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Stage 1 > Theme 8 part 2 > Flashcards

Theme 8 part 2 Flashcards

1
Q

what is intramembrous ossification

A

mesoderm to bone

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2
Q

what is endochondral ossification

A

cartilage to bone

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3
Q

how does the cranial vault form

A

intramembranous ossification

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4
Q

how does the cranial base form

A

endochondral ossification

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5
Q

how does the facial skeleton form

A

intramembranous ossifcation (neural crest)

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6
Q

what are the unpaired bones of the skull in the interior cranium

A

frontal
ethmoidal
occipital
sphenoid

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7
Q

what are the paired bones of the skull in the interior cranium

A

parietal

temporal

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8
Q

what is the boundary between the middle and anterior cranial fossa

A

lesser wings of sphenoid

anterior clinoid process and jugum sphenoidale

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9
Q

what is the boundary between the middle and posterior cranial fossa

A

superior borders of the petrous temporal bones, posterior clinoid processes and dorsum sellae

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10
Q

what are the features of the anterior cranial fossa

A

crista galli
cribriform plate
orbital plate of frontal bone

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11
Q

What are the features of the middle cranial fossa ?

A 
Jugum sphenoidale 
sella turcica 
pituitary fossa 
optic canal 
Fo. Lacerum 
Superior orbital fissure 
Fo.Rotundum 
Fo. Ovale 
Fo.Spinosum 
Hiatus for the greater and lesser petrosal nerves
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12
Q

What are the features of the posterior clinoid fossa ?

A 
Clivus 
Fo. Magnum 
Hypoglossal canal 
jugular Fo 
Internal auditory meatus 
Internal occipital protuberance
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13
Q

Which cranial nerves emerge in the anterior cranial fossa ?

A

I

olfactory

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14
Q

Which cranial nerves emerge in the middle cranial fossa ?

A 
II, III, IV, V, VI
optic 
oculomotor 
trochlear 
trigeminal 
abducens
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15
Q

Which cranial nerves emerge from the posterior cranial fossa ?

A 
VII, VIII, IX, X, XI, XII
Facial 
vestibulocochlear 
glossopharyngeal 
vagus 
spinal accessory 
hypoglossal
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16
Q

What are the 3 layers of the meninges (part of protective tissue)?

A

dura matter
arachnoid matter
pia matter

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17
Q

what are the four parts of dura matter

A

falx cerebri
falx cerebelli
diaphragma sella
tentorium cerebelli

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18
Q

What does the falx cerebri do ?

A

hangs down into the cranial cavity and separates the 2 cerebral hemispheres

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19
Q

What does the falx cerebelli do ?

A

separates the right and left cerebellar hemispheres

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20
Q

What is the diaphragma sellae do ?

A

a small fold between the anterior and posterior clinoid processes

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21
Q

What are the 2 spaces between the meningeal layers ?

A

extradural space

subarachnoid space

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22
Q

What is the extradural space ?

A

space between the dura and the bone

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23
Q

What is the subarachnoid space ?

A

below the arachnoid mater and is filled with CSF

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24
Q

where do the frontal lobes of the cerebral hemisphere normally rest

A

the orbital plate of the frontal bone

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25
Q

where do the temporal lobes of the cerebral hemisphere normally rest

A

greater wing of sphenoid

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26
Q

what would damage to the middle meningeal artery cause

A

extradural haemorrhage

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27
Q

where is the petrous sinus located

A

on the superior border of the petrous temporal bone

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28
Q

what bone is the dorsum sellae apart of

A

sphenoid

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29
Q

which bone is the cerebellar fossa located in

A

squamous part in temporal bone

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30
Q

where does the cerebellum rest

A

cerebellar fossa

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31
Q

where is the transverse sinus located

A

groove on the occipital bone

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32
Q

where is tentorum cerebelli usually attached

A

to the margins of the grooves on the occipital bone

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33
Q

where is the superior sagittal sinus located

A

Groove on the inferior surface of the calvarium in the midline on the frontal bone and extending onto the parietal bones on either side of the sagittal suture

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34
Q

where does the superior sagittal sinus drain

A

transverse sinus at confluence of sinuses

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35
Q

which groove does the internal carotid artery pass medial to

A

groove in the body of the sphenoid bone where the carvenous sinus is located

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36
Q

which nerves enter at the internal auditory meatus

A

facial and vestiboluocochlear

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37
Q

what would happen if there was damage to the facial nerve at the internal auditory meatus

