lecture final Flashcards
4 questions on the skull
when you think of neurocranium and viscerocranium think _______
neurocranium(8 total)= big bones:
frontal bone, parietal, temporal, occipital,
sphenoid.,..
Viscerocranium (14 total)= small bones:
Nasal, lacrimal, vomer...what passes through the supra orbital fissure?
Optic, Trochlear, Abducens, V1 and superior opthalmic vein
what structure lies right below the pterion?
the middle menengial artery
the bregma is the former sight of ______?
the lambda is the former sight of ______?
the asterion is the former sight of _______?
- the anterior fontanel
- the posterior fontanel
- Posterio-lateral fontanel
3 questions on the development of the skull
what is the neurocranium and the viscerocranium derived from?
neurocranium= somites and somitomeres viscerocranium= ectoderm (mainly from the 1st 2 pharyngeal arches)
what are:
Scaphocephaly?
Plagiocephaly?
oxycephaly?
craniosyntosis?- scaphocephaly- premature closure of sagital suture
- plagiocephaly- premature closure of the coronal or lamboid suture on one side only
- oxycephaly- premature closure of the coronal suture
- craniosyntosis- premature closure of the sutures of the skull
what is
Acrania?
Microcephaly?
- acrania- associated with meroanencephaly which results from failure of neural tube to close during 4th week of development
- microcephaly-small brain due to lack of folic acid, normaly ends up on sever retardation
cervical triangles 4 questions
what nerves are located at erbs point?: mid point of the posterior border of the SCM
- lesser occipital (C2), Greater auricular (C2,3), Transverse cervical (C2,3), supra clavicular (C3,4)
what vein drains the scalp and the side of the face?
- External Jugular vein (which ends at subclavian vein)
the infrahyoid muscles are all innervated by the ansa cervicalis(made up of superior root from C1 and a inferior root from descending cervical) (C1-3) except what?
the thyrohyoid muscle which is innervated by C1
the carotid triangle has all the goodies:
cca, eca, ica, IJV, internal and external laryngeal nerves, CN9, 10, 12
what makes up the carotid artery?
the right CCA is a branch of the brachiocephalic artery
the left CCA comes off of the aortic arch
CCA divides in to ECA and ICAat the superior border of the thyroid cartilage
the ______ recieves blood from the brain face and neck and begins at the jugular foramen, it also gives off what tributaries?
Internal Jugular vein
- inferior petrosal sinus, common facial vein, pharyngeal veins, lingual vein, superior and middle thyroid veins
what vein comes directly off of the subclavian vein?
the external jugular vein
what divides the subclavian in to three portions?
the anterior scalene
cervical viscera (4 questions)
what is the arterial supply to the thyroid?
what is the venous drainage to the thyroid?
whats the hormonal regulation?
artery: superior and inferior thyroid
venous drainage: superior and middle thyroid vein- drains in to internal jugular vein
inferior thyroid vein drains in to the brachiocephalic vein
hormonal regulation: hypothalamus, pituitary gland
clinical applications of thyroid issues
hyperthyroidism
hypothyroidism
hyperthyroidism: loss of weight, high BP, tachycardia, exophthalmos(swelling behind eye). ex) graves diesease
hypothyroidism: leads to myxedema and cretinism, bradycardia, lethargy, suceptable to cold weather, increase in body weight
what are the clinical considerations for the parathyroid glands/
hypoparathyroidism: hypocalcemic tetany, carpopedal spasm; hyperparathyroidism: hypercalcemia- muscular hypotonia and weakness
what is the extent of the trachea?
starts at lower border of C6 passes through the thoracic inlet and then divides in to primary bronchi at the upper border of T5
- innervated by the recurrent laryngeal nerve
- artery and vein= inferior thyroid
the esophagus is innervated by ?
sympathetic and vagus nerves.
the cervical part of the esophagus recieves blood from the inferior thyroid artery
development of the pharyngeal apperatus (3 questions)
what comes from the pharyngeal arches?
first?
second?
third?
fourth and sixth?
