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BPK326 > Unit 1: Head and Neck > Flashcards

Unit 1: Head and Neck Flashcards

1
Q

CN I

A
  • olfactory nerve
  • sensory (sensation of smell)
  • goes through olfactory foramina of the cribriform plate of the ethmoid bone; synapses on the olfactory bulb
  • receptors in the nasal cavity (olfactory epithelium)
  • transmitted directly through cortex (not thalamus)
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2
Q

Olfactory Bulb

A

bilateral to the crista galli, lies within the cribriform plate

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3
Q

CN II

A
  • optic nerve
  • sensory (detection of visual stimuli)
  • goes through the optic canal of the sphenoid bone then crosses at optic chiasm
  • receptors in the retina
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4
Q

Optic Chiasm

A

found at sella turcica of sphenoid bone

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5
Q

Optic Tract

A

continuation of visual sensory fibers from the optic chiasm to the thalamus (LGN)

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6
Q

Optic Radiations

A

projection fibers traveling from thalamus to V1 (primary visual cortex) in occipital lobe

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7
Q

CN III

A
  • oculomotor nerve
  • motor (control of muscles that move the eye in orbit, voluntary eye movements, constriction of the pupil, eye tracking)
  • originate in midbrain, exit the skull through superior orbital fissure of the sphenoid
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8
Q

CN IV

A
  • trochlear nerve
  • motor (down and medial eye movements)
  • originates in midbrain, exits the skull through superior orbital fissure of the sphenoid
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9
Q

CN V

A
  • trigeminal nerve
  • mixed
  • 3 branches: ophthalmic (V1), maxillary (V2), mandibular (V3)
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10
Q

CN V1

A
  • ophthalmic branch
  • sensory (sensory information from orbital structures and upper third of face)
  • passes through superior orbital fissure of the sphenoid
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11
Q

CN V2

A
  • maxillary branch
  • sensory (sensory information from the middle third of the face; innervates upper facial features such as lower eye lid, upper lip, etc.)
  • enters skull through the foramen rotundum of the sphenoid
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12
Q

CN V3

A
  • mandibular branch
  • mixed
  • sensory: sensation of lower third (teeth, lower gums, etc.)
  • motor: muscles of mastication
  • travels through foramen ovale of the sphenoid and mental foramen of the mandible
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13
Q

CN VI

A
  • abducens nerve
  • motor: eye movements (abduction of eye; up and laterally)
  • originates in pons, leaves the skull through the superior orbital fissure of the sphenoid
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14
Q

CN VII

A
  • facial nerve
  • mixed
  • sensory: taste
  • motor: facial expressions
  • enters through the internal acoustic meatus of the temporal bone; emerges from skull through the stylomastoid foramen
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15
Q

CN VIII

A
  • vestibulocochlear nerve
  • sensory: balance + equilibrium (receptors in semicircular canals) and hearing (receptors in cochlea)
  • exits skull at internal acoustic meatus
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16
Q

CN IX

A
  • glossopharyngeal nerve
  • mixed
  • sensory: information from posterior portion of the tongue + pain
  • motor: muscles that elevate the larynx and pharynx during swallowing
  • exits the skull via the jugular foramen
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17
Q

CN X

A
  • vagus nerve
  • mixed (largely involved in autonomic function)
  • sensory: innervation of skin on head and sensation of heart, etc.
  • motor: muscles for swallowing, digestive tract, heart, etc.
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18
Q

CN XI

A
  • accessory nerve
  • motor: movements of the head and neck; innervates the sternocleidomastoids and trapezius
  • exits the skull via the foramen magnum/jugular foramen
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19
Q

CN XII

A
  • hypoglossal nerve
  • motor: innervates intrinsic and extrinsic muscles of the tongue (speaking, swallowing, etc.)
  • exits the skull via the hypoglossal canal
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20
Q

how many bones does the neurocranium have?

A

6: 2 parietal bones, 2 temporal bones, frontal bone, occipital bone

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21
Q

how many bones does the viscerocranium have?

A

8:
- 2 centred on the midline: vomer, mandible
- 6 are bilateral: maxillae, inferior nasal conchae, palatine, zygomatic, lacrimal bones

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22
Q

what are the landmarks of the frontal bone?

A
  • nasal part
  • squamous part
  • orbital part
  • supraorbital margin/superciliary arch
  • supraorbital foramen
  • frontal sinus (prevents bones from drying out because of its mucosal lining)
  • anterior cranial fossa
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23
Q

what is the function of the supraorbital margin/superciliary arch?

A
  • forms the eyebrow ridge
  • contains the supraorbital foramen
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24
Q

what are the landmarks of the occipital bone?

A
  • external occipital protuberance
  • external occipital crest
  • superior nuchal lines
  • inferior nuchal lines
  • occipital condyles
  • condyloid (condylar) fossa
  • groove for transverse sinus
  • groove for superior sagittal sinus
  • internal occipital crest
  • posterior cranial fossa
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25
Q

what are the foramina of the occipital bone?

