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TBL 36 Flashcards

1
Q

Use Figure 7.101 (B), pp. 955 (COA) to observe the cartilaginous skeleton of the nose.

A

ID

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2
Q

nasal vestibule is continuous posteriorly with _____.

A

nasal vestibule is continuous posteriorly with the nasal cavity

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3
Q

(structure) the nasal cavity into right and left sides.

A

nasal septum bisects the nasal cavity into right and left sides.

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4
Q

the walls of the nasal cavity are formed from anterior to posterior (structures).

A

the walls of the nasal cavity are formed from anterior to posterior by the maxillae, ethmoid bone, and vertical plates of the palatine bones.

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5
Q

Discuss the superior and middle conchae and inferior concha.

A

superior and middle conchae are bony processes of the ethmoid bone and the inferior concha is an independent bone.

conchae hang like louvers from the walls and the superior, middle, and inferior nasal meatuses underlie the respective conchae.

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6
Q

sphenoethmoidal recess is (spatial relation) to which concha?

A

sphenoethmoidal recess posterior to the superior concha.

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7
Q

Ethmoid bone, middle concha, and superior concha- what cell types are in them?

A

ethmoid bone, middle concha, and superior concha are hollowed out by ethmoidal air cells.

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8
Q

Locate the inferior concha

A

ID

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9
Q

(location) of the nasal septum is attached to the hard palate.

A

the inferior portion of the nasal septum is attached to the hard palate.

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10
Q

the nasal septum is formed from anterior to posterior by (structures).

A

the nasal septum is formed from anterior to posterior by the septal nasal cartilage, the perpendicular plate of the ethmoid bone, and the vomer bone.

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11
Q

(type) sensations from CN V1 regions of the nasal septum and walls of the nasal cavity are conveyed to the (structure) by the (structure).

A

somatic sensations from CN V1 regions of the nasal septum and walls of the nasal cavity are conveyed to the trigeminal ganglion by the nasociliary nerve

Note: nasociliary nerve is an orbital branch of the CN V1

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12
Q

What structures form as conduits for the branches of CN V1?

A

small fissures in the ethmoid bone are conduits for its branches between the nasal cavity and orbit.

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13
Q

What artery supplies the nasal cavity and nasal septum? What’s special about the artery?

A

sphenopalatine artery supplies the nasal cavity and nasal septum.

it anastomoses with multiple arteries in the Kiesselbach area of the anterior septum.

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14
Q

What lines the nasal cavity and septum and what’s the function of the lining?

A

respiratory mucosa lines the nasal cavity and septum, and deduce mucociliary flow moves filtrates from inspired air toward the nasopharynx.

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15
Q

paranasal sinuses are filled with what?

A

paranasal sinuses are air-filled cavities in the cranial bones associated with the nasal cavity.

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16
Q

Type of cells subdivide the ethmoidal sinus.

Which sinuses are single chambered?

What are the functions of these sinuses?

A

ethmoidal cells subdivide the conchae in the ethmoidal sinus.

the frontal, sphenoidal, and maxillary sinuses are single-chambered.

sinuses reduce the muscular workload required to hold the head in the upright position.

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17
Q

How do the respiratory mucosa enter and line the paranasal sinuses? As a result sinuses drain via _______.

A

the respiratory mucosa invaginates ostia in the walls of the nasal cavity to enter and line the paranasal sinuses

the sinuses drain via mucociliary flow into the nasal cavity.

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18
Q

What drain into the middle meatus?

A

the frontal sinus, maxillary sinus, and anterior and middle ethmoidal cells drain into the middle meatus.

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19
Q

posterior ethmoidal cells drain into the (structure)

sphenoidal sinus drain into the (structure)

A

posterior ethmoidal cells drain into the superior meatus

sphenoidal sinus drain into the sphenoethmoidal recess.

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20
Q

the nasolacrimal duct empties lacrimal fluid onto the (structure).

