w 6 and w 7 Flashcards
1
Q
what movements rely on an upper and motor neuron?
A
voluntary
2
Q
which motor pathway controls voluntary movement?
A
pyramidal (direct)
3
Q
which motor pathway controls involuntary movement?
A
extrapyramidal (indirect)
4
Q
how many neurons are involved in the voluntary movement of skeletal muscle?
A
2 UMN and LMN
5
Q
how many tracts are involved in voluntary motor control?
A
2 anterior and lateral tracts
6
Q
where does the UMN in corticospinal tract originate?
A
cerebral cortex
7
Q
what does the corticospinal tract provide?
A
voluntary motor function
8
Q
what are the three main locations axons leave the cortex in the corticospinal tract?
A
premotor cortex
primary motor cortex
supplementary motor cortex
(some leave sensory cortex)
9
Q
where does the corticospinal tract travel through after cortex?
A
corona radiata - cerebral white mater
then decends through internal capsule (posterior limb)
then through cerebral crus
then brain stem into spinal cord
10
Q
where do the majority of sorticospinal fibres cross to form lateral tract?
A
medulla
11
Q
what forms the lateral tract of corticospinal pathway?
A
crossing of fibres at pyramids in medulla
12
Q
what forms the anterior tract of corticospinal pathway?
A
the uncrossed fibres
13
Q
where does the UMN of corticospinal tract synapse with the LMN?
A
ventral horn of spinal cord
14
Q
where does crossing of the lateral corticospinal tract take place?
A
medulla
15
Q
where does crossing of anterior corticospinal tract take place?
A
spinal cord
16
Q
A lesion affecting corticospinal fibres in the left side of the ventral pons impairs voluntary movement of the arm and the leg on which side?
A
RIGHT SIDE (contralateral) Hemiplegia or Paresis
17
Q
A lesion affecting the cervical spinal cord on the left side impairs voluntary movement of the limbs on which side?
A
LEFT SIDE (ipsilateral) Hemiplegia or Paresis
18
Q
give an example of an UMN lesion of cortico spinal tract
A
stroke
19
Q
signs of stroke
A
spastic paralysis
no muscle atrophy
hyperflexia
hypertonia
20
Q
give an example of a LMN lesion of corticospinal tract
A
trauma or poliomyelitis
21
Q
what are signs of LMN lesion
A
flaccid paralysis
significant muscle atrophy
hyporeflexia
hypotonia
22
Q
what supplies sensory innervation to the face?
A
CNV
great auricular from C2-C3 supplies angle of mandible
23
Q
what branch of trigeminal supplies sensory innervation to the auriculotemporal area?
A
CNV3
24
Q
what nerves supply the scalp?
A
C2 and C3
25
what nerve does C2 alone give rise to?
great ocipital
26
what nerve does C3 alone give rise to?
third occipital
27
what nerve does C2 and C3 give rise to?
great auricular and lesser occipital
28
where does CNV1 exit the cranium?
superior orbital fissre
29
where does CNV2 leave the cranium?
exits cranium through foramen rotundum
30
where does CNV3 exit the cranium?
foramen ovale
31
how are muscles of facial expression arranged?
sphincters or dilators around facial orifices
32
what innervates the buccinator?
facial nerve - buccal branch
33
what innervates orbicularis oris?
facial nerve - buccal branch and marginal mandibular branch
34
what innervates orbicularis oculi?
facial nerve -zygomatic branch and temporal branch
35
what innervates occipitofrontalis frontal head?
facial nerve - temporal branch
36
what innervates platysma?
facial nerve - cervical branch
37
where does the facial nerve enter and exit the skull?
enters via internal acoustic meatus and exits via stylomastoid foramen
38
what two branches are given off when the facial nerve exits the stylomastoid foramen?
posterior auricular and digastric nerve
39
what does the digastric nerve innervate?
posterior belly of digastric and stylohyoid muscle
40
after giving off the posterior auricular and digastric nerve, where does the facial nerve travel?
into the parotid gland where 5 terminal branches arise
41
where are the muscles of facial expression derived from?
