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ESA 4 - 2017 - Incomplete/Some errors > Head & Neck 9 > Flashcards

Head & Neck 9 Flashcards

1
Q

What makes up the roof of the oral cavity?

A

The hard palate

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2
Q

What makes up the floor of the oral cavity?

A

The tongue and other soft tissues

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3
Q

WHat forms the lateral walls of the oral cavity?

A

The cheeks

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4
Q

What forms the anterior boundary of the oral cavity?

A

The oral fissure

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5
Q

What forms the posterior boundary of the oral cavity?

A

The oropharyngeal isthmus

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6
Q

What is the oral vestibule?

A

The space between the cheeks/lips and teeth

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7
Q

What defines the oral cavity proper?

A

Teeth -> ring made by palatopharangeal arch, uvula, tip of epiglottis

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8
Q

What is the palatoglossal arch?

A

Curve from tonsil to uvula AKA anterior arch

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9
Q

What is the platopharyngeal arch?

A

AKA posterior arch, located behind palatoglossal arch

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10
Q

What is the hard palate?

A

Roof of oral cavity, formed from maxilla and palatine bones

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11
Q

Which bones conrtibute to the floor of the oral cavity?

A

Maxilla and palatine

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12
Q

What is the soft palate?

A

Muscular tissue that forms the posterior part of the roof of the oral cavity

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13
Q

What is the function of the soft palate?

A

Tenses to elevate during yawning and swallowing

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14
Q

Which nerve innervates the muscles of the soft palate?

A

Vagus predominantly, pharyngeal branch.

If damaged the stronger side is unopposed so uvula pulls away from affected side

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15
Q

Which two nerves are involved in the gag refelx and how?

A

Glossopharyngeal on afferent limb (back of throat area)

Vagus on efferent (pharyngeal muscles of soft palate)

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16
Q

Name the teeth from back to front of the mouth

A 
3rd to 1st molar
2nd to 1st premolar
Canine 
Lateral incisor
Central incisor
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17
Q

What is the sensory supply to the lower jaw?

A

Inferior alveolar nerve CN V3

Sensation can be lost in mandibular fracture

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18
Q

How many extrinsic muscles of the tongue are there? What are they called?

A 
4 - all "glossus" endings
Styloglossus 
Hyoglossus
Genioglossus
Palatoglossus
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19
Q

What is the main function of the extrinsic muscles of the tongue?

A

Anchoring of the tongue to the hyoid bone and mandible

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20
Q

How many intrinsic muscles of the tongue are there? Names?

A 
5
Superior longitudinal 
Vertical 
Transverse
Inferior longitudinal
Septum
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21
Q

What is the function of the intrinsic muscles of the tongue?

A

Help tongue to change shape. Actions based on direction of fibres

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22
Q

Which nerve innervates the majority of the muscles of the tongue?

A

Hypoglossal nerve (glossus) CN XII

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23
Q

Which muscles of the tonuge are not innervated by the hypoglossal nerve?

A

Only Palatoglossus

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24
Q

Which way does the tongue deviate when a nerve is not functioning properly?

A

Towards the affected side i.e. normal muscle overpowers weaker one

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25
Q

How does the parotid gland enter the oral cavity?

A

Single opening - Stenson’s Duct

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26
Q

How does the submandibular gland enter the oral cavity?

A

Single opening - Wharton’s duct

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27
Q

How does the sublingual gland enter the oral cavity?

A

Multiple ducts

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28
Q

Describe salivary gland stones

A

Usually calcium-based

The result of crystallisation of saliva in ducts

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29
Q

Which gland most commonly suffers from salivary stones and why?

A 
Submandibular duct (Wharton's)
Produces comparatively thicker slaiva
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30
Q

What is the common presentation of salivary gland stones?

A

Pain or swelling of affected gland at meal times

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31
Q

How are salivary stones treated?

A

Small stones may resolve spontaneosuly, otherwise they can be removed

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32
Q

What is tonsilitis?

A

Inflammation of the palatine tonsil

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33
Q

How does tonsilitis present?

A

Sore throat
Odynophagia (pain on swallowing)
Dysphagia
Tonsils are tyoically elarged and erythematous

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34
Q

What causes tonsilitis?

A

Usually infective
Viral e.g. rhinovirus, adenovirus
Bacterial e.g. beta haemolytic strep

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35
Q

What additional symptoms are seen in viral tonsilitis?

