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Nervous System > Head & Neck Anat > Flashcards

Head & Neck Anat Flashcards

1
Q

What are the boundaries of the neck?

A

Superior: Inferior border of mandible + mastoid process + superior nuchal line

Inferior: Thoracic inlet

Posterior: T1 vertebra

Anterior: 1st rib + costal cartilage + manubrium

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2
Q

Where is the thoracic outlet?

A

Space between clavicle and 1st rib

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3
Q

What bony landmarks are located adjacent to the occipital protuberance?

A

Superior nuchal line

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4
Q

The C3/4 vertebral level contains:
i) upper margin of ___________
ii) bifurcation of _____________

A

The C3/4 vertebral level contains:
i) upper margin of thyroid cartilage
ii) bifurcation of common carotid artery

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5
Q

The C6 vertebral level contains:
i) arch of _____________
ii) superior end of ____________
iii) superior end of ___________

A

The C6 vertebral level contains:
i) arch of cricoid cartilage
ii) superior end of esophagus
iii) superior end of trachea

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6
Q

What is the clinical name of the “Adam’s apple”?

A

Thyroid cartilage

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7
Q

What are the 3 superficial anterior structures of the neck (from superior to inferior)?

A

1) Hyoid bone
2) Thyroid cartilage
3) Cricoid cartilage

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8
Q

What are the bounds of the anterior triangle of the neck?

A

Base/superior: inferior margin of mandible

Lateral: Sternocleidomastoid

Medial: Midline of neck

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9
Q

Which structure divides the anterior and posterior triangles of the neck?

A

Sternocleidomastoid muscle

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10
Q

What are the bounds of the posterior triangle of the neck?

A

Base/inferior: Clavicle

Medial: posterior margin of sternocleidomastoid

Lateral: anterior margin of trapezius

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11
Q

How do the structures coursing through the anterior and posterior triangles of the neck differ?

A

Anterior: btwn head and thorax

Posterior: btwn thorax/neck and upper limb

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12
Q

Which structure separates the internal and external jugular vein?

A

Sternocleidomastoid

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13
Q

Which muscle can be found within the superficial fascia of the neck?

A

Platysma

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14
Q

Which muscles form the “wall” of the neck?

A

Anterior: SCM
Posteior: Trapezoids

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15
Q

Which group of muscles are found directly inferior to the hyoid bone?

A

Infrahydoid (Strap) muscles

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16
Q

What is the arrangement of the structures of the neurovascular bundle of the neck (lateral to medial)?

A

1) Internal jugular vein
2) Vagus nerve (CNX)
3) Carotid artery

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17
Q

Which muscles sandwich the brachial plexus at the neck?

A

Scalenus anterior and medius

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18
Q

Where is the phrenic nerve located with reference to the pre-vertebral muscles of the neck?

A

Anterior to scalenus anterior

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19
Q

What are the 3 groups of deep fascia in the neck/deep cervical fascia ?

A

1) Investing layer
2) Pre-vertebral fascia
3) Pre-tracheal layer

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20
Q

What is formed by the union/contribution of the 3 deep cervical fascia?

A

Carotid sheath

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21
Q

What are the muscles of the anterior triangle of the neck that attach to the hyoid bone?

A

1) Digastric (anterior and posterior) (suprahyoid)
2) Omohyoid (1/4 infrahyoid muscles)

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22
Q

What are the strap/infrahyoid muscles of the neck?

A

1) Omohyoid
2) Sternohyoid
3) Sternothyroid
4) Thyrohyoid

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23
Q

True or false: In the neck the vertebral vein and artery run together.

A

True

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24
Q

True or false: The arterial branches that supply the neck arise from both the internal and external carotid artery.

A

False.
Internal carotid no branches in neck.
All branches from external carotid.

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25
Q

Where does the vertebral artery arise from?

A

Subclavian artery

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26
Q

Describe the path of the vertebral artery.

A

Subclavian → vertebral artery
→ pass through foramen transversarium
→ enter cranial cavity with internal carotid

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27
Q

What are the branches of the external carotid artery?

A

Some – Superior thyroid
Anatomists – Ascending pharyngeal
Like – Lingual
Freaking – Facial
Out – Occipital
Poor – Posterior auricular
Medical – Maxillary
Students – Superficial temporal

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28
Q

Describe the innervation of the strap muscles of the neck?

A

By branches of the ansa cervicalis (branch of cervical plexus)

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29
Q

What structure connects the anatomical lobes of the thyroid gland?

