Midterm 1 Flashcards
(528 cards)
1
Q
Which triangle of the neck contains the infrahyoid muscles?
A
muscular triangle
2
Q
Which triangle of the neck contains the thyroid gland?
A
muscular triangle
3
Q
Which triangle of the neck contains the larynx?
A
muscular triangle
4
Q
Which triangle of the neck contains the trachea?
A
muscular triangle
5
Q
Which triangle of the neck contains CN XI (spinal accessory n.)?
A
occipital triangle
6
Q
Which triangle of the neck contains cutaneous nerves from cervical plexus?
A
occipital triangle
7
Q
Which triangle of the neck contains the common carotid artery?
A
carotid triangle
8
Q
Which triangle of the neck contains the vagus nerve?
A
carotid triangle
9
Q
Which triangle of the neck contains the internal jugular vein?
A
carotid triangle
10
Q
Which triangle of the neck contains the anterior scalene muscle?
A
supraclavicular triangle
11
Q
Which triangle of the neck contains brachial plexus elements?
A
supraclavicular triangle
12
Q
Which triangle of the neck contains the phrenic nerve?
A
supraclavicular triangle
13
Q
Which triangle of the neck contains the subclavian artery and vein?
A
supraclavicular triangle
14
Q
Which triangle of the neck contains the facial artery and vein?
A
submandibular triangle
15
Q
Which triangle of the neck contains the submandibular glands?
A
submandibular triangle
16
Q
Which triangle of the neck contains the root of the tongue?
A
submental triangle
17
Q
Which triangle of the neck contains part of the oral cavity?
A
submental triangle
18
Q
Which triangles are in the anterior neck?
A
muscular, carotid, submandibular, submental
19
Q
Which triangles are in the posterior (& lateral) neck?
A
occipital, supraclavicular
20
Q
At what vertebral level is the thyroid cartilage?
A
C4-C5
21
Q
At what vertebral level is the cricoid cartilage?
A
C6
22
Q
At what vertebral level is the hyoid bone?
A
C3
23
Q
At what vertebral level is the tracheal cartilage?
A
C6 and below
24
Q
Which spinal nerves innervate the skin of the neck and head?
A
C2, C3, C4
25
What innervates the platysma muscle?
facial n. (VII)
26
What innervates the SCM?
spinal accessory n. (XI), and C2(3) ventral ramus
27
Which rami make up the cervical plexus?
C1-C4 ventral rami
28
What are the 5 branches of the cervical plexus?
cutaneous, hitchhiker, ansa, motor, phrenic
| CHAMP
29
What are the 4 terminal cutaneous branches of the cervical plexus?
lesser occipital, great auricular, transverse cervical, supraclavicular nn.
30
Ventral rami of which roots form the lesser occipital n?
C2
31
Ventral rami of which roots form the great auricular n?
C2, C3
32
Ventral rami of which roots form the transverse cervical n?
C2, C3
33
Ventral rami of which roots form the supraclavicular n?
C3, C4
34
Which nerve penetrates the platysma muscle?
transverse cervical n.
35
Which cervical cutaneous nerve has named branches?
supraclavicular n. (lateral, intermediate, medial)
36
Which nerve innervates skin on the posterior scalp behind the ear?
lesser occipital n.
37
Which nerve innervates part of the ear and the skin over angle of mandible?
great auricular n.
38
Which nerve innervates skin of the anterior neck?
transverse cervical n.
39
Which nerve innervates skin of base of neck into thorax and shoulder?
supraclavicular n.
40
Which cervical roots hitchhike on hypoglossal n?
C1
| geniohyoid & thyrohyoid muscles
41
What innervates the geniohyoid m.?
C1 (hitchhiker)
42
What innervates the thyrohyoid m.?
C1 (hitchhiker)
43
What innervates the sternohyoid m.?
ansa cervicalis
44
What innervates the sternothyroid m.?
ansa cervicalis
45
What innervates the omohyoid m.?
ansa cervicalis
46
What innervates the mylohyoid m.?
trigeminal n. (V)
47
What innervates the digastric m.?
anterior: CN V
posterioir: CN VII
48
What innervates the stylohyoid m.?
facial n. (VII)
49
What innervates the scalenes mm.?
lower cervical ventral rami
50
What innervates that longus colli m.?
C2-C7 ventral rami
51
What innervates the longus capitis m.?
C1-C3 ventral rami
52
What innervates the rectus capitis anterior and lateralis mm.?
C1-C2 ventral rami
53
What are the contents of the carotid sheath?
common carotid a., internal jugular v., vagus n. (X)
54
What are the 3 layers of deep cervical fascia?
superficial, pretracheal, prevertebral
55
Which layer of deep cervical fascia includes the infrahyoid mm.?
superficial layer
56
Which layer of deep cervical fascia includes the thyroid gland?
pretracheal layer
57
Which layer of deep cervical fascia includes the trachea?
pretracheal layer
58
Which layer of deep cervical fascia includes the esophagus?
pretracheal layer
59
Which layer of deep cervical fascia includes the spine?
prevertebral layer
60
Which layer of deep cervical fascia includes the deep neck muscles?
prevertebral layer
61
Which infrahyoid muscles is NOT innervated by ansa cervicalis?
thyrohyoid m. (C1)
62
Which ventral rami form the superior root of the ansa cervicalis?
C1
63
Which ventral rami form the inferior root of the ansa cervicalis?
C2, C3
64
What's the other name for the superior root of the ansa cervicalis?
descending hypoglossal ramus of ansa cervicalis
65
What's the other name for the inferior root of the ansa cervicalis?
descending cervical ramus of ansa cervicalis
66
Which rami contribute to the phrenic n.?
