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Neuro > Oral And Nasal Cavities, Sinuses, And Pterygopalatine Fossa > Flashcards

Oral And Nasal Cavities, Sinuses, And Pterygopalatine Fossa Flashcards

1
Q

What is the shallow midline sulcus between nose and upper lip?

A

Philtrum

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2
Q

What is the portion of lips that is due to thin epithelium and extensive underlying capillary network?

A

Red margin

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3
Q

What are the midline folds of mucosa which extend between inside of lips to gingivae?

A

Upper and lower labial frenulae

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4
Q

Describe lymph drainage of lips

A

Directly into submental and submandibular (pericervical) lymph nodes
Then into deep cervical nodes

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5
Q

What is the recess between cheeks and gums?

A

Vestibule

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6
Q

Describe the histology of the skin of the cheek

A

Keratinzed stratified squamous epithelium

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7
Q

What innervates the skin and mucosa of the cheek?

A

Buccinator nerve (V)

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8
Q

What innervates the buccinator muslce?

A

Facial nerve (VII)

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9
Q

What pierces the buccinator muscle?

A

Parotid duct

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10
Q

Where is the orifice of the parotid duct?

A

Loacted on inner cheek opposite crown of second upper molar

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11
Q

What is the histology of the mucosa of the cheek?

A

Non-keratinized stratified squamous epithelium

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12
Q

What are formed by mucosa which is firmly attached to underlying alveolar portion of maxilla and mandible by dense fibrous connective tissue?

A

Gingivae (gums)

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13
Q

What is the midline mucosal fold that extends between floor of mouth to inferior surface of tongue?

A

Frenulum of tongue

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14
Q

What is a small ridge of mucosa which located bilaterally on floor of mouth?

A

Sublingual fold or plica

Has numerous small openings for sublingual ducts along crest

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15
Q

What is located at the antero-medial end of the sublingual fold?

A

Sublingual caruncle or papilla

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16
Q

Where does the orifice of submandibular duct open?

A

Apex of sublingual caruncle

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17
Q

The lingual nerve spirals from superior-lateral to inferior-medial around what?

A

Submandibular (Wharton’s) duct

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18
Q

Describe relationships of submandibular duct to other structures

A

Submandibular duct will be above lingual nerve

Sublingual gland will be lateral to submandibular duct

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19
Q

Describe where the hypoglossal nerve enters in the sublingual region

A

Hypoglossal nerve enters more posterior and deeper than lingual n/submand duct/sublingual gland
It is closely adherent to hypoglossus muscle

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20
Q

Describe the relationship of the sublingual gland to other structures in the floor of the mouth

A

Sublingual gland is flattened between mandible and genioglossus/geniohyoid musles
Sublingual gland rests on superior surface of mylohyoid
Submandibular duct crosses medial side of sublingual gland
Lateral side is relatively free of nerves and vessels

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21
Q

Describe ducts of sublingual gland

A

12 small sublingual duct (Bartholin’s) per side

They have minute opening along crest of sublingual fold

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22
Q

What is the blood supply of the sublingual gland?

A

Sublingual branch of lingual artery

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23
Q

Describe parasympathetic innervation to sublingual gland

A

Preganglionic parasympathetic fibers from superior salivatory nucleus exit brainstem with facial nerve (VII)
Travel through chorda tympani
Join with lingual nerve before terminating in submandibular ganglion
Postgangionic parasympathetic fibers from submandibular ganglion distribute numerous short branches to sublingual gland

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24
Q

Describe sympathetic innervation to sublingual gland

A

Postganglionic sympathetic fibers originate in superior cervical ganglion
They reach the sublingual gland by coursing in external carotid and facial plexuses in adventitia of respective arteries
They can also reach the sublingual gland via sublingual plexus which courses in adventitia of sublingual branch of lingual artery

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25
Q

Summarize innervation of tongue

A

Anterior 2/3: V (GSA) and VII (SVA)
Posterior 1/3: IX (GVA and SVA)
Intrinsic muscles: XII (GSE)

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26
Q

Describe sulcus terminalis

A

V-shaped furrow which extends from foramen cecum (at midline apex) to palatoglossal folds (laterally)

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27
Q

Hypoglossal nerve innervates all extrinsic and intrinsic muscles of the tongue except for what? What innervates this one?

