The Face and Senses Flashcards
The eye is connected to the central nervous system via the:
Optic nerve (CN II)
Sphenoid
Zygomatic
Maxilla
Lacrimal
Ethmoid
Optic canal
Frontal
Where is the upper border of the orbit?
the frontal bone
Where is the medial border of the orbit?
formed from the frontal bone, the fronal process of the maxilla an the lacrimal bone
Where is the lower border of the orbit?
consists of the maxilla and zygomatic bones, also known as the infraorbital margin
Where is the lateral border of the orbit?
forms the frontal process of zygomatic bone and the zygomatic process of the frontal bone
Where is the roof of the orbit?
is a part of the frontal bone’s orbital plate
Where is the floor of the orbit?
made of the maxilla and zygomatic bones
Where is the lateral wall of the orbit?
consists of the zygomatic bone and greater wing of sphenoid bone
Where is the medial wall of the orbit?
the frontal process of the maxilla and the lacrimal and ethmoid bones form this wall
Optic nerve
Choroid
Sclera
Vitreous body
Retina
Lens
Anterior compartment
Cornea
Pupil
Iris
Ciliary body and muscle
Outer layer of the Eye
- cornea
- sclera
Middle layer (Choroid) of the eye
- blood supply
- pupil
- iris
- muscles controlling the lens and pupil
Deep layer (the retina) of the eye
- Rods
- Cones
- Fovea Centralis
- Optic disc
Chambers of the Eye
- Anterior chamber
- Posterior chamber
- Vitreous body
Anterior chamber of the eye
This diameter contains a liquid, the aqueous humor, and the pupil
Posterior chamber of the eye
It is posterior to the iris, also contains aqueous humor, and surrounds the lens
Vitreous body
This is behind the lens forming the majority of the organ; it is filled with the gelatinous vitreous humor
Intraocular muscles
- Ciliary muscles
- Dilator Pupillae
- Sphincter pupillae
Extraocular muscles
- 6 extraocular muscles + the levator palpebrae superioris
- control eye movement
- Superior rectus
- Inferior rectus
- Medial rectus
- Lateral rectus
- Superior oblique
- Inferior oblique
Ciliary muscles (function, innervation)
- control the thickness of the lens via the suspensory ligaments
- under parasympathetic nervous control by cranial nerve 3 via the ciliary ganglion
Dilator and Sphincter Pupillae
- control the amount of light entering the pupil
- sphincter pupillae are under parasymethetic nervous control by cranial nerve 3 via the ciliary ganglion
- dilator pupillae is under sympathetic nervous control
Superior rectus
Lateral Rectus
Inferior oblique
medial rectus
Superior oblique
Medial rectus
Lateral rectus
Superior rectus
Common tendinous ring
Movement of the eyeball by the superior rectus
Elevation
Movement of the eyeball by the inferior rectus
Depression
Movement of the eyeball by the medial rectus
In (adduction)
Movement of the eyeball by the lateral rectus
Out (abduction)
Movement of the eyeball by the superior oblique
abduction and depression
Movement of the eyeball by the inferior oblique
abduction and elevation
Superior rectus
Lateral rectus
Medial rectus
Superior oblique
Optic nerve
Which orbital muscles does oculomotor nerve (CN 3) supply
all of the orbital muscles except lateral rectus and superior oblique
CN 6 supplies which oribital muscles
lateral rectus
CN 4 supplies which oribital muscles
Superior oblique
The sympathetic preganglionic axons leave the spinal cord at ________, travel up the ________, and synapse in the __________
- T1
- Sympathetic trunk
- Superior cervical ganglion
Interruption in the sympathetic pathway leads to:
ptosis (drooping of eyelid) and permanently constricted pupil
The parasympathetic pathway innervates:
the lacramal gland and the interior surface of the eye
Describe the innervation of the lacrimal gland and what the activation of this pathway leads to
- Preganglionic nerve fibres from the facial nerve (CN 7) synapse in the pterygopalatine ganglion and travel to the lacrimal gland
- Activation of this pathway leads to contraction of the smooth muscle of the lacrimal gland producing tears
Innervation of the interior surface of the eye
- The oculomotor nerve (CN 3) sends preganglionic fibres to the ciliary ganglion (directly behind the eyeball)
- Some postganglionic axons travel to the sphincter puppillae, while others travel to the ciliary muscle of the lens
Conjunctiva
a continuous membrane that covers the inside of the eyelids and blends into the cornea
Tarsal plates
thick fascial core of the eyelids
Palperbral fissure
opening of the eyelids
The lacrimal glands (where are they situated? Where do their ducts enter? pathway of tears?)
