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Anatomy unit 4 > Unit 4 comprehensive > Flashcards

Unit 4 comprehensive Flashcards

1
Q

What does investing fascia sourround

A

SCM and trapezius

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2
Q

What are the 3 parts of pretracheal fascia

A

Visceral
Muscular
Buccopharyngeal

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3
Q

Which fascia wraps around infrahyoid m

A

Musclar part of pretrachial fascia

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4
Q

What are key contents of posterior triangle of neck

A

EJV
Roots of brachial plexus
Accessory nerve
Cervical and supraclavicular lymph nodes

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5
Q

EJV is(superficial/deep) to SCM

A

Superficial

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6
Q

IJV is (superficial/deep) to SCM

A

Deep

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7
Q

The Phrenic nerve descends vertically across which muscle?

A

Anterior scalene

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8
Q

The phrenic nerve is crossed anteriorly by which arteries

A

Transverse cervical and sprascapular
Both branches of thyrocervical trunk

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9
Q

The phrenic nerve enters the thorax between which artery and vein

A

Between Subclavian artery and vein

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10
Q

The phrenic nerve travels along what structure to supply the diaphragm

A

the pericardial sac

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11
Q

Where do the scalene muscles insert

A

First rib (anterior and middle scalene) and second rib (posterior scalene)

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12
Q

The retromandibular vein is formed by which veins

A

Superficial temporal and maxillary
Facial and posterior auricular veins flow into it

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13
Q

Where does the retromandibular vein drain into

A

Anterior division joins facial vein to make common facial vein, and then drains to IJV.
Posterior division joins with posterior auricular and drains into EJV

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14
Q

Which veins make up the common facial vein

A

Anterior division of retromandibular vein, facial vein.
Drains into internal jugular vein

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15
Q

Which cranial nerves are in the anterior cervical triangle

A

Facial (7)
Glossopharyngeal (9)
Vagus (10)
Accessory (11)
Hypoglossal (12)

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16
Q

All of the Infrahyoid muscles insert at the hyoid bone besides….

A

Sternothyroid muscle- insesrts at thyroid cartilage

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17
Q

What are the 3 posterior branches of the external carotid artery

A
  1. Ascending Pharyngeal
  2. Occipital
  3. Posterior Auricular
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18
Q

What are the 3 anterior branches of the external carotid artery

A
  1. Superior Thyroid
  2. Lingual
  3. Facial
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19
Q

The mylohyoid nerve off CNV3 suppplies which 2 muscles

A

Mylohyoid and anterior belly of digastric

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20
Q

The superior and middle thyroid veins drain into the __________ vein while the inferior thyroid vein drains into the __________ vein.

A
  • internal jugular vein
  • brachiocephalic vein
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21
Q

The vertebral vein drains into the

A

Brachiocephalic vein

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22
Q

The vertebral artery is posterior to the ___ v and ___ in the neck

A

Posterior to the vertebral vein, deep in the neck

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23
Q

The Vertebral artery arises from the ___ artery prior to the ___trunk

A

Subclavian artery, Thyrocervical trunk

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24
Q

The vertebral artery enters the transverse foramen of which vertebrae

A

C6 and superior

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25
Q

The sympathetic trunks of the neck are located anterior to which muscles

A

prevertebral muscles ( Longus colli, longus capitis, rectus capitis anterior, anterior scalene)

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26
Q

3 sympathetic ganglia are found in the cervical region. Name them

A

Superior cervical, middle cervical, and Cervical thoracic (stellate) ganglia

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27
Q

The superior cervical ganglia is anterior to which muscle

A

Longus capitis

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28
Q

The middle cervical ganglia is posterior to which gland

A

thyroid gland

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29
Q

The cervicothoracic ganglia is inside of what

A

thoracic inlet

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30
Q

The junction of the sphenoid, frontal , parietal, and temporal bones is significant for which reason

A

It is the junction of many bones merging, and it is a thin and weak area. The middle meningeal artery sits under here, which can cause a Epidural hematoma

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31
Q

Most of the muscles of facial expression originate on ___ and insert into ___

A

Facial bones
Skin and connective tissue of the face

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32
Q

Fascia in the scalp blends with what in the neck posteriorly?

A

Superficial fascia, extends into temporal regions laterally

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33
Q

Parotid fascia covers which muscle and invests the parotid gland?

