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ianto jocks Flashcards

1
Q

where are the only places movement in cranial skeleton occurs?

A

TMJ and Atlanta-occipital joint

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2
Q

which bones are formed by intramembranous ossification?

A

flat bones

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3
Q

which bones are formed by endochondreal ossification

A

irregular

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4
Q

what are pneumatised bones and give 4 examples?

A

bones with air spaces (sinus)
temporal, frontal, ethmoid, spenoid

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5
Q

what is the skull composed of

A

neurocranium and viscerocranium

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6
Q

what is the neurocranium?

A

bony case of the brain and meninges- skull cap (calvaria) and cranial base

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7
Q

what is viscerocranium?

A

facial skeleton

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8
Q

which bone is part of the skull but not included in neurocranium or viscerocranium?

A

the 3 ossicles of the ear - malleus, incus and stapes

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9
Q

how many bones are there in neurocranium?

A

8
2 pairs
-temporal
-parietal
4 single
-frontal
-occipital
-spenoid
-ethmoid

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10
Q

what are the borders of the temporal fossa?

A

superior - superior temporal line
posterior - inferior temporal line
anterior - frontal process of zygomatic bone
inferior- infra temporal crest deep to zygomatic arch
floor includes pterion

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11
Q

define norma lateralis

A

lateral view of skull

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12
Q

define norma frontalis

A

frontal view of skull

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13
Q

define norma basalis

A

view from base of skull

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14
Q

define norma verticalis

A

view from superior aspect

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15
Q

define norma occipitalis

A

view from behind the skull

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16
Q

what do the superior and inferior temporal lines provide attachment for?

A

temporalis muscle and temporal fascia

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17
Q

what is the vertex

A

superior part of neurocranium

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18
Q

define bregma

A

the junction between sagittal and coronal sutures

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19
Q

define lambda

A

where lambdoid and sagittal sutures join

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20
Q

define nasion

A

where frontonasal and internasal sutures meet

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21
Q

define inion

A

most prominent part of the external occipital protuberance

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22
Q

define asterion

A

star/Y shapes junction between the occipital parietal and temporal bones

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23
Q

define glabella

A

smooth part of frontal bone superior to the root of the nose and between supracilliary arches - most anterior part of forehead

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24
Q

what does it mean if the head is in anatomical position?

A

aka orbitomeatal or Frankfort horizontal plane
horizontal line can be drawn between superior margin of external acoustic meatus and inferior margin of the orbit

