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OPTHT801 > Skull, face, meninges > Flashcards

Skull, face, meninges Flashcards

1
Q

Describe the layers of the cranial bones

A

Covered with periosteum

external and internal compact bone with spongey bone in between

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2
Q

Describe the 8 cranial bones

A 
2x temporal
2x parietal
frontal
orbital
ethmoid
sphenoid
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3
Q

Describe the facial bones

A 
All paired except vomer and mandible
 zygomatic 2x
maxillary 2x
nasal 2x
palatine 2x
inferior conchae 2x
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4
Q

Do an anatomy flashcard of the skull and face

A

Okay

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5
Q

Which two bones are separated by the coronal, squamous and lambdoid suture?

A

Coronal:Frontal and parietal
Squamous: Parietal and temporal
Lambdoid: Parietal and occipital

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6
Q

Which four bones make up the pterion?

A

Frontal, sphenoid, temporal, parietal

Lies over middle meningeal artery and vein

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7
Q

Within which bone are the pterygopalatine fossa and sphenopalatine foramen?

A

Sphenoid

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8
Q

Within which bone is the sella turcica and sulcus chiasmaticus/prechiasmatic groove?

A

Sphenoid

Where pituitary gland sits

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9
Q

Which bones does the palaptine bone articulate with?

A 
Sphenoid
Nasal concha
Maxillary
Vomer
Ethmoid
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10
Q

Which bones make up the anterior cranial fossa?

A

Frontal bone, ethmoid and lesser wing of sphenoid
Contains frontal lobe
Contains crista gali

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11
Q

Which bones make up the middle cranial fossa?

A

Greater wing and body of sphenoid
Temporal bone
Parietal bone (laterally)
Houses temporal lobe

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12
Q

Which bones make up the posterior cranial fossa?

A

Mainly occipital
also parietal
Houses cerebellum, pons and medulla

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13
Q

What travels through the incisive fossa?

A

Nasopalatine nerve

Branches of sphenopalatine and greater palatine artery

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14
Q

What travels through the jugular fossa?

A

CN IX
CNX
CN XI
Internal jugular vein

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15
Q

What travels through the foramen lacerum?

A

Greater petrosal nerve

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16
Q

What travels through the foramen ovale?

A

Lesser petrosal nerve
CN V3
Accessory meningeal artery

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17
Q

What travels through the foramen spinosum?

A

Middle meningeal vessels

meningeal branch of mandibular nerve

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18
Q

What travels through the carotid canal?

A

Internal carotid artery and internal carotid plexus

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19
Q

What travels through stylomastoid foramen?

A

Facial nerve

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20
Q

What travels through mastoid foramen?

A

Mastoid emissary vein

Posterior meningeal artery

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21
Q

What travels through the foramen magnum?

A

Medulla oblongata

Vertebral arteries and venous plexus

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22
Q

What lies in the superior orbital fissure?

A

Between lesser and greater wings of sphenoid bones
CN III
CNIV
Lacrimal, frontal and nasociliary branches of V1
CNVI
Superior ophthalmic vein

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23
Q

What travels through the foramen rotundum?

A

V2 maxillary nerve

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24
Q

What is the attachment for the free border of the tentorium cerebelli?

A

Anterior clinoid process of sphenoid bone

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25
Q

Where is the optic canal and what travels within it?

A

Lesser wing of sphenoid

Optic nerve and ophthalmic artery and meninges

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26
Q

What travels in the internal acoustic meatus?

A

Facial nerve
Vestibulocochlear nerve CN VIII
Labyrinthine artery

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27
Q

Where does the trigeminal ganglion sit?

A

Trigeminal impression of temporal bone

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28
Q

What travels within the hypoglossal canal?

A

Hypoglossal nerve

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29
Q

What are the two layers of dura mater?

A

Periosteal and meningeal

Separates to form sinus

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30
Q

What is the blood supply of the dura?

A

Middle meningeal artery

Middle meningeal vein

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31
Q

What lies between the two cerebral hemispheres?

A

Falx cerebri
Attaches to crista gali (ethmoid) anteriorly
Attaches to tenetorium cerebelli posteriorly
Contains inferior sagittal sinus, superior sagittal sinus and straight sinus

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32
Q

Where is the tentorium cerebelli?

A

Between the cerebellum and occipital lobe
Fixed at posterior clinoid process anteriorly and occipital protuberance posteriorly
medial edge is free
Roofs over cavernous sinus
Where free and fixed borders cross is cavernous sinus

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33
Q

Describe the nerves and vessels in the cavernous sinus from superior to inferior

A 
Optic chiasm
Internal carotid artery (above)
Run between endothelial lining and dura mater
CN III
CN IV
Internal carotid artery (within)
CN VI
CN V1
CNV2
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34
Q

What is special about the venous sinuses?

A

Nil muscles in walls

Nil valves

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35
Q

Which way do the inferior and superior sagittal sinuses turn as they join the transverse sinus?

A

Superior: right
Inferior: left

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36
Q

Which sinus surrounds the pituitary gland?