A

Masseter

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34
Q

Which muscle lifts the eyebrows

A

Frontalis

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35
Q

Which muscle closes the eyelids and squints the eyebrows

A

Orbicularis oculi

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36
Q

Which muscle brings the eyebrows together

A

Corrugator supercilli

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37
Q

Which muscles lift the side of the mouth into a passive smile?

A

Zygomaticus major and minor

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38
Q

The parotid duct crosses over which muscle and pierces through which muscle

A

Crosses over masseter and pierces buccinators

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39
Q

The parotid duct opens into the oral cavity where

A

Maxillary 2nd molar

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40
Q

Which nerve innervates the parotid gland

A

Glossopharyngeal (9)
Facial runs through it, but glossopharyngeal innervates it w parasymp innervation

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41
Q

Which artery and vein are related to the parotid gland

A

Maxillary artery and Maxillary vein

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42
Q

The chorda tympani provides sensory innervation where

A

Taste to the anterior 2/3 of the tongue

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43
Q

Which nerve innervates
- Zygomaticus major & minor
- Levator labii superioris
- Levator anguli oris
- Buccinator
- orbicularis oris Nasalis

A

Buccal branch of facial nerve

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44
Q

If your patient is unable to raise their eyebrows, which nerve is likely implicated?

A

Temporal branch of facial nerve- innervates Frontalis and orbicularis oculi

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45
Q

A parotid gland tumor can cause what

A

paralysis of the facial muscles- the facial nerve is under/within the parotid gland, so can cause paralysis

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46
Q

Which layer of the scalp are emissary veins in

A

Loose areolar connective tissue

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47
Q

_____ veins are a communication between superficial veins of the scalp (in connective tissue layer) and dural venous sinuses

A

Emissary

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48
Q

The olfactory nerve exits through which foramena

A

Cribiform plate in anterior cranial fossa

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49
Q

The pituitary gland sits in which fossa

A

Hypophyseal fossa

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50
Q

If you see only veins, you are looking at the _______________ mater
If you only see sulca and gyra, you are looking at the __________ mater

A

Arachnoid mater
Pia mater

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51
Q

An epidural hematoma is caused by what most commonly

A

Skull to dura mater middle meningeal artery bleed

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52
Q

Which nerve supplies sensory information above the vocal cord to the pharynx

A

Internal branch of superior laryngeal nerve ( Not recurrent laryngeal)

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53
Q

Which nerve supplies sensory information below the vocal cord to the pharynx

A

Recurrent laryngeal nerve

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54
Q

Which muscle is most important for elongating the vocal cords

A

Cricothyroid
- Innervated by external branch of superior laryngeal nerve

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55
Q

Which muscle is responsible for abduction of the vocal cords

A

Posterior cricoarytenoid (recurrent laryngeal)

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56
Q

Which muscles are responsible for closing the vocal cords

A

Lateral cricoarytenoid adducts
Transverse Cricoarytenoid closes rima glottis

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57
Q

What is the attachment of the vocalis muscle

A

Right on the vocal ligament- provides very specific and fine control of tone because of insertion on the vocal ligament

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58
Q

The constrictor muscles of the pharynx are innervated by which nerve

A

Pharyngeal plexus- Vagus (X)

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59
Q

The Innervation to the pharynx and larynx is all done by one nerve, with the exception of one muscle. Which nerve provides the majority of innervation to this region, and what is the exception

A

Vagus provides most of the innervation through pharyngeal plexus. Stylopharyngeus is innervated by glossopharyngeal.

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60
Q

Which nerves provides sensory innervation to the pharynx

A

Nasopharynx- CN V2 (Maxillary of trigeminal)
Oropharynx- Glossopharyngeal
Laryngopharynx- Vagus

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61
Q

Which nerve runs with the inferior thyroid artery

A

Recurrent laryngeal nerve

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62
Q

Which nerve and artery pierce through the thyrohyoid membrane

A

Superior laryngeal (External laryngeal) nerve and artery

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63
Q

Which artery is in close proximity to the recurrent laryngeal nerve during a thyroidectomy

A

Recurrent laryngeal nerve crosses inferior thyroid artery

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64
Q

Which artery runs with the superior laryngeal nerve(External laryngeal)

