Lab 2 Quiz Flashcards
What are the 7 bones of the orbital?
Zygomatic, Frontal, Lacrimal, Ethomoid, Maxillary, Palatine, Sphenoid
What is a blow-out structure?
Fracture of orbital floor into maxillary sinus
What usually causes blow-out fractures?
Blunt or penetrating trauma
What is the orbital septum and where is it located?
Fibrous membrane that becomes continuous with the periosteum of the orbital margins
What is the significance of the orbital septum?
Crucial with penetrating the spread of infection into the orbit
The nasolacrimal duct conveys fluid from ______ to the ______.
From lacrimal sac to inferior nasal meatus
What are the 7 extraocular muscles?
Levator Palpebrae Superioris, Superior Oblique, Inferior Oblique, Superior Rectus, Inferior Rectus, Medial Rectus, Lateral Rectus
What is the origin of the Levator Palpebrae Superioris?
Lesser Wing of Sphenoid
What is the insertion of the Levator Palpebrae Superioris?
Superior tarsus and skin of upper eyelid
The superior division of the CN 3 innervates which 2 extraocular muscles?
Levator Palpebrae Superioris and Superior Rectus
What is the primary action of the Levator Palpebrae Superioris?
Elevation of upper eyelid
What 4 extraocular muscles originate by inserting anterior to equator on the common tendinous ring?
All recti muscles. (Superior, Inferior, Medial, Lateral)
What is the insertion of the Superior Rectus?
Anterosuperior half of the eye
What are the primary, secondary, and tertiary actions of the superior rectus?
elevation, intorsion, adduction (respectively)
What is the insertion of the Inferior Rectus?
Anteroinferior half of the eye
What are the primary, secondary, and tertiary actions of the Inferior Rectus?
depression, extorsion, adduction (respectively)
What is the insertion of the medial rectus?
Anteromedial half of the eye
What is the insertion of the lateral rectus?
Anterolateral half of the eye
What is the primary action of the medial rectus?
Adduction
What is the primary action of the lateral rectus?
Abduction
The inferior division of CN 3 innervates which 3 extraocular muscles?
Inferior Rectus and Medial Rectus and Inferior Oblique
The lateral rectus is innervated by _____.
CN 6 (Abducens)
What is the origin of the Superior Oblique?
Body of the Sphenoid
What is the origin of the Inferior Oblique?
Anteromedial floor of the orbit
Which extraocular muscles inserts into the sclera deep to the superior rectus?
Superior Oblique
What is the insertion of the inferior oblique?
Sclera deep to lateral rectus
Cranial Nerve 4 innervates which extraocular muscle?
Superios Oblique
What are the primary, secondary, and tertiary actions of the superior oblique?
Intorsion, Depression, Abduction (respectively)
What are the primary, secondary, and tertiary actions of the inferior oblique?
Extorsion, Elevation, Abduction (respectively)
Which nerve innervates the inferior oblique?
Inferior division of Cranial Nerve 3
Superior Oblique, Inferior Oblique, and Lateral Rectus hold the eye _______.
abducted
Superior, Medial, and Inferior Recti hold the eye _____.
adducted
When eye is adducted, Superior Oblique_____ and Inferior Oblique _____ the eye.
depresses;raises
When eye is abducted, Superior Rectus_____ and Inferior Rectus _____ the eye.
raises;depresses
What 3 deviations are expected for Cranial Nerve 3 palsy?
- Eye is down and out
- Dilated Pupil
- Complete Ptosis
What 2 deviations are expected for Cranial Nerve 4 palsy?
- Eye is hyper
2. Head tilts opposite to side of palsy
What deviations are expected for Cranial Nerve 6 palsy?
- Eye is deviated toward the nose
2. Elevated IOP
Blood supply to the eye is from the __________ artery , which is a branch of the ________ artery.
Ophthalmic; Internal Carotid
What are the 10 arteries of the orbit and which structures do they supply?
- Dorsal Nasal (to terminal branch to root of nose and lacrimal sac)
- Central Retinal Artery (pierces CN2 and perfuses retina)
- Long Posterior Ciliary Arteries (to ciliary body and iris)
- Lacrimal Artery (to lacrimal gland)
- Anterior Ethmoidal Artery (to ethmoid air cells, frontal sinus, nasal cavity, external nose)
- Medial Palpebral Arteries (to arcades in upper and lower eyelids)
- Posterior Ethmoidal Artery (to ethmoid sinuses and nasal cavity)
- Supraorbital (to forehead and anterior scalp)
- Supratrochlear (to forehead and anterior scalp)
- Short Posterior Ciliary Arteries (to choroid)
The Dilator Pupillae and Sphincter Pupillae fibers are oriented in which manner?
radial;circumferential (respectively)
T/F: The smooth muscle responsible for dilating the pupil is innervated by the sympathetic system.
