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ESA 3 > Head, Neck and Neuroanatomy > Flashcards

Head, Neck and Neuroanatomy Flashcards

1
Q

Emergence

A

complex behaviour emerges from interactions of individual relatively simple units

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2
Q

Which side of the brain controls which side of the body?

A

Contralateral side bar cerebellum

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3
Q

CNS (3)

A

Cerebellar hemispheres
Brainstem and cerebellum
Spinal cord

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4
Q

PNS (3)

A

Dorsal and Ventral roots
Spinal nerves
Peripheral nerves

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5
Q

Midbrain (mesencephalon) (2)

A

Eye movements

Reflex responses to sound and vision

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6
Q

Pons (metacephalon) (2)

A

Feeding

Sleep

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7
Q

Medulla (myencephalon)n (2)

A

Cardiovascular and respiratory centres

Contains a major pathway medullary pyramids

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8
Q

Sulcus

A

Groove

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9
Q

Gyrus

A

Ridge

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10
Q

Fissure

A

Split between adjacent large areas of the brain

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11
Q

Frontal lobe (3)

A

Higher cognition
Speech
Motor function

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12
Q

Parietal lobe (2)

A

Sensation

Special awareness

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13
Q

Temporal lobe (3)`

A

Smell
Hearing
Memory

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14
Q

Occipital lobe

A

Vision

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15
Q

Cerebellum (2)

A

Co-ordination

Motor learning

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16
Q

Optic chiasm

A

location where optic fibres crossover

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17
Q

Uncus

A

Part of temporal lobe that can herniate, compressing midbrain (eye movements, sound/vision reflexes)

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18
Q

Medullary pyramid

A

location of descending motor fibres

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19
Q

Corpus collosum

A

fibres connecting two hemispheres of the brain

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20
Q

Thalamus

A

sensory relay station projecting to sensory cortex

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21
Q

Hypothalamus

A

Essential centre for homeostasis

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22
Q

Which NS can regenerate?

A

PNS

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23
Q

Which NS is the most sophisticated?

A

CNS

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24
Q

What kind of tumours occur in the CNS and PNS?