A

Superior laryngeal artery

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65
Q

Where does the pretracheal space run

A

from the thyroid cartilage to the anterior mediastinum

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66
Q

Where does the prevertebral danger space run

A

Between alar fascia and prevertebral fascia
From the skull to the posterior mediastinum
-Eating sharp food can damage the esophagus and cause a problem here
- Common place for inferior infections to spread

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67
Q

Where does the retropharyngeal space run

A

Base of skull to superior mediastinum

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68
Q

What spaces are anterior/posterior to alar fascia

A

Retropharyngeal space is ANTERIOR, from skull base to superior mediastinum

Prevertebral (danger) space is POSTERIOR, running from skull to POSTERIOR mediastinum

Split by alar fascia

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69
Q

If there is blood pooling in the carotid sheath, what structure can this implicate

A

The heart- blood pooling in the carotid sheath puts pressure on the heart.

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70
Q

After the bifercation of the common carotid artery into the external and internal carotid arteries, which one still runs in the carotid sheath?

A

Internal carotid- external has to split to supply face and scalp blood supply

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71
Q

Subclavian artery runs between which muscles and in which groove

A

Between anterior scalene and middle scalene muscles via the subclavian artery groove of the 1st rib

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72
Q

C1 from the ansa cervicalis joins which nerve on its way to where

A

C1 joins hypoglossal nerve to get to Thyrohyoid– Nerve to thyrohyoid innervates it- Not ansa cervicalis.

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73
Q

External carotid artery terminates as what

A

maxillary artery and superificial temporal artery

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74
Q

The superior cervical ganglion is located anterior to which muscle

A

longus capitis

75
Q

The middle cervical ganglion is located posterior to what

A

thyroid gland

76
Q

The cervicothoracic (stellate) ganglion is located inside of what

A

the thoracic inlet

77
Q

The pterion is the point where which bones meet

A

Parietal, Frontal, Sphenoid, Temporal bones.

78
Q

What does a breakage of the pterion commonly cause

A

Epidural hematoma– Middle meningeal artery runs right deep to it.

79
Q

Skull bones are connected via which joints

A

suture joints

80
Q

The Buccinator muscle is pierced by what

A

the parotid duct

81
Q

What provides motor innervation to the muscles of facial expression

A

Buccal branch of Facial nerve (CN 7)– NOT buccal nerve from Trigeminal nerve.

82
Q

The Chorda tympani nerve branches from the facial nerve where

A

As the facial nerve exits the stylomastoid foramen

83
Q

What does the chorda tympani provide and what nerve does it travel with

A

Travels with the mandibular (V3) branch of trigeminal to get to the tongue where it provides special sensory innervation (taste)

84
Q

Which veins travel through the bones of the skull connecting the deep connective tissue to the dural venal sinuses

A

emmissary veins

85
Q

Where do emmissary veins run

A

between the deep connective tissue and dural venous sinuses

86
Q

Where do bridging veins run

A

From brain surface to venous sinuses
Can cause subdural hematoma (Between Dura mater and arachnoid mater)

87
Q

Where is an epidural hematoma

A

Between Skull and Dural mater
Epidural hematoma is more superifcial than subdural hematoma

88
Q

Which muscle is responsible for ensuring that food does not go into the nasopharynx when swallowing

A

The levator veli palatini closes off the nasopharynx to food when elevating the soft palate.
Innervated by Pharyngeal branch of Vagus from pharyngeal plexus

89
Q

Which papillae on the tongue do not have taste buds

A

filiform pipillae

90
Q

What protects the larynx when swallowing

A

Epiglottis moves when swallowing to cover pharynx
False vocal cords cover larynx when food is swallowed

91
Q

Which nerves provide sensation to the anterior 2/3 of the tongue

A

Special sensation (taste)- 7- Facial- chorda tympani
Sensory- V3- Lingual nerve

92
Q

What nerve provides sensation to the posterior 1/3 of the tongue

A

Glossopharyngeal (9)
General sensation and taste

93
Q

Which muscle does the parotid duct run over

A

masseter

94
Q

Which muscle does the parotid duct pierce

A

buccinator

95
Q

Where does the parotid duct enter the mouth

A

parotid papillae

96
Q

Which nerve innervates muscles of mastication

A

V3 Mandibular of trigeminal

97
Q

The lingual artery travels deep to which muscle on its way to the tongue

A

hyoglossus

98
Q

The submandibular ganglion sits on top of which muscle

A

Hyoglossis- sits superficially to hyoglossus inbetween Lingual nerve and Hypoglossal nerve

99
Q

If you get an infection in your posterior tongue and Lingual tonsil, where will your lymph nodes swell?