C3, C4, C5
67
Where in the neck is the ansa cervicalis?
in the carotid sheath
68
What is innervated by the phrenic n.?
diaphragm
69
Which muscles are innervated by motor branches of the cervical plexus?
scalenes & prevertebral mm.
70
Which 4 muscles are "infrahyoid"?
sternohyoid, sternothyroid, omohyoid, thyrohyoid
71
Which 4 muscles are "suprahyoid"?
digastric, stylohyoid, mylohyoid, geniohyoid
72
Which 4 muscles are "prevertebral"?
longus colli, logus capitis, rectus capitis anterior, rectus capitis lateralis
73
Which roots form the brachial plexus?
C5-T1
74
What are the contents of the scalene triangle?
subclavian a., roots of brachial plexus
75
What are the borders of the scalene triangle?
anterior and middle scalenes, first rib
76
Where is the "thoracic outlet syndrome" caused?
scalene triangle
77
Where does the right common carotid a. originate?
brachiocephalic trunk
78
Where does the left common carotid a. originate?
aortic arch
79
Where does the common carotid a. split into internal and external branches?
superior border of the thyroid cartilage (C3-4)
80
What is the carotid sinus?
dilation at the bifurcation; baroreceptor in vessel walls
81
What is the carotid sinus reflex?
increase in BP triggers CNS to reduce BP & HR
82
What innervates the carotid sinus?
sinus branch of glossopharyngeal n. (IX)
83
What is the carotid body?
chemoreceptor near carotid bifurcation
84
What does the carotid body measure/respond to?
changes in O2 and CO2 levels
85
What does the internal carotid a. supply?
brain and orbit
86
What are the cervical branches of the internal carotid a.?
no branches in the neck
87
The superior thyroid a. is a branch of which artery?
external carotid a.
88
The ascending pharyngeal a. is a branch of which artery?
external carotid a.
89
The lingual a. is a branch of which artery?
external carotid a.
90
The facial a. is a branch of which artery?
external carotid a.
91
The occipital a. is a branch of which artery?
external carotid a.
92
The posterior auricular a. is a branch of which artery?
external carotid a.
93
The maxillary a. is a branch of which artery?
external carotid a.
94
The superficial temporal a. is a branch of which artery?
external carotid a.
95
The superior laryngeal a. is a branch of which artery?
superior thyroid a.
96
What is supplied by the superior thyroid a.?
thyroid, larynx, infrahyoid mm., part SCM
97
What is supplied by the ascending pharyngeal a.?
pharyngeal wall
98
What is supplied by the lingual a.?
tongue and floor of oral cavity
99
What is supplied by the facial a.?
submandibular gland, upper & lower lips, anterior face (mandible to orbit, not jaw or teeth)
100
What is supplied by the occipital a.?
posterior scalp
101
What is supplied by the posterior auricular a.?
external ear, skin behind ear
102
What is supplied by the maxillary a.?
mandible, maxilla, teeth, muscles of mastication, dura mater
103
What is supplied by the superficial temporal a.?
parotid gland, superficial structures of parieto-temporal region
104
What's the name of CN I?
olfactory n.
105
What's the name of CN II?
optic n.
106
What's the name of CN III?
oculomotor n.
107
What's the name of CN IV?
trochlear n.
108
What's the name of CN V?
trigeminal n.
109
What's the name of CN VI?
abducent n.
110
What's the name of CN VII?
facial n.
111
What's the name of CN VIII?
vestibulocochlear n.
112
What's the name of CN IX?
glossopharyngeal n.
113
What's the name of CN X?
vagus n.
114
What's the name of CN XI?
accessory n.
115
What's the name of CN XII?
hypoglossal n.
116
What's the olfactory n.?
CN I
117
What's the optic n.?
CN II
118
What's the oculomotor n.?
CN III
119
What's the trochlear n.?
CN IV
120
What's the trigeminal n.?
CN V
121
What's the abducent n.?
CN VI
122
What's the facial n.?
CN VII
123
What's the vestibulochochlear n.?
CN VIII
124
What's the glossopharyngeal n.?
CN IX
125
What's the vagus n.?
CN X
126
What's the accessory n.?
CN XI
127
What's the hypoglossal n.?
CN XII
128
Where does the right subclavian a. originate?
brachiocephalic trunk
129
Where does the left subclavian a. originate?
aortic arch
130
What are the 4 branches of the subclavian a.?
internal throacic a., vertebral a., thyrocervical trunk, costocervical trunk
131
What is supplied by the internal thoracic a.?
anterior thoracic wall & breast
132
What is supplied by the vertebral a.?
deep neck, spinal nerves, cord, brain
133
What are the branches of the thyrocervical trunk?
inferior thyroid, ascending cervical, transverse cervical, suprascapular aa.
134
What are the branches of the costocervical trunk?
deep cervical, superior intercostal branches
135
What's another name for the deep transverse cervical a.?
dorsal scapular a.
136
What is supplied by the inferior thyroid a.?
thyroid, esophagus, larynx, trachea
137
What is supplied by the ascending cervical a.?
deep cervical structures
138
What is supplied but the transverse cervical a.?
trapezius (superficial); rhomboids & levator scapulae (deep)
139
What is supplied by the suprascapular a.?
supraspinatus, infraspinatus
140
What is supplied by the deep cervical a.?
deep posterior neck structures
141
What is supplied but the superior intercostal a.?
superior thorax
142
Where does the internal jugular vein begin?
where the sigmoid venous sinus exits the skull
143
What veins drain to the internal jugular vein?
facial, lingual, thyroid, pharyngeal vv.
