the ansa cervicalis (C1-3), sternothyroid is innervated by C2 and C3, thyrohyoid is innervated by C1
What are the vertebral routes of the cervical plexus?
C1 - 4
Between what two muscles do the roots of the cervical plexus emerge?
levator scapulae and middle scalene
What is the ansa cervicalis?
A loop of nerves, part of the cervical plexus
What are the three anatomical parts of the thyroid gland?
The right and left lobes and the isthmus
Where does the isthmus of the thyroid gland lie anterior to?
2nd and 3rd tracheal rings
Which of the four compartments of the neck does the thyroid gland lie?
Muscular triangle
What is the total number of deciduous teeth?
20 - 8 incisors, 4 canines and 8 molars
What is the total number of permanent teeth?
32- 8 incisors, 4 canines, 8 premolars and 12 molars
What type of joint is the temperomandibular joint
Hinge joint (synovial)
What are the 2 articular processes that form the temperomandibular joint?
mandibular fossa of the temporal bone and the condylar process of the mandible
What 5 movements of the mandible occur at the temperomandibular joint?
depression, elevation, protraction, retraction and lateral movements
What are the 4 muscles of mastication?
Temporalis, masseter, lateral pterygoid and medial pterygoid
What are the bony attachments of the temporalis muscle?
Temporal fossa and coronoid process of the mandible
In what direction do the anterior fibres of the temporalis muscle run?
vertically
In what direction do the posterior fibres of the temporalis muscle run?
horizontally
What action does the anterior fibres of the temporalis have on the mandible when they contract?
elevation (closes jaw)
What action does the posterior fibres of the temporalis have on the mandible when they contract?
retracts mandible (pushes back)
What are the bony attachments of the masseter muscle?
Maxillary process of zygomatic and outer surface of the ramus and coronoid process of the mandible
What is the action of the masseter muscle?
elevates the mandible
Where does the lateral pterygoid muscle attach on the sphenoid bone?
lateral surface of the lateral pterygoid plate
Where does the medial pterygoid muscle attach on the sphenoid bone?
medial surface of the lateral pterygoid plate
To which part of the mandible does the medial pterygoid muscle attach?
medial surface - near its angle
What action does the lateral pterygoid muscle have?
depression of mandible (opening jaw) - along with gravity
What action does the medial pterygoid muscle have?
elevation of mandible (closing jaw)
Name the suprahyoid muscles that depress the mandible
Digastric, mylohyoid and geniohyoid
What nerve supplies the muscles of mastication?
branches of the mandibular division of trigeminal nerve (V)
Where does the mandibular nerve branch and supply the muscles of mastication?
infratemporal fossa
What branch of the mandibular nerve provides sensory information to the mandibular area? Where does it enter?
inferior alveolar nerve - enters the mandibular foramen
What 3 muscles elevate the mandible?
Masseter, medial pterygoid and temporalis (anterior fibres)
What 3 muscles depress the mandible?
geniohyoid, mylohyoid and digastric
What muscle retracts the jaw?
temporalis (posterior fibres)
What muscles allows lateral movements of the jaw?
lateral pterygoid
Name 4 functions of the nose?
Smell (olfaction) trapping dirt repsiration humidification of inspired air filtration of dust
Which bone do the nasal bones articulate with superiorly?
frontal bone
Which bone do the nasal bones articulate with laterally?
maxilla
What part of the ethmoid bone contributes to the nasal cavity?
Cribriform plate
What structures form the floor of the nasal cavity?
The hard palate is formed by the palatine processes of the maxillae and palatine bones.
Floor is extended posteriorly by the soft palate
What two bones form the nasal septum?
Vomer and perpendicular plate of the ethmoid bone
What structure lies anterior to the bones of the nasal septum?
septal nasal cartilage
What passes through the cribriform plate?
Olfactory nerve (I)
What are cells are present in the ethmoid bone?
ethmoidal air cells
What kind of epithelium lines lines most of the nasal cavity?
ciliated columnar epithelium with goblet cells (sinonasal mucosa)
What type of mucosa lines the roof of the nasal cavity?
olfactory mucosa
What are conchae (turbinates)?
projections on the lateral walls of the nasal cavity
What are meatuses?
the spaces lying superior to the projecting conchae/turbinates
What is the name given to the space above the superior concha?
sphenoethmoidal recess
What bone are the superior and middle conchae a part of?
ethmoid bone
The nose recieves arterial supply from branches of which artery?
opthalmic
What is the clinical significance of the rich vascular supply to the nose?
epistaxis (nosebleed)
What are paranasal air sinuses?
air filled extensions of the respiratory part of the nasal cavity
What are the functions of the paranasal air sinuses?