- situated at the upper, outer orbit
- their ducts enter the conjunctival sacs
- tears migrate medially into the lacrimal duct via the lacrimal punctum
The pharynx
a muscular tube that hangs down from the base of the occipital bone in front of the cervical vertbrae
3 layers of the pharynx
- the inner mucosa
- the middle fibrous tissue
- the outer muscular layer
The pharynx communicates anteriorly with the:
- nasal cavity
- mouth
- larynx
3 regions of the pharynx
- Nasopharynx
- Oropharynx
- Laryngopharynx
Nasopahrynx (where does it open? How does it communicate with the middle ear?)
- opens anteriorly into the nasal cavity via the choanae
- communicates with the middle ear by means of the tympanic (or Eustachian) tube, whose opening is on the side wall of the pharynx
Oropharynx (location? how does it connect to the mouth?)
- extends from the soft palate down to the hyoid bone
- it is connected to the mouth through the fauces; this is the arch connecting the mouth to the pharynx
Laryngopharynx (where is it located? where is the opening to the larynx? what protects the entrance to the larynx?)
- This extends from the hyoid bone to the esophagus
- The opening to the larynx is located in the wall of the proximal laryngopharynx
- The entrance is protected by the epiglottis
Nasal cavity
Hard palate
Lip
Vestibule
Larynx
Trachea
Esophagus
Laryngo-pharynx
Oral pharynx
Nasal pharynx
Uvula
Nasal cavity
Hard palate
3 types of tonsils
- Pharyngeal tonsil
- Palatine tonsil
- Lingual tonsil
Pharyngeal tonsil
a single entity and is located at the posterior wall of the top of the parynx
Palatine tonsils
- are paired and sit in a depression at the base of the fauces, with one on each side
- oval and have an upper and lower pole
- they rest on an extremely thick, fibrous base
- easily removed surgically
Lingual tonsils
- are small cluster of lymphoid tissue found on the posterior part of the tongue
uvula
Palatine tonsil
Tongue
Fauces
2 parts of the mouth
- Vestibule
2. Oral Cavity - the mouth proper
Vestibule
- located between the lips and gums (and teeth)
- lined by a mucous membrane and contains the opening of the duct of the parotid gland opposite the upper second cavity
Oral cavity
- contains the tongue
- roof (the palates)
- floor (beneath the tongue)
- two walls (the teeth)
Two muscle groups of the tongue
- Intrinsic muscles
- Extrinsic muscles
Intrinsic muscles of the tongue (location, fibers, function)
- make up the body of the tongue
- consist of three groups of fibers: verticle, longitudinal and transverse fibers
- responsible for altering the shape of the tongue
4 extrinsic muscles of the tongue
- Genioglossus
- Hyoglossus
- Styloglossus
- Palatoglossus
Genioglossus
- this muscle pulls the tongue forward
- originates from the genial tubercle on the inside of the mandible
- inserts on the base of the tongue
Hyoglossus
- originates on the hyoid bone
- it is paired
- each individual muscle inserts on one side of the tongue
- depressed the tongue laterally
Styloglossus
- originates on the styloid process
- inserts onto the side of the tongue
- functions to elevate and retract the tongue
Palatoglossus
- runs from the side of the palate to enter the tongue
- elevates the tongue
Palatoglossus
Styloglossus
Hypoglossus
Genioglossus
Genial tubercle
Palatoglossus
Styloglossus
Hypoglossus
Genioglossus
Vertical
Transverse
Longitudinal
Papillae
specialized processes that are contained within the unique mucosa that covers the tongue
Where are most of the papillae concentrated?
