Nose and Paranasal Sinuses, Pharynx, Pterygopalatine Fossa Flashcards
1
Q
What are the bones of the septum?
A
- Vomer (posteroinferior)
2. Ethmoid (anterosuperior)
2
Q
What forms the floor, roof, lateral wall of nasal cavity?
A
- Maxilla
- Palatine bone
- Frontal bone
- Nasal bone
- Ethmoid bone
- Sphenoid
- Lacrimal bone
- Inferior concha
3
Q
What is the anterior opening of the nose?
A
A single piriform aperture (surrounded by nasal bones above and maxillae laterally and below)
4
Q
What is the posterior opening of the nose?
A
Choanae separated by bony septum
5
Q
What are the cartilages of the nose?
A
- Septal
- Lateral
- Alar cartilages
6
Q
What is the septal cartilage of the nose attached to?
A
Bony septum
7
Q
What is the lateral cartilage of the nose attached to?
A
Posteriorly to bony lateral walls, inferiorly to alar cartilages
8
Q
What do the alar cartilages curve to form?
A
Nostril
9
Q
What are the 3 chonchaes?
A
- superior
- middle
- inferior
10
Q
Where are the 3 meatuses located?
A
Below each concha
11
Q
What is the space posterosuperior to superior choncha?
A
Sphenoethmoidal recess
12
Q
What does the middle meatus contain?
A
Longitudinal bulge - ethmoidal bulla with a curved indentation below - hiatus semilunaris
13
Q
What is the function of the chonchae?
A
Air movement to trap particles, warm air and possible improve olfaction
14
Q
What are the 4 sinus openings into meatuses?
A
- Spehnoetmoidal recess - sphenoidal sinus
- Superior meatus - posterior ethmoidal sinus
- Middle meatus - frontal sinus via infundibulum, middle and anterior ethmoidal, maxillary sinus
- Inferior - nasolacrimal duct
15
Q
Where do tears drain from surface of eye?
A
Via lacrimal canalicui (one per medial corner or eye) into lacrimal sac
16
Q
Where does the nasolacrimal duct extend from?
A
Duct extends from lacrimal sac in medial corner of eye through lacrimal bone, maxilla and inferior concha
17
Q
What comprises the region of nasal cavity lined with skin + hairs? (2)
A
- Nares
2. Vestibule
18
Q
Where is the nares and vestibule?
A
Anterior opening onto face and space just inside nares
19
Q
Wha comprises the region of the nasal cavity lined with stratified non keratinising squamous?
A
Atrium (above vestibule, in front of conchae)
20
Q
What comprises the region of the nasal cavity lined with respiratory epithelium?
A
- Respiratory region - between inferior and middle concha
2. Choanae (with soft tissue in place - behind conchae and in front of auditory tube)
21
Q
What comprises the region of the nasal cavity lined with olfactory epithelium?
A
Superior concha, upper septum, roof over upper septum,
22
Q
What passes through the cribriform plate of ethmoid to olfactory bulb and tract?
A
Olfactory axons from olfactory mucosa
23
Q
What is the blood supply to the external nose?
A
Facial artery and facial vein
24
Q
What is the motor innervation to the external nose?
A
Facial nerve
25
What are the sensory nerves to the external nose?
Cutaneous branches of trigeminal
26
What is the blood supply to the nasal cavity?
Branches of opthalmic, maxillary and facial arteries and accompanying veins
27
What are the sensory nerves for the nasal cavity?
Trigeminal (opthalmic and maxillary branches)
28
What are the sympathetic nerves that accompany sensory nerves?
Vasomotor
| Secretomotor to mucosal glands
29
What do paranasal sinuses develop from and drain into?
Nasal cavity
30
How are paranasal sinuses paired?
Through septa dividing left and right sinuses may be incomplete
31
What are the paranasal sinuses?
1. Sphenoidal sinus
2. Ethmoidal sinuses/air cells
3. Frontal
4. Maxillary
32
Where are the sphenoidal sinuses? What does it open into? What is it supplied by?
