Head, Neck, Trunk 1 to 119 Flashcards by Johnny B

The skull, composed of ___ bones, consists of the cranial bones (cranium) and the facial bones (face)

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The skull forms the large cranial cavity and smaller cavities, including the __ and orbits (eye sockets)

nasal cavity

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Certain skull bones contain mucous membrane lined cavities called

paranasal sinuses

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The only moveable bones of the skull are the

mandible and the ear ossicles.

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Immovable joints called ___ hold the skull bones together

sutures

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The skull is the skeleton of the head. A series of bones forms its two parts:

Neurocranium

Facial skeleton

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Cranial vault or “brain box”

Provides case for brain, cranial meninges, cranial nerves, and associated structures

Neurocranium

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Viscerocranium or splanchnocranium

Anterior part of the skull containing the orbits, nasal cavities, maxilla (upper jaw), mandible (lower jaw)

Facial skeleton

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The neurocranium in adults is formed by the

Frontal bone (1)
Parietal bones (2)
Temporal bones (2) 
Occipital bone (1) 
Sphenoid bone (1) 
Ethmoid bone (1)

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Frontal bone (1)
Parietal bones (2)
Temporal bones (2) 
Occipital bone (1) 
Sphenoid bone (1) 
Ethmoid bone (1)

Bones of the neurocranium

Most are largely flat, curved bones united by fibrous interlocking sutures

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The space in the skull within the neurocranium occupied by the brain

Cranial vault

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Cranial vault is bound by:

Calvaria

Basicranium

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domelike roof of the cranium made up of the superior portions of the frontal bone, occipital bone, and parietal bones

Calvaria (skullcap)

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the floor of the cranium, basically comprising the occipital, sphenoid, temporal (petrous portion), vomer, palatine(s), and some portion of the maxillae

Basicranium

AKA cranial base

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Their inner surfaces attach to membranes that stabilize the positions of the brain, blood vessels, and nerves.

The outer surfaces of cranial bones provide large areas of attachment for muscles that move the various parts of the head.

Facial bones form the framework of the face and protect and provide support for the nerves and blood vessels in that area.

Cranial bone functions (protect the brain)

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Cranial and facial bones together protect and support the ___

special sense organs

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protect brain and house ear ossicles

muscle attachment for jaw, neck and facial muscles

8 Cranial bones

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protect delicate sense organs – smell, taste, vision

support entrances to digestive and respiratory systems

14 Facial bones

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8 Cranial Bones?

Frontal
Parietal (2)
Temporal (2)
Occipital
Sphenoid
Ethmoid

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Slide 10 for bones of the skull

tight

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Forms forehead, roof of orbits, and anterior cranial floor

Frontal suture gone by age 6 (not closed = metopic suture)

Supraorbital margin and frontal sinus

Frontal Bone

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sides and roof of cranial cavity

Parietal

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zygomatic process forms part of arch
external auditory meatus
mastoid process
styloid process
stylomastoid foramen (CN VII)
mandibular fossa (TMJ)
petrous portion (CN VIII)

Temporal

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carotid foramen (carotid artery)
jugular foramen (jugular vein)

Temporal

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foramen magnum occipital condyles external occipital protuberance attachment for ligamentum nuchae superior and inferior nuchal lines

Occipital

Located in the middle part of the base of skull Pterygoid processes are attachment sites for jaw muscles

Sphenoid bone

Called the keystone bone because it articulates with all other cranial bones

Sphenoid bone

Greater wings form the ___ floor of the cranium and lateral part of the skull (this part can be viewed externally) (sphenoid)

anterolateral

Body is a cubelike portion holding sphenoid sinuses Lesser wings form posterior part of ___ and part of cranium floor (sphenoid)

orbit of eye

____ processes are attachment points for some muscles that move the mandible (lateral and medial pterygoid muscles on each side) (sphenoid)