the top and the side of the tongue
Lingual frenulum
the mid-line which tethers the underside of the tongue to the floor of the mouth
Suluc terminalis
V-shaped groove two thirds back from the tip of the tongue, sepearating the tongue into an anterior 2/3 and posterior 1/3
Hard palate
Soft palate
Pharyngeal tonsil
Uvula
Pharynx
Esophagus
Trachea
Larynx
CN 9
CN V3
CN 7
Sulcus terminalis
CN 9
Motor innervation of the tongue
all of the muscle are innervated by the hypoglossal nerve (CN 12) excpet the palatoglossus, which is innervated by the vagus nerve (CN 10)
Sensory innervation of the tongue
- On the anterior 2/3 of the tongue there is V3 innervation for general sensation and CN 7 innervation for taste
- On the posterior 1/3 of the tongue CN 9 relays both general sensation and taste
3 salivary glands
- Parotid gland
- Submandibular gland
- Sublingual glands
Parotid gland (location? where do its ducts empty? what does it secrete? innervation?)
- located in front of the ear (parotid means in front of the ear)
- its duct empties into the mouth opposite the upper second molar
- secretes mostly a serous liquid
- innervated by CN 9
Submandibular gland (where is it located? where is its ducts opening and location? what does it secrete? innervation?)
- rests around the angle of the jaw
- its duct runs forward under the tongue and its opening is close to the base of the frenulum
- it secretes a mixed serous and mucous fluid
- innervated by CN 7
Sublingual glands (where is it located? where do its ducts open? innervation?)
- sit on the floor of each side of the mouth, lateral to the duct of the submandibular gland
- multiple ducts from this gland empty, by a series of small openings, into the floor of the mouth or they may open into the submandibular ducts
- innervated by CN 7
Parotid gland
Submandibular gland
Names of teeth that each half jaw contains:
- 2 incisors
- 1 canine
- 2 premolars
- 3 molars
Innervation of the upper jaw and teeth
innervated by the maxillary component of the trigeminal nerve (CN V2)
Innervation of the lower jaw and teeth
innervated by the mandibular component of the trigeminal nerve (CN V3)
Epiglottis
- prevents food from entering the airway by covering the entrance
- proximally protects the larynx
The organ of phonation
the larynx
The external skeleton of the larynx
- thyroid cartilage
- cricoid cartilage
Thyroid cartilage of the larynx (size, shape, made of, features)
- largest cartilage
- shaped like a shield
- made of hyaline cartilage
- has an anterior prominence where the two sides meet forming the adam’s apple
- each side has a prominent superior and inferior horn
- the superior horn articulates with the hyoid bone
- the inferior horn articulates with the cricoid cartilage
Cricoid cartilage of the larynx (shape, features)
- shaped like a signet ring and is wide posteriorly
- articlulates with the inferior horn of the thyroid cartilage
- between the thyroid and cricoid structures anteriorly is the cricothyroid ligament
Internal skeleton of the larynx
- Arytenoids
- Epiglottal cartilage
Arytenoids (how many, shape, articulates with, controlled by, anterior processes, what attaches to these processes, any other process)
- paired, pyramidal structures
- articulate with the back of the cricoid cartilage
- controlled by muscles that cause them to rotate horizontally
- anterior processes are called the vocal processes
- vocal cords attach to the vocal processes
- Postero-laterally is a muscular process
Epiglottal cartilage (Type of cartilage, shape, location, what happens during swallowing)
- elastic type of cartilage
- racket-shaped
- attached to the inside of the front of the thyroid cartilage
- epiglottis is lined with respiratory epithelium on its underside
- when swallowing, the thyroid cartilage raises and the epiglottis drops to close off the laryngeal opening
Hyoid bone
Thyroid cartilage
Left lobe of thyroid gland
Cricoid cartilage
Trachea
Isthmus of thyroid gland
Right lobe of thyroid gland
Greater hyoid cornu
Cricothyroid
Tracheal rings
Recurrent laryngeal nerve
Membranes of the larynx
- Quadrangular membrane
- Triangular membrane
Quadrangular membrane (upper or lower? anteriorly attached? posteriorly attached? lower free border name)
- upper membrane
- anteriorly attached to the sides of the epiglottis and the thyroid
- posteriorly attached to the arytenoids
- has a lower free border called the false vocal cords
Triangular membrane (Upper or lower? AKA? Lower border is attached to? Upper border is attached to? Attaches to?)