2nd pharyngeal arch
42
what are muscles of facial expression innervated by?
facial nerve
43
where is the facial nerve derived from embryologically?
2nd pharyngeal arch
44
what innervates the occipital belly of occipitofrontalis?
Facial nerve - posterior auricular nerve
45
what is the function of occipitofrontalis?
occipital belly retracts scalp
frontal belly protracts scalp
wrinkle forehead and raise eyebrows
46
where does the occipital belly of occipitofrontalis insert into / where does the frontal belly originate?
epicranial aponeurosis
47
what are the two parts of orbicularis oculi?
orbital and palpebral
48
what is the function of palpebral part?
close eyelids gently - involuntary blinking
49
what is the function of orbital part?
close eyelids tightly - voluntary
50
what is the first of the three sphincters associated with alimentary system?
orbicularis oris
51
where does the orbicularis oris originate and insert?
maxilla, medial mandible, buccinator and other surrounding muscles
mucous membrane of lips
52
what is the function of orbicularis oris?
close lips
protrude lips
keep food bolus on occlusal surface
speaking
53
what is the function of the buccinator?
keep food bolus on occlusal surfaces of teeth
smiling
54
where does buccinator originate and insert?
pterygomandibular raphe, posterior alveolar process of maxilla and mandible
inserts into fibres of orbicularis oris
55
what pierces the buccinator and buccal fat pad?
parotid duct
56
why is the buccal fat pad larger in infants?
to reinforce and support cheeks during feeding
57
what is the function of platysma?
tense skin of inferior face and neck and depress mandible
58
what is the function of levator/depressor anguli oris?
lift/depress corners of mouth
59
what is the function of zygomaticus major?
lift corners of mouth to smile
unilateral to sneer
60
what is the function of depressor labi oris?
express sadness
pout
61
what is the function of levator labi oris?
elevate and/or evert upper lip
62
what is the function of zygomaticus minor?
work with levator labi superioris to elevate and evert upper lip
63
what is the function of mentalis muscle?
elevates skin of chin
elevates and protrudes lower lip
64
what is the function of levator labi superioris aleque nasi?
flaring of nostrils
65
what is the transverse part of nasalis called?
procerus
66
what is the function of procerus of nasalis?
wrinkles skin over nose
67
what are the two parts of nasalis?
procerus
alar
68
what is the function of the alar part of nasalis?
act with levator labi superioris alaeque nasi to depress ala
elevate upper lip
69
what blood vessels supply the face?
majority of blood supply from external carotid artery - facial, maxillary and superficial temporal branches
a little from internal carotid - Opthalmic branch
70
what does the facial artery cross?
mandible, buccinator and maxilla
71
where does the opthalmic artery come from?
internal carotid
72
what artery is the mental artery a branch of?
maxillary branch artery of external carotid
73
where on the face can you take a pulse?
facial artery at inf. border of mandible
transverse facial artery just anterior to auricle
74
describe the venous drainage pf the face
most of the face is drained by the facial vein which runs alongside the facial artery
part of the upper face is drained into transverse facial vein
veins of the face ultimately drain into the internal jugular vein
75
what vein does the facial vein communicate with at the medial corner of the eye?
superior ophthalmic vein
76
where does the superior ophthalmic vein drain to?
cavernous sinus
77
what vessels join to make the retromandibular vein?
superficial temporal and maxillary vein
78
the sperficial temporal vein joins with the maxillary vein to form what?
retromandibular vein
79
which major salivary gland does the retromandibular vein run in?
parotid
80
what does the a terior branch o retromandibular vein unite with?
facial vein
81
what does the posterior branch of retromandibular vein give rise to?
external jugular vein when it joins the posterior auricular vein
82
where does the external jugular vein drain into?
subclavian vein
83
what muscle does the EJV cross?
