HNS Anatomy Flashcards
What is the first branch of the internal carotid artery?
Ophthalmic artery
Numbness over the lower lip after tooth extraction - which nerve?
Inferior alveolar nerve
Loss of general sensation at the side/anterior of the tongue - which nerve?
Lingual nerve
Submandibular gland injury and patient tongue deviation - which nerve?
Hypoglossal nerve
Nerve injury during submandibular gland surgery near the duct
Lingual nerve
Most common nerve injury in the cavernous sinus?
Abducens
Site of origin of vagus and CN9 nerve?
Medulla
Unilateral soft palate and tongue reduced sensation, site of origin of involved cranial nerve?
Medulla
Which cranial nerve does not contain parasympathetic fibres?
Optic nerve
Origin of occulomotor nerve?
Midbrain
Numbness at the chin - nerve involved?
Mental nerve (branch of inferior alveolar nerve)
Numbness over the cheek - which nerve?
Infraorbital nerve
Nerve supplying forehead above eye?
Supra-orbital nerve
Numbness over the lower lip - which nerve?
Inferior alveolar nerve
Numbness over lower lip and paralysis of muscles of mastication - which nerve?
V3 (Mandibular branch of trigeminal)
With intracranial haemorrhage/increased internal cranial pressure - which nerve?
Abducens
Single test to differentiate between UMNL and LMNL for facial nerve
Inability of eyebrow elevation
Nerve injury to parotid gland during surgery?
Facial nerve
Nerve injury during parotid glad surgery with drooping of the lip and asymmetric smile?
Marginal mandibular branch of facial nerve
Nerve injury during superficial dissection of the parotid gland?
Great auricular nerve
Hoarseness of voice following thyroidectomy
Vagus nerve (recurrent laryngeal nerve)
Which nerve gives motor supply to the trapexius and sternocleidomastoid
Accessory nerve
Nerve injury in the posterior triangle of neck
Spinal accessory nerve
Patient unable to shrug shoulder - which nerve?
Spinal accessory nerve
Patient with torticollis - which nerve?
Spinal accessory nerve
After endarterectomy, the patient had deviated tongue - which nerve?
Hypoglossal
Numbness at the angle of the lower jaw - which nerve?
Greater auricular nerve (C2-3)
All of the following pass through the superior orbital fissure except
Ophthalmic artery
What does the ophthalmic artery pass through?
Optic canal
What does the maxillary nerve passes through?
Foramen rotundum
What does the mandibular nerve pass through
Foramen ovale
What does C9, 10, 11 pass through?
Jugular foramen
What does the middle meningeal artery pass through?
Foramen Spinosum
What does the internal carotid artery pass through?
Foramen lacerum
What does the hypoglossal nnerve pass through
Hypoglossal canal
What does the ophthalmic nerve pass through?
Superior orbital fissue
In a cerebello-pontine angle lesion, what is the lesion and affected nerves?
Acoustic nmeuroma which affects CN 7, 8
The patient hit on the vertex, which sinus is affected?
Superior sagittal sinus
What is the vertebral artery is a branch from?
Subclavian artery
What does the verterbral artery pass through?
Foramen transversium of C6
Which vessel will be affected by a fracture of the middle third of the clavicle?
Subclavian vein
What are the branches of the internal carotid artery?
Ophthalmic artery
Anterior choroidal artery
Anterior cerebral artery
Middle cerebral artery
Posterior communicating artery
Stroke with ACA. Presentation?
Lower limb more affected
Nerve not contained in posterior triangle?
Ansa cervicalis 123
Phrenic nerve is in which triangle?
Posterior triangle of neck
During thyroidectomy, the infrahyoid muscules are divided where?
Upper part
Neurovascular structures in the parotid gland?
NVAN
Facial nerve
Retromantibular vein
ECA and 2 terminal branches
Which muscles does pharyngeal pouch lie between?
Cricopharyngeous and thyropharyngeous through inferior constrictor
Ganglia responsible for lacrimation?
Sphenopalatine ganglion CN7
Where is the nucleus of the glossopharyngeal nerve located in?