1st: malleus, incus, mandible, maxilla, zygomatic, muscles of mastication, mandibular division of the trigeminal
2nd: stapes, styloid process, body of hyoid, muscles of facial expression and stapedius, facial nerve
3rd: lower body of hyoid, epiglottis, stylopharyngeus, glossopharyngal nerve
4th and 6: laryngeal cartilages, superior laryngeal and recurrent laryngeal nerve
what is the 1st endocrine to develop?
the thyroid
(Cranial nerves 12 questions on exam)
Olfactory Nerve (CN 1) tell me about it…
-Sensory-smell-SVA
-fibers penetrate cribiform plate of ethmoid bone to enter olfactory bulb and synapse
-conditions:
Anosmia- loss of smell from aging
Parosmia- distortion of the sense of smell
phantosmia- olfactory hallucinations (smelling something that is not there)
Optic nerve (CN 2)- tell me a bit about it…
- Carries sensation of sight (SSA)
- optic nerve exits eye ball >orbital cavity> optic canal> Cranial cavity
- Conditions:
- right monocular blindness- damage rt. optic nerve
- bitemporal hemianopsia- damage to optic chiasm
- Left homonyous hemianopsia- damage to rt. optic tract
Oculomotor Nerve (CN3) whats so damn important?
-GSA GSE GVE- motor to ciliary muscles, sphincter pupillae, ectrensic muscles of eye
- ant. surface of midbrain> superior and inferior divisions> orbital cavity> superior orbital fissure
conditions-
- Oculomotor nerve palsy- lesion that damages all except sup. oblique and lat. rectus
- Ptosis- drooping of eyelid
-no dialation - pupilary light reflex
- eyeball= down and out
Trochlear Nerve (CN 4)- what muscle does it primarily innervate?
motor-GSE- superior oblique muscle
- posterior surface of midbrain> lateral all of coavernous sinus> superior orbital fissure> Sup. oblique
Trigeminal (CN 5)- theres alot of shit here so…
is it sensory or motor?
what is trigeminal neuralgia?
where does V3 exit the skull?
where does the sensory roots divide in to V1, V2 and V3?
sensory-GSA, SVE- face, sinus, teeth
-ant. aspect of PONS with sensory and motor root
-@ petrous temporal bone- sensory root > trigeminal ganglion> gives off V1, V2, V3
V1= purely sensory- 3 branches: frontal, lacrimal, nasociliary
V2= purely sensory- 3 branches- zygomatic, infraorbital, superior alveolar
V3= motor and sensory- leaves skull through foramen ovale- 5 branches- auriculotemporal, buccal, lingual, inferior alveolar, branches to muscles of mastication
** chorda tympani(submandibular ganglion)- SVA-ant. 2/3 of tongue
condition-
trigeminal neuralgia-sever pain in V2, V3 dermatome. burning or shock like symptoms that last few swconds> few minutes. triggered by vibration or contact with cheek. shaving, washing face, eating…
Abducent Nerve (CN 6)- what does it supply?
what does it travel with?
what the hell is diplopia?
motor-GSE- lateral rectus
-emerges between PONS and MEDULLA OBLONGATA, passes forward with ICA through cavernous sinus> superior orbital fissure
condition
-abducens nerve injury- paralysis of lateral rectus, medial deviation of affected eye
- diplopia- double vission
Facial nerve (CN 7)- is it motor or sensory?
what does it travel with?
what foramen does it pass through?
motor-GSA,GVE,SVA, SVE- submandibular, sublingual, lacrimal glands
sensory- taste to anterior 2/3 of tongue & soft palate
-emerges between PONS and MEDULLA OBLONGATA> 2 roots (motor & Sensory)> travels with vestibulocochlear nerve (CN 8)> internal accoustic meatus> facial canal> stylomastoid foramen> parotid gland
conditions:
- eversion of lower eye lid, displacment of mouth w/ drooping of corner…
- facial nerve injury- produces paralysis of some or all facial muscles
Vestibulochoclear Nerve (CN 8) where do the two roots arise?
what is Tinnitus?