A
  • foramen magnum
  • hypoglossal canal
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26
Q

what is the function of the superior nuchal lines?

A

origin of the trapezius + occipitalis and insertion of the sternocleidomastoids

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27
Q

where does the flax cerebri attach?

A

groove for superior sagittal sinus of the occipital bone, the frontal crest of the frontal bone, and the crista galli of the ethmoid bone

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28
Q

where does the tentorium cerebelli attach?

A

groove for transverse sinus of the occipital bone

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29
Q

where does the flax cerebelli attach?

A

internal occipital crest of the occipital bone

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30
Q

what is the function of the occipital condyles?

A

attaches to the atlas

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31
Q

what is the function of the foramen magnum?

A
  • entrance/exit of the vertebral arteries, which provide blood to the brain (cerebellum, posterior cortex, brainstem) and spine
  • entrance/exit of spinal cord
  • admits passage of the brainstem (medulla oblongata) and the accessory nerve (XI)
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32
Q

what is the function of the hypoglossal canal?

A
  • pathway for the hypoglossal nerve (XII)
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33
Q

what are the landmarks of the sphenoid bone?

A
  • greater wing
  • lesser wing
  • medial pterygoid plate
  • lateral pterygoid plate
  • body of sphenoid
  • sella turcica
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34
Q

what is the function of the lateral pterygoid plate?

A

origin of medial pterygoids (medial side) and lateral pterygoids (lateral side)

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35
Q

what are the holes/foramina of the sphenoid bone?

A
  • foramen rotundum
  • foramen ovale
  • foramen spinosum
  • superior orbital fissure
  • optic canal
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36
Q

what is the function of the body of the sphenoid?

A

houses the sphenoidal sinuses

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37
Q

what is the function of the sella turcica?

A

contains the pituitary gland (also called the pituitary fossa)

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38
Q

what is the function of the foramen rotundum?

A

passage for the maxillary branch of the trigeminal nerve (V2)

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39
Q

what is the function of the foramen ovale?

A

passage for the mandibular branch of the trigeminal nerve (V3)

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40
Q

what is the function of the superior orbital fissure?

A

passage of the oculomotor (III), trochlear (IV), ophthalmic branch of trigeminal (V1), and abducens (VI) cranial nerves

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41
Q

what is the function of the optic canal?

A

passage of the optic nerve (II)

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42
Q

what are the landmarks of the ethmoid bone?

A
  • crista galli
  • cribriform plate
  • perpendicular plate
  • nasal conchae
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43
Q

what is the function of the crista galli?

A

attachment point for flax cerebri

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44
Q

what is the function of the cribriform plate?

A

passage for olfactory nerves that turn into CN I at the olfactory bulb

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45
Q

what is the function of the perpendicular plate?

A

constitutes part of the nasal septum

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46
Q

what is the function of the nasal conchae?

A

increase surface area of the nasal cavities for warming and humidification of air passing into the lungs

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47
Q

what are the landmarks of the temporal bone?

A
  • squamous part
  • petrous part
  • mastoid process
  • styloid process
  • mandibular fossa
  • zygomatic process
  • middle cranial fossa
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48
Q

what are the holes/foramina of the temporal bone?

A
  • external acoustic meatus
  • foramen lacerum
  • carotid canal
  • jugular foramen
  • stylomastoid foramen
  • internal acoustic meatus
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49
Q

what is the function of the mastoid process?

A

insertion of the sternocleidomastoid and filled with air cells to equalize pressure in the middle ear

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50
Q

what is the function of the styloid process?

A

attachment point for stylohyoid

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51
Q

what is the function of the external acoustic meatus?

A

tube connecting inner and outer ear

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51
Q

what is the function of the foramen lacerum (and carotid canal)?

A

passage for the internal carotid artery

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52
Q

what is the function of the jugular foramen?

A

passage for the glossopharyngeal, vagus (X), and accessory (XI) nerves + internal jugular vein

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53
Q

what is the function of the stylomastoid foramen?

A

passage for the facial nerve (VII)

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54
Q

what is the function of the internal acoustic meatus?

A

passage for the facial nerve (VII) and the vestibulocochlear nerve (VIII)

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55
Q

what suture separates the frontal bone from the parietal bone?

A

coronal suture

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56
Q

what suture separates the bilaterally paired parietal bones?

A

sagittal suture

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57
Q

what suture separates the parietal bones from the occipital bone?

A

lambdoid suture

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58
Q

what is the intersection between the coronal and sagittal sutures called?

A

bregma

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59
Q

what is the junction of the lambdoid and sagittal sutures called?

A

lambda

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60
Q

what are the landmarks of the mandible?

A
  • body
  • angle
  • ramus
  • coronoid process (anterior)
  • condyle (head/condyloid process) (posterior)
  • alveolar part
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61
Q

what is the function of the angle?