True.
T/F: The muscle responsible for pupil constriction is innervated by pre-ganglionic parasympathetic fibers.
False. (post-ganglionic parasympathetic fibers)
The intraocular lens is composed of what 2 substances?
Water and protein
T/F: Cataracts are a result of the breakdown of the lens proteins.
True
The vitreous is mostly composed of what 2 substances?
Water and collagen
Where is the anterior chamber located?
Between the iris and cornea
The central retinal vein drains the _____, leaves through ____, and drains into the _______.
Retina; CN 2; Superior ophthalmic vein
How many vorticose veins are typical from each quadrant of the choroid?
One per quadrant.
Vorticose veins pierce the _____ and drain into the ______ and ______ ophthalmic veins.
sclera; superior; inferior
GVE fibers travel from cranial nerve __, to _____ petrossal nerve, to nerve of _____ canal, to ______ ganglion, to hitchhike with ______ branch, to ______ fissure, to lacrimal nerve, and finally to innervate the ____________.
7; greater; pterygoid; pterygopalatine; zygomatic; infraorbital; lacrimal gland
Which 4 bones together form the pterion?
Frontal, Temporal, Parietal, Greater Wing of Sphenoid
What is the site of origin of the temporalis muscle?
temporal fossa
Which arteries are found in the infra temporal fossa?
maxillary
Which nervous soft tissue structures are found in the infratemporal fossa?
Mandibular, Inferior Alveolar, Lingual, Buccal, Chorda Tympani
Which ganglion is found in the infra temporal fossa?
Otic ganglion
What are the 6 main components of the TMJ?
Mandibular Condyle, Articular surface of the temporal bone, Capsule, Articular Disc, ligaments, lateral pterygoid muscle
What is the Articular Disc composed of?
fibrocartilage
What are the 4 true muscles of mastication?
temporalis, masseter, medial pterygoid, lateral pterygoid
All 4 of the 4 true muscles of mastication are innervated by _______.
motor root of CN V3 (Mandibular)
What are the 4 accessory muscles of mastication?
Digastric muscle, Buccinator, Tongue, Orbicularis Oris
The anterior belly of the digastric muscle is innervated by which nerve?
afferents from CN V3 (Mandibular)
The posterior belly of the digastric is innervated by which nerve?
efferents from CN 7 (Facial)
Venous drainage of the eye is via superior and inferior _______ artery, this drains into the _____________.
ophthalmic ; cavernous sinus
What is the function of the temporalis and masseter muscles?
Elevators, retractors
What is the function of the medial pterygoid muscle?
Elevator, protractor
What is the function of the lateral pterygoid muscle?
Depressor, protractor
What is the buccinator muscle innervated by?
Cranial Nerve 7
What is the Orbicularis Oris muscle innervated by?
Cranial Nerve 7
What innervates the tongue?
Cranial Nerve 9
Where is the fibrocartilage (which makes up the articular disc) located?
Between the superior and inferior articular surfaces of the TMJ
List all 7 of the nerves found in the infratemporal fossa.
- Auricotemporal Nerve 2. Nerve to Mylohyoid
- Chorda Tympani 4. Lingual Nerves
- Inferior alveolar nerve 6. Muscular branches of CN V3
- Buccal Branch of CN V3
List all 4 branches of the maxillary artery.
Buccal, Masseter, Middle Meningeal, Infrorbital
What is the name of the groove that runs from the mandibular foramen down towards the bottom of the mandible?
Mylohyoid Groove
List all 9 branches of the mandibular artery.
- Buccal Nerve 2. Auriculotemporal Nerve
- Lingual Nerve 4. Meningeal branch
- Masseteric Nerve 6. Inferior Alveolar Nerve
- Nerve to Lateral Pterygoid 8. Nerve to Medial Pterygoid
- Deep Temporal Nerve
What is another name for the meningeal branch of mandibular artery?
Nervous Spinosus
What are the 3 types of tears?
Basal, Reflex, Emotional
What are the 3 function of basal tears?
lubricating, cleaning, removing of bacteria
T/F: Basal tears are stimulated by the parasympathetic system.