A

Isthmus

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30
Q

Which structure at the 2nd-4th tracheal ring level of the neck maybe injured during a tracheostomy?

A

Isthmus of thyroid gland

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31
Q

What is the muscle between the thyroid and cricoid cartilage?

A

Cricothyroid muscle

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32
Q

Describe the collateral circulation supplying the thyroid gland.

A

1) Superior thyroid (from external carotid)

2) Inferior thyroid (from subclavian)

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33
Q

Describe the venous drainage of the thyroid gland.

A

1) Superior thyroid vein → internal jugular vein

2) Inferior thyroid vein → subclavian or brachiocephalic vein

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34
Q

Which nerve supplies the cricothyroid muscle?

A

External laryngeal nerve (branch of vagus nerve)

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35
Q

Which nerve is closely associated to the superior thyroid artery?

A

External laryngeal nerve

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36
Q

Which nerve is closely associated to the inferior thyroid artery?

A

Recurrent laryngeal nerve

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37
Q

What are the cervical lymph nodes?

A

1) Submental
2) Submandibular
3) Auricular
4) Mastoid
5) Parotid
6) Occipital

→ Drain to nodes surrounding internal jugular vein
7) Deep cervical nodes
→ thoracic duct (L) / R lymphatic trunk

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38
Q

What are the 2 structures located superior to the nasal ridge?

A

Depression: Nasion
Elevation: Glabella

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39
Q

The zygomatic arch is ___________ to the maxilla.

A

Lateral

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40
Q

Where is the pterion?

A

1 finger length lateral from lateral border of orbit and above zygomatic arch

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41
Q

What is the clinical significance of the pterion?

A

1) Thinnest part of skull

2) Middle meningeal artery and vein run directly deep

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42
Q

What are the layers of the scalp?

A

S - Skin
C - Connective tissue
A - Aponeurosis (Epicranial)
L - Loose areolar tissue
P - Pericranium

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43
Q

What bony landmark is located bilaterally on the anterior surface of the mandible?

A

Mental foramina

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44
Q

What bony landmark of the maxillary bone is located bilaterally below the orbits?

A

Infraorbital foramina

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45
Q

What bony landmark of the frontal bone is located bilaterally above the orbits?

A

Supraorbital ridge/foramina

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46
Q

What type of joint is formed between the bones of the skull?

A

Fibrous

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47
Q

What is the pterion formed by?

A

Junction of:
1) Frontal
2) Parietal
3) Temporal
4) Sphenoid bones

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48
Q

What is the biggest opening in the skull?

A

Foramen magnum

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49
Q

Which bones form the hard palate?

A

1) Maxilla
2) Palatine

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50
Q

What are the bounds of the scalp?

A

From supraorbital margin
to external occipital protuberance and superior nuchal line

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51
Q

What are the communications between the scalp and the cranial cavity?

A

Venous
- emissary vein (valveless)

(route of infection)

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52
Q

What are the 2 muscles that attach to the aponeurosis of the scalp?

A

1) Frontalis
2) Occipitalis

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53
Q

Why are longitudinal lacerations of the scalp more favorable than lateral?

A

Lateral → scalp will be pried open by action of occipitalis and frontalis muscles

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54
Q

What type of muscles close the eye and the mouth orifices?

A

Sphincteric

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55
Q

What are the sphincteric muscles of the eye?

A

Orbicularis oculi

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56
Q

What are the sphincteric muscles of the mouth?

A

Orbicularis oris

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57
Q

What type of muscles open the eye and mouth?

A

Levator

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58
Q

What are the levator muscles of the eye?

A

Levator palpebro superioris

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59
Q

What are the levator muscles of the mouth?

A

1) Levator labi superioris
2) Depressor labi inferioris

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60
Q

What muscle rests on the nasion of the face?

A

Procerus

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61
Q

What muscle is found deep to the frontalis?

A

Corrugator supercili

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62
Q

What are the muscles lateral to the mouth/nasal cavity?

A

Lateral to medial:
1) Risorius
2) Zygomaticus major
3) Zygomaticus minor
4) Levator labi superioris
5) Levator angularis oris

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63
Q

What are 3 facial muscles inferior to the mouth?

A

1) Depressor angularis oris
2) Depressor labii inferioris
3) Platysma
4) Mentalis

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64
Q

Which 2 muscles are the parotid duct related to?

