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Neuro Exam 3 > Palate and PPF > Flashcards

Palate and PPF Flashcards

1
Q

PPF

A

posteroinferiorly to apex of orbit
posterior to maxillary sinus
deep to infratemporal region

contains nerves. arteries, veins

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2
Q

transantral access to PPF

A

can be accessed via maxillary sinus

to remove tumors or ligate sphenopalatine artery in cases of chronic nose bleeds (epistaxis)

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3
Q

contents of PPF

A

maxillary artery third portion

maxillary branch of trigeminal
-V2

pterygopalatine ganglion - parasympathetics

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4
Q

lateral border of PPF

A

pterygomaxillary fissure

**open - from infratemporal fossa to pterygomaxillary fissure

location of maxillary artery 3rd portion and posterior superior alveolar a/v/n

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5
Q

superior border of PPF

A

greater wing of sphenoid

no foramina here, just roof

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6
Q

anterior border of PPF

A

maxilla

inferior orbital fissure
-transmits infraorbital a/v/n and zygomatic a/v/m

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7
Q

medial border of PPF

A

palatine bone

sphenopalatine foramen

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8
Q

inferior border o PPF

A

open via pterygopalatine canal

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9
Q

posterior border of PPF

A

pterygoid process of sphenoid bone

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10
Q

inferior orbital fissure

A

anterior PPF

-transmits infraorbital a/v/n and zygomatic a/v/n

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11
Q

sphenopalatine foramen

A

medial PPF
sphenopalatine a/v
nasopalatine n
posterior superior lateral nasal n

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12
Q

pterygomaxillary fissure

A

lateral PPF
maxillary a
posterior superior alveolar a/v/n

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13
Q

pterygopalatine canal

A

inferior PPF
descending palatine a
greater and lesser palatine nn

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14
Q

foramen rotundum

A

posterior PPF
to middle cranial fossa
transmits V2

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15
Q

pterygoid canal

A

posterior PPF
to to middle cranial fossa
transmits n and a of pterygoid canal

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16
Q

pharyngeal canal

A

posterior PPF
to nasopharynx
transmits pharyngeal a/v/n

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17
Q

posterior PPF lateral to medial

A

foramen rotundum
pterygoid canal
pharyngeal canal

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18
Q

maxillary artery

A

courses through infratemporal fossa

-3rd portion enters PPF through phenomaxillary fissure

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19
Q

branches of pterygopalatine portion of maxillary artery

A 
posterior superior alveolar a.
infraorbital a.
descending palatine a.
artery of pterygoid canal
pharyngeal a.
sphenopalatine a.
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20
Q

posterior superior alveolar a.

A

enters un-named foramen in maxillary bone

maxillary teeth and gingiva

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21
Q

infraorbital a

A

exits PPF - inferior orbital fissure
ANTERIOR

to face via infraorbital foramen

floor of orbit, maxillary sinus, maxillary theeth, skin of face

branches along the way
-middle superior and anterior superior alveolar aa

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22
Q

descending palatine a

A

exits PPF - pterygopalatine canal
INFERIOR

to palate, nasal cavity, palatine fossa

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23
Q

artery of pterygoid canal

A

exits PPF - pterygoid canal
POSTERIOR

to nasopharynx, auditory tube, tympanic cavity

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24
Q

pharyngeal a

A

exits PPF - pharyngeal canal
POSTERIOR

to nasopharynx, sphenoid sinus, auditory tube

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25
Q

sphenopalatine a

A

exits PPF - sphenopalatine foramen
MEDIAL

to nasal cavity

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26
Q

maxillary nerve

A

V2 - GSA to middle dermatome of face

enters PPF via foramen rotundum

PS to pterygopalatine ganglion

has meningeal branch

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27
Q

zygomatic nerve

A

exits PPF anterior - inferior orbital fissure

  • GSA to face
  • zygomaticofacial and zygomaticotemporal
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28
Q

GSA to face

A

zygomaticofacial and zygomaticotemporal

branches of zygomatic nerve from V2

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29
Q

posterior superior alveolar nerve

A

branch of infraorbital nerve

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30
Q

infraorbital nerve

A

exits PPF anterior - inferior orbital fissure

supplies floor of orbit, maxillary sinus, maxillary teeth, skin of face

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31
Q

pterygopalatine nerves

A

suspend pterygopalatine ganglion from V2

-carry PS to ganglion**

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32
Q

greater palatine nerve

A

exits PPF inferior - pterygopalatine canal

to oral cavity - hard palate

branch - posterior inferior lateral nasal artery

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33
Q

lesser palatine nerve

A

exits PPF inferior - pterygopalatine canal

to soft palate and tonsillar bed

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34
Q

posterior superior lateral nasal nerve

A

exits PPF medial - sphenopalatine foramen
-to nasal cavity

lateral wall of nasal cavity

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35
Q

pharyngeal nerve

A

exits PPF posterior - pharyngeal canal

to nasopharynx

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36
Q

nerve to pterygoid canal

A

exits PPF posterior - pterygoid canal

autonomics to PPG

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37
Q

nasopalatine nerve

A

exits PPF medial - sphenopalatine foramen
-to nasal cavities

then through incisive foramen to anteiror hard palate

38
Q

nerve blocks 2x?

A

nasopalatine n - incisive foramen

greater palatine n - greater palatine foramen

39
Q

ganglion we need to know?