A

Those of a URTI e.g. dry cough

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36
Q

What additional symptoms are seen in bacterial tonsilitis?

A

Cervical lymphadenopathy
Fever
Pus

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37
Q

In terms of arches, what occurs during tonsilitis?

A

The posterior arch disappears

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38
Q

What is Quinsy?

A

Peritonsillar abscess as a complication of bacterial tonsilitis

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39
Q

What are the common organisms involved in Quinsy?

A

Strep pyogenes
Staph Aureus
H. influenza

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40
Q

What are the symptoms of Quinsy?

A

Systemically unwell
Trismus, or “hot potato voice”
Dysphagia +/- drooling

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41
Q

Describe the temporomandibular joint

A

Modified hinge, synovial, between the cranium and mandible

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42
Q

Specify the articulation point of the TMJ

A

Condyle of mandible with articular tubercle of temporal bone (in mandibular fossa)

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43
Q

Name the ligaments of the TMJ

Hint: 3

A

Lateral or temporomandibular ligament
Stylomandibular
Sphenomandibular

44
Q

Which muscles elevate the mandible?

Hint: 3

A

Temporal, masseter, medial pterygoid

45
Q

Which muscles depress the mandible?

Hint: 3

A

Lateral pterygoid, supr/infra hyoid

46
Q

Which musle(s) is/are used in protrusion of the mandible?

A

Lateral pterygoid

47
Q

Which musle(s) is/are used in retrusion of the mandible?

A

Temporal

48
Q

Which muscles are involved in lateral movement of the mandible?
Hint: 3

A

Temporal on same side
Pterygoids of opposite side
Masseter

49
Q

Which muslces are involved in mastication? What nerve supplies them all? Hint: 3

A

Temporalis, masseter, pterygoids

Mandibular branch of trigeminal nerve CN V3

50
Q

How is the TMJ dislocated?

A

Sideways blow to chin when mouth open

51
Q

Anatomically speaking, what happens when the TMJ dislocates?

A

Movement of head of mandible anteriorly to articular tubercle

52
Q

List some other TMJ disorders

A

Bruxism
Osteoarthritis
Inter-articular disk derangement

53
Q

What is arteritis and how can it relate to the TMJ?

A

Inflammation of arteries. Can cause pain around TMJ if temporal artery involved

54
Q

What is the infratemporal fossa?

A

Irregularly shaped space deep and inferior to zygomatic arch, deep to ramus of mandible

55
Q

What is the superior border of the infratemporal fossa?

A

Inferior greater wing of the sphenoid bone

56
Q

What is the posterior border of the infratemporal fossa?

A

Temporal bone

57
Q

What is the inferior border of the infratemporal fossa?

A

Point of attachement of the medial pterygoid at the mandible

58
Q

What is the anterior border of the infratemporal fossa?

A

Posterior maxillary bone

59
Q

What is the lateral border of the infratemporal fossa?

A

Ramus of mandible

60
Q

What is the medial border of the infratemporal fossa?

A

Lateral pterygoid plate of sphenoid

61
Q

What is the muscular content of the infratemporal fossa?

Hint: 3

A

Temporal muscle

Lateral and medial pterygoid muscles

62
Q

Wha is the vessel content of the infratemporal fossa?

A

Maxillary artery

Pterygoid venous plexus (comms with cavernous sinus)

63
Q

Which nerves are found in the infratemporal fossa?

Hint: 6

A 
Mandibular
Inferior alveolar
Lingual 
Buccal
Chorda tympani
Otic ganglion
64
Q

What does the otic ganglion supply?

A

Parotid gland (parasympathetically)

65
Q

What is the clinical relevance of the infratemporal fossa?

A

Site of isolated infection
Risk of infection spreading to cavernous sinus via pterygoid plexus
Possible site of mandibular nerve blocks

66
Q

Recap: What are the pharyngeal arches?

A

A complex tissue system making up the embryonic head and neck Involves the brain, cvs & special sensory organs

67
Q

Which factors drive the development of the face?

Hint: 3

A

Expansion of the cranial neural tube
Developmnet of complex tissue associated with the cranial gut tube & heart outflow
The need to separate resp. and GI tracts

68
Q

Recap: What is a pharyngeal arch made of?

