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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
Q

What insulates CNS fibres?

A

Oligodendracytes

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26
Q

What insulates PNS fibres?`

A

Schwann cells

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27
Q

Sections of the brainstem? (3)

A

Midbrain
Pons
Medulla

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28
Q

Immunity in the CNS

A

Microglia ( immune privilege)

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29
Q

What embryological layer does the CNS arise from?

A

Ectoderm

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30
Q

Function of the ear

A

hearing and balance

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31
Q

Parts of the ear (3)

A

External
Middle
Inner

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32
Q

Signs and symptoms of ear disease (6)

A 
Otalgia (can be referred from larynx)
Discharge
Hearing loss (conductive vs sensorineural)
Tinnitus
Vertigo
Facial nerve palsy
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33
Q

Which bone has the parts of the ear?

A

Temporal

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34
Q

What are the parts of the external ear?

A

Pinna
External Auditory Meatus
Lateral surface of the tympanic membrane

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35
Q

Function of the external ear

A

Collect and transmit sound waves to tympanic membrane

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36
Q

Facial nerve palsy signs

A

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

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37
Q

What is Ramsey-Hunt syndrome?

A

Varicella Zoster infection of CN VII, shingles

Can cause tinnitus

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38
Q

Pinna Haematoma

A

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

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39
Q

Cauliflower deformity

A

Fibrosis that occurs if pinna haematoma is not properly treated

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40
Q

External Auditory Meatus

A

Sigmoid shaped skin-lined cul-de-sac, up and back to straighten and examine
!/3 cartilage, 2/3 bone

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41
Q

What is the function of the hair and wax in the external auditory canal?

A

Prevents objects entering deeper into ear canal

Aids desquamation and skin migration out of canal

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42
Q

How long is the external auditory canal?

A

2.5 cm

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43
Q

What is Otitis Externa?

A

Inflammation of the external ear

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44
Q

Tympanic membrane features? (8)

A 
Posterior mallear fold
Anterior mallear fold
Pars flacida
Lateral process of the malleus
Handle of the malleus
Umbo
Pars tensa
Cone of light
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45
Q

Treatment for a perforated tympanic membrane?

A

Self-resolving

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46
Q

Contents of the middle ear?

A

Ossicles (Malleus, Incus, Stapes)

Air filled cavity

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47
Q

Function of middle ear?

A

Amplifies vibration from tympanic membrane to cochlea via oval window

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48
Q

Ossicle function

A

Transmit vibration from air filled medium to fluid filled cochlea via oval window

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49
Q

How is ossicle movement controlled?

A

Vibrations are dampened by tensor tympani and stapedius

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50
Q

What is the innervation for the stapedius?

A

CN VII, can be affected in CN VII palsy

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51
Q

What are the ossicles?

A

Malleus
Incus
Stapes

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52
Q

What is Otosclerosis?

A

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

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53
Q

What is the function of the Pharyngotympanic Tube?

A

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
Q

Otitis media with effusion (glue ear)

A

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
Q

Acute Otitis media

A

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
Q

Complications of Acute Otitis media?

A

Perforation
Facial nerve involvement
Potentially life-threatening with mastoiditis, meningitis, sigmoid sinus thrombosis, brain abscess

57
Q

Mastoiditis

A

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
Q

What part of the facial nerve runs through the middle ear?

A

Everything bar the greater petrosal nerve to the lacrimal gland

59
Q

Cholesteatoma

A

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
Q

Content of inner ear

A

Vestibular apparatus
Cochlea
Both are fluid filled tubes

61
Q

Function of Cochlea

A

Converts vibration in electrical signal which is perceived as sound

62
Q

Function of Vestibular apparatus

A

Maintains sense of position and balance

63
Q

How the Cochlea works?

A

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
Q

How the Vestibular apparatus works?

A

Semicircular canals containing semicircular ducts, the saccule and utricle sacs respond to position and rotation and maintain sense of balance

65
Q

Symptoms and Signs of vestibular apparatus damage?

A

Vertigo

Nystagmus (involuntary eye movements)

66
Q

Rinne test

A

Testing bone conduction vs sensorineural conduction

67
Q

AC > BC

A

Normal

Sensorineural hearing loss, problem with bone and air conduction

68
Q

BC>AC

A

Conductive hearing loss, air conduction is abnormal

69
Q

Weber test

A

A test of sensorineural hearing function

70
Q

In sensorineural hearing loss, which side will the sound localise to in the Weber test?

A

Normal side

71
Q

In conductive hearing loss, which side will the sound localise to in the Weber test?

A

Affected side

72
Q

Causes of conductive hearing loss?

A 
Pathology affecting external/middle ear:
Wax
Acute Otitis media
Glue ear (Otitis media with effusion)
Otosclerosis
73
Q

Causes of sensorineural hearing loss?

A

Pathology of inner ear:
Presbyacusis (>55, age-related hearing loss)
Meniere’s disease
Acoustic neuroma (cancer of schwann cells)
Ototoxic medications

74
Q

Optic chiasm

A

Where fibres of visual system cross over

75
Q

Uncus

A

Part of the temporal lobe that can herniate into the midbrain

76
Q

Medullary pryramids

A

location of descending motor fibres

77
Q

Structures on inferior aspect of the brain? (3)

A

Optic chiasm
Uncus
Medullary pyramids

78
Q

Structures on medial aspect of the brain? (3)

A

Corpus collosum
Thalamus
Hypothalamus

79
Q

Corpus collosum

A

Fibres connecting two cerebral hemispheres

80
Q

Thalamus

A

Sensory relay station projecting to sensory cortex

81
Q

Hypothalamus

A

Essential centre for homeostasis

82
Q

Superior border of orbit? (2)

A

Frontal

Sphenoid

83
Q

Medial border of orbit (4)

A

Lacrimal
Maxillary
Ethmoid
Sphenoid

84
Q

Inferior border of orbit (2)

A

Maxillary

Zygomatic

85
Q

Lateral border of orbit (2)

A

Zygomatic

Sphenoid

86
Q

What structures lie medially and inferiorly to the orbit? What is their clinical relevance?