144
What major vein does the internal jugular join?
joins subclavian v. to become brachiocephalic v.
145
Where do the vertebral veins drain?
into brachiocephalic or subclavian vv.
146
At what vertebral levels is the thyroid gland found?
C5-C7
147
What is the isthmus?
functional thyroid tissue connecting the left & right lobes
148
What is the pyramidal lobe?
extra thyroid tissue going superiorly from isthmus
149
What is the thyroglossal duct?
embryonic remnant; may leave cysts in anterior midline; marks the path of migration of the gland from the tongue to it's final position (usually disappears)
150
What does the thyroid gland produce?
thyroxine and calcitonin hormones
151
What does thyroxine do?
increase cellular metabolism
152
What artery supplies the thyroid gland?
superior thyroid a. from external carotid, inferior thyroid a. from thyrocervical trunk
153
What is the thyroideus "ima"?
artery to thyroid along ventral midline (<10%); branch from brachiocephalic a. or aortic arch
154
What veins drain the thyroid gland?
superior, middle, inferior thyroid vv.
155
How many parathyroid glands are there?
4: L&R superior & inferior
156
What does calcitonin do?
decrease serum calcium levels
157
What does parathyroid hormone do?
increase serum calcium levels
158
Where does the right jugulo-lymphatic trunk drain to?
into confluence of R subclavian v. and R internal jugular v.
159
Where does the left jugulo-lymphatic trunk drain to?
into thoracic duct
160
Where does the thoracic duct (lymph) drain to?
confluence of L internal jugular v. and L subclavian v.
161
What is the anterior 2/3 of the head called?
the face
162
What innervates the face?
trigeminal n. (V)
163
What is the galea aponeurotica?
helmet of intermediate tendon joining frontalis m. and occipitalis m.
164
What are the 5 layers of the scalp?
skin, CT, aponeurosis, loose CT, pericranium
165
What is the pericranium?
periosteum on outer skull
166
What innervates the muscles of facial expression?
facial n. (VII)
167
What muscles moves the scalp and elevates the eyebrows?
epicranius m. (frontalis + occipitalis)
168
What muscle is used for blinking?
orbicularis oculi m.
169
What muscle forms a sphincter around the mouth?
orbicularis oris m.
170
What muscle retracts the angle of the mouth?
risorius m.
171
What muscles elevate the mouth and lip?
zygomaticus major & minor mm.
172
What muscles depressed the angle of the mouth?
depressor anguli oris m.
173
What muscle depresses the lower lip?
depressor labii oris m.
174
What muscle draws the cheek against the teeth and gums?
buccinator m.
175
What muscle is used for pouting?
mentailis m.
176
What muscle is used for grimacing?
platysma m.
177
Where does the facial n. emerge to the face?
through the parotid gland
178
Where does the facial n. exit the skull?
through the stylomastoid foramen
179
What are the branches of the facial n.?
temporal, zygomatic, buccal, mandibular, descending cervical, posterior auricular
180
What's the biggest salivary gland?
parotid glands
181
What are the three large paired salivary glands?
parotid, submandibular, sublingual
182
What are the three smaller salivary glands?
labial, lingual, palatine
183
What is the parotid papilla?
fleshy prominence opposite 2nd molar where duct connects
184
What is Stensen's duct?
duct that connects the parotid gland to the oral cavity
185
What muscle is penetrated by the parotid duct?
buccinator m.
186
What type of secretions do the parotid and submandibular glands produce?
mainly serous (submandibular - some mucous)
187
What kind of innervation does a salivary gland get from sympathetic fibers?
vasomotor
188
What kind of innervation does a salivary gland get from paraympathetic fibers?
secretomotor
189
Where are the preganglionic fibers for the parotid gland?
glossopharyngeal n. (CN IX)
190
Where are the preganglionic fibers for the submandibular gland?
facial n. (CN VII)
191
Where are the preganglionic fibers for the sublingual gland?
facial n. (CN VII)
192
Where are the postganglionic neurons for the parotid gland?
otic ganglion
193
Where are the postganglionic neurons for the submandibular gland?
submandibular ganglion
194
Where are the postganglionic neurons for the sublingual gland?
submandibular ganglion
195
What is Wharton's duct?
duct that connects the submandibular gland to the oral cavity
196
Where are the labial glands found?
oral side of upper & lower lips
197
Where are the preganglionic fibers of the labial glands?
facial n. (CN VII)
198
Where are the postganglionic neurons for the labial glands?
submandibular ganglion
199
Where are the lingual glands found?
on the tongue
200
Where are the preganglionic fibers for the lingual glands?
facial n. (CN VII)
201
Where are the postganglionic neurons for the lingual glands?
submandibular ganglion
202
Where are the palatine glands found?
in the roof of the oral cavity
203
Where are the preganglionic fibers for the palatine glands?
facial n. (CN VII)
204
Where are the postganglionic neurons for the palatine glands?
sphenopalatine ganglion
205
Which salivary gland is not innervated by the facial n.?
parotid glands - glossopharyngeal n. (CN IX)
206
What is the sublingual papilla?
openings under tongue for Wharton's duct to submandibular gland (aka caruncle)
207
What is the sublingual caruncle?
openings under tongue for Wharton's duct to submandibular gland (aka papilla)
208
Which salivary glands are not innervated by neurons from the submandibular ganglion?
parotid (otic ganglion) & palatine (sphenopalatine ganglion)
209
What are the main branches of the facial artery?
inferior labial a., superior labial a., angular a.
