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Head and Neck > Pterygopalatine Fossa > Flashcards

Pterygopalatine Fossa Flashcards

1
Q

which nerve components spinal or cranial mix into combined nerves

A

the spinal combine (cranial always stay separate)

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2
Q

Is the dorsal root sensory or motor nerves

A

sensory

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3
Q

what comes out of the pterygoid canal

A

Vidian nerve (CN 7 parasympathetics- greater petrosal nerve and sympathetics- deep petrosal nerve)

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4
Q

what comes out of the optic canal

A

optic nerve 2 and ophthalmic artery (from internal carotid)

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5
Q

what comes through the superior orbital fissue

A

ophthalmic nerve V1, CN 3, CN 4, CN 6, and branch of ophthalmic vein

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6
Q

what comes through the inferior orbital fissure

A

infraorbital nerve V2, inferior ophthalmic vein leading to pterygoid venous plexus

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7
Q

what goes through the infraorbital groove, canal and foramen

A

infraorbital nerve V2

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8
Q

what goes through the zygomaticofacial foramen

A

zygomaticaofacial nerve V2

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9
Q

what goes through the lacrimal groove

A

nasolacrimal duct

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10
Q

what goes through the ethmoid foramen

A

anterior and posterior ethmoidal nerves

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11
Q

what goes through the supraorbital foramen

A

supraorbital nerves from frontal nerve V1

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12
Q

where does CN1 olfactory exit the braincase and what is the path through the skull

A

cribriform plate in ethmoid bone and into the nasal cavity

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13
Q

where does CN2 optic exit the braincase and what is the path through the skull

A

optic canal of sphenoid and into the orbit

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14
Q

where does CN3 oculomotor exit the braincase and what is the path through the skull

A

superior orbital fissure of sphenoid and into superior orbit

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15
Q

does CN 3 oculomotor carry sensory or motor and what is its target

A

motor and eye muscles

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16
Q

where does CN4 trochlear exit the braincase and what is the path through the skull

A

superior orbital fissure of sphenoid and into superior orbit

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17
Q

where does CN6 Abducens exit the braincase and what is the path through the skull

A

superior orbital fissure of sphenoid and into superior orbit

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18
Q

where does CN12 Hypoglossal exit the braincase and what is the path through the skull

A

hypoglossal canal and into tongue

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19
Q

does CN4 trochlear carry sensory or motor and what is its target

A

motor and superior oblique muscle

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20
Q

does CN6 abducens carry sensory or motor and what is its target

A

motor and lateral rectus muscle

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21
Q

does CN 12 hypoglossal carry sensory or motor and what is its target

A

motor and intrinsic tongue muscles

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22
Q

which branch of the trigeminal nerve carries sensory and motor branches

A

V3- mandibular

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23
Q

what synapses in the trigeminal ganglion

A

nothing- nerve only pass through here

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23
Q

what is trigeminal neuralgia (TN)

A

one of most common causes of facial pain, sudden/severe pain, compression of trigeminal nerve root before entry into the pons

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23
Q

where would you inject to numb the lower teeth, lower lip and chin

A

inferior alveolar nerve (branch of V3)

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23
Q

what goes through the mylohoid groove

A

V3 branch to mylohyoid nerve

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23
Q

what are the 4 parasympathetic ganglia

A

ciliary, otic, pterygopalatine, and submandibular

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23
Q

which parasympathetic ganglia are for CN 7

A

pterygopalatine and submandibular

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23
Q

which parasympathetic ganglia are for CN 3

A

ciliary ganglion

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23
Q

what nerves do the parasympathetics hitchhike on

A

trigeminal nerves

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23
Q

which parasympathetic ganglia are for CN 9

A

otic ganglion

23
Q

how many branches of the trigeminal does CN 7 hitchhike on the reach the lacrimal gland

A

2: V2 and then V1

23
Q

what nerve would be damaged as a result of orbitozygomatic fracture caused by a blow to the lateral cheekbone

A

the infraorbital nerve in the infraorbital canal

24
Q

what autonomics (parasympathetics) are carried by CN 3 oculomotor

A

short ciliary nerves (synapse in ciliary ganglion)

25
Q

what opposes the action of the short ciliary nerves

A

the long ciliary nerves (sympathetics)

26
Q

where does V1 ophthalmic exit the braincase and what is its path through the skull

A

superior orbital fissure of sphenoid and into superior orbit

27
Q

where does V3 mandibular exit the braincase and what is its path through the skull

A

foramen ovale and into the infratemporal fossa

28
Q

what are the 5 targets for V2 maxillary nerve

A

infraorbital nerve for face above mouth, nasopalatine nerve for mucosa, greater/lesser palatine nerves for roof of mouth, zygomaticotemporal nerve for skin of temple and overlying cheekbone and superior alveolar nerve to upper teeth

29
Q

when would lacrimation be possibly impaired

A

if zygomaticotemporal nerve is damaged

30
Q

what are the 3 sensory targets for V3 mandibular nerve

A

inferior alveolar nerve to lower teeth and jaw, buccal nerve to mouth interior and lingual nerve for touch of anterior 2/3 of tongue

31
Q

what are the 4 motor targets for V3 mandibular nerve

A

muscles of mastication and tensor veli palatine muscles and nerve to mylohyoid: anterior belly of digastrics and mylohyoid muscle

32
Q

where does CN 7 and 8 facial and vestibulococchlear exit the braincase

A

internal acoustic meatus of petrous temporal bone

33
Q

what area would you be aiming at to block pain for an adenoidectomy in the pterygopalatine ganglion

