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Anatomy > Head & Neck Practical & Exam II > Flashcards

Head & Neck Practical & Exam II Flashcards

1
Q

What are the branches of the cervical plexus?

A

Ansa cervicalis (C1, C2)

Nerve point:

  • greater auricular (C2, C3)
  • lesser occipital (C2, C3)
  • transverse cervical (C2, C3)
  • lateral, intermediate, and medial supraclavicular (C3, C4)

Phrenic (C3 - C5)

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2
Q

What are the branches of the external carotid artery?

A 
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior Auricular
Superficial Temporal
Maxillary
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3
Q

What are the branches of the thyrocervical trunk (off of subclavian artery)?

A

Supraclavicular
Transverse cervical
Inferior thyroid
Ascending thyroid

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4
Q

What nerve(s) innervate(s) the platysma?

A

CN VII

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5
Q

What nerve(s) innervate(s) the trapezius?

A

CN XI

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6
Q

What nerve(s) innervate(s) the sternocleidomastoid?

A

CN XI

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7
Q

What is the function of the posterior, middle, and anterior scalenes?

A

Lateral bending of the neck and accessory breathing

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8
Q

What nerve(s) innervate(s) the mylohyoid?

A

nerve to mylohyoid (V3)

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9
Q

What nerve(s) innervate(s) the digastric?

A

anterior belly - nerve to mylohyoid (V3)

posterior belly - CN VII

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10
Q

What nerve(s) innervate(s) the stylohyoid?

A

CN VII

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11
Q

What nerve(s) innervate(s) the geniohyoid?

A

C1 via CN XII

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12
Q

What nerve(s) innervate(s) the thyrohyoid?

A

C1 via CN XII

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13
Q

What nerve(s) innervate(s) the sternohyoid?

A

ansa cervicalis

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14
Q

What nerve(s) innervate(s) the sternothyroid?

A

ansa cervicalis

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15
Q

What nerve(s) innervate(s) the omohyoid?

A

ansa cervicalis

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16
Q

What is the one infrahyoid muscle that is not innervated by the ansa cervicalis?

A

thyrohyoid (C1 via CN XII)

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17
Q

What are the layers of fascia of the neck?

A

superficial fascia –> investing fascia –> prevertebral fascia (w/ alar fascia)/carotid sheath/pretracheal fascia

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18
Q

What muscles are enclosed within the investing fascia?

A

Trapezius and sternocleidomastoid

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19
Q

What is the function of the genioglossus? What nerve innervates it?

A

protrude tongue; CN XII (this is what is evidently affected in a CN XII lesion)

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20
Q

What is the function of the palatoglossus? What nerve innervates it?

A

elevate tongue and depress soft palate; CN X

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21
Q

What is the function of the styloglossus? What nerve innervates it?

A

retract and elevate posterior part of tongue; CN XII

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22
Q

What is the function of the hyoglossus? What nerve innervates it?

A

flatten the tongue; CN XII

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23
Q

What three tongue muscles are innervated by the hypoglossal nerve? What is the other muscle innervated by?

A

genioglossus, styloglossus, hyoglossus; palatoglossus - CN X

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24
Q

What is the function of the geniohyoid? What nerve innervates it?

A

shortens floor of mouth; C1 via CN XII

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25
Q

What muscle forms the boundary between the oral cavity and the oropharynx?

A

palatoglossus

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26
Q

What is the name for the space between the gingiva and the teeth? What is its sensory innervation in this area?

A

Vestibule

exterior maxillary gingiva - superior alveolar nerve
exterior mandibular gingiva - inferior alveolar nerve
interior hard palate (maxillary) gingiva - greater palatine nerve
interior lingual (mandibular) gingiva - lingual nerve

upper labial mucosa - labial branches of infraorbital nerve (V2)
lower labial mucosa - labial branches of mental nerve (V3)

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27
Q

What provides sensory innervation to the cheek?

A

Buccal branches of V3 aka long buccal nerve

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28
Q

What provides sensory innervation to the exterior maxillary gingiva?

A

superior alveolar nerve

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29
Q

What provides sensory innervation to the exterior mandibular gingiva?

A

inferior alveolar nerve

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30
Q

What provides sensory innervation to the interior hard palate (maxillary) gingiva?

A

greater palatine nerve

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31
Q

What provides sensory innervation to the interior lingual (mandibular) gingiva?

A

lingual nerve

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32
Q

What provides sensory innervation to the upper labial mucosa?

A

labial branches of infraorbital nerve (V2)

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33
Q

What provides sensory innervation to the lower labial mucosa?

