Skull, Scalp, Face Flashcards
Asterion?
Point where temporal, occipital, and parietal bones meet
Bregma?
Meeting of frontal and parietal bones
When does the anterior fontanelle close?
By the first 18 months of life
Glabella
This is the smooth tranverse ridges connecting the supraorbital ridges
Inion:
highest point on EOP
Lambda:
Meeting point of the occiput and parietals
When does the posterior fontanelle close?
By the 2-3rd month of life
Nasion:
Center of the frontonasal suture between the frontal and nasal bones
Pterion:
Where frontal, sphenoid, parietal, and temporal bones meet
Vertex
Highest point on skull in the sagittal plane
Basion:
Middle of the anterior aspect of the foramen magnum
Opisthion:
Middle of posterior aspect of the foramen magnum
What are the layers of the scalp?
Skin, closed connective tissue, aponeurosis, loose connective tissue, pericranium
In which layer of the scalp do you find blood vessels and nerves?
Closed connective tissue
What makes up the aponeurosis of the scalp?
Flattened tendon of the occiptofrontalis muscle
Innervation of the scalp?
Branches of CN V, C2 and C3
Blood supply of the scalp?
Branches of the external carotid A
Foramen cecum bones? Contents?
Frontal and ethmoid
Nasal emissary V
Anterior/posterior ethmoidal bones? Contents?
Ethmoid
A/P ethmoidal N/A/Vs
Cribriform foramina bones? Contents?
Ethmoid Olfactory Ns (CN I)
Optic canal bones? Contents?
Sphenoid Optic N (CN II) and ophthalmic A
Superior orbital fissure bones? Contents?
Sphenoid
CN III, IV, V1, VI, ophthalmic V
Foramen rotundum bones? Contents?
Sphenoid
CN V2
Foramen ovale bones? Contents?
Sphenoid
CN V3, accessory meningeal A/V
Foramen spinosum bones? Contents?
Sphenoid
Recurrent meningeal br of CN V3, middle meningeal A and V
Foramen lacerum bones? Contents?
sphenoid and temporal
Internal carotid A, venous plexus, sympathetic N passing horizontally
Internal acoustic meatus bones? Contents?
Temporal
CN VII, VIII, nervus intermedius and labyrinthine A
Jugular foramen bones? Contents?
Temporal/occipital
CN IX, X, XI, inferior petrosal and sigmoid sinuses and posterior meningeal A
Hypoglossal foramen bones? Contents?
Occipital
CN XII
Foramen magnum bones? Contents?
Occipital
Medulla, vertebral and spinal A, spinal part of CN XI
All facial expression muscles are derived from what embryological tissue from what arch?
Mesoderm of the 2nd branchial arch
Levator palpebrae superioris is innervated by?
Sympathetic fibers from the stellate ganglion
How to differentiate between a stroke (upper motor neuron lesion of CN VII) and Bells palsy (lower motor neuron lesion of CN VII)?
Pt can wrinkle forehead with stroke because of frontalis being innervated from both sides but not able to wrinkle forehead in bells palsy
3 layers of the eye?
Sclera, choroid, retina
Anterior part of the sclera is transparent and called the?
Cornea
Choroid layer of the eye contains?
Blood vessels
Which is the photosensitive layer of the eye?
Retina
The pigmented iris separates what chambers that contain aqueous humor?
Anterior and posterior chambers
What attached to the lens secretes aqueous humor?
Ciliary body
Where does the aqueous humor drain?
Scleral venous sinus @cornea-scleral junction
Blockage of the scleral venous sinus/canal of Schlemm will result in what pathology?
Glaucoma
What is the oval yellow pot in the retina lateral to the optic disc?
Macula lutea
Where is the highest concentration of cones
Fovea centralis
Where are there no receptors in the retina?
Optic disc
The lens is attached to the ciliary body via what ligament?
Suspensory ligament of the lens
Contraction of the ciliary body is done through what type of stimulation?
Parasympathetic
Contraction of the ciliary body relaxes the tension on the suspensory ligament of the lens causing it to thicken to?
Focus on near objects
Relaxation of the ciliary muscles allows for the lens to thicken to?
Focus on near objects
Sympathetic stimulation causes contraction of the radial iris muscle resulting in pupillary?
Dilation
Parasympathetic stimulation causes contraction of obicularis iris resulting in?
Constriction
Eternal ear consists of what structures?
Pinna and external ear canal
The tympanic membrane separates what two structures?
External and middle ear
What bones amplify sound in the middle ear?
Malleus, incus, stapes
The malleus is attached to what structure?
Tympanic membrane
The stapes lies on what structure?
Oval window
Function of the:
Cochlea?
Semicircular canals, utricle, saccule?
Hearing
Balance
Where is endolymph found in the cochlea?
Scala media
Where does the cochlea pick up vibration?
Sacla vestibuli and tympani
Where is mechanical sound vibration turned into electrical impulses?
Tectorial membrane (outer hair cells)
The utricle contains what that detets linear acceleration?
Otoliths/statoconia
The saccule with its otoliths detects?