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25
where is the pterion?
it is an H shaped junction between the temporal, parietal, frontal and greater wing of sphenoid bone 4cm superior to mid zygomatic arch and 3cm posterior to brontal process of zygomatic bone
26
what are the risks of pterion?
it is a weak area of the skull therefore vulnerable to injury pterion overlies the anterior branch of the middle meningeal artery so trauma can cause rupture and epidural/extradural haematoma - a bleed between the skull and dura which puts pressure on the brain
27
what is the calvaria covered by?
pericranium and scalp underneath lies the dura which is the outermost of the meninges
28
what is the calvaria covered by?
pericranium and scalp underneath lies the dura which is the outermost of the meninges
29
what is the name gives to the small islands of bone found within cranial sutures?
wormian bones aka sutural or accessory bones
30
what is the purpose of wormian bones?
they facilitate growth and development of brain
31
what is a suture?
a type of fibrous joint which has limited or no movement
32
what is a fontanelle?
flat bones are separated by fibrous membrane or soft spot which fuse to become sutures in post natal life soft spots on babies head there are anterior and posterior fontanelles and mastoid and sphenoidal (less important)
33
what is the purpose of fontanelles?
facilitate growth of the brain
33
when does the anterior fontanelle close?
by 18 months
34
when does the posterior fontanelle close?
by the end of the first year
35
when does the frontal suture fuse?
starts to fuse at 2 and is completely fused by 8
36
what is the metopic suture?
if the frontal suture remains which is the case in 8% of people it is then called the metopic suture
37
when does the mandibular symphysis close?
fuses in 2nd year
38
what bones make the nasal septum?
superiorly - perpendicular plate of ethmoid inferiorly - vomer
39
what is the name given to the anterior nasal opening shaped like a pear?
perform aperture
40
what exits the supraorbital notch
ophthalmic branch of CNV
41
what exits the infra-orbital foramen?
maxillary branch of CNV5 - exits foramen rotunda interiorly and then infra-orbital foramen
42
what exits the mental foramen?
the mandibular branch of the CNV exits the mental foramen after it exits the cranium through foramen spinosum
43
what are the paranasal sinuses?
frontal sinuses ethmoid sinuses maxillary sinuses
44
name pneumatised bones in the skull
frontal temporal sphenoid ethmoid
45
what separates the posterior and anterior nasal apertures?
vomer
46
where does the interior carotid artery enter the neurocranium?
carotid canal
47
where does the external jugular vein leave the neurocranium?
jugular foramen
48
what passes through the foramen magnum?
spinal cord, meninges, vertebral and spinal arches and spinal root of accessory nerve
49
what nerve does the hypoglossal canal carry?
hypoglossal nerve CNXII
50
what passes through the foramen spinosum?
middle meningeal artery and vein and meningeal branch of mandibular nerve
51
what exits the foramen ovale?
mandibular branch of CNV and accessory meningeal artery
52
what is the foramen lacerum?
an artefact of dry bone - only small veins and branches of meningeal artery pass through
53
what cervical vertebrae are typical and which are atypical?
typical C3-C6 atypical C1 atlas, C2 axis and C7 vertebral prominence
54
what ligament connects the spinous processes of the cervical vertebrae to the occipital bone and foramen magnum?
nuchal ligament
55
which ligament is the nuchal ligament continuous with?
supraspinous ligament
56
what connects the vertebral spinous processes from C7 to the sacrum
supraspinous ligament
57
what is the purpose of the nuchal ligament?
support the head, provide attachment for muscles and resist flexion
58
which cervical vertebrae are bifid?
C2-C6
59
which are the only vertebrae with transverse foramen?
cervical
60
what passes through vertebral foramen?
spinal cord
61
what passes through transverse foramen and which vertebrae has an exception?
vertebral blood vessels except in C7 where vertebral artery does not pass through
62
is C7 spinous process bifid or non-bifid
non-bifid
63
why has c7 got smaller or absent transverse foramen?
the vertebral artery does not need to pass through it
64
what replaces the spinous process in C1?
posterior tubercle
65
which vertebrae has a dens ans what is its function?
C2 - acts as an axis for the atlas
66
what does the atlanto-occipital joint enable?
flexion and extension - nodding
67
what does atlanto axial joint allow?
rotation of the head assisted by transverse ligament of atlas holding dens in position
68
what does the transverse ligament of the atlas do?
holds the dens of the axis in place creates a socket for the dens as makes a posterior border for dens and the anterior border is the articular facet for the dens on the atlas
69
what do the alar ligaments do?
manage movement of the head within safe parameters prevent excessive rotation connect the dens to the occipital condyles run from the side of the dens to lateral border of foramen magnum
70
between which cervical vertebrae is there no intervertebral disc?
C1 and C2
71
what does the articular surfaces of the atlas articulate with?
occipital condyles
72
what level of cervical vertebrae will you find the hyoid bone?
C3
73
what bone does the hyoid articulate with?
trick Q lol it is suspended by muscles and ligaments
74
where does the hyoid connect to by muscles?
mandible, thyroid cartilage, sternum, manubrium, styloid process and scapula
75
what is the site of attachment for anterior neck muscles?
hyoid bone
76
What connects the oral cavity with the pharynx and larynx?
hyoid bone
77
where does the stylohyoid ligament connect?
lesser horn of the hyoid bone to the styloid process of the skull
78
what is the superior boundary of the neck?
base of skull and inferior border of mandible
79
what is the inferior boundary of the neck?
clavicle, sternum, acromion and C7
80
what is the risk of no bony protetion on the neck?
it houses critical structures and major BVs can be damaged
81
what is the risk of no bony protection on the neck?
it houses critical structures and major BVs can be damaged
82
what are the 3 compartments of the neck?
visceral, vascular, vertebral
83
what is contained within the visceral compartment?
trachea, oesophagus, thyroid and parathyroid gland
84
what is contained within the vascular compartment?
carotid sheath containing internal jugular vein and internal carotid artery and vagus nerve
85
what is contained within the vertebral compartment?
cervical spine, muscles of neck and back, nerves and nerve roots of cervical nerves
86
what is the role of fascia in the neck?
provides containment and protection provides slipperiness so structures can slide over one another prevents spread of infection
87
where will you find superficial fascia?
between dermis and investing layer
88
what will you find within the superficial fascia?
platysma muscle, cutaneous nerves, BVs and lymphatics
89
name the three deep cervical fascia
investing fascia pretracheal prevertebral
90
hat does the investing fascia surround and split to enclose?
surrounds neck splits to enclose SCM, trapezius, parotid and submandibular glands
91
what vein pierces the deep investing fascia?
external juglar vein and anterior jugular vein
92
what is the platysma?
broad thin sheet of muscle covering the anterior of the neck
93
where does superficial fascia attach to?
mandible and facial muscles - continuous with thorax superficial fascia
94
where does the investing fascia attach superiorly?
superiorly to superior nuchal line of occipital bone, mastoid process of temporal bone, anterioly to hyoid bone
95
where does the investing fascia attach inferiorly?
inferiorly to scapula, acromion, clavicle and manubrium
96
where does the investing fascia attach anteriory?
anterioly to hyoid bone
97
where does the investing fascia attach posteriorly?
continuous with ligamentum nuchae and periosteum of C7 spinous process
98
what is enclosed by the visceral part of the pretracheal fascia?
oesophagus, trachea, thyroid and parathyroid gland
99
what is enclosed by the muscle part of the pretracheal fascia?
infrahyoid muscles
100
where does the pre tracheal fascia extend from and to?
hyoid bone to upper thoracic cavity base of skull to thoracic cavity
101
what does the pre tracheal fascia fuse with laterally?
alar fascia and carotid sheath
102
what fascia wraps around the omohyoid?
pretracheal
103
what fascia is pierced by the thyroid vessels?
pretracheal
104
what does the prevertebral fascia surround?
vertebral column and pre and post vertebral muscles
105
where is prevertebral fascia fixed to superiorly?
base of skull
106
what muscles does the prevertebral layer surround?
anteriorly -longus colli -longus capitus laterally -scalenes posteriorly -deep cervical muscles
107
which layers of cevical fascia blend with the carotid sheath?
all three layers of deep cervical fascia blend with the carotid sheath pretracheal, investing and prevertebral
108
what does the carotid sheath surround?
common and internal carotid artery, internal jugular vein and vagus nerve (also contains deep cervical lymphnodes and nerves)
109
where does the carotid sheath run from and therefore connect?
runs from carotid canal to aortic arch therefore connecting the cranial cavity with thorax
110
what are the boundaries of the anterior triangle of neck?
midline, inferior border of mandible and anterior border of SCM
111
another name for superior thoracic aperture
thoracic inlet
112
what are the boundaries of the posterior triangle of the neck?
posterior border of SCM, anterior border of trapezius, and mid third of clavicle
113
what provides connection between upper limb and head and neck?
axillary inlet
114
which nerves can be found in SCM region?
great auricular and transverse cervical
115
what vein can be found in the SCM region?
external jugular vein
116
what are the 4 regions in anterior triangle?
carotid muscular submandibular submental
117
what nerves can be found in the carotid triangle?
CNX vagus CNXI accessory CNXII hypoglossal superior root of ansa cervicalis branches of cervical plexus
118
name the two subdivisions of posterior triangle
occipital omoclavicular
119
what divides the posterior triangle into two subdivisions?
inf. belly omohyoid
120
what is the origin and insertion of SCM?
origin sternal head - manubrium clavicular head - mid 3rd of clavicle insertion mastoid process
121
what innervates the SCM?
motor - spinal accessory nerve CNXI pain and proprioception C2 and C3 nerves
122
what is the name of the fossa between the two heads of SCM?
supraclavicular fossa
123
what is the action of the SCM?
draws head fwd tips head towards ipsilateral shoulder
124
how would you test the SCM?
turn head to opposite side against resistance - can be seen/palpated if acting normal
125
what innervates the trapezius?
spinal accessory nerve CNXI
126
where is the origin and insertion of the trapezius?
origin superior nuchal line external occipital protuberance ligamentum nuchae spinous process T7-T12 insertion spine of scapula acromion lateral 3rd of clavicle
127
what is the action of the trapezius?
assists in scapula rotation upper fibres elevate scapula middle fibres adduct scapula lower fibres depress scapula
128
how to test trapezius?
shrug against resistance and should see superior border
129
what nerves make up the cervical plexus?
anterior rami of spinal nerves C1-C4
130
what are the muscular branches of cervical plexus?
phrenic nerve - C3 C4 C5 ansa cervicalise C1 C2 C3
131
what are the cutaneous branches of cervical plexus?
C2 – lesser occipital nerves C2, C3 – great auricular & transverse cervical nerves C3, C4 – supraclavicular nerves
132
what cervical nerves give rise to ansa cervicalis?
C1 C2 C3
133
where does the superior root of ansa cervicalis decend from
hypoglossal nerve
134
what does ansa cervicalis innervate?
infrahyoid muscles except for thyrohyoid
135
what innervates the thyrohyoid muscle?
C1 and C2 fibres which decend from hypoglossal nerve independently
136
where does the anterior jugular vein drain into?
external jugular vein
137
where does the external jugular vein drain into?
subclavian vein
138
which vein runs across SCM?
external jugular vein
139
what nerves and vasculature cross SCM
external jugular vein great auricular and transverse cervical
140
which nerves cross the posterior triangle superficial to prevertebral fascia?
spinal accessory CNXI lesser occipital supraclavicular
141
what vasculature crosses the posterior triangle superficial to the prevertebral fascia?
external jugular vein transverse cervical artery transverse cervical vein
142
what roofs and floors the anterior triangle?