A

Anterior and posterior intercavernous sinuses

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37
Q

Which is it significant that the superior ophthalmic vein joins the cavernous sinus?

A

Orbital cellulitis can spread to the meninges

38
Q

Where is the arachnoid mater?

A

Between dura and pia mater
Potential subdural space
Actual subarachnoid space filled with nerves, arteries and CSF

39
Q

Where is CSF produced?

A

Choroid plexuses of lateral, 3rd, 4th ventricles

CSF enters blood stream via arachnoid villi projecting into venous sinuses

40
Q

What is significant about pia mater?

A

Adherent to brain
Fuses with cranial nerves and arteries
Forms tela choroidea on the roof of 3rd and 4th ventricles
Fuses with ependyma to form choroid plexus of lateral, 3rd and 4th ventricle

41
Q

What is the embryological development of the skull?

A

Neurocraniam in 2 parts
Cartilaginous anteriorly
3rd month base of skull formed and ossifies
Membranous part forms flat bones of sides and roof of skull
Bones are reabsorbed internally and deposited externally to allow for growth of growing brain
Neonatal skull not fused with anterior posterior fontanelles
Fused by 18 months

42
Q

Describe what is special about the skin of the face

A

Thinnest skin in body over eyelids
Highly vascular
Many sebaceous glands
Sweat glands regulate body temperature

43
Q

What are the four fat pads in proximity to the orbit?

A

Sub brow
Malar (central, medial and lateral)
Orbital
Pre-aponeurotic

44
Q

What is the embryonic origin of the facial muscles?

A

Mesoderm of 2nd branchial arch

45
Q

What are the muscles of the upper face?

A

Frontalis (elevates brow)
Corrugator supercilli (depresses brow)
Procerus (depresses brow)
Orbicularis oculi (depresses brow)

46
Q

What are the muscles of the mid face?

A 
Nasalis
Levator labii superioris alaequae nasi
Levator labii superioris
Zygomaticus minor
Zygomaticus major
Levator anguli oris
Buccinator
Orbicularis oris
47
Q

What are the muscles of the lower face?

A

Depressor labii inferioris
Depressor anguli oris
Mentalis
Platysma

48
Q

Insertion and origin of corrugator supercilli

A

Attaches to orbital ring medially
Inserts with frontalis on skin more laterally
Produces frown lines

49
Q

Insertion and origin of procerus

A

Origin facial aponeurosis overlying nasal bones
Inserts on skin of the eyebrow and lower forehead
Glabellar lines

50
Q

What is the course of the facial nerve?

A

Through internal auditory canal into inner and middle ear and mastoid bone, emerges from skull at stylomastoid foramen
After exiting bone gives off 3 small branches, supplying postauricular muscles, posterior belly of digastric and stylohyoid
Main trunk then enters parotid and divides into 5 at pes anserinus 1.5cm distal to foramen

51
Q

What is the course of the VII temporal?

A

Superficial to zygomatic arch

Motor innervation to OO, frontalis and corrugator

52
Q

What is the course of the VII zygomatic?

A

Courses towards lateral canthus to innervate OO above and below the canthus

53
Q

What is the course of the VII buccal?

A

Supplies muscles of midface, including zygomaticus major and minor, levator labii superioris, levator anguli oris and the buccinator

54
Q

What is the course of the VII mandibular?

A

Dips below angle of mandible and back again to supply OO, depressor anguli oris and mentalis

55
Q

What is the course of the VII cervical?

A

Courses through neck to innervate platysma

Follows a superficial course

56
Q

Describe the course and innervation of the ophthalmic nerve?

A

Trigeminal ganglion-> cavernous sinus -> orbital fissure
Divides into lacrimal branch to the upper lateral lid, nasociliary to glabella and larger frontal branch.
Frontal branch becomes supraorbital and supratrochlear
Supplies skin over forehead, glabella and upper nose

57
Q

Describe the course and innervation of the maxillary nerve?

A

Skin of midface
Exits skull via foramen rotundum
Gives off zygomaticotemporal and zygomaticofacial branches
Infraorbital foramen to supply cheek, lower lid, upper lip and lower nose

58
Q

Describe the course and innervation of the mandibular nerve?

A

Supplies lower lip,chin, lower mandible, gingiva and around the ear and temple
Exits skull via foramen ovale
Divides into buccal, auricotemporal and inferior alveolar nerve and exits the mental foramen as the mental nerve

59
Q

Which arteries of the face come from the internal carotid artery?

A

Ophthalmic artery (supraorbital and supratrochlear arteries)

60
Q

List the branches of the external carotid artery

A 
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
61
Q

Where are the sites of anastomoses in the face between the ICA and ECA?

A

Supratrochlear, supraorbital, superficial temporal, infraorbital and angular arteries
Allows reverse flow in occlusive disease

62
Q

What are the two major complications of superficial temporal artery biopsy?

A

Stroke due to compromise of collateral circulation with ICA occlusion
Facial nerve trauma

63
Q

What is the anatomical danger zone for superficial temporal artery biopsy?