Linear acceleration in the vertical plane
The semicircular canals are oriented vertically 90o to each monitor and monitor movement in what planes?
Sagittal - back and forth
Coronal - L/R bend
Vertical - rtn
Four extrinsic muscles of the tongue?
Genioglossus, hyoglossus, styloglossus, palatoglossus
Pharyngeal arch 1 bone and cartilage?
Mandible, malleus, incus
Meckel’s cartilage
Pharyngeal arch 2 bone and cartilage?
Stapes, styloid process, small horn and superior hyoid bone
Reichert’s cartilage
Pharyngeal arch 3 bone and cartilage?
Greater horn and inferior hyoid
No cartilage
Pharyngeal arch 4 bone and cartilage?
No bone
Thyroid and cricoid cartilage
Pharyngeal arch 6 bone and cartilage?
No bone
Arytenoid, corniculate, cuneiform cartilages
All muscles of the tongue are supplied by hypoglossal EXCEPT palatoglossus which is supplied by?
Pharyngeal plexus of vagus
All muscles of the palate are supplied by the pharyngeal plexus of the vagus EXCEPT tensor veli palatini which is supplied by?
Mandibular division of the trigeminal N
All muscles of the larynx are supplied by recurrent laryngeal N of Vagus EXCEPT cricothyroid which is supplied by?
Superior laryngeal br of CN X
Posterior cricoarytenoid does what to the vocal cords?
Abducts
Cricothyroid does what to the vocal cords?
Tenses
Thyroarytenoid does what to the vocal cords?
Relaxes
Vocalis does what to the vocal cords?
Relax posterior part
Tighten anterior part
The frontal sinus lies where?
Frontal bone above and between orbits
The frontal sinus drains into?
Hiatus semilunaris in middle meatus of nasal cavity
The ethmoid sinus lies between?
The orbits: posterior, middle, anterior
The ethmoid sinus drains into?
Superior (posterior) and middle (middle and anterior) meatus
The maxillary sinus drains into?
Hiatus semilunaris of middle meatus
The sphenoid sinus lies where?
sphenoid below pituitary fossa
The sphenoid drains into?
the spenoethmoidal recess above the superior concha
The cervical plexus is derived from?
Ventral rami C1-4
C1 ventral rami supply what muscles?
Geniohyoid and thyrohyoid
Ansa cervicalis comes from?
C1, 2, 3
Ansa cervicalis supplies what muscles?
Sternothyroid, sternohyoid, superior and inferior bellies of omohyoid
What makes of the great auricular N and what does it supply?
C2/3 ventral rami
Most of the ear
Lesser occipital nerve comes from? Supplies what?
Ventral rami C2/3
skin over back of head to vertex
Greater occipital N comes from? Supplies what?
C2 dorsal rami over lower part of back of head
Transverse cervical N comes from? Supplies what?
Ventral rami C2 and 3
Supplies skin over anterior cervical triangle
Supraclavicular N comes from? Supplies what?
Ventral rami C3/4
Skin over clavicle
Brachial plexus is derived from?
C5, 6, 7, 8, T1
Brachial plexus passes between what two muscles in the neck?
Anterior and medial scalene
The upper trunk of the brachial plexus comes from?
Middle trunk?
Lower trunk?
Where are they located?
C5/6
C7
C8/T1
Posterior cervical triangle
The trunks of the brachial plexus divide into A/P divisions where?
Behind the clavicle
The A + P divisions join to form 3 cords around the axillary A. What nerve roots do they come from?
Posterior
Lateral
Medial
C5, 6, 7, 8, T1
C5, 6, 7
C8, T1
Radial nerve origin? Supplies?
C5, 6, 7,8 T1
Triceps, anconeus, brachioradialis, extensors of wrist, abductors of thumb, supinators
Median N origin? Supplies?
C5, 6, 7, 8, T1
Muscles of the forearm (except FCU, ulnar 1/2 flexor digitorum) and Lumbricals, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
Anterior interosseous branch of the median N innervates?
Flexor pollicis longus, pronator quadratus, radial 1/2 of flexor digitorum profundus
Ulnar N derived from? Supplies?
C8/T1
Intrinsic muscles of hand except those supplied by median N
Musculocutaneous N is derived from? Supplies?
C5, 6, 7
Biceps, brachialis, coracobrachialis, skin of lateral forearm
Axillary N is derived from? Supplies?
C5/6
Goes through quadrangular space to supply deltoid, teres minor plus skin over insertion of deltoid
Dorsal scapular N is derived from? Supplies?
C5
Levator scap, rhomboid major and minor
Long thoracic N s derived from? Supplies?
C5, 6, 7
Seratus anterior
Damage to the Long Thoracic N results in what pathology?
Winged scapula
Suprascapular N is derived from? Supplies?
C5, 6
Supraspinatus, Infraspinatus
N to subclavius is derived from? Supplies?
C5
Subclavius
What nerves come off the posterior cord and what are they derived from? Supplies?