210
Which artery supplies the lower lip?
inferior labial a. (from facial a.)
211
Which artery supplies the upper lip?
superior labial a. (from facial a.)
212
Which artery supplies skin of nose and lower eyelid?
angular a. (from facial a.)
213
What artery anastomoses with the terminal branch of the facial a.?
infraorbital a. anastomoses with angular a.
214
What artery supplies the submandibular and sublingual glands?
facial a.
215
What artery supplies the palatine tonsils?
tonsilar branch of facial a.
216
What is the clinical significance of the anastomosis between the infraorbital, opthalmic, and angular vv.?
infection risk to brain because veins can drain into cranial cavity
217
What does the facial v. drain in to?
external, internal, or anterior jugular v.
218
Which cranial nerve has three named divisions?
CN V (trigeminal n.) - V1, V2, V3
219
What kind of information is carried the by the trigeminal n.?
both sensory and motor
220
Which division(s) of the trigeminal n. carry sensory fibers?
all 3
221
Which division(s) of the trigeminal n. carry motor fibers?
V3 (mandibular)
222
What innervates the muscles of mastication?
V3 (mandibular)
223
What innervates the tensor beli palatini and tensor tympani mm.?
V3 (mandibular)
224
What is the Gasserian ganglion?
trigeminal ganglion
225
Where are the sensory neuron bodies of CN V?
trigeminal ganglion
226
What is V1 called?
opthlamic n.
227
What is V2 called?
maxillary n.
228
What is V3 called?
mandibular n.
229
What is the extent of the dermatome for V1?
top of scalp to top of eye
230
What is the extent of the dermatome for V2?
cheek, below eye to bottom lip
231
What is the extent of the dermatome for V3?
in front of ear to chin, skipping angle of mandible
232
What is the opthalmic n?
V1
233
What is the maxillary n.?
V2
234
What is the mandibular n.?
V3
235
What are the 8 bones of the cranium?
2 parietal, 2 temporal, frontal, occipital, sphenoid, ethmoid
236
What are the 14 bones of the face?
2 maxillas, 2 zygomatic, 2 palatine, 2 inferior concha, 2 nasal, 2 lacrimal, vomer, mandible
237
What are the 3 bones in each middle ear?
malleus, incus, stapes
238
What are the ossicles?
the tiny bones in the middle ear
239
What kind of joint is found between most skull bones?
sutural, synarthrosis
240
What joints in the skull are not sutures?
TMJ, ossicles (synovial)
241
What kind of CT is found in a sutural joint?
fibrous CT
242
What is the suture between the frontal and parietal bones?
coronal suture
243
What is the suture between L&R parietal bones?
sagittal suture
244
What is the suture between the occipital and parietal bones?
lambdoidal suture
245
What is the suture between the squamous part temporal bone and parietal bone?
squamosal suture
246
Where is the coronal suture?
between frontal and parietal bones
247
Where is the sagittal suture?
between L&R parietal bones
248
Where is the lambdoidal suture?
between occiput and parietal bones
249
Where is the squamosal suture?
between the squamous part temporal bone and parietal bones
250
What is the vertex?
top most point of the skull
251
What is the bregma?
junction between coronal and sagittal sutures
252
What is the lambda?
junction between sagittal and lambdoidal sutures
253
Where are the parietal eminences?
area on side of head with greatest convexity
254
What is the superciliary arch or ridge?
ridge along superior border of orbit
255
What is the glabella?
smooth prominence between eyebrows, above bridge of nose
256
What is the inion?
external occipital protuberance
257
What is the temporal fossa?
depression on side of skull above zygomatic arches; filled by temporalis mm.
258
What are the temporal lines?
circular lines showing the outline of temporal fossae; origin of temporalis mm.
259
What makes up the zygomatic arch?
zygomatic bone & zygomatic process of temporal bone
260
What are the divisions of the cranial floor?
3 fossae: anterior, middle, posterior
261
Where is the anterior cranial fossa?
between the orbital plates of the frontal bone, cribriform plate of ethmoid bone, and lesser wings & body of sphenoid bone and anterior clinoid processes
262
What foramina are found in the anterior cranial fossa?
cribriform foramina (olfactory n.)
263
What is the midline crest on the ethmoid bone?
crista galli
264
What goes through the cribriform foramina?
olfactory n. (CN I)
265
Where is the middle cranial fossa?
bordered by squamous & petrous temporal bones, body & greater wings of sphenoid bone
266
What is the sella turcica?
saddle-like depression in superior surface of body of sphenoid
267
What is the hypophyseal fossa?
space for pituitary gland in sella turcica
268
What foramina are found in the middle cranial fossa?
optic canals, superior orbital fissures, foramen rotundum, foramen ovale, foramen spinosum, foramen lacerum
269
What goes through the optic canals?
optic n. (CN II), opthalmic a.
270
What goes through the superior orbital fissure?
oculomotor n. (CN III), trochlear n. (CN IV), abducens n. (CN VI), opthalmic n. (V1)
271
What goes through the foramen rotundum?
maxillary n. (V2)
272
What goes through the foramen ovale?
mandibular n. (V3)
273
What goes through the foramen spinosum?
middle meningeal a.