roof - investing fascia floor- pretracheal fascia and carotid sheath posterolaterally
143
what is contained in the submandibular triangle of the anterior triangle?
submandibular gland, lymph nodes, parts of CNXII - hypoglossal, facial artery and vein, mylohyoid nerve
144
what is contained in the submental triangle of the anterior triangle?
submental lymph nodes, small veins which unite to form anterior jugular vein
145
what is contained in the carotid triangle of the anterior triangle?
carotid sheath, thyroid gland, larynx and pharynx, part of external carotid, part of cervical plexus, part of ansa cervicalis, deep cervical lymphnodes, parts of accessory and hypoglossal nerve
146
what is contained in the muscular triangle of the anterior triangle?
sternothyroid and sternohyoid muscles larger part of thyroid and parathyroid glands
147
name the suprahyoid muscles
mylohyoid digastric stylohyoid geniohyoid
148
name the infrahyoid muscles
sternohyoid sternothyroid thyrohyoid omohyoid
149
all muscles of anterior triangle attach to the hyoid bone except for one. which?
sternothyroid
150
what seperates the mylohyoid?
mylohyoid raphe
151
where is the geniohyoid?
similar position to digastric but inserts directly into hyoid and is deep
152
where do infrahyoid muscles attach?
scapula, clavicle, sternum and thyroid cartilage
153
where does the mylohyoid originate and insert?
mylohyoid line of mandible inserts into body of hyoid and fibres of the opposotr mylohyoid
154
what is the function of suprahyoidmuscles?
elevate hyoid and larynx and constitute to the floor of mouth
155
what is the action of the mylohyoid?
elevate hyoid and constitute to floor of mouth
156
where is the origin of the anterior belly of digastric?
digastric fossa on lower medial mandible
157
where is the origin of posterior belly of digastric
mastoid notch on medial mastoid process
158
where is the insertion of the digastric?
attach to their intermediate tendon at hyoid which is attached by a fascial sling
159
what is the action of the digastric?
anterior belly raises hyoid and opens mouth by lowering mandible posterior belly elevates and retracts hyoid
160
what nerve innervates the mylohyoid?
branch of the trigeminal mandibular division inferior alveolar nerve called nerve to mylohyoid
161
what innervates the digastric muscle
anterior belly CNV3 nerve to mylohyoid posterior belly CNVII facial nerve digastric branch
162
what is the origin and insertion of stylohyoid?
originates at styloid process and inserts into body of hyoid
163
what is the action of the stylohyoid
pulls the hyoid bone upwards and back
164
what innervates the stylohyoid?
facial nerve CNVII
165
what nerve innervates the mylohyoid?
CNV3 nerve to mylohyoid with is a branch of the inferior alveolar nerve branch of mandibular division
166
what innervates the digastric?
anterior belly innervated by nerve to mylohyoid CNV3 posterior belly innervated by facial nerve CNVII digastric branch
167
what innervates the geniohyoid?
anterior ramus of C1 which travels with hypoglossal nerve
168
what is the action of geniohyoid?
elevates and oulls hyoid forward pulls mandible down and in
169
where is the insertion and origin of geniohyoid?
originates from mandible mental spine and inserts at body of hyoid
170
what is the purpose of the infrahyoid muscles aka strap muscles?
fix and depress hyoid depress larynx
171
what are the superficial infrahyoid muscles?
sternohyoid omohyoid
172
what is the origin and insertion of sternohyoid?
posterior surface of subclavicular joint and manubrium insertion - body of hyoid medially
173
what is the action of sternohyoid?
depresses hyoid after elevation during swallow
174
what connects the superior and inferior bellies of omohyoid?
intermediate tendon
175
where does the superior belly of omohyoid originate and insert?
originates at tendon and inserts into body of hyoid laterally
176
where does the inferior belly of omohyoid originate and insert?
originates at superior body of scapula and inserts into tendon
177
where is the intermediate tendon of omohyoid attached to and how?
clavicle by a facial sling
178
what are the two deep infrahyoid muscles?
thyrohyoid and sternohyoid
179
where does thyrohyoid originate and insert?
originates at oblique line on thyroid cartilage and inserts into hyoid body and greater horn
180
where does sternothyroid originate and insert?
originates at posterior surface of manubrium and inserts into oblique line on thryroid cartilage
181
what is the action of sternothyroid?
draws larynx downwards
182
what is the action of thyrohyoid?
depresses hyoid and can raise larynx
183
which deep infrahyoid muscle draws larynx down?
sternothyroid
184
which deep infrahyoid muscle raises larynx?
thyrohyoid
185
what innervates infrahyoid muscles?
all infrahyoid muscles are innervated by the anterior rami of C1-C3 through the ansa cervicalis except for thyrohyoid which is a bit different
186
what innervates thyrohyoid?
C1 innervates thyrohyoid which runs with CNXII hypoglossal - same as geniohyoid
187
what compartment of the neck will you find the thyroid gland?
visceral
188
where does the thyroid cartilage begin and end?
from thyroid cartilage to 5th tracheal ring
189
what is the thyroid gland pyramidal lobe remenant of?
embryonic thyroglossal duct - lobe is present in 50%
190
what is the venous supply of the thyroid gland?
superior thyroid artery - 1st branch of external carotid artery inferior thyroid artery - branch of the thyrocervical trunk from subclavian superior middle and inferior thyroid vein
191
what is the venous drainage of the thyroid gland?
thyroid venous plexus
192
where does the superior thyroid vein drain to?
inferior jugular vein
193
where does the middle thyroid vein drain into?
internal jugular vein
194
where does the inferior thyroid vein drain into?
brachiocephalic
195
what is the name of the small thyroid artery in 10% of people?
ima thyroid artery
196
where does the ima artery usually but not always arise from?
brachiocephalic trunk
197
how many pairs of parathyroid glands are there?
2
198
what is the venous drainage of parathyroid?
thyroid venous plexus - same as thyroid
199
what blood vessel supplies the parathyroid?
inferior thyroid artery which is a branch of the thyrocervical trunk of the subclavian
200
what nerves innervate the thyroid and parathyroid gland?
thyroid branches from cervical sympathetic ganglia
201
what regulates the endocrine secretions of thyroid and parathyroid gland?
pituitary
202
what nerve runs posteromedial to thyroid gland?
recurrent laryngeal nerve from vagus nerve
203
what does the right recurrent laryngeal nerve loop around?
right subclavian artery at T1-T2 level
204
what does the left recurrent laryngeal nerve loop around?
arch of aorta at T4-T5 level
205
which recurrent laryngeal nerve is at risk of injury and why?
right recurrent laryngeal nerve as it runs close to the inferior thyroid artery and is at risk during neck surgery e.g. bruising or pressure from accumulated blood or exudate
206
what symptoms will indicate one or both of the recurrent laryngeal nerves have been damaged?
hoarseness, temporary aphonia, phonation disturbance and laryngeal spasm
207
describe a cricothyrotomy
large bore needle pierces cricothyroid ligamenr
208
when does a cricothyrotomy become surgical?
if needle is replaced with a tracheostomy tube
209
describe a tracheostomy
retraction of infrahyoid muscle and incision of isthmus of thyroid to insert tube between 1st and 2nd or 2nd-4th tracheal rings
210
name a risk of tracheostomy
presence of ima artery softness of trachea in children or neonates
211
what does the lymphoid system drain?
surplus tissue fluid and leaked plasma proteins
212
what does the lymphoid system remove?
debris from cellular decomposition and infection
213
how do lymphnodes indicate infection?
they are swollen if active, can palpate and feel harder
214
through what duct will most of the lymph of the body renter the bloodstream (except the superior right quadrant)?
thoracic duct
215
where does the lymph from the superior right quadrant enter the bloodstream?
right upper limb, right side of head and neck and right side of thorax drain into the right lymphatic duct
216
describe the chain of lymph drainage in the head
all lymphnodes except for the occipital nodes drain into superior deep cervical nodes and then into inferior deep cervical nodes (facial, anterior and posterior auricular, superficial and deep parotid, retropharyngeal) occipital nodes drain directly to inferior deep cervical nodes they then drain into left and right subclavian vein through thw thoracic duct or right lymphatic duct
217
name the 5 groups of paired superficial lymphnodes in the head
facial occipital superficial parotid posterior auricular anterior auricular
218
how many groups of paired superficial lymphnodes are there in the head?
5
219
how should lymphnodes be in healthy patients
small, soft, mobile
220
what do the superficial parotid, posterior and anterior auricular lymphnodes drain?
external ear, lacrimal gland, adjacent regions
221
what do the occipital nodes drain?
scalp of that region
222
where are facial lymphnodes located?
along the facial vein
223
what are the four subgroups of facial nodes?
malar or infraorbital (zygomatic region) mandibular nasiolabial buccal
224
what and how do the facial nodes drain?
skin and mucous membranes in location of node and then they drain to eachother superior to inferiorly and then into deep cervical nodes
225
name deep lymphnodes of the head which can't be palpated
deep parotid retropharyngeal
226
what do deep partotid nodes drain?
middle ear, auditory tube, parotid gland
227
what do the retropharyngeal nodes drain?
palate, pharynx, paranasal sinises and nasal cavity
228
what lymphnodes on head disappear at age of 4-5?
retropharyngeal
229
what do the midline submental nodes drain?
tissue in the submental triangle bilaterally - the only superficial cervical lymphnode that drains bilaterally
230
how many groups of superficial cervical lymphnodes are there?
4
231
what are the four groups of superficial cervical lymphnodes?
submental submandibular external jugular anterior jugular
232
what do the submental lymphnodes drain?
lower lip, chin, floor of mouth, apex of tongue, mandibular incisors with associated peridontium and gingivae
233
where do the submental nodes drain into?
directly to deep cervical or via submandibular lymphnodes firt
234
what could cause swelling of submental node?
Epstein Barr Virus, dental infection including periodontitis
235
what do the submandibular glands drain?
they unilaterally drain the cheeks upper lip body of tongue anterior hard palate most of teeth with periodontium and gingivae except for mandibular incisors (submental nodes) and maxillary third molars (superior deep cervical lymphnodes)
236
what is the most common cause of submandibular node enlargement?
infections of head, neck, sinuses, ears, eyes, scalp and pharynx cancers from oral cavity, anterior nasal cavity, soft tissues and submandibular salivary gland
237
what do external jugular lymphnodes drain?
back of head auricular and parotid region
238
what does the anterior jugular lymphnodes drain?
infrahyoid region
239
where are deep cervical lymphnodes located?
along the internal jugular vein
240
can deep cervical lymphnodes be palpated?
yes
241
what divides the deep cervical lymphnodes into inferior and superior?
the omohyoid crossing the internal jugular
242
what do the superior deep cervical lymphnodes drain?
posterior nasal cavity, posterior hard palate, soft palate, back of the tongue, maxillary third molars with associated periodontium and gingiva, TMJ, oesophagus, trachea and thyroid
243
is lymph drainage at the back of the tongue unilateral or bilateral
bilateral
244
what node drains the palatine tonsils?
jugulodigastric node
245
where are inferior deep cervical lymphnodes located?
inferior to where omohyoid crosses internal jugular vein
246
what do inferior deep cervical lymphnodes drain?
posterion scalp and neck, superficial pectoral region and part of the arm
247
what does the jugulo-omohyoid node drain?
tongue and submental triangle - enlargement may be a sign of pathology of tongue
248
why are inferior deep cervical lympnodes at greatest risk for involvement in spread of breast cancer?
they communicate with the axillary lymph nodes that drain the breast region
249
what lymphnodes drain lateral triangles of neck?
accessory and supraclavicular lymph nodes
250
what do enlarged lymphnodes indicate?
current or past pathology or area of immune activity systemic or local disease
251
what is the most common route of initial spread of carcinomas?
lymphogenous
252
what do swollen and tender lymph nodes indicate?
infection or inflammation
253
what do hard painless lymph nodes indicate?