A

insertion of the medial pterygoid

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62
Q

what is the function of the ramus?

A

insertion of the medial pterygoid and masseter

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63
Q

what is the function of the coronoid process?

A

insertion of the temporalis

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64
Q

what is the function of the condyle (head/condyloid process) ?

A

insertion of the lateral pterygoid

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65
Q

what is the function of the alveolar part of the mandible?

A

origin of the buccinator and articulates with teeth for support

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66
Q

what are the foramina of the mandible and their functions?

A
  • mandibular foramen
  • mental foramen
  • both are passages for the trigeminal nerve (V)
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67
Q

what are the landmarks of the maxillae?

A
  • frontal process
  • body
  • zygomatic process
  • alveolar process
  • maxillary sinus
  • palatine process
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68
Q

what is the function of the frontal process of the maxilla?

A
  • origin of the orbicularis oculi
  • origin of the medial palpebral ligament
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69
Q

what is the function of the alveolar process of the maxilla?

A

houses teeth

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70
Q

what is the function of the palatine process?

A

forms the hard palate

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71
Q

what are the maxillae joined together by?

A

intermaxillary suture

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72
Q

what is the function of the prefrontal cortex?

A

executive function

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73
Q

what runs through the sylvian fissure?

A

middle cerebral artery

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74
Q

what is the precentral gyrus also known as?

A

primary motor cortex

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75
Q

what is the postcentral gyrus also known as?

A

primary somatosensory cortex

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76
Q

how are the precentral/postcentral gyri organized and what are their differences?

A
  • medial = lower limb and lower extremities
  • lateral = upper limb and face
  • primary somatosensory cortex contains genital sensory information
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77
Q

what divides the parietal lobes from the occipital lobe?

A

parieto-occipital sulcus

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78
Q

what is the lateral parietooccipital line?

A

the imaginary line that connects the parieto-occipital sulcus and the pre-occipital notch, separating the lobes

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79
Q

where is Broca’s area located?

A

inferior portion of the frontal lobe

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80
Q

where is Wernicke’s area located?

A

inferior parietal lobe/posterior temporal lobe

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81
Q

what is the cingulate gyrus?

A

limbic lobe

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82
Q

what is the limbic lobe’s function and its structures?

A
  • crucial role in emotional processing, memory formation, and regulation of basic instincts and drives such as hunger, thirst, and sexual behavior
  • includes the amygdala, hippocampus, hypothalamus, thalamus
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83
Q

what is the calcarine sulcus?

A

location of the primary visual cortex

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84
Q

how is the visual field organized on the calcarine sulcus?

A
  • superior to sulcus represents inferior visual field
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85
Q

what is the paracentral lobule?

A

medial extension of the precentral and postcentral gyri

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86
Q

what are the structures of the brainstem?

A
  • midbrain
  • pons
  • medulla oblongata
  • cerebellum
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87
Q

what is the function of the midbrain?

A

relays sensory and motor information between higher brain centres and spinal cord

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88
Q

what is the function of the pons?

A

bridge between the cerebellum and the rest of the brain + relaying information from cortex to cerebellum, resulting in coordinated movement

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89
Q

what is the function of the medulla oblongata?

A
  • autonomic centre (heart rate, breathing, etc.)
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90
Q

what is the function of the cerebellum?

A

balance and smooth, coordinated movement

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91
Q

what are the 3 white matter tracts discussed?

A
  • corona radiata
  • internal capsule
  • corpus callosum
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92
Q

what are the types of communication fibers?

A
  • association (within hemisphere)
  • commissural (between hemispheres)
  • projection (lower to higher brain centres)
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93
Q

what is the function of the corona radiata?

A

projection fibers carrying sensory and motor information to and from the brain

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94
Q

what is the function of the internal capsule?

A

couples cerebral cortex to deeper structures of the brain + divides thalamus and basal ganglia

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95
Q

what is the function of the corpus callosum?

A

commissural fibers connecting the hemispheres

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96
Q

what is the basal ganglia composed of?

A
  • caudate nucleus (C-shaped)
  • lentiform nucleus (bean)
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97
Q

what is the lentiform nucleus composed of?

A
  • putamen
  • globus pallidus (medial to putamen)
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98
Q

what is the role of the thalamus?

A

relay station and integrative hub for sensory information; gateway for sensory modalities and their respective cerebral areas

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99
Q

what is the role of the basal ganglia (nuclei)?

A

regulation of voluntary motor control + suppression of involuntary movements + reward centre

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100
Q

what arteries make up anterior circulation?

A
  • common carotid arteries
  • internal carotid arteries
  • external carotid arteries
  • middle cerebral arteries
  • anterior cerebral arteries
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101
Q

what are characteristics of the common carotid arteries?

A
  • left CC directly bifurcates into its divisions after aortic arch
  • right CC is first the brachiocephalic trunk off the aortic arch which divides into the subclavian artery and the right CC, then bifurcates into internal and external divisions
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102
Q

what does the internal carotid pass through to enter the skull and what does it branch into?

