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HNNS > HNS21 Structure And Function Of Head And Neck > Flashcards

HNS21 Structure And Function Of Head And Neck Flashcards

1
Q

Cervical vertebrae

A
  • 7
  • Convex forward / Lordotic
  • On top of T1
  • Supports skull
  • Transverse foraminae (present in ALL 7 vertebrae) —> allow Vertebral artery to ascend to supply brain (ONLY in upper 6 vertebrae)
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2
Q

Skull

A
  • Calvaria / Neurocranium: surrounds the brain
    (Boundaries: Supraorbital ridge —> Tip of mastoid process)
  • Calvaria + Upper half of face —> Cranium
  • Cranium + Mandible —> Skull
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3
Q

Facial bones

A
  • 14 in total

6 Paired:

  • Lacrimal bone
  • Zygomatic bone
  • Nasal bone
  • Maxilla
  • Inferior nasal concha
  • Palatine bone

2 Unpaired:

  • Mandible (lower jaw)
  • Vomer
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4
Q

Calvaria (Superior view)

A
  1. Frontal bone (anterior)
    —> Coronal suture (connect with parietal bone)
    —> 中間點: Anterior fontanelle (unfused suture, closed by 18 months) —> Bregma (not found in newborn)
  2. Parietal bone (middle)
    —> Sagittal suture (connect between 2 parietal bone)
    —> Parietal foramen: Emissary vein
    —> Pterion (太陽穴): thinnest part of cranium (formed by antero-inferior border of parietal bone and greater wing of sphenoid) —> overlies anterior division of ***Middle meningeal artery + vein
  3. Occipital bone (posterior)
    —> Lambdoid suture (connect with parietal bone)
    —> 中間點: Posterior fontanelle (unfused suture, closed by 1st year) —> Lambda (not found in newborn)
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5
Q

Maxilla / Maxillary bone (Anterior view)

A

Bone of upper jaw (正面)

  1. Frontal process
    - join frontal bone
    - forms medial border of orbit
  2. Zygomatic process of Maxilla
    - join to zygomatic bone (lateral)
    - forms zygomatic arch
  3. Alveolar process
    - bears upper teeth
  4. Palatine process
    - articulates with contralateral side —> hard palate
  5. **Infraorbital foramen
    - **    Maxillary nerve (CNV2) exits —> ***Infraorbital nerve
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6
Q

Temporal bone

A

側腦

Lateral view:
1. Mastoid process

  1. External acoustic meatus
  2. Styloid process
    - attachment of stylohyoid muscle
  3. Squamous part
  4. Zygomatic process of Temporal bone
    - forms zygomatic arch

Inferior view:
6. Tympanic plate

  1. Petromastoid part

Additional parts:

  1. Stylomastoid foramen
    - exit of ***CN7 from middle ear
  2. Carotid foramen
    - entry of ***Internal carotid artery
  3. Jugular foramen
    - exit of ***Internal jugular vein, CN9, CN10, CN11
  4. Foramen lacerum
    - covered by fibrous tissue
    - exit of **Greater petrosal nerve (branch of CN7, carries taste fibre + parasympathetic fibres from middle ear)
    - entry of **    Emissary vein
  5. Internal acoustic meatus
    - exit of ***CN7, CN8
  6. Digastric notch
    - attachment of tendon of digastric muscle
  7. Glenoid / Mandibular fossa
    - articulate with head of Mandible
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7
Q

Zygomatic bone (Lateral view)

A

側面

  1. Temporal process
    - join temporal bone
    - forms zygomatic arch
  2. Frontal process
    - join frontal bone
  3. Maxillary process
    - join maxilla
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8
Q

Zygomatic arch

A

Maxilla zygomatic process + Zygomatic bone + Temporal bone zygomatic process

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9
Q

Sphenoid bone (Lateral view)

A

Wedge shape in middle of skull

Anterior: to Ethmoid bone
Posterior: to Occipital bone

2 parts:

  1. Greater wing
    - articulate with Frontal, Parietal, Temporal, Zygomatic bone
  2. Lesser wing

Feature:
Pterygomaxillary fissure

Border:

  • Lateral: open to Infratemporal fossa
  • Medial: Palatine bone
  • Anterior: Maxilla
  • Posterior: Pterygoid lateral plate / process of sphenoid bone

Pterygopalatine fossa:
—> **Pterygopalatine ganglion: Supply nasal cavity
—> **Sphenopalatine foramen: Sphenopalatine artery (branch of ***Maxillary artery) —> supply majority of nasal cavity

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10
Q

Frontal bone (Anterior view)

A
  1. Articulate with Nasal bone
  2. Maxillary process
    - join maxilla
  3. Zygomatic process
    - join zygomatic bone
  4. **Supraorbital notch / foramen
    - **    Supraorbital VAN
    - ***Supratrochlear VAN
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11
Q

Orbit

A

Formed by:

  1. Frontal bone
  2. Zygomatic bone
  3. Maxilla
  4. Ethmoid bone
  5. Sphenoid bone (greater wing)
  6. Lacrimal bone

Inferior part of floor (Maxilla): Infraorbital foramen —> exit of ***Infraorbital nerve (branch of CNV2)

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12
Q

Anterior nasal aperture (鼻窿)

A

Formed by:

  1. Maxilla
  2. Nasal bone
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13
Q

Inferior view of Cranium

A
  1. Maxilla
    - Palatine process: join palatine bone
  2. Palatine bone

Palatine process + Palatine bone —> Hard palate

  1. Sphenoid bone
    - **Foramen ovale (大d): exit of **CNV3 + **Lesser petrosal nerve
    - **    Foramen spinosum (細d): entry of **Middle meningeal artery (branch of **Maxillary artery)
    - **Foramen rotundum: exit of **CNV2
    - **Optic canal: entry of **CN2, Ophthalmic arteries
    - Medial + Lateral pterygoid plate: attachment of ***Medial + Lateral pterygoid muscle
  2. Vomer bone
    - form Nasal septum (inferior)
  3. Posterior nasal apertures (choanae)
  4. Temporal bone
    - Styloid process
    - Tympanic plate
    - Petromastoid part
    - **Stylomastoid foramen (CN7)
    - **    Carotid foramen (Internal carotid artery)
    - **Jugular foramen (Internal jugular vein, CN9, CN10, CN11)
    - **    Foramen lacerum (Greater petrosal nerve, Emissary vein)
    - ***Internal acoustic meatus (CN7, CN8)
    - Digastric notch (digastric muscle)
    - Glenoid / Mandibular fossa (head of Mandible)
  5. Occipital bone
    - ***Foramen magnum: CN11, Vertebral arteries, Spinal cord, Medulla oblongata
    - Occipital condyles: articulate with Atlas (C1)
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14
Q

***Interior view of Cranium, Openings of skull

A

頂:

  1. Grooves for branches of Middle meningeal artery
  2. Groove for Superior sagittal sinus (part of Dura sinuses)

底:
3 levels of Cranial fossae:

Anterior cranial fossa (Frontal lobe of brain, above Orbit)
1. Cribriform plate —> Ethmoid bone —> CN1

Middle cranial fossa (Temporal lobe of brain, above Zygomatic arch)

  1. Optic canal —> Lesser wing of Sphenoid —> **CN2 + **Ophthalmic arteries
  2. Foramen rotundum —> Greater wing of Sphenoid —> ***CNV2
  3. Foramen ovale —> Greater wing of Sphenoid —> ***CNV3, Lesser petrosal nerve
  4. Foramen spinosum —> Greater wing of Sphenoid —> ***Middle meningeal artery
  5. Superior orbital fissure —> Between lesser and greater wings of Sphenoid —> **CN3, 4, V1, V2, 6, **Superior ophthalmic vein
  6. Foramen lacerum —> Between petrous part of Temporal and Sphenoid —> **Greater petrosal nerve, **Emissary vein

Posterior cranial fossa (Cerebellum (below superior nuchal line; Occipital lobe: above superior nuchal line))