A

Courses superficial to masseter before piercing the buccinator

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65
Q

What are 3 muscles that move the ear?

A

Auricular
- superior
- anterior
- posterior

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66
Q

How would a botox injection of the corrugator supercilli and procerus cause a droopy eyelid?

A

Injection may spread to underlying levator palpebra superioris

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67
Q

What is the embryological origin of the muscles of facial expression?

A

2nd pharyngeal arch

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68
Q

What is the nerve that supplies the muscles of facial expression?

A

CNVII: Facial nerve

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69
Q

What is the nerve that is closely related to the parotid gland?

A

CNVII: Facial nerve

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70
Q

What are the terminal branches of the facial nerve?

A

Superior to inferior:
1) Temporal
2) Zygomatic
3) Buccal
4) Mandibular
5) Cervical

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71
Q

Describe the innervation of the muscles of the face.

A

Mainly by CNVII: facial nerve (LMN)
- receives bilateral UMN influence motor cortex
- EXCEPT lower part of face → only contralateral

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72
Q

What are the muscles of mastication supplied by?

A

Trigeminal
- all from 1st pharyngeal arch

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73
Q

Describe the sensory innervation of the head.

A

Front: CNV1-3 (ophthalmic, maxillary, mandibular)

Back: Cervical plexuses
- ventral rami (supply lateral behind ear to neck)
- dorsal rami (posterior skull)

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74
Q

Describe the arterial supply of the face?

A

1) Internal carotid → cranial cavity → orbit (opthalmic artery)

2) External carotid →
i) Facial
ii) Superficial temporal
iii) Maxillary → infraorbital
iv) Occipital
v) Posterior auricular

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75
Q

How does the facial nerve exit the skull before entering the parotid gland?

A

Stylomastoid foramen

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76
Q

Which muscles are (i) superficial (ii) deep to the rami of the mandible?

A

i) Masseter
ii) Medial pterygoid

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77
Q

What are the anterior relations of the parotid gland (3)?

A

Medial to lateral:
1) Medial pterygoid
2) Rami of mandible
3) Masseter

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78
Q

What are the posterior relations of the parotid gland?

A

Medial to lateral:
1) Sternocleidomastoid
2) Mastoid process
3) Digastric muscles
4) Styloid process
5) Styloid process muscles (styloglossus, stylohyoid, and stylopharyngeus)

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79
Q

What are the vessels that are within the parotid gland?

A

Deep to superficial:
1) External carotid artery
2) External carotid vein
3) Facial nerve

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80
Q

Describe the innervation of the parotid gland.

A

CNIX: Glossopharyngeal

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81
Q

What are the 2 sets of lymph nodes of the head and neck

A

1) Submandibular
2) Submental
3) Parotid
4) Mastoid
5) Occipital
All drain to:
6) Deep cervical lymph nodes (along internal jugular vein)
- R → right lymphatic trunk
- L → thoracic duct

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82
Q

What forms the boundaries of the cranial fossae?

A

Anterior and middle → lesser wing of sphenoid bone

Middle and posterior → Petrous part of Temporal bone

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83
Q

Which bone forms the boundary of the posterior aperture of the nasal cavity?

A

Sphenoid

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84
Q

Which bones of the skull are air sinuses found?

A

1) Ethmoid
2) Sphenoid
3) Frontal
4) Maxillary

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85
Q

Which part of the sphenoid bone forms part of the pterygoid?

A

Greater wing

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86
Q

What are the sutures of the cranial cavity?

A

1) Coronal
2) Sagittal
3) Lambdoid

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87
Q

What are the holes located along the superior sagittal sinus of the skull?

A

Granular foveolae
(for arachnoid granulations)

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88
Q

Which cranial fossa is the cerebellum located in?

A

Posterior

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89
Q

Which part of the cranial cavity are the inner and middle ear located?

A

Petrous part of temporal bone

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90
Q

Where is the olfactory nerve in relation to the cranial cavity?

A

Cribriform plate of the anterior fossa

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91
Q

Where is the oculomotor nerve in relation to the cranial cavity?

A

Superior orbital fissure of middle fossa

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92
Q

Where is the adducens nerve in relation to the cranial cavity?

A

Superior orbital fissure of the middle fossa

93
Q

Where is the trochlear nerve in relation to the cranial cavity?

A

Superior orbital fissure of middle fossa

94
Q

Where is the ophthalmic vein in relation to the cranial cavity?