A

Palatoglossus

Vagus via pharyngeal plexus

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28
Q

What extends from lateral corner of nose to angle of mouth? Clinical reference?

A

Nasolabial sulcus

Unilateral diminution or absence of sulcus may indicate neurological disorder

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29
Q

Describe paralysis of the tongue

A

Unilateral hypoglossal palsy results in paralysis, atrophy, and fasciculations of intrinsic muscles of the tongue
When protruded, normal gengioglossus deviates tongue towards affected side
Bilateral paralysis may cause airway obstruction (dyspnea), dysarthria, and dysphagia

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30
Q

Describe lymphatic drainage of the tongue

A

Drain into deep cervical lymph nodes

  • jugulodigastric
  • juguloomohyoid
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31
Q

What innervates the tensor veli palatini muscle?

A

Mandibular nerve (V)

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32
Q

What innervates the levator veli palatini muscle?

A

Vagus (X) via the pharyngeal plexus

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33
Q

Describe paralysis of the tensor or levator palate

A

Allows muscles on non-paralyzed side to pull or deviate the uvula towards the normal side

34
Q

What gives rise to the greater and lesser palatine arteries?

A

Descending palatine artery (branch of sphenopalatine artery)

35
Q

What is the intrinsic muslce of the soft palate that forms part of the midline uvula? Innervation?

A

Muscularis uvulae muscle

Vagus (X)

36
Q

What is the frequent bleeder during a tonsillectomy?

A

Tonsillar vein

37
Q

Describe lymphatic drainage from palatine tonsil

A

Directly into jugulodigastric (tonsillar) nodes

38
Q

What make up the upper portion of the nose?

A

Frontal, maxillae, and nasal bones

39
Q

What make up the lower portion of the nose?

A

Septal and alar cartilages

40
Q

What make up the nasal septum?

A

Septal cartilage
Perpendicular plate of ethmoid
Vomer

41
Q

Where do fractures of the nose frequently occur?

A

At junction between septal cartilage and ethmoid & vomer bones.
Cartilaginous fragments may telescope posteriorly

42
Q

What is the respiratory region of the nasal cavity covered by?

A

A tightly adherent mucoperiosteum and mucoperichondrium

43
Q

Where does the the sphenoidal sinus drain into?

A

Sphenoethmoidal recess

44
Q

Where is the sphenoethmoidal recess? Sphenopalatine foramen?

A

Spehnoethmoidal recess: postero-superior to superior concha

Sphenopalatine foramen: posterior to superior concha in submucosa

45
Q

What forms a bony eminence overlying the middle ethmoidal air cells?

A

Ethmoidal bulla

46
Q

What is the crescent-shaped trough located anterior and inferior to ethmoidal bulla?

A

Hiatus semilunaris

47
Q

Where do the frontal and anterior ethmoidal sinuses drain into? Where is this?

A

Ethmoidal infundibulum

Located in anterosuperior portion of hiatus semilunaris

48
Q

If the frontal sinuses drain through a separate opening besides the ethmoidal infundibulum and is anterior to the hiatus semilunaris, this is called ___

A

Frontal recess

49
Q

Where is the nasolacrimal duct?

A

Located in inferior meatus, posterior to anterior edge of concha

50
Q

What supplies the posterior 2/3 of the nasal cavity?

A

Branches of the sphenopalatine artery

51
Q

What supplies the anterior 1/3 of the nasal cavity?

A

Anterior ethmoidal artery

52
Q

What is the importance of Kiesselbach’s area?

A

This region is where septal branches of superior labial and sphenopalatine arteries meet
The majority of nasal hemorrhages (epistaxis) occurs at this junction

53
Q

What innervates the posterior 2/3 of the nasal cavity?

A

Branches of the sphenopalatine/pterygopalatine ganglion

54
Q

What innervates the anterior 1/3 of the nasal cavity?

A

Anterior ethmoidal nerve (branch of nasociliary nerve (V))

55
Q

What branch of the pterygopalatine ganglion courses diagonally beneath septal mucosa and innervates mucosa of gingiva and hard palate in area of upper incisors?