Paired spaces in sphenoid bone - posterosuperior to upper nasal cavity
Open into spheno-ethmoidal recess
Suppled by posterior ethmoid nerve
33
Where are the ethmoidal sinuses located? How are divided?
Between upper nasal cavity and orbit
| Divided into 2 groups - posterior and anterior
34
Where are the frontal paranasal sinuses located?
Posterosuperior to superciliary arches and within frontal bone
35
Where does the frontal paranasal sinus open into?
Middle meatus via frontonasal duct
36
What is the frontal paranasal sinus supplied by?
Supraorbital nerve
37
Where is the maxillary paranasal sinus located?
Within bodies of maxillae
38
What does the maxillary paranasal sins overlie?
Canines and first and second molars
39
What is the maxillary paranasal sinus supplied by?
Infraorbital nerve
40
What does the inferior constrictor attach to?
1. Cricoid and thyroid cartilages of larynx
| 2. Median pharyngeal raphe
41
What is the inferior constrictor pierced by?
External branch of superior laryngeal nerve
42
What passes under the inferior constrictor?
Recurrent laryngeal nerve and inferior laryngeal artery pass under lower border
43
What are the 2 parts of the inferior constrictor? What are their respective functions?
1. Upper thyropharyngeus - propulsive
| 2. Lower cricopharyngeus - sphincter
44
What is the inferior constrictor innervated by?
Mostly pharyngeal plexus
| Also innervated by external and recurrent laryngeal nerves
45
What is the maxillary nerve associated with?
1. Pterygopalatine fossa
2. Floor and lower lateral walls of orbit
3. Innervation of maxillary teeth
46
What is the maxillary nerve transmitted by?
Transmitted via foramen rotundum into pterygopalatine fossa
47
What is the branch of maxillary nerve located within the skull?
Meningeal branch
48
What is the branch of maxillary nerve located within the pterygopalatine fossa?
1. Ganglion branches
2. Zygomatic/zygomaticoorbital
3. Posterior superior alveolar
49
What is the branch of maxillary nerve located within the infraorobital groove/canal?
1. Middle superior alveolar nerve
| 2. Anterior superior alveolar nerve
50
What is the meningeal branch responsible for innervating?
Sensory to dura of the middle cranial fossa
51
What is the relation of the ganglion branches with the pterygopalatine ganglion?
Pass through but do not synapse in the pterygopaaltine ganglion.
52
What type of branches are the ganglion branches?
Sensory
53
What other nerve does the zygomatic/zygomaticoorbital nerve travel with? What do they enter the orbit via?
Maxillary nerve
| Enter orbit via the inferior orbital fissure
54
What are the branches of the zygomaticoorbital nerve?
1. Facia. parasympathetic hitchhikers (secretomotor) to the lacrimal gland
2. Zygomaticofacial
3. Zygomaticotemporal
55
Where does the zygomaticoorbital nerve pass through?
Orbital periosteum to lateral wall of orbit
56
Where does the zygomaticoorbital nerve pass through if it is undivided? Where does it eventually divide? What does it form?
Single zygomatico-orbital foramen on the lateral wall of the orbit to divide within the zygomer to form the cutaneous zygomaticofacial and zygomaticotemporal nerves
57
Where does the posterior superior alveolar nerve enter canal? What with? What does it form?
In the posterior maxilla along with branches of the maxillary artery through mucosa of maxillary sinus to form a superior dental plexus and to supply molars
58
Where does the infraorbital nerve/maxillary nerve pass across? In what groove? Into which canal?
Floor of orbit and along the infraorbital groove and into infraorbital canal.
59
Where does the middle superior alveolar nerve arise from?
Infraorbital nerve in infraorbital groove
60
What does it supply?
Premolars
61
Where does the anterior superior alveolar nerve leave the in infraorbital nerve? What does it supply?
Infraorbital canal
| Supplies incisors and canines
62
What do all 3 superior alveolar nerves pass through? What does it usually form? What do all supply?