malignancy
254
if submandibular lymphnodes are enlarged, where is potential location of disease or malignancy?
oral cavity, face, nasal cavity and maxillary sinus
255
if supraclavicular lymphnodes are enlarged, where is potential location of disease or malignancy?
abdomen or thorax
256
what are the boundaries of the oral cavity?
hard and soft palates tongue and soft tissues cheeks
257
what are the two parts of the oral cavity?
oral cavity vestibule oral cavity proper
258
where is the oral vestibule?
the slit like space created by teeth and gingivae and lips and cheeks communicates with exterior through oral fissure (lips)
259
where is the oral cavity proper?
space between upper and lower dental arches which also limit it anteriorly and laterally
260
what does the oral cavity communicate with posteriorly?
oropharynx via oropharyngeal isthmus
261
what is a vestigial feature above the upper lips ?
philtrum
262
what muscle acts as a sphincter for the oral fissure?
orbicularis oris
263
what arteries anastomose in the lips to form an arterial ring?
superior and inferior labial arteries
264
where does the lip get sensory innervation form?
maxillary and mandibular branches of trigeminal
265
what is the main muscular component of the cheek?
buccinator
266
what supplies motor innervation to the buccinator?
facial nerve
267
what duct pierces the buccinator?
parotid duct
268
where does the parotid duct enter the oral cavity?
around maxillary 2nd molar
269
what muscles create the floor of the mouth?
the two mylohyoid
270
where does the geniohyiod attach?
inferior mental spine of mandible and the hyoid superior to mylohyoid
271
what nerve supplies mylohyoid and anterior belly of digastric?
nerve to mylohyoid - branch of IAN
272
what separates anterior and posterior parts of tongue?
terminal sulcus - v shaped groove at dorsum of tongue
273
name the 4 papillae found on tongue
foliate fungiform vallate - largest filiform
274
which is the only tongue papillae with no tastebuds?
filiform
275
where does the posterior 1/3 of tongue lie?
oropharynx
276
what is the foramen cecum of tongue?
small pit rememnant of embryonic structure - where thyroid developed
277
what is the root body and apex of the tongue?
root - attached posterior portion body - anterior 2/3 between body and apex apex - tip which rests against incisor teeth
278
where are fungiform papillae most numerous?
apex of tongue
279
what are foliate papillae?
folds of lingual mucosa
280
what are the lymphoid nodules at the posterior tongue?
lingual tonsil
281
what does waldeyers ring consist of?
4 pairs of tonsils pharyngeal tonsil/adenoid tubul tonsil palatine tonsil lingual tonsil
282
what vein can you see on each side of the frenulum of tongue?
lingual vein
283
what structure houses the opening of the submandibular duct from the submandibular salivary gland?
sublingual caruncle
284
what separates the extrinsic and intrinsic muscles of the tongue?
sagittal septum
285
what do intrinsic muscles of tongue do?
change size and shape of tongue
286
what are the four intrinsic muscles of the tongue?
superior longitudinal inferior longitudinal transverse vertical
287
what are the four extrinsic muscles of the tongue?
genioglossus styloglossus hyoglossus palatoglossus
288
what do extrinsic muscles of the tongue do?
move the tongue
289
what effect do the inferior and superior longitudinal muscles have on tongue?
make short and thick
290
what do the transverse and vertical muscles do to the tongue?
make it long and narrow
291
where does the genioglossus originate and attach?
superior mental spines of mandible hyoid bone inferiorly and intrinsic muscles of tongue superiorly
292
what is the function of genioglossus?
protruding the tongue
293
what happens when genioglossus is not working?
falls posteriorly and obstructs airway - this is what happens in general anaesthesia hence why an airway is inserted
294
what is the origin and insertion of hyoglossus?
greater horn of hyoid intrinsic muscles of tongue lies lateral to genioglossus
295
what is the function of hyoglossus?
depressing lateral sides of tongue
296
where does the lingual artery enter the tongue?
between genioglossus and hyoglossus
297
what vessel gives rise to lingual artery?
external carotid
298
where does the lingual and hypoglossal nerve enter the tongue?
external surface of hyoglossus
299
where does styloglossus originate and insert?
styloid process of temporal bone inserts to fibres of intrinsic muscles and hyoglossus
300
what is the function of styloglossus?
elevating and retracting the tongue
301
what is the origin and insertion of palatoglossus?
originates from palatine aponeurosis blends with intrinsic muscles fibres
302
what is the function off palatoglossus?
depress the soft palate towards the tongue
303
what innervates the palatoglossus?
vagus - more a muscle of the palate than tongue
304
what nerve gives motor supply to the muscles of the tongue?
hypoglossal nerve supplies all muscles except for palatoglossus which is supplied by vagus
305
what nerves give general sensation to tongue - pain, pressure and temperature?
anterior 2/3 mandibular nerve of trigeminal posterior 1/3 glossopharyngeal nerve
306
what nerve gives special sensation of taste to the tongue?
ant 2/3 facial nerve via chorda typani posterior 1/3 glossopharyngeal
307
what blood vessels supply the tongue?
lingual artery from external carotid
308
what blood vessels drain the tongue?
deep lingual and dorsal lingual veins drain into internal jugular vein
309
What is found in the carotid body and what do they do?
chemoreceptors - monitor blood gases o2 and co2 and temperature and ph
310
Where are baroreceptors found in the arterial system and what do they do?
carotid sinus - sends signals along glossopharyngeal nerve to regulate blood pressure
311
What is the term for nucleus pulposis applying pressure to spinal nerves?
slipped disc
312
What is an indication of congestive heart failure?
dilation of external jugular
313
Which disease causes thickening of the bone of the vault of the skull?
Paget's disease
314
The border of which bones make up the pterion?
frontal, temporal, parietal, sphenoid
315
What purpose does the circle of Willis provide?
equalises the blood pressure to the brain
316
Where are the muscles supplied by CN 3,4,6 and 12 formed from?
somites
317
Where are the muscles supplied by CN 5,7,9,10 and 11 formed from?
pharyngeal arches
318
Where do the motor neurons of the lower left side of the face receive their input?
RHS of brain
319
What is a common cause of extra Dural haemorrhage?
rupture of middle meningeal artery due to pterion fracture
320
what happens in a sub-dural haemorrhage?
superior cerebral veins detach from dura and rupture due to minor trauma
321
what causes a sub-arachnoid haemorrhage?
rupture of cerebral arteries usually due to brain aneurism
322
what is the cause and symptoms of cavernous sinus thrombosis?
Bacteria from an upper molar abscess travel through pterygoid venous plexus to sphenoidal emissary veins that join the cavernous sinus symptoms - swellings, boils, visual problems etc
323
what causes osteoarthiritis of the spine?
osteophytes at facet joints
324
why might someone with osteoarthritis feel dizzy when turning their head?
osteophytes press against vertebral artery causing vertebrobasilar ischaemia
325
what is ptosis?
drooping eyelid
326
what is anhydrosis?
lack of sweating
327
ptosis and anyhydrosis are both diagnostic of Horners syndrome, what else may be a sign?
pupillary constriction
328
what causes Horners syndrome and its symptoms?
damage to the sympathetic trunk
329
which parasympathetic ganglion supplies the cilliary muscles and pupillary constrictor muscles?
ciliary ganglion
330
what is supplied by the submandibular ganglion?
sublingual and submandibular salivary glands
331
what is supplied by the pterygopalatine ganglion?
lacrimal glands nasal mucosa Palate general sensation Nasal cavity
332
which ganglion supplies the parotid gland?
otic ganglion
333
what region will you find lymph nodes which drain into the parotid lymph nodes?
area above the line between eye and angle of mandible
334
why might profuse bleeding occur when a patient presents with a cut lip?
inferior and superior labial branches of facial artery anastomose
335
what causes the mediolus?
overlap of muscle fibres of the buccinator - posterior fibres cross to opposite side on labial side e.g. superiorly to inferiorly
336
what is ludwigs angina?
bacterial infection affecting floor of mouth
337
what muscle is responsible for retrusion of the mandible?
temporalis
338
along what do the fibres conveying taste travel from the lingual nerve to the facial nerve?
chorda tympani
339
which nerve supplies the geniogloosus, styloglossus and hyoglossus?
hypoglossal CN12
340
which nerve supplies palatoglossus?
vagus CN10
341
what risk is associated with surgery to remove stones from the submandibular duct?
laceration of lingual vein damage to lingul nerve
342
where may food get trapped in the pharynx?
piriform fossa and vallecula
343
what is waldeyers ring and what is it composed of?
tonsillar ring first line of defence pairs of adenoid, lingual, palatal and tubul tonsils
344
what forms the palatal aponeurosis?
tendon of tensor veli paletini
345
which epithelial type lines inferior nasal cavity?
ciliated pseudostratefied columnar epithelium
346
which epithelial type lines superior nasal cavity?
olfactory epithelium
347
how might infection of frontal sinus spread?
infection can track through the frontal sinus opening in hiatus semilunaris to the maxillary sinus opening
348
what is supplied by maxillary branch of trigeminal?
skin over maxilla, upper teeth, hard and soft palate, nasal cavity and nasopharynx
349
Which gland may be affected by disease if you can see the sclera superior to the iris?
thyroid
350
what may cause a stye?
infection of the hair follicle of the eyelashes
351
which glands produce oily secretions to hold tears within the eye?
meibomian glands
352
what may also be damaged if medial eye is damaged?
lacrimal canaliculli
353
what is conjunctivitis?
infection of the conjunctiva that lies over the sclera - causes eyes to appear red
354
which muscle is responsible for opening upper eyelid?
levetator palpaebrae superiosis
355
which muscle is responsible for moving eye upward?
superior rectus
356
which nerve supplies superior rectus and levatator palpebral superiosis?
oculomotor CN3
357
how do excess tears end up in nasal cavity?
they drain to lacrimal canaliculi then through to the nasolacrimal duct to the inferior meatus of the nasal cavity
358
explain LR6SO4O3
lateral rectus supplied by CN6 superior oblique supplied by CN4 all other eye muscles supplied by CN3
359
which nerve supplies lateral rectus?
CN6 abducens
360
what is found in the fenestra vestibuli?
stapes
361
what is the fenestra cochlea?
the round window which expands to relieve pressure of the cochlea
362
what might happen when the anular ligament of the stapes becomes calcified?
deafness
363
how might infection from the pharynx spread to middle ear?
through the auditory tube
364
what is glue ear?
infection of the pharynx causing swelling of the tubule tonsil in turn blocking the middle ear as no air can get in, the goblet cells proliferate and become more active producing mucous the mucous prevents movement of the ossicles causing deafness
365
how do middle ear infections spread to the mastoid antrum and what may be damaged as a result?
middle ear infection can spread through the aditus to the mastoid antrum and the facial nerve may be affected
366
why do patients with facial palsy hear noises as louder?
the tensor tympani and stapedius responsible for dampening sounds will be paralysed
367
what is the function of the pinna?
funnel sound to the external auditory meatus and tympanic membrane
368
what is the pinna made of?
elastic cartilage
369
what protects external auditory meatus?
hair and ceruminous glands
370
what angle is the tympanic membrane?
45
371
what emergency procedure would be carried out if patients airway becomes blocked?
cricothyrotomy
372
what are the causes of goitre?
graves disease iodine deficiency
373
what condition may cause a bruit?
congestive heart failure
374
what are tender lymph nodes indicative of?
infection
375
what are non-tender swollen lymph nodes indicative of?
tumour
376
what is hortons disease?
inflammation of superficial temporal artery that can lead to blindness or stroke aka temporal arteritis
377
why will injuries to the scalp heal quickly?
it has a rich blood supply
378
what are the symptoms of pagets disease?
deafness and blindness sign would be thickening of bone
379
what is osteoma?
benign tumour of the bone
380
what is a tumour of plasma cells in the bone marrow?
multiple myeloma
381
