Head, Neck, Trunk 1 to 119 Flashcards
The skull, composed of ___ bones, consists of the cranial bones (cranium) and the facial bones (face)
22
The skull forms the large cranial cavity and smaller cavities, including the __ and orbits (eye sockets)
nasal cavity
Certain skull bones contain mucous membrane lined cavities called
paranasal sinuses
The only moveable bones of the skull are the
mandible and the ear ossicles.
Immovable joints called ___ hold the skull bones together
sutures
The skull is the skeleton of the head. A series of bones forms its two parts:
Neurocranium
Facial skeleton
Cranial vault or “brain box”
Provides case for brain, cranial meninges, cranial nerves, and associated structures
Neurocranium
Viscerocranium or splanchnocranium
Anterior part of the skull containing the orbits, nasal cavities, maxilla (upper jaw), mandible (lower jaw)
Facial skeleton
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)
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
The space in the skull within the neurocranium occupied by the brain
Cranial vault
Cranial vault is bound by:
Calvaria
Basicranium
domelike roof of the cranium made up of the superior portions of the frontal bone, occipital bone, and parietal bones
Calvaria (skullcap)
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
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)
Cranial and facial bones together protect and support the ___
special sense organs
protect brain and house ear ossicles
muscle attachment for jaw, neck and facial muscles
8 Cranial bones
protect delicate sense organs – smell, taste, vision
support entrances to digestive and respiratory systems
14 Facial bones
8 Cranial Bones?
Frontal Parietal (2) Temporal (2) Occipital Sphenoid Ethmoid
Slide 10 for bones of the skull
tight
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
sides and roof of cranial cavity
Parietal
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
carotid foramen (carotid artery) jugular foramen (jugular vein)
Temporal
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
26
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