True
T/F: Reflex tears are from stress.
False (from irritation)
Where is the Parotid Gland located?
Side of the face
The submandibular gland is located in the submandibular and ________ spaces.
sublingual
Which 2 arteries supply the parotid gland?
External Carotid and Superficial Temporal
Which artery supplies the sumandibular gland?
Submental branch of facial artery
General afferent innervation and post-ganglionic parasympathetics are distributed to the parotid gland by which nerve?
Auriculotemporal nerve
General afferent innervation and post-ganglionic parasympathetics are distributed to the submandibular gland by which nerve?
Lingual Nerve
Preganglionic parasympathetic innervation to the parotid gland is provided by which 2 nerves?
Tympanic Nerve and Lesser Petrosal Nerve
Preganglionic parasympathetic innervation to the submandibular gland is provided by _____?
Chorda Tympanic
The sympathetics of the parotid and submandibular occurs through which plexus?
External Carotid Artery Plexus
What is cavernous sinus thrombosis? (most basic answer)
Formation of thrombosis in the cavernous sinus
What is cavernous sinus thrombosis caused by?
Bacterial Infection
The suprahyoid muscles are located in the ______ and _______ triangles.
Submental and Submandibular
T/F: The suprahyoid muscles raise the mandible and and depress the hyoid bone.
False. (raise hyoid and depress mandible)
Where are the infra hyoid muscles located?
Musuclar triangle
What are the 4 suprahyoid muscles?
- Anterior belly of digastric
- Posterior belly of digastric
- Stylohyoid
- Mylohyoid
- Geniohyoid
What is the innervation of the Stylohyoid?
Cranial Nerve 7
What is the innervation of the Mylohoid?
efferents from CN V3
What is the innervation of the Geniohyoid?
CN 1-3
The ansa cervicalis innervates which muscles?
All 4 infrahyoid muscles.
What are the 4 infrahyoid muscles?
Omohyoid, Sternohyoid, Sternothyroid, Thyrohyoid
What are the 8 direct branches of the external carotid artery?
- Ascending Pharnygeal Artery 2. Superior Thyroid Artery
- Superficial Temporal Artery 4. Facial Artery
- Lingual Artery 6. Occipital Artery
- Maxillary Artery 8. Posterior Auricular Artery
What are the 6 tributaries of the internal jugular vein?
- Facial Vein
- Lingual Vein
- Occipital Vein
- Middle Thyroid Vein
- Pharyngeal Plexus
- Superior Thyroid Vein
List a few symptoms seen with a blow-out fracture.
Diplopia, Up gaze may be inhibited due to inferior rectus entrapment, numbness, enopthalmos,
What leaves the middle cranial fossa by traveling throughout he wall of the cavernous sinus?
ophthalmic division of trigemnial nerve
T/F: The trigeminal nerve has a small sensory root and a long motor root.
False. (large sensory and small motor)
The trigemnial nerve sits in _____ cave under the _____ in a depression on the petrous part of the ______ bone.
Meckel’s; dura; temporal
The maxillary division of CN 5 leaves the middle cranial fossa via what structure?
Foramen Rotundum
T/F: Posterior ethmoidal nerve -general afferents from the sphenoidal sinus and dura of the anterior cranial fossa.
True.
T/F: Cranial nerve roots stay separate and never combine into mixed nerves.
True.
A fracture in the orbito-sygomatic fracture causes damage to which nerve?
Infra-orbital nerve
This structure is known as “nothing but the open roof of the pterygopalatine fossa.
Infraorbital fissure
Where does Cranial Nerve 1 (Olfactory) exit the braincase?
Cribiform plate of ethmoid bone
Cranial Nerve 1 targets to what location?
Nasal Epithelium
Where does Cranial Nerve 2 (Optic) exits the braincase?
Optic Canal of Sphenoid
Which 3 cranial nerves exit the braincase via the superior orbital fissure of sphenoid?
CN 3, 4, 6
Cranial Nerve 12 (Hypoglossal) exits the braincase at the hypogloassal canal and goes in to the ______.
tongue
The mandibular division of the trigeminal nerve exits the brain via which structure?
Foramen Ovale of Sphenoid
Cranial Nerve 7 and 8 together form which larger nerve?
Facial vestibulococchlear
Where does the facial vestibulococchlear nerve exit the brain?
Internal Acoustic Meatus of Petrosal Temporal
Where do Cranial Nerves 9 and 10 exit the brain?