A

Superior orbital fissure of middle fossa

95
Q

What are the contents of the optic canal?

A

1) Optic nerve
2) Ophthalmic artery

96
Q

What are the contents of the superior orbital fissure?

A

1) Oculomotor nerve
2) V1: Ophthalmic branch of trigeminal nerve
3) Abducens nerve
4) Trochlear nerve
5) Ophthalmic vein

97
Q

What are the contents of the foramen rotundum of the cranial cavity?

A

V2: Maxillary nerve

98
Q

What are the contents of the foramen ovale of the brain?

A

V3: Mandibular nerve

99
Q

What are the contents of the foramen spinosum of the brain?

A

Middle meningeal artery

100
Q

Describe the venous communication between the extra and intracranial cavities.

A

Emissary veins pass through cartilage of foramen lacerum

101
Q

Where is the pituitary gland in relation to the cranial cavity?

A

Hypophyseal fossa (formed by body of sphenoid bone)

102
Q

What are the contents of the hypoglossal canal?

A

CNXII: Hypoglossal nerve

103
Q

What are the contents of the jugular foramen?

A

1) Internal jugular vein
2) CNIX: Glossopharyngeal nerve
3) CNX: Vagus nerve
4) CNXI: Accessory nerve

104
Q

What are the contents of the internal acoustic meatus?

A

1) CNVII: Facial nerve
2) CNVIII: Vestibulocochlear nerve
3) Labyrinthine artery

105
Q

Which nerve is located within the pterygopalatine fossa?

A

V2: Maxillary nerve

106
Q

What are the structures located within the pterygopalatine fossa?

A

1) Maxillary nerve
2) Maxillary artery
3) Pterygopalatine ganglion

107
Q

How does the internal carotid artery enter the cranial cavity?

A

1) Carotid canal
2) Foramen lacerum
3) Intracranial cavity

108
Q

What are the folds of the dura and what do they separate?

A

1) Falx cerebri
- lateral hemispheres of cerebrum

2) Tentorium cerebelli
- occipital lobe from cerebellum

3) Falx cerebelli
- lateral hemispheres of cerebellum

109
Q

What are the 2 venous sinuses found on the falx cerebri?

A

1) Superior sagittal sinus
2) Inferior sagittal sinus

110
Q

How do infections of the face and orbit spread into the cranial cavity?

A

Via ophthalmic vein

111
Q

Describe the deep venous sinus drainage of the cranial cavity.

A

1) Superior + Inferior Sagittal Sinus
→ Straight Sinus
→ Confluence of Sinuses
→ Transverse Sinus
→ Sigmoid Sinus
→ Internal Jugular vein

2) Ophthalmic vein
→ Cavernous Sinus
→ Superior + Inferior Petrosal Sinus

112
Q

Which cranial nerves/lobes would be affected in a cavernous sinusitis?

A

1) Temporal lobe
2) Internal carotid artery
3) CNIII: Oculomotor
4) CNIV: Trochlear
5) CNV1: Ophthalmic
6) CNV2: Maxillary
7) CNVI: Abducens

113
Q

What are the 3 sets of veins in the brain?

A

1) Superficial
2) Dural venous sinuses
3) Deep

114
Q

True or false:
The dural venous sinuses contain valves to prevent the backflow of blood from the deep to the superficial cranial veins.

A

False.
Dural venous sinuses no valves
- low resistance blood drainage

115
Q

Where is CSF produced?

A

Choroid plexus
- modified capillaries along wall of ventricles

116
Q

How does CSF travel from the ventricles to the subarachnoid space?

A

Via 3 openings of 4th ventricles

117
Q

How does CSF get reabsorbed into venous circulation?

A

Openings in 4th ventricles
→ subarachnoid space
→ arachnoid granulations along superior end of skull
→ superior sagittal sinuses

118
Q

Epidural and subdural haemorrhages are differentiated on imaging as they present as _________shape due to being confined by ___________ respectively.

A

Epidural: Middle meningeal artery
- confined by cranial sutures → biconcave lens

Subdural: Bridging veins
- confined by dural reflections → crescent

119
Q

What are the arteries that supply the spinal cord?

A

2 from vertebral arteries:
1) Anterior spinal artery
2) Posterior spinal artery

1 from aorta/branches of aorta:
3) Segmental (radicular) arteries

120
Q

Which spinal tracts would be affected in a posterior spinal artery lesion?