A
  • carotid canal of the petrous portion of the temporal bone
  • branches into the anterior and middle cerebral arteries
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103
Q

how do the external carotid arteries project?

A

laterally

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104
Q

what do the middle cerebral arteries supply?

A

the lateral surface and temporal poles of the brain
- runs along the sylvian fissure

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105
Q

what do the anterior cerebral arteries supply?

A

medial and superior surfaces and frontal pole of the brain

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106
Q

what connects the anterior cerebral arteries?

A

anterior communicating artery

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107
Q

what arteries make up posterior circulation?

A
  • posterior communicating arteries
  • vertebral arteries
  • posterior inferior cerebellar arteries (PICA)
  • basilar artery
  • anterior inferior cerebellar arteries
  • pontine arteries
  • superior cerebellar arteries
  • posterior cerebral arteries
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108
Q

what does the posterior communicating artery do?

A

connects the internal carotid artery to the posterior cerebral artery

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109
Q

where do the vertebral arteries originate?

A

subclavian arteries

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110
Q

how do the vertebral arteries enter the skull?

A

through the foramen magnum

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111
Q

what do the posterior inferior cerebellar arteries (PICAs) supply?

A

medulla oblongata and the inferior aspect of the cerebellum

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112
Q

what does the basilar artery supply?

A

carries blood to the back of the brain (brainstem, cerebellum, occipital lobe)

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113
Q

what do the anterior inferior cerebellar arteries (AICAs) supply?

A

anterior portion of the cerebellum

114
Q

what do the pontine arteries supply?

115
Q

what do the superior cerebellar arteries supply?

A

superior portion of the cerebellum

116
Q

what do the posterior cerebral arteries supply?

A

inferior surface, occipital lobe

117
Q

what are the 4 dural folds?

A

main:
- falx cerebri
- tentorium cerebelli
smaller:
- falx cerebelli
- sellar diaphragm

118
Q

what is the function of the falx cerebri?

A

divides the left and right hemispheres (located in the longitudinal cerebral fissure between the hemispheres)

119
Q

what is the function of the tentorium cerebelli?

A

separates the brainstem and cerebellum from the occipital lobes

120
Q

what is the function of the falx cerebelli?

A

partially divides the cerebellar hemispheres

121
Q

what is the function of the sellar diaphragm?

A

covers the pituitary gland

122
Q

what makes up the venous drainage system?

A
  • superior sagittal sinus
  • inferior sagittal sinus
  • straight sinus
  • confluence of sinuses
  • transverse sinuses
  • sigmoid sinuses
  • internal jugular veins
123
Q

wheres does the superior sagittal sinus lie and where does it drain?

A
  • begins at the crista galli and ends at the confluence of sinuses
  • located inside the flax cerebri
  • drains into the right transverse sinus at the confluence of sinuses
124
Q

where does the absorption of CSF primarily begin?

A

superior sagittal sinus

125
Q

where does the inferior sagittal sinus drain?

A

into the straight sinus, then the confluence of sinuses, then the left transverse sinus

126
Q

how is the straight sinus formed?

A

joining of the inferior sagittal sinus and the great cerebral vein

127
Q

what is the confluence of sinuses?

A

collective reservoir of all sinuses

128
Q

what is the dominant side for drainage of the confluence of sinuses?

129
Q

where does the internal jugular vein drain and which foramen does it pass through?

A

projects through the jugular foramen and drains into the brachiocephalic vein (then vena cava)

130
Q

what are the components of the ventricular system?

A
  • lateral ventricles
  • interventricular foramina
  • third ventricle
  • cerebral aquaduct
  • fourth ventricle
  • central canal
131
Q

what connects the lateral ventricles to the third ventricle?

A

interventricular foramina

132
Q

what would happen if there was a blockage at the cerebral aquaduct?

A

CSF would build up in the third ventricle since it is directly above the cerebral aquaduct. This would cause swelling of the third ventricle, known as hydrocephalus, putting pressure on the thalami, since the third ventricle is sandwiched between them. This can cause deficits in relaying sensory information to the cerebral cortex, resulting in loss of sensation of multiple modalities, excluding smell.

133
Q

where does the fourth ventricle lie and what does it drain into?

A
  • posterior to the pons and anterior to the cerebellum
  • CSF drains into the subarachnoid space through apertures
134
Q

how does CSF drain into the sinuses?

A

arachnoid granulations/villi

135
Q

where is CSF made?

A

choroid plexus

136
Q

what is endochondral ossification and when does it occur?

A
  • process of bone development from hyaline cartilage
  • occurs from 6 weeks of embryonic development to 25 years of age
137
Q

why is cartilage hard to heal or regrow?

A

cartilage is avascular and degenerates as bone formation progresses

138
Q

how are joints classified (i.e. what are the 2 major systems of classification)

A
  • histological
  • functional
139
Q

what is histological classification and what types fall under this category?