Between petrous temporal and basioccipital neural portion of jugular foramen
The accessory nerve (CN 11) targets which two muscles?
trapezius, and sternocleidomastoid
Name 4 features of the sphenoid bone.
Optic canal, Superior Orbital Fissure, Inferior Orbital Fissure, Pterygoid canal
What are the 4 targets of the sympathetics of the oculomotor nerve?
Pupillary Dilator, Smooth muscle of blood vessels, smooth muscle of eyelid, sweat glands
The facial nerve within the facial canal branches into which 3 nerves?
greater petrosal nerve, chorda tympani, auricular
The greater petrosal nerve carries pre-ganglionic parasympathetic fibers to which 4 locations?
lacrimal gland, mucus gland of the palate, nasal cavity, and nasopharynx
Where does the greater petrosal nerve meets with the deep petrosal nerve?
Foramen Lacerum
The pharyngeal plexus is formed by which two cranial nerves?
CN 9 and 10
What are carotid bodies?
small, browninsh-red, chemoreceptors that monitors the level of oxygen in blood
When oxygen levels are low the carotid body reacts initiating a reflex that increases what 3 factors?
increases respiration, cardiac rate, and blood pressure
What is the most common form of facial pain that may last a few seconds to a few hours?
trigeminal neuralgia
A lesion in the trigeminal nerve can results in what effects?
- paralysis of muscles of mastication
- deviation of jaw to affected side
- anesthesia of the face
- loss of corneal reflex
- loss of sneezing reflex
A facial nerve lesion at/distal to stylomastoid foramen results in what kind of impairment?
Bell’s Palsy
A facial nerve lesion distal to geniculate ganglion but proximal to the branching of the chord tympani results in what kind of impairments?
Bell’s Palsy, decrease in salivation, loss of taste from a interior 2/3 of tongue, some hyperacusis
A facial nerve lesion at/proximal to geniculate ganglion results in what kind of impairments?
Bell’s Palsy, decrease in salivation, loss of taste from anterior 2/3 of tongue, loss of lacrimation, some hyperacusis
A facial nerve lesion in the infratemporal fossa, injury of the lingual nerve proximal to the junction with the chorda tympani results in what kind of impairments?
anesthesia of anterior 2/3 of tongue, anesthesia of the floor of the mouth, and anesthesia of lingual gums
A facial nerve lesion in the infratemporal fossa, injury of the chorda tympani nerve prior to junction with lingual nerve results in what kind of impairments?
decrease in salivation, loss of taste from most of the tongue on affected side
A facial nerve lesion in the orbit causing injury tot he communicating branch from the zygomatic nerve results in what kind of impairment?
loss of lacrimation
A facial nerve lesion in the orbit injuring the zygomatic nerve results in what kind of impairments?
loss in lacrimation, facial anesthesia of the upper cheek and anterior temple.
What are the symptoms of a lesion in the glossopharyngeal nerve?
loss of taste from posterior 1/3. of the tongue, and loss of gag reflex in the affected side.
Which condition includes severe pain in the back of the tongue/throat, tonsillar area, and middle ear lasting from a few seconds to minutes?
Glossopharyngeal neuralgia
A lesion in the pharyngeal branch of the vagus nerve results in what impairments?
impairment of speaking/swallowing, results in disphagia,
A lesion in the laryngeal branch of the vagus nerve results in what impairments?
hoarseness, disphoria if unilateral and aphoria if bilateral.
What is the Jugular Foramen Syndrome?
unilateral impairment of cranial nerves 9, 10, and 11 caused by penetrating neck injuries, basilar skull fractures or glomus jugular tumors at the jugular foramen.
Which nerve is responsible suspending the ciliary ganglion and distributing post-ganglionic sympathetic and parasympathetic fibers to the smooth muscle of the eyeball.
Nasociliary nerve
T/F: The supra- trochlear and supra-orbital nerves both exit the orbit onto the face.
True
The Frontal nerve splits into which two nerves?
Supra-trochlear and Supra-orbital Nerve
Long and short ciliary nerve have general afferents from _____ and _____ and visceral efferents to the ______ of the eye.
cornea; conjunctiva; smooth muscle
Which nerves is responsible for general afferents from the sphenoid sinus and dura of anterior cranial fossa?
Posterior Ethmoidal Nerves
Which nerves is responsible for general afferents from ethmoidal air cells, anterior and superior area of nasal cavity, tip of nose, and dura of the anterior cranial fossa.
