Maxillofacial Anatomy and Correlates Flashcards
1
Q
Vertical buttresses
A
Zygomatico-fronto-maxillary (lateral)
Nasomaxillary (medial)
Pterygomaxillary (posterior)
2
Q
Major buttresses of midface
A
Frontal bar
Medial nasomaxillary
Lateral zygomaxillary
3
Q
Horizontal buttresses
A
Supraorbital bar
Inferior orbital rim/Orbital floor
Alveolus
4
Q
Upper third of face
Any fracture is classified ⬆️
A
Frontal bone
Frontal sinus
Supraorbital ridge
5
Q
Fx of middle third of face may involve
A
Nasal Orbital Naso orbito ethmoidal complex Zygoma Maxilla Alveolar process
6
Q
Orbit (bones)
A
Frontal Lacrimal Ethmoidal Zygomatic Maxillary Sphenoidal Palatine
7
Q
Roof of orbit
A
Orbital plate of frontal bone
Lesser wing of sphenoid
rooFS
8
Q
*Floor of orbit
A
Orbital plate of maxilla
Zygomatic bone
Orbital process of palatine bone
Maxilla
Zygomatic
Palatine
Floor MZP
9
Q
Medial wall of orbit
A
Orbital plate of ethmoid
Lacrimal bone
Frontal process of maxilla
Body of sphenoid
10
Q
Lateral wall or orbit
A
Frontal process of zygomatic
Greater wing of sphenoid
11
Q
Strongest and thickest wall of orbit
A
Lateral wall
12
Q
Apex of orbit transmits
A
Optic canal
CN II
13
Q
Orbital margin
A
Frontal
Zygoma
Maxilla
14
Q
Fracture of walls or floor of orbit
A
Blow out fracture
15
Q
Opacification in upper maxillary sinus
represents periorbital fat and possibly an entrapped extraocular muscle in maxillary sinus on x ray
A
Tear drop sign
16
Q
When patient tilts her head to left toward normal
the right eye does not deviate upward when normal left eye fixates
When patient tilts her head to right toward paralyzed muscle right eye deviates upward
A
Bielschowsky head tilt test
Parks three step test
17
Q
Oculomotor nerve paralysis muscle affected
A
Levator palpebrae superioris
18
Q
Down and out muscle
A
SO and LR
19
Q
Low level type of fracture
Transverse Maxillary Fracture
Horizontal fracture through maxilla
Floating palate
A
Le Fort I
Guerin type
20
Q
Separates maxilla from face
Fracture through frontal process of the maxilla
Through the orbital floor
Floating maxilla
A
Pyramidal fracture
Le Fort II
21
Q
High level fracture
Facial bone, including zygomas are detached from anterior cranial base
Extends through the nasofrontal suture and frontozygomatic suture
Floating face
Craniofacial separation
A
Lefort III
Craniofacial dysjunction
22
Q
Fracture of this plate is mandatory to diagnose Le Fort fracture
A
Pterygoid plate
23
Q
Includes fracture:
Lateral orbital wall
Inferior orbital floor
Zygomatic arch
A
Zygomaticomaxillary complex
Tripod/Malar fracture
24
Q
Most common part fractured in mandible
Weakest part
A
Condylar neck
25
Tripod fracture has 4 components
Orbital floor fracture
Fracture of lateral wall of maxillary antrum
Zygomatic arch
Widening of the zygomatico-frontal suture
26
Fracture of the condyle injures the
inferior alveolar nerve
27
Most commonly fractured bones of face
Nasal
Zygomatic
Mandible
eNZYme
28
unpaired facial bones
Vomer
| Mandible
29
Most common site of epistaxis
Anterior epistaxis
Anteroinferior part of nasal septum
Kiesselbach plexus
| Little area
30
Posterior epistaxis
Woodruf’s plexus
31
Kiesselbach plexus
Arterial anastomosis
Anterior ethmoidal artery
Sphenopalatine artery
Greater palatine artery
Septal branch of superior labial artery
GASS
32
Cavernous sinus contents
CN III, IV, V(1,2), VI
| ICA
33
Infection in danger triangle of face may lead to
CST from facial vein thrombosis
34
Facial vein -> superior ophthalmic vein -> cavernous sinus
Cavernous sinus thrombosis
35
Mandibulofacial dysostosis
Treacher Collins syndrome
36
Prominent risorius in
Tetany
37
Horizontal wrinkle in forehead
Epicranius
38
Crow’s feet
Orbicularis occuli
39
Muscles of mastication
Temporalis
Internal medial pterygoid
Masseter
External lateral pterygoid
40
Opens the mouth
All other TIME muscles of mastication close the mouth except
Lateral pterygoid
41
Diplopia
Loss of sensation of skin of cheek and gum
Entrapment of inferior rectus limiting upward gaze
nerve affected?