- lower membrane
- also called the conus elasticus
- its lower border is attached to the cricoid cartilage
- its upper border is free, forming the vocal cords
- attaches to the vocal processes and to the inside of the thyroid cartilage
- also called the cricothyroid ligament
Rima glottidis
- the opening between the vocal folds
- the muscles that act on the arytenoid, cricoid and thyroid cartilages change the width of this opening and the tension on the vocal cords
What is the largest muscle controlling the larynx?
the cricothyroid
Motor innervation of the larynx
the reccurent laryngeal nerves, which branches from the vagus nerve, innervate all muscles except the cricothyroid, which is served by the external laryngeal nerve, which is also a branch of the vagus
Sensory innervation of the larynx
above the vocal cords sensory information is carried by the superior laryngeal nerves, while below vocal cords it is carried by the recurrent laryngeal nerves
Quadrangular membrane
False vocal cords
True vocal cords
Triangular membrane
Thyroid
Rima glottidis
Vocal process
Arytenoid
Temporomandibular joint movements
- this joint allows for opening and closing of the mouth and limites side to side movements
- it is a synovial joint with a disc to facilitate complex movement
Temporomandibular joint bones
- the condyle (head) of the jaw articulates with the mandibular fossa in the base of the temporal bone
- the back of the socket is concave, but anteriorly the joint surface is convex, so that as the jaw moves forward there is some physiological (that is, natural) dislocation
Temporalis
Masseter
Orbicularis
Buccinator
Orbicularis oris
Sternomastoid muscle (location, origin, insertion, function, innervation)
- divides the neck into the anterior and posterior triangles
- originates on the manubrium and the medial end of the clavicle
- inserts on the mastoid process of the temporal bone
- turns the head to the opposite side
- innervated by the spinal accessory nerve (CN 11)
Scalene muscles (location, origin, insertion, function, innervated)
- 3 scalene muscles found in the posterior triangle: anterior, middle, and posterior
- all 3 originate from the transverse process of the middle to lower cervical vertebrae
- anterior division inserts on the scalene tubercle of the first rib
- middle division inserts behind it and the subclavian artery passes between the two insertions
- posterior division inserts onto the second rib
- they raise the thoracic cage as secondary muscles of respiration
- they are innervated by small twigs from the cervical nerves
Stylohyoid
Anterior digastric
Posterior digastric
Thyrohyoid
Sternomastoid
Scalene muscles
Trapezius
Muscles of the floor of the mouth (3)
- Mylohyoid
- Digastric
- Stylohyoid
Mylohyoid muscle (location, origin, insertion, function, innervation)
- makes up the floor of the mouth
- originates on the inside of the mandible
- inserts on the hyoid bone and upon its opposite partner by means of a raphe
- elevates the hyoid bone
- innervated by the mandibular nerve (CN V3)
Digastric muscle (location, origin, insertion, function, innervation)
- has an anterior and posterior belly
- the posterior belly runs down from the mastoid process
- the anterior belly runs up to the side of the genial tubercle
- help depress the mouth and elevates the hyoid
- the anterior belly is innervated by the mandibular nerve (CN V3)
- the posterior belly is innervated by the facial nerve (CN 7)
Stylohyoid muscle (origin, insertion, function, innervation)
- originates from the styloid process
- inserts on the body of the hyoid bone
- elevates the hyoid bone
- innervated by the facial nerve (CN 7)
Anterior belly of the digastric muscle
Posterior belly of the digastric muscle
Hyoid bone
Mylohyoid muscle
Mandible
Temporalis
Masseter
Lateral pterygoid
Medial pterygoid
Muscles of mastication (4)
- Temporalis
- Masseter
- Medial pterygoid
- Lateral pterygoid
Temporalis muscle (shape, location, insertion, function, innervation)
- large fan-shaped muscle occupying the temporal fossa
- its fibers pass through the zygomatic arch and insert on the coronoid process of the mandible
- Its function is to close the mouth
- innervated by the mandibular nerve (CN V3)
Masseter muscle (origin, insertion, innervation)
- originates on the zygomatic arch
- inserts onto the outside of the angle of mandible
- innervated by the mandibular nerve (CN V3)
Medial pterygoid muscle (origin, insertion, function, innervation)
- originates from the inside of the lateral pterygoid plate