A

ipsilateral facial paralysis combined with a loss of taste to the anterior ⅔of the tongue, loss of the stapedial reflex and loss of lacrimal gland secretion

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38
Q

what would happen if there was damage to the vestibulocochlear nerve

A

hearing loss and balance affected

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39
Q

where does the trigeminal ganglion lodge

A

trigeminal impression

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40
Q

what would happen if there was damage to the spinal accessory

A

nerve (XI)paralysis of the sternocleidomastoid and trapezius muscles

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41
Q

what would happen if there was damage to the vagus nerve

A

loss of sensation from the larynx and the thoracic and abdominal viscera and paralysis of the muscles of the larynx, pharynx and soft palate and muscles lining the thoracic and abdominal viscera

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42
Q

what would happen if there was damage to the glossopharyngeal nerve

A

loss of touch and taste sensation from the posterior ⅓ of the tongue, loss of sensation from the oropharynx and from the carotid chemo- and baroreceptors, paralysis of stylopharyngeus and loss of parotid salivary secretion.

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43
Q

how does the cerebrospinal fluid (CSF) protect the brain

A

Lies between the meningeal layers: arachnoid and the pia mater
It acts as a shock absorber

44
Q

how do the Meningeal reflections (CSF) protect the brain

A

Helps protect the brain from mechanical damage

shock absorbers

45
Q

how do the Venous sinuses protect the brain

A

Help in cooling the brain and protect if against transient fluctuations in venous pressure

46
Q

how do the bones of the skull help protect the brain

A

through their thickness and immobility of their joints (sutures)

47
Q

Do venous sinuses contain valves?

A

no

48
Q

What do the dural venous sinuses do ?

A

drain blood from the brain into the internal jugular vein and the jugualr foramen

49
Q

What does the superior sagittal sinus drain into ?

A

the confluence

50
Q

What does the inferior sagittal sinus do ?

A

turns into the straight sinus as it approaches the tentorium cerebelli

51
Q

What is the transverse sinus ?

A

passes laterally from the confluence and becomes the sigmoid sinus as it passes to the petrous temporal bone

52
Q

What is the sigmoid sinus ?

A

continues medially from the petrous ridge to the jugular fo. All blood drains into the sigmoid sinus

53
Q

What are the cavernous sinuses ?

A

lie in the body of the sphenoid on either side of the sella tursica - draineed by the superior and inferior petrosal sinuses

54
Q

What does the superior petrosal sinus do ?

A

drains into the cavernous sinus

55
Q

What does the inferior petrosal sinus do ?

A

drains directly into the internal jugular vein

56
Q

What is the arterial supply of the brain ?

A

vertebral and the internal carotid arteries

57
Q

How does the internal carotid artery enter the posterior cranial fossa ?

A

through the carotid canal

58
Q

How does the vertebral artery enter the posterior cranial fossa ?

A

foramen magnum

59
Q

what are the foramina in the anterior cranial fossa

A

cribriform plate- olfactory nerves

60
Q

what are the foramina in the middle cranial fossa

A 
superior orbital fissure 
optic canal 
rotundum 
ovale 
spinosum 
lacerum 
hiatus for greater petrosal 
hiater for lesser petrosal
61
Q

what are the foramina in the posterior cranial fossa

A

internal auditory meatus
jugular
hypoglossal canal
magnum

62
Q

what are the structural buttresses of the skull

A

areas of bone that are the most structurally stable and are the least likely to break

63
Q

what does the buttress system do

A

absorbs and transmits forces applied to the facial skeleton to protect fragile bony areas

64
Q

what is an extradural haemorrhage and what structure does it affect

A

bleeding between dura and skull- middle meningeal

65
Q

what is a sub haemorrhage and what structure does it affect

A

bleeding in subdural space- superior cerebral veins

66
Q

what is a subarachnoid haemorrhage

A

bleeding into the subarachnoid- aneurysms, angiomas

67
Q

what is a intracerebral haemorrhage and what structure does it affect

A

bleeding into brains itself- middle cerebral artery

68
Q

what are the typical routes for infection

A

tissue planes
venous
lymphatic
direct erosion

69
Q

what are the severe untreated consequences of orofacial infections

A

airway obstruction
intracranial spread
septicaemia

70
Q

what will happen if a periapical abscess is left untreated

A

passes into soft tissues through thin cortical bone before thick bone

71
Q

where can infection spread in tissue spaces in the jaw and neck

A
  • can spread backwards till it reaches the posterior border of mylohyoid. can spread into submandibular and submental space with infection on either side of mylohyoid pushing tongue up and covering airway- ludwigs angina
  • between 2 heads of anterior digastric, left and right
72
Q

what is ludwigs angina

A

where airways are obstructed due to the tongue being pushed up and back. this is bc infection has spread to both sides of the mylohyoid

73
Q

what are the tissue spaces in the lower jaw

A 
sublingual space
submental space
submandibular space
pterygomandibular space 
peritonsillar space
parotid space
74
Q

Describe the route of infection spread from a 3rd mandibular molar ?