A

based on the dominant type of connective tissue: fibrous, cartilaginous, synovial

140
Q

what is functional classification and what types full under this category?

A

based on the amount of movement they permit:
- synarthroses: immovable
- amphiarthroses: slightly moveable
- diarthroses: freely moveable

141
Q

how do the 2 classification schemes of joints relate?

A
  • synarthroses are fibrous joints
  • amphiarthroses are cartilaginous joints
  • diarthroses are synovial joints
142
Q

what are synarthroses (fibrous) joints?

A

bones connected by fibrous tissue that permits little or no movement

143
Q

what are the 3 main types of fibrous joints?

A
  • sutures of the skull
  • syndesmoses
  • gomphoses
144
Q

how are the sutures of the skull connected?

A

by short, dense fibres

145
Q

how do syndesmoses move relative to the sutures of the skull?

A

they permit more movement based on the length of the fibres, which are generally longer

146
Q

where are gomphoses found?

A

between the teeth and their sockets

147
Q

how is the tooth connected to its socket?

A

connective tissue called the periodontal ligament

148
Q

what are amphiarthroses (cartilaginous) joints?

A

bones connected by cartilage, sometimes permitting limited movement/flexibility

149
Q

what are the types of amphiarthroses joints?

A
  • synchondroses
  • symphyses
  • primary/temporary amphiarthroses
  • secondary/permanent amphiarthroses
150
Q

what is synchondroses?

A

bones are united by hyaline cartilage

151
Q

what is symphyses?

A

bones are united by fibrocartilage (collagen fibres resist tension)

152
Q

what is primary/temporary amphiarthroses?

A

cartilage is replaced by bone during development, producing a synostosis (ex. epiphyseal plate)

153
Q

what is secondary/permanent amphiarthroses?

A

cartilaginous joint persists through adult life, permitting some movement throughout childhood (ex. pubic symphysis)

154
Q

what are diarthroses (synovial) joints?

A

joints specialized for mobility: enclosed by a joint capsule, lined by a serous membrane that produced synovial fluid

155
Q

what is arthroscopy (keyhole surgery)?

A

minimally invasive surgical procedure on a joint; arthroscope is a camera used to view the inside of a joint

156
Q

what is an arthoplasty?

A

replacement of a joint

157
Q

where does muscle injury typically occur?

A

at the myotendinous junction/complex (MTJ): the transition from muscle to tendon to bone

158
Q

how is muscle damage usually shown on imaging?

A

as bright spots due to edema

159
Q

what makes up the PNS?

A

cranial nerves, peripheral nerves, and ganglia

160
Q

what is a plexus?

A

a collection of peripheral nerves functionally related

161
Q

where is the cervical plexus?

A

neck and throat

162
Q

where is the brachial plexus?

A

pectoral girdle and upper limb

163
Q

where is the lumbar plexus?

A

anterior hips and thigh

164
Q

where is the sacral plexus?

A

glutes, posterior thigh, leg

165
Q

where in the spinal cord are sensory neurons located?

A

dorsal root is part of the ascending tract, including sensory neurons

166
Q

where in the spinal cord are motor neurons located?

A

ventral root (descending tract)

167
Q

what is hilton’s law?

A

the nerve supplying the muscles extending across and acting at a given joint not only supplies the muscle, but also innervates the joint capsule and the skin overlying the muscle, and distal to the muscle

168
Q

what is paralysis?

A

loss of function in a muscle OR loss of a movement

169
Q

what is weakness or paresis?

A

partial loss of function in a muscle OR partial loss of movement

170
Q

what is numbness?

A

loss of sensation

171
Q

what is paresthesia?

A

partial loss of sensation

172
Q

what is the principle of x-ray imaging?

A

variations in tissue density

173
Q

what is the order of tissue density from most to least dense?

A

metal/contrast agents > bone > soft tissue > fat > air

174
Q

how do dense tissues appear on x-rays?

175
Q

what is opacity?

A

the tendency for a structure to block x-rays from reaching the detector; hyperdense

176
Q

what is lucency?

A

tendency for a structure to allow x-rays to pass through and reach the scanner; hypodense

177
Q

what is isodense?

A

when the brightness is about the same

178
Q

what are characteristics of an x-ray?

A
  • fast and inexpensive
  • limited soft-tissue resolution, but can be improved with contrast agents
179
Q

what is CT?

A

similar to x-rays, but captures many measurements of density across a digital slice of a patient (rather than taking a single view)

180
Q

what are characteristics of a CT?

A
  • much better for imaging soft tissue over x-ray
  • faster and inexpensive to MRI
  • can be performed in people with metal implants (unlike MRI)
  • less anatomical resolution than MRI
181
Q

what is the order of density for CTs, from hyperdense to hypodense?

A

bone > blood > grey matter > white matter > CSF > water > fat > air

182
Q

what is a CT angiogram?

