Lecture 6 (head pt 3) Flashcards
What sinuses make up the paranasal sinuses? List each and whether they’re paired or unpaired
Frontal: Paired
Ethmoid: midline/paired
Sphenoid: midline
Maxillary: paired
1) Where does the frontal sinus run through/ go?
2) What innervates it?
1) Run through frontal nasal duct into ethmoidal infundibulum of middle meatus
2) Innervated by CN 6
Where do the 3 groups of cells of the ethmoid sinuses open to?
1) Anterior cells drain into infundibulum of middle meatus
2) Middle cells open directly into middle meatus
3) Posterior cells form the bulla, open directly into superior meatus
1) Where are the sphenoid sinuses?
2) Do they open into the nasal cavity?
1) Occupy the cavity in delicate sphenoid bone, drain into. 2) No real opening into the nasal cavity.
What drains the maxillary sinuses, and where do they drain into?
Maxillary ostium; into the middle meatus
What is the rich plexus where all the arteries supplying the septum anastomose? What is the clinical significance of this area?
Keisselbach; profuse epistaxis (nosebleeds)
Where do the veins that drain the septum go?
Into sphenopalatine, facial, and ophthalmic veins
What nerves innervate the nose? (2)
1) Posterio-inferior ½ to 2/3 of cavity is primarily: CN V2 (maxillary n.)
2) Anterior superior cavity (both septum & lateral wall) is primarily: anterior ethmoidal nerves from CN V1 (ophthalmic n.)
True or false: Mucosa of the oral cavity is continuous with the gingiva
True
Where can you find gingiva?
Around the neck of teeth
What structure will you find on the buccal side of the mandibular second molar?
Opening of the parotid duct
True or false: There’s both ipsilateral and contralateral drainage of cheeks, lips, and chin lymphatics
True
True or false: infections don’t easily spread from one side of the face to another
False; infections and cancers can spread easily because there’s both ipsilateral and contralateral lymphatic drainage
What covers the roots of teeth?
Cementin
Describe the path of V3 through the lower face
V3 goes into the mandible at the mandibular foramen and provides alveolar nerves, then comes out the mental foramen for the skin
Where is lidocaine placed to numb an entire side of the bottom teeth?
V3
1) What does the hard palate separate?
2) What does the soft palate separate?
1) Oral cavity from nasal cavity
2) Oral cavity from nasopharynx
Where are the lingual tonsils found?
Posterior 1/3 of tongue
1) What is the soft palate?
2) What is it made of?
3) How is it attached?
1) Movable posterior 1/3rd of the palate
2) Mainly muscular
3) Palatine aponeurosis; attached to hard palate anteriorly
What does the soft palate do?
Assists in swallowing and prevents bolus entering nasal cavity (by moving/ closing while swallowing)
1) What provides sensory innervation for the gag reflex?
2) What provides motor innervation for the gag reflex?
1) CN IX afferent
2) CN X efferent
What provides motor innervation for tongue protrusion?
CN XII
What nerve provides taste sensation?
CN VII chordae tympani
What nerve provides somatic sensory innervation to the oral cavity?
CN V3 (lingual n.)
Name 3 muscles of the soft palate
1) Palatoglossus
2) Palatopharyngeus
3) Uvula
What does the palatoglossus muscle do?
Forms palatoglossal arch
What does the palatopharyngeal muscle do?
Forms palatopharyngeal arch
What is the uvula?
A muscle of the soft palate
How are the palates innervated with sensory nerve fibers?
From branches of CN V2 (maxillary n) (foramen rotundum) that pass through pterygopalatine ganglia
What two nerves supply the palates with motor fibers?
1) CN V3: Tensor veli palatini (forms palatine aponeurosis)
2) Pharyngeal plexus from vagus n. CN X: All other (motor) muscles of soft palate (& much of oral pharynx)
1) What nerve does the pharyngeal plexus of nerves come from?
2) What does this nerve do?
1) Vagus n.
2) Acts as motor arm of GAG reflex
True or false: Only CNV motor is thru V3, mandibular n., (foramen ovale)
True
What are two types of tonsil inflammation?
Tonsillitis and peritonsillar abscess
What are the 3 parts of the ear?
External, middle, and internal
1) What term do you use to refer to both ears?
2) What term do you use to refer to the left ear?
3) What term do you use to refer to the right ear?
1) AU(bilateral)
2) AS (left)
3) AD(right)
What are the 3 parts of the external ear?
1) Auricle (Pinna)
2) External acoustic meatus of Auditory Canal (EAC)
3) Tympanic membrane (TM) (separates outer and middle)
What two nerves provide primary innervation to skin of auricle?
1) Great auricular n.
2) Auriculotemporal n. (CN V3)
What two nerves have a minor contribution to innervation of skin of auricle?
1) CN7
2) CN10
What two nerves innervate the auditory canal and external TM?
CN V3 & CN X
What does it mean if the tympanic membrane is in a neutral position?
The pressure is equal between the middle ear and outside
1) Where do PE tubes go?
2) What do they do?
1) Through anterior inferior aspect of TM near cone of light
2) Allows pressure equalization until Eustachian tube heals itself.
True or false: air conduction is usually more efficient than bone conduction
True
Do you usually hear through air conduction, bone conduction, or both?
Both
What are the two openings of the middle ear?
1) Posterosuperior with mastoid antrum (i.e. to mastoid air cells)
2) Pharyngotympanic tube (aka Eustachian tube)
What is found within the middle ear/ tympanic cavity? (4 things)
1) Auditory ossicles
2) Tendons of stapedius and tensor tympani m.
3) Chorda tympani n. (br. of CN VII )
4) Tympanic plexus of nerves
Is the carotid plexus sympathetic or parasympathetic?
Sympathetic
1) What is the malleolus (mallet) attached to and what does it articulate with?
2) What does the incus (anvil) articulate with?
1) Attached to TM, articulates with Incus
2) Articulates with malleolus and stapes
1) What is the stapes (stirrup)?
2) How are sound waves converted from air to mechanical force?
1) Base or footplate occupies the oval window
2) At TM through ossicles
What allows for 10x vibratory amplification in the middle ear?
Base of stapes is considerably smaller than TM
Two muscles of middle ear slide 43
1) What do the two muscles of the middle ear collectively do?
2A&B) Name the two muscles of the ear, describe what each does, and what each is innervated by
1) Resist or dampen movement of auditory ossicles
2a) Tensor tympani: Inserts into handle of malleolus
-CN V3
2b) Stapedius: Pyramidal eminence that inserts onto stapes
-CN VII (nerve to stapedius)
What equalizes pressure between the middle ear cavity and external atmosphere?
Eustachian tube
Describe the Pharyngotympanic tube/ Auditory canal/ Eustachian tube; what is it made of and what does it open to?
1) Bony and cartilaginous parts
2) Into nasopharynx
What does the vestibulocochlear organ do? (2 things)
Sound and balance
Where is the vestibulocochlear organ?
Embedded in petrous part of temporal bone