274
What goes through the foramen lacerum?
nothing; closed with fibrocartilage; internal carotid a. goes across
275
Where are the optic canals?
connecting middle fossa to the orbit; anterioir corners of sphenoid body
276
Where is the superior orbital fissure?
between great and small wings of sphenoid
277
Where is the foramen rotundum?
connecting middle fossa to sphenopalatine fossa
278
Where is the foramen ovale?
connecting middle fossa to infratemporal fossa
279
Where is the foramen spinosum?
posterior corners of sphenoid body
280
Where is the foramen lacerum?
medial to foramen ovale
281
Where does CN I exit the skull?
cribriform foramen of ethmoid bone (ant. fossa)
282
Where does CN II exit the skull?
optic canal (middle fossa)
283
Where does CN III exit the skull?
superior orbital fissure (middle fossa)
284
Where does CN IV exit the skull?
superior orbital fissure (middle fossa)
285
Where does CN V1 exit the skull?
superior orbital fissure (middle fossa)
286
Where does CN V2 exit the skull?
foramen rotundum (middle fossa)
287
Where does CN V3 exit the skull?
foramen ovale (middle fossa)
288
Where does CN VI exit the skull?
superior orbital fissure (middle fossa)
289
Where does CN VII exit the skull?
internal auditory meatus (posterior fossa)
290
Where does CN VIII exit the skull?
internal auditory meatus (posterior fossa)
291
Where does CN IX exit the skull?
jugular foramen (posterior fossa)
292
Where does CN X exit the skull?
jugular foramen (posterior fossa)
293
Where does CN XI exit the skull?
jugular foramen (posterior fossa)
294
Where does CN XII exit the skull?
hypoglossal canal (posterior foramen)
295
Which cranial fossa is the largest?
posterior
296
Where is the posterior cranial fossa?
bordered by occipital bone, petrous temporal bones, body of sphenoid (dorsum sella, posterior clinoid processes)
297
What goes through the internal auditory meatus?
facial n. (CN VII), vestibulochochlear n. (CN VIII), internal auditory a.
298
What is the internal occipital crest?
midline, between IOP and foramen magnum
299
What foramina are in the posterior cranial fossa?
internal auditory meatus, jugular foramen, foramen magnum, hypoglossal canal, condylar canal, transverse & sigmoid sinus sulci
300
What goes through the jugular foramen?
CN IX, CN X, CN XI, internal jugular v.
301
What goes through the foramen magnum?
spinal cord to brainstem, vertebral aa., spinal root of CN XI
302
What goes through the hypoglossal canal?
hypoglossal n. (CN XII)
303
What goes through the condylar canal?
emissary veins
304
What are the 3 layers of meninges in the cranial vault?
dura mater, arachnoid, pia mater
305
What are the 2 layers of arachnoid?
primary layer & trabeculae
306
Which meningeal laters make up the leptomeninges?
arachnoid and pia
307
Which layers make up the pachymeninges?
the dura
308
What are the layers of cranial dura mater?
perosteal & meningeal
309
What are the layers of spinal dura?
spinal dura has only one layer
310
What fills the subarachnoid space?
CSF
311
Where is the subarachnoid space?
between pia mater and arachnoid
312
Where is the cranial epidural space?
between the dura and the bones of the cranial vault
313
Where is the subdural space?
between the dura and arachnoid (potential space)
314
What fills the cranial epidural space?
no space exists until clinical condition e.g., hematoma
315
What fills the subdural space?
no space exists until clinical condition e.g., hematoma
316
What are the 4 dural folds?
falx cerebri, tentorium cerebelli, falx cerebelli, diaphrama sella
317
What is falx cerebri?
dural fold separating L&R cerebrum; attaches to crista galli
318
What is the tentorium cerebelli?
dural fold in the transverse cerebral fissure
319
What is the falx cerebelli?
dural fold separating L&R cerebellum
320
What is the diaphrama sella?
dural fold that partially covers the hypophyseal fossa
321
What is the histology of the dural venous sinuses?
dense regular CT; dural walls, lined by endothelium, no smooth muscle or valves
322
What is drained by the dural venous sinuses?
brain (cerebral vv.)
323
What are major dural venous sinuses?
superior & inferior sagittal, straight, occipital, confluence of the sinuses, 2 transverse, 2 sigmoid, 2 cavernous
324
Where is the superior sagittal sinus?
superior border of falx cerebri
325
Where is the inferior sagittal sinus?
inferior margin of falx cerebri
326
Where is the straight sinus?
junction of falx cerebri and tentorium cerebelli
327
Where is the occipital sinus?
posterior/inferioir margin of falx cerebelli
328
Where is the transverse sinus?
posteriori margin of tentorium cerebelli
329
Where is the sigmoid sinus?
S-curve continuation of transverse sinus
330
Where is the cavernous sinus?
on each side of the sphenoid bone
331
Where is the confluence of the sinuses?
just inferior to the IOP
332
Where does the superior sagittal sinus drain?
posteriorly into the confluence
333
Where does the inferior sagittal sinus drain?
into straight sinus with great cerebral vein of Galen
334
What does the confluence of the sinuses drain and to where?
superior sagittal, straight, and occipital sinuses converge here; into transverse sinus
335
Where does the occipital sinus drain?
superiorly into confluence
336
Where does the transverse sinus drain?
from the confluence laterally into sigmoid sinus; along the posterior border of the tentorium cerebelli
337
Where does the sigmoid sinus drain into?
internal jugular vein at jugular foramen
338
What does the cavernous sinus drain and to where?
drains parts of brain, pituitary, orbit; into petrosal sinuses
339
Where do the superior and inferior petrosal sinuses drain?
superior - to transverse sinus
| inferior - to sigmoid sinus
340
What are the 3 meningeal arteries?
anterior, middle, posterior
341
Where are the meningeal arteries?
within the dura
342
What forms the anterior meningeal a.?
internal carotid a.