what haemorrhage causes deterioration over a few hours?
extra dural
382
what haemorrhage causes deterioration over a few days/weeks?
sub dural
383
what haemorrhage causes immediate deterioration?
sub arachnoid
384
what name is given to out poaching of cerebral arteries?
berry aneurism
385
patient presents with poor ability to speak and process language, which artery is affected?
middle cerebral artery
386
what is the cause of bells palsy?
if you know the cause it wouldnt be bells palsy
387
why can bacteraemia or thrombosis form in cavernous sinus after abscess?
sphenoidal emissary veins flow slowly allowing for multiplication of bacteraemia
388
how can facial palsy be caused by an ear infection?
if infection spreads to mastoid air cells, it can affect the facial nerve as it passes through the mastoid process
389
surgery to which gland may cause facial palsy ?
parotid
390
how can an IANB cause facial palsy?
if LA is injected too far posteriorly then it will affect the facial nerve dense fascia around parotid mean effects will be prolonged as LA cannot escape
391
what will be affected by a stroke in the internal capsule?
facial and hypoglossal nerve causing paralysis of the oposing side below the eyebrow
392
what are osteophytes?
bony projections which grow at joints
393
what symptoms can arise due to damage to the sympathetic trunk?
ptosis, anhydrosis and pupillary constriction
394
ptosis, anhydrosis and pupillary constriction are symptoms of what condition?
horners syndrome
395
which nerve can cause pain when parotid gland is inflamed?
glossopharyngeal
396
how can trigeminal neuralgia be treated?
carbamazepine injection of alcohol to cause necrosis of trigeminal at foramen ovale surgical removal
397
why can salivary gland calculi form in the submandibular duct?
as it flows uphill the flow rate of saliva is slower
398
what should be done prior to removing submandibular duct calculi?
true occlusal radiograph to confirm position
399
which muscle does the submandibular gland wrap around?
mylohyoid
400
describe the secretion of the submandibular gland
mixed - serous and mucous
401
what nerve loops under the submandibular duct?
lingual nerve CNV3
402
what blood vessels supply the submandibular gland?
submental arteries-branch of facial artery
403
where do the submandibular lymph nodes drain to?
deep cervical lymph nodes particularly the jugulo-omohyoid lymph node
404
what is the fascial capsule of the submandibular gland continuous with?
deep investing cervical fascia
405
where do submandibular ducts open?
3 orifices besides the base of the tongue frenulum
406
what veins drain the submandibular gland?
submental veins to lingual and facial veins
407
describe the secretion of sublingual gland
mostly mucous but some serious
408
where does the sublingual gland lie?
sublingual fossa of mandible between mandible and hyoglossus lateral to the submandibular duct and lingual nerve
409
what is the smallest and most deep major salivary gland?
sublingual
410
where do sublingual ducts open?
numerous open into the floor of the mouth along sublingual folds
411
what artery supplies the sublingual gland?
sublingual - branch of lingual artery submental arteries - branch of facial artery
412
what veins drain the sublingual gland?
submental veins to lingual and facial veins - same as submandibular
413
which major salivary gland has no true fascial capsule?
sublingual
414
describe parasympathetic innervation of submandibular and sublingual gland
secretomotor to produce saliva -preganglionic parasympathetic fibres travel to the submandibulaar ganglion from the chorda tympani CNVII and via the lingual nerve CNV3 -postganglionic parasympathetic fibres travel in the lingual nerve CNV3 to the sublingual gland OR travel directly to the sublingual and submandibular glands (not in a nerve)
415
what effect does sympathetic innervation have on the salivary glands?
derived from the superior cervical ganglia and nerve plexus on ECA results in vasoconstriction, reduction in saliva, dry mouth
416
where are minor salivary glands found?
diffusely embedded in mucosa buccal lingual palatine labial
417
what nerves innervate minor salivary glands?
CNVII and CNV
418
what are mucoceles and which glands are susceptible to them?
minor salivary glands swelling due to blockage of associated ducts
419
describe parasympathetic innervation of the minor salivary glands above the oral fissure
-preganglionic fibres travel to the pterygopalatine ganglion in the greater petrosal nerve branch of CNVII -postganglionic fibres travel to the palate via palatine nerves
420
describe parasympathetic innervation of the minor salivary glands below the oral fissure
-preganglionic fibres travel to the submandibular ganglion from the chorda tympani CNVII and via the lingual nerve CNV -postganglionic fibres travel in the lingual nerve CNV to the glands or travel directly to the glands
421
what is mumps?
viral infection that presents as painful swelling over the salivary glands most commonly over parotid
422
what is sialolithiasis?
salivary stones - patients have pain, swelling and lack of salivation, common in submandibular duct due to upwards course into the oral cavity
423
what is ptyalism?
excessive salivation occurs prior to vomiting and can be associated with several diseases
424
what will you find in the submandibular triangle?
submandibular gland, lymph nodes, hypoglossal nerve, mylohyoid nerve and parts of the facial artery and vein
425
what will you find in the submental triangle?
submental lymph nodes and small veins
426
what will you find in the carotid triangle?
carotid sheath and contents, ECA, parts of accessory and hypoglossal nerve and deep cervical lymph nodes
427
name the suprahyoid muscles
geniohyoid digastric mylohyoid stylohyoid
428
name the infrahyoid muscles
sternohyoid omohyoid thyrohyoid sternothyroid
429
what innervates the mylohyoid?
nerve to mylohyoid from CNV3
430
where does the mylohyoid originate and insert?
originates at mylohyoid line on mandible and inserts into body of hyoid and opposite fibres
431
what is the action of mylohyoid?
elevate hyoid and floor of mouth
432
what is the action of suprahyoid muscles?
elevate the hyoid and larynx and constitute to FOM
433
what innervates the digastric muscle?
anterior belly - nerve to mylohyoid CNV3 posterior belly - digastric branch of CNVII
434
what is the action of the digastric muscle?
anterior - raises hyoid and opens mouth posterior- elevates and retracts hyoid bone
435
what innervates the stylohyoid?
innervated by CNVII
436
what innervates the geniohyoid?
innervated by anterior ramus of C1 travels with CNXII
437
what is the function of geniohyoid?
fixed mandible - elevates and pulls hyoid forward fixed hyoid - pulls mandible down and in
438
what is the function of stylohyoid?
pull hyoid upward
439
what are the branches of external carotid artery?
superior thyroid ascending pharyngeal lingual facial occipital posterior auricular maxillary superficial temporal
440
what replaces the common carotid superiorly in the carotid sheath?
internal carotid artery
441
what are the contents of carotid triangle?
superior root ansa cervicalis carotid sheath thyroid gland larynx pharynx deep cervical lymph nodes parts of hypoglossal and accessory nerve
442
where do deep cervical lymphnodes lie in the carotid triangle?
along carotid sheath and internal jugular vein
443
where does the carotid sheath run from?
foramen of carotid canal to aortic arch
444
which common carotid artery is a branch of the brachiocephalic trunk?
right
445
which common carotid arises directly from aortic arch?
left
446
where is the bifurcation of the common carotid artery?
C3 C4 level
447
where does the internal carotid artery travel and supply?
no branches in the neck, ascends to enter carotid canal and supply the anterior brain
448
what is the carotid sinus?
dilation at the bifurcation of common carotid containing baroreceptors in wall of internal carotid
449
what do baroreceptors monitor?
they are sensitive to stretch and monitor blood pressure and keep it within homeostatic values
450
what innervates the carotid sinus?
innervated by glossopharyngeal via carotid sinus nerve
451
where is the carotid body?
bifurfcation of CCA at C3/C4 level
452
what receptors are found in carotid body and what do they do?
chemoreceptors monitor blood O2 CO2 pH and temperature
453
how will chemoreceptors respond in an emergency?
increase respiration, increase cardiac rate and increase blood pressure
454
what nerve supplies the carotid body?
glossopharyngeal via carotid sinus nerve
455
where is the carotid canal?
petrous part of temporal bone
456
the external carotid artery supplies most structures external to the cranium except for what?
scalp and part of forehead which are supplied by supraorbital artery which derives from internal carotid
457
what are the terminal branches of external carotid artery?
maxillary and superficial temporal
458
how many branches are there of the ECA?
8 - 6 and 2 terminal branches 1 medial 2 posterior 3 anterior 2 terminal
459
where does the middle meningeal artery branch from?
maxillary artery branch of ECA
460
where does the middle meningeal artery run?
interior to skull in pterion region
461
where does the middle meningeal artery enter the cranium?
foramen spinosum in the sphenoid
462
what is the largest vein in the neck?
internal jugular
463
what does the internal jugular drain?
blood from brain, face and parts of neck
464
where does the internal jugular vein exit the skull?
jugular foramen and into the carotid sheath
465
which vein does the internal jugular vein join and to become what?
internal jugular vein joins the subclavian vein to become brachiocephalic vein
466
what veins drain into IJV?
facial, lingual, occipital, superior thyroid, middle thyroid, pharyngeal and inferior petrosal sinus
467
what is the inferior bulb of the internal jugular vein?
inferior end of IJV bicuspid valve which permits blood flow towards the heart but prevents backflow
468
what is the dilation at the origin of IJV?
superior bulb of IJV where inferior petrosal sinus enters IJV after it leaves the cranium through jugular foramen
469
what two veins does the external jugular vein join?
retromandibular and posterior auricular veins
470
what veins drain into external jugular vein?
posterior EJV, transverse cervical, suprascapular and anterior jugular
471
what crosses the SCM?
external jugular vein transverse cervical nerve great auricular nerve
472
where does the external jugular vein run?
angle of mandible in or below parotid to the mid clavicle
473
where does the external jugular vein run?
angle of mandible in or below parotid to the mid clavicle
474
what nerve does the EJV lie parallel with?
great auricular nerve
475
where do the anterior jugular veins run?
on either side of midline
476
what is the communication between anterior jugular veins called?
jugular venous arch
477
where do the ant. jugular veins drain?
EJV or directly into subclavian
478
what does the cervical branch of the facial nerve innervate?
platysma muscle
479
where does the facial nerve emerge from?
stylomastoid foramen
480
in the parotid, the facial nerve forms the parotid plexus abd gives rise to the 5 terminal branches of the facial nerve, what are these branches?
two zebras bit my cock temporal zygomatic buccal marginal mandibular cervical
481
where does the glossopharyngeal nerve exit the the skull?
anterior aspect of jugular foramen
482
what nerves exit the jugular foramen alongside IJV?
glossopharyngeal CN9 vagus nerve CN10 spinal accessory CN11
483
what does the glossopharyngeal nerve supply?
most of the nerve travels fwd to supply oral cavity but some branches travel down to supply carotid sinus and body and pharynx - sensory stylopharyngeus - motor
484
what are the bulges (2 on 2 nerves) you can see just below the jugular foramen?
vagus and spinal accessory superior and inferior ganglion
485
where does vagus nerve exit the skull?
jugular foramen and then travels in carotid sheath
486
what branches does the vagus nerve give rise to in the neck?
pharyngeal, laryngeal and cardiac
487
where do recurrent laryngeal nerves arise from?
vagus
488
if the recurrent laryngeal nerve is damaged during neck surgery, what are the symptoms?
aphonia and hoarseness
489
where does the right recurrent laryngeal nerve loop around?
subclavian artery and brachiocephalic trunk
490
where does the left recurrent laryngeal nerve loop around?
arch of the aorta
491
where does the spinal accessory nerve exit the skull?
exits at the jugular foramen
492
what innervates the SCM and trapezius?
spinal accessory nerve CN11
493
where does the hypoglossal nerve exit the skull?
hypoglossal canal
494
what does the hypoglossal nerve cross on route to oral cavity?
internal carotid artery and external carotid artery