A

pterygopalatine
otic
submandibular
ciliary

4x***

40
Q

pterygopalatine ganglion contains

A

postganglionic parasympathetic neurons

receives:
nerve of pterygoid canal
-deep petrosal - S
-greater petrosal - PS

41
Q

deep petrosal nerve

A

postganglionic S from superior cervical sympathetic ganglion

pass through PPG

42
Q

greater petrosal nerve

A

preganglionic PS from CN VII **

synapse at PPG

43
Q

nerve to pterygoid canal

A

contains S and PS

from greater petrosal n and deep petrosal n

44
Q

parasympathetic to lacrimal gland

A

increase gland secretions
-PPG - to zygomatic branch of V2

lacrimal branch of V1 to gland

**source is greater petrosal nerve of CN VII

45
Q

sympathetic to lacrimal gland

A

secretions more watery

vasomotor - more watery lacrimal fluid
-PPG - zygomatic branch of V2

lacrimal branch of V1 to gland

**source is IMLCC > SCG to deep petrosal nerve

46
Q

dysfunction of PS to lacrimal gland?

A

dry, red eye

eyes itchy and very dry

use eye drops all the time

47
Q

parasympathetic to mucous-secreting glands of palate

A

increases production of mucus

dysfunction: dry, irritated nasal passages, increased risk of infection

PPG - postganglionic fibers with branches of V2 to nasal cavities and paranasal sinuses

48
Q

sympathetic to mucous secreting glands

A

makes gland secretions more watery

dysfunction - minimal effect

49
Q

sympathetic levels

A

T1-T4 lateral horn
> superior cervical ganglion via sympathetic chain
> postganglion via internal carotid nerves to PPG

PPG > distributes

50
Q

sympathetics to head

A

not too significant

lacrimal and mucous glands

51
Q

Palate

A

between nasal and oral cavity

52
Q

hard palate

A

bony
anterior 2/3

palatine process of maxillary bone
horizontal plate of palatine bone

53
Q

soft palate

A

fascial support

posterior 1/3

54
Q

foramina of hard palate

A

incisive foramen
greater palatine foramen
lesser palatine foramen

55
Q

mucosa of hard palate

A

mucous secreting

palatine glands

transverse palatine folds

palatine raphe

56
Q

incisive foramen

A

nasopalatine n

greater palatine a

57
Q

greater palatine foramen

A

passage of greater palatine a/v/n

58
Q

lesser palatine foramen

A

passage of lesser palatine a/v/n

59
Q

composition of soft palate

A

palatine aponeurosis

-ends at uvula

60
Q

fauces

A

oral cavity to pharynx

61
Q

boundaries of fauces

A

superior palate
inferior base of tongue
lateral - faucial pillars

62
Q

faucial pillars

A

palatoglossal arch
palatopharyngeal arch
isthmus of fauces

63
Q

palatoglossal arch

A

fold of mucosa overlying palatoglossus muscle

64
Q

palatopharyngeal arch

A

fold of mucosa over palatopharyngeus muscle

65
Q

isthmus of fauces

A

constricted portion of fauces bounced by palatoglossal pillars

66
Q

palatine tonsil

A

lymphoid tissue

-between palatoglossal and palatopharyngel arches

67
Q

tonsillar bed

A

depression between palatoglossal and palatopharyngeal arches

-houses palatine tonsil

68
Q

tonsillar bed blood supply

A 
facial a
palatine branch of ascending pharyngeal a
ascending palatine a
dorsal lingual a
lesser palatine a

5 arteries supplying blood

complications after tonsillectomy** - because of rich blood supply

69
Q

formation of tonsillar bed

A

superior constrictor m
hyoglossus m
middle constrictor m

70
Q

glossopharyngeal n

A

courses right through tonsillar bed

71
Q

venous drainage of palatine tonsil

A

tonsillar plexus and pharyngeal plexus of veins

72
Q

oropharyngeal membrane

A

at tonsillar bed

73
Q

innervation of tonsillar bed

A

posterior - glossopharyngeal GVA

anterior - lesser palatine GSA

74
Q

palatoglossus m.

A

soft palate - tongue

vagus innervation

pulls tongue and soft palate together during swallowing

75
Q

palatopharyngeus m.

A

soft palate to thyroid

vagus innervation

swallowing - pulls thyroid up to epiglottis

76
Q

musculus uvulae

A

soft palate to uvula

vagus innervation

shortens and elevates uvula

77
Q

tensor veli palatini

A

tenses palate
-passes under pterygoid hamulus

during mastication and swallowing - opens membranous portion of auditory tube

78
Q

levator veli palatini

A

elevates palate
pull against roof of pharynx

base of skull to soft palate

79
Q

paralysis of CN X

A

soft palate and faucial pillars sag
-uvula deviates to UNAFFECTED side***

when open mouth and say “AH”

80
Q

not innervated by vagus

A

tensor veli palatine

trigeminal V3

81
Q

muscles that attach to auditory tube

A

tensor veli palatini and levator veli palatini

tensor - only one to membranous part**

results in opening of auditory tube

to equalize pressure**

82
Q

vascular to palate

A

maxillary artery - greater and lesser palatine aa

facial artery
-ascending palatine a

83
Q

venous drainage of palate

A

pterygoid plexus of veins to maxillary vein

84
Q

anterior to incisive foramen innervation

A

nasopalatine nerve

85
Q

posterior to incisive foramen innervation

A

greater palatine nerve majority

also a little lesser palatine nerve

86
Q

nerve to upper lip

A

V2 via infraorbital

-in PPF

87
Q

dry irritated nasal passages

A

PS to PPG > nasal passages

88
Q

inschemia to posterior nasal cavity

A

sphenopalatine a.

from maxillary a. in PPF

89
Q

red, irritative eye

A

less PS to lacrimal and mucous glands of deep head

90
Q

xerostomia

A

dry mouth

not affected in PPF

either otic ganglionic or chorda tympani

submandibular and sublingual glands

Neuro Exam 3 (15 decks)

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