A

Artery, vein, nerve
Mesenchyme filling
Ectodermal covering
Endometrial lining

69
Q

How are the pharyngeal arches arranged?

A

Around the aortic arch vessels

70
Q

What is the neural crest?

A

Specialised cell population originating from lateral borders of neuroectoderm

71
Q

List the major features of the face

A

Palpebral fissures
Oral fissure
Nares
Philtrum

72
Q

From where does the facial skeleton arise?

A

Neural crest of 1st pharyngeal arch

73
Q

From where do the muscles of mastication arise?

A

Mesoderm of 1st pharyngeal arch

74
Q

From where do the muscles of facial expression arise?

A

Mesoderm of 2nd pharyngeal arch

75
Q

What is the frontonasal prominence (FNP)?

A

The area from which arises the forehead, bridge of nose, nose and philtrum

76
Q

What is the maxillary prominence?

A

Structure giving rise to cheeks, lateral upper lip & lateral upper jaw

77
Q

What is the mandibular prominence?

A

Structure from which the lower lip and jaw arise

78
Q

Briefly describe the preliminary stages of embryonic nose development

A

Nasal placodes appear on FNP -> sink to become nasal pits -> medial and lateral nasal prominences form on eith side of pits

79
Q

Briefly describe the latter stages of embryonic nose development

A

Maxillary prominences grow medially -> push nasal prominences closer to midline -> prominences fuse -> medial nasal prominences fuse in midline

80
Q

What is the intermaxillary segment?

A

Result of fusion of medial nasal prominences

81
Q

What is responsible for the separation of the nasal & oral cavities?

A

The development of the secondary palate, derived from the palatal shelves from the maxillary prominences

82
Q

What is needed of the mandible to allow separation of the nasal and oral cavities?

A

Growth to a size large enough to allow tongue to drop

83
Q

Describe how the lip and palate have a dual origin

A

They are formed from the maxillary process as well as the intermaxillary segment

84
Q

What is a lateral cleft lip?

A

Result of failure of fusion of medial nasal prominence with maxillary prominence

85
Q

What is a cleft lip and cleft palate?

A

Cleft lip + failure of palatal shelves to meet in midline

86
Q

When does development of the eyes begin?

A

4th week

87
Q

Describe the preliminary stages of eye development

A

Out-pocketings of forebrain grow out making contact with ectoderm, optic placodes form

88
Q

What do optic placodes become?

A

Lenses

89
Q

Describe the intermediate stages of embryonic eye development

A

Optic vesicles grow out towards surface in direction of placodes
Placode then invaginates and pinches off

90
Q

From where is the retina derived?

A

The forebrain

91
Q

How do the eye primordia move as facial prominences grow?

A

Side -> front (allowing binocular vision)

92
Q

From where does the external auditory meatus arise?

A

1st pharyngeal cleft

93
Q

From where do the pinnas arise?

A

Proliferation around teh 1st and 2nd

94
Q

What is a lateral cleft lip?

A

Result of failure of fusion of medial nasal prominence with maxillary prominence

95
Q

What is a cleft lip and cleft palate?

A

Cleft lip + failure of palatal shelves to meet in midline

96
Q

When does development of the eyes begin?

A

4th week

97
Q

Describe the preliminary stages of eye development

A

Out-pocketings of forebrain grow out making contact with ectoderm, optic placodes form

98
Q

What do optic placodes become?

A

Lenses

99
Q

Describe the intermediate stages of embryonic eye development

A

Optic vesicles grow out towards surface in direction of placodes
Placode then invaginates and pinches off

100
Q

From where is the retina derived?

A

The forebrain

101
Q

How do the eye primordia move as facial prominences grow?

A

Side -> front (allowing binocular vision)

102
Q

From where does the external auditory meatus arise?

A

1st pharyngeal cleft

103
Q

From where do the pinnas arise?

A

Proliferation around the 1st and 2nd

104
Q

How do the ears migrate in development?

A

Neck -> ascend to side of head as mandible grows

105
Q

What are the otic placodes?

A

Placodes involved in hearing

Invaginate auditory vesicles

106
Q

Why is foetal alcohol syndrome significant to development?

A

Neural crest migration + brain development are extremely sensitive to alcohol (FAS+ARND = 1/100 births)

ESA 4 - 2017 - Incomplete/Some errors (19 decks)

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