SCM
84
how can skin infections spread intracranially?
facial veins and veins of pterygoid plexus in the danger triangle of the face drain to the cavernous sinus
cavernous sinus lies lateral to pituitary
skin infections of face can spread into cavernous sinus and pathogens multiply leading to a cavernous sinus thrombosis or infection spreading to cranial meninges and intracranially
85
what causes a cavernous sinus thrombosis?
skin infections
facial veins and veins of pterygoid plexus in the danger triangle of the face drain to the cavernous sinus
skin infections of face can spread into cavernous sinus and pathogens multiply leading to a cavernous sinus thrombosis
86
why are does facial inflammation cause considerable swelling?
due to there being no deep fascia and the subcutaneous tissue is loose connective meaning fluid and blood can accumulate
87
what nerve supplies muscles of the ear?
CNVII
88
what blood vessels supply and drain the ear?
external carotid via posterior auricular and superficial temporal arteries
drains to external jugular vein
89
describe the lymphatic drainage of the ear
to parotid and ,mastoid lymph nodes and then to deep cervical nodes
90
describe the lymphatic drainage of the ear
to parotid and mastoid lymph nodes and then to deep cervical nodes
91
what are the layers of the eyelid?
skin
connective tissue
conjunctiva
muscle - orbicularis oculi
tarsus
orbital septum
92
what is a risk of there being loose connective tissue in the eyelid?
fluid accumulation from scalp post injury
93
what is the function of the eyelid?
protection - injury and light
spread lacrimal fluid
94
at is the name of the transparent mucous membrane covering the eyelid internally?
conjunctiva
95
what is the palpebral fissure?
space between eyelids
96
what are the tarsi of the eyelid?
dense bands of connective tissue that provide a sort of skeleton for eyelid
97
what forms the anterior border of orbit and is continuous with periosteum?
orbital septum
98
what nerves supply sensory innervation to the eyelids?
CNV1 and CNV2
99
what blood vessels supply the eyelids?
external carotid artery - facial, transverse facial and superficial temporal
internal carotid artery - supratrochlear, supraorbital, lacrimal
100
what lymph nodes drain the eyelids?
parotid
101
describe the parotid secretion
serous
102
what is the largest salivary gland?
parotid
103
what encloses the paroid gland?
parotid sheath
104
where is the parotid sheath derived frm?
investing layer f deep cervical fascia
105
what lies between the lobes of the parotid gland to accomodate movement of the mandible?
fatty tissue
106
what structures are found within the parotid gland?
retromandibular vein
External carotid artery
CNVII - does not innervate parotid though
107
what blood vessels supply and drain parotid?
supply - external carotid A - post auricular, maxillary and superficial temporal branches
drain - retromandibular vein - formed when superficial temporal and maxillary veins unite
108
where do retromandibular veins drain to?
anterior retromandibular vein drains to internal JV
posterior retromandibular vein drains into external jugular vein
109
what branches does the external carotid give off in the parotid gland?
posterior auricular artery
2 terminal branches - superficial temporal and maxillary arteries
110
describe parasympathetic (secretomotor) innervation of parotid gland
preganglionic - glossopharyngeal
synapse on otic ganglion
postganglionic - auriculotemporal from trigeminal CNV3
111
what is the effect of sympathetic innervation to parotid gland?
vasoconstriction and reduction in saliva volume
112
describe sympathetic innervation of parotid
superior cervical ganglion and nerve plexus on external carotid
113
where is the intra temporal portion of the facial nerve?
from where it exits pons to where it exits skull
114
CNVII exits pons as which two roots?
motor
intermediate nerve (sensory and parasympathetic)
115
where does the facial nerve enter the cranium?
internal acoustic meatus and then facial canal
116
what forms the geniculate ganglion and where?
the two roots of facial nerve fuse and enlarge in the facial canal to become the geniculate ganglion
117
what nerve branches off the facial nerve in facial canal at geniculate ganglion?
greater petrosal nerve
118
what does the greater petrosal nerve supply?