  1. Internal acoustic meatus —> Temporal bone —> ***CN7, 8
  2. Jugular foramen —> Temporal and Occipital bone —> ***Internal jugular vein, CN9, 10, 11
  3. Foramen magnum —> Occipital bone —> **CN11, **Vertebral arteries, Spinal cord, Medulla oblongata
  4. Hypoglossal canal —> Occipital bone —> ***CN12
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15
Q

Mandible

A
  1. Body
  2. Ramus
    - ***Condylar process (head articulates with glenoid fossa of temporal bone)
    - Coronoid process
    - Mandibular / Condylar notch (depression between condylar and coronoid process)
  3. Angle
  4. **Mental foramen (2 lateral openings)
    - exit of **    Mental nerve (branch of ***CNV3)
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16
Q

Temporomandibular joint

A
  • between Mandibular condyle and Glenoid fossa (of temporal bone)
  • Synovial joint
  • Lax capsule anteriorly
  • Intra-articular disc (divide joint into upper and lower chamber)

3 basic movements:

  1. Jaw opening: combination of hinge and sliding movement
  2. Forward gliding
  3. Grinding: movement to left and then right (oblique movement), involves movements through a sagittal axis and vertical axis

Dislocation of joint:

  • condyle displaced anteriorly to ***articular eminence —> muscle spasm prevents return of condyle into glenoid fossa
  • reduction: first push condyle inferiorly and then posteriorly
17
Q

Major compartments of head

A
  1. Cranial cavity
    - protect brain
    - brain floats in CSF
    - brain surrounded by layers of meninges
  2. Orbits x2
    - eyeballs (Stereoscopic vision)
  3. Nasal cavities x2
    - olfaction
    - respiration
    - filter, moisturise, warm air
    - drainage of paranasal sinuses (air-filled extension of nasal cavities)
  4. Oral cavity
    - taste
    - mastication
18
Q

Nasal cavities

A
  • Lateral border: Maxillary bones
  • Open anteriorly at anterior nasal aperture
  • Open posteriorly at posterior nasal aperture (choanae) —> leads into nasopharynx
  • Part of upper respiratory tract

Main functions:

  1. Olfaction
  2. Respiration
  3. Filter, moisturise, warm air
  4. Drainage of paranasal sinuses (air-filled extension of nasal cavities)

Paranasal sinuses:

  • Air-filled
  • In bones around nasal cavity (frontal, maxillary, sphenoid, ethmoid)
  • Communicates with nasal cavity
  • Resonance in voice production
  • Reduce weight of skull

4 pairs:

  1. Frontal sinuses
  2. Maxillary sinuses (more superficial)
  3. Sphenoidal sinuses (deeper)
  4. Ethmoidal sinuses
19
Q

Oral cavity

A
  • Separated from nasal cavity by Hard palate
  • Upper end of digestive tract

Functions:

  1. Mastication (prepare food; also by enzymes)
  2. Swallowing (food bolus pushed posteriorly by tongue into pharynx)
20
Q

Neck

A

Inferior boundary:

  • Sternum
  • Clavicle
  • Acromion
  • C7 spinous process (non-bifided)

Superior boundary:

  • anterior: Mandible
  • posterior: Basicranium
21
Q

***Neck Fasciae and Compartments

A

Superficial fascia

  1. SC tissue connecting skin to deep fascia
  2. Cutaneous nerves
  3. Superficial veins
  4. Platysma muscle (very thin)

Deep fascia

  1. Deep investing layer (outermost)
    - enclose muscles (e.g. **SCM, **Trapezius)
  2. Pretracheal layer
    - enclose ***visceral structures (e.g. larynx, trachea, pharynx, esophagus, glands in neck: thyroid, parathyroid, thymus)
  3. Prevertebral layer
    - surround ***vertebral compartment (cervical spine, flexor + extensor muscles of neck)
  4. Carotid sheath (Convergence of the 3 layers of Deep fascia)
    - **Common carotid arteries
    - **    Internal carotid arteries
    - **Internal jugular vein
    - **    Vagus nerve
22
Q