A

CNS - malignant and benign

PNS - benign

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25
What insulates CNS fibres?
Oligodendracytes
26
What insulates PNS fibres?`
Schwann cells
27
Sections of the brainstem? (3)
Midbrain Pons Medulla
28
Immunity in the CNS
Microglia ( immune privilege)
29
What embryological layer does the CNS arise from?
Ectoderm
30
Function of the ear
hearing and balance
31
Parts of the ear (3)
External Middle Inner
32
Signs and symptoms of ear disease (6)
``` Otalgia (can be referred from larynx) Discharge Hearing loss (conductive vs sensorineural) Tinnitus Vertigo Facial nerve palsy ```
33
Which bone has the parts of the ear?
Temporal
34
What are the parts of the external ear?
Pinna External Auditory Meatus Lateral surface of the tympanic membrane
35
Function of the external ear
Collect and transmit sound waves to tympanic membrane
36
Facial nerve palsy signs
Inability to move facial muscles Hyperacusis Decreased salivation Inability to taste with anterior 2/3rds of the tongue Inability to cry Inability to close eyelid, eye tends to swivel upwards
37
What is Ramsey-Hunt syndrome?
Varicella Zoster infection of CN VII, shingles | Can cause tinnitus
38
Pinna Haematoma
Secondary to blunt trauma of external ear Blood accumulates between cartilage and perichondrium Deprives cartilage of blood supply and pressure/avascular necrosis can occur Drainage allows for re-apposition of 2 layers
39
Cauliflower deformity
Fibrosis that occurs if pinna haematoma is not properly treated
40
External Auditory Meatus
Sigmoid shaped skin-lined cul-de-sac, up and back to straighten and examine !/3 cartilage, 2/3 bone
41
What is the function of the hair and wax in the external auditory canal?
Prevents objects entering deeper into ear canal | Aids desquamation and skin migration out of canal
42
How long is the external auditory canal?
2.5 cm
43
What is Otitis Externa?
Inflammation of the external ear
44
Tympanic membrane features? (8)
``` Posterior mallear fold Anterior mallear fold Pars flacida Lateral process of the malleus Handle of the malleus Umbo Pars tensa Cone of light ```
45
Treatment for a perforated tympanic membrane?
Self-resolving
46
Contents of the middle ear?
Ossicles (Malleus, Incus, Stapes) | Air filled cavity
47
Function of middle ear?
Amplifies vibration from tympanic membrane to cochlea via oval window
48
Ossicle function
Transmit vibration from air filled medium to fluid filled cochlea via oval window
49
How is ossicle movement controlled?
Vibrations are dampened by tensor tympani and stapedius
50
What is the innervation for the stapedius?
CN VII, can be affected in CN VII palsy
51
What are the ossicles?
Malleus Incus Stapes
52
What is Otosclerosis?
Fusion at the articulations of the ossicles, especially the foot plate of the stapes and the oval window Sound vibrations cannot be transmitted Causes gradual hearing loss and deafness
53
What is the function of the Pharyngotympanic Tube?
Mucous membrane of the middle air constantly reabsorbs air resulting in a negative pressure in the middle ear Pharyngotympanic tube allows for pressure equalisation of the middle ear Also allows for ventilation of and drainage of mucus into the nasopharynx
54
Otitis media with effusion (glue ear)
Pharyngotympanic tube dysfunction Negative pressure results on fluid build up from mucous membranes Can predispose to infection Decreases movement of TM and ossicles affecting hearing Most resolve after 2-3 months Those that don't resolve require a grommet
55
Acute Otitis media
Acute middle ear infection More common in infants as their pharyngotympanic tube is shorter and more horizontal making it easier for infections to track up from nasopharynx Otalgia Red +/- bulging TM with loss of normal landmarks
56
Complications of Acute Otitis media?
Perforation Facial nerve involvement Potentially life-threatening with mastoiditis, meningitis, sigmoid sinus thrombosis, brain abscess
57
Mastoiditis
Middle ear infections can spread to the mastoid air cells as they communicate, and spread into mastoid bone Sign is redness behind the ear
58
What part of the facial nerve runs through the middle ear?
Everything bar the greater petrosal nerve to the lacrimal gland
59
Cholesteatoma
Abnormal skin growth (sac or cyst of skin cells) in middle ear Painless but can result in smelly ear discharge Usually secondary to chronic ET dysfunction or recurring/chronic ear infections Not malignant but can erode into adjacent structures
60
Content of inner ear
Vestibular apparatus Cochlea Both are fluid filled tubes
61
Function of Cochlea
Converts vibration in electrical signal which is perceived as sound
62
Function of Vestibular apparatus
Maintains sense of position and balance
63
How the Cochlea works?
Movements at oval window causes movement of fluid in the cochlea This causes movement of special sensory cells (stereocilia) generate action potentials in CN VIII which are transmitted to the primary auditory cortex Damage hear causes sensorineural hearing loss
64
How the Vestibular apparatus works?
Semicircular canals containing semicircular ducts, the saccule and utricle sacs respond to position and rotation and maintain sense of balance
65
Symptoms and Signs of vestibular apparatus damage?
Vertigo | Nystagmus (involuntary eye movements)
66
Rinne test
Testing bone conduction vs sensorineural conduction
67
AC > BC
Normal | Sensorineural hearing loss, problem with bone and air conduction
68
BC>AC
Conductive hearing loss, air conduction is abnormal
69
Weber test
A test of sensorineural hearing function
70
In sensorineural hearing loss, which side will the sound localise to in the Weber test?
Normal side
71
In conductive hearing loss, which side will the sound localise to in the Weber test?
Affected side
72
Causes of conductive hearing loss?
``` Pathology affecting external/middle ear: Wax Acute Otitis media Glue ear (Otitis media with effusion) Otosclerosis ```
73
Causes of sensorineural hearing loss?
Pathology of inner ear: Presbyacusis (>55, age-related hearing loss) Meniere's disease Acoustic neuroma (cancer of schwann cells) Ototoxic medications
74
Optic chiasm