343
What forms the middle meningeal a.?
maxillary a.
344
What forms the posterior meningeal a.?
vertebral & occipital aa.
345
Which meningeal artery is the largest?
middle
346
Which meningeal artery enters the skull?
middle, through the foramen spinosum
347
What is supplied by meningeal arteries?
bone of cranium (a little blood to brain)
348
What is one cause of an epidural hematoma?
skull fracture tearing meningeal a.
349
What is one cause of a subdural hematoma?
usually damage to cerebral vv. where they pass thru the subdural space; whiplash
350
What do emissary veins do?
directly connect dural venous sinuses and vv. outside of skull
351
Where are diploic veins located?
within the medullary cavity of cranial bones
352
What do diploic veins do?
drain blood from cranial bones into superficial veins of scalp and/or dural venous sinuses
353
What innervates the anterior cranial fossa?
meningeal branches of trigeminal n.
354
What innervates the middle cranial fossa?
meningeal branches of trigeminal n.
355
What innervates the posterior cranial fossa?
vagus n. & upper 3 cervical spinal nn.
356
What provides vasomotor innervation to the dura?
postganglionic sympathetic fibers travel with the arteries
357
What are the cutaneous branches of the trigeminal n.?
from V1: supraorbital, supratrochlear, lacrimal
from V2: infraorbital, zygomatic
from V2: mental, buccal, auriculotemporal
358
Where is the spinal dura attached to bone?
foramen magnum, bodies of C2-3
359
What are Hoffman's ligaments?
small ligamentous slips that attach spinal dura to PLL (C7-L5)
360
Where does the dural sac end?
S2
361
What part of spinal dura continues below S2?
filum dura
362
What is the dural coccygeal ligament?
same as filum dura
363
What is the filum terminale?
extension of pia from conus medullaris to end of dural sac
364
What is a denticulate ligament?
lateral extensions of pia penetrating arachnoid to attach to dural sac
365
What layer of meninges is continuous with epinuerium of spinal nerves?
dura
366
What layer of meninges is continuous with perineurium of spinal nerves?
arachnoid and pia
367
Where is the spinal epidural space?
between the dural sac and borders of vertebral canal
368
What fills the spinal epidural space?
loose CT, adipose, vessels
369
What is the idea of epidural anesthesia?
can affect small range of spinal cord segments because diffusion to others is slow
370
What is the filum dura?
extension of dura below end of dural sac; aka dural coccygeal lig.
371
How is a spinal nerve named?
cervical: named for vertebra below IVF
| T/L/S: named for vertebra above IVF
372
What is the lumbar cistern?
subarachnoid space below the conus medullaris; L2-S2
373
What is the conus medullaris?
the end of the spinal cord, around L2
374
What is a "spinal tap"?
biopsy of fluid from the lumbar cistern, usually between L3-4 or L4-5
375
What is a "spinal block"?
introduction of anesthetics into the lumbar spine, usually between L3-4 or L4-5
376
What fills the lumbar cistern?
CSF
377
What nerve rootlets are in the lumbar cistern?
cauda equina
378
What is a choroid plexus?
ventricular structure that secretes CSF
379
Where is CSF found?
ventricles of brain, subarachnoid space of brain and spinal cord
380
What causes CSF flow?
continued CSF secretion/resorption, arterial pulse in subarachnoid space, movements of vertebral column
381
How much CSF does a body hold?
about 150 ml
| 80-150ml
382
How often is CSF replaced?
3-4 times per day
383
What are arachnoid villi?
tufts of arachnoid that extend into the dural venous sinus system
384
Where are most arachnoid villi found?
superior sagittal sinus
385
What are arachnoid granulations?
hypertrophic villi; normal with aging
386
How do the cranial bones accomodate arachnoid granulations?
forming fovea granulares
387
What are fovea granulares?
pit-like depressions on inner surface of cranial cavity from arachnoid villi pushing against
388
What happens to CSF at arachnoid villi?
CSF mixes with venous blood
389
What supplies the vertebral column with blood?
segmental vessels
390
What vessels form segmental vessels in the thoracic spine?
intercostal a. & v.
391
What vessels form segmental vessels in the lumbar spine?
lumbar a. & v.
392
What vessels form segmental vessels in the cervical spine?
branches of aa. and vv. of the deep neck (e.g. vertebral, ascending cervical)
393
Which part of a segmental artery forms the spinal branch?
the dorsal branch
394
What is supplied by the spinal branch of a segmental artery?
vertebrae & paraspinal tissue (ligs), outer annulus fibrosus, nerve rootlets, maybe spinal cord
395
What protects the blood supply to the vertebrae?
extensive anastomses between segmental arteries
396
What is Batson's plexus?
internal and external vertebral venous plexus
397
Where is the external vertebral venous plexus?
distributed to external part of vertebral column and deep paraspinal tissue
398
Where is the internal vertebral venous plexus?
distributed within the epidural space of vertebral canal
399
Where is the basivertebral vein?
within vertebral body
400
What drains the vertebral body?
the basivertebral vein
401
What is unusual about the veins of the vertebral venous plexus?
they lack valves
402
Where are the spinal veins?
between internal & external vertebral plexuses, at pedicles
403
What do the vertebral venous plexuses drain into?
spinal vv. to segmental vv.
404
What drains the spinal cord?
internal vertebral venous plexus
405
What innervates the ventral paraspinal region?
gray rami communicantes of sympathetic chain, ventral rami of spinal nn, & recurrent meningeal n.