A

Superior deep cervical lymph nodes– Posterior 1/3 of tongue drain to superior deep cervical lymph nodes

100
Q

Where will the anterior tip of your tongue drain if infected

A

submental lymph nodes

101
Q

Where will the middle of your tongue (midline and in the middle 1/3) drain?

A

To Inferior deep cervical lymph nodes

102
Q

Where will the lateral 1/3 in the medial 1/3 of your tongue drain (outside edges in the middle)

A

To submandibular lymph nodes

103
Q

Which muscle does the hypoglossal nerve run on top of (superficially to) when going to the tongue

A

They hyloglossus

104
Q

The lingual nerve (V3) and Chorda tympani (7) travel to which ganglion

A

Submandibular ganglion
- Preganglionic parasympathetic travel from 7 to submandibular gland and then to sublingual gland and submandibular glands
Lingual originates from V3 and provides general sensory to anterior 2/3 of tongue
chorda tympani provides parasympathetic innervation and taste sensation to the anterior 2/3 of the tongue

105
Q

The chorda tympani serves what functions

A

Taste
Parasympathetic

106
Q

The hard palate is formed by which bones

A

Maxilla (anterior) and Palatine bone (posteriorly)

107
Q

Which muscle runs from the soft palate to the tongue

A

Palatoglossus

108
Q

Which muscle runs from the soft palate to the pharynx

A

Palatopharyngeus

109
Q

The hypoglossal nerve is inferior to which nerve when running to the tongue

A

Lingual nerve

110
Q

The lingual nerve runs deep to what structure right below the tongue

A

The Sublingual and submandibular gland sits below the tongue, the lingual nerve runs to these glands, and the submandibular duct crosses over the lingual nerve

111
Q

The mental foramen is located where and which nerve/artery travels through it

A

Located between 1st and 2nd premolars, the Mental nerve (branch off inferior alveolar, terminal branch of Mandibular nerve) pierces it.
Inferior alveolar artery runs through it ( Off maxillary artery)

112
Q

Is the deep petrosal nerve sympathetic or parasympathetic

A

Sympathetic- Innervation goes from the spinal cord to the superior cervical ganglion, and postsynaptic sympathetic innervation travels on the deep petrosal nerve

113
Q

Is the Greater petrosal nerve sympathetic or parasympathetic

A

Parasympathetic innervation. Parasympathetic from Facial (Saliva and tears) travel on this nerve. The

114
Q

From the sympathetic trunk, where does the sympathetic innervation synapse before going to travel along the internal carotid artery

A

At the superior cervical ganglion, postsynaptic sympathetic innervation begins

115
Q

Where does the Greater petrosal nerve’s sympathetic innervation become postsynaptic

A

At the pterygopalatine ganglion in the pytergopalatine fossa– Parasympathetic innervation traveled from the superior salivatory nucleus (Facial nerve) along the greater petrosal nerve to synapse in the pytergopalatine ganglion

116
Q

What seperates the external and middle ear

A

Tympanic Membrane

117
Q

Where is the pharyngotympanic tube connecting in the ear

A

Middle ear

118
Q

Which branch of the external carotid artery supplies the ear

A

Superficial temporal
Branches into anterior auricular, posterior auricular

119
Q

Which nerve innervates the external surface of the ear CANAL

A

9 and 10

120
Q

Which nerve runs across the medial surface of the tympanic membrane

A

Chorda tympani

121
Q

Where does the chorda tympani merge with the lingual nerve

A

By the medial and Lateral ptyergoid muscles, deep to Masseter, Risorius and buccinator

122
Q

A middle ear infection can spread where that it is very hard to treat

A

Mastoid antrum (air filled space), extremely hard to fix if this happens.