parasympathetic innervation to nasal and lacrimal glands
119
what nerves does the facial nerve give rise to before exiting the skull through stylomastoid foramen?
nerve to stapedius
chorda tympani
120
where does the facial nerve exit the skull?
stylomastoid foramen
121
what nerve does chorda tympani hitchhike with to supply?
hitchhikes with lingual nerve to supply taste to anterior 2/3 of tongue
122
what does nerve to stapedius supply?
motor to stapedius muscles of middle ear
123
define the extratemporal part of facial nerve
portion where nerve exits skull at stylomastoid foramen
124
what branches are given off at the beginning of the extratemporal part of facial nerve before it enters the parotid?
posterior auricular
digastric
125
what is formed by the facial nerve within the parotid gland?
parotid plexus giving rise to the 5 terminal branches of CNVII
126
what are the 5 terminal branches of facial nerve?
temporal
zygomatic
buccal
marginal mandibular
cervical
127
name one thing temporal branch of facial nerve supplies
superior orbicularis occuli
128
name one thing zygomatic branch of facial nerve supplies
inferior orbicularis occuli
129
name one thing buccal branch of facial nerve supplies
buccinator
130
name one thing marginal mandibular branch of facial nerve supplies
risorius and muscles of lower lip and chin e.g. mentalis, depressor labi oris
131
name one thing cervical branch of facial nerve supplies
platysma
132
what is a complication of a parotidectomy?
facial paralysis - muscles affected depends on which branch is damaged
133
what is the most common type of facial paralysis?
bells palsy
134
what is most commonly paralyzed in bells palsy?
upper and lower unilateral face
135
why must you protect the eye of a bells palsy patient?
blinking reflex is lost
136
what causes bells palsy?
no obvious cause
137
what is static reconstruction and when will static reconstruction be considered for facial palsy patients?
creates a sling using muscle from elsewhere in body to create facial symmetry at rest
after 2 years of paralysis with no improvement - reconstruction of face is considered
138
a tumour of the parotid gland will affect which nerve?
facial
139
how do you treat a parotid tumour?
parotidectomy
140
what nerve can be used as a nerve graft for the facial nerve?
great auricular nerve can be used as a nerve graft when the facial nerve has been or is predicted to be damaged
141
what condition is associated with swelling of the parotid gland?
Mumps
142
what are symptoms of mumps?
fever
headache
joint pain
swelling of parotid gland
143
what causes mumps?
viral infection
144
why is swelling of the parotid so painful?
parotid gland is contained within fibrous capsule
145
where do two parts of the mandible fuse after development?
mandibular symphysis
146
where is the linguala?
edge of mandibular foramen and mylohyoid groove
147
what is a clinical relevence of the mylohyoid line?
for dentures - has to stop short of mylohyoid line or will lift when mylohyoid contracts speaking
provides a boundary between OC and neck
infections of lower teeth can spread below mylohyoid line into sub mandibular region causing Ludwig angina
148
what mandible landmarks are important in denture design?
mylohyoid line - mylohyoid lifts denture when contracts
oblique line - buccinator interferes with denture
149
what passes through the mylohyoid groove?
nerve to mylohyoid
150
what does the nerve to mylohyoid supply?
mylohyoid and anterior belly of digastric
151
where does the mandible articulate with the skull?
mandibular fossa of temporal bone
152
what type of joint is the TMJ?
modified hinge synovial joint
153
what type f cartilage covers the articular surfaces of TMJ?
fibrocartilage
154
what separates the TMJ into superior and inferior articular cavities?
articular disc
155
what is the most common dislocation of TMJ?
anterior as it is more strengthened posterior
156
which two bones articulate to form TMJ?
mandibular fossa of temporal bone and condyler process of mandible
157
what are the three ligaments of the TMJ?
stylomandibular
sphenomandibular
lateral
158
what are the extrinsic ligaments of TMJ?
stylomandibular
sphenomandibular
159
what is the intrinsic ligament of tmj?