Mucosa of maxillary sinus
Grooves in the bony wall of the sinus
Maxillary sinus
63
What does the cutaneous part of infraorbital nerve emerge onto face via?
Infraorbital foramen
64
Where is the cutaneous infraorbital nerve initially?
Deep to orbicularis oculi
65
What does the cutaneous infraorbital nerve supply?
Sensory fibres to anterior face down to upper lip and also to nose and lower eyelid
66
What does the pterygopalatine fossa contain?
1. Pterygopalatine ganglion
2. Maxillary nerve
3. Maxillary artery
4. Fatty fascia
5. Openings
67
What is the pterygopalatine ganglion?
One of the two parasympathetic ganglia of the facial nerve
68
Parasympathetic fibres are the only ones to synapse on the ptergopalatine ganglion. True or False.
True. Sympathetic and sensory pass through the ganglion without synapsing
69
What does the maxillary nerve enter the pterygopalatine fossa from? What does it leave via?
Foramen rotundum
| Leaves via inferior orbital fissure
70
When does the maxillary artery enter pterygopalatine fossa?
After passing through the two heads of lateral pterygoid.
71
What are the openings in the wall of pterygopalatine fossa that go into fossa?
1. Foramen rotundum
| 2. Pterygoid canal
72
What are the openings that lead out of the pterygopalatine fossa?
1. Inferior orbital fissure
2. Sphenopalatine foramen
3. Greater and lesser palatine foramina
4. Palatopharyngeal canal
73
What does foramen rotundum provide a passage for?
Maxillary nerve into fossa
74
What does the pterygoid canal carry?
Nerve of pterygoid canal
75
Where does the sphenopalatine foramen open into?
Lateral wall of the nasal cavity at the level of and just posterior to the middle concha.
76
Where does the greater and lesser palatine foramina open onto?
Posterior hard palate
77
What does the palatopharyngeal canal open into?
Opens posterior to nasal septum
78
What is the pterygopalatine ganglion?
Parasympathetic ganglion of the facial nerve
79
What are the characteristics of the roots of the pterygopalatine ganglion?
1. Parasympathetic
2. Sympathetic
3. Sensory
80
Where do the parasympathetic roots arise? How do they reach the ganglion?
Facial nerve
| Via the greater petrosal nerve and nerve of the pterygoid canal
81
Where do the sympathetic fibres of the pterygopalatine ganglion arise?
Carotid plexus via deep petrosal nerve and nerve of pterygoid canal
82
Where are the sensory roots of the pterygopalatine ganglion from?
Maxillary nerve
83
How do the sensory fibres reach the pterygopalatine ganglion?
Via its branches and then pass to the maxillary nerve via ganglion branches
84
What do the branches of the pterygopalatine ganglion carry?
Mixture of fibres - postganglionic parasympathetic, sympathetic
85
What branches of the pterygopalatine ganglion take the course via the inferior orbital fissure?
1. Infraorbital (maxillary) nerve
2. Zygomaticoorbital nerve
3. Orbital branches
86
What branches of the pterygopalatine ganglion take the course via the sphenopalatine foramen?
1. Nasopalatine nerve
| 2. Posterior nasal branches
87
What branches of the pterygopalatine ganglion take the course via the palatine canals?
Greater and lesser palatine nerves
88
What branches do greater and lesser palatine nerves have?
Nasal branches - colletively called posterior inferior nasal nerves
89
What branch arises from the palatopahryngeal canal?
Palatopharyngeal nerve
90
What is the parasympathetic innervation of the lacrimal gland?
Pterygopalatine ganglion and pass to the maxillary nerve via ganglion and then to the zygomaticoorbital nerve.
91
What is the triple innervation of the lacrimal gland?
1. Sensory from opthalmic nerve
2. Parasympathetic from facial neve
3. Sympathetic via several routes - hitchhikjers on zygomaticoorbital and opthalmic nerves
92
What are the orbital branches? What do they supply?
Multiple fine branches arising from the dorsal surface of the pterygopalatine ganglion.
Supply orbital periosteum