Pterygoid

___ transmits optic nerve (CN II) and ophthalmic artery | sphenoid

Optic foramen

____ is the passageway for oculomotor, trochlear, abducens, and ophthalmic nerves (CNs III, IV, VI, and V1) (sphenoid)

Superior orbital fissure

Maxillary branch of the trigeminal (CN V2) passes through the ____ (sphenoid)

foramen rotundum

Foramen ___ transmits the mandibular nerve (CN V3) | sphenoid

ovale

Mnemonic for trigeminal nerve foramina ? | sphenoid

Standing Superior orbital fissure V1 Room Foramen rotundum V2 Only Foramen ovale V3

Sella turcica holds pituitary gland. 3 landmarks? | sphenoid

Anterior ridge = tuberculum sellae Central depression = hypophyseal fossa Posterior ridge = dorsum sellae

forms part of the anterior portion of the cranial floor, the medial wall of the orbits, the superior portion of the nasal septum, and most of the superior side walls of the nasal cavity. It is a major superior supporting structure of the nasal cavity

Ethmoid Bone

attaches to the falx cerebri (the dura mater subdivision that separates the right and left cerebral hemispheres)

Crista galli

___ foramina through which olfactory nerves pass (CN I)

Olfactory

contain ethmoid sinuses

Lateral masses

upper part of nasal septum

Perpendicular plate (of ethmoid bone)

(AKA turbinates)

Superior and middle nasal conchae

participate in sense of smell (olfactory receptors)

Superior conchae

Increase vascular surface: warms air | Causes inhaled air to swirl and impact mucus: filters air

Superior and middle nasal conchae

14 Facial Bones

``` Nasal (2) Maxillae (2) Zygomatic (2) Mandible (1) Lacrimal (2) Palatine (2) Inferior nasal conchae (2) Vomer (1) ```

house the teeth

Maxillae and mandible

Form the skeleton of the upper jaw | Fixed to the cranial base

maxillae

Forms the skeleton of the lower jaw | Articulates with the cranial base at the temporomandibular joints (TMJs), and is moveable

mandible

Alveolar processes of the maxillae and mandible comprise

The sockets (termed alveoli) Supporting bone that house the teeth: Maxillary teeth Mandibular teeth

___ hold upper teeth | maxillary bones

Alveolar processes

___ is lack of union of maxillary bones | maxillary bones

Cleft palate

Cheekbones Lateral wall of orbit along with sphenoid Part of zygomatic arch along with part of temporal

Zygomatic Bones

part of medial wall of orbit lacrimal fossa houses lacrimal sac

Lacrimal bones

Separate bones (not part of ethmoid) Same function as superior conchae, except not involved in sense of smell (only superior nasal conchae are)

Inferior nasal concha (AKA turbinate)

The ___ transits the mandibular foramen. Inferior alveolar nerve anesthesia is a local anesthetic technique used by dentists and physicians. The ___ is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. (mandible)

inferior alveolar nerve

Body, angle and rami Condylar and coronoid processes Alveolar processes for lower teeth Mandibular and mental foramen

Mandible

“L-shaped” (more like two Ls back-to-back, or an upside-down T): one end is back part of hard palate, other end is part of orbit

Palatine

posterior part of nasal septum

Vomer

Vertical partition that divides nasal cavity into left and right sides Formed by vomer, perpendicular plate of ethmoid and septal cartilage

Nasal Septum

The orbits contain the eyeballs and associated structures and are formed by portions of seven bones of the skull:

``` Maxillary Frontal Zygomatic Ethmoid Lacrimal Sphenoid Palatine ```

Five important foramina are associated with each orbit:

``` Optic foramen Superior orbital fissure Inferior orbital fissure Supraorbital foramen Lacrimal fossa ```

Bones of the Orbit: Roof is ___

frontal and sphenoid

Lateral wall is ___ | bones of the orbit

zygomatic and sphenoid

Floor is ___ | bones of the orbit

maxilla, zygomatic and palatine

Medial wall is ____ (4 bones) | bones of the orbit

maxilla, lacrimal, ethmoid and sphenoid

immovable joints found only between skull bones and hold skull bones together

Sutures

Sutures of primary importance are:

Coronal Sagittal Lambdoidal Squamous

___ suture unites parietal and occipital

Lambdoid

___ suture unites 2 parietal bones

Sagittal

___ unites frontal and both parietal bones

Coronal suture

___ unites parietal and temporal bones

Squamous suture

dense connective tissue membrane-filled spaces between the cranial bones of fetuses and infants. They remain unossified at birth but close early in a child's life

fontanels

Anterior Posterior Anterolaterals Posterolaterals

Major fontanels

They enable the fetal skull to modify its size and shape as it passes through the birth canal They permit rapid growth of the brain during infancy.

Fontanels

cavities in bones of the skull that communicate with the nasal cavity.

Paranasal Sinuses

They are lined by mucous membranes and also serve to lighten the skull and serve as resonating chambers for speech.

Paranasal Sinuses

Cranial bones containing the ___ are the frontal, sphenoid, ethmoid, and maxillae.

paranasal sinuses

occurs when membranes of the paranasal sinuses become inflamed due to infection or allergy.

sinusitis

Paired cavities in ethmoid, sphenoid, frontal and maxillary | Lined with mucous membranes and open into nasal cavity

Paranasal Sinuses

Muscles of mastication (Muscles that Move the Mandible). Arise from skull and insert on mandible CN V (Mandibular division)

Masseter, temporalis and pterygoids

Protracts, elevates or retracts mandible

Temporalis and Masseter elevate the mandible (biting) Temporalis retracts

Protracts mandible Depresses the mandible (opens the jaw)

Lateral pterygoid

elevates and protracts mandible

Medial pterygoid

Together, they move jaw side-to-side to grind food

Medial pterygoid Lateral pterygoid

4 extrinsic mm arise elsewhere, but insert into tongue

Genioglossus Styloglossus Palatoglossus Hyoglossus

Together move tongue in various directions | Intubation is necessary during anesthesia since ___ relaxes and tongue falls posteriorly blocking airway

Genioglossus

Originate on bones of the skull and insert onto skin or other muscles Encircle eyes, nose and mouth Express emotions All are innervated by the facial nerve (CN VII)

Muscles of Facial Expression

Branches of CN VII are:

``` Temporal Zygomatic Buccal Marginal mandibular Cervical ```

Motor innervation to each muscle of facial expression is provided by a branch (sometimes two branches) of the facial nerve in the vicinity of the muscle

Mnemonic for facial nerve branches To Zanzibar By Motor Car Temporal Zygomatic Buccal Marginal mandibular Cervical

The terminal branches of CN VII arise from the ___ plexus within the parotid gland, emerge from the gland, and radiate in a generally anterior direction

parotid

Muscles of Facial Expression

Orbicularis oculi Orbicularis oris Buccinator

closes the eye

Orbicularis oculi

puckers the mouth

Orbicularis oris

forms the muscular portion of the cheek and assists in whistling, blowing, sucking and chewing

Buccinator

___ opens the eye (NOT a muscle of facial expression)

Levator palpebrae superioris

Origin: Occipital belly: occipital bone Frontal belly: galea aponeurotica Insertion: Occipital belly: galea aponeurotica Frontal belly: fascia and skin superior to eye and nose

Occipitofrontalis

Action: overall, elevates (raises) eyebrows and wrinkles skin of forehead horizontally as in look of surprise Innervation: facial nerve (CN VII): temporal branch

Occipitofrontalis

Origin: (both) zygomatic bone Insertion: Major: skin at angle of mouth and orbicularis oris Minor: upper lip