A

the nasolacrimal duct empties lacrimal fluid onto the epithelial surface of the inferior nasal meatus

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21
Q

the roof of the nasal cavity is formed by (structures) and lined by (tissue type).

A

the roof of the nasal cavity, which is formed by the superior nasal conchae, the cribriform plate, and the superior perpendicular plate of the ethmoid bone, is lined by the olfactory mucosa.

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22
Q

the (type) cilia of the olfactory cells (bipolar neurons) are activated by (type) substances.

A

the dendritic cilia of the olfactory cells (bipolar neurons) are activated by odoriferous substances.

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23
Q

axons of the bipolar neurons traverse (structures) in the (structure) of the (structure) and synapse with (type) neurons whose central axons from the (Structures) of CN I.

A

axons of the bipolar neurons traverse tiny foramina in the cribriform plate of the ethmoid bone and synapse with sensory neurons whose central axons form the olfactory tracts of CN I (olfactory nerve).

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24
Q

How is the intermaxillary segment formed? The segment then differentiates into the (structures)

A

the medial nasal prominences fuse to form the inter- maxillary segment that differentiates into the primary (anterior) palate and central portions of the maxillae and upper lip.

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25
Q

Discuss the role of the Bilateral Nasal Pits to the formation of the Vestibule and Nasal cavity (define spatial relation).

A

the bilateral nasal pits penetrate the mesenchyme of the frontonasal prominence to form the vestibule and nasal cavity postero- superior to the primary palate.

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26
Q

Discuss/define the palatine shelves.

A

the palatine shelves are outgrowths from the maxillary prominences that fuse with each other and the nasal septum.

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27
Q

The fusion of the palatine shelves forms (structures/spatial relation).

A

the fusion forms the secondary (posterior) palate and the midline incisive foramen between the primary and secondary palates.

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28
Q

What completes the formation of the posterior hard palate?

A

postnatal union of the horizontal plates of the palatine bones with the secondary palate completes the formation of the posterior hard palate.

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29
Q

Use Figure 7.83, pp. 935 to observe the muscular soft palate

A

ID

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30
Q

What is the medial wall of the infra temporal fossa?

the pterygomaxillary fissure opens into the (structure/define).

A

the lateral pterygoid plate is the medial wall of the infra- temporal fossa

the pterygomaxillary fissure opens into the pterygopalatine fossa, a small intracranial space.

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31
Q

the sphenopalatine foramen resides (location of bone) that forms the (spatial relation structure) of the (structure).

The sphenopalatine foramen (define its function).

A

the sphenopalatine foramen resides in the vertical plate of the palatine bone that forms the medial wall of the pterygopalatine fossa

the sphenopalatine foramen is a conduit between the pterygo- palatine fossa and the nasal cavity.

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32
Q

Discuss the route of the maxillary artery and what artery to generates which then traverses (structure) into the nasal cavity.

A

the maxillary artery passes through the pterygo- maxillary fissure into the pterygopalatine fossa and generates the sphenopalatine artery that traverses the sphenopalatine foramen into the nasal cavity.

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33
Q

Discuss the origin of the infraorbital artery.

A

the infraorbital artery arises from the maxillary artery in the fossa

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34
Q

The maxillary artery generates (arteries) in the PTERYGOPALATINE FOSSA.

A

the maxillary artery generates the greater palatine and lesser palatine arteries in the pterygopalatine fossa.

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35
Q

The foramen rotundum opens into the (structure).

A

the foramen rotundum opens into the pterygopalatine fossa

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36
Q

CN V2 traverses the (structure) into the pterygopalatine fossa, which houses the (structure).

A

CN V2 traverses the foramen rotundum into the pterygopalatine fossa, which houses the pterygopalatine ganglion.

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37
Q

List nerves which arise from CN V2 in the pterygopalatine fossa.

A

the infraorbital, nasopalatine, greater palatine, and lesser palatine nerves arise from CN V2 in the pterygopalatine fossa.

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38
Q

Discuss the function of the inferior orbital fissure.