vestibular-SSA-sensory- equilibrium, motion
cochlear- sensory- hearing
-vestibular fibers- arrise from vestibule & semicircular canals
-cochlear fibers arrise from cochlea of inner ear
conditions:
tinnitus- ringing or buzzing in ears
deafness
vertigo- dizziness, loss of balance
Glossopharyngeal Nerve (CN 9)
what does it supply?
what does it travel through to leave skull?
where does it originate?
motor- GSA, GVA, GVE,SVA, SVE-parotid gland, stylopharyngeus
sensory-taste- posterior 1/3 of tongue; general sensation- pharynx, tonsilar sinus, auditory tube, middle ear
- from anterior surface of medulla oblongata from between olive and peduncle> leaves skull through jugular foramen
Vagus nerve (CN 10)
what does it exit the skull through?
what is included in the carotid sheath?
motor-GSA, GVA, GVE, SVA, SVE palate, pharynx, larynx, trachea, heart
sensory- pharynx, larynx, lungs, heart…
-from anterior surface of medulla oblongata> exits skull through jugular foramen
-descends neck with carotid arteries and internal jugular vein in the carotid sheath
-conditions:
-dysphagia- difficulty in swallowing
-dysphonia- difficulty speaking
-aphonia- loss of voice
-inspiratory stridor- difficulty to breathe
Spinal Accessory (CN 11)
what are the nerve roots?
what foramen does it travel through? (trick question)
what would a lesion cause?
motor-GSA, SCM and Traps
-has 2 roots- cranial & spinal
- cranial root emerges from anterior surface of medulla oblongata
- spinal root- c1-5 anterior horn, enters skull through foramen magnum, joins the cranial root and then they both leave through the jugular foramen
-cranial root merges with vagus
conditions:
- lesions could cause weak traps and SCM, patient has impairment of rotary movment, winging of the scapula
Hypoglossal Nerve (CN 12)
what canal does it travel through?
in a unilateral injury, which direction would the tip of the tongue deviate?
motor-GSA, GSE intrinsic and extrensic muscles of tongue (excluding palatoglossus)
- emerges from anterior surface of medulla oblongata, leaves skull through hypoglossal canal
- condition:
- unilateral injury cause tip of tongue to deviate TOWARD affected side because of unopposed action of genioglossus of normal side
(Pharynx/ prevertebral region- 18 total questions)
- the pharynx extends from ______ to ______.
- the pharynx is divided in to three sections which are:______?
- base of the skull > soft palate
- Naso-, oro- and laryngeo- pharynx
Nasopharynx
what is the extent of the nasopharynx? and what is it entirely responsible for?
boundaries?
-from the base of the skull to the soft palate
- it is entirely respiratory
boundaries:
roof- body of sphenoid, basilar part of occiput
floor- soft palate
anterior wall- nasal apperature
posterior wall- anterior atlantic arch
lateral wall- opening of auditory tube, salpingopharyngeal fold, tubal elevation
Oropharynx
what does it represent?
whats the extent?
what are the boundaries/
-represents the digestive entrance
- from soft palate to epiglottis
-boundaries:
floor-posterior 1/3 of tongue
roof- soft palate, pharyngeal Isthmus
anterior wall- opens to mouth
posterior wall- C2, C3 and IVD in between
lateral wall- palato glossal and pharyngeal folds- palatine tonsil in between
All muscles ending in glossus will be supplied by hypglossus except
palatoglossus- which is innervated by the VAGUS
all muscles ending in pharyngeus are supplied by the VAGUS except ______?
the stylopharyngeus- which is innervated by the glossopharyngal nerve
what lies deep inside the piriform recess?
the internal laryngeal nerve
the retropharyngeal space also called the space of stiles is important because ______
blood will accumulate there in a whiplash injury. also is the space between the constrictor muscles and prevertebral muscles
what are the external muscles of the pharynx?
what are the internal muscles of the pharynx?
- external- superior, middle and inferior (md, and inf. get pharyngal plexus and external/ recurrent laryngeal nerves)constrictors (all constrict when swallowing)
- internal- salpingopharyngeus, stylo pharyngeus(glossopharyngeal)and palatopharyngeus (elevate (shorten and widen) when swallowing or speaking)