- inserts on the deep angle of the jaw
- closes the mouth
- innervated by the mandibular nerve (CN V3)
Lateral pterygoid muscle (origin, insertion, function, innervation)
- arise from the greater wing and outer lateral pterygoid plate of the sphenoid bone
- inserts on the neck of the mandibular condyle
- when contracted, it causes protrusion of the jaw
- innervated by the mandibular nerve (CN V3)
Superior constrictor
Middle constrictor
Thryohyoid
Inferior constrictor
Muscles of the pharynx
- Superior constrictor
- Middle constrictor
- Inferior constrictor
Superior constrictor
- originates from the medial pterygoid plate and the ptergomandibular raphe
- shares an origin with the buccinator
- supplied by the vagus nerve (CN 10)
The middle constrictor
- originates from the stylohyoid ligament and the hyoid bone
- supplied by the vagus nerve (CN 10)
Inferior constrictor
- originates from the thyroid and cricoid cartilages
- supplied by the vagus nerve (CN 10)
Muscles of the faces
- Orbicularis oris
- Orbicularis occuli
- Buccinator
Orbicularis oris
- the circular muscle that orbits the mouth
- its function is to protrude the lips
Orbicularis occuli
- this muscle surround the orbit
- it closes the eyes when contracted
Buccinator
- principle muscle of the neck
- orginates from the pterygomandibular raphe and the mandible
- inserts onto the corner of the mouth
- helps the muscles of mastication by moving the food around in the mouth
Muscles of the scalp
Frontalis and occipitalis
Frontalis (origin, insertion, innervation)
- originates from the eyebrows
- insert into the fronto-occipital aponeurosis
- Inneravted by facial nerve (CN 7)
Occipitalis (origin, insertion, innervation)
- originates from the occipital bone
- inserts into the fronto-occipital aponeurosis
- innervated by the facial nerve (CN 7)
Layers of the scalpe
(Spells SCALP)
- Skin
- Connective tissue
- Aponeurosis
- Loose connective tissue
- Periosteum (bone)
Fronto-occipital aponeurosis
a thick layer of fascia crossing the head
External nose
- 2 nostrils
- paired nasal bones
- 2 sets of hyaline cartilages
- septal cartilage
- 2 lateral plates
- 2 alar cartilages
Septal cartilage
forms the interior part of the septum and unites posteriorly with the bony septum
nasal bone
lateral cartilage
alar cartilage
Internal nose
- links the external nose to the choanae
- ethmoid
- vomer
- sphenoid
- palatine bones
- cribiform plate
- spheno-ethmoidal recess
- superior, middle, inferior meatus
- maxillary sinus
- nasolacrimal duct
Sinus of frontal bone
Nasal bone
alar cartilage
Sphenoid sinus
Cribiform plate
Spheno-ethmoidal recess
Superior meatus
Middle meatus
Maxillary sinus
Nasolacrimal duct
Inferior meatus
Paranasal air sinuses
lines spaces inside the frontal, maxillary, ethmoid and sphenoid bones which have ducts to empty into the nasal cavity
Maxillary sinus
- a large space in the maxilla
- duct drains into the middle meatus
- its opening, the ostium, is high on the medial wall
Ethmoid sinuses
- series of small air-lined pockets in the lateral wall of the ethmoid bone
- easily seen in the medial wall of the orbit
- the anterior group drains into the middle meatus and the posterior group drains into the superior meatus
Frontal sinus (location, where do their ducts drain)
- large spaces are found above the margin of the orbit and their long ducts drain into the middle meatus
Sphenoidal sinus
- Two spaces in the body of the sphenoid bone, one on each side
- They drain into the spheno-ethmoidal recess
Middle ethmoid sinuses
Posterior Ethmoidal Sinuses
Maxillary sinus
Anterior ethmoidal sinus
Frontal sinus
Frontal sinus
Posterior ethmoid sinus
Orbit
Anterior ethmoid sinus
Maxillary sinus
Maxillary sinus
Nasolacrimal duct
Ostium
Spheno ethmoidal recess
Sphenoid sinus
External ear
- external acoustic canal
- auricle
- tympanic membrane
Auricle is made of what type of cartilage
made up of elastic cartilage
External acoustic canal
- The lateral third of the canal is cartilaginous and the medial two thirds are bony
- The outer part has hair, sebaceous glands and ceruminous (wax) glands
- The distal end of the canal is blocked by the bilaminar tympanic membrane, known commonly as the ear drum
Middle ear
- a chamber in the temporal bone
- contains the ossicles
- round and oval windows
Ossicles
the entrance to the auditory tube, a connection within the mastoid air cells and the round and oval windows
Malleus
Incus
Staples
How do the ossicles transmit sound waves to the inner ear?