Medulla
Where is the trigeminal nerve nucleus present?
Pons
What are the layer of the scalp?
Skin, connective tissue, aponeurosis, loose connective tissue, periosteum
What is the dangerous area of the scalp?
Extracranial in loose connective tissue
Emissary veins connected to intracranial veins?
Sensory supply of scalp?
Cervical plexus (greater and lesser occipital nerve
Trigeminal nerve
Internal carotid artery branches in neck?
No branches
Venous drainage of the scalp?
Facial vein
Muscles dividing triangle in posterior neck
Inferior belly of omohyoid
Structures passing in posterior triangle?
Nerves and plexus: Accessory nerve, cervical plexus, roots and trunks of brachial plexus, phrenic nerve
Vessels: Subclavian artery (third part) and terminal part of external jugular vein
Muscles: Inferior belly of omohyoid and 3 scalenes
Structures passing in anterior triangle?
Facial vessels, hypoglossal nerve, anterior jugular vein, carotid sheath, ansa cervicalis and strap muscules
What is in the carotid sheath
Common carotid artery, internal jugular, vagus
Tongue sensation and lymph drainage/metastasis of anterior 2/3?
Taste: Corda tympani
Sensation: Lingual nerve
Lymph: Tip to submental, anterior 2/3 to unilateral sub-mandibnular then deep cervical
Tongue sensation and lymph drainage/metastasis of posterior 2/3?
Glossopharangeal for sensation
Drainage bilateral to upper deep cervical node
Submandibular Warthon duct opens in?
Frenulum in floor of mouth
Parotid Stenson’s duct opens?
Opposite fo 2nd upper molar teeth
What is the course of the recurrent laryngeal nerve on the right side
Hooks around the right subclavian artery
Superior thyroid artery and vein is from/drain into?
External carotid artery/drains into interior jugular vein
Inferior thyroid artery and vein is from/drain into?
Thyrocervical trunk of subclavian artery/drains into left brachiocephalic vein
What is the course of the recurrent laryngeal nerve on the left side?
Hooks around arch of aorta
What is the level of the hyoid bone?
C3
What is the level of the common carotid bifurcation?
C4
Level of the angle of louie and arch of aorta
T4
Level of pulsation of CCA and end of trachea
C6
Referred pain to ear during tonsillitis through?
Glossopharyngeal nerve
What does abducens supply?
Lateral rectus
What does trochlear supply?
Superior oblique
Prominent C-vertebra felt?
C7
Patient hears hyperacoustic sound - which nerve?
Facial nerve
Vertebral artery intracranial branch?
Posterior inferior cerebral artery
Which cerebellar branches do basilar artery give off?
Superior and anterior inferior cerebellar artery
Circle of Willins anastomosis between?
2 internal carotid arteries and basilar arteries
Source of bleeding during lumbar puncture?
Lumbar venous plexus
Cervical verterbra which has long bifid spine?
Axis (C2)
What does the dorsal root ganglion carry?
Sensory fibres
Enlarged lateral ventricles and the 3rd ventricle - diagnosis?
Aqueduct of salivius occlusion
Lateral horn of the dorsal spinal cord is part of which nervous system?
Sympathetic nervous system
What is the last ligament to be encountered during lumbar puncture?
Ligamentum flavum
Order of ligaments encountered in LP?
Supraspinous ligament, interpinous, ligamentum flavum
CSF is collected from which space?
Subarachnoid space
CSF is absorbed in which plexus?
Arachnoid plexus
Disc hernation happens when…
Nucleus palposus herniates through a defect in annulous fibrosus
Bony mark iliac crest is at which level
L4-5
Adult spinal cords terminate at which level
L1
Paediatric spinal cords terminate at which level
L3
Spinal cord tract which carries sensation for motor signals?
Coricospinal
Spinal cord tract which carries sensation for pain and temperature?
Spinothalamic
What does lobe of ear drain into?
Superficial cervical nodes
Which nerve can be damaged in carotid exploration?
Hypoglossal