Where fibres of visual system cross over
75
Uncus
Part of the temporal lobe that can herniate into the midbrain
76
Medullary pryramids
location of descending motor fibres
77
Structures on inferior aspect of the brain? (3)
Optic chiasm Uncus Medullary pyramids
78
Structures on medial aspect of the brain? (3)
Corpus collosum Thalamus Hypothalamus
79
Corpus collosum
Fibres connecting two cerebral hemispheres
80
Thalamus
Sensory relay station projecting to sensory cortex
81
Hypothalamus
Essential centre for homeostasis
82
Superior border of orbit? (2)
Frontal | Sphenoid
83
Medial border of orbit (4)
Lacrimal Maxillary Ethmoid Sphenoid
84
Inferior border of orbit (2)
Maxillary | Zygomatic
85
Lateral border of orbit (2)
Zygomatic | Sphenoid
86
What structures lie medially and inferiorly to the orbit? What is their clinical relevance?
Ethmoid air cells Maxillary sinus Infections can spread from sinus to orbit an vice versa Orbital contents can herniate into these areas upon trauma
87
Signs of a blowout fracture (4)
Periorbital pain/swelling Diplopia esp. on vertical gaze Impaired vision Anaesthesia to affected cheek, upper teeth and gums due to damage to the infraorbital nerve (V2)
88
In what bone are the superior orbital fissure, inferior fissure and optic canal found?
Sphenoid bone
89
Contents of the superior part of the superior orbital fissure?
Lacrimal part CN V1 Frontal part CN V1 CN IV Superior opthalmic vein
90
Contents of inferior part of superior orbital fissure?
Nasocillary part CN V1 Superior branch of CN III CN VI Inferior branch of CN III
91
Contents of inferior orbital fissure?
Inferior orbital vein
92
Contents of the optic canal?
Optic nerve | Opthalmic artery
93
Which foramen does the MMA pass through?
foramen spinosum
94
What muscle depresses the jaw?
lateral pterygoid
95
Which part of the orbicularis oris closes the eyes tight?
Orbital part
96
Which cranial nerves pass through cavernous sinus? (4)
Trigeminal (V1, V2) Abducens Trochlear Oculomotor
97
Which cranial nerves carry special sensory nerves? (5)
``` Olfactory Optic Vestibulocochlear Facial Glossopharyngeal ```
98
Which pharyngeal arch is glossopharyngeal nerve derive from?
Arch 3
99
What area do you insert a central venous catheter?
Carotid triangle
100
Branches of CN VII that arise from petrous part of temporal bone?
Chorda tympanii Greater petrosal Nerve to stapedius
101
Contents of the posterior triangle? (8)
``` Accessory nerve CN XI Cervical plexus Roots of brachial plexus Phrenic nerve Subclavian artery Suprascapular a EJV Transverse cervical Occipital node Supraclavicular node ```
102
Superficial lymph nodes
``` Submental Submandibular Pre-auricular Post-auricular Occipital Cervical: Anterior Posterior Superificial ```
103
Deep lymph nodes
Jugulo-digastric Jugulo-omohyoid Supraclavicular
104
Which cranial nerves carry parasympathetic fibres?
CN III CN VII CN IX CN X
105
Structures of forebrain?
Cerebrum | Diencephalon (hypothalamus, thalamus)
106
Structures of hindbrain?
Pons Medulla Cerebellum
107
General sommatic innervation of the external ear?
CN X Cervical nerve (C2) CN V3
108
Signs of a cavernous sinus thrombosis? (4)
Orbital oedema Pupillary dilation drooping eyelids
109
Innervation of levator palpabrae superioris?
CN III (total ptosis)
110
Innervation of superior tarsal muscle?
Sympathetic fibres (partial ptosis)
111
Parasympathetic functions associated with vagus nerve?
Smooth muscle in GI Mucosal glands of pharynx Cardiac conducting system Smooth muscle of respiratory tract
112
Sympathetic autonomic outflow
T1 - L2 | Pre-ganglionic cell bodies in lateral horn of grey matter in spinal cord
113
Parasympathetic autonomic outflow
CN III/VII/IX?X | S2 - S4
114
Actions of sympathetic
Smooth muscle of blood vessels Superior tarsal muscle (partial ptosis) Decreases secretions from salivary and lacrimal glands
115
Actions of parasympathetic
Smooth muscle of iris and ciliary body Lacrimal glands Salivary and mucosal glands
116
Path of sympathetic fibres
Superior cervical ganglion Associate with ICA/opthalmic artery to orbit forming carotid plexus, innervate dilator pupilae and superior tarsal muscle Associate with ECA to innervate facial sweat glands
117
Horner's syndrome (4)
Pathology of apex of the lung causes sympathetic innervation loss as sympathetic fibres wrap around subclavian: Partial ptosis Narrowing of pupil Loss of ability to sweat (anhydrosis)
118
Which post ganglionic CN do parasympathetic fibres associate with?
CN V
119
Parasympathetic ganglia (4)
Ciliary Submandibular Otic Pterygopalatine
120
Path of parasympathetic fibres associated with CN III
``` Edinger-Westphal nucleus Hitch-hike on CN III Ciliary ganglion CN V1 Ciliary body/sphincter pupillae ```
121
Direct light relfex
Pupil that light is shone in constricts
122
Consensual light reflex
Contralateral pupil constricts
123
Path of parasympathetic fibres associated with CN VII
Pons Fibres hitch-hike on CN VII Chorda tympanii/greater petrosal Submandibular ganglion/ptergopalatine ganglion Hitch-hike on CN V Submandibular and sublingual salivary glands/lacrimal and nasal and oral mucosal glands
124
Path of parasympathetic fibres associated with CN IX
``` Medulla Hitch-hike on CN IX Otic ganglion CN V3 Parotid gland ```
125
Branches of the CN IX associated autonomic fibres?
``` Tympanic nerve (sensory of middle ear) Lesser petrosal nerve ```
126
Path of parasympathetic fibres associated with CN X
``` Medulla Hitch-hike on CN X meets at ganglion in respective tissues Glands in laryngopharynx/larynx/smooth muscle of oesophagus/trachea Heart SM in resp and gi tract ```
127
CN associations with pharyngeal arches
CN V - 1 CN VII - 2 CN IX - 3 CN X - 4/6
128
Muscular derivatives of pharyngeal arches
``` Muscle of mastication - Ph 1 Facial expression - Ph 2 Stylopharyngeus - Ph 3 Cricothyroid/Levator palatini/constrictors of pharynx - Ph 4 Intrinsic muscles of larynx - Ph 6 ```
129
Lateral cleft lip
Failure for medial nasal prominence and maxillary prominence to fuse
130
Cleft lip & cleft palate
Combined with failure of palatal shelves to meet in midline

ESA 3 (5 decks)

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