Midterm Exam: Lecture 10+11 (Study Other Decks Too) Flashcards
What is the neurocranium?
Bones of the head that surround the brain
What is the viscerocranium?
Facial bones between the nose, TMJ joints, and mental protuberance (chin)
Which bones make up the neurocranium?
- frontal
- parietal (2)
- occipital
- temporal (2)
- sphenoid
- ethmoid
Which nuerocranial bones make up the “calvaria roof”?
Frontal, parietal (2), occipital
Which bones make up the viscerocranium?
- ethmoid
- vomer
- mandible
- maxilla (2)
- inferior nasal concha (2)
- zygomatic (2)
- palatine (2)
- lacrimal (2)
What are fontanelles?
Uncalcified (soft) regions after birth
- anterior (bregma)
- posterior (lambda)
What are the 3 sutures of the skull?
- coronal (divides frontal bone from parietal bones)
- sagittal (divides left and right parietal)
- lambdoid (posterior skull)
Which nerve passes through the cribiform plate?
CN I (olfactory)
Which nerve goes through the optic canal?
CN II (optic)
Which nerves go through the superior orbital fissure?
Cranial nerves III (Oculomotor), IV (Trochlear), V1 ophthalmic of the trigeminal, VI (Abducent)
Which nerve goes through foremen rotundum?
CN V2 maxillary of trigeminal
Which nerve goes through the foramen ovale?
CN V3 Mandibular of trigeminal
Which nerves go through the internal acoustic meatus?
CN VII (Facial) and VIII (Vestibulocochlear)
VII exits the skull via stylomastoid foramen
Which nerves go through the jugular foramen?
CN IX (Glossopharyngeal), X (Vagus), XI (Accessory)
And internal jugular vein
Which nerve goes through the hypoglossal canal?
CN XII (Hypoglossal)
Which nerves go through the foramen magnum?
CN XI (Accessory)….. then goes out of the skull via the jugular foramen
Spinal cord, brainstem, vertebral artery
Where does the middle meningeal artery enter the skull?
Foramen spinosum
What goes into the carotid canal?
Internal carotid artery
What is the role of CN V1 (Ophthalmic)?
Responsible for general sensory of the upper face
What is the role of CN V2 (Maxillary)?
Responsible for general sensory of the middle face
What is the role of CN V3 (Mandibular)?
Responsible for general sensory of the lower face
Also innervates the muscles of chewing (motor)
What is different about CN VII?
Which glands does CN VII (facial) innervate?
It provides parasympathetic innervation, special sensation (taste), and muscles of facial expression
Also innervates salivary glands, lacrimal glands
Explain the role of CN IX (Glossopharyngeal)
Responsible for general sensation of posterior 1/3 of tongue (and taste), pharynx, palatine tonsils, external/middle ear
Innervates stylopharyngeus muscle and parotid gland
Does visceral sensory and motor
Explain the role of CN X (Vagus)
Innervates muscles of pharynx, taste to epiglottis, and general sensation to inferior part of pharynx, visceral motor (parasympathetic)
Damage to the vagus nerve may cause difficulty speaking and swallowing
Explain the role of CN XI (Accessory)
Somatic motor to trapezius and SCM
Explain the role of CN XII (Hypoglossal)
Somatic motor to intrinsic muscles and extrinsic muscles of the tongue
Which nerve supplies the face?
CN V (Trigeminal)
- V1 (ophthalmic division)
- V2 (maxillary division)
- V3 (mandibular division)
If a tumor was present in the stylomastoid process, and the structure that passed through it was damaged, what would the symptoms be?
(CN VII: facial nerve) Paralysis of the muscles of facial expression
Your patient has a tumor compressing the nerve that passes through foramen ovale. What would you expect their symptoms to be?
(CN V1: mandibular of trigeminal) Decreased sensation over the chin
Describe the cervical plexus
- A small plexus originating from the ventral rami of C1-C4 with some contribution from C5
- contains 4 cutaneous nerves
- contains the phrenic and ansa cervicalis
The cutaneous portion of the cervical plexus contains 4 nerves, what are they?
Lesser Occipital (C2)
- innervates the skin of neck and scalp, posterior to the ear
Great Auricular (C2/C3)
- innervates the ear region, particularly the parotid gland, and mastoid process
Transverse Cervical (C2/C3)
- innervates the lateral and anterior neck
Supraclavicular (C3/C4)
- innervates the clavicle and shoulder region
Describe the phrenic nerve
Motor and sensory
- motor to diaphragm
- sensory to pericardium, pleura
- originates from anterior rami of C3-C5
Describe the ansa cervicalis
A loop of nerves from C2-3 (inferior), and C1 (superior)
- Has motor branches that innervate the infrahyoid muscles
- C1 blends with CN XII (Hypoglossal)
Name the veins of the neck
- Retromandibular (posterior to ramus)
- Facial (face)
- External jugular (drains the entire head to bring venous blood back to the subclavian)
What does external jugular vein distention indicate?