A

Temporal region where facial nerve runs close to STA
The temporal branch of the facial nerve runs beneath the superficial temporal fascia and superficial temporal artery
Do not go into fascia when doing STA biopsy

64
Q

What is the danger triangle of the face?

A

Triangle around eyes and nose

Ophthalmic veins drain into cavernous sinus and meninges potentially spreading infection

65
Q

What is the lymph drainage of the face?

A 
Variable
Periparotid lymph nodes
Submandibular lymph nodes
Submental nodes
Jugular chain
Eyelids: Submandibular and preauricular lymph nodes
66
Q

What are the 5 layers of the scalp?

A

Skin (thick)
Connective tissue (nerves and blood vessels)
Aponeurosis epicranium (insertion of frontalis)
Loose areolar tissue (relatively avascular)
Pericranium

67
Q

What are the attachments of the epicranial aponeurosis?

A

Posterior: superior nuchal line
Lateral: superior temporal line
Anterior: subaponeurotic space extends to upper eyelids
Blood can pass from scalp to upper eyelids and orbit

68
Q

Origin, insertion, nerve and action of occipitofrontalis

A

Origin: occipital bellies- superior nuchal lines
frontal bellies- skin and superficial fascia of upper eyelids
Insert: Epicranial aponeurosis
Nerve: occipital belly=posterior auricular branch of facial nerve
frontal belly=frontal branch of facial nerve
Action: raises eyebrows

69
Q

Which surgery is frontalis used in?

A

Ptosis correction

Frontalis sling operation

70
Q

What are the six sensory nerves of the scalp?

A 
Supratrochlear V1
Supraorbital V1
Zygomaticotemporal V2
Auricotemporal V3
Lesser occipital C2
Greater occipital C2
71
Q

What is the blood supply of the scalp?

A

ICA and ECA
Freely anastomose
Venous drainage accompanies arteries
No valves so can transmit infection

72
Q

Lymph drainage of scalp

A

Parotid, submandibular and deep cervical =anterior to auricles
Posterior auricular, occipital = posterior to auricles

73
Q

Why do scalp wounds bleed profusely?

A

Fibrous fascia prevents vasoconstriction

74
Q

What anastomoses occurs at the medial canthus?

A 
Facial artery (ECA) and dorsal nasal branch of ophthalmic artery (ICA)
In ICA occlusion, intracranial arterial supply may be obtained via retrograde flow from ECA
75
Q

Which layer of the dura acts as the blood brain barrier?

A

Arachnoid

No vessels pass between arachnoid and dura mater

76
Q

Which vessels are contained within the tentorium cerebelli?

A

Right and left transverse sinuses, sigmoid sinus, superior petrosal sinus

77
Q

What is the main blood supply of the meninges?

A

Middle meningeal
Ophthalmic and anteriorly ethmoidal
Internal carotid

78
Q

Where is an extradural haemorrhage?

A

Between dura mater and cranium
Looks like a lemon
Arterial injury

79
Q

What is a subdural haemorrhage?

A

Between dura and arachnoid mater
Bridging vein bleeding
Looks like a banana

80
Q

What is a subarchnoid haemorrhage?

A

Bleeding between arachnoid mater and pia mater

Usually rupture of circle of willis

81
Q

Memorise circle of Willis grays anatomy cue card

A

Okay

82
Q

Which two vessels form the basilar artery?

A

Left subclavian-> left vertebral
Right subclavian -> right vertebral
Both vertebral combine-> basilar

83
Q

Which vessels form the circle of Willis?

A 
Right and left internal carotid arteries
Basilar artery
Posterior communicating arteries
Posterior cerebral
Middle cerebral
Anterior cerebral
Anterior communicating arteries
84
Q

What does the basilar supply?

A

Cerebellum and pons

85
Q

Which two structures are encircled by the optic chiasm?

A

Pituitary and optic chiasm

86
Q

What does the MCA supply?

A

Most commonly embolises
Biggest
Travels up lateral sulcus between temporal and parietal lobes
Supply motor and sensory areas contralateral half (but not leg or perineum)
Supplies auditory and speech areas

87
Q

What does the ACA supply?

A

Lies superior to optic nerve
Supplies orbital surface of frontal lobe
Medial surface of hemisphere
Above corpus collusum
Reaches pareitoccipital sulcus
Supply motor and sensory areas for contralateral leg and perineum
Supplies micturation and defecation centres

88
Q

What does the PCA supply?

A

Passes posteriorly over cerebral peduncle
Superior to tentorium supplies inferomedial temporal lobes and occipital lobe
Supplies contralateral visual area
Sometimes MCA can extend posteriorly enough to supply macula

89
Q

What do the striate branches supply?

A

Internal capsule
Thalamus
Basal nuclei

90
Q

What is the venous drainage of the cerebrum?

A

Superior sagittal->Straight sinus-> transverse sinus-> cavernous sinus->sigmoid sinus-> internal jugular vein

91
Q

What is the basilar plexus?

A

Lies on the clivus
Drains lower pons and medulla
Thrombosis can be fatal due to backward pressure on the brain stem

OPTHT801 (20 decks)

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