Zygomaticus major and Zygomaticus minor

Action: Major: draws angle of mouth superiorly and laterally, as in smiling Minor: Raises (elevates) upper lip, exposing maxillary teeth Innervation: facial nerve (CN VII): zygomatic branch and buccal branch

Zygomaticus major and Zygomaticus

Origin: N/A Insertion: skin at angle of mouth and orbicularis oris

Levator labii superioris

Action: raises (elevates) upper lip Innervation: facial nerve (CN VII): zygomatic branch

Levator labii superioris

Origin: N/A Insertion: skin of lower lip

Depressor labii inferioris

Action: depresses (lowers) lower lip Innervation: facial nerve (CN VII): marginal mandibular branch

Depressor labii inferioris

Origin: N/A Insertion: angle of the mouth

Depressor anguli oris

Action: draws angle of mouth laterally and inferiorly Innervation: facial nerve (CN VII): marginal mandibular branch

Depressor anguli oris

Origin: muscle fibers surrounding the opening of the mouth Insertion: skin at the corner of the mouth

Orbicularis oris

Action: closes and protrudes the lips; compresses lips against teeth; shapes lips during speech Innervation: facial nerve (CN VII): buccal branch

Orbicularis oris

Origin: N/A Insertion: orbicularis oris

Buccinator

Action: presses cheeks against teeth and lips, as in whistling, blowing, sucking; draws corner of mouth laterally; assists in mastication (chewing) by keeping food between the teeth Innervation: facial nerve (CN VII): buccal branch

Buccinator

Origin: N/A Insertion: skin at the angle of the mouth

Risorius

Action: draws angle of the mouth laterally, as in grimacing Innervation: facial nerve (CN VII): buccal branch

Risorius

Origin: N/A Insertion: skin of chin

Mentalis

Action: elevates and protrudes the lower lip and pulls up skin of chin, as in pouting Innervation: facial nerve (CN VII): marginal mandibular branch

Mentalis

Origin: N/A Insertion: mandible, muscle around angle of mouth, and skin of lower face

Platysma

Action: draws outer part of lower lip inferiorly and posteriorly as in pouting; depresses mandible Innervation: facial nerve (CN VII): cervical branch

Platysma

Origin: N/A Insertion: circular path around orbit

Orbicularis oculi

Action: closes and squints eye (orbital part), depresses upper eyelid and elevates lower eyelid Innervation: facial nerve (CN VII): temporal branch and zygomatic branch

Orbicularis oculi

Origin: N/A Insertion: skin of eyebrow

Corrugator supercilii

Action: draws eyebrow inferiorly and medially, wrinkles skin of forehead vertically as in frowning Innervation: facial nerve (CN VII): temporal branch

Corrugator supercilii

Cutaneous innervation of the head and face

Branches of the trigeminal nerve (CN V) V1 = ophthalmic V2 = maxillary V3 = mandibular

Face dermatome?

CN V (trigeminal nerve)

Occipital protuberance (occipital protuberance is the prominent feature within the dermatome area, which is generally the area normally covered by hair)

C2 (dermatome)

Gentleman’s collar

C3 (dermatome)