Poor vascular return to the heart
What makes the border of the anterior triangle of the neck?
Midline (anterior)
Mandible (superior)
SCM (posterior)
What makes the border of the posterior triangle of the neck?
SCM (anterior)
Clavicle (inferior)
Trapezius (posterior)
The hyoid bone divides the anterior neck into two regions. What are they?
Suprahyoid and infrahyoid
The suprahyoid muscles are innervated by what?
Cranial nerves
The infrahyoid muscles are innervated by what?
Ansa cervicalis
What is the function of hyoid muscles?
Assists in swallowing, and can elevate the bone for speech purposes
The hyoid bone is controlled by which muscle? What can it do?
Digastric muscle (2 bellies)
- hyoid can elevate when the jaw is in a fixed position
- mandible can depress/retract when hyoid is in a fixed position
Which nerve innervates the posterior digastric muscle?
CN VII (Facial)
Which nerve innervates the anterior digastric muscle?
CN V3 (Mandibular of trigeminal)
What is the stylohyoid muscle? Innervation? Function?
Runs from styloid process to hyoid bone
- innervated by CN VII (Facial)
- elevates hyoid
What is the mylohyoid muscle? Innervation? Function?
Runs from mandible to hyoid
- innervated by CN V3 (Mandibular of trigeminal)
- elevates hyoid when mandible is fixed, depresses mandible when hyoid is fixed
What is the geniohyoid muscle? Innervation? Function?
Runs from mandible to hyoid (deep to mylohyoid)
- depresses mandible when hyoid is fixed, elevates hyoid when mandible is fixed
- innervated my CN XII (Hypoglossal)
Which muscles are considered “suprahyoids”?
Digastric, stylohyoid, mylohyoid
Which muscles are considered “infrahyoids”?
Omohyoid, sternohyoid, thyrohyoid, sternothyroid
What is the omohyoid muscle? Innervation? Function?
Runs from hyoid to superior border of the scapula
- is superficial to internal jugular vein
What is the thyrohyoid muscle?
Stabilizes and depresses the hyoid
- if hyoid is fixed, it will elevate the larynx
What is the sternothyroid muscle?
Not attached to hyoid and depresses larynx
Which artery supplies blood to the brain?
Internal carotid artery
Which artery supplies blood to the neck and the face?
External carotid artery
Name the branches of the external carotid artery
(SALFOPS Max)
- Superior thyroid artery
- Ascending pharyngeal artery
- Lingual artery
- Facial artery
- Occipital artery
- Posterior auricular artery
- Superficial temporal artery
- Maxillary artery
Which artery supplies the tongue with blood?
Lingual artery
Which artery supplies the face with blood?
Facial artery
Which artery brings blood to the pharynx?
Ascending pharyngeal
Which artery supplies the ear with blood?
Posterior Auricular artery
Which artery supplies the superficial skull with blood?
Superficial temporal artery
Which artery supplies the deep face with blood?
Maxillary artery
Which major vessels of the neck run parallel to one another? Which nerve runs with them?
Internal jugular vein and common carotid artery
The vagus nerve also runs with the vessels
Which nerve innervates the trapezius?
CN XI (Spinal accessory)
Which nerve innervates the larynx? Which artery supplies it with blood?
Superior laryngeal nerve, superior laryngeal artery
Which nerve innervates the cricothyroid muscle?
External laryngeal nerve
Which nerve provides sensation below the vocal cords and innervates all the muscles that help move the vocal cords?
Recurrent laryngeal nerve
Which nerve innervates the vocal cords?
Vagus nerve
What is the role of the CN VII (facial nerve)?
- innervates muscles of facial expression
- Innervates glands (lacrimal, submandibular, salivary)
- Provides taste and sensory to anterior 2/3 of the tongue
What is Bell’s Palsy?
An injury to CN VII (Facial) that causes
- paralysis of muscles that control facial expression (droopy face on one side)
- cornea can become vulnerable to injury
- can cause hyperacusis and affect taste (anterior 2/3 of tongue)
Which nerve goes through the parotid gland?
Facial nerve
What is the function of the parotid gland? Innervation?