A

the inferior orbital fissure is a conduit between the pterygopalatine fossa and the orbit.

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39
Q

What structures través the inferior orbital fissure into the orbit?

A

the infraorbital nerve and artery traverse the inferior orbital fissure into the orbit.

40
Q

the nasopalatine nerve traverses (structures) to enter the (structures).

A

the nasopalatine nerve traverses the sphenopalatine and incisive foramina to enter the nasal septum and anterior hard palate

it conveys sensations to the trigeminal ganglion from the nasal septum and anterior hard palate.

41
Q

Discuss the role of the palatine canal in the VERTICAL plate of the PALATINE bone.

A

the greater palatine and lesser palatine nerves and arteries are conveyed from the pterygopalatine fossa by the palatine canal in the vertical plate of the palatine bone to the greater and lesser palatine foramina.

42
Q

Sensations from the POSTERIOR hard palate and soft palate are conveyed to the TRIGEMINAL ganglion how?

A

sensations from the posterior hard palate are conveyed to the trigeminal ganglion by the greater palatine nerves

sensations from the the soft palate are conveyed to the trigeminal ganglion by the lesser palatine nerves

43
Q

Observe the palatine canal.

What also conveys somatic sensations from the CN V2 region in the walls of the nasal cavity?

A

ID

the greater palatine nerve also conveys somatic sensations from the CN V2 region in the walls of the nasal cavity.

44
Q

Discuss the route of CN VII.

A

CN VII enters the internal acoustic meatus and at the end of the meatus, passes directly through the geniculate ganglion (a sensory ganglion for taste)

45
Q

Where and by what is the presynaptic parasympathetic greater petrosal nerve generated and it traverses where/how?

A

in the geniculate ganglion, the facial nerve generates the presynaptic parasympathetic greater petrosal nerve

it pierces a fissure in the petrous temporal bone to enter the middle cranial fossa.

46
Q

Discuss the innervation of the POSTsynaptic fibers from the superior cervical ganglia that form CAROTID PLEXUSES around the INTERNAL CAROTID arteries.

A

the postsynaptic fibers from the superior cervical ganglia that form carotid plexuses around the internal carotid arteries provide sympathetic innervation to the cranial cavity.

47
Q

What forms the nerve of the PTERYGOID CANAL?

A

the deep petrosal nerve from the carotid plexus and the greater petrosal nerve form the nerve of the pterygoid canal.

48
Q

Discuss the Pterygoid canal’s route (spatial relation to structures).

A

the bony pterygoid canal courses parallel to the carotid groove and medial to the foramen rotundum to open into the pterygopalatine fossa.

49
Q

the greater petrosal nerve synapses in the (structure) and POSTsynaptic parasympathetic fibers join the (nerve) for the transport through the (structure) into the ORBIT.

A

the greater petrosal nerve synapses in the pterygopalatine ganglion and postsynaptic parasympathetic fibers join the zygomatic nerve (CN V2) for transport through the infraorbital fissure into the orbit.

50
Q

the zygomatic nerve transfers the PARAsympathetic fibers to the (nerve) for what?

(fiber type) of the lacrimal nerve activate lacrimal gland secretion.

(fiber type) of the lacrimal nerve convey sensations to the TRIGEMINAL ganglion from the gland.

A

the zygomatic nerve transfers the parasympathetic fibers to the lacrimal nerve (CN V1) for transport to the lacrimal gland in the superolateral orbit.

visceral motor fibers of the lacrimal nerve activate lacrimal gland secretion and its somatic afferent fibers convey sensations to the trigeminal ganglion from the gland.

51
Q

Discuss how branches of the deep petrosal nerve gets transported around.

A

branches of the deep petrosal nerve are transported by the infraorbital and zygomatic nerves to the orbit and by the greater palatine, lesser palatine, and nasopalatine nerves to the palate and nasal cavity.

52
Q

Discuss the oral cavity (spatial relation to structures) and what occupies it.

A

oral cavity is between the upper and lower teeth and it is fully occupied by the tongue when the mouth is closed.

