Skull and the cervical spine Flashcards

1
Q

Where in the skull is there movement?

A
  • Mandible at the temporomandibular joint

* Atlanto-occipital joint

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2
Q

What are the functions of the skull?

A
  • Protects the brain, brainstem, vasculature and cranial nerves
  • Provides attachment for the muscles
  • Provides a framework for the brain
  • Gives us our identity
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3
Q

How are smooth flat bones formed?

A

Intramembranous ossification

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4
Q

How are irregular bones formed?

A

Endochondral ossification

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5
Q

What are pneumatised bones?

A
  • Bones with air spaces

* Frontal, temporal, sphenoid and ethmoid bones

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6
Q

What are the functions of pneumatised bones?

A
  • To reduce weight

* Add resonance to our voice

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7
Q

What makes up the neurocranium?

A
  • bony case of the brain
  • Cranial meninges with a dome live roof and a floor (cranial base)
  • occipital bones, frontal, temporal, parietal, sphenoid, ethmoid bones
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8
Q

What makes up the viscerocranium?

A
  • Anterior part of the cranium
  • Bones surrounding the oral cavity, nasal cavity and most of the orbit
  • Ethmoid, palatine bones, vomer, nasal bones, zygomatic bones, maxilla, mandible, lacrimal, inferior nasal concha, palatine
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9
Q

What is the temporal fossa bound by?

A
  • Zygomatic process of the frontal bone
  • Frontal process of the zygomatic bone
  • Superior temporal line
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10
Q

What is the superior temporal line?

A
  • line on the side of the skull, on the parietal and frontal bone
  • point of attachment of temporal fascia
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11
Q

What is the inferior temporal line?

A

Point of attachment for the temporalis muscle (muscle of mastication)

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12
Q

What is the pterion?

A
  • H shaped point where the 4 bones articulate

* Parietal, frontal, temporal and zygomatic bones

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13
Q

What is the surface anatomy of the pterion?

A

4cm superior to the midpoint of the zygomatic arch and 3cm posterior to the frontal process of the zygomatic bone

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14
Q

What is a risk at the pterion?

A
  • Deep to the pterion is the middle meningeal artery

* Risk of epidural haemorrhage

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15
Q

Where does CSF return to the venous circulation?

A

Via arachnoid granulations at the granular fovelae

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16
Q

What is the superior nuchal line?

A

• Point of attachment for deep neck and back muscles

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17
Q

What are wormion bones?

A
  • Small bones within a suture
  • Sutural/accessory bones
  • Most commonly seen in the lambdoid suture
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18
Q

What are the functions of the fontanelles

A
  • Allow moulding of the cranium during birth

* Allows post natal growth of the brain

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19
Q

What type of joint are sutures?

A
  • Type of fibrous joint

* Synarthrosis - no, or limited movement

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20
Q

Depressed fontanelle

A

Depressed if the baby is dehydrated or malnourished

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21
Q

Bulging fontanelle

A

Raised intracranial pressure

22
Q

What is the anterior opening of the nasal canal?

A

Piriform aperture

23
Q

What passes through the supra-orbital notch?

A

Ophthalmic nerve

24
Q

What passes through the info-orbital foramen?

25
What passes through the mental foramen?
Mandibular nerve
26
What does the superior orbital fissure transmit?
* Lacrimal nerve * Frontal nerve * Trochlear nerve * Superior ophthalmic vein * Nasociliary nerve * Oculomotor nerve * Abducens nerve
27
What does the inferior orbital fissure transmit?
* Zygomatic branch of the maxillary nerve * Infraorbital nerve * Inferior ophthalmic nerve * Sympathetic nerve
28
What are the boundaries of the infratemporal fossa?
* Laterally: ramus of the mandible * Medially: lateral pterygoid plate of the sphenoid bone * Anteriorly: Posterior aspect of the maxilla * Posteriorly: tympanic plate, mastoid and styloid processes * Superiorly: Infratemporal crest of sphenoid bone * Inferiorly: angle of the mandible
29
What is the pterygopalatine fossa?
A slit like space between the palatine and sphenoid bone
30
What can cribriform plate fractures present with?
CSF rhinorrhoea
31
Where does the pituitary gland lie?
In the hypophyseal fossa
32
What surrounds the pituitary gland?
* 4 clinoid processes | * 2 superior projections (dorsum sell posteriorly and the tubercular sell anteriorly)
33
What is within the alveolar process?
• Mandibular teeth
34
What type of joint is the temporomandibular joint?
• Modified hinge (Atypical) synovial joint
35
What makes up the temporomandibular joint?
* Glenoid (mandibular) fossa of temporal bone and condylar process of the mandible * Articular surfaces of the bone are covered in fibrocartilage
36
What does the fibrocartilaginous articular diss separate the temporomandibular joint into?
* Superior articular cavity | * Inferior articular cavity
37
What is the most common dislocation of the temporomandibular joint?
Anterior
38
What ligaments connect the cranium to the mandible
``` Extrinsic: • Sphenomandibular • Stylomandibular Intrinsic: • Lateral ligament ```
39
Sphenomandibular ligament
Primary passive support of the mandible
40
Lateral ligament
* Strengthens the TMJ laterally, with the postglenoid tubercle * Prevents posterior dislocation
41
What are the movements of the mandible?
* Flexion * Extension * Protraction * Retraction * Elevation * Depression * Rotational movements
42
Which muscles are involved in the protrusion of the mandible?
Lateral pterygoid assisted by the medial pterygoid
43
Which muscles are involved in the retraction of the mandible?
* Posterior fibres of temporalis * Deep part of masseter * Geniohyoid * Digastric
44
Which muscles are involved in the elevation of the mandible?
* Temporalis * Masseter * Medial pterygoid
45
Which muscles are involved in the depression of the mandible?
• Digastric • Geniohyoid • Mylohyoid Main depressor is gravity
46
During which movement is the temporomandibular joint most unstable? Why?
* During depression * The condylar processes move anteriorly and lie under the articular eminences with the mandibular head being vulnerable to anterior dislocation into the infratemporal fossa
47
What is the movement of the Atlanto-occipital joint?
Flexion and extension
48
What are the articular surfaces of the atlanto-occipital joint?
Occipital condyle and superior articular facets of the atlas
49
What forms the median and lateral atlantoaxial joint?
Dens of the axis and an osteoligamentous ring of the atlans anteriorly and transverse ligament posteriorly • Pivot joint
50
Pretracheal space
* Between investing layer and pretracheal fascia | * Area extends between the neck and superior mediastinum
51
True retropharyngeal space
* Between the buccopharyngeal fascia and superficial prevertebral (alar) fascia * Extends between the base of the skull and the superior mediastinum
52
Alar space
* Within the prevertebral layer (alar fascia and deep prevertebral layer) * Area extends from the base of the skull through posterior mediastinum to the diaphragm