Supplies the mouth with saliva
Parasympathetically innervated by CN IX
Which major vessels supply and drain the head?
Superficial temporal vein and artery (head), and the facial vein and artery (face)
What is the TMJ?
Synovial joint also known as the “Temporal Mandibular joint” (junction between mandibular fossa and condyle of mandible)
- lower cavity: hinge joint
- upper cavity: gliding joint
Which nerve passes through the mental foramen of the mandible?
CN V3 (mandibular of trigeminal)
List the two ligaments of the TMJ
lateral “TMJ” ligament
- runs from zygomatic arch to neck of mandible
- prevents posterior dislocation
sphenomandibular ligament
- runs inferior and anterior from the sphenoid bone to the lingula of mandible
- prevents mandibular depression
What is the stylomandibular joint?
Connects styloid process to mandible
What are the basic movements of the TMJ?
Elevation, depression, retraction, protraction, side to side
What are the 4 muscles of mastication?
Masseter, temporalis, lateral pterygoid, medial pterygoid
Which nerve innervates the muscles of mastication?
CN V3 (mandibular of trigeminal)
Explain the masseter muscle
Origin: zygomatic arch
Insertion: angle, ramus, and part of inferior border of mandible
Action: elevation and protrusion (forwards)
Explain the temporalis muscle
Origin: temporal fossa
Insertion: coronoid process of mandible, anterior margin of ramus
Action: elevation and retrusion (backwards)
Explain the medial pterygoid muscle
Origin: medial surface of lateral pterygoid plate and tuberosity of maxilla
Insertion: medial ramus of mandible (near angle)
Action: elevation
Explain the lateral pterygoid muscle
Origin: infratemporal surface of sphenoid, lateral surface of lateral pterygoid plate of sphenoid
Insertion: TMJ Joint capsule, neck of mandible
Action: protrusion (forwards)
What is the name of CN I? Function?
Olfactory nerve (smell)
What is the name of CN II? Function?
CN II: Optic nerve (vision)
What is the name of CN III, IV, VI? Function?
CN III: Oculomotor
CN IV: Trochlear
CN VI: Abducent
(Provides motor signals to muscles that move the eyes)
What is the name of CN VIII? Function?
CN VIII: Vestibulocochlear (hearing/balance)
What is the name of CN V and its branches? Function?
CN V: Trigeminal
- V1: ophthalmic
- V2: maxillary
- V3 mandibular
Provides sensory innervation to the face
What is the name of CN VII? Function?
CN VII: Facial nerve (motor to muscles of facial expression)
What is the name of CN IX? Function?
CN IX: Glossopharyngeal (parasympathetic, motor, sensory innervation to lacrimal and salivary glands, as well as the mouth and throat)
What is the name of CN X?
CN X: Vagus
What is the name of CN XI? Function?
CN XI: Spinal accessory (motor to SCM and trapezius)
What is the name of CN XII? Function?
CN XII: Hypoglossal (motor to tongue)
Which nerve passes through the cribiform plate?
CN I: Olfactory
Which nerve passes through the optic canal?
CN II: Optic nerve
Which nerve(s) go through the superior orbital fissure?
CN III: Oculomotor nerve
CN IV: Trochlear
CN VI: Abducent
CN V1: Ophthalmic
Which nerve goes through foramen rotundum?
CN V2: Maxillary of trigeminal
Which nerve passes through foramen ovale?
CN V3: Mandibular of maxillary
Which nerves passes through the internal acoustic meatus?
CN VII: Facial
CN VII: Vestibulocochlear
Which nerve passes through the jugular foramen
CN IX: Glossopharyngeal
Which nerve goes through foramen magnum?
CN XI: Spinal accessory
Which nerve passes through the hypoglossal canal?
CN XII: Hypoglossal
Which foramen is filled with cartilage?
Foramen lacerum
Where is the pituitary gland?
Sella Turcica
Which two foramen does the facial nerve go through?
Internal acoustic meatus (to the head) and stylomastoid foramen (to the face)
If there is damage to the stylomastoid foramen or the facial nerve, what could happen?
Damage to the muscles of facial expression
Which nerve innervates the parotid gland?
CN IX (Glossopharyngeal)
❗️If a tumor was present in the stylomastoid foramen, what could happen?
Paralysis of the facial expression muscles (because facial nerve runs through it)
Which foramen do V1, V2, and V3 go through? Are they sensory or motor?
V1: superior orbital fissure
V2: foramen rotundum
V3: foramen ovale
V1 and V2 are just sensory, whereas V3 is sensory and motor