406
What innervates the dorsal paraspinal region?
dorsal primary rami
407
What innervates the ALL?
gray rami communicantes of sympathetic chain & ventral rami of spinal nn,
408
What innervates the annulus fibrosus?
ant & lat: gray rami communicantes of sympathetic chain & ventral rami of spinal nn.
post: recurrent meningeal n.
409
What innervates the periosteum on vertebral bodies?
ant & lat: gray rami communicantes of sympathetic chain & ventral rami of spinal nn.
post: recurrent meningeal n.
409
What innervates the vertebral body?
gray rami communicantes of sympathetic chain, ventral rami of spinal nn., recurrent meningeal n.
410
What innervates the PLL?
recurrent meningeal n.
411
What innervates the dorsal thecal sac?
not well innervated (?)
412
What innervates the ventral thecal sac?
recurrent meningeal n.
413
What innervates the dura around spinal nerves?
recurrent meningeal n.
414
What is the sinu vertebral n.?
same as the recurrent meningeal n.
415
What is the nerve of Luschka?
same as the recurrent meningeal n.
416
What 2 roots form the recurrent meningeal n,?
somatic root from ventral ramus + autonomic root from gray ramus communicantes
417
What innervates anterior & lateral structures in the ventral paraspinal compartment?
gray rami communicantes (sympathetic), ventral rami
418
What innervates the posterior structures in the ventral paraspinal compartment?
recurrent meningeal n.
419
What innervates skin of the lateral back?
lateral branches of dorsal primary rami
420
What innervates skin of the midline back?
medial branches of dorsal primary rami
421
What innervates iliocostalis m.?
lateral branches of dorsal primary rami
422
What innervates longissimus m.?
intermediate branches of dorsal primary rami
423
What innervates transversospinalis mm.?
medial branches of dorsal primary rami
424
What are the branches of dorsal primary rami that innervates dorsal compartment structures?
lateral, intermediate, & medial in T/L; lateral & medial in cervical (?)
425
What innervates the zp joint?
articular branches of medial division of dorsal primary rami
426
What innervates the supraspinous ll.?
medial branches of dorsal primary rami
427
What innervates ligamentum flavum?
medial branches of dorsal primary rami
428
What innervates the interspinous l.?
medial branches of dorsal primary rami
429
A given dorsal primary ramus's medial division articular branch innervates which zp joint?
the zp at that level and one below
430
Specifically which rami innervate a given zp joint?
articular branch of medial division of DPR at that level and one above
431
What kind of innervation are found in paraspinal nerves?
motor, vasomotor, sensory
432
What lies over the medial branch of a lumbar dorsal primary ramus?
mamillo-accessory l.
433
What kind of innervation is provided by the autonomic system to spinal/paraspinal tissues?
perivascular; postganglionic sympathetic fibers, vasomotor
434
How many neurons are required for somatic efferent communication?
1
435
How many neurons are required for visceral efferent communication?
2 - pre/postganglionic
436
Where is the neuron cell body found in the autonomic system?
preganglionic in CNS & postganglionic in PNS autonomic ganglion
437
What are the 2 divisions or the autonomic nervous system?
sympathetic and parasympathetic
438
What is the thoracolumbar division of the ANS?
sympathetic division
439
What is the craniosacral division of the ANS?
parasympathetic division
440
What spinal nerves are used by the sympathetic ANS?
T1-L2
441
What spinal nerves are used by the parasympathetic ANS?
III, VII, IX, X, S2-4
442
Where are the preganglionic axons in the sympathetic ANS?
T1-L2
443
Where are the preganglionc axons in the parasympathetic ANS?
III, VII, IX, X, S2-4
444
Where are the preganglionic cell bodies in the sympathetic ANS?
lateral horns of spinal cord (T1-L2)
445
Where are the preganglionic cell bodies in the parasympathetic ANS?
brain and lower spinal cord
446
Where do preganglionic sympathetic axons exit the spinal cord?
through ventral roots of spinal nn. T1-L2
447
Which spinal nn. have white rami communicantes?
T1-L2
448
Which spinal nn. have grey rami communicantes?
all
449
Which rami communicantes are used in the sympathetic ANS?
white and gray
450
What is an interganglionic nerve?
connections between ganglia in the sympathetic chain
451
What is a white ramus communicante?
preganglionic pathway for spinal nerve to sympathetic chain ganglion
452
What is a gray ramus communicante?
postganglionic pathway from sympathetic chain back to spinal nerve
453
What is a splanchnic nerve?
nerve carrying sympathetic preganglionic axon to prevertebral ganglion
454
What is a visceral nerve?
nerve carrying sympathetic postganglionic axon to effector cell in organ
455
What are the 2 sets of ganglia in the sympathetic ANS?
paravertebral (L&R chains) and prevertebral (near target organs)
456
What is found in paravertebral ganglia?
postganglionic sympathetic neuron cell bodies
457
What is found in prevertebral ganglia?
postganglionic sympathetic neuron cell bodies
458
What is formed by paravertebral ganglia and interganglionic nerves?
sympathetic chain
459
How many chain ganglia are there overall?
~22-23
460
How many sympathetic chain ganglie are there in the cervical region?
2 or 3
461
How many sympathetic chain ganglia are there in the thoracic region?
12
462
How many sympathetic chain ganglia are there in the lumbar region?
4
463
How many sympathetic chain ganglia are there in the sacral region?