Layer of the Scalp(superficial to deep)

``` Skin Connective tissue (subcutaneous) Aponeurosis Loose connective Pericranium ```

The first three layers (skin, connective tissue, and ___) are intimately connected and move as a unit, such as when wrinkling the forehead and moving the scalp.

aponeurosis

The ____ is somewhat like a sponge because of its many potential spaces that may distend with fluid resulting from injury or infection. This layer is termed the danger area of the scalp because pus, blood, or infection can spread easily in it.

loose connective tissue

The pericranium is a layer of dense irregular connective tissue that forms the external periosteum of the ____.

calvaria

unique component of the axial skeleton because it does not articulate with any other bones.

hyoid bone

The hyoid bone consists of a horizontal body and paired projections, the lesser and greater ___

horns

U-shaped single bone Articulates with no other bone of the body Suspended by ligament and muscle from skull Supports the tongue and provides attachment for tongue, neck and pharyngeal muscles

hyoid bone

arises from sternum and clavicle and inserts onto mastoid process of the temporal bone innervated by cranial nerve XI (spinal accessory)

Sternocleidomastoid

contraction of both flexes the cervical vertebrae (so chin approaches manubrium) and extends head (thrust chin forward, keeping head level) contraction of one, laterally flexes the neck and rotates face in opposite direction

Sternocleidomastoid

upper back of the neck) is the triangular area inferior to the occipital region of the head

suboccipital region

Rectus capitis posterior, both major and minor Obliquus capitis, both inferior and superior

The four small muscles in the suboccipital region

Slide 76 ya heard

AIGHT

Two groups of muscles are associated with the anterior aspect of the neck, being named for their position relative to the hyoid bone:

Suprahyoid muscles | Infrahyoid muscles

Both groups of muscles stabilize the hyoid bone, allowing it to serve as a firm base on which the tongue can move

Suprahyoid muscles | Infrahyoid muscles

Digastric Stylohyoid Mylohyoid Geniohyoid

The suprahyoid muscles

As a group, they elevate the hyoid bone, floor of the oral cavity, and tongue during swallowing

Digastric Stylohyoid Mylohyoid Geniohyoid

Omohyoid Sternohyoid Sternothyroid Thyrohyoid

Infrahyoid muscles

Most of the infrahyoid muscles depress the hyoid bone, and some move ___

the larynx during swallowing and speech

Attach cervical vertebrae to uppermost ribs Flex, laterally flex and rotate the head Participate in forced inspiration Innervated by cervical spinal nerves C3 – C8

Scalene Muscle Group

largest artery of the body

Aorta

2 coronary arteries supply myocardium

ascending aorta

branches to the arms and head

arch of aorta

branches into right common carotid and right subclavian

brachiocephalic trunk

left subclavian and left common carotid arise ____

independently

pericardium, esophagus, bronchi, diaphragm, intercostal and chest muscles, mammary gland, skin, vertebrae and spinal cord supplied by?

thoracic aorta

Are direct branches of the subclavian arteries Course through transverse foramina of cervical vertebrae Unite to form the unpaired basilar artery on ventral surface of the pons

Vertebral arteries

Are branches of the common carotid artery Enter skull through the carotid canal(s) (carotid foramen (foramina)) To inferior anterior surface of the brain

Internal carotid arteries

supplies structures external to skull as branches of maxillary and superficial temporal branches

External carotid arteries

supply eyeballs and parts of brain

Internal carotid arteries (contribute to Circle of Willis)

The arterial circle of Willis is an

anastamosis

Circle of Willis Connects the posterior and anterior blood supplies to the brain by interconnecting the branches of the ____ artery with branches of the internal carotid arteries

basilar

Important in controlling blood supply to the brain when pressure varies in one or more of the major arteries Provides alternate pathways for blood to travel in the event of blockage or occlusion

Arterial circle of Willis

drain the head and neck into the superior vena cava

External and Internal jugular veins

empty into internal jugular vein

Dural venous sinuses

The thoracic duct drains lymph into venous blood at the junction of the

left internal jugular and left subclavian veins.

The right lymphatic duct, lymph drains into venous blood at the junction of the right internal jugular and right subclavian veins.

right internal jugular and right subclavian veins.

Slide 88

for lymph drainage

supplies the skin and muscles of the head, neck, and upper part of the shoulders