Blow out fracture
infraorbital nerve
42
Patient unable to look at his shoulder due to paralysis of this muscle (and nerve)
Head may tilt to opposite side to minimize diplopia
Superior oblique
| CN IV
43
CN III innervates muscles of the eye:
Levator palpebrae superioris
Sphincter pupillae
SR, IF, MR, IO
44
Contact between teeth
Relationship between maxillary (upper) and mandibular (lower) teeth when they approach each other as occurs during chewing or at rest.
Occlusion
45
Misalignment of teeth and jaws
Bad bite
Malocclusion
46
Unpaired of the 14 facial bones
Vomer
| Mandible
47
Components of nasal septum
Vertical plate of ethmoid
Vomer
Septal cartilage
48
Masseter, Temporalis, Lateral pterygoid, Medial pterygoid innervation
Mandibular branch of V
49
All muscles of the tongue are innervated by CN XII except
Palatoglossus CN X
50
Palate muscles are innervated by CN X except
Tensor veli palatine V
51
Pharyngeal muscles are innervated by CN X except
Stylopharyngeus CN IX
52
Branches of ICA
```
Choroidal artery
Anterior Cerebral
Middle Cerebral
Posterior Communicating
Ophthalmic artery
Superior Hypophyseal artery
```
CAMPOS
53
Branches of ECA
```
Supeior Thyroid
Ascending pharyngeal
Lingual
Maxillary
Facial
Occipital
Posterior Auricular
Superficial Temporal
```
54
Paired clefts develop by
4 weeks
55
Superior oblique
Abducens
Oculomotor muscles
Skeletal derivative: Maxillary, Palatine, Jugal, Trabecular cranii
CN V2
Pharyngeal arch 1
| Maxillary V2
56
Muscles of mastication
Tensor tympani
Anterior belly of digastrics
Incus anterior ligament of malleus
Palatoquadrate
Meckel’s cartilage
CN V3
Pharyngeal arch 1
| Mandibular V3
57
Muscles of facial expression
Posterior belly of digastric
Stylohyoid
Stapes, hyoid bone, Reichert’s cartilage
Facial nerve CN VII
Pharyngeal arch 2
| Hyoid
58
Stylopharyngeus
Horns of hyoid
Thyroid cartilage
CN IX
Pharyngeal arch 3
59
Striates muscle of esophagus
Cricoid cartilage
Laryngeal branch of Vagus CN X
Pharyngeal arch 4 and 6
60
Fistula is seen most commonly in
Presents in 1st decade of life
Tx is complete excision
2nd brachial cleft
61
Skeletal derivatives of Second (Hyoid) Arch
```
Stapes
Styloid process
Stylohyoid ligament
Lesser horn of hyoid bone
Superior part of body of hyoid bone
```
62
Second arch muscle derivatives
Muscles of facial ex
Stylohyoid
Stapedius
Posterior belly of digastric
CN VII
63
Vascular element of Second Arch derivatives
Stapedial artery
| Tympanic branch of ICA
64
Pharyngeal arch 1 is also called
and forms
Meckel’s cartilage
Head of malleus and body of incus
65
Second pharyngeal arch is also called
and forms
Reichart’s cartilage
Handle of malleus
Long process of incus
Crurae of stapes
66
Otic capsule forms
foot plate of Stapes
67
Anomaly in brachial cleft 1 openings
```
Preauricular (external)
Middle ear (internal)
```
68
Anomaly at 2nd branchial cleft opens at
```
Lateral neck SCM (external)
Tonsillar fossa (internal)
```
69
Anomaly at 3rd branchial cleft opens at
```
Lateral neck at SCM (external)
Pyriform sinus (internal)
```
70
Most common cause of neck mass in child
Enlarged lymph node
71
Branchial cleft anomaly occuring in association with biliary atresia and congenital cardiac anomalies
Goldenhar complex
72
Most common site for lodging of ingested sharp foreign body
Piriform sinus
73
Infrahyoid/Strap muscles
Sternohyoid
Sternothyroid
Omohyoid
Thyrohyoid
74
All strap/infrahyoid muscles are innervated by ansa cervicalis except
Thyrohyoid C1 and C2
75
Contents of submandibular triangle
```
Submandibular gland
Facial vein and artery
Nerve to mylohyoid
Submental artery
Lymph nodes
```
76
Contents of submental triangle
Anterior jugular vein
| Lymph node
77
Contents of carotid triangle
Common internal carotid
Internal jugular vein
Vagus nerve
Hypoglossal
78
Contents of carotid sheath
Common and internal carotid
Internal jugular vein
Vagus nerve
79
Bifurcation of common carotid