A

the sphenopalatine foramen

34
Q

what is the dorsal root ganglion for CN 7 facial

A

geniculate ganglion

35
Q

what 2 places does V2-maxillary distribute to after the pterygopalatine fossa

A

to nasal epithelium via pterygoid canal and onto face via infraorbital groove, canal and foramen

36
Q

what are the 5 targets of V1 opthalmic nerve

A

supraorbital/supratrochlear to forehead, lacrimal nerve to lateral eyelids and conjunctiva, sensory branches through ciliary ganglion to eyeball, posterior and anterior ethmoidal nerve, and infratrochlear nerve to medial conjunctiva and medial eyelids

37
Q

what results from infraorbital nerve damage

A

impairs sensation to face and lower eyelid (NOT eyelid function- unless V2 branch to orbiculiaris oculi is also damaged)

38
Q

what is the dorsal root ganglion for CN 8 vestibulococchlear

A

vestibular and cochlear (spiral) ganglion

39
Q

what is the dorsal root ganglion for CN 9 glossopharyngeal

A

superior/inferior glossopharygeal ganglia

40
Q

which nerve of V2 maxillary nerve also carries parasympathetics from CN 7

A

zygomaticotemporal nerve

41
Q

what is the dorsal root ganglion for CN 10 vagus

A

superior/inferior vagal ganglia

42
Q

what are the 3 pathways through the skull for CN 7 and CN 8

A

through the facial canal and exits: 1. stylomastoid foramen to face muscles 2. greater petrosal groove (GPN) on anterior petrous temporal in middle cranial fossa, traversing lateral foramen lacerum 3. petrotympanic fissure (chorda tympani)

43
Q

what are the 3 motor targets for CN 7 facial

A

muscles of facial expression, including buccinator, stapedius muscle, and posterior belly of digastric muscle

44
Q

what is the path through the skull for CN 9 glossopharyngeal

A

into pharynx (into infratemporal fossa for lesser petrosal nerve)

45
Q

is CN 9 glossopharyngeal sensory or motor

A

both

46
Q

are CN 7 facial and CN 8 vestibulocochlear sensory or motor

A

CN 7 is both and CN 8 is only sensory

47
Q

where does CN 10 vagus exit the braincase

A

between petrous temporal and basioccipital neural portion of jugular foramen

48
Q

is CN 10 vagus sensory or motor

A

both

49
Q

where does CN 11 spinal accessory exit the braincase

A

through the jugular foramen

50
Q

is CN 11 spinal accessory sensory or motor

A

motor

51
Q

what is the sensory target for CN 7 facial

A

from geniculate ganglion to interior of ear canal and taste to anterior 2/3 of tongue

52
Q

what is the target for CN 8 vestibulocochlear

A

hearing cochlea and balance semicircular canals

53
Q

what are the 7 sensory targets for CN 9 glossopharyngeal

A

carotid body (O2), taste/touch posterior 1/3 of tongue, external ear, inner tympanic membrane, middle ear mucosa, auditory tube, and pharynx

54
Q

what is the motor target for CN 9 glossopharyngeal

A

stylopharyngeus

55
Q

what are the 8 sensory targets for CN 10 vagus

A

external ear canal, external tympanic membrane, larynx, pharynx, viscera trachea, stretch receptors in arotic arch walls, chemoreceptors in arotic bodies, and taste for posterior medial tongue

56
Q

what are the 3 motor targets for CN 10 vagus

A

muscles of pharynx and larynx and palatoglossus muscle

57
Q

what are the 2 motor targets for CN 11 spinal accessory

A

trapezius and sternocleidomastoid muscles

58
Q

what is the dorsal root ganglion for CN 5 Trigeminal

A

semilunar ganglion (trigeminal ganglion)

60
Q

what are 3 hitchhikers on V2 maxillary

A

CN 7 postganglionics from pterygopalatine ganglion, zygomaticotemporal nerve to lacrimal gland, and to nasal mucosa via nasopalatine nerve

61
Q

what are the 2 hitchhikers on V3 mandibular

A

CN 7 presynaptic parasympathetics from chorda tympani to submandibular ganglion and lingual nerve to submandibular and sublingual glands

62
Q

what are the 2 hitchhikers on CN 7 facial and CN 8 vestibulocochlear

A

parasympathetics from nervus intermedius to: 1. submandibular/sublingual glands via chorda tympani 2. lacrimal gland - GPN/DPN to nerve of pterygoid canal to pterygopalatine ganglion (synpase) to infraorbital nerve V2 to zygomaticofacial nerve V2 to lacrimal nerve V1

63
Q

what are 4 motor targets for CN 7 facial

A

muscles of facial expression, including buccinator, stapedius muscle, and posterior belly of digastric muscle

64
Q

what is the hitchhiker on CN 9 glossopharyngeal

A

lesser petrosal nerve tympanic canaliculis to tympanic plexus on middle ear promontory to groove lateral to greater petrosal groove, out through foramen ovale- synapse in otic ganglion and travels with V3 auriculotemporal nerve to parotid gland

65
Q

what are the 2 hitchhikers on CN 10 vagus

A

viscera up to left colic flexure; glands of pharynx and larynx

66
Q

what is the hitchhiker on CN 11 accessory

A

none

69
Q

what are 2 hitchhikers on V1 ophthalmic

A

short ciliary nerve carries CN 3 parasympathetics from ciliary ganglion and lacrimal nerve carries CN 7 parasympathetics to lacrimal gland

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