The cervical plexus

Ventral rami of spinal nerves (C1 to C5)

The cervical plexus

In addition to this “local” innervation, the ____ innervates the diaphragm

phrenic nerve (C3-C5)

supplies the skin of the neck and scalp posterosuperior to the auricle

Lesser occipital nerve

skin over the parotid gland, mastoid process, auricle, and the area of skin from the angle of the mandible to the mastoid process (posterioinferior part of the face and inferior part of the auricle)

Great auricular nerve

Check out the weird dude on slide 92

thumbs up

The greater occipital nerve is NOT a branch of the cervical plexus (which the lesser occipital nerve is)

pertinent negative, I reckon

After arising from between vertebrae C1 and C2, emerges beneath the obliquus capitis inferior muscle, passes through the semispinalis capitis and trapezius muscles, and ascends to supply the skin along the posterior part of the scalp to the vertex

Greater occipital nerve

Disorder of the nerve is one of the causes of occipital neuralgias, as it can be entrapped at the ____ muscle (greater occipital nerve)

obliquus capitis inferior

Damage to the spinal cord above the origin of the ____ causes respiratory arrest.

phrenic nerves (C3-C5) Breathing stops because the phrenic nerves no longer send impulses to the diaphragm.

The mandible articulates with the temporal bone to form the

temporomandibular joint

______ syndrome is dysfunction to varying degrees of the temporomandibular joint. Causes appear to be numerous and the treatment is similarly variable.

Temporomandibular joint (TMJ)

Temporal Masseter Lateral pterygoid Medial pterygoid

TMJ MUSCLES

Check out the neck triangles on slide 99 - 108

now go do some shrugs

The ____ derives its name from the fact that it contains the subclavian artery and subclavian vein. This same triangle is also called the supraclavicular triangle because it is superior to the clavicle.

subclavian triangle

Glandular area sometimes called the digastric triangle. The submandibular gland nearly fills this triangle. It also contains the facial artery and facial vein.

Submandibular triangle

Important components include the common carotid artery, internal/external carotid arteries, internal jugular vein, vagus nerve, thyroid gland, and larynx

carotid triangle

contains infrahyoid muscles, viscera of the neck, such as the thyroid and parathyroid glands, and the trachea and larynx

The muscular triangle

are “just passing through” on their way to innervate a more remote part of the body. They comprise the vagus nerve and phrenic nerve.

Transient nerves of the neck

The ____, along with the sternum and ribs, makes up the trunk of the skeleton.

vertebral column

The __ bones of the vertebral column are arranged into five regions: cervical, thoracic, lumbar, sacral, and coccygeal

how many in each? cervical vertebrae in the neck thoracic vertebrae in the thorax lumbar vertebrae in the low back region sacrum coccyx

7 12 5 5, fused 4, fused

The four normal vertebral curves are:

cervical and lumbar (anteriorly convex curves) thoracic and sacral (anteriorly concave curves)

Between adjacent vertebrae, from the ____ to the sacrum, are intervertebral discs that form strong joints, permit various movements of the vertebral column, and absorb vertical shock

second cervical (axis)

thoracic and sacral are formed during fetal development In the fetus, there is only a single anteriorly concave curve

Primary curves

cervical is formed when infant raises head at 4 months lumbar forms when infant sits up and begins to walk at about 1 year

Secondary curves

characterized by an abnormal increase in the thoracic curvature

Kyphosis (humpback)

It can result from erosion of the anterior part of one or more vertebrae, such as demineralization resulting from osteoporosis. Dowager’s hump is a colloquial name for ___ in older women caused by wedge fractures of the thoracic vertebrae resulting from osteoporosis, but kyphosis occurs in both male and female geriatric patients.

kyphosis

characterized by an anterior rotation of the pelvis at the hip joints producing an abnormal increase in the lumbar curvature

Lordosis (sway back)

It is often associated with weakened trunk musculature. Women develop temporary ___ during late pregnancy to compensate for alterations to their normal line of gravity. Obesity in both sexes can also cause ___ and low back associated with it due to increased weight of the abdominal contents.

lordosis

characterized by an abnormal lateral curvature that is accompanied by rotation of the vertebrae.

Scoliosis (curved back)

In scoliosis, the spinous processes turn ___ the cavity of the abnormal curvature. When bending over, the ribs protrude.

toward