A

Dorsal column (DCML)
- conscious proprioception, fine touch, vibration

121
Q

The ciliary body is an extension of which layer of the eye?

A

Choroid

122
Q

Which cranial cavity does the orbit project into?

A

Middle cranial fossa

123
Q

The roof of the orbit forms the floor of the _________________________.

A

Anterior cranial fossa

124
Q

The medial wall of the orbit is related to the ______________.

A

Nasal cavity + Ethmoid sinuses

125
Q

The lateral wall of the orbit is related to the _________ fossa.

A

Temporal

126
Q

The floor of the orbit is related to the ________ and its sinus.

A

Maxilla (Maxillary sinus)

127
Q

What are the bones that form the walls of the orbit?

A

Roof: Frontal

Lateral: Sphenoid + Zygomatic

Floor: Maxilla

Medial: Ethmoid + Lacrimal + Maxilla

128
Q

What are the openings of the orbit and their contents?

A

1) Optic canal
- optic nerve
- ophthalmic artery

2) Superior orbital fissure
- CN3, 4, V1, 6
- ophthalmic vein

3) Inferior orbital fissure
4) Infraorbital foramen
5) Lacrimal fossa + Nasolacrimal duct

129
Q

Which extraocular muscle that is supplied by CNIII: Oculomotor nerve but does not control the eyeball?

A

Levator Palpebrae Superioris (lifts eyelid)

130
Q

Where do the extraocular muscles originate from and attach to?

A

Origin: Common tendinous ring over optic canal and superior orbital fissure

Attachment: Sclera

131
Q

Which muscle runs parallel to the axis of the orbit?

A

Superior Rectus

132
Q

What nerve provides somatic sensory innervation to the orbit?

A

V1: Ophthalmic nerve

133
Q

What are the components of the lacrimal apparatus and their functions?

A

1) Lacrimal gland
- secrete tears

2) Excretory ducts
- convey tears to surface (via conjunctival fornix)

3) Lacrimal canaliculi
- empty tears into lacrimal sac

4) Lacrimal sac

5) Nasolacrimal duct
- convey tears into nasal cavity

134
Q

What is the function of the lacrimal apparatus?

A

Tear production and drainage

135
Q

What are the parts of the conjunctiva and where do tears accumulate before flowing laterally?

A

1) Palpebral (inner side of eyelid)

2) Bulbar (on sclera)

3) Conjunctival fornix
- where tears accumulate

136
Q

What are the Meibomian (tarsal) glands and where are they located?

A

Modified sebaceous glands → produce meibum to prevent evaporation of eye’s tear film

Along rims of eyelid

137
Q

What is the superior tarsal (Muller’s) muscle is its function?

A

Smooth muscle component of levator palpebrae superioris muscles
- helps raise upper eyelid

138
Q

What is the pathophysiology of partial ptosis in a superior cervical ganglion lesion?

A

Disrupted autonomic innervation to the Muller’s muscle (smooth muscle component of the levator palpebrae superioris muscle)

139
Q

What structure separates the left and right nasal cavities?

A

Nasal septum

140
Q

What are the names of the nostril and the opening into the nasopharynx?

A

Anterior and posterior nasal aperture respectively

141
Q

What are the structures lining the lateral walls of the nasal cavities?

A

Concha (count from bottom up)
1) Inferior
2) Middle
3) Superior

142
Q

What is the name of the space between the conchi?

A

Meatus

143
Q

What are 2 important relations of the superior posterior aspect of the nasal cavity?

A

1) Sphenoidal sinus
2) Pituitary gland and fossa

144
Q

Where do the nasolacrimal ducts open into?

A

Inferior meatus

145
Q

What is the space above the superior meatus?

A

Spheno-ethmoidal recess
- where 1 of the paranasal sinuses open into

146
Q

What are the structures found in the middle meatus?

A

1) Ethmoidal bulla → ethmoidal sinus

2) Semilunar groove → frontal sinus + maxillary sinus

147
Q

Which sinus opens into the superior meatus?

A

Ethmoidal sinus

148
Q

The majority of the nasal cavity is lined by _______________ epithelium, with the exception of ___________________.

A

Respiratory (ciliated pseudostratified columnar epithelium)

  • except:
    1) nasal vestibule → keratinized stratified squamous with hair
    2) Roof of nasal cavity → olfactory epithelium/mucosa
149
Q

Describe the innervation of the nasal cavity.