The malleus, incus, and stapes bones connect the tympanic membrane, via synovial joints, to the oval window and its membrane, and thus transmit sound waves from the tympanic membrane to the inner ear
Internal ear
- Bony labyrinth
- Membranous labyrinth
- Endolymph fluid
- Perilymph fluid
- Cochlea
- ## Vestibular apparatus
The vestibular and cochlear components of CN V3 travel to the brain via the ___________
internal acoustic meatus
External ear
Accoustic canal
Tympanic membrane (ear drum)
Eustachian tube
Cochlear duct
Round window
Inner ear
Semicircular canals
Oval window
Middle ear
Describe the pathways of the carotid artieries in the head and neck
- The common carotid artery ascends in the neck in the carotid sheath along with the internal jugular vein and vagus nerve
- The common carotid bifurcates into the internal (which enters the brain) and external carotid arteries
- The bifurcation is at the same level as the top of the thyroid cartilage
External carotid artery supplies:
the face and neck
Branches of the external carotid artery:
- Superior thyroid
- Lingual
- Facial
- Occipital
- Posterior auricular
- Maxillary
- Superficial temporal
Maxillary artery
Facial artery
Lingual artery
External carotid
Superior thyroid artery
Internal jugular
Internal carotid
CN 11
Occipital artery
Posterior auricular artery
Internal carotid enters the skull through the:
carotid canal
Carotid siphon
S or U shaped turns of the internal carotid artery that sits on either side of the pituitary gland and its distal end runs through the cavernous sinus
Vertebral arteries
- The paired vertebral arteries run up the transverse foramina in the cervical vertebrae and enter the skull via the foramen magnum
- They give off branches in the neck
Venous drainage from the brain
- The drainage of blood and CSF from the brain is done mainly by the dural venous sinuses
- These all eventually drain into the internal jugular vein as it leaves the jugular foramen
Name the dural venous sinuses (6)
- Superior sagittal sinus
- Inferior sagittal and straight sinuses
- Transverse sinus
- Sigmoid sinus
- Cavernous sinus
- Superior and inferior petrosal sinuses
Cavernous sinus
Inferior petrousal sinus
Sigmoidal sinus
Transverse sinus
Confluence
Superior petrosal sinus
Jugular foramen
Straight sinus
Tentorum cerebelli
Explain the superior sagittal in venous drainage
The superior sagittal meets the straight sinus (which drains the inferior sagittal sinus) in the confluence at the center of the occipital bone
Explain the transverse sinuses in venous drainage
The transverse sinuses take the blood and CSF laterally to the sigmoid sinuses which empty into the internal jugular veins
Where do the cavernous sinus empty during venous drainage
The cavernous sinus empties into the superior and inferior petrosal sinuses
Where do the superior and inferior petrosal sinuses drain into
The inferior petrosal sinuses goes directly into the jugular and the superior petrosal sinuses drains into the proximal sigmoid sinus
Explain venous drainage from the face
- The retromandibular vein bifurcates to drain into the internal and external jugular veins
- The facial vein empties into the internal jugular vein
- The posterior auricular vein drains into the external jugular vein
Sensory innervation of the head and neck
- The three sensory branches of the trigeminal nerve all receive information from the face
- The opthalmic branch (CN V1) is sensory to the forehead
- The maxillary branch (CN V2) supplies the nose, cheek and temple
- The mandibular branch (V3) serves the skin of the jaw and lateral cheek
- The anterior neck and the area posterior to the ear are innervated by C2 and C3
- The side and back of the neck and back of the head are innervated by branches from C2-C5.
Posterior auricular artery
External jugular vein
Internal jugular vein
Facial vein
Retromandibular vein