lateral
160
what are the 5 movements of the mandible?
protrusion, retraction, elevation, depression and lateral
161
which movements occur in superior cavity of TMJ?
protrusion and retraction
162
which movements occur in inferior cavity of TMJ?
depression and elevation
163
when is TMJ most unstable?
during depression
164
what muscle is associated with anterior TMJ dislocation?
excessive contraction of lateral pterygoid
165
when might anterior dislocation of jaw occur?
yawning
blow to chin when mouth open
166
what tubercle resists posterior dislocation of mandible?
postglenoid tubercle alongside lateral ligament
167
what are the main muscles that move mandible?
MOM
temporalis
pterygoin
masseter
168
what muscle retrudes mandible?
twmporalis
169
what muscle protrudes mandible mainly?
lateral pterygoid
170
what pharyngeal arch are the muscles of mastication derived from?
1st pharyngeal arch
171
what supplies the muscles of mastication?
mandibular division of trigeminal
172
where does temporalis originate sand insert?
temporal fossa and fascia
inserts into coronoid process and anterior border of ramus
173
what is the function of temporalis?
retracts and elevates mandible
174
what innervates temporalis?
deep temporal nerves of CNV mandibular division
175
what innervates the masseter?
massentric nerve from CNV mandibular division
176
what is the function of masseter?
elevates mandible
177
where does the masseter originate and insert?
zygomatic bone
and zygomatic arch
inserts into angle and lateral ramus of mandible
178
where does the upper head of lateral pterygoid originate?
infratemporal surface of greater wing of sphenoid
179
where does the lower head of lateral pterygoid originate?
lateral surface of lateral pterygoid plate of sphenoid
180
where does the lateral pterygoid insert?
superior head - articular disc of TMJ
inferior head - pterygoid fovea on neck of condyle
181
what is the function of lateral pterygoid?
bilateral - protrude and depress
lateral movements when acting unilaterally
182
what is the function of medial pterygoid?
elevation and assist lateral movements
183
where does the medial pterygoid originate and insert?
origin -
deep head - medial surface of lateral pterygoid plate
superficial - maxillary tuborisity
inserts - medial of ramus and angle of mandible
184
what can cause trismus?
needle pierces medial pterygoid during LA and it contracts reflexively and closes mouth
185
what are the superior and posterior borders of infratemporal fossa?
superior and inferior temporal lines
186
what is the anterior border of the temporal fossa?
frontal process of zygomatic bone and zygomatic process of frontal bone
187
what is the inferior border of temporal fossa?
infratemporal crest deep to zygomatic arch
188
what forms the floor of temporal fossa?
frontal, parietal, temporal and greater wing of sphenoid including pterion
189
what forms the roof of temporal fossa?
temporal fascia
190
what is lateral the border of the infra temporal fossa?
ramus of mandible
191
what is the medial border of the infra temporal fossa?
lateral pterygoid plate of sphenoid bone
192
what is the anterior border of the infra temporal fossa?
posterior aspect of maxilla
193
what is the posterior border of the infra temporal fossa?
tympanic plate, mastoid and styloid processes
194
what is the superior border of the infra temporal fossa?
infratemporal crest of sphenoid
195
what is the inferior border of the infra temporal fossa?
angle of mandible
196
what muscles are found in infratemporal fossa?
medial pterygoid
temporalis
lateral pterygoid
197
what blood vessels are found in the infratemporal fossa?
maxillary artery
pterygoid venous plexus
198
what nerves are found in infratemporal fossa?
mandibular
IAN
lingual
buccal
chorda tympani
otic ganglion
199
where does the mandibular division of CNV arise and exit the skull?
arises from trigeminal ganglion in middle cranial fossa - motor root
exits via foramen ovale
200
what are the branches of CNV3?