A

common clinical test in which radio-opaque contrast is introduced into the vasculature; could be oral or rectal injection

183
Q

what is MRI?

A

tissue contrast is based on proton behaviour (water and fat content); based on intensity

184
Q

what are characteristics of MRI?

A
  • better anatomical resolution
  • slow and expensive
  • dangerous for people with metal in bodies
185
Q

how can contrast-based imaging be performed in MRI?

A

using gadolinium, which is paramagnetic

186
Q

what is anatomical position?

A

the standard reference in which all positions, planes, and movements are described:
- erect postures
- hands at side
- palms and feet facing forward
- gaze forward

187
Q

what are the different variants of anatomical position?

A
  • supine: lying on back (face up)
  • prone: lying on the front
188
Q

what is the sagittal/longitudinal plane?

A

divides the body into left and right sections

189
Q

what is the (mid)sagittal of medial (median) plane?

A

divides the body into equal left and right halves

190
Q

what is the parasagittal plane?

A

divides the body into unequal left and right halves

191
Q

what is the frontal/coronal plane?

A

divides the body into front and back halves

192
Q

what is the transverse/horizontal/axial plane?

A

divides the body into top and bottom halves?

193
Q

what are the 3 axes?

A
  • sagittal (anterior-posterior) axis
  • frontal (medial-lateral) axis
  • longitudinal (superior-inferior) axis
194
Q

how is direction expressed above the brainstem?

A
  • rostral = anterior
  • caudal = posterior
  • dorsal = superior
  • ventral = inferior
195
Q

how is direction expressed below the brainstem?

A
  • rostral = superior
  • caudal = inferior
  • dorsal = posterior
  • ventral = anterior
196
Q

what is flexion vs extension?

A
  • flexion = movement that reduces the joint angle
  • extension = movement that increase the joint angle
197
Q

what axis does flexion of the forearm occur in?

A

mediolateral (frontal) axis

198
Q

what is abduction vs adduction?

A
  • abduction: movement away from the midline
  • adduction: movement toward the midline
199
Q

what is medial (internal) rotation vs lateral (external) rotation?

A
  • medial = rotation of the anterior surface toward the midline
  • lateral = rotation of the anterior surface away from the midline
200
Q

what part of the body does retrusion/protrusion refer to?

201
Q

what part of the body does protraction/retraction refer to?

202
Q

what is abduction of the thumb?

A

moving thumb out of the plane of the hand

203
Q

what is opposition of the thumb?

A

opposing other digits with the thumb

204
Q

what is dorsiflexion vs plantarflexion?

A

occurs at the anke joint; moving foot up or down

205
Q

what is inversion (supination) vs eversion (pronation)?

A

occurs at foot; pressure on outer foot vs inner foot

206
Q

what age to cranial sutures fuse (on average)?

207
Q

what is a point of vulnerability on the skull?

A
  • pterion: junction of temporal, zygomatic, frontal, and parietal bones
  • very thin, overlies a branch of the middle meningeal artery
208
Q

how are skull bones formed?

A

intramembranous ossification: direct production of bone from mesenchyme (precursor cells)

209
Q

what is the diploe?

A

spongy bone between 2 layers of compact bone; can be seen sandwiched between external and internal tables of compact bone on x-ray

210
Q

what are the paranasal sinuses?

A

anatomically continuous with the nasal cavity for the purposes of:
- reducing the weight of the skull
- humidifying and heating inhaled air
- increasing the resonance of speech
- serving as a “crumple zone” to protect vital structures in the event of facial trauma

211
Q

what are the features of the neonate skull?

A
  • large cranium, relatively small face
  • prominent fontanelles (spaces between skull bones)
  • persistent mandibular division
212
Q

where are the anterior and posterior fontanelles located and when do they close?

A
  • anterior fontanelle: on bregma; closes at 18-24 months
  • posterior fontanelle: on lambda; closes at 2-3 months
213
Q

what can sunken fontanelles indicate?

A

inadequate feeding

214
Q

what can elevated fontanelles suggest?

A

intracranial pressure build up

215
Q

what is craniosynostosis?

A

premature suture ossification: when skull growth is restricted in one direction and attempts to compensate in another

216
Q

what is metopic craniosynostosis?

A

premature fusion of the metopic suture; compensates by enlarged temporal lobes (expanding mediolaterally)

217
Q

what is sagittal craniosynostosis?

A

premature fusion of the sagittal suture; compensates by expanding rostrocaudally

218
Q

what is unicoronal craniosynostosis?

A

premature fusion of one coronal suture; compensates by enlarged other side of the brain (posterior portions and other frontal lobe)

219
Q

what is lambdoid craniosynostosis?

A

premature fusion of one of the lamboid sutures; compensates by enlarged other side of the brain (anterior portions and other temporal lobe)

220
Q

what is endoscopic trans-sphenoidal surgery?