A

labial branches of mental nerve (V3)

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34
Q

What nerve goes directly under the submandibular duct?

A

Lingual nerve (hypoglossal nerve is more inferior but still closely underneath)

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35
Q

What type of innervation does the lingual nerve provide to the tongue?

A

General sensation to anterior 2/3 of tongue

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36
Q

What type of innervation does the chorda tympani provide?

A

Taste to anterior 2/3 of tongue + parasympathetic innervation of submandibular and sublingual glands

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37
Q

What type of innervation does the glossopharyngeal nerve provide to the tongue?

A

general sensation and taste to posterior 1/3 of tongue

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38
Q

What provides sensation to the soft palate?

A

Lesser palatine nerve

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39
Q

What provides sensation to the hard palate?

A

Greater palatine nerve

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40
Q

What provides sensation to the primary palate (most anterior portion of hard palate)?

A

Nasopalatine nerve (V2)

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41
Q

What nerve is associated with the 1st pharyngeal arch?

A

Lingual nerve (V3)

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42
Q

What nerve is associated with the 2nd pharyngeal arch?

A

chorda tympani (VII)

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43
Q

What nerve is associated with the 3rd pharyngeal arch?

A

glossopharyngeal (XII)

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44
Q

What nerve is associated with the 4th pharyngeal arch?

A

vagus (X)

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45
Q

What embryological structure are the tongue muscles derived from?

A

Occipital somites

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46
Q

What are the 5 soft palate muscles?

A 
tensor veli palatini
levator veli palatini
palatopharyngeus
palatoglossus
uvula muscles
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47
Q

What nerve supplies the soft palate muscles? Which muscle is the exception?

A

vagus nerve, except tensor veli palatini (supplied by V3)

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48
Q

Where are the palatine tonsils located?

A

between the palatoglossus and the palatopharyngeus

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49
Q

Where are the pharyngeal tonsils located?

A

Pharyngeal recess (above torus tubarius)

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50
Q

Where are the lingual tonsils located?

A

Posterior tongue behind foramen cecum

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51
Q

What nerve is at risk in a palatine tonsillectomy?

A

Glossopharyngeal nerve

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52
Q

What lymph node becomes enlarged in tonsillitis?

A

jugulodigastric (deep cervical node)

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53
Q

What muscle goes around the hamulus of the medial pterygoid plate?

A

Tensor veli palatini (has a shiny tendon because of this)

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54
Q

What does the tensor veli palatini prevent during eating?

A

Regurgitation of food into the nasopharynx

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55
Q

Where does the tensor veli palatini originate?

A

Scaphoid fossa on medial pterygoid plate

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56
Q

What nerve innervates the laryngeal muscles?

A

vagus

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57
Q

What muscles are used to push food back into the oropharynx by elevating and retracting the tongue? What are their innervations?

A

Mylohyoid (V3), styloglossus (XII), palatoglossus (X)

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58
Q

What muscles tense and elevate the soft palate when swallowing? What are their innervations?

A

Levator veli palatini (X) and tensor veli palatini (V3)

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59
Q

What muscles close the laryngeal inlet when swallowing? What are their innervations?

A

aryepiglottic and oblique arytenoids (recurrent laryngeal nerve from X)

60
Q

What muscles close the glottis when swallowing? What are their innervations?

A

transverse arytenoids, oblique arytenoids, lateral cricoarytenoid (recurrent laryngeal nerve from X)

61
Q

What muscles elevate the larynx and pharynx when swallowing? What are their innervations?

A

stylopharyngeus (IX), salpingopharyngeus (X), and palatopharyngeus (X)

62
Q

What is the innervation for the muscles of mastication?

A

V3

63
Q

What is the innervation for the muscles of the tongue?

A

CN XII, except for palatoglossus, which is CN X

64
Q

What is the innervation for the muscles of the soft palate?

A

CN X, except for the tensor veli palatini, which is V3

65
Q

What is the innervation for the muscles of the pharynx?

A

CN X, except for stylopharyngeus, which is CN IX

66
Q

What does the middle constrictor attach to?

A

Hyoid bone

67
Q

What does the superior constrictor attach to?

A

buccinator (pterygomandibular raphe) and pharyngeal tubercle on base of skull

68
Q

What does the inferior constrictor attach to?

A

Thyroid and cricoid cartilages

69
Q

What passes through the gap above the superior constrictor?

A

Eustachian tube

70
Q

What passes through the gap between the superior and middle constrictors?