A

Nasopalatine nerve

56
Q

Where is the pharyngeal tonsil is located where and is called what when it hypertrophies?

A

Located in roof of nasopharynx

Called adenoid, which can obstruct auditory tube or nasopharynx

57
Q

What is the cartilaginous eminence above the opening of the auditory tube?

A

Tonus tubarius

58
Q

What is the function of the levator veli palatini?

A

Elevator of soft palate

59
Q

What is the function of the tensor veli palatini?

A

Tenses soft palate and opens auditory tube

60
Q

What is the mucosal fold located between the anterior part of the torus and palate and contains no underlying muscle?

A

Salpingopalatine fold

61
Q

What is the mucosal fold that extends between the posterior part of the torus and pharyngeal wall and is formed by underlying muscle?

A

Salpingopharyngeal fold

62
Q

What is located posterior to the torus tubarius and may contain a tubal tonsil?

A

Pharyngeal recess

63
Q

What causes many of the facial changes of childhood?

A

Growth of sinuses and development of dentition

64
Q

What does the medial wall of the maxillary sinus form?

A

Lateral wall of nasal cavity

65
Q

What does the roof of the maxillary sinus form?

A

Floor of the orbit

66
Q

What is the maxillary sinus floor a part of, and what forms elevations in the floor? Clinical relevance?

A

Part of alveolar portion of maxilla
Elevations are formed by first and second molars
Due to close relationship, maxillary sinusitis may be associated with a toothache of first or second molars

67
Q

What does the posterior wall of maxillary sinus form?

A

Anterior wall of pterygopalatine fossa and infratemporal fossa

68
Q

Describe drainage of maxillary sinus

A

Drains by ciliary action, gravity, and negative pressure into one or more openings into hiatus semilunaris

69
Q

Describe the transmaxillary approach for surgery

A 
Superior: orbit
Inferior: molar teeth of maxilla
Posterior: pterygopalatine fossa
Infraorbital neurovascular bundle
Palatal neurovascular bundle (descending palatine artery, greater & lesser palatine arteries & nerves)
70
Q

Describe where the anterior, middle, and posterior ethmoidal cells open into

A

Anterior: into anterior part of hiatus semilunaris
Middle: onto surface of bulla ethmoidalis
Posterior: into superior meatus

71
Q

What is the frontal sinus regarded as?

A

Displaced anterior air cells which have invaded frontal bone

72
Q

What does the frontonasal duct drain into?

A

Into either ethmoidal infundibulum

Or frontal recess of middle meatus

73
Q

Describe the sphenoidal sinus

A

Cube-shaped sinus located in body of sphenoid with extensions into greater wings or pterygoid processes
Drains into sphenoethmoidal recess

74
Q

What is posterior to sphenoidal sinus?

A

Pons

Basilar artery

75
Q

What is superior to the sphenoidal sinus?

A

Pituitary

76
Q

What is anterior to sphenoidal sinus?

A

Nasal cavity

77
Q

What is inferior to the sphenoidal sinus?

A

Nasopharynx

78
Q

What is lateral to the sphenoidal sinus?

A

Internal carotid
V1
Cavernous sinus

79
Q

Describe the pterygopalatine (sphenopalatine) ganglion

A

Attached to maxillary nerve (V2) in fossa

Branches: vidian nerve (nerve of pterygoid canal), lesser & greater palatine nerves, nasopalatine nerve

80
Q

Describe the vidian nerve (nerve of pterygoid canal)

A

Formed by merging of deep petrosal and great petrosal nerves

Conveys postganglionic sympathetic, GVE parasympathetic, and GVA to ptergyopalatine ganglion

81
Q

Describe the lesser and greater palatine nerves

A 
Largest branches of pterygopalatine ganlgion
Convey GSA (V2), GVA( VII), GVE parasympathetic, postganglionic sympathetic fibers to mucosa of inferior surface of soft and hard palate, respectively
82
Q

Describe innervation through pterygopalatine ganglion

A

Preganglionic (GVE) parasympathetic fibers originate in superior salivatory nucleus and synapse in pterygopalatine ganglion
Postganglionic parasympathetic fibers supply lacrimal gland

Neuro (13 decks)

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