A

Somatosensory:
1) V2/Maxillary nerve
2) CNI: Olfactory nerve

(Ophthalmic nerve a bit to external nose via anterior ethmoidal nerve)

150
Q

Which artery supplies the nasal cavity?

A

Maxillary artery (branch of external carotid artery)

(a bit from anterior ethmoidal artery from ophthalmic artery)

151
Q

Which branch of the maxillary nerve and artery also supply the palate, other than the nasal cavity?

A

Artery: Sphenopalatine branch

Nerve: Nasopalatine branch

152
Q

How do the sphenopalatine branch of the maxillary artery and the nasopalatine branch of the maxillary nerve enter the oral cavity?

A

Via the incisive canal

153
Q

Which area of the nose is most prone to nose bleeds and why?

A

Nasal septum
- rich blood supply/anastomoses by lateral branches of maxillary artery on both sides

154
Q

What are 2 veins that drain the nasal cavity?

A

1) Maxillary
2) Ophthalmic

155
Q

Which of the paranasal sinuses are most prone to infection?

A

Maxillary
- very big but hole into inferior meatus is not on floor of sinus → difficult to drain
- closely related to upper teeth → infection can spread

156
Q

True or false:
The paranasal sinuses are fixed at birth and thus do not stay proportionate to facial size.

A

False.
Grow with age

157
Q

How does the pterygo-palatine fossa communicate with the nasal cavity?

A

Sphenopalatine foramen

158
Q

How does the pterygo-palatine fossa communicate with the cranial cavity?

A

1) Foramen rotundum
2) Pterygoid canal

(both into middle cranial fossa)

159
Q

How does the pterygo-palatine fossa communicate with the infratemporal fossa and their contents?

A

Pterygomaxillary fissure
- infraorbital nerve and artery

160
Q

How does the pterygo-palatine fossa communicate with the palate?

A

Palatine canal

161
Q

Where is the oral vestibule?

A

Between cheeks/lips and teeth

162
Q

Where are the frenulum of the upper and lower lip?

A

Midline of oral cavity within vestibule

163
Q

What structure separates the oral cavity and oropharynx?

A

Oropharyngeal isthmus
- superiorly: palate
- lateral: palatoglossal fold
- anterior: posterior 1/3 of tongue

164
Q

Which fold is located posterior to the palatoglossal fold?

A

Palatopharyngeal fold

165
Q

Which muscle run deep to the oropharyngeal isthmus within the oropharynx?

A

1) Palatoglossus
2) Palatopharyngeus

166
Q

What structure is found between the palatopharyngeal and palatoglossal folds?

A

Palatine tonsils

167
Q

What structure is found between the lingual tonsils and epiglottis?

A

Valeculla

168
Q

Where is the foramen caecum and what is its embryological significance?

A

Between terminal sulci of tongue
- where thyroid gland orginated before descending

169
Q

What structure of the tongue has a very high density of taste buds?

A

Circumvallate papilla

170
Q

What are the muscles of the tongue?

A

Extrinsic (move tongue):
1) Palatoglossus → elevate
2) Styloglossus → retract
3) Hyoglossus → depress
4) Genioglossus → protrude

Intrinsic (change shape of tongue):
5) Superior longitudinal
6) Vertical
7) Transverse
8) Inferior longitudinal

171
Q

Describe the innervation of the tongue.

A

Motor:
All by CNXII: Hypoglossal
- except Palatoglossus by CNX: Vagus

Sensory:
Anterior 2/3
General → Lingual nerve (branch of CNV3: Mandibular)
Taste →Chorda tympani (branch of CNVII: Facial) (except circumvallate papilla → follow posterior)

Posterior 1/3
General + taste → CNIX: Glossopharyngeal

172
Q

Which artery supplies the tongue

A

Lingual artery (branch of external carotid)

173
Q

What is the term for the ridges found posterior to the incisors on the roof of the mouth?

A

Palatine rugae

174
Q

Describe the innervation and blood supply of the hard palate.

A

Innervation:
1) Nasopalatine nerve (anterior part)
2) Greater palatine nerve (from greater palatine foramen → posterior)

Blood supply:
1) Sphenopalatine artery (anterior part)
2) Greater palatine artery (from greater palatine foramen → posterior)

175
Q

What are the muscles of the soft palate?

A

1) Tensor veli palatini → tense + elevate
2) Levator veli palatini → elevate
3) Palatoglossus → depress
4) Palatopharyngeus → depress
5) Musculus uvulae

176
Q

Describe the innervation of the muscles of the soft palate.

