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)
tonsilar ring aka waldeyer’s ring consits of ______?
lingual, palatine, pharyngeal and tubal tonsils
Sensory nerve supply to the pharynx:
Nasopharynx- maxillary nerve
Oropharynx- glossopharyngeal nerve
enterance to the larynx- internal laryngal nerve
** also does the epiglottis
arterial supply to the pharynx (theres a few…)
and venous drainage…
- ascending pharyngeal- branch of external carotid
- ascending palatine and tonsilar a.- branch of facial
- dorsal lingual- branch of lingual
- greater palatine- branch of maxillary
all blood drains in to pharyngeal venous plexus and then goes to internal jugular vein
what 3 muscles attatch to the oblique line of the thyroid cartilage?
- sternothyroid
- thyrohyoid
- inferior constrictor
prevertebral muscles:
which ones are they? what are they innervated by?
Longus capitis- VR C1-3
longus colli- VR C2-6
rectus capitis anterior- VR C1-2
rectus capitis lateralis- VR- C1-2
cervical sympathetic trunk-
whats the extent?
what 3 ganglia compose it?
- from neck of 1st rib> base of skull
- superior, middle and inferior cervical ganglion
(Larynx-10 questions on exam)
name the elevators and depressors of the larynx…
elevators:
digastric
stylohyoid, mylohyoid, genihyoid
stylopharyngeus, salpingopharyngeus and palatopharyngeus
depressors:
sternothyroid, sternohyoid and omohyoid
name the actions of the muscles:
cricothyroid- posterior cricothyroid- transverse and oblique arytenoids- lateral cricoarytenoids- thyroarytenoid- vocalis-
- cricothyroid- chief tensot of vocal ligament
- posterior cricothyroid- abducts vocal folds
- transverse and oblique arytenoids- close rima glottidis
- lateral cricoarytenoids- Adducts vocal folds
- thyroarytenoid-slackens vocal folds and closes rima glottidis
- vocalis- adjusts tension on vocal ligament
name the paired and unpaired laryngeal cartilages:
unpaired:
thyroid, cricoid and epiglottis
Paired:
arytenoids, corniculates and cuneiforms
what structures make up the conus elasticus?
the lateral cricothyroid ligament and the vocal ligament
what is the motor nerve supply to the larynx?
the external laryngeal nerve- which innervates the cricothyroid muscle
the recurrent laryngeal which innervates the rest of the larynx
the internal laryngeal nerve is accompanied by ________ and pierces the ________.
Superior Laryngeal artery
they pierce the thyrohyoid membrane
what are the different exams and procedures connected with the larynx?
Laryngoscopy- visual examination of the larynx
Laryngotomy- to induce air into lower larynx and trachea
larynectomy-surgical resection, normally a tumor
what is the sensory supply to the larynx?
internal laryngeal- above vocal folds
recurrent laryngeal- below vocal folds
the recurrent laryngeal nerve lies in the _________ - ________ groove.
tracheo- esophageal
outline the arterial supply and venous drainage to the larynx.
Arterial supply:
superior laryngeal- branch of superior thyroid
inferior laryngeal- branch of inferior thyroid
Venous drainage:
superior laryngeal goes to superior thyroid which goes to internal jugular vein
inferior laryngeal goes to inferior thyroid which goes to brachiocephalic vein
(Nasal Cavity and paranasal sinuses 8 questions on exam)
what is kiesselbach’s plexus?
frequent area for nose bleeds also known as epistaxis. the most common cause is from nose picking
what is the arterial supply of the nose?
mainly through the branches of the maxillary and opthalmic arteries
the maxillary branches are - sphenopalatine and greater palatine
what are paranasal sinuses?
air filled extensions in respiratory part of the nasal cavity into the frontal and ethmoid bones
what is a visual examination of the nose called?
rhinoscopy
what tonsils are removed during a adenoidectomy?
the pharyngeal tonsils
the acronym FMAM in regaurds to the hiatus semilunaris means what?
the hiatus contains the openings for: F- frontal sinus M- middle ethmoidal air cells A- anterior ethmoidal air cells M- maxillary sinus
where does the sphenoid sinus drain into?
the sphenoethmoidal recess
what is the innervation to the nose?
special sense- olfactory nerves
general sense- V1, V2 of trigeminal
anterior ethmoidal branch of the nasocilliary supplies anterior part of nasal cavity
the nasal conchae divide the nasal cavity into 4 passages: what are they and what do they contain?
1- sphenoethmoidal recess- contains opening for sphenoid sinus
2- superior meatus- contains opening for posterior ethmoidal air cells
3- middle meatus- contains ethmoidal bulla which has openings for middle ethmoidal air cells; below the bulla is the hiatus semilunaris (it gets the radio FMAM)
4-inferior meatus- contains the opening for the nasolacrimal duct
what are the stiff hairs in the nose called?
Vibrissae
(Oral cavity- 10 questions on exam)
what are the boundaries of the oral cavity:
roof- palate
floor-tongue
lateral walls- cheeks
what is the frenulum of upper/lower lip?
mucous membrane that attatches lips to gingiva
what is the frenulum linguae?
connects inferior surface of tongue to floor of mouth
what is the sublingual papilla?
a papillae on each side of frenulum of tongue for submandibular duct
where does the duct for the parotid gland open?
opposite upper second molar tooth
what is the sensory supply to the lips and cheeks?