123
Q

Which muscles tense the tympanic membrane and what are they innervated by

A

Both reduces vibration to delicate inner ear

Tensor Tympani– Innervated by Mandibular of Trigeminal

Stapedius– Innervated by CN 7

124
Q

What is the parasympathetic function of chorda typani

A

Sublingual and submandibular salivary glands

125
Q

What is the special sense for chorda tympani

A

Taste for anterior 2/3 of tongue (along w Lingual nerve from trigeminal that gives general sensory)

126
Q

Is chordatympani presynaptic or postsynaptic

A

Presynaptic, travels to submandibular ganglion to synapse

127
Q

What happens when the tensor veli palatini contracts

A

For soft palate, tenses, so that food doesn’t enter nasopharynx
For ear, When we yawn, the tensor veli tenses and the lumen opens the auditory tube to equalize pressure between middle ear and nasopharynx

128
Q

What makes up the chochlea

A

Scala vestibuli, cochlear duct, scala tympani

129
Q

The membranous labyrinth is suspended in what and contains what

A

suspended in perilymph, contains endolymph
- Conduct sound vibrations, respond to mechanical forces (movement and accleeration)

130
Q

The bony labyrinths are sourrounded by what and filled with what

A

Sourrounded by otic capsule (dense bone)
Suspended in Perilymph

131
Q

Sound comes in which window and out which window

A

In through oval windown, to Vestibulocochlear (8) nerve, and out through scala tympani–> round window

132
Q

The anterior and posterior semicircular canals are at what angle, and the lateral is at what angle?

A

Anterior and posterior are at a right angle
Lateral is horizontal

133
Q

Where are equilibrium receptors housed and what are they called

A

Maculae are housed in ampullae, utricle, and saccule

134
Q

What structures run between the base of the skull and superior constrictor

A

Pharyngotympanic tube

135
Q

What structures run between superior and middle constrictor

A

Glossopharyngeal nerve, stylopharyngeus muscle

136
Q

What strcutres are between middle and inferior constrictor muscles

A

Superior laryngeal vessels and Internal laryngeal nerve (Superior laryngeal nerve) (Sensory abvove VF)

137
Q

What does salpingopharyngeus connect to

A

Opening of eustacian tube- Elevate pharynx

138
Q

A CT scan shows a skull fracture and an accumulation of blood between dura and the cranial bone. What type of hemmorhage is this considered

A

Epidural- between dura and skull. Typically caused by rupture of middle meningeal artery, which supplies blood to the dura mater and bones of cranium.

139
Q

A CT scan shows a skull fracture and an accumulation of blood between pia mater and the arachnoid mater. What type of hemmorhage is this considered

A

Subarachnoid hemorrhage

140
Q

Which structure connects the third and fourth ventricles

A

Cerebral aquaduct

141
Q

Which structure connects the lateral ventricles with the 3rd ventricle

A

Interventricular foramen

142
Q

Where does CSF flow in relation to the layers of the meninges. Why do we care?

A

Between the pia and arachnoid mater (Subarachnoid space)
This is clinically relevent because meningitis is bacteria in the CSF between these layers.

143
Q

Where does the middle meningeal artery supply blood to

A

The dura mater and cranial vault bones

144
Q

Where does the middle cerebral artery supply blood to

A

The lateral surface of the cerebral hemispheres, most of temporal lobe.

145
Q

Where does the anterior cerebral artery supply blood

A

medial and superior surfaces of brain- frontal pole

146
Q

Where does the posterior cerebral artery supply the brain

A

Inferior surface of brain and occipital pole

147
Q

A sixty-four-year old man was diagnosed with an acoustic neuroma (tumor of the VIIIth cranial nerve) where it entered the temporal bone. What other cranial nerve might also be affected since this nerve uses the same foramen as the VIIIth in its course?

A

Facial! Runs through the internal acoustic meatus.

148
Q

The danger zone of the scalp is which layer?

A

Loose connective tissue- can pass quickly into brain and meninges.
Scalp layers are Skin, Connective tissue, Aponeurosis, Loose connective tissue, and Pericranium.

149
Q

The presence of blood in a spinal tap taken from an individual with a closed head injury signals arterial bleeding into which brain space?

A

Subarachnoid space- CSF is taken for a spinal tap, and CSF runs in the brain in the subarachnoid space.

150
Q

The most likely source of blood in a patient with an epidural hemorrhage is:

A

Middle meningeal artery

151
Q

Vertebral arteries travel through the transverse foramina of which vertebral levels

A

C1-C6

152
Q

Which cranial nerve runs under the Posterior inferior cerebellar artery

A

Spinal accessory nerve (CN 11)

153
Q

An aneurysm of the superior cerebellar artery is in close proximity to which cranial nerve that might cause vision deficits?