495
what does the hypoglossal nerve supply?
motor innervation of the tongue supplies intrinsic muscles and 4/5 extrinsic muscles of the tongue (palatoglossus is innervated by vagus nerve)
496
what suprahyoid muscle does hypoglossal nerve give off branches to?
geniohyoid
497
what nerve gives off the superior root of ansa cervicalis?
hypoglossal
498
what makes up ansa cervicalis and what does it supply?
C1 - C3 and supplies infrahyoid muscles
499
what cervical anterior rami form transverse cervical nerve?
C2-C3
500
what cervical anterior rami form cervical plexus?
C1-C4
501
what does the cervical plexus supply?
infrahyoid muscles C3 and C4 supply diaphragm via phrenic nerve skin of anterior and lateral neck skin of inferior head
502
what gives rise to brachial plexus?
C5-T1
503
what does the phrenic nerve descend parallel to?
internal jugular vein
504
name the three ganglia of the cervical sympathetic trunk
superior C1/C2 level middle C6 level inferior C7 level
505
the inferior ganglia of the cervical sympathetic trunk is commonly fused with the ganglion of T1 to form what?
cervicothoracic/stellate ganglion
506
what is the root of the neck?
junction between neck and thorax
507
axillary inlet allows communication between what?
neck and upper limp
508
when does the subclavian artery become the axillary artery?
at lateral border of the first rib (after passing through cervicoaxillary canal)
509
where do the external and anterior jugular veins terminate?
root of the neck
510
what drains the upper limb?
axillary vein (becomes subclavian vein at border of first rib)
511
how many roots does the brachial plexus have?
5 - anterior rami of C5-C8 and T1 C5-T1
512
how many trunks do the 5 roots of brachial plexus form?
3 superior middle inferior
513
what are the 5 terminal branches (peripheral nerves) of brachial plexus?
ride me under my attic radial median ulnar musculocutaneous axillary
514
what do the 5 terminal branches of brachial plexus innervate?
upper limb
515
what do all structures going from thorax to head or upper limb pass through?
thoracic inlet/aperture
516
what does the omohyoid divide the posterior triangle into?
omoclavicular triangle and occipital triangle
517
what is pneumothorax?
lungs or pleaural spaces infiltrated by air
518
what is haemothorax?
when lungs or pleural spaces are infiltrated by blood
519
what is chylothorax?
when lungs or pleaural spaces are infiltrated by chyle
520
pleural cavity forms between what pleura?
visceral pleura which adheres to lungs parietal pleura
521
what is the purpose of suprapleural membrane?
stops changes in intrathoracic pressure from affecting contents of the neck
522
injuries at the root of the neck can compromise what?
lungs and pleural sacs as the lungs extend above the first rib and clavicle mid third
523
what is the name of the dome shape cup formed by cervical pleura?
pleura cupola
524
why are infants more susceptible to injury to lungs or pleural sacs?
lungs extend further superior as their necks are shorter
525
what 3 branches come off the aortic arch?
brachiocephalic left subclavian artery left common carotid artery
526
what does the brachiocephalic trunk branch to?
right subclavian artery right common carotid artery
527
what joins the aorta to the left pulmonary artery?
ligamentum arteriosum
528
what determines the division of the subclavian artery into 3 parts?
anterior scalene
529
what are thw 3 parts of subclavian artery?
medial - medial to anterior scalene posterior - posterior to anterior scalene lateral - lateral to anterior scalene
530
how many arteries branch off the 1st part of subclavian artery and what are they?
3 vertebral thyrocervical trunk internal thoracic artery
531
what cervical vertebrae does vertebral artery enter the foramen transversium?
C6
532
describe the path of the vertebral artery
branches from 1st part of subclavian artery ascends to C6 - cervical part enters transverse foramin of C6-C1 as vertebral part exits transverse foramen of C1 enters foramen magnum joins vertebral artery of opposite side at inferior border of pons to form basilar artery
533
where do the two vertebral arteries join to form basilar artery?
inferior border of pons
534
what are the branches of the thyrocervical trunk?
inferior thyroid artery - largest transverse cervical artery suprascapular artery ascending cervical artery
535
what are the branches of the 2nd part of the subclavian artery?
costocervical trunk supreme intercostal artery deep cervical artery
536
what are the branches if the 3rd part of the subclavian artery?
dorsal scapular artery
537
what is the only tributory into subclavian vein?
external jugular vein
538
what is the venous angle?
the union of internal jugular vein with subclavian vein to form brachiocephalic vein
539
where does the thoracic duct LHS and right lymphatic trunk RHS drain lymph into venous circulation?
venous angle - union of IJV and subclavian to form brachiocephalic
540
where do inferior thyroid veins drain to?
directly into brachiocephalic vein
541
what is the major lymphatic drainage channel on the LHS?
thoracic duct
542
what are the anterior prevertebral muscles?
longus colli longus capitus rectus capitus anterior anterior scalene
543
what are the lateral prevertebral muscles?
rectus capitus lateralis splenius capitus levitator scapulae middle scalene posterior scalene
544
what is the function of prevertebral muscles?
flex and rotate head and neck except for levitator scapulae which levitates and rotates scapula
545
what makes up the central nervous system?
spinal cord and brain
546
what neaurons travel from CNS to periphery?
efferent
547
what neurons travel from periphery to CNS?
afferent
548
what is the function of autonomic nervous system?
control involuntary physiological processes
549
what does an increase in sympathetic cause?
dilation of pupils deacreased salivation increase bp
550
what does an increase in parasympathetic cause?
decrease cardiac output decrease bp speeds up peristalsis increases salivation
551
are autonomic pathways afferent or efferent?
efferent
552
how many neurons are in autonomic pathways?
2 preganglionic and postganglionic
553
which neurons are myelinated?
preganglionic
554
which neurons are unmyelinated?
nonmyelinated emma what was this Q
555
which part of autonomic nervous system has longer preganglionic neurons?
parasympathetic (remember parasympathetic is a longer word than sympathetic)
556
what are the two neurotransmitter in ANS?
acetylcholine noradrenaline
557
what are cholinergic fibres?
neurons that release acetylcholine
558
what are adrenergic fibres?
neurons that release noradrenaline
559
which nervous system communicates directly through a single lower motor neuron?
somatic
560
where are the cell bodies for all sensory nerves?
spinal ganglion
561
where do visceral motor nerves synapse?
peripheral ganglion
562
what is a synaptic cleft?
space between axon terminal of one neuron and dendrite of receiving neuron which neurotransmitters diffuse across
563
how do neurotransmitters allow action potentials to be passed on?
they bind to post synaptic receptors to cause specific ion channels to open
564
what effect does acetylcholine and noradrenaline have?
excitatory
565
what will release of acetylcholine form postganglionic parasympathetic neuron cause?
increase in gut motility and decrease in cardiac muscle contraction
566
what does sympathetic release of acetylcholine cause?
innervation of sweat glands
567
what will release of norepinephrine from postganglionic sympathetic fibres cause?
decrease in gut motility and increase in cardiac muscle contraction
568
where are the preganglionioc neurons located in the parasympathetic NS?
cranio sacral cranial nerves 3 7 9 and 10 sacral S2-S4 spinal segments
569
where are the preganglionic neurons located in the sympathetic NS?
thoraco lumbar spinal segments T1-L2 specifically in the lateral horn
570
what forms ganglion impar?
R and L paravertebral ganglia from the sympathetic chain extend from the base of skull to coccyx and join to form ganglion impar
571
what is the origin of parasympathetic neurons?
nuclei in brain stem and cranial nerves 3 7 9 and 10 and sacral spinal segments S2-S4
572
how many ganglia are there in the neck?
3 superior mid and inferior mid is at C6 level and can be absent inferior is at C7 but often fuses with T1 ganglia to form stellate ganglion
573
what does the superior cervical ganglia supply?
ICA & ECA Cervical spinal nerves (C1-C4, cervical plexus) Pharynx Superior cardiac nerves
574
what does the middle cervical ganglia supply?
cervical spinal nerves C5-C6 middle cardiac nerves
575
what does the inferior cervical ganglia supply?
C7 C8 T1 inferior cardiac nerves vertebral artery
576
define horners syndrome
damage to cervical sympathetic trunk resulting in absence of sympathetically stimulated functions on ipsilateral side of head
577
what are the symptoms of horners syndrome?
miosis - constriction of pupil ptosis- drooping of eyelid - paralysis of levatator palpebrae superiosis anhydrosis- ansence of sweat
578
what are splanchnic nerves?
preganglionic neurons that do not synapse in the sympathetic chain
579
what do splanchnic nerves synapse with?
postganglionic neurons in prevertebral ganglia
580
where is the adrenal gland located?
superior to kidney
581
what supplies the adrenal medulla?
sympathetic preganglionic neurons
582
what are the cells in the adrenal medulla that release adrenaline and noradrenaline into the blood stream called?
chromaffin cells
583
which neurons travel to ganglia close to target organ?
parasympathetic
584
where does vagus nerve provide parasypathetic supply to?
abdomen and thorax
585
what are the layers of the scalp?
S - skin C - connective tissue dense A - aponeurosis L - loose connective tissue P - pericranium
586
what will you find in skin of scalp?
hair follicles, sweat and sebaceous glands
587
what will you find in connective tissue of scalp?
richly vascularised and cutaneous nerves
588
what layer of scalp prevents superficial wounds gaping open and requires suturing if compromised?
aponurosis (epicranial)
589
what does loose connective tissue allow?
loose areolar tissue allows free movement of outer layers over calvaria
590
how do scalp infections spread intracranially?
emissary veins
591
what nerve supplies the skin over the angle of the mandible?
great auricular nerve from cervical plexus C2 and C3
592
what nerve supplies cutaneous/sensory innervation of posterior scalp?
posterior innervation of scalp by posterior rami of C2 and C3
593
what nerve supplies cutaneous/sensory innervation of side of head and angle of mandible?
anterior rami of C2 and C3 supply side of head and angle of mandible
594
what nerve supplies cutaneous/sensory innervation of vertex to nose?
CNV1 supplies vertex to nose
595
what nerve supplies cutaneous/sensory innervation of inferior eyelid?
CNV2 supplies inferior eyelid to superior lip and a little bit of frontal/side eye
596
what nerve supplies cutaneous/sensory innervation of cheek?
CNV3 supplies temple cheek part of ear and mandible except for angle which is supplied by great auricular
597
what arteries supply the anterior scalp?
internal carotid artery
598
what arteries supply the lateral and posterior scalp?
external carotid artery
599
describe the venous drainage of the scalp
veins run alongside arteries and have same names and drain into external jugular vein except for occipital vein which drains into internal jugular vein
600
which branches of ecternal acarotid supply scalp?
superficial temporal, occipital and posterior auricular
601
which branches of internal carotid artery supplies scalp?
supraorbital and supratrocheal
602
how does the posterior scalp drain lymph?
mastoid and occipital nodes drain into deep cervical nodes
603
hoe does the anterior scalp drain lymph?
pre-auricular and parotid nodes
604
what occupies the anterior cranial fossa?
frontal lobes
605
how do olfactory bulbs of CN1 recieve nerve fibres drom the nasal cavity?
via the foramina on the cribiform plate
606
what occupies the middle cranial fossa?
temporal lobes
607
what fossa does the pituitary lie in?
hypophyseal fossa of spheboid bone
608
what occupies the posterior cranial fossa?
cerebellum and brainstem
609
what lies superficial and deep to calvaria?
scalp and pericranium calvaria dura
610
what are buttresses?
thicker regions of cranial bone that transmit forces around weaker areas of the cranium
611
what is the purpose of cranial meninges?
membranous layers that help in protection of the brain
612
what are the layers of dura mater?
periosteal layer - attached to bone meningeal layer - contacts arachnoid mater
613
name the cranial meninges
dura mater arachnoid mater subarachnoid space pia mater
614
what fills the subarachnoid space?