V1 and V2 of the trigeminal
cheeks-
infraorbital n. (V2)
Zygomaticofacial (V2)
Buccal (V3)
lips-
Infraorbital (V2)- upper lip
mental (V3)- lower lip
whats the vasculature and innervation to the teeth?
vasculature- superior and inferior alveolar arteries- branchs of maxillary a.
lymphatic vessels- drain into submandibualr lymph nodes
innervation: superior alveolar (V2) inferior alveolar (V3)
what is the space between the oral cavity and the pharynx called?
the fauces
the soft palate receives blood from_______?
the greater and lesser palatine arteries ( branches of descending palatine)
what are the intrinsic muscles of the tongue and their actions?
superior longitudinal-curls tongue upward
inferior longitudinal- curls tongue downward
transverse-protrudes tongue (narrows & elongates)
vertical-flattens and broadens
what are the extrinsic muscles of the tongue and their shape?
genioglossus- fan shaped, main bulk of tongue
hyoglossus- thin- quadrilateral
styloglossus- small, short and triangular
palatoglossus- narrow and crescent shaped
what is the motor innervation to the tongue?
hypoglossal nerve, to everything excepth the palatoglossus (VAGUS)
what is the sensory innervation to the tongue/
anterior 2/3- lingual of V3 does general
chorda tympani (of facial)- special
posterior 1/3- glossopharyngeal
internal laryngeal- does small part towards very back of tongue
(the ear- 8 questions)
what is the depression in the tympanic membrane called?
the umbo (from it the cone of light radiates anteriorly and inferiorly)
what is the membranous labrynth filled with?
and what seperated the membranous labrynth from the bony labrynth?
endolymph
perilymph
what makes up the bony labrynth?
cochlea, vestibule and the semicircular canals
what makes up the membranous labrynth?
the utricle, saccule, semicircular ducts and cochlear duct
the oval window is closed by what structure?
the stapes
*the oval and round window are also closed by a secondary tympanic membrane
what is cerumin?
yellowish brown wax produced byceruminous glands locaed in the external acoustic meatus
the ear gets its blood from branches coming off of the_________,______ and______?
superficial temporal, posterior auricular and the occipital a.a
what nerves innervate the ear?
great auricular, auriculotemporal (V3), lesser occipital and auricular branch of vagus (motor to auricular muscles)
(orbit…-3 questions)
the sebacious glands are called ______? and if they are plugged it leads to a _______?
the sweat glands are called_______? and when they are clogged it leads to _______?
what are the modified sebacous glands called? whats their function? and what happens if they get inflamed?
glands of Zeis, leads to stye or external hordeolum
ciliary glands aka glands of Moll, leads to stye or external hordeolum
-tarsal glands- they secrete a oily discharge to create airtight seal around eyelid- iflamation leads to a chalazion or internal hordeolum
the plica semilunaris forms the lateral boundary of the lacrimal lake and is a evolutionary remininant of _______?
nicitating membrane
in the center of the lacrimal lake there is a lacrimal _________.
caruncle
rods let us see _______
cones let us see ________
dim, black/white
bright light and color
anterior and posterior chambers are filled with _______
vitrous chamber is filled with
Aqueas humor
vitrous humor
what are:
papilledema? hyperopia myopia astigmatism presbyopia cataracts glaucoma asthenopia
papilledema- edema of optic disc hyperopia- far sightedness myopia- short sightedness astigmatism- irregular refraction presbyopia- inability to focus on near or far objects cataracts-opacity of lens due to aging glaucoma-increase in intraocular pressure asthenopia- eye strain
(cranial meninges-3 questions)
what are the arteries of the dura matter?
anterior meningeal- branch of anterior ethmoidal a.
middle meningeal- branch of the maxillary a.
posterior meningeal- branch of ascending pharyngeal a.
what are the veins of the dura matter?
middle meningeal- go through foramen ovale and spinosum to the ptergoid plexus
anterior and posterior meningeal a. go through dural sinus and cranial fossae
emissary veins which go to the intracranial venous sinus then to extracranial veins
what is significant about the space between the dura and arachnoid space?
it is only present if there is bleeding
what is in the subarachnoid space?
CSF- cerebro-spinal fluid
face and scalp-3 questions
what is the arterial supply to the scalp?
an anastamotic connection of vessels-
supratrochlear, supraorbital, superficial temporal, posterior auricular, occipital
if you get a cut on the scalp blood is lost from both ends of the severed vessel
what are the nerves of the scalp?
sensory-
supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal, lesser occipital and greater occipital
all muscles of the face originate from which pharyngeal arch?
the second pharyngeal arch
all muscles of the face recieve motor innervation from which nerve?
the facial nerve
what is lagothalmus and xerophalmia?
dryness of eye, and dryness of cornea
the branches of the facial nerve are _______…
the zebra bit my mothers cat
temporal sygomatic buccal marginal mandibular cervical
what type of ganglion is the ottic ganglion
parasympathetic ganglion located in the infratemporal fossa directly under the foramen ovale and just medila to madibular nerve