A

All by CNX: Vagus
- except tensor villi palatine (by CNV: trigeminal)

177
Q

What are the 2 branches of the mandibular nerve?

A

1) Lingual
- supply tongue

2) Inferior alveolar nerve
- supply teeth and gingiva

178
Q

What are 3 glands of the oral cavity?

A

1) Parotid
2) Submandibular
3) Sublingual

179
Q

What nerve branches from the inferior alveolar nerve before it enters the mandibular foramen and what does it supply?

A

Nerve to mylohyoid
- mylohyoid + anterior belly of digastric

180
Q

What does the lingual nerve curve around before supplying the tongue?

A

Submandibular duct

181
Q

The chorda tympani is a branch of the _________ nerve and synapses at the _______ before supplying the _____________.

A

Branch of CNVII: Facial
Synapse at submandibular ganglion
Supply submandibular and sublingual glands

182
Q

The hypoglossal nerves crosses the ______ before supplying the muscles of the tongue.

A

Internal and external carotid arteries

183
Q

How do the the histology of the salivary glands differ?

A

Parotid:
- totally serous, very basophilic

Sublingual:
- very mucous, lighter

Submandibular:
- mixed

184
Q

What are the ligaments of the TMJ?

A

1) Lateral ligament
2) Stylomandibular ligament
3) Sphenomandibular
4) Capsule

185
Q

What are the bony components of the TMJ?

A

Condyle of mandibular and mandibular groove temporal bone + articular tubercle

186
Q

What kind of cartilage lines the TMJ?

A

Fibrocartilage

187
Q

What makes the TMJ a modified hinge joint?

A

2 cavities separated by articular disc (fibrocartilage):
i) Superior → plane joint
ii) Inferior → hinge joint

188
Q

What are the movements of the TMJ?

A

1/2: Elevation/depression
3/4: Protrusion/retraction
5: Lateral

189
Q

What are the muscles of mastication?

A

1) Masseter
- elevate

2) Temporalis
- anterior: elevate
- posterior: retract

3) Medial pterygoid
- elevation

4) Lateral pterygoid
- protrusion

190
Q

True or false:
The medial pterygoid attaches to the medial plate of the pterygoid process while the lateral pterygoid attaches to the lateral plate of the pterygoid process.

A

False.
Both attach to lateral plate
i) Medial → medial surface
ii) Lateral → lateral surface

191
Q

Which artery and nerve supplies the TMJ?

A

Maxillary artery
Mandibular nerve

192
Q

What are the 3 parts of the pharynx?

A

1) Nasopharynx
2) Oropharynx
3) Laryngopharynx

193
Q

What are the components of Waldeyer’s ring?

A

1) nasopharyngeal tonsils
2) palatine tonsils
3) lingual tonsils

194
Q

Where does the eustachian tube open into?

A

Nasopharynx (pharyngeal orifice)

195
Q

What are 2 muscles that are related to the tubal elevation/pharyngeal orifice of the eustachian tube?

A

1) Salpingopharyngeal → (fold)
2) Levator vili palatini

196
Q

The nasopharynx extends from the ______________ to the ________________.

A

Choana/posterior nasal aperture → epiglottis

197
Q

What are 2 locations in the upper GIT that fish bones commonly get stuck?

A

1) Vallecula (oropharynx)
2) Piriform recess (laryngopharynx)

198
Q

What are the muscles of the pharynx?

A

Longitudinal:
1) Stylopharyngeus
2) Salpingopharyngeus
3) Palatopharyngeus

Circular(sphincteric):
4) Superior constrictor
5) Middle constrictor
6) Inferior constrictor

199
Q

How does the lining epithelium of the pharynx change as it descends?

A

Nasopharynx: respiratory
Oro/laryngopharynx: stratified squamous

200
Q

Describe the nerve and blood supply of the pharynx.

A

Blood supply:
Pharyngeal branches of external carotid

Nerve supply:
Pharyngeal plexus
- all by CNX (+XI) except stylopharyngeus (CNIX)

201
Q

What are the cartilages of the larynx?

A

1) Thyroid
2) Cricoid
3) Epiglottis

Paired
4) Arytenoid
5) Corniculate
6) Cuneiform

202
Q

What are 2 features of the lateral fold of the larynx?

A

1) Vestibular fold (superior)
2) Vocal fold (inferior, whiter)

203
Q

What are the rima vestibule and glottidis?