4
464
What connects the left and right sympathetic chains?
ganglion impar
465
What is the ganglion impar?
unpaired coccygeal ganglion of sympathetic chain
466
What is the fusion of the inferior cervical and first thoracic ganglia?
stellate ganglion
467
What is the stellate ganglion?
the fusion of the inferior cervical and first thoracic sympathetic chain ganglia
468
How many chain ganglia are there overall?
~22-23
469
How many sympathetic chain ganglie are there in the cervical region?
2 or 3
470
How many sympathetic chain ganglia are there in the thoracic region?
12
471
How many sympathetic chain ganglia are there in the lumbar region?
4
472
How many sympathetic chain ganglia are there in the sacral region?
4
473
What connects the left and right sympathetic chains?
ganglion impar
474
What is the ganglion impar?
unpaired coccygeal ganglion of sympathetic chain
475
What is the fusion of the inferior cervical and first thoracic ganglia?
stellate ganglion
476
What is the stellate ganglion?
the fusion of the inferior cervical and first thoracic sympathetic chain ganglia
477
Are sympathetic axons myelinated?
preganglionic thinly; postganglionic no
478
Where do the postganglionic axons from the sympathetic chain go?
join spinal nn. via gray rami comm, arterial plexuses, to an organ
479
Where do the preganglionic sympathetic axons for the head & neck enter the chain?
white rami comm. of T1-T5
480
What distributes the postganglionic sympathetic axons for the head & neck?
cervical ganglia
481
Which spinal nn. have fibers in the superior cervical ganglia?
C1-C3(4)
482
What spinal nn. have fibers in the middle cervical ganglia?
C4-C6
483
Which spinal nn. have fibers in the inferior cervical ganglia?
C6-C8
484
Which cervical ganglia have postganglionic fibers distributed by cardiac nn.?
superior, middle, & inferior
485
Which cervical ganglion distributes fibers by the internal and external carotid plexuses?
superior
486
Which cervical ganglion distributes fibers with the first thoracic ganglion
inferior
487
What is a vertebral arterial nerve plexus?
nerve fibers following arteries to get to target cells
488
How are the fibers from prevertebral ganglia distributed to effector cells?
mostly via arterial nerve plexuses
489
What are the visceral effector cells?
cardiac & smooth muscle, glands
490
What innervates the prevertebral ganglia?
preganglionic sympathetic neurons passing through sympathetic chain to ganglia on splanchnic nerves
491
What are 3 prevertebral ganglia?
celiac, superior & inferior mesenteric
492
Where is the celiac ganglion?
near celiac a.
493
Where is the superior mesenteric ganglion?
near superior mesenteric a. & renal aa.
494
Where is the inferior mesenteric ganglion?
near inferior mesentertic a.
495
What is innervated by the celiac ganglion axons?
foregut & midgut structures
496
What is innervated by superior mesenteric ganglion axons?
midgut structures
497
What is innervated by inferior mesenteric ganglion axons?
hindgut structures
498
Which nerves send fibers to the celiac ganglion?
greater splanchnic nn.
499
Which nerves send fibers to superior mesenteric ganglion?
lesser splanchnic nn.
500
Which nerves send fibers to the inferior mesenteric ganglion?
lumbar splanchnic nn.
501
What are the functions of the sympathetic division of the ANS?
cutaneous vasocontriction, increase sweat glands and arrector pili mm., skeletal muscle vasodilation, pupil dilation, increase HR & BP
502
Which division of the ANS controls "fight or flight" responses?
sympathetic
503
What are the functions of the parasympathetic ANS?
decrease HR & BP, constrict pupils, increase peristalsis & digestive secretions
504
Are paraympathetic axons myelinated?
preganglionic yes; postganglionic no
505
What are the 4 pairs of parasympathetic ganglia near target organs?
ciliary, submandibular, sphenopalatine, otic
506
What are 5 parasympathetic intarmural ganglia?
Auerbach's plexus, Meissner's plexus, cardiac plexus, pulmonary plexus, pelvic plexus
507
What are intramural ganglia?
found in the wall of target organs
508
Which ganglia receive fibers from CN III?
ciliary (parasympathetic)
509
Which ganglia receive fibers from CN VII?
submandibular & sphenopalatine (parasympathetic)
510
Which ganglia receive fibers from CN IX?
otic (parasympathetic)
511
Which ganglia receive fibers from CN X?
intramural ganglia (parasympathetic)
512
Which spinal nerve goes the the ciliary ganglion?
CN III
513
Which spinal nerve goes to the submandibular ganglion?
CN VII
514
Which spinal nerve goes to the sphenopalatine ganglion?
CN VII
515
Which spinal nerve goes to the otic ganglion?
CN IX
516
Which spinal nerve goes to the intramural ganglion?
CN X
517
Where are the postganglionic cell bodies of the parasympathetic ANS?
ciliary, submandibular, sphenopalatine, and otic ganglia; intramural ganglia
518
Where are the cell bodies of visceral afferent neurons?
ganglia of CN IX and X; DRG of T1-L2 and S2-4
519
Are visceral afferent fibers myelinated?
some are & some aren't
520
What are the 2 types of visceral afferents?
physiological & pain
521
Which visceral afferents follow the parasympathetic paths?
physioloical
522
Which visceral afferents follow the sympathetic paths?
physiological and pain
523
What is the clinical effect of pain afferent pathways?
pain from viscera can be referred to somatic tissue innervated by T1-L2
524
What are visceral afferents?
single cell pathways, sensory from viscera
525
How many neurons are required for visceral afferent communication?
one
526
What is measured by physiological afferents?
chemical levels, pressures, distension...
527
Which communicating ramus is used for visceral afferent communication?
white