Upper and lower subscapular C5, 6 (Subscapularis)
Lower subscapular N also supplies teres major
Thoracodorsal N (C6, 7, 8) supplies Latissimus dorsi
What nerves come off the medial cord and what are they derived from? Supplies?
Medial pectoral N C8/T1 Pectoralis minor and major
Medial brachial cutaneous N skin over medial arm
Madial antebrachial cutaneous N skin over medial forearm
What nerves come off the lateral cord and what are they derived from? Supplies?
Lateral pectoral N C5, 6, 7
Pectoralis major
Damage to C5 and 6 roots causes what pathology?
Erb-Duchenne palsy - waiter’s tip deformity (elbow extended, forearm pronated, fingers flexed)
Damage to C8 and T1 roots causes what pathology?
Klumpke’s palsy - claw hand
Lumbar plexus is derived from?
Ventral rami L1-4
Lumbar plexus is formed within what muscle?
Psoas major
The nerves of the Lumbar plexus leave the lateral aspect of psoas major except for?
Genitofemoral - anteriorly
Obturator - medially
Iliohypogastric N is derived from? Supplies?
Ventral rami L1
Lower abdomen above inguinal region
Ilioinguinal N is derived from? Supplies?
Ventral rami L1
Supplies inguinal region
Genitofemoral N is derived from? Supplies?
Ventral rami L1/2
Medial upper thigh, anterior scrotum, cremasteric muscle
Lateral femoral N is derived from? Supplies?
Ventral rami L2, 3
Anterolateral aspect of the thigh
Femoral N is derived from? Supplies?
Ventral rami L2, 3, 4 posterior divisions
Supplies extensor thigh compartment
Obturator N is derived from? Supplies?
Ventral rami L2, 3, 4 anterior divisions
Supplies adductor thigh compartment
What from the lumbar plexus contributes to the formation of the lumbosacral trunk?
Ventral rami L4 and 5
Lumbosacral plexus is derived from?
Ventral rami L4-S4
Which ramus is shared by both the lumbar and lumbosacral plexuses?
Ventral ramus L4
Sacral nerves exit which foramina in the sacrum to form the lumbosacral plexus?
Anterior sacral foramina
Where do you find the lumbosacral plexus?
In front of the piriformis
Superior gluteal N is derived from? Supplies?
Ventral rami L4, 5, S1
Gluteus medius, minimus, TFL
Which foramen in the pelvis does the superior and inferior gluteal N cross through?
Greater sciatic foramen
Inferiorgluteal N is derived from? Supplies?
Ventral rami L5, S1, 2
Gluteus maximus
Pudendal N is derived from? Supplies?
Ventral rami S2, 3, 4
External anal sphincter, deep and superficial perineal muscles, penis, clitoris, posterior scrotum, labia
Sciatic N is derived from? Supplies?
Ventral rami L4-S3
Muscles in posterior thigh and all muscle below the knee, skin below the knee except medial strip of leg from saphenous N
The sciatic N lies beneath what muscle?
Piriformis
What are the two parts of the sciatic N?
Tibial + Common peroneal/fibular N
Tibial N is derived from? Supplies?
Ventral rami L4-S3
Posterior compartment of leg and plantar aspect of foot, skin over posterior leg and plantar aspect of foot via medial and lateral plantar br and supplies flexor digitorum brevis, flexor hallucis brevis, abductor hallucis and 1st lumbrical and everything else is lateral in sole of foot
Common peroneal/fibular N is derived from? Supplies (with br)?
Ventral rami L4-S2
Superficial - fibularis longus/brevis, skin of dorsum of foot except web btw 1st/2nd toe
Deep: Tibialis anterior, extensor hallucis/digitorum longus, peroneus tertius, skin of web space btw 1/2 toes
Deep fibular/peroneal N passes through what muscle and doesn’t supply it?
Peroneus/fibularis longus
What structures pass through the greater sciatic foramen above the piriformis? Below?
Above: superior gluteal N/A/V
Below: pudendal, inferioir gluteal N/A/V
What structures pass through the lesser sciatic foramen?
Pudenal N, internal pudendal A, V, N to obturator internus, tendon of obturator internus
Spinal N's dermatome, muscle, reflex: C5 C6 C7 C8
Shoulder, deltoid (abduct shoulder), biceps brachii
lateral forearm to thumb, biceps brachii (flex elbow), brachioradialis
Middle finger, triceps (extend elbow), triceps
Little finger to medial forearm, flexor digitorum
Spinal N's dermatome, muscle, reflex: T1 T2 T7 T10 T12
Medial elbow, palmer interossei no reflex Axilla - - Xiphoid Umbilicus Suprapubic
Spinal N's dermatome, muscle, reflex: L1 L2 L3 L4 L5 S1
Inguinal
Anterior thigh, iliopsoas, -
Lateral thigh, quadriceps femoris (ext knee), patellar
Medial leg, medial big toe, tibialis anterior (heel walk) patellar
Dorsum of foot, extensor hallucis longus, hamstring
Lateral foot, peroneus longus (toe walk), ankle