Anterior Ethmoidal Nerves
Which nerve originates from CN 5, exits the middle cranial fossa through the foreman rotundum, through the pterygopalatine fossa and exiting as infraorbital nerve?
Maxillary Nerve
Just deep to the mucosa of the maxillary sinus the posterior superior alveolar nerve joins with what?
Superior Dental Plexus
What 3 terminal branches does the infraorbital nerve divide into?
Nasal, Palpebral, and Superior labial branches
What is the function of the nasopalatine nerve?
supplies the mucosa and gingival of the incisor teeth.
Which nerve passes posterior to the TMJ and superiorly through the parotid gland?
Auriculotemporal nerve
T/F: Buccal nerve innervates the Buccinator Muscle.
False. (passes along and pierces buccinator, but does not innervate it)
What are the 2 terminal branches of the inferior dental plexus?
Incisive nerve and mental nerve
What is the first branch given off of the facial nerve?
Greater Petrosal Nerve
Postganglionic parasympathetic and sympathetic fibers reach the lacrimal gland through which branch of which nerve?
communicating branch of the zygomatic nerve (which communicates with lacrimal nerve)
Which 2 cranial nerves carry visceral afferents from the carotid body/carotid sinus and participate in the gag and swallow reflex?
Glossopharyngeal and Vagua
What are the branches of CN 9?
Tympanic branch and Pharyngeal branches, and carotid sinus branch
Which nerves carry general afferents from the mucus membrane of the oropharynx?
Pharyngeal branches of CN 9
What is the name for the cartilage and membranous tube connecting the pharynx and the middle ear?
Pharyngotympanic tube (A.K.A Eustachian tube)
Where does the facial canal end?
At stylomastoid foramen
CN 10 (Vagus) carries general Afferents from what three areas?
Skin of deep ear and EAM, Dura of posterior cranial fossa, and mucosa of larynx/laryngopharynx
CN 10 carries visceral Afferents from what areas?
Aortic arch and para-aortic body, carotid body/sinus, thoracic and abdominal viscera
CN 10 carries general Efferents to what muscles?
Muscles of pharynx, most muscles of soft palate, and laryngeal muscles
CN 10 carries visceral Efferents for what areas?
Mucosal gland of the larynx and laryngopharynx, thoracic and abdominal viscera
Which nerve branch conveys visceral Afferents containing information about blood pressure and partial pressure of oxygen and carbon dioxide in blood?
Carotid Body Branch of Vagus Nerve in the neck.
The superior laryngeal nerve divides into which two branches?
Internal and External laryngeal branches
T/F: Cardiac branches of vagus nerve supply post-ganglionic sympathetic innervation to the cardiac plexus.
False: (they supply PRE-ganglionic PARA-sympathetic innervation)
General Afferents from the root of the nose use which nerve?
Infratrochlear Nerve
Posterior Superior Alveolar Nerve carries general Afferents from ______ and _______.
Maxillary Molar Teeth; buccal gingivae
T/F: Anterior Superior Alveolar Nerve supplies parts of the nasal floor and walls.
True
Which 2 sinuses are supplied by contributed branches of the orbital branches of the pterygopalatine ganglion?
Ethmoidal and Sphenoidal
The pharyngeal branch leaves the pterygopalatine fossa through which structure to supply what area?
palatovaginal canal ; supplies the mucosa and glands of the nasopharynx.
The posterior superior lateral nasal nerves pass through what structure and supply what area?
sphenopalatine foramen ; supplies lateral wall of the nasal cavity
Which nerve carries general Afferents from the chin, lower lip, lower teeth and anterior buccal gingival?
Inferior Alveolar Nerve
The Facial Nerve provides visceral Efferent fibers (pre-gang parasym) for which 3 areas?
- lacrimal gland of the orbit
- mucus glands of the nasal cavity
- mucus and salivary glands in oral cavity.
Given off just superior tot the stylomastoid foramen, this nerve carries general Afferents from the EAM and skin to deep part of ear.
Auricular Branch of Facial Nerve within facial canal
Which 2 branches of CN 10 are within the jugular foramen?
Meningeal and Auricular Branches
This branch of the Vagus nerve, located in the neck, carries general Afferents from where?
superior part of the larynx and piriform recess
This branch of the Vagus nerve located in the neck, carries general Efferents to where?
Cricothyroid and Inferior Pharyngeal Constrictor Muscle
Where is the left recurrent laryngeal nerve given off of the Vagus Nerve?
In the thorax
Where is the right recurrent laryngeal nerve given off of the Vagus Nerve?
In the root of the neck