A

used to remove pituitary tumours less invasively

221
Q

what is commissure vs decussation?

A
  • commissure: tract that crosses almost at a single rostral-caudal level
  • decussation: tract that crosses obliquely
222
Q

what is the corticospinal tract?

A

governs much of the voluntary control of musculature of the body

223
Q

when does the corticospinal tract cross the midline?

A

in the medullary pyramids

224
Q

what is an upper motor neuron lesion (UMNL) and what side is the deficit on?

A

damage to the primary motor cortex; contralateral side

225
Q

what is a lower motor neuron lesion (LMNL) and what side is the deficit on?

A

damage to the spinal nerve; ipsilateral side

226
Q

what side does deviation of the tongue occur?

A

the weaker side

227
Q

how does sensory input from the face and head enter the brain?

A

from the sensory cranial nerves and join the tracts

228
Q

how is information about fine touch and proprioception from the face transmitted to the cortex?

A

through the medial leminiscus

229
Q

how is information about pain and temperature from the face transmitted to the cortex?

A

through the spinothalamic tract

230
Q

what are the leptomeninges?

A

pia mater and arachnoid mater

231
Q

where is the cerebral vasculature?

A

in the arachnoid mater

232
Q

what portion of the skull does the tentorium cerebelli cover?

A

posterior cranial fossa

233
Q

how much does each artery that supplies the brain contribute?

A

internal carotid = 80%
vertebral arteries = 20%

234
Q

what stroke is the most common?

A

distal MCA stroke

235
Q

what is an ischemic stroke?

A

a clot blocking blood flow to an area of the brain; time window in which clot can be unblocked

236
Q

what is a hemorrhagic stroke?

A

bleeding inside or around brain tissue usually caused by bursting of a blood vessel

237
Q

where does the CSF go after the fourth ventricle?

A

it is released through lateral apertures into 1) the spinal cord and 2) the subarachnoid space

238
Q

where are cerebral arteries located?

A

subarachnoid space

239
Q

where are meningeal arteries located?

A

between skull and dura, supplying meninges

240
Q

what is the corticospinal tract?

A
  • coordinates fine movements (ex. distal extremities)
  • governs motor control of the body
  • originates in the primary motor cortex
  • descends through the internal capsule
  • enters the brainstem via cerebral peduncles (stalks of white matter connecting cerebrum to brainstem)
  • crosses (mostly) in the caudal medulla
241
Q

what is the corticobulbar tract?

A
  • governs motor control of the head
  • originates in the primary motor cortex
  • descends through the internal capsule
  • enters brainstem via cerebral peduncles
  • exits to synapse on cranial nerve nuclei (LMNs) in the brainstem
242
Q

axons from the corticobulbar tract …

A

branch away from the corticospinal tract to synapse in cranial nerve nuclei

243
Q

what kind of deficits do cortical injuries produce?

A

contralateral

244
Q

what kind of deficits do cranial nerve injuries produce?

A

ipsilateral

245
Q

what kind of innervation does the upper half of the face have?

A

bilateral innervation

246
Q

what deficit would a supranuclear lesion of the face area lead to?

A

paralysis in right lower half of face, normal/weakness in upper half

247
Q

what deficit would a lesion in the right facial nerve lead to?

A

paralysis of upper and lower half of face

248
Q

what does the dorsal column-medial meniscus system mediate?

A

fine touch and proprioception

249
Q

what does the spinothalamic tract mediate?

A

pain and temperature

250
Q

what are the muscles of the forehead and eyes?

A
  • frontalis
  • corrugator supercilli
  • procerus
  • nasalis
  • orbicularis occuli
251
Q

what connects the frontalis and the occipitalis?

A

epicranial aponeurosis

252
Q

what is the frontalis?

A
  • anterior scalp
  • origin: galea aponeurotica (hairline area)
  • insertion: orbicularis occuli
  • function: raises eyebrows (surprised), wrinkles forehead
253
Q

what is the corrugator supercilli?

A
  • posterior to superior portions of the orbicularis occuli (deep to frontalis)
  • origin: medial end of superciliary arch
  • insertion: deep surface of the skin of middle orbital arch
  • function: draws eyebrows together (vertical wrinkes)
254
Q

what is the procerus?

A
  • vertical muscle on nose bridge
  • origin: lower part of nasal bone
  • insertion: skin over lower part of forehead between eyebrows (superficial to frontalis)
  • function: pulls eyebrows down inferiorly
255
Q

what is the nasalis?

A
  • superficial to procerus; deep to muscles above/around mouth
  • origin: maxilla
  • insertion: nasal bone
  • function: transverse portion compresses nostrils, alar portion flares nostrils
256
Q

what is the orbicularis occuli?

A
  • superficial
  • function: closes the eyelids (palpebral part: gently closes eyes such as sleeping, blinking + arises from medial palpebral ligament; orbital part: attach to maxillary and frontal bones, forcefully closes eyes for squinting or winking)
257
Q

what are the muscles above and around the mouth?