IAN
lingual nerve
buccal nerve
auriculotemporal nerve
201
what nerve travels with superficial temporal artery?
auriculotemporal nerve
202
where does otic ganglion receive most presynaptic parasympathetic fibres from?
glosspharyngeal
203
what artery does the auriculotemporal nerve encircle when branching from otic ganglion?
middle meningeal
204
what does auriculotemporal nerve supply?
sensory - auricle and temporal region
secretomotor - parotid gland postsynaptic parasymp.
205
where is the pterygoid venoud plexus located?
infratemporal fossa between temporalis and pterygoid muscles
206
what artery is pterygoid venous plexus the venous equivalent of?
maxillary artery
207
what other veins does the pterygoid plexus anastemose with?
facial vein via deep facial vein
cavernous sinus via emissary veins
208
what does IAN supply?
mandibular teeth on is side
209
what does mental nerve supply?
skin and mucous membrane of lower lip and chin and gingivae of mandibular incisor teeth
210
what does lingual nerve supply?
sensory to anterior 2/3 of tongue
lingual gingivae and FOM
211
what joins lingual nerve within infratemporal fossa?
chorda tympani
212
what is the larger terminal branch of ECA?
maxillary
213
what decides the division of the maxillary artery in 3 parts?
lateral pterygoid
214
what are the 3 parts of the maxillary artery?
mandibular
pterygoid
pterygopalatine
215
how many branches does the maxillary artery have?
15
216
name 6 branches of maxillary artery are important to us
inferior alveolar artery
middle meningeal artery
masseteric artery
anterior and posterior deep temporal
buccal
superior alveolar
217
what part of maxillary artery does middle meningeal artery branch and where does it supply?
mandibular/1st partsuppliesdura mater
218
where does middle meningeal artery enter cranial cavity?
foramen spinosum
219
which artery passes through a split in the auriculotemporal nerve?
middle meningeal
220
what part of maxillary artery does inferior alveolar artery branch and where does it supply?
1st/mandibular part
supplies mandibular teeth of that side
221
what part of maxillary artery does masseteric artery branch and where does it supply?
2nd/pterygoid part
masseter muscle
222
what part of maxillary artery do superior and inferior deep temporal arteries branch and what do they supply?
pterygoid part
temporalis muscle
223
what part of maxillary artery does buccal artery branch and where does it supply?
pterygoid/2nd part
buccinator and buccal oral mucosa
224
what part of maxillary artery does posterior superior alveolar artery branch and where does it supply?
3rd part/pterygopalatine
maxillary teeth and adjacent mucosa and gingivae
225
how many neurons are involved in corticobulbar tract?
2 UMN and LMN
226
where does the UMN originate in corticobulbar tract?
primary motor cortex
227
where does the corticobulbar pass through in the internal capsule?
genu
228
where do the corticobulbar tracts and corticospinal tracts pass through the internal capsule?
corticobulbar - genu
corticospinal - posterior limb
229
what kind of fibre is the UMN in corticobulbar pathway?
supranuclear
230
each upper motor neuron connects bilatteraly to a cranial nuclei except fr 2. What are the exceptions?
facial nerve CNVII - facial expression
hypoglossal nerve CNXII - tongue
231
what is the LMN in corticobulbar pathway?
a cranial nerve
232
what function will cranial nerve bodies innervated by an UMN have?
motor
233
what is caused by a lesion to a cranial nerve UMN and causes a mild weakness in muscles?
pseudobulbar palsy
234
what happens when there is a facial nerve UMN lesion?
contralateral lower facial paralysis with sparing of contralateral upper face
235
what happens when there is a facial nerve LMN lesion?
all facial muscles paralysed on ipsilateral side
236
hypoglossal nerve supplies motor to all but one tongue muscle, which?
palatoglossus - innervated by vagus
237
what happens when there is an UMN lesion of hypoglossal nerve?
deviation of tongue to contralateral side
238
what happens when there is a LMN lesion of hypoglossal nerve?
deviation of tongue to ipsilateral side
239
which cranial nerve has a LMN innervating contra lateral side?
trochlear