A

glossopharyngeal nerve, stylopharyngeus, stylohyoid muscle

71
Q

What passes through the gap between the middle and inferior constrictors?

A

internal laryngeal nerve

72
Q

What is the name of the bulge where the submandibular duct opens into the mouth?

A

Sublingual caruncle

73
Q

What is the main function of the glossopharyngeal nerve (CN IX)?

A

Sensory innervation to posterior 1/3 of tongue and most of oropharynx (including supplying carotid sinus and carotid body)

74
Q

What is the primary function of the vagus nerve? Secondary?

A

Motor innervation to muscles of palate, larynx, and pharynx; sensation to part of oropharynx and all of larynx and pharynx

75
Q

What is C1 a landmark for?

A

occlusal plane

76
Q

What is C2 a landmark for?

A

angle of mandible

77
Q

What is C3 a landmark for?

A

hyoid bone

78
Q

What is C4/C5 a landmark for?

A

thyroid cartilage

79
Q

What is C6 a landmark for?

A

cricoid cartilage

80
Q

Where is the vallecula?

A

between the back of the tongue and the epiglottis

81
Q

Where is the piriform recess?

A

Superior to the esophagus/lateral to the pharynx

82
Q

Where is the ventricle?

A

The space between the true and the false vocal cords

83
Q

Where is the rima glottidis?

A

The space between the true vocal cords

84
Q

Where is the vestible (in pharynx)?

A

Area above the true and false vocal cords (bounded by the quadrangular membrane, epiglottis, and arytenoid cartilages)

85
Q

Where are the aryepiglottic folds

A

Overlying the quadrangular membrane

86
Q

Which membrane gives rise to the false vocal cords?

A

quadrangular membrane

87
Q

Which membrane has an upper free edge that forms the true vocal cords?

A

conus elasticus

88
Q

Which membrane is pierced by the internal laryngeal nerve and superior laryngeal artery?

A

thyrohyoid membrane

89
Q

Which membrane is incised to create an emergency airway?

A

cricothyroid membrane

90
Q

Which membrane has an upper free edge known as the aryepiglottic fold?

A

quadrangular membrane

91
Q

Which laryngeal muscle has different innervation from the others?

A

cricothyroid (external laryngeal)

92
Q

Which laryngeal muscle abducts the vocal cords?

A

posterior cricoarytenoid

93
Q

Which laryngeal muscle is attached directly to the vocal ligaments?

A

vocalis

94
Q

Which laryngeal muscles adduct the vocal cords?

A

lateral cricoarytenoid and transverse interarytenoid

95
Q

Which laryngeal muscle relaxes the vocal cords?

A

thyroarytenoid

96
Q

Which laryngeal muscle widens the laryngeal inlet?

A

thyroepiglottic

97
Q

Which laryngeal muscles are likely to be tagged on the exam?

A

posterior cricoarytenoid or cricothyroid

98
Q

What is the function of the posterior cricoarytenoid?

A

abduct vocal cords

99
Q

What is the function of the cricothyroid?

A

tense vocal cords

100
Q

What is the function of the lateral cricoarytenoid?

A

adduct vocal cords for whispering

101
Q

What is the function of the thyroarytenoid and vocalis?

A

relax vocal cords (vocalis relaxes segments of vocal cords to adjust pitch)

102
Q

What is the function of the thyroepiglottic muscle?

A

widen laryngeal inlet (by drawing epiglottic cartilage anteriorly)

103
Q

The thyroepiglottic muscle is made from the superior fibers of what other muscle?

A

thyroarytenoid

104
Q

What is the function of the oblique and transverse arytenoids?

A

narrow laryngeal inlet and adduct the vocal cords

105
Q

What is the function of the aryepiglottic muscle?

A

narrow laryngeal inlet (like string on a duffle bag)

106
Q

What is the space below the glottis (vocal cords + space in between them)?

A

infraglottic cavity

107
Q

What nerve provides sensation above the vocal cords?

A

internal laryngeal nerve (branch of superior laryngeal from vagus; pierces thyrohyoid membrane)

108
Q

What nerve provides sensation below the vocal cords?

A

recurrent laryngeal nerve (branch of vagus)

109
Q

All but one of the laryngeal muscles receive motor innervation from ___.

A

recurrent laryngeal nerve

110
Q

What is the one muscle that does not receive motor innervation from the recurrent laryngeal nerve? What is its innervation?

A

Cricothyroid - external laryngeal nerve (branch of superior laryngeal from vagus)

111
Q

What nerve provides sensation to the piriform recess?