fluid filled space filled by CSF and blood vessels
615
where will you find arachnoid granulations/villi?
in the sagital sinus and lateral lacunae
616
what do arachnoid villi do?
reabsorb CSF into venous system
617
what does pia mater adhere to?
pia mater adheres to the surface of the brain and enters sulci of the brain
618
what do the dura mater folds do?
limit movement of brain within cavity
619
what arteries supply dura and calvaria?
meningeal arteries in periosteal layer anterior, middle, accessory and posterior meningeal arteries
620
what is at risk of damage during salivary calculi removal from submandibular duct?
lingual nerve
621
what nerve is at risk during lower third molar extraction?
IAN and lingual
622
what tumour may affect the pharyngeal recess?
neoplasm tumours
623
what risk is associated with biopsy of a neoplasm tumour?
rupture of internal carotid
624
what is the cause of mortality in tonsilectomy?
lymphoid tissue is highly vascular so can bleed profusely
625
a grommet is used to treat what?
glue ear
626
why is ot easier to breathe through right nostril when lying on LHS?
L nostril becomes engorged
627
child presents with bad breath and a build up of pus what may be cause?
object lodged in inferior meatus
628
why does your nose run when crying?
tears are drained through the nasolacrimal duct to the inferior meatus
629
what condition is treated with functional endoscopic surgery?
sinusitis
630
why might clear fluid be running out the nose?
damage to ethmoid sinus can cause CSF to leak from nose
631
what differs between OAC and OAF?
OAF is epithelial lined
632
what can happen to the ligament within the fenestra vestibulli?
annular ligament may become calcified leading to deafness
633
what can cause referred pain to the ear?
pain may travel form tooth along trigeminal nerve to the ear
634
what may need surgically reattached after damage to eye?
retina
635
what is sinus pneumatisation?
when maxillary sinus extends in to the space previously occupied by a removed tooth
636
what appears as a radiolucency beginning above canine and sloping down to premolars?
nasolabial fluid
637
what cartilage can be found between thyroid cartilage and hyoid bone?
triciteal cartilage - small three pointed star cartilage
638
what does the pharynx lie posterior to?
nasal cavity - nasopharynx oral cavity - oropharynx larynx - laryngopharynx
639
where does nasopharynx extend from and to?
nasal septum to soft palate
640
where are the tubul tonsils found?
nasopharynx
641
what epithelium is found in oropharynx?
stratified squamous
642
where does oropharynx extend from and to?
soft palate to epiglottis
643
what function does oropharynx have
digestive
644
what function does nasopharynx have?
repiratory
645
hgat are the names of the dura mater folds?
falx cerebelli falx cerebri tentorium cerbelli diaphragm sellae
646
what are the boundaries of laryngopharynx?
superior epiglottis to inf cricoid cartilage
647
what is laryngopharynx continuous with?
oropharynx and laryngopharynx
648
what does laryngeal inlet allow communication between?
larynx and laryngopharynx
649
what lymphoid tissue forms waldeyers ring?
adenoids/pharyngeal tonsils - nasopharynx tubular tonsils - nasopharynx lingual tonsils - posterior 1/3 of tongue palatine tonsils - oropharynx 'tonsils'
650
how do tonsils protect the airway?
they recognise microorganisms as self or non-self and start immune response
651
name the fascia that holds nasopharynx open
pharyngobasilar
652
what muscle pushes the food bolus towards oesophagus?
pharyngeal constrictors - superior middle and inferior like paper cups stacked
653
what muscle lifts pharynx to receive food bolus from oral cavity?
pharyngeal elevators
654
what nerve supplies the pharyngeal constrictors?
vagus nerve via pharyngeal plexus
655
what is cricopharyngeus?
circle part of inferior pharyngeal constrictor that forms a sphincter around oesophagus and prevents air being drawn into stomach during inhalation
656
what is the function of palatpoharyngeus?
elevates larynx and pharynx
657
what supplies palatopharyngeus?
vagus nerve
658
what are the pharyngeal elevators called?
palatopharyngeus salpingopharyngeus stylopharyngeaus
659
what supplies stylopharyngeus?
is is the only pharyngeal muscle supplied by glossopharyngeal nerve
660
what is the function of stylopharyngeus?
elevates larynx and pharynx
661
what is the only muscle derived from 3rd pharyngeal arch?
stylopharyngeus
662
the 3rd pharyngeal arch gives rise to only one muscle, what is it?
stylopharyngeus
663
whach pharyngeal muscle originates from the auditory tube?
salpingopharynx
664
what is the function of salpingopharyngeus?
elevates larynx and pharynx and opens auditory tube to equalise pressure in middle ear during swallowing
665
what nerve supplies the salpingopharyngeus?
vagus nerve
666
what muscle connects auditory tube to pharynx?
salpingopharyngeaus
667
what is the voluntary phase of swallowing?
oral phase
668
what is the involuntary phases of swallowing?
pharyngeal and oesophageal
669
what closes nasopharynx during deglutition (swallowing)?
soft palate
670
epiglottis function during swallowing
closes laryngeal inlet to protect airway
671
what bones form the hard palate?
anterior 3/4 palatine process of maxilla posterior 1/4 horizontal plate of palatine bone
672
what is anterior to palatal rugae ?
incisive papilla
673
what passes through incisive canal?
nasopalatine nerve
674
what is the soft palate?
muscular continuation of hard and soft palate that separates nasopharynx and oropharynx
675
what emerges the greater palatine fossa?
greater palatine nerve and vessels
676
what emerges the lesser palatine fossa?
lesser palatine nerves and vessels
677
what strengthens the anterior soft palate?
palatine aponeurosis
678
where does the palatine aponeurosis attach?
hard palate and between the pterygoid humulus of medial plate of pterygoid process
679
what lies between palatoglossal and palatopharyngeal arches?
palatine tonsil
680
what is located in the fossa between palatoglossal and palatopharyngeal arches?
palatine tonsil
681
what do palatine glands secrete?
mucous
682
what joins soft palate to tongue and pharynx?
palatoglossal and palatopharyngeal arches
683
what supplies motor innervation to the palate muscles?
CN10 vagus except for tensor veli paletini which is supplied by mandibular branch of trigeminal?
684
what supplies tensor veli paletini?
CNV3 T for tensor T for trigeminal
685
what are the muscles of the palate?
palatopharyngeous palatoglossus tensor veli palatini levator veli palatini musculous uvulae
686
which muscles insert into paletine aponeurosis?
tensor veli palatini and levator veli palatini
687
what artery supplies the hard palate?
greater palatine artery
688
which artery supplies soft palate?
lesser palatine artery
689
blood supply of palate
greater and lesser palatine arteries branches of maxillary artery from external carotid
690
which artery does the lesser palatine artery anastemose with?
ascenidng paletine artery
691
which artery does the greater palatine artery anastemose with?
sphenopalatine artery
692
what supplies sensory innervation to the palate?
CNV2 maxillary branchs of trigeminal coming via pterygopalatine ganglion lesser palatine greaterpalatine nasopalatine
693
what does the greater palatine nerve supply?
hard palate until 1st premolar
694
what does nasopalatine nerve supple?
anterior gingiva and mucosa from canine
695
what forms the posterior boundary of oral cavity?
palatoglossal arch - formed by palatoglossal muscle
696
what lies between the two arches in oral cavity ?
tonsillar fossae with palatine tonsils
697
what muscle moves the uvula?
musculus uvulae moves uvula to create better seal to separate nasopharynx from oropharynx during swallowing
698
where is larynx located?
anterior neck at C3-C6 level
699
what is the function of the larnyx?
air passage in and out of trachea protective sphincter prevents foreign bodies entering trachea organ of phonation
700
what is larynx continuous with inferiorly ?
inferiorly - trachea
701
what is laryngopharynx continuous with inferiorly?
oesophagus
702
what type are the laryngeal cartilages?
all hyaline except for epiglottis which is elastic
703
what laryngeal cartilage is the only complete ring?
cricoid cartilage
704
how many cartilages make up larynx?
9 thyroid criocoid epiglottis and 3 pairs - only one of interest is arytenoid
705
how many cartilages make up larynx?
9 thyroid cricoid epiglottis and 3 pairs - only one of interest is arytenoid
706
where does arytenoid cartilage lie?
behind the thyroid cartilage
707
what do the laminae of thyroid cartilage fuse to form anteriorly?
laryngeal prominence
708
what is the V shape on superior thyroid cartilage?
superior thyroid notch
709
where does epiglottis attach to the thyroid cartilage?
posterior
710
what cartilage forms epiglottis?
elastic
711
what connects thyroid cartilage to epiglottis?
thyro-epiglottic ligament
712
what connects epiglottis to hyoid bone?
hyoepiglottic ligament
713
what does the arytenoid cartilage articulate with inferiorly?
cricoid cartilage
714
what membrane connects the thyroid cartilage to the hyoid bone?
thyrohyoid membrane NOT LIGAMENT BRO
715
what is the anterior and posterior thickenings of the thyrohyoid membrane called?
medial thyrohyoid ligament lateral thyrohyoid ligament
716
what is the name of the thin sheet of connective tissue that extends between the arytenoid and epiglottic and thyroid cartilages called?
quadrangular membrane
717
what does the inferior free end of quadrangular membrane form?
vestibular ligament - mucosa overlies o form vestibular fold
718
what ligament extends from cricoid to thyroid cacrtilage?
cricothyroid ligament
719
what ligament does the superior free end of cricithyroid ligament form??
vocal ligament - mucosa overlies to form vocal fold
720
what does the superior free end of quadrangular membrane form?
aryepiglottic ligament - mucosa overlies to form aryspiglottic fold
721
what creates vocal folds?
larynx is lined with mucosa which create folds over free edges of membranes and ligaments
722
what fold forms the laryngeal inlet?
aryepiglottic fold
723
what are the false vocal cords?
vestibular folds - over inferior free end of quadrangular membrane
724
what are the true vocal cords?
vocal folds - formed over superior free end of cricothyroid ligament
725
what is the name of the space between vocal folds?
rima glottidis
726
name the space formed between the laryngeal inlet and the vestubular folds
vestibule
727
what do vocal folds control?
sound production from larynx main inspiratory constrictor
728
what forms the glottis?
vocal folds and processes and rima glottidis
729
what is the function of intrinsic laryngeal muscles?
move laryngeal components -open/close rima glottidis alter tension of vocal folds open or close laryngeal inlet
730
what are the extrinsic muscles of larynx?
infrahyoid muscles and stylopharyngeus
731
what muscle opens rima glottidis?
posterior cricoarytenoid - sole abductor
732
what muscle closes rima glottidis?
transverse arytenoid and lateral cricoarytenoid - adductors
733
what effect does lengthened vocal cords have?
increased tension = higher pitch
734
what muscle lengthens vocal folds?
cricothyroid muscle
735
what muscle shortens vocal folds?
thyroarytenoid
736
what effect does shortened vocal cords have?
less tension = lower pitch
737
what nerves supply motor function to intrinsic muscle of the larynx?
all intrinsic muscles are supplies by recurrent laryngeal nerve except for cricothyroid which is supplied by external branch of superior laryngeal nerve both branches are branches of vagus
738
what nerve supplies sensory innervation just above the vocal folds?
internal branch of superior laryngeal nerveanch of vagus
739
what nerve supplies sensory innervation below the vocal folds?
recurrent laryngeal nerve - branch of vagus
740
what respiration abducts rima glottidis wide open?
forced respiration (quiet respiration only narrow)
741
where are vocal folds in speech production?
adducted - closed so air is forced through causing soeech production
742
where are vocal folds in respiration?
abducted
743
when are vocal folds and vestibular folds tightly adducted?
swallowing forced closure cough sneeze weight lifting
744
what are the posterior apertures of the nasal cavity that open into nasopharynyx?
choanae
745
which bones form the external nose?
nasal bones frontal process of maxillae
746
what cartilage is found in nose?
septal cartilage major and minor alar cartilages
747
what are the three nasal muscles?
nasalis - transverse and alar part levator labii superioris alaeque nasi depressor septi nasi
748
what nasal muscle lifts the alae and superior lips?
levator labii superioris alaeque nasi
749
what muscle draws alae down?