A

The space between the vestibular and vocal folds respectively

204
Q

What is the lining epithelium of the larynx?

A

Respiratory epithelium
- except vocal fold (stratified squamous)

205
Q

The larynx extended from the __________ to the __________.

A

Epiglottis to cricoid cartilage

206
Q

The vocal folds are attached to the _________.

A

Arytenoid cartilage

207
Q

What are the muscles of the cartilage?

A

1) Cricothyroid
2) Thyroepiglottis
3) Thyroarytenoid
4) Vocal
5) Cricoarytenoid (lateral and posterior)
6) Aryepiglottic muscles
7) Inter/transverse arytenoid
8) Oblique arytenoid

208
Q

Which muscles control the laryngeal inlet?

A

1) Aryepiglottic muscles
2) Lateral cricoarytenoids
3) transverse (inter) arytenoids)
4) oblique arytenoids,

209
Q

What are the movements of the vocal folds?

A

1/2) Ab/adduct

210
Q

Which muscle abduct the vocal folds?

A

Posterior cricoarytenoid

211
Q

Which muscle raises the pitch of our voice?

A

Cricothyroid (tenses vocal folds)

212
Q

What forms the laryngeal inlet?

A

Superior: epiglottis
Lateral: periepiglottic folds
Inferior: interarytenoid folds

213
Q

What are the branches of the superior laryngeal nerve (from CNX)?

A

1) Internal laryngeal nerve: sensory to area superior to vocal folds

2) External laryngeal nerve: motor to cricothyroid

214
Q

Where does the superior thyroid artery arise from and what does it supply?

A

External carotid
- supply (i) thyroid (ii) larynx (iii) pharynx

215
Q

In the supply of the larynx, both the ____________ and _____________ are closely opposed to each other.

A

Superior supply:
- superior thyroid artery and external laryngeal nerve

Inferior supply:
- inferior thyroid artery and recurrent laryngeal nerve

216
Q

What nerve supplies the larynx?

A

Vagus
i) Superior laryngeal nerve → external/internal laryngeal nerve
ii) Recurrent laryngeal nerve

217
Q

What type of cartilage forms the skeleton of the larynx?

A

All hyaline except epiglottis (elastic)

218
Q

The left recurrent laryngeal nerve loops around the _____________ while the right recurrent laryngeal nerve loops around the _________________.

A

Left → Arch of aorta
Right → Subclavian artery

219
Q

During phonation, the vocal folds are ______ while the vestibule is ________.

A

Vocal folds adducted
Vestibule open

220
Q

During forced inspiration, the vocal folds are ______ while the vestibule is ________.

A

Vocal folds abducted (rima glottis open)
Vestibule open

221
Q

During effort closure, the vocal folds are ______ while the vestibule is ________.

A

Vocal folds adducted
Vestibule closed

222
Q

What does the pharyngotympanic tube connect?

A

Nasopharynx and middle ear

223
Q

What are the ossicles (from lateral/closest to tympanic membrane to medial)?

A

1) Malleus
2) Incus
3) Stapes

224
Q

What are the muscles of the middle ear, innervations, and their function?

A

1) Tensor tympani (malleus)
- CNV
2) Stapedius (stapes)
- CNVII

Both: pull ossicles away to disrupt transmission during loud noise

225
Q

What is the nervous supply to the middle ear?

A

Tympanic branch of CNIX: glossopharyngeal nerve

226
Q

What are the relations of the middle ear?

A

Superior:
i) temporal lobe

Medial:
i) Inner ear
ii) Stapes
iii) Promontory
iv) Tympanic nerve
v) Round window
vi) Oval window

Anterior:
i) Eustachian tube
ii) Internal carotid + sympathetic plexus

Inferior:
i) Internal jugular vein

Posterior:
i) Facial nerve
ii) Mastoid antrum (to mastoid sinus)

227
Q

What is the blood supply of the inner ear?

A

Labyrinthine arteries (branch of basilar artery)

228
Q

What are 5 sources of referred pain of the ear?

A

1) C2/3
2) CNIX (posterior 1/3 of tongue + oropharynx)

CNX:
3) Oesophagus
4) Larynx + hypopharynx

CNV:
5) Teeth
6) Parotid
7) TMJ
8) Nose + Sinuses

229
Q

Which 2 structures are at most risk of being damaged during a thyroidectomy?

A

1) Recurrent laryngeal nerve
2) Parathyroid glands

Nervous System (14 decks)

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