| Just beneath anterior border of sternocleidomastoid at the level of the superior border of thyroid cartilage
Carotid pulse
80
Occipital triangle contents:
Spinal accessory nerve XI
Brachial plexus trunk
Occipital artery
81
Subclavian triangle contents
Supraclavicular/omoclavicular triangle
```
Subclavian artery third part
Three trunks Brachial plexus
EJV
Nerve to subclavius
Suprascapular nerve
```
82
Superior thyroid artery is closely related to
External laryngeal nerve
83
Inferior thyroid artery is closely related to
Recurrent laryngeal nerve
84
The subclavian artery is divided into three parts by the
anterior scalenes
85
Subclavian artery branches
Vertebral artery
Internal thoracic artery: superior epigastric, musculophrenic, perocardiophrenic
Thyrocervical trunk: inferior thyroid artery, ascending cervical, transverse cervical, suprascapular artery
Costocervical trunk: supreme intercostal, deep cervical
86
Inferior aspect of cricoid cartilage to thoracic outlet
Zone I
87
Cricoid to angle of mandible
Most common injured
Zone 2
88
Angle of mandible to the base of the skull
Zone III
89
Cutaneous branches of cervical plexus
Lesser occipital
Greater auricular
Transverse cutaneous
Supraclavicular
90
Muscular branches of cervical plexus
```
Prevertebral muscles
SCM C2 C3
Levator scapulae C3 C4
Trapezius C3 C4
Nerve to thyrohyoid/geniohyoid C1
Ansa cervicalis C1,2,3
Phrenic Nerve C3, C4, C5
```
91
Level 1 LN
Submental, submandibular
92
Level 2 LN
Upper jugular
93
Level 3 LN
Midjugular
94
Level 4 LN
Lower jugular
95
Level 5 LN
Suboccipital
96
Level 6 LN
Central
97
Upper limb hemorrhage can be stopped by strong pressure downward and backward on the third part of
subclavian artery
against upper surface of first rib
98
Arm abducted and externally rotated
Head extended and turned to side of lesion
Radial pulse monitored while deep breath is taken and held
Positive if there is dimunition or loss of pulse
Adson maneuver
99
Cath of the internal jugular vein is inserted
halfway between the tip of the mastoid process and the angle of the jaw to the sternoclavicular joint
100
Posterior approach of internal jugular vein catheterization
Tip of needle and catheter are introduced into the vein about two fingerbreadths above the clavicle at the posterior border of the SCM
101
Anterior approach of internal jugular vein catheterization
Patient’s head turned to opposite side
| Needle and catheter are inserted into vein at the apex of the triangle in a caudal direction
102
Begins just below chin by the union of several small veins
Runs down the neck close to midline
Drains to external jugular vein
Anterior jugular vein
103
Airway compression tracking to thorax and mediastinum
Retropharyngeal abscess
104
80% of CLADs are
Neoplastic
Metastatic
From above clavicle
105
Head and neck mass 7 days etiology
inflammation
106
Head and neck mass 7 months etiology
Neoplastic
107
Head and neck mass 7 years
Congenital
108
80% of HN Cancers are
SCC
109
85% of patients with HN Cancers
smoke
110
Most common primary malignant solid tumor in children
Rhabdomyosarcoma
111
Infants etiology of neck mass
Congenital
112
Adolescents etiology of neck mass
Inflammatory
113
Adults etiology of neck mass
Malignancy
114
80% of neck mass in children are
benign
115
80% of neck mass in adults >40 are
malignant
116
Most common malignant neck mass in children, adolescent and young adult
Lymphoma
117
Radical Neck Dissection removes
Levels I-V
Spinal accessory
Internal jugular
SCM
118
Type I Modified RND preserves
Spinal Acessory Nerve
119
Type II Modified RND preserves
Spinal Accessory Nerve
| Internal jugular
120
Type III Modified RND preserves
Spinal accessory nerve
Internal jugular
SCM
121
Also called functional neck dissection
Modified RND
122
Preserves lymphatics normally removed in RND or MRND
Neck dissection
123
Superior orbital fissue transmits
```
Superior ophthalmic vein
Abducens
Oculomotor
Trochlear
V1
```
124
Located deep to lateral portion of the eyelid
Lacrimal