A

internal laryngeal nerve (branch of superior laryngeal from vagus; pierces thyrohyoid membrane)

112
Q

What is the afferent nerve for the cough reflex?

A

Internal laryngeal nerve (branch of superior laryngeal from vagus)

113
Q

What nerve runs parallel to the superior thyroid artery?

A

External laryngeal nerve

114
Q

What are the main nerves that supply sensation to the outer ear? Where do they each cover?

A

Lesser occcipital (C2) - upper outer ear; greater auricular (C2, C3) - lobule; auriculotemporal branch of mandibular nerve (V3) - tragus and surrounding area

115
Q

What are the secondary nerves that supply sensation to the outer ear? Where do they each cover?

A

Facial nerve (VII) - entire inside of outer ear (medial to helix); vagus - concha

116
Q

What nerves provide sensation to the external part of the tympanic membrane?

A

CN V3, CN VII, CN X

117
Q

What nerve provides sensation to the internal part of the tympanic membrane?

A

Glossopharyngeal

118
Q

Where is the light reflex seen on a right ear? On a left ear?

A

Right - 5 o’clock; left - 7 o’clock

119
Q

What ear structures come from the 1st pharyngeal arch?

A

Malleus, incus, tensor tympani

120
Q

What ear structures come from the 2nd pharyngeal arch?

A

stapes and stapedius

121
Q

What are the two muscles within the middle ear, and what are they innervated by?

A

Tensor tympani (V3); stapedius (VII)

122
Q

What is the name of the procedure to reduce fluid buildup in the middle ear?

A

Myringotomy

123
Q

What structure(s) are found in/on the lateral wall of the middle ear?

A
  • tympanic membrane
  • handle of malleus (with tensor tympani attached)
  • chorda tympani
124
Q

What structure(s) are found in/on the superior wall of the middle ear?

A

tegmen tympani (bone)

125
Q

What structure(s) are found in/on the medial wall of the middle ear?

A
  • lateral semi-circular canal
  • facial nerve
  • promontory + tympanic plexus (between CN VII and tympanic nerve from CN IX)
  • oval window (for stapes)
  • round window
126
Q

What structure(s) are found in/on the inferior wall of the middle ear?

A
  • internal jugular

- (entrance of tympanic nerve from CN IX)

127
Q

What structure(s) are found in/on the posterior wall of the middle ear?

A
  • aditus to mastoid air cells

- pyramidal eminence

128
Q

What structure(s) are found in/on the anterior wall of the middle ear?

A
  • internal carotid
  • opening of Eustachian tube
  • semi-canal for tensor tympani
129
Q

What is the presentation of Meniere’s Syndrome? What is it’s cause?

A
  • vertigo
  • progressive hearing loss
  • persistent ringing and sense of pressure in ear

from excess endolymph in ear

130
Q

Defects or damage to the cochlea or cochlear nerve leads to what type of hearing loss?

A

Sensorineural

131
Q

Aging and persistent exposure to excessively loud sounds leads to what type of hearing loss?

A

high tone hearing loss

132
Q

Which hair cells are the most susceptible to damage? What does this lead to?

A

inner hair cells at basal end of cochlea –> difficult to hear consonants (s, f, h, th, k, p) and difficult to hear in loud situations

133
Q

Loss of sound conduction from the external or middle ear due to impaired movement of the oval or round window leads to what type of hearing loss?

A

Conductive

134
Q

Between what two embryological structures was the tensor tympani formed?

A

1st pharyngeal cleft and 1st pharyngeal pouch

135
Q

What ear structure comes from the 1st pharyngeal cleft?

A

external acoustic meatus

136
Q

What ear structures come from the 1st pharyngeal pouch?

A

Eustachian tube and middle ear cavity

137
Q

What ear structure comes from the otic placcode?

A

membranous labyrinth in inner ear

138
Q

What type of motion do the semi-circular canals respond to?

A

rotational motion

139
Q

What type of motion do the utricle and saccule respond to?

A

gravity and linear motion

140
Q

What plane of motion does the utricle register?

A

horizontal

141
Q

What plane of motion does the saccule register?

A

vertical

142
Q

In a CT of the ear? What two bones look like an ice cream cone?

A

ice cream scoop - head of malleus

cone - incus

143
Q

What blood vessel does the ansa cervicalis run around?

A

internal jugular vein

144
Q

Where is the “danger space” located?

A

Between alar fascia and prevertebral fascia

145
Q

The superior laryngeal artery goes along with which nerve?

A

internal laryngeal nerve

Anatomy (5 decks)

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