53
Q

(Portion) of tongue attaches to the MANDIBLE AND HYOID BONE.

(PORITON) of tongue is between the ROOT AND APEX of the tongue.

A

the posterior third (root) of the tongue attaches to the mandible and hyoid bone

mobile anterior two thirds (body) is between the root and apex (tip) of the tongue.

54
Q

Discuss lymph drainage of apex/lateral portions of the body of the tongue.

A

lymph from the apex of the tongue drains into the submental lymph nodes.

lymph from the lateral portions of the body of the tongue drains into the submandibular lymph nodes

55
Q

Discuss lymph drainage from the submental and submandibular nodes. What parts of tongue also drain into (answer)?

A

the submental and submandibular nodes drain into the deep cervical lymph nodes that also receive lymph directly from the root and central body of the tongue.

56
Q

What form the lingual tonsil on the DORSUM of the POSTerior tongue?

Discuss the TINY PAPILLAE of the DORSUM of the ANTerior tongue.

What demarcates the anterior and posterior tongue?

A

aggregates of lymphoid nodules form the lingual tonsil on the dorsum (dorsal surface) of the posterior tongue

tiny papillae create the rough texture of the dorsum of the anterior tongue

V-shaped row of large papillae demarcates the anterior and posterior tongue.

57
Q

Where do taste buds reside?

A

taste buds reside in the epithelia of the large papillae (taste buds also reside in some of the tiny papillae).

58
Q

Discuss the nerve fibers emerging from the taste buds (origin).

A

the nerve fibers emerging from the taste buds are peripheral projecting taste fibers from the geniculate ganglion of CN VII.

59
Q

Discuss taste fibers (what they join/pierce) and their entrance into the INFRATEMPORAL FOSSA.

A

the taste fibers join the chorda tympani that branches from CN VII in the facial canal and pierces a fissure in the petrous temporal bone to enter the infratemporal fossa.

60
Q

(NERVE) transports the chorda tympani from the fossa to the tongue.

respective afferent fibers of the lingual nerve and chorda tympani convey (type of information and where).

A

the lingual nerve (CN V3) transports the chorda tympani from the fossa to the tongue

respective afferent fibers of the lingual nerve and chorda tympani convey somatic and taste sensations to the trigeminal and geniculate ganglia from the anterior tongue.

61
Q

from the posterior tongue, CN IX conveys (type of sensations to structure).

A

from the posterior tongue, CN IX conveys somatic sensations to its superior sensory ganglia.

from the posterior tongue, CN IX conveys taste sensations to its inferior sensory ganglia.

62
Q

the chorda tympani also contains PREsynaptic PARAsympathetic fibers from CN VII that leave the (nerve) in the (structure) to synapse in the (structure).

A

the chorda tympani also contains presynaptic parasympathetic fibers from CN VII that leave the lingual nerve in the oral cavity to synapse in the submandibular ganglion.

63
Q

the submandibular ganglion resides in the (tissue type and structure).

A

the submandibular ganglion resides in the mucosa of the oral cavity floor

64
Q

POSTsynaptic PARAsympathetic fibers are transported from the submandibular ganglion by (structures which reside where)?

A

postsynaptic para- sympathetic fibers are transported from the submandibular ganglion by branches of the lingual artery to the submandibular and sublingual glands that reside in the mucosa of the oral cavity floor.

65
Q

Function of MIDLINE lingual septum

A

midline lingual septum separates the bilateral extrinsic muscles of the tongue.

66
Q

Discuss the PROXIMAL extension of the styloglossus and hypoglossus.

A

the styloglossus extend proximally from the styloid process of the temporal bone to the inferolateral tongue distally.

the hyoglossus extend proximally from the hyoid bone of the temporal bone to the inferolateral tongue distally.

67
Q

Discuss the (proximal/distal) extension of the genioglossus.

A

the genioglossus extends from the midportion of the mandible proximally and to the hyoid bone and dorsum of the tongue distally.