A

periapical abcess - in the roots of molar
breaks through on the lingual side
enters the sublingual space
spread backward - ludwigs angina

75
Q

what is quinsy

A

medical condition caused by pressure on CNIX

76
Q

where are the tissue spaces in the upper jaw

A

canine
palatal
infratemporal

77
Q

where can infection from a lower 3rd molar spread

A

intraorally- sublingual space
extraorally- submandibular
neck-para- or retropharyngeal spaces

78
Q

what are the 3 routes of entry for intracranial spread of infection

A

tissue spaces
paranasal sinuses
venous commincation

79
Q

what can infections erode

A

basiocciput

enter the mediastinum

80
Q

What is the second route of infection spread ?

A

from submandibular space
into lateral pharyngeal space
retropharyngeal space

81
Q

Describe a route of infection spread from the cavernous sinus ?

A

from the cavernous sinus into the emissary veins and the into the infraorbital vein into the facial vein

82
Q

Describe a second route of infection from the cavernous sinus ?

A

from the cavernous sinus into the pterygoid plexus of veins and into the RM vein

83
Q

what is carvenous sinus thrombosis

A

deep seated infection which will erode the wall of the carvenous sinus which is close to the carotid artery.

84
Q

what are the types of facial fractures

A

mandibular fractures
middle third fractures
zygomatic fractures

85
Q

what are the signs of a fractured zygoma

A

pain
swelling
problems opening mouth
numbness over the lip, side of nose and teeth in that area

86
Q

what are the common places for a mandibular fracture

A

condyle (neck) -thin
angle- grain crosses over so weak spot
mental fo- weak spot

87
Q

where in an unusual place for a mandibular fracture

A

coronoid process

88
Q

what is an indirect fracture

A

where injury on one side leads to injury on the other side

89
Q

what is an unfavourbale fracture

A

where muscle distracts the fracture

90
Q

what is a favourbale fracture

A

muscle aligns the fracture

91
Q

what are the functional problems with mandibular fractures

A

disturbance in occlusion
nerve damage
AIRWAY PROBLEMS!!!

92
Q

where would the fracture in the mandible occur for there to be nerve damage

A

between mandibular and mental fo- numb lower lip on one side

93
Q

what occurs in bilateral parasymphseal mandibular fractures

A

the infra glossal muscles pull that segment backwards which also pulls the tongue occluding airways

94
Q

what is the safest way to open the airway

A

jaw thrust not head tilt chin lift

95
Q

what are the growth disturbances in children if the condyle of mandible fractures

A

mandible grows from the condyle so can be disproportion in the mandible, occlusal facial disturbances

96
Q

what occurs in bony ankylosis

A

top condyle fuses with bone to the fossa it sits in leading to limited mouth opening
bone forms between the condyle and fossa

97
Q

how can mandibular fractures be treated

A
  1. Reduction- get bone ends together
  2. Fixation- keep them together

Re-establish occlusion

98
Q

what is a middle third fracture

A

from occlusal surface of upper teeth to the ridge of the nose

99
Q

where is the anterior facial buttress

A

frontal bone

100
Q

where is the middle facial buttress

A

frontal bone and base of skull

101
Q

where is the posterior facial buttress

A

base of skull

102
Q

how can middle third fractres block airways

A

middle third of the face is attached to the base of the skull and the force can go down a 45 degree angle and back dwon
if it goes down too much can block airway

103
Q

how can middle third fractures be treated

A

ORIF- open reduction and internal fixation

104
Q

what are the symptoms of zygomatic (malar) fractures- cheek bone (zygomatic arch damage)

A

pain
limited mouth opening
orbital deformity
redness in the eye- subconjuctiva haemorrhage

105
Q

what are the fucntional prbelms with a fractures

A

eyes- one further down, double image, blow out fractures, diplopia due to muscle trapping
nerves
mandibular movement

106
Q

how can zygomatic fractures be treated

A

ORIF- incison in buccal sulcus of the mouth or in the lateral eyebrow and insert a plate to fix

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