A

CN 3- occulomotor

154
Q

An aneurysm of the anterior communicating or anterior cerebellar arteries are in close proximity with which nerves and could cause which deficits?

A

Close to olfactory, could change smell. Close to Optic nerve- could change visual accuity and visual fields.

155
Q

The posterior inferior cerebellar artery is in very close proximity to which nerve if it is ruptured

A

Accessory Nerve (CN 11)

156
Q

You have been asked to assess the neurological deficit that might exist in a patient diagnosed with cavernous sinus thrombosis. You will focus your examination on cranial nerves related to the sinus, and that examination includes examination of which nerves?

A

CN 3
CN 4
CN V1/V2
6

157
Q

The cavernous sinus is lateral to the body of which bone

A

Sphenoid bone

158
Q

The structures that pass through which skull foramina enter the cavernous sinus

A

The superior orbital fissure
- Occulomotor nerve, trochlear nerve, Abducens nerve, V1 and V2.

159
Q

During childbirth, an excessive anteroposterior compression of the head may tear the anterior attachment of the falx cerebri from the tentorium cerebelli. The bleeding that follows is likely to be from which of the following venous sinuses?

A

Straight sinus
- Drains the deep cerebrum- lies in junction of falx cerebri and tentorium cerebelli

160
Q

Which sinus drains the cerebellum

A

Occipital sinus- lies in dura mater at base of falx cerebelli (inferior to straight sinus)

161
Q

The inferior sagittal sinus is found in the free edge of what structure?

A

Falx cerebri- Sagital fold of dura mater lying between cerebral hemispheres.
Inferior saggital sinus runs on inferior margin of falx cerebri.

162
Q

The superior orbital fissure is a fissure in which bone

A

Sphenoid bone

163
Q

The optic canal is a fissure in which bone

A

Sphenoid bone

164
Q

What are the sensory detectors in the semicircular canals

A

Ampulla has crista ampullaris that respond to rotational movements
Utricle and saccule have maculae that respond to changes in head position

165
Q

What drains into the middle meatus

A

Frontal sinus
Maxillary sinus
Anterior ethmoid cells
Middle ethmoid cells (ethmoid bulla of middle meatus)

166
Q

What drains into the sphenoethmoid recess

A

Sphenoid recess

167
Q

What drains into the superior meatus

A

Posterior ethmoid cells

168
Q

Which nerve loops around the middle meningeal artery

A

auriculotemporal nerve
Branch off the mandibular nerve (CN V3)

169
Q

What structure does the tentorium cerebelli divide

A

Cerebellum from cerebrum

170
Q

What drains into the superior conchae

A

sphenoidal sinus

171
Q

What is the piriform recess and its clinical significance

A

Food gets stuck in it and need surgery to remove from the laryngopharynx

172
Q

The hypoglossal nerve sits on top of which muscle in the mouth, and what is the function of this?

A

the hyoglossus muscle
Innervated by hypoglossal
Depresses and sticks out tongue

173
Q

What is the artery most commonly implicated in an ischemic stroke?

A

MCA–>arises from Internal carotid
Supplies lateral surfaces of frontal, parietal, and temporal lobes

174
Q

In the case of a tympanic membrane rupture, what is the most common nerve that is injured?

A

Chorda tympanie–> runs over TM

175
Q

Which spinal nerves create the cervical plexus

A

C1-C4–> Ventral rami

176
Q

What is the motor component of the cervical plexus

A

The ansa cervicalis

177
Q

What does the ansa cervicalis sit on top of

A

the carotid sheath

178
Q

Ansa cervicalis innervates every infrahyoid muscle except which one

A

thyrohyoid

179
Q

Which layer of meninges sourrounds the pituitary

A

Diaphragma sellae

180
Q

Vagus nerve provides motor innervation to all of the muscles of larynx and pharynx and palate muscles except for which 2 exceptions

A

Stylopharyngeus (innervated by CN 9) and tensor villi palatini (innervated by V3–> nerve to medial ptyergoid)

181
Q

What is the carotid body innervated by

A

Glossopharyngeal nerve–> carotid branch

182
Q

Which nerve innervates all of the tongue muscles except for palatoglossus

A

Hypoglossal
Palatoglossus innervated by vaugs in pharyngeal plexus

183
Q
A

Anatomy unit 4 (6 decks)

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