68
Q

Discuss how the tongue is protruded and retracted (nerve innervation/muscles involved)

A

CN VII activates the bilateral genioglossus to protrude the tongue and the bilateral hyoglossus and styloglossus to retract the tongue.

69
Q

(structures/spatial relation of GENIOglossus) form the muscular floor of the oral cavity.

A

the geniohyoid and mylohyoid are inferior to the genioglossus and form the muscular floor of the oral cavity.

70
Q

the geniohyoid, mylohyoid, and stylohyoid of the suprahyoid muscle group extend from (structures), respectively to the HYOID bone distally/proximally.

A

the geniohyoid, mylohyoid, and stylohyoid of the suprahyoid muscle group extend from the mandible and styloid process of the temporal bone, respectively to the hyoid bone distally.

71
Q

Proxima/Distal attachments of the posterior/anterior bellies of the digastric.

A

posterior and anterior bellies of the digastric attach to the mastoid process of the temporal bone and mandible proximally and to the hyoid bone distally.

72
Q

SUPRAHYOID muscle group elevates the (structures) during swallowing.

A

the suprahyoid muscle group elevates the hyoid bone and larynx during swallowing.

73
Q

the INFerior ALVEOLAR nerve (CN V3) generates the nerve to the mylohyoid that innervate the (structures).

A

the inferior alveolar nerve (CN V3) generates the nerve to the mylohyoid that innervates the mylohyoid and anterior belly of the digastric.

74
Q

NERVE innervation of the stylohyoid and posterior belly of the digastric and the geniohyoid.

A

CN VII innervates the stylohyoid and posterior belly of the digastric and the geniohyoid is innerved by C1.

75
Q

What forms the palatine aponeurosis; the aponeurosis attaches to (structure/spatial relation).

A

the tendons of the tensor palatine and levator palatine merge as the palatine aponeurosis that attaches to the posterior edge of the hard palate.

76
Q

Discuss the tensor palatine (attachments) and its tendon uses (structure/why) to do what to the SOFT PALATE during swallowing?

A

the tensor palatine attaches between the pterygoid plates proximally and its tendon uses the pterygoid hamulus as a pulley to tense the soft palate during swallowing.

77
Q

the levator palatine attaches (proximally) and functions to do what during swallowing?

A

the levator palatine attaches to the external surface of the petrous temporal bone proximally

levator palatine elevates the soft palate during swallowing.

78
Q

Discuss how the soft palate joins to the TONGUE and PHARYNX.

A

the soft palate is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal arches

79
Q

What form the palatoGLOSSAL and palatoPHARYNGEAL arches?

A

the slender palatoglossus and palatopharyngeus muscles form the palatoglossal and palatopharyngeal arches.

80
Q

During swallowing discuss the posterior tongue and uvula.

A

during swallowing, the palatoglossus elevates the posterior tongue and the uvula is pulled superiorly by its muscular core.

81
Q

the soft palate muscles are derived from (cell type from where) except which muscle?

A

the soft palate muscles are derived from myoblasts of the 4th and 6th arches, except the tensor palatine that is derived from myoblasts of the 1st arch.

82
Q

(Nerve) supplies the 4th and 6th pharyngeal arches.

(Nerve) supply the 1st pharyngeal arch.

Note: look up the derivations of these arches.

A

CN X supplies the 4th and 6th pharyngeal arches and somatic efferent fibers of CN V3 supply the 1st pharyngeal arch.

83
Q

Define the fauces. It is bounded superiorly/inferiorly/laterally by (structures).

A

the fauces (throat) is the space between the oral cavity and oropharynx.

Note it is bounded superiorly by the soft palate, inferiorly by the root of the tongue, and laterally by the palatoglossal and palatopharyngeal arches.

84
Q

the tonsillar fossa is between (structures)

Discuss the palatine tonsil children/adults.

A

the tonsillar fossa is between the palatoglossal and palatopharyngeal arches

the palatine tonsil fills the fossa in children but only tonsillar remnants remain in adults.