A

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
Q

Signs of a blowout fracture (4)

A

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
Q

In what bone are the superior orbital fissure, inferior fissure and optic canal found?

A

Sphenoid bone

89
Q

Contents of the superior part of the superior orbital fissure?

A

Lacrimal part CN V1
Frontal part CN V1
CN IV
Superior opthalmic vein

90
Q

Contents of inferior part of superior orbital fissure?

A

Nasocillary part CN V1
Superior branch of CN III
CN VI
Inferior branch of CN III

91
Q

Contents of inferior orbital fissure?

A

Inferior orbital vein

92
Q

Contents of the optic canal?

A

Optic nerve

Opthalmic artery

93
Q

Which foramen does the MMA pass through?

A

foramen spinosum

94
Q

What muscle depresses the jaw?

A

lateral pterygoid

95
Q

Which part of the orbicularis oris closes the eyes tight?

A

Orbital part

96
Q

Which cranial nerves pass through cavernous sinus? (4)

A

Trigeminal (V1, V2)
Abducens
Trochlear
Oculomotor

97
Q

Which cranial nerves carry special sensory nerves? (5)

A 
Olfactory
Optic
Vestibulocochlear
Facial
Glossopharyngeal
98
Q

Which pharyngeal arch is glossopharyngeal nerve derive from?

A

Arch 3

99
Q

What area do you insert a central venous catheter?

A

Carotid triangle

100
Q

Branches of CN VII that arise from petrous part of temporal bone?

A

Chorda tympanii
Greater petrosal
Nerve to stapedius

101
Q

Contents of the posterior triangle? (8)

A 
Accessory nerve CN XI
Cervical plexus
Roots of brachial plexus
Phrenic nerve
Subclavian artery
Suprascapular a
EJV
Transverse cervical
Occipital node
Supraclavicular node
102
Q

Superficial lymph nodes

A 
Submental
Submandibular
Pre-auricular
Post-auricular
Occipital
Cervical:
Anterior
Posterior
Superificial
103
Q

Deep lymph nodes

A

Jugulo-digastric
Jugulo-omohyoid
Supraclavicular

104
Q

Which cranial nerves carry parasympathetic fibres?

A

CN III
CN VII
CN IX
CN X

105
Q

Structures of forebrain?

A

Cerebrum

Diencephalon (hypothalamus, thalamus)

106
Q

Structures of hindbrain?

A

Pons
Medulla
Cerebellum

107
Q

General sommatic innervation of the external ear?

A

CN X
Cervical nerve (C2)
CN V3

108
Q

Signs of a cavernous sinus thrombosis? (4)

A

Orbital oedema
Pupillary dilation
drooping eyelids

109
Q

Innervation of levator palpabrae superioris?

A

CN III (total ptosis)

110
Q

Innervation of superior tarsal muscle?

A

Sympathetic fibres (partial ptosis)

111
Q

Parasympathetic functions associated with vagus nerve?

A

Smooth muscle in GI
Mucosal glands of pharynx
Cardiac conducting system
Smooth muscle of respiratory tract

112
Q

Sympathetic autonomic outflow

A

T1 - L2

Pre-ganglionic cell bodies in lateral horn of grey matter in spinal cord

113
Q

Parasympathetic autonomic outflow

A

CN III/VII/IX?X

S2 - S4

114
Q

Actions of sympathetic

A

Smooth muscle of blood vessels
Superior tarsal muscle (partial ptosis)
Decreases secretions from salivary and lacrimal glands

115
Q

Actions of parasympathetic

A

Smooth muscle of iris and ciliary body
Lacrimal glands
Salivary and mucosal glands

116
Q

Path of sympathetic fibres

A

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
Q

Horner’s syndrome (4)

A

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
Q

Which post ganglionic CN do parasympathetic fibres associate with?

A

CN V

119
Q

Parasympathetic ganglia (4)

A

Ciliary
Submandibular
Otic
Pterygopalatine

120
Q

Path of parasympathetic fibres associated with CN III

A 
Edinger-Westphal nucleus
Hitch-hike on CN III
Ciliary ganglion
CN V1
Ciliary body/sphincter pupillae
121
Q

Direct light relfex

A

Pupil that light is shone in constricts

122
Q

Consensual light reflex

A

Contralateral pupil constricts

123
Q

Path of parasympathetic fibres associated with CN VII

A

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
Q

Path of parasympathetic fibres associated with CN IX

A 
Medulla
Hitch-hike on CN IX
Otic ganglion
CN V3
Parotid gland
125
Q

Branches of the CN IX associated autonomic fibres?

A 
Tympanic nerve (sensory of middle ear)
Lesser petrosal nerve
126
Q

Path of parasympathetic fibres associated with CN X

A 
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
Q

CN associations with pharyngeal arches

A

CN V - 1
CN VII - 2
CN IX - 3
CN X - 4/6

128
Q

Muscular derivatives of pharyngeal arches

A 
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
Q

Lateral cleft lip

A

Failure for medial nasal prominence and maxillary prominence to fuse

130
Q

Cleft lip & cleft palate

A

Combined with failure of palatal shelves to meet in midline

ESA 3 (5 decks)

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