depressor septi nasi
750
what forms the floor of nasal cavity?
hard palate (palatine process of maxilla and palatine bones)
751
what travels in incisive canal?
greater palatine artery and nasopalatine nerves
752
what is the nasal crest?
ridge between the palatine and maxillae bones along midline that provides site of attachment for vomer
753
what are the components of the nasal septum?
septal cartilage vomer perpendicular plate of ethmoid
754
what is the medial wall of nasal cavity?
nasal septum
755
what is a cause of septal deviation?
birth defect injury
756
what are the symptoms of septal deviation?
snoring difficulty breathing through nose nose bleeds
757
what forms the highest point o the nasal cavity?
cribiform plate of ethmoid bone
758
why does the cribiform plate have many holes?
to allow olfactory nerves to pass into nasal cavity from olfactory bulb
759
what bones form anterior roof of nasal cavity?
frontal and nasal
760
what bone forms posterior roof of nasal cavity?
sphenoid
761
what bones form th lateral wall of nasal cavity?
frontal nasal lacrimal ethmoid maxilla inferior concha palatine sphenoid
762
what does the ethmoid bone project into the nasal cavity?
superior and middle conchae 2/3 nasal conchae
763
what are they 3 nasal conchae?
superior middle inferior
764
what underlies each nasal conchae?
corresponding meatus
765
what is the name given to the space between superior nasal concha and roof of nasal cavity?
speno-ethmoidal recess
766
what is purpose of conchae and meatus in nasal cavity?
increase surface area and allows purification, moisturization and warming of air
767
what nerve supplies sense of smell?
olfactory
768
what cranial nerves innervate or give branches that innervate nose?
olfactory CN1 trigeminal CNV1 and CNV2
769
what forms the highest point of the nasal cavity?
cribiform plate of ethmoid
770
what makes up the ethmoid bone?
midline perpendicular and cribiform plate left and right ethmoidal labyrinth
771
what concha does ethmoidal labyrinth project?
superior and middle
772
what wall of the nasal cavity do you find the concha?
lateral
773
what branch of ophthalmic nerve supplies nasal cavity?
anterior ethmoidal
774
what nerve supplies alae of the nose?
maxillary division of trigeminal
775
what do you need to be aware of when extracting maxillary molars?
maxillary sinus lies in close relation so extraction can cause damage to floor of maxillary sinus
776
why might maxillary sinus infection mimic dental pain?
the innervation of maxillary teeth and maxillary sinus is by the superior alveolar nerve
777
what is the parasympathetic supply to nasal cavity?
pregangolic - greater petrosal nerve of facial nerve postganglionic - maxillary nerve
778
what is the sympathetic supply to nasal cavity?
pregangolic - sympathetic trunk postganglionic - maxillary nerve
779
where do veins that follow the maxillary arteries drain into?
pterygoid plexus
780
where do veins that follow the ethmoidal arteries drain into?
opthalmic vein and then cavernous sinus
781
what are the paranasal sinuses?
bones in the skull lined with respiratory epithelium that open into nasal cavity ethmoidal, frontal, maxillary and sphenoid
782
where do veins that follow the facial arteries drain into?
facial vein
783
what paranasal sinus does not drain into the lateral waall?
sphenoid it drains into sphenoethmoidal recess posterior and superior to nasal cavity
784
where does the sphenoid sinus drain?
sphenoethmoidal recess
785
where does the frontal sinus drain?
infundibulum of middle meatus
786
where does maxillary sinus drain?
semilunar hiatus of middle meatus
787
where does ethmoidal air cells/sinus drain?
anterior cells drain to infundibulum middle cells drain into middle meatus at ethmoid bulla posterior cells drain into superior meatus
788
what bones make up the margin of the orbit?
frontal, zygomatic, maxilla
789
name all bones of the orbit
frontal, maxilla, zygomatic, lacrimal, sphenoid, ethmoid
790
what structures pass through the optic canal?
optic nerve and opthalmic artery
791
what nerves pass though the superior orbital fissure?
3 4 5 6 occulomotor superior and inferior branch trochlear ophthalmic div of trigeminal (3 branches nasocilliary, lacrimal and frontal) abducens
792
what is the function of retrobulbar fat?
support the eyeball
793
name the extra orbital muscles
superior rectus inferior rectus lateral rectus medial rectus superior oblique inferior oblique levator palpebrae superioris
794
what artery and vein will you find in the optic nerve?
central retinal artery and vein
795
what coats the optic nerve?
cranial meninges - dura, arachnoid, subarachnoid space and pia extend from skull along optic nerve to the sclera
796
where might fragments of a blowout fracture of the orbit end up?
maxillary sinus as floor of orbit is weaker and closely related to maxillary sinus
797
what do optic nerves meet to form when they enter the skull?
optic chiasm
798
what lies inferior and posterior to the optic chiasm?
pituitary gland
799
why is the close proximity of the optic chiasm to the pituitary gland clinically relevant?
the pituitary gland lies in the pituitary fossa so if there is a tumour of the pituitary it can only spread upwards and therefore ends up pressing on the optic chiasm this causes visual field issues and tunnel vision symptoms
799
the optic nerve travels anteriorly from the optic chiasm to the orbit whereas the optic tract travels posteriorly to where?
fibres make their way to the visual cortex in the occipital lobe
800
what causes papilloedema?
raised intracranial pressure is transmitted to the meninges and subarachnoid space around the optic nerve that slows retinal venous drainage via the central retinal vein - papilloedema
801
what is the effect of raised intracranial pressure on the optic nerve?
the pressure is transmitted to the meninges around the optic nerve which slows venous drainage through central retinal vein and causes swelling of optic disk (papilloedema)
802
what can cause painless temporary loss of vision in the eye?
amaurosis fugax - temporary loss of vision due to lack of blood flow to the eye due to central retinal artery occlusion
803
what is amaurosis fugax?
temporary loss of vision due to lack of blood flow to the eye due to central retinal artery occlusion
804
what is papilloedema?
swelling of optic disk
805
what is bitemporal hemianopia?
happens when there is an injury to optic chiasm and there is tunnel vision as lateral side of each visual field is gone
806
what happens when there is an injury to the optic tract?
the medial side on the affected side and the lateral side on the unaffected side will not work
807
what happens when there is injury to the optic nerve?
sight to that eye will be lost
808
what is the function of orbicularis oculi muscle?
palpebral part - blinking/involuntary orbital part - tightly closing the eye/voluntary
809
what innervates the obicularis oculi muscle?
facial nerve CN7
810
how does issues with facial nerve affect orbicularis oculi?
sagging of lower eyelid, leakage of tears, drying out of cornea with risk of damage to eye
811
where is the lacrimal gland?
upper lateral corner of orbit
812
what muscle must function correctly to ensure cornea and conjunctiva stay moist?
orbicularis oculi
813
where does the lacrimal gland secrete tears into?
conjunctival sacs and then the tears are dispersed across eye by blinking
814
what do the conjunctival sacs lie between?
eyeball/cornea and eyelids
815
how do tears drain?
tears drain into lacrimal puncta then to lacrimal canaliculli then to lacrimal sac then to nasolacrimal duct and then to inferior nasal meatus
816
why does our nose run when we cry?
nasolacrimal duct drains into the inferior nasal meatus and is also involved in pathway of tear drainage
817
what innervates the lacrimal gland?
preganglionic parasympathetic - facial nerve in greater petrosal nerve postganglionic parasympathetic - zygomatic branch of maxillary nerve
818
what nervous system controls production of tears?
parasympathetic
819
how many extraocular muscles are there?
6 4 recti and 2 oblique but 7 if you include levator palpebrae superioris
820
what is the function of levator palpebrae superioris?
elevate the upper eyelid
821
what muscle fibres are found in levator palpebrae superioris?
smooth and striated muscle fibres
822
what muscle lies deep to levator palpebrae superioris?
superior rectus
823
what is the name of the tendon that attaches superior oblique to thwe eyeball?
trochlea
824
what attaches to the common tendinous ring?
all the posterior tendons of the recti and superior oblique
825
what muscle moves the eye laterally?
lateral rectus
826
what muscle moves the eye medially?
medial rectus
827
what muscle moves the eye straight up?
combination of superior rectus and inferior oblique
828
what muscle moves the eye straight down?
combination of inferior rectus and superior oblique
829
what muscle moves the eye up and medially?
superior rectus
830
what muscle moves the eye down and lateral?
superior oblique - think O for out O for oblique
831
what muscle moves the eye down and medial?
inferior rectus
832
what muscle moves the eye up and laterally?
inferior oblique - O for oblique O for out
833
what does sympathetic fibres of occulomotor do?
supplies smooth muscle component of levator palpebrae superioris
834
what are the parasympathetic fibres of occulomotor for?
regulating pupil constriction and accomodation
835
what iwill happen when there is damage to the occulomotor nerve?
paralysis of the muscles it supplies eye moves down and out as LR and SO are intact eye will droop - ptosis - as LPS is paralysed dilated pupil -mydriasis- as there is loss of parasympathetic supply
836
what are the three layers of the eye outermost to innermost?
sclera - fibrous choroid -vascular retina
837
what does the sclera of the eyeball become anteriorly?
cornea
838
what does the iris of eye seperate?
anterior and posterior chambers containing aqueous humour
839
what makes up the eyeball itself?
vitreous chamber containing vitreous humour
840
which part of the retina is non-visual?
anterior
841
what forms the ciliary body and what muscle will you find in the ciliary body?
choroid layer and ciliaris muscle
842
what muscles does the iris contain?
sphincter pupillae dilator pupillae
843
what does the ciliary body secrete?
aqueous humour
844
where is aqueous humour reabsorbed?
scleral venous sinus
845
what causes glaucoma?
build up of fluid and pressure
846
how does the lens accommodate distance vision?
the ciliary muscle is relaxed zonular fibres are under tension so the lens is stretched thin to refract light for distance
847
how does the lens accommodate near vision?
ciliary muscle contracts zonular fibres relax lens goes more spherical to refract light for near vision
848
what controls sphincter pupillae?
parasympathetic
849
what controls dilator pupillae?
sympathetic
850
the right side of the brain controls skeletal muscle on which side of the body?
left
851
which cerebral hemiphere tends to be more dominant?
left
852
what connects the two hemispheres of the brain?
corpus collosum
853
what two sulci divide the brain into quarters essentially?
longitudinal cerebral fissure antero - postero central ulcus coronally
854
how many layers of neuronal cell bodies comprise the cerebral cortex/grey matter?
6
855
how is grey and white matter organised in the brain?
grey surrounds white
856
how is grey and white matter organised in the spinal cord?
white matter surrounds grey matter
857
what increases the surface area of the brain?
gyri
858
what are the parts of the brainstem?
midbrain pons medulla oblongata
859
what seperates the gyri?
sulci
860
what dural septum runs in the longitudinal fissure?
falx cerebri
861
what are the ridges of cerebellum called?
folia
862
what unites the two hemispheres of cerebellum?
vermis
863
what does cerebellum control?
balance on the ipsilateral (same) side
864
what composes the diencephalon?
hypothalamus thalamus epithalamus
865
what cranial nerves are associated with the midbrain?
CN3 and CN4
866
what cranial nerves are associated with the pons?
CN5
867
what cranial nerves are associated with the medulla oblongata?
CN9 CN10 CN12
868
where do cranial nerves 6-8 emerge?
the junction between pons and medulla
869
what seperates the temporal lobe from the frontal lobe?
lateral sulcus
870
what separates the parietal lobe from the frontal lobe?
central sulcus
871
what area of the cerebral cortex is exposed when you pull the lateral sulcus apart?
insula
872
what is the opercula?
the lines where the lateral sulcus can be pulled apart
873
what areas will you find in the frontal lobe?
brocas area prefrontal cortex primary motor cortex/precentral gyrus

anatomy 3 (3 decks)

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