85
Q

What forms an incomplete tonsillar ring.

A

the palatine tonsils, pharyngeal tonsil, and lingual tonsil of the posterior tongue form an incomplete tonsillar ring.

86
Q

lymph from the tonsillar ring drains into (structure and discuss it).

A

lymph from the tonsillar ring drains into the jugulodigastric (aka tonsillar) lymph nodes, which are part of the deep cervical nodes associated with the IJV.

87
Q
  1. From Epistaxis, pp. 964: Why is epistaxis relatively common?
A

Because of the rich blood supply to the nasal mucosa, esp. from Kiesselbach area.

88
Q
  1. From Infection of Ethmoidal Cells, pp. 964: How can severe infections of the ethmoidal cells
    cause blindness?
A

If nasal drainage is blocked, infections of ethmoidal cells may break through fragile medial wall of orbit. Some posterior ethmoidal cells lie close to the optic canal.

89
Q
  1. From Infection of Maxillary Sinuses, pp. 964: Why do sinus infections most commonly occur
    in the maxillary sinuses and how are the sinuses cannulated for draining?
A

Maxiillary sinuses’ ostia are small and located high on there superomedial walls. When head is erect impossible to drain unless sinus becomes full. And being located on medial side will drain contralateral maxillary sinus to side laying down.

Thought nose, to ostia, to sinus.

90
Q
  1. From Leakage of Cerebrospinal Fluid, pp. 887: Where do cranial fractures occur that result
    in otorrhea or rhinorrhea?

Why do these conditions increase the risk of meningitis?

A

Otorrhea- fractures in the floor of the middle cranial fossa
Rhinorrhea- fractures in the floor of the anterior cranial fossa which may involve the cribiform plate of ethmoid bone.

Because exposure of meningies out external surface.

91
Q
  1. From Facial Clefts pp. 279 and Figure 17.28, pp. 280 (ME): What is the dividing landmark between anterior and posterior cleft palate deformities?

How can anterior cleft deformities vary in severity?

A

The incisive foramen.

Vary in severity from barely visible defect in the vermilion of the lip to the extension into the nose.

In severe cases, the cleft extends to a deeper level forming a cleft of the upper jaw, and maxilla split between the lateral incisor and the canine tooth.

92
Q
  1. From Pterygopalatine Fossa, pp. 954: How is the deeply placed fossa surgically accessed?
A

Surgical access to the deeply placed pterygopalatine fossa is gained through the maxillary sinus.

93
Q
  1. From Injuries to Facial Nerve, pp. 863: Where would CN VII injury have occurred if its somatic efferent fibers were severed but its afferent taste fibers and visceral efferent fibers remained intact?

Where would facial nerve injury have occurred if all its functions were lost?

A

Styloid mastoid foramen.

Everything before the origin of the greater petrosal nerve.

94
Q
  1. From Paralysis of Genioglossus, pp. 949-950: Why is an exogenous airway inserted into a
    patient under general anesthesia?
A

When the genioglossus muscle is paralyzed (e.g. during general anesthesia), the tongue tends to fall posteriorly, obstructing the airway and presenting the risk of suffocation.

95
Q
  1. From Injury to Hypoglossal Nerve, pp. 950: What is the clinical sign of unilateral hypoglossal.
A

Tongue deviates to paralyzed side during protrusion of tongue because of action of unaffected Genioglossus muscle of other side.

96
Q
  1. From Table 7.14, pp. 938: What is the most likely unilateral nerve deficit in a patient whose
    uvula deviates to the left during swallowing?
A

Right pharyngeal branch of CN via pharyngeal plexus.

97
Q
  1. Clinical Point, pp. 203 (EH): What are the symptoms of palatine tonsillitis and when is tonsillectomy advised?
A

Sore throat and fever.

Tonsillectomy advised when swallowing and breathing are compromised or when repeated episodes of tonsillitis occur in a year.

Nervous System (3 decks)

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