Humidify and warm inspired air
Regulate intranasal pressure
Decrease weight of front of skull
What opens into the sphenoethmoid recess?
sphenoid sinus
What opens into the superior turbinate?
posterior ethmoid air cells
What opens into the middle turbinate?
maxillary and frontal air sinuses
anterior and middle ethmoid air cells
What opens into the inferior turbinate?
nasolacrimal canal
What branch of the trigeminal nerve (V) innervates the frontal air sinus?
V1 (opthalmic)
What branch of the trigeminal nerve (V) innervates the maxillary air sinus?
V2 (maxillary)
What branch of the trigeminal nerve (V) innervates the sphenoid air sinus?
V1 and V2 (opthalmic and maxillary)
What branch of the trigeminal nerve (V) innervates the ethmoidal air cells?
V1 (opthalmic)
What is the vestibule of the oral cavity?
The space between the teeth, lips and cheeks
What muscle lies in the lateral walls of the oral cavity?
buccinator
What is the posterior opening of the oral cavity called?
oropharyngeal isthmus
Name 3 functions of the tongue
Moving food during chewing
Moving food during swallowing
Speech
Taste
What divides the anterior 2/3 and posterior 1/3 of the tongue?
terminal sulcus
What is the embryological significance of the foramen caecum?
it’s a remnant of the proximal part of the embryonic thyroglossal duct (from which the thyroid duct develops)
What are the 3 types of papillae present on the anterior 1/3 of the tongue surface? Which ones contain taste buds?
filiform, foliate and vallate
foliate and vallate contain taste buds
What are the surface elevations present on the posterior 1/3 of the tongue?
lymphoid tissue of lingual tonsils
What is the name of the fold of mucous membrane fixing the tongue to the floor of the mouth?
Frenulum
The duct for which gland is present underneath the tongue?
submandibular salivary gland
What does the anterior 2/3 of tongue receive sensory innervation from?
mandibular division of trigeminal nerve (V)
What does posterior 1/3 of tongue receive sensory innervation from?
glossopharyngeal nerve (IX)
What does anterior 2/3 of tongue recieve taste sensation from?
chorda tympani branch of facial nerve (VII)
What does posterior 1/3 of tongue receive taste sensation from?
lingual branch of glossopharyngeal (IX)
What do the intrinsic muscles of the tongue do?
alter the shape of the tongue
What do the extrinsic muscles of the tongue do?
alter the position of the tongue
What are the 4 extrinsic muscles of the tongue?
genioglossus, hyoglossus, styloglossus, palatoglossus
What is the bony attachment of the genioglossus?
inner surface of the mandible, close to the midline
What is the bony attachment of the hyoglossus?
upper border of the hyoid
What is the bony attachment of the styloglossus?
styloid process
What is the attachment of the palatoglossus?
soft palate
What nerve(s) supplies the extrinsic muscles of the tongue?
Hypoglossal nerve (XII) innervates all muscles APART from the palatoglossus, which is innervated by the vagus nerve (X)
What nerve supplies the parotid salivary gland, causing secretion?
glossopharyngeal (IX)
What nerve supplies the submandibular salivary gland, causing secretion?
facial (VII)
What nerve supplies the sublingual salivary gland, causing secretion?
facial (VII)
What are the 5 muscles in the soft palate?
- levator veli palatine
- tensor vali palatine
- palatoglossus
- palatopharngeus
- musculus uvulae
What nerve(s) supply the muscles in the soft palate?
All innervated by pharyngeal plexus via the vagus nerve (X) APART from tensor veli palatine, which is innervated by mandibular branch of trigeminal nerve (V)
What are the actions of the soft palate muscles collectively?
soft palate is elevated during swallowing so that it’s in contact with posterior wall of pharyx, sealing off oral passage from nasopharynx
What structure lies between the palatoglossus and palatopharyngeus muscles?
palatine tonsil
What three types of tonsils are there?
palatine, lingual and pharyngeal (adenoids)
What type of cellular tissue makes up tonsils?
lymphatic tissue
What are the 3 parts of the pharynx? (name from superior to inferior)
nasopharynx, oropharynx and laryngopharynx
What is the roof of the pharynx formed by?
body of sphenoid and basilar part of occipital bone
In relation to the larynx, the pharynx lies….
posterior
What prevents a bolus from entering the larynx?
closure of the epiglottis
What are the 3 muscles forming the inner longitudinal layer of the pharynx?
stylopharyngeus, salpingopharyngeus & palatopharyngeus
What does the pharynx receive innervation from?
pharyngeal plexus
What does the constrictor muscles of the pharynx do during swallowing?
shorten and widen pharynx
What is the larynx continuous with inferiorly?
the trachea
What prominence makes the “adam’s apple”?
the thyroid