Pharynx

A
  • a half cylinder made of thin layers of muscles and fascia

Attaches to:
- Base of skull / Pharyngeal tubercle of occipital bone
- Back of face (nasal cavity + oral cavity: Buccinator muscle)
- Larynx (inferior)
—> continues distally as Esophagus

3 divisions:

  1. Nasopharynx: behind nasal cavity
  2. Oropharynx: behind oral cavity
  3. Laryngopharynx: behind larynx
23
Q

Larynx

A
  • Specialised region of airway

Consists of:

  1. Cartilages
  2. Muscles that allow movement of vocal cords —> voice production

Attaches to:

  1. ***Hyoid bone (superiorly)
  2. ***Trachea (inferiorly)

Opens to:

  1. Oropharynx (superiorly)
  2. Trachea (inferiorly)
24
Q

Neck Triangles

A

Neck divided into 2 Triangles (Anterior + Posterior) on each side by:

  1. Sternocleidomastoid muscle (分開anterior / posterior)
    - Superior: Mastoid, Occipital bone
    - Inferior: Sternum, Clavicle
  2. Trapezius (posterior boundary)
    - Axial attachment: Skull, Ligamentum nuchae, Thoracic vertebrae (spinous processes, supraspinous ligaments)
    - Shoulder girdle attachment: Lateral 1/3 clavicle, Acromion, Scapular spine
25
Q

Posterior triangle

A

Anterior boundary: SCM
Posterior boundary: Trapezius

Apex: back of skull
Base: root of neck, middle of clavicle

Floor: flexor and extensor muscles of cervical spine (covered by prevertebral fascia)
Roof: deep investing layer of cervical fascia

Contents:

  1. ***CN11
  2. Brachial plexus (Cervical plexus covered by SCM)
  3. Arteries: ***Subclavian, Suprascapular, Dorsal scapular, Occipital artery
  4. Veins: ***External jugular
  5. Omohyoid muscle
  6. Lymph nodes
26
Q

Anterior triangle

A

Anterior boundary: Midline
Posterior boundary: SCM anterior border
Superior boundary: Mandible lower border

Contents:
1. Trachea

  1. Esophagus
  2. Infrahyoid muscles (**Strap muscles —> Control position of larynx —> innervated by **Ansa cervicalis C1-3 (part of cervical plexus))
    - Sternohyoid
    - Omohyoid
    - Thyrohyoid
    - Sternothyroid
  3. Thyroid gland
    - 2 lobes joined by isthmus
    - each lobe lies deep to Sternohyoid and Sternothyroid
    - on side of larynx and trachea
    - enclosed by splitting of pretracheal fascia
  4. Parathyroid gland
    - 4 total
    - 2 behind each thyroid lobe
27
Q

Subdivisions of Anterior triangle

A
  1. Submental triangle (below floor of mouth) (下巴前)
    - ***Submental LN
    - Anterior jugular vein (beginning)
    - borders: midline, anterior belly of digastric, hyoid bone
    - floor: Mylohyoid
  2. Submandibular triangle (下巴後)
    - **Submandibular glands
    - **    External + Internal carotid arteries
    - **Internal jugular vein
    - Facial artery and vein
    - **    CN10, CN12
    - ***Submandibular LN, Deep cervical LN
    - borders: inferior border of mandible + anterior and posterior bellies of digastric muscles
    - floor: Mylohyoid + Hyoglossus
  3. Muscular / visceral triangle (頸前)
    - **Thyroid gland (behind strap muscles), Parathyroid gland
    - **    Larynx, Trachea, Esophagus
    - borders: midline, hyoid bone, upper belly of omohyoid, SCM
    - floor: Sternohyoid, Sternothyroid
  4. Carotid triangle (頸後)
    - **Common carotid artery (dividing into external + internal carotid artery)
    - **    Internal jugular vein
    - **CN10, CN11, CN12
    - **    Deep cervical LN
    - borders: upper belly of omohyoid, stylohyoid, posterior belly of digastric, SCM
    - floor: Thyrohyoid, Hyoglossus, Pharynx

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