A
  • zygomatic major
  • zygomatic minor
  • levator anguli oris
  • levator labii superioris
  • orbicular oris
  • risorius
  • buccanator
258
Q

what is the zygomaticus major?

A
  • origin: zygomatic bone
  • insertion: angle of the mouth
  • function: elevates the upper lip (pulls angle of the mouth upwards)
259
Q

what is the zygomaticus minor?

A
  • superior to major
  • origin: zygomatic bone
  • insertion: skin of the upper lip
  • function: elevates the upper lip
260
Q

what is the levator anguli oris?

A
  • deep to other elevation muscles
  • origin: maxilla
  • insertion: angle of the mouth
  • function: elevating angle of the mouth
261
Q

what is the levator labii superioris?

A
  • origin: lateral aspect of the nose
  • insertion: upper lip
  • function: dilates the mouth by raising the upper lip
262
Q

what is the orbicularis oris?

A
  • superficial to surrounding muscles
  • function: protrudes and compresses lips, controls size of the oral fissure
263
Q

what is the risorius?

A
  • superficial
  • origin: lateral cheek
  • insertion: corner of the mouth
  • function: pulls corners of the mouth laterally
264
Q

what is the buccinator?

A
  • deep to surrounding muscles
  • connected by the alveolar processes of the maxilla and mandible
  • function: prevents cheeks from being bit during chewing, tightens the cheek
265
Q

what are the muscles below the mouth?

A
  • depressor anguli oris
  • depressor labii inferioris
  • mentalis
  • platysma
266
Q

what is the depressor anguli oris?

A
  • superficial to surrounding muscles
  • origin: mental tubercle of mandible
  • insertion: corner of mouth (lower lip)
  • function: depresses the corners of the mouth
267
Q

what is the depressor labii inferioris?

A
  • deep to depressor anguli oris, superficial to mentalis
  • origin: oblique line of mandible
  • insertion: lower lip
    -function: depresses lip inferolaterally
268
Q

what is the mentalis?

A
  • deepest muscle below the mouth
  • origin: bottom of mandible
  • insertion: lower lip
  • function: active when pouting
269
Q

what is the platysma?

A
  • most superficial muscle of neck
  • function: depresses the mandible and pulls corners of the mouth caudally (grimacing)
270
Q

what are the muscles of mastication?

A
  • temporalis
  • masseter
  • pterygoids
271
Q

what is the temporalis?

A
  • origin: temporal fossa
  • insertion: coronoid process of mandible
  • function: protrusion and retrusion of the mandible
272
Q

what innervates the muscles of mastication?

A

the mandibular branch of the trigeminal nerve (V3)

273
Q

what is the masseter?

A
  • superficial to surrounding muscles
  • origin: zygomatic arch
  • insertion: ramus
  • function: elevates the mandible, moves the mandible forward
274
Q

what is the lateral pterygoid?

A
  • origin: lateral side of lateral pterygoid plate
  • insertion: temporomandibular joint (condyle of mandible)
  • function: protracting mandible bilaterally
275
Q

what is the medial pterygoid?

A
  • origin: medial side of lateral pterygoid
  • insertion: ramus of mandible
  • function: elevates the mandible (closes mouth)
276
Q

what are the muscles of the neck?

A
  • scalenes
  • sternocleidomastoids
  • superior portion of the trapezius
  • levator scapulae
277
Q

what are the scalenes?

A
  • divided into anterior, middle, and posterior
  • innervated by the cervical and brachial plexuses
  • deeper than sternocleidomastoid
  • origin: anterior on c3-c6, middle on c3-c7, posterior on c5-c7
  • insertion: anterior. and middle on 1st rib, posterior on 2nd rib
  • function: inspiration, lateral flexion, lateral rotation
278
Q

what are the sternocleidomastoids?

A
  • superficial to scalenes
  • origin: sternal head at sternum, clavicular head at clavicle
  • insertion: mastoid process of temporal bone and superior nuchal line of occipital bone
  • function: laterally flex the head and contralaterally rotate the head
  • innervated by CN XI
279
Q

what is the superior portion of the trapezius?

A
  • innervated by CN XI
  • origin: external occipital protuberance and superior nuchal line of occipital bone
  • insertion: scapula and clavicle
  • function: elevation of scapula, lateral flexion, dorsiflexion of head, rotation of scapula
280
Q

what is the levator scapulae?

A
  • deep to trapezius
  • origin: c1-c4
  • insertion: medial border of scapula
  • function: elevation of scapula, rotation of scapula
281
Q

what muscles are involved in smiling?

A
  • depressor anguli oris
  • zygomaticus major
  • zygomaticus minor
  • risorius
  • levator labii superioris
282
Q

what muscles are involved in frowing?

A
  • corrugator supercilli
  • depressor anguli oris
  • depressor